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Several of the bloggers on Science-Based Medicine have been — shall we say? — rather critical of Oprah Winfrey. The reason, of course, is quite obvious. Oprah is so famous that if you mention her first name nearly everyone will know exactly of whom you speak. For the last quarter century, her daytime TV talk show has been a ratings juggernaut, leading to the building of a media behemoth and making Oprah one of the richest and most famous women in the world. Unfortunately, part of Oprah’s equation for success has involved the promotion of quackery and New Age woo, so much so that last year I lamented about the Oprah-fication of medicine, which scored me a writing gig in the Toronto Star. Whether it be promoting bio-identical hormones, The Secret (complete with a testimonial from someone who used The Secret to persuade herself not to pursue conventional therapy for breast cancer), Suzanne Somers, the highly dubious medicine promoted by Dr. Christiane Northrup, or foisting reiki aficionado Dr. Mehmet Oz or anti-vaccine “mother warrior” Jenny McCarthy onto a breathless public, arguably no one is a more powerful force for the promotion of pseudoscience in America, if not the world. Truly, the ending of Oprah’s TV show in the spring is a very good thing indeed for science and rationality. Or it would be, were it not for the fact that the reason Oprah is wrapping up her show after a quarter of a century is to start up her own cable channel, so that we can have Oprah-branded and -inspired programming 24/7.

The mind boggles.

Still, my dislike for how Oprah promotes New Age mysticism and pseudoscience on a distressingly regular basis aside, I actually did think there were limits to how low she would go. I actually thought there were limits to how egregiously vile a quackery Oprah would endorse. The operative word, of course, is “did,” which now needs to be struck off after last Wednesday, which is when Oprah did an entire show entitled Do You Believe in Miracles? (Guess what answer was implicitly, if not explicitly, endorsed.) Featured prominently in that episode were several segments on the faith healer John of God.

Who is John of God?

For those of you who are not familiar with John of God, he is one of the most famous faith healers in the world. Born João Teixeira de Faria, John of God claims that he channels more than thirty doctor entities to heal the sick using the power of God. (Actually, I get a bit confused here; John claims to channel these doctors but then says that he doesn’t heal and that “only God heals.”) Here is how John of God’s website used to describe him, citing an account written in 1995 by Robert Pellegrino-Estrich and reprinted all over the web:

They come in their thousands. The sick, the lame, the ‘incurable’ and the medically discarded, to a small town in central Brazil. They endure long international flights and for some long bus trips to Abadiânia, high on the plateaux of Central Brazil. They come to be cured by the miracle healer, João Teixeira de Faria … the man they call John of God.

He will scrape away cataracts and eye tumours with a knife, remove breast cancers with a small incision and cause the crippled to walk with just the touch of his hand. In a meditation room a ceiling high stack of discarded crutches, wheelchairs and braces pays silent testimony to his success. He is acclaimed as the greatest healer of the past 2,000 years.

[…]

To call him “the Miracle Man” is in a way a misnomer, because a miracle implies the absence of a natural law, when in fact his achievements are only the results of the law of reincarnation and the subsequent use of spirit doctors from the spirit plane. He is classified as miraculous only because we in the western world are reluctant to accept that a spirit world exists and therefore that his work is the result of this natural law.

Compare this hagiography to the introduction to Oprah’s segment on John of God (video here). In this segment, after being treated to an introduction that could have come from the article I just quoted and that exults about how “millions upon millions” of people have traveled to Brazil to visit him, we see John of God doing his thing while Oprah herself does a voiceover that describes John as “persecuted,” “misunderstood,” and “working tirelessly” to heal the sick. The images are even more disturbing. For one thing, John of God seems to have a proclivity for women’s breasts. In one scene, his is shown apparently making an incision on a woman’s breast, her nipple chastely blurred out, and squeezing something out of the breast, which the woman described as “something black coming out of my heart.” Disturbing video aside, this multimedia blitz is also accompanied by a long article published in O Magazine by editor-in-chief Susan Casey entitled Leap of Faith: Meet John of God. This article details the journey Casey undertook to meet John of God and be healed of her prolonged grief reaction to the death of her father. Conveniently enough, Casey was interviewed on this particular episode of Oprah’s show (video here).

Here is a taste of Casey’s treatment of John of God:

For John of God—or as he is known in Abadiânia, Medium João— the realization of his gift was accompanied by years of persecution and lawsuits for practicing medicine without a license. That didn’t stop him from his mission—to aid anyone who requested it, free of charge—and as time passed and he managed to help such high-profile politicians as the president of Peru and the mayors of assorted Brazilian towns, he was accepted and even protected, treated as a national treasure.

The question of how a malignant tumor disappears from someone’s body, how a blind person ends up seeing again, how the lame suddenly walk—how darkness turns to light, in other words—is not a small one. Our rational minds search for analytical handholds, evidence. In Abadiânia, the currency is more ephemeral: To show up here to see John of God is an act of faith.

This passage, of course assumes that malignant tumors really do disappear from the bodies of those whom John of God “heals,” that blind people do see again, that the lame suddenly walk, and that John somehow turns the darkness into light. There is no evidence presented that might make a rational, science-minded person actually start to wonder whether John can actually do those things. Be that as it may, John of God is not your typical faith healer. He’s become very famous not just in Brazil but all over the world. Despite his apparently not asking for any money for himself, John of God has also made a lot of people a lot of money. For instance, traveling to the remote village where John lives has become a cottage industry in Brazil. Tour operators in particular benefit from all the penitents needing travel arrangements to visit him. As for motivation, John of God’s supporters make much of his not requesting money for his services, but they conveniently forget that there are many other forms of motivation that are as powerful–or even more so–than money. There’s the feel of adulation of the crowd, for instance. There’s the sense of being important, of being so beloved of God that you can channel his power to heal. No one ever seems to consider these motivations when considering faith healers like John of God. Sure, there are faith healers like Peter Popoff who are complete and total frauds, but many (probably including John of God) believe.

Oprah, John of God, and “balance”

If there’s one thing we’ve complained about on this blog when it comes to how the media presents quackery, pseudoscience, the paranormal, or whatever form of non-science-based beliefs, it’s been the journalistic convention of “telling both sides” as though they had equal validity. Credulous journalists do this far more often than they should, but in this episode Oprah took the credulity and cranked it up to 11. In fact, the attempt at “balance” is risibly superficial and perfunctory, so much so that it strikes me as being there more for the story telling than for any actual attempt at critical thinking or true balance. This appears in two forms. First, we have the woman seeking healing for her psychic wounds (Susan Casey). In her interview with Oprah herself, Casey tells the story of how she decided to seek out John:

While at the Casa, Susan was also searching for her own healing. After her father suddenly passed away two years ago, Susan experienced a “tsunami of grief” that she says she couldn’t escape from. She wondered if John of God could help heal her grief.

When she first met with John of God, she says all he did was look her in the eyes. “I thought, ‘That was it?’ I was expecting a lightening bolt, where there’s a big flash of insight. And they just said, ‘Come back later.’ It’s basically, ‘Take a blessing and come back.'”

Susan met with him a second time, and again, he didn’t spend any time with her. What he did do was look at a picture of Susan and her father. He then told Susan to sit in the “healing room,” a room in the Casa reserved for meditation and prayer, for three hours. Susan says she was surrounded by hundreds of people in the healing room, all of whom were praying and meditating with their eyes closed.

“Three hours went by like 20 minutes,” Susan says, “and it was blissful—it was like I was floating.”

In her own state of meditation, Susan says she was able to speak with her father. “It was very real,” she says. “More of a vision than I had ever had before. … I got this feeling like I shouldn’t be sad, that everything was okay.”

While Susan acknowledges that the whole experience sounds skeptical, she says she’s “not a woo-woo person,” and that the Casa helped her find healing.

They all say they aren’t “woo-woo” people, don’t they? In fact, if you hear someone on a show about a faith healer, the paranormal, or whatever form of quackery you can imagine say they’re a skeptic or “not a woo-woo person” you can be pretty sure that she either has just said or is about to say something that proves she is indeed a woo-woo person par excellence. In the video, Casey goes on and on about how after meeting John she felt as though a “cloud had lifted” and how she felt “lighter.” She describes sitting in the “healing room,” where she was floating and talking to her dead father. She then describes a scene in which she and other supplicants are sitting and praying, not allowed to cross their legs (which apparently for some reason would ruin he “energy” being channeled) and how she felt during that. it is also in this segment that I saw perhaps the most hilarious thing I’ve ever seen on Oprah’s show. Oprah looks at her editor and, in all seriousness, says, “You know this sounds very woo-woo to me.”

Oh, Oprah, you skeptic you!

More hilarious is the answer. Casey says that she can’t be woo-woo because she spends her time around people with surfers who surf 100 foot waves, and they’re “very linear” and “focused” in their thinking. Uh, Casey, have you ever noticed that a lot of surfers are into a lot of woo? At the very least they’re at least as prone to woo as anyone else. This isn’t as though Casey was hanging out with Randi! In any case, it would be churlish indeed of me not to be happy that Casey seems to have found a way to overcome her grief at the loss of her father, but medicine and science this is not, and science-based medicine it is especially not. It is, contrary to Casey’s claim otherwise woo-woo, and Casey is anything but a skeptic. In fact, she appears to have been in such a state of mourning that she may have even been in a state of clinical depression at the time. Indeed, she describes having the feeling that she would “never feel joy again.” Clearly, she had such an emotional need for something to shake her out of that state that she latched onto John of God. Whatever happened, it’s quite obvious that Casey is was not neutral and, unlike a real skeptic, turned off her critical thinking faculties (if they were ever on in the first place) when she traveled to Brazil.

The next obligatory part of any story about faith healing, quackery, pseudoscience, or the paranormal is what I like to call “Bring in the skeptic!” This part of the story usually takes one of two forms. Sometimes the skeptic is a real skeptic, but is not given anywhere near the amount of time to make his case that the supporters of quackery are. The second form this segment can take is for the skeptic to investigate and then become a believer. Guess which form our “skeptic” takes on Oprah?

That’s right. Our “skeptic” isn’t very skeptical at all. His name is Dr. Jeff Rediger, and he is presented thusly:

Dr. Jeff Rediger is a psychiatrist who traveled to the Casa seven years ago as a skeptic. His goal was to collect lab reports, radiological exams and photos of people who reported that they were physically healed by John of God and to see if the healings could be documented.

Like Susan, he witnessed several physical surgeries while he was there—an experience he says changed the way he thought about the world.

“Some people who I spoke with were able to remember the events going around them completely, and some people seem to enter a sort of altered state during these surgeries,” he says. “When I was assisting in one of the surgeries, [John of God] cut this woman’s cornea. She didn’t flinch. She didn’t try to pull away from him. I can’t explain that. I heard some people use the term ‘spiritual anesthesia.’ I have no way to understand that.”

Well, science and skepticism would be a good start. Unfortunately, in the video I don’t see a whole lot of that coming from Dr. Rediger. One thing that irritated the hell out of me about this segment was how the producers blurred the blood when John was doing his “psychic surgery.” It made it impossible for me to make any judgment regarding whether there was any fakery involved. Looking at the blood and bits of tissue, I wasn’t convinced that this really was human tissue. In any case, everything in the video was a rehash of the sorts of nonsense that John of God has been doing for over three decades. Indeed, several years ago, ABC did a special on John of God with a similar lack of skepticism; the only difference between Oprah’s puff piece and the earlier special was that the earlier special was a whole hour and didn’t feature Oprah as the host and didn’t bother to interview someone like James Randi, who would have informed the producers that everything John of God did was nothing more than hoary old carny tricks, in particular the old “forceps up the nose” and “cornea scraping” tricks.

The latter trick apparently fooled Dr. Rediger completely, as he breathlessly describes a woman whose cornea Rediger said that John of God cut. So did the “forceps up the nose” trick, as evidenced in this credulous description of the episode. Unfortunately, the camera angles used made it impossible for me to judge whether John was doing what he claimed. In the only close-up that was presented, it was clear to me that the knife never touched the woman’s eye, and when John actually appeared to be doing something, the camera never actually focused on the woman’s eye. How convenient. It was almost as though the Oprah producers were making a conscious effort not to show a camera angle that would allow viewers to judge whether the procedure actually being done was what John of God claimed. Personally, I’d have loved to see an ophthalmologist–or even just a surgeon rather than a psychiatrist–allowed to have a close-up view of John’s activities. Rediger is also shown in a video clip apparently bleeding from the chest, apparently after having viewed John do his cornea scraping bit. He expresses fear and is concerned that the bleeding doesn’t stop as soon as he thinks it should, pointing out that he doesn’t have a bleeding disorder.

Let’s just put it this way. I don’t think Dr. Rediger is much of a skeptic. As partial evidence, I Googled his name and quickly found his his website. Here are some choice quotes:

  • “We live in a culture that has advanced enough that we can send the person with a medical problem to the medical doctor; a person with an emotional problem to the psychologist, and a person with a spiritual problem to the priest, minister or rabbi. Yet The Initiative for Psychological and Spiritual Development is founded upon the belief that, beneath and behind all the masks and appearances that we present to the world, there is something more, and that whatever healing potential exists comes from this place.”
  • “Many of us benefit every day from the advances made in medicine and biological psychiatry. But these disciplines as they are currently conceived are only part of the story. They are rooted in an overly materialist understanding of the body and the brain. We will be limited in our capacity to help people until we can enlarge our vision and understanding of the true nature and needs of the human person.”
  • “The next evolutionary step for both medicine and psychiatry is to explore and point the way towards what it will take to develop a rich, vital life of courage, faith and love. This means that we need to allow the capacities of mind and heart to stand on their own terms, and not be reduced solely to the language of biology and physics. And then seek to understand these hidden capacities, and how to cultivate them.”

It sounds to me that not only is Dr. Rediger not a skeptic, but rather he is a believer in mind-body dualism and “spirituality,” so much so that he heads something called the Initiative for Psychological and Spiritual Development.

Yet another segment describes a breast cancer testimonial for a woman named Lisa, who was apparently diagnosed with breast cancer at age 37, her mother having died of the disease. Before you examine her story, you might want to read a post I did very early in the history of this blog that describes how cancer testimonials can deceive. Read Dr. Peter Moran’s excellent discussion of the same topic. Then look at the story of a woman named Lisa, who was interviewed as part of this show. Her testimonial is described in this video and this segment on the Oprah website:

Doctors recommended a double mastectomy and chemotherapy, but Lisa refused. Desperate to find an alternative treatment, she traveled from her home in South Africa to Abadiania to see John of God. While at the Casa, Lisa volunteered for a visible surgery—a nasal probe.

“My heart was beating very fast [during the surgery]. And then I sort of felt him turning this instrument, and I remember a crunching sound and thinking ‘How far can this thing go back?’ because it felt really far,” she says. “I wouldn’t say it was painful. It was more like shock.”

When she left Brazil, Lisa says she followed the guidelines she had received from John of God, such as abstaining from sex and alcohol for 40 days. She later had a biopsy and, unfortunately, her tumor was still malignant.

“It’s never gone away, meaning I’ve never been out of the cancer realm,” Lisa says. “I was told I was at a fourth-stage diagnosis.”

Even though Lisa did not experience a physical healing at the Casa, she says she has no regrets.

So basically Lisa decided to forgo effective therapy and travel to see a faith healer, who did her no good. Now she has a stage IV diagnosis. Indeed, I wonder if she has hideously enlarged cervical lymph nodes on her left side. Her neck looked very odd during this interview, as though it’s asymmetrical with a bulge on the left side. Whatever the case, Lisa’s story demonstrates the true price of quackery like that of John of God. Quacks and faith healers hold out the hope of cure without that nasty surgery, chemotherapy, and radiation. Believe me, I understand why patients might want to avoid surgery, chemotherapy, and radiation, but they are all we currently have that actually works against breast cancer. Magical thinking leads to outcomes like that of Lisa.

What is John of God doing really?

John of God has been doing what he’s been doing for well over thirty years, and in that time he’s produced thousands of people who think they’ve been healed by him. The question becomes: What is it that’s happening here? To many people these stories sound very convincing. However, their plausibility is arguably no greater than the plausibility of homeopathy. Certainly they are no more plausible than reiki. Consider the similarities. Reiki masters claim that they can channel energy from the “universal source” into the patient for healing purposes. John of God claims that he can channel energy from 30 different spirit doctors (and God) through himself and into patients in order to heal them. The similarities in the claims are indeed striking. Add to that the element of strong religious faith, which tends to depress the level of evidence that the faithful require to convince them of the validity of claims of healing. A perfect example of this comes from Robert Carroll’s deconstruction of John of God, where he describes the tally of people seeking healing in an ABC special on John of God that aired about five years ago:

The final tally for the show was: 1. a man’s brain tumor was smaller after he visited John of God (natural but unexplained regression and an amazing coincidence? treatment before he came to John finally showed some results? one of John’s channeled spirits did invisible surgery? the patient’s will to live and be healed affected the tumor’s growth? or ?); 2. a lady complaining of chronic fatigue says she feels a lot better after John slit her above one of her breasts (psychosomatic? John’s spirits cut just the right place to relieve her symptoms? placebo effect?); 3. a man with ALS shows no effect (didn’t have enough faith? just what you’d expect?); 4. a young actress from South Africa with breast cancer shows no effect (same as 3); 5. a woman paralyzed from the waist down is able to walk using rails to hold on to, but she clearly has no use of her legs; she says she feels something is improving, though (placebo effect? delusion? didn’t have enough faith? in any case, we don’t know if she tried to walk with rails before seeing John and, if so, what the results were), and 6. the journalist’s shoulder didn’t heal in 40 days as John promised but Quinones admits he didn’t follow John’s advice not to have sex or eat pepper.

Number 6 may be the most telling of all as to ABC’s seriousness in doing this program. If Quinones wasn’t going to follow John’s instructions, why was this material included in the program? Did he think it was a joke?

Add to that one more from Oprah’s episode: Lisa, who had stage IV breast cancer when she met John of God and still has stage IV breast cancer, with no evidence of improvement or regression.

Another thing that any surgeon watching these videos would notice is that John of God’s incisions appear to be very superficial. For instance, in Oprah’s introduction to who John of God is, he is seen, as I mentioned, making an incision on a woman’s breast. From what I could see in the video, the incision looked quite tiny and superficial, barely enough to draw blood; It wouldn’t surprise me if the incision didn’t even make it all the way through the dermis. No wonder the woman said it didn’t hurt much, if at all! As for John of God’s other tricks, James Randi and Joe Nickell have documented what is almost certainly really happening, namely that all of John of God’s antics appear to be the tricks used by “psychic surgeons” and carnival sideshow geeks for many generations. Worse, by promoting John of God so credulously, with such a lack of skepticism and attention to science, Oprah Winfrey has done a grave wrong to her audience. I have to wonder how many people with life-threatening illnesses are now buying plane tickets to Brazil to seek out John of God. I wonder how many people with terminal illnesses are wasting their remaining cash to enrich the tour operators that service John of God’s operation.

I wonder how many more people like Lisa will be given false hope, only to have it yanked away when reality doesn’t conform to John of God’s claims.

Unfortunately, this favoring of the credulous viewpoint, the non-science-based viewpoint, is a recurring pattern on Oprah’s TV show. As James Randi has documented, Oprah’s show is rigged to make sure that no skeptic, be he a skeptic of the paranormal or a proponent of science-based health care, can provide evidence or make a point that causes too much discomfort to her guests or challenge her audience’s belief in these things. Still, even though Oprah has facilitated John of God’s claims, she is not the only force that keeps people believing in him. What allows John of God to persist in producing new believers includes a combination of things. First, because he is tapping into strong religious belief, there is a lower than the already low bar to convince people of his powers. Second, no one has performed (or is likely to perform) a detailed study of people who have come to him for healing, complete with careful documentation of their pre-John of God condition and then a rigorous followup of what happened to them after they sought healing from John of God. Finally, faith healers like John of God produce a “heads I win tails you lose” situation. If a patient isn’t healed, it’s not because John’s mystical powers failed. Oh, no! It’s because the patient didn’t believe enough or didn’t follow John’s instructions closely enough. John of God also tells people who come to him that they need to wait at least 40 days for healing, which, conveniently enough, is usually long after they have left Brazil.

Come to think of it, the idea that, if quackery doesn’t work it’s the fault of the patient for “coming too late,” failing to follow the quack’s instructions closely enough, or not believing strongly enough isn’t unique to faith healing. As we’ve pointed out here many times before, it’s a frequent “out” used by purveyors of unscientific medical treatments of many varieties, which is why studying John of God and how his activities deceive is valuable for more than just uncovering how faith healers do what they do. It’s also useful for considering how “alternative medicine” can appear to work despite no evidence. It’s also useful to consider how the media take advantage of all these aspects of faith healing to weave a compelling story that is ultimately misleading. Unfortunately, Oprah is very, very good at this and utterly shameless when it comes to unscientific remedies. It’s a very good thing indeed that she will be going off the air next spring.

Except that the reason she’s going off the air is to start up her own cable channel, where it can be all Oprah-branded programming all the time. Oh, joy.

ADDENDUM: Monica Pignotti weighs in. Also, it occurs to me that what John of God is doing is likely very much like what James Randi is demonstrating here:

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Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.