Lest anyone think I am a heartless bastard, I would like it to be known that I do not like to see any creature suffer or die. I am the kind of person who, when finding a spider in the house, is likely to catch it and toss it outside. I always think, “I can’t squish the end result of 6 billion years of evolution”. Except mosquitoes. Those I squish with glee. Infection vectors can die die die die.

I like animals and hate to see them suffer unnecessarily. Like sticking them with needles. Frontal lobes are nice to have. They can let you know that pain is coming and provide preparation and compensation. Once I had a steel bar smack me on the head, opening up a six-inch cut to the bone. No, my brain was not affected, thank you very much. Everything predates the head trauma. When the ER doc numbed the scalp for sutures, he missed the last half-inch and I felt the needle. Knowing what was going on I steeled myself and let him do the last two sutures with no lidocaine, since the needle hurt only a little worse than the lidocaine injection. I have had many other unpleasant medical procedures in my 56 years but knowing what was coming and understanding why makes it easier to tolerate a needle popping into the knee joint or an abdominal drain being pulled.

Animals, and young humans, lack the ability to comprehend the what and why of pain inflicted as part of medicine. Adults can make a conscious decision to be endure pain and fool themselves into thinking it is of benefit. No pain, no gain. Animals can make no such choice.

For example consider sea turtles, who, apparently, are subjected to all sorts of nonsense at the New England Aquarium including acupuncture and laser therapy. As is obvious, I am no veterinarian, the only animal of which I have any understanding of anatomy and physiology is a human, but even with that background it is remarkable what is reported from New England. I used to say the ‘B’ students went into journalism; given the credulous reporting perhaps the standards have been lowered. They certainly have for marine biologists and veterinarians, who are evidently shortchanged in their education.

Several hundred sea turtles were washed ashore in New England after a severe storm. Hypothermic, injured, infected and malnourished, they were transferred to the New England Aquarium for care. It sounds like the animals were quite ill.

Some animals were not getting better rapidly enough with conventional medicine. Conventional medicine: based on known reality. The application of physiology, biochemistry, anatomy, epidemiology, etc to disease that has led to astounding increases in life expectancy and relief from innumerable diseases that plagued humankind.

So they decided to inflict a pair of fantasy based, I mean alternative, therapies on some of the turtles. Alternative: not based on physiology, biochemistry, anatomy, epidemiology, and has never had an impact on any important disease, ever.

At first I read the headline (with the obligatory pun) “Slow pokes: Acupuncture helps hypothermic turtles” as the acupuncture was being used to help hypothermia, which made me laugh. Turtle thermoregulation is complex but just moving them from the cold sea to a warm lab should raise their temperature. But then I realized I misinterpreted the headline. Acupuncture was being used as ineffective therapy for conditions other than hypothermia.

To summarize acupuncture, a topic discussed at length in this blog, its basic principles, those of meridians and chi, are fictional. I tried to find a meridian map of turtles and failed. I found a pig, a cat, a dog, a cow and a horse diagram, but no turtle. Not that it matters, since the meridians are fantasy. The horse, which has no gallbladder, does have a gallbladder meridian, although it conveniently has nothing to do with the gallbladder:

Although the horse does not have a gall bladder organ as such, the meridian is the same as in the human, and it has a lot to do with the integrity of ligaments especially in the hips and pelvis.

Like I said. Fantasy anatomy and physiology.

I note again that on every human and animal acupuncture map there are no meridians or puncture points in the genitalia. Ironically no important life energy runs through the reproductive organs, perhaps explaining why there is no acupuncture-based (or alternative therapy of any kind for that matter) birth control, although a few needles in the genitalia could certainly have a negative effect on reproduction.

Acupuncture does not have any effect on physiological processes outside of those that determine perception. It doesn’t matter where you put the needles, or even if you use needles. Twirled toothpicks have the same effect. Acupuncture only has effects on subjective outcomes and only then if the receiver is a believer and thinks they are receiving acupuncture. I am always amused by those who note sticking a needle into flesh yields a pain response:

The mechanisms underlying pain relief from insertion of needles are unknown, but it has been suggested that it may involve recruitment of the body’s own pain reduction system, possibly attended by an increased release of endorphins, serotonin, norepinephrine, or gamma-aminobutyric acid.

Gee, acupuncture does cause the physiologic effects one would expect from the noxious stimuli of being poked with a needle. Or hitting one’s toe with a hammer.

Acupuncture does not, as the report says,

…reduce stress, increase blood flow and boost the immune system.

Can an animal have a response to a therapy whose entire result is dependent on higher-level cognitive functions that convince the receiver they are improved? The same effect as your mother kissing your injury to make it better? I am, well, skeptical.

In the photographs the turtle looks nonplussed, although they appear to be holding the poor animal so it cannot escape. But then, every turtle in every picture looks nonplussed. Expressive faces are not in the reptilian repertoire. Usually. Not like some dogs who, to my anthropomorphizing eye, do not look happy being stuck with needles.

I am a very ill turtle. Infected, injured, starving. I have been hauled out of my usual environment, taken out of the water, held down on a table by enormous creatures who are sticking me with needles. I would think that the turtle would, in its tiny ‘I don’t want to get eaten’ brain’, be having the turtle equivalent of NONONONONONONONONO I DON’T WANT TO DIE.

But that’s probably just me who thinks perhaps the whole process of worthless needling would only be stressful for the turtle.

The turtle gets combined reality and fantasy based therapies and gets better, the fantasy based therapy gets some of the credit:

Dexter and Fletcher Moon have already had three acupuncture sessions, scheduled once a week, said Merigo, who broke into a broad smile as she described their improvements over the past three weeks.

“These two turtles really had very limited limb use and they weren’t eating. We are seeing improved limb use and improved appetite,” Merigo said. “They are eating on their own, which is fantastic.”

McManus, the acupuncturist, was restrained when describing her reaction to the results.

“It makes me feel very happy,” McManus said. “Acupuncture is not alternative to conventional medicine – they are also receiving Western treatments as well, but the fact that it can work in conjunction with the other treatments they are getting makes me very happy.”

Although the stress of being punctured may have slowed their recovery, it is the usual mistake of crediting effects where there is none.

It was nice that, unlike most acupuncturists, animal and human, the practitioner is using gloves, although everyone appears to wear gloves when handling the turtles.

I am extrapolating from humans and am probably in error when applying what I know to turtles. When humans have severe pneumonia or other severe infectious diseases or trauma, like these turtles, the inflammatory response may be followed by an anti-inflammatory response. A week or two into their hospitalization, a patient may have an increased risk of infection, not only from all the interventions but also because they are at an immune nadir. The greater the initial insult, the greater the subsequent immune dysfunction and risk of infection. Stress is bad.

Take the stress of the initial insult, the infections and malnutrition, being held down and poked with needles and then, with new holes in your hide, being tossed in bacteria-laden salt water. Can’t be good.

Years ago I was sitting in the wards of a hospital in LA when a patient started yelling in pain. The surgeon had ordered sugar for an open wound and the cafeteria had sent up salt by mistake, making the aphorism all too real. I doubt the needles were causing enough damage to the hide to sting when placed back in the salt water, nor to allow the bacteria in the water a chance to find a toe hold (pili hold?) but who can say? Yertle ain’t talking and, like all turtles all the time, looks unfazed.

The preponderance of data suggests that acupuncture effects are almost entirely in the mind of the beholder. The well-designed studies demonstrate that the effects are due almost entirely to bias and are clinically trivial. A placebo effect, the archetype of which was in Penn and Teller’s episode on magnetism. A gutter downspout was bent into the shape of a giant magnet and guess what? The patient had an effect from the fake therapy. That is the basic mechanism of all alternative medicine, including acupuncture.

I went searching the Pubmeds for animal clinical trials of acupuncture and found little, although human trials are animal trials.

Acupuncture being the needling equivalent of faux magnets makes experiments and therapies on animals a little discomforting. There are many animal models for acupuncture and I would wonder if they cross the ethical Rubicon. Is it OK to do studies on animals when the prior plausibility of efficacy is as close to zero as one could want and well-done clinical trials show effects are limited to higher cognitive abilities the animals lack? Is it OK to poke a turtle to induce a marginal placebo effect when it lacks the higher functions to generate such an effect? At some level are not all animal acupuncture studies animal abuse? I wonder.

Animal acupuncture raises other questions: are the rat, dog or turtle meridians the same as humans? If so, why? Genetics? Is the chi same? If so, why? Does a species as evolutionarily removed from humans as a sea turtle have the same response to acupuncture? Does the shell not have any acupuncture sites? If not, why not? It appears from the pictures on the web they only target the soft structures. If human meridians map onto reptiles, are they not missing important sites hidden under the shell, leading to misaligning the energy flow, like only balancing two tires on a car? Of course, asking reality-based questions about acupuncture is like asking about the genetic differences between Orcs, Elves, and Hobbits. It is all fiction.

At some level I can understand trying acupuncture as it has a certain cachet in popular culture, albeit an undeserved one. Most people are not going to wander to the pages of SBM looking for a critical appraisal of acupuncture. But lasers? Really? Laser therapy is nuts, unless you like to get your therapeutic interventions from advertising copy:

When all the results were in it turned out this turtle has a systemic infection. We started treating for the infection but the swelling did not seem to diminish. As we continued the antibiotics we also started using a laser for the edema (swelling) of the joint area.

How does the laser therapy work?
I found this at the Companion Therapy Laser website:

The Companion therapy laser system sends photons, or packets of light energy, deep into tissue without damaging it. These photons are absorbed within the mitochondria of the cells and induce a chemical change called “photo-bio-modulation”. This light energy then inspires production of ATP in the cell. ATP is the fuel, or energy, cells need for repair and rejuvenation. Impaired or injured cells do not make this fuel at an optimal rate. Increased ATP production leads to healthier cells, healthier tissue, and healthier animals.

Show of hands. Does this modified photosynthesis make sense to anyone? I guess the biochemistry of turtles resembles plants more than I suspected. And why did it make sense to the veterinarians at the New England Aquarium?

The closest explanation I could find of this bizarro statement was:

ATP production, according to Kremer’s research, is not based on chemical energy release, as taught in universities today, but rests on the absorption of photons of light from the zero-point quantum medium.

Or for those who prefer their gibberish more science-y:

Biochemistry and medical science have failed to this day to explain the function of the adenine groups of ATP as no biochemical reaction with this adenine ring molecule is shown. However, an understanding can be gained, within the framework of the cell symbiosis concept, from the biophysical attributes of light absorption of the adenine group. All essential components of mitochondrial cell respiration are light absorbing molecules with characteristic “frequency windows” of absorption maxima from nearly UV spectrum to the longer wave yellow/orange spectral range of visible light up to ca. 600nm. Yet the source of the electromagnetic energy is not sunlight. In fact a low frequency pulsating electromagnetic field is induced by the constant flow of uncoupled, paramagnetic aligned electrons in the respiratory organelles. The electromotive power generated by this process is catalytically enormously strengthened by the enzyme complexes of the respiratory chain (acceleration factor1017). This effects an interaction between the electrons and the protons likewise aligned parallel to the induced magnetic field dependent on the strength of the magnetic field between the antiparallel aligned electrons and protons. This process produces a quantum dynamic transfer of information via photon exchange energy. The source of photons is ultimately fluctuations of resonance frequencies of the physical vacuum (zero-point energy field). The transferred information is stored in the spin of the protons that proceed to the ATP synthesis complex via proton gradients. There the resonance information is transferred by a unique rotation system to the adenine group of ATP whose electrons can move freely in the alternating double bonds of the ring molecules. The ATP serves as an “antennae molecule” for the reception and relaying of resonance information from the “morphogenetic background field.” Human symbiosis is consequently not a heat power machine but a light frequency modulated information transforming medium. All the time this cell symbiosis is resonance coupled with the lowest not yet materialized energy status (physical vacuum as inexhaustible “global information pool”).

I suspect the laser they used is not producing a zero-point quantum medium. As to why they further stressed the turtle with useless laser therapy, I cannot say. The internet said it would help, I suppose. In the photos the turtle has the same stoic expression that marks the species, but I can’t imagine that from the turtle perspective the process is any less terrifying than a shark coming at them. Three large animals holding it down, preventing flight or fight and flashing them with a worthless laser.

I just hope the laser unit was donated, as they cost $18,900 to $27,900 depending on the model. My fish would be fried if I was a member of the aquarium and saw that they wasted money on a laser therapy.

I am grateful they saved the turtles but I hope I do not come back as a turtle in the next life. Cold, starving, injured and infected, thrown from the sea, held down to prevent escape then poked with needles and flashed with lasers. Beats dying on the beach, but I hope my caregivers have a little more sense and education.

*I know, a stretch, but I so wanted the acronym PETA.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He is a founder and  the President of the Society for Science-Based Medicine where he blogs under the name sbmsdictator. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His growing multi-media empire can be found at edgydoc.com.