David Gorski suggested I expand on a comment I left recently on one of his November posts. His subject was the then new documentary movie, “A Beautiful Truth.“ “Truth” is about the Gerson method – the dietary deprivation cum coffee enema cancer treatment developed by Dr. Max Gerson, a refugeee from Germany I the 1930s. His daughter, Charlotte now runs the Gerson Institute in Tijuana, Mexico. Gerson is one of the models for the Gonzales method recently reviewed by Kim Atwood.
I had previously referred to the movie in a prior post (1) (but in a different context. Here I’ll explore the movie from a different angle – with its partners, propaganda documentaries.
David called my attention to “Truth” plus another by the same producer – with trailers on You Tube. When I watched the trailers last year I saw myself interviewed briefly, but could not recall being filmed, or even identify where the scene took place. I had to email Steve Barrett, also in the movie, who reminded me about filmmaker Steve Kroschel’s visits 2-3 years before, although neither did he have strong memory of the interview.
I slowly began to recall. Kroschel had called for an interview saying he had previously made a movie about Gerson but felt he should make more objective one, presenting “both sides.“ He pitched himself as having been misled in making the first one. He spoke and asked as though he was being critical of Gerson. After he left I did not think about it again.
Before critiquing such documentaries, some words about the Gerson method. According to the American Cancer Society’s “Unproven Methods” pamphlet, the Gerson regimen, includes eating large amounts of fruits and vegetables, limiting fat and meat; consuming only fresh, raw juices prepared in a special way, eliminating salt, and “detoxifying” the liver through coffee enemas, and taking injected liver extracts. (2)
Saul Green also wrote a definitive description of coffee enemas and the Gerson method (Green S. A critique of the rationale for cancer treatment with coffee enemas and diet.(3) JAMA. 1992;268:3224-3227.)
Other components of the Gerson regimen, include consuming only fresh, raw juices prepared in a special way, eliminating salt. and “detoxifying” the liver through coffee enemas and injected liver extracts. Years earlier, Eisele reported in JAMA deaths from potassium deficiency induced by frequent coffee enemas. (4) Other complications include colon perforation and ulceration.
A sad and poignant small book about Gerson’s method is “Death be Not Proud” by former (and late) writer, John Gunther. His young son had a brain tumor and was sent to Gerson where for his last months on earth he submitted to the dietary torture that is Gerson‘s method. It’s a trying read.
As for efficacy, G. Hildenbrand, the Gerson publicist for years, his son, and a statistician reported prolonged survival of a group of melanoma patients treated by Gerson as a “nested” group – of their patients, in this case, a group selected from within a larger group, retrospective and without concurrent control.(5) Other reports of success have been single testimonials, or studies invalidated by large dropout rates, lack of controls, and other deficits.
When I viewed the “Truth” trailer I concluded the film was a push piece advertisement for Gerson, and as my memory re-formed, I concluded I had been had. The film had been edited – a lot. I had said more things than shown, and probably so had Steve and Dean. Edell (who also had been interviewed and had not recalled Kroschel when I emailed him.)
Kroschel did not mention to me he was also interviewing Barrett and Edell. Want to ask why?
The lesson is that we have been shown an edited propaganda film made by a probable contract advertiser, likely financed by the Gerson Clinic itself or a support organization, who presented false or incomplete credentials and misrepresented his approach.
This is even more important: We do not know the whole stories of any of the patients. The patient testimonials were filmed and the records “shown” to the camera, but were not shown to us, the critical docs. Why were our opinions not requested?
Kroschel made no reference to any specific case to me, although he already knew of cases, used in the prior film or a prior one. The trailers present the sequences of us first and then the interviews, making it seem that the cases are evidence in opposition to our statements. The order should have been reversed.
Moreover, the film does not mention what if any, other standard treatments the patients had received. So I reviewed the trailer again for statements of other treatments or denial of them.
Kroschel selects two cases “at random.” I do not believe that. If the clinic had so many successes, they could have written them up and presented the report to a scientific forum or journal like the rest of us do. They have not done so. Those were probably setup – selected cases. Selected from a group of 100? Out of thousands of people who have gone there, dating to before WW II?
Second, Gerson Clinic is not a primary care institution – people go there for a few weeks at most, return home and records there are not complete. They often do not know what other treatments the people get. Now for the two patients shown .
The first woman with melanoma. The diagnosis was apparently confirmed by biopsy. Good. But melanoma is one of the 4-5 most common tumors that regress “spontaneously“. This single episode is credible, but cannot be used as a proof of Gerson effectiveness.
The second, a man with testis cancer, referred to receiving chemotherapy. Chemotherapy is 90 percent effective in producing complete remissions, and about 80 percent of those are considered cures. As for the doc’s surprise, I also usually showed surprise and enthusiasm when a person had a good response. People often considered their responses as “miraculous” or a least special – an assumption I did not discourage.
The third, the Japanese professor, relates an ultrasound as the evidence for the colon cancer metastases. In absence of a biopsy proof, we do not know what the ultrasound finding really was.
So I cannot believe that all three had the respective cancers and had complete responses to the diet and coffee enemas. I do not know what evidence was withheld. And why was a third film made or recreated out of material made for the second one? Were the cases collected since the “Beautiful Truth” film was made? Why not call us back to review the cases? Kroschel considers himself the arbiter of what constitutes review, evidence, and the validity of his own inexpert conclusions. Kroschel’s principles for validity- replication, confirmation, and publication – some sort of journalistic scale of things. Replication was apparently the presence of three cases; confirmation was apparently done by interviewing the patients, and publication – the making of a promotional film. The viewers are supposed to accept that as proof.
Promotional documentaries misrepresenting pseudo-scientific subjects and quacks have become a neat route to public opinion molding. David Gorski in his post took on “Expelled”, with Ben Stein, the pop economist turned education expert who promotes the concept of equal time for Intelligent Design with Evolution in the public education science classroom. Makes me wonder if in fairness, the ID people would allow biology teachers to show one of the excellent films on evolution after every sermon in fundamentalist churches. Stein’s motive seems to be intellectual freedom in education, but in expressing it, how come he has to render Evolution a smack aside the head? Well, that seems to go along with quack claims doesn’t it? Demeaning of what we know to be valid is a convenient and apparently powerful tool.
In 1988 a main attraction was “Hoxsey: Quacks Who Cure Cancer?“ It is a classic promotional piece for a quack. Hoxsey’s history and battles with the FDA and the AMA’s Morris Fishbein spanned three decades, as Hoxsey’s fortunes went from clinics in 27 states to his ignominious end in a storefront clinic in Tijuana and his own death from cancer. But not before he had won a defamation suit against Dr. Fishbein and was awarded $1 for his trouble and reputation. Incidentally, Hoxsey’s cure was a mix of herbs and common backyard weeds.
“Quacks” was not just a retro on an interesting pseudosci – folk hero episode in American history. The film concentrated on the presumed greed and power of the medical-pharmaceutical industry, and the evils of the FDA, all presented as a conspiracy against the public. Reviewers (Vincent Canby) from the NY Times (http://movies.nytimes.com/movie/review?_r=1&res=940DE5DD153BF930A35751C0A96E948260) to the SF Chronicle were moved enough by the movie to accept its content as accurate, and to give favorable reviews. “Quacks” was a political propaganda piece with a heavy ideological agenda, evident to us, but which took in the unknowledgeable.
“Quacks‘s” release was hyped over national news networks (I have a tape of the NPR segment) and was timed to coincide with the launching of the Office of Technoogy Assessment’s investigation of “Unorthodox Cancer Treatments” ordered by Congressman Molinari (D, New Jersey,) whose chief of staff was also an employee of the Lawrence Burton “Immuno-augmentive therapy” in the Bahamas – where Burton set up shop after being successfully prosecuted in New York. This clinic was found to be infusing plasma contaminated with HBV and HIV. Molinari’s abuse of office in ordering an investigation of off-beat quack cancer claims was the precedent for Senator Harkin’s (D, Iowa) equally offensive surge into “CAM“ resulting in the NCCAM and our present history in the making. The film was also the center for a rally on the steps of the Capitol.
And no collection would be complete without a mention of “Sicko!” by film propagandist Michael Moore. Lots of people got taken in by his driveling and drooling hailing to the chief medical system of Castro’s Cuba. Sicko won Moore a special Oscar and an award at Cannes. Sicko was exposed as an edited, biased promotion for a revolution in the medical and health system in the US, and yet another out-of-court indictment and conviction of the evils of physicians and the US medical system.
I saw “Quacks”, and still have a tape of it. I have not seen “Sicko“ or “Truth” or its one or two predecessors, nor, like David, do I plan to cross Kroschel’s palms with as much as two cents for it. So I can be criticized for critiquing films I have not seen, right? OK, but I’m satisfied that I’ve seen enough of “Truth” to suspect it contains nothing that would warm my heart or brain.
3. Green S Cancer treated with Diet and Coffee Enemas. JAMA 1992
4.) (Deaths related to coffee enemas. Eisele JW, Reay DT. JAMA. 1980 Oct 3;244(14):1608-9.
5. (Hildenbrand GL, Hildenbrand LC, Bradford K, Cavin SW. Five-year survival rates of melanoma patients treated by diet therapy after the manner of Gerson: a retrospective review. Altern Ther Health Med. 1995;1:29-37. )