I am starting to think that there’s something about neurosurgeons that make them especially susceptible to woo.  Perhaps it’s because they work on the brain, and marvel at the connection between the piece of meat they stick scalpels into and the mind that comes from that meat. Or perhaps it’s something else, but there does seem to be a trend. Think of creationist flack Michael Egnor,  heaven-visitor Eben Alexander (author of Proof of Heaven, in which he had a near-death experience, saw God, and made a ton of dosh), and evolution denialist Ben Carson, who got a Presidential Medal of Freedom but says he doesn’t have the “faith” to accept evolution.  All of these men are neurosurgeons.

And so is Dr. Sanjay Gupta , chief medical editor for the Cable News Network (CNN), which, I thought, was a respectable venue. While Gupta, a professor of neurosurgery at Emory, has had a bit of controversy, the few broadcasts I’ve seen by him seemed okay. That is, until reader John alerted me to a new piece at CNN—which aired yesterday and today—in which Gupta interviews the unctuous Joel Osteen. If you’re an American, you’ll have heard of Osteen. He’s the pastor of the largest megachurch in the U.S.—the Lakewood Church in Houston Texas, with 43,500 people at each weekly service!—and, according to Wikpedia, gets 7 million viewers a week in over 100 countries.  He basically stays away from theology (e.g., hell), decries gay marriage and, despite his denials, preaches a “prosperity gospel” in which Jesus will bring you material STUFF if you believe and do good (see some of his quotes here). He’s a feel-good pastor for the “me” generation, and doesn’t bring them down by talking about fire and brimstone.

Gupta’s piece is called “When religion and medicine meet“, and that meeting seems quite cordial.  (There’s also a short video clip at the link.)  And Gupta basically laps up what Osteen has to say. Here are some snippets from  Gupta’s piece:

If you don’t immediately recognize the name, you will certainly remember his perfectly coiffed thick head of hair, megawatt smile and most of all his optimism, which I would best describe as indefatigable. You feel good just being around a guy like him. I did.

If you watch him closely during the interview, you will often see him look up to the sky when answering a question. While I know many people who have difficulty maintaining eye contact, that wasn’t the case for Osteen. Instead, it almost appeared as if he was seeking out some divine inspiration for the answers to the questions I was about to ask him.

. . . He also took time to remind me that “sacrifice” around the holidays will be rewarded. . . Listening to all Joel Osteen has to say, of course you will agree with him, despite the fact he doesn’t often take a stance on hot-button issues, instead deferring to God as the ultimate decision-maker.

Gupta agreed with him? Even about God as the ultimate decision-maker? Gupta then describes how his mother was healed of terminal cancer by God. Gupta notes:

Osteen is describing a sort of faith healing or at least the power of prayer, and it is an issue that deeply divides the medical community.

According to Gallup polls, 92% of Americans believe in God. And 80% believe in the power of God or prayer to improve the course of their illness.

We know that many people turn to God during times of illness, either in public or private. It is a profoundly human response, but also based on belief in some mechanism that we can’t explain.

Gupta doesn’t note that it’s also a mechanism for which there’s no evidence.

Critics worry that studying prayer relies on the assumption of supernatural intervention, which will always place it outside the realm of science. [JAC: Well, that statement is clearly wrong, for you can test the supernatural if it involves assertions about how God intervenes in the world.]At its worst, they say, people may rely solely on prayer instead of proven, effective treatments.

It is not that science hasn’t tried to prove and even describe the impact of prayer on healing.

A review of nearly 50 studies involving 125,000 people showed those with low levels of religious involvement had odds of early mortality that were 1.29 times higher than for those with high levels of religious involvement. Religious groups such as Mormons, Seventh-day Adventists and Amish have lower rates of heart disease and cancer.

I can’t say I’m an expert on this study, but of course that reduced mortality could be due not to religious belief itself, but to religious strictures against smoking, drinking, and so on, as well as the positive effects of meditation that might occur during services, and the social support networks provided by megachurches like Osteen’s.  And it irks me that Gupta neglects the several studies on the lack power of intercessory prayer to bring healing.  Instead Gupta cites one meta-analysis on mortality but passes over the several direct studies on prayer and other forms of spiritual healing that failed to show effects. And, to be fair, Gupta mentions one study later in the piece.

There has also been a fair amount of research into the mechanism of psychoneuroendocrinology, the relationship between psychology, endocrinology and neuroscience — in other words, the interactions between the mind, hormones and brain.

That could account for the results Herbert Benson cites about the positive impact of prayer on heart disease.

I can’t find any results on that page, but if readers know them please direct me to the papers.

Gupta does mention the one negative result (funded by Templeton) on the failure of intercessory prayer to lesson complications in recovery from cardiac bypass surgery. In that case, patients who knew they were being prayed for got significantly higher frequencies of postoperative complications than those who were prayed for but didn’t know it. The probability value that this was simply due to chance and that knowledge of prayer really had no effect was not terribly low (p = 0.022), and the authors did not do a Bonferroni correction for multiple tests of significance in their study, which I see as a mistake.  (That is a correction to remove “significant’ statistical results that are inevitable when one does multiple comparisons in the same set of data.) I doubt that there would have been any effect of prayer, negative or positive, had such corrections been applied.

But here’s what Gupta says about that negative result:

I did want to point out one of the more remarkable findings in a study from the American Heart Journal on this topic. It showed people were more likely to suffer complications if they knew someone was praying for them. Go ahead, read that sentence again.

No matter your point of view, how do you explain that?

[JAC: I’d explain it as a marginally significant result that would probably disappear if the data were properly analyzed with statistics.]

Nobody knows for sure, but it could be that those people didn’t typically have prayer or faith in their daily lives, and only relied on it when things had become particularly bleak or desperate. They may have thought, “I must be close to death,” if they were now resorting to prayer.

When I asked Osteen about that, he immediately nodded and agreed with that explanation. But he immediately reminded me, that is the nature of faith — the belief that it will work — and the benefits of that optimism flow from it.

Well, those people were chosen randomly, and I can’t tell whether, in the study, they knew that they were one of several groups with different types of “intercessions” (there were two other groups who didn’t know whether they were being prayed for, and were told that they “may or may not be being prayed for”, with one group prayed for and the other not).  So I doubt that third group were initially less religious than the others, and Gupta’s explanation doesn’t wash in that respect. I suppose members of that group might have thought that they were in bad shape if they knew they knew they were being prayed for, but they also knew they were part of a study, and, at any rate, I know of no evidence that pessimism increases cardiac complications after bypass surgery. In fact, I’m not an expert on whether optimism in general facilitates healing from surgery or disease (as opposed to stuff like meditation ameliorating stress and high blood pressure); and would appreciate any readers’ references about this. We always hear that optimism can help you prevent recurrence of cancer and other diseases, but really, is there evidence for that?

Gupta makes a NOMA argument that doesn’t hold water:

While writing this, I realized it is quite possible we will never have the answers we want, because the intersection between religion and science can never be fully explored.

That would require trying to “reduce it to basic elements than can be quantified, and that makes for bad science and bad religion,” according to Dr. Richard Sloan, author of the book “Blind Faith.”

Bad religion is religion that makes either falsified claims about the real world or unfalsifiable claims (in which case one shouldn’t believe them).  And, in fact, the intersection between religion and science can be pretty fully explored. If it hasn’t yet been, after tens of thousands of books on this topic, it will be when I finish writing my own book about it! What Gupta really means there is “that we’ll never have ironclad proof whether or not God exists and can heal people.”  As for “we can’t test religious claims”—what Gupta means when he quotes Richard Sloan—that’s just the old canard that believers use when they say we should believe either in spite of counterevidence (Tertullian, Kierkegaard) or in the absence of evidence. “You can’t test or measure God,” they say.  In that case, what reason do we have to believe in Him, especially in matters of such import for our lives? In fact, Gupta might have said, “the intersection between the existence of fairies and science can never be fully explored” because “to reduce belief in fairies to quantifiable elements makes for bad science and bad pseudoscience.”

In the end, Gupta signs onto being optimistic about one’s health.

When it comes to the power of prayer, though, proponents and critics do find some common ground. They both cite evidence that when it comes to our health, prayers and faith may have less to do about God than it does with optimism overall. [JAC:  is there really any scientific evidence for that proposition? Even if we’re talking about religious people being more healthy, is that due to “optimism”—or something else?]

.  . . It turns out that truly understanding optimism and relying on it to help you during tough times requires practicing it on a daily basis, and that may be the most important message Joel Osteen gives us this holiday season

Gupta didn’t need to interview a preacher for that message. All he had to do is find some data showing a relationship between optimism and health. By inteviewing Osteen, I think Gupta gave some credibility to religion as a source of optimism.  And why isn’t he interviewing any nonbelievers, or psychologists? What, after all, does a prosperity-gospel preacher have to teach us about health?

I suppose if one is ill it’s psychologically better to be optimistic rather than pessimistic (as a secular Jew, I tend toward the latter), but I don’t know if that makes me less likely to be cured. I’d like to see the evidence.

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I’ll add a comment from one reader who later read Gupta’s piece and emailed me:

The tiptoeing around the interviewee so as not to cause offense leaves the general idea behind  that faith is a perfectly reasonable alternative to medicine; rather the one that is obvious – and that Gupta even raises – that prayer has no effect at all, or perhaps even a negative one.