‘Cured’ Review: Miracles Versus Medicine – Wall Street Journal

By | March 6, 2020
Photo: Getty Images

As a popular ad for state lotteries goes, someone has to win. And that is true. But the chances of that someone being you are so very slim that it makes no sense to bother buying a lottery ticket. People die of disease every day. And yet every once in a while, a patient told an incurable illness will kill her spontaneously recovers. Long after she’s supposed to be dead, she finds herself cured. It doesn’t happen often, but it does happen. Are the chances of that someone being you so slim you should ignore them? Or can you do something to increase your odds of surviving?

In “Cured: The Life-Changing Science of Spontaneous Healing,” psychiatrist Jeffrey Rediger tries to find commonalities across people who experienced “spontaneous remissions” of deadly diseases: All were given a death sentence, but lived. These “miraculous” cures occur more often than we think, he says, and studying them may help us to discover new treatments. It’s a lofty goal. In searching for similarities amongst patients who experienced spontaneous remissions, Dr. Rediger considers changes in diet, exercise, social relations, stress reduction and meditation, eventually summarizing his approach as “changing your relationship with yourself,” a concept he admits is “nebulous.”

Cured

By Jeffrey Rediger
Flatiron, 386 pages, $ 28.00

Dr. Rediger is at his best when he voices the reasons we should be skeptical about outrageous scientific claims, and when he reviews some of the fascinating history of medical advances. He recounts, for example, how the surgeon William Coley discovered, in the 1890s, that a high fever sometimes corresponded with the disappearance of cancerous tumors, by kicking the immune system into high gear. Recent evidence supports this, attributing the effect to adaptive immune function and T cell lymphocytes. Dr. Rediger posits that our efforts to reduce a fever could be making us more vulnerable to cancer.

He typically starts out each section of the book laying out the reasons to be skeptical and how one would appropriately evaluate evidence. His mission is to investigate reports of “genuinely incurable illness with documented evidence of both accurate diagnosis and clear remission with no complicating factors that could explain their recovery.” He is truly gifted with analogies. Describing a patient with a devastating, progressive form of arthritis, he explains why an anti-inflammatory medication, such as Naproxen, wouldn’t help. “No-anti-inflammatory medication that’s been developed so far can make a significant dent on chronic, systemic inflammation in the body and brain. Naproxen attempts to reduce one pathway of inflammation in a body that has multiple pathways. It’s like putting a Road Closed sign up when there are five other roads that run to the same location.”

Part of prophylactic medicine is “treating the whole person,” with doctors helping patients to manage their stress. The news is that stress is not just what the doctor or other people think might be stressful to you, but what you find stressful in your own life, two very different things; people respond to the same life events very differently.

Dr. Rediger gradually abandons his skepticism as he seems to change his relationship with the scientific approach, as when he writes, of a stay at a healing center in Brazil, “I particularly enjoyed the açai bowls, which are considered by many to be a superfood.” There are no “superfoods.” We don’t even know if dietary sources of antioxidants actually change antioxidant levels in the body.

He embraces the new-age view that refined flours and sugar cause accumulation of toxins in the body requiring detoxification. Although flour and sugar are not healthy, “detoxification” is not a thing. He touts Rolfing, a pseudo-scientific form of soft tissue manipulation. Any pretense of logic or skepticism completely vanishes when he lauds praise on Dr. Issam Nemeh, a faith healer, who has been taken to task by Jerome Groopman and Paul Offit, two writer-MDs who suffer neither fools nor such quackery.

And Dr. Rediger never grapples with the statistics of medical prognoses. The book recounts stories of patients who were told things like “you have six months or less to live.” Hidden in the pithy and presumed certainty of such a statement is the fact that this is merely an average across a lot of people who are not you, who have their own distinct biology, complications and mediating factors. Some will die within a day, some will live 20 years. That’s just basic, freshman probability: Averages are what happen in the aggregate (and in many cases happen to no one). In anything we describe with the Gaussian—or “normal”—distribution, the tails theoretically trail off to infinity. That means that if we say that something is “incurable” we mean that, statistically, a very small number of cases “out in the tails” will be cured. As statistician Jim Ramsay has said, “the fundamental problem with tails is that we don’t have much data on them.” And this is because, by definition, there are so few cases in the tails. Misapplying these statistics leads the uncareful to draw all kinds of unwarranted conclusions.

Equally worrying, he utterly ignores half of the statistical question that could shed some light on all of this. Sure, some people rid themselves of cancer while following the “keto diet.” But the information we really need to know is: How many people followed the keto diet and were not cured? If 9 out of 10 are cured, you’ve got my attention. But if it is 9 out of 10,000, that just falls in the category of fluke. In other words, counting only the “yes” votes while ignoring the “no” votes leads you to faulty conclusions. By that logic, I could conclude that every car in Pasadena is green (because I only counted the ones that were).

The book’s ultimate story of a “spontaneous remission” is a woman named Mirae who had metastatic melanoma that was deemed incurable. Dr. Rediger reports that she turned things around after she reassessed “her fundamental understanding of who she was and what her purpose was in this life.” She named her tumor “Mel” and wished it away. She had a recurring dream in which “a set of hands appeared in front of her, big and gentle. She knew them . . . they just radiated a sense of home.” She “changed the way she ate and thought about nutrition.” Oh, and she had a round of chemotherapy. Incredibly, Dr. Rediger asks us: “Was Mirae simply a ‘high responder’ to the chemotherapy drug?” Um . . . yes. Yes she was.

Dr. Rediger quotes the 19th-century physician William Osler: “The person who takes medicine must recover twice. Once from the disease and once from the medicine.” Well, the person who refuses to take established treatments is playing the lottery with their recovery. When Osler said this, it was common to treat coughs and diarrhea with opium, toothaches with cocaine, not to mention all of the other nostrums offered at traveling medicine shows. The FDA and medical microbiology were in their infancies at the end of Osler’s life. He was not referring to modern medicines that have been scientifically developed and clinically tested—drugs that, for the most part, effectively and safely do what they are supposed to do.

For the sake of giving Dr. Rediger the benefit of the doubt, I suspended disbelief and allowed myself to drink the medicine of his woo-woo thinking for the first 280 pages of the book. But now, thankfully, I am cured.

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