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PAUL SOLMAN: Surgeon Mehmet Oz and team at Columbia Presbyterian Medical Center hovering over a heart, the muscle that, of course, pumps blood through the body. But 61-year-old Bob Groer’s pump was in trouble because three of the blood vessels that keep it going were clogged and needed to be bypassed using veins and an artery removed from elsewhere in his body. To operate on a heart you need to just about shut it down and reroute the blood through a heart-long machine.
Fascinating stuff, but actually we were less intrigued by the surgery than by what that woman was doing. Nancy Delushia, a touch therapist, was balancing Bob Grower’s energy field and also when his heart when on total bypass-get this-trying to heal blood cells damaged by the machine.
NANCY DELUSHIA: And my intention is to make available a healing energy because every cell in the body has its own intelligence.
PAUL SOLMAN: Do you understand that it looks almost kooky for you to be doing that?
NANCY DELUSHIA: I guess it does, yes. But there’s a healing energy everywhere that’s available to all of us. All we need to do is connect to it.
PAUL SOLMAN: Now, you may be asking yourself, what was a touch therapist, much less an economics reporter, doing in the operating room of one of New York’s most prestigious hospitals? Well, Columbia is studying the cost-effectiveness of alternative medicine, a fast growing industry outside the trillion dollar mainstream. The question: Are far cheaper alternative treatments cost effective by helping patients feel better sooner, getting them back to work faster? Heart surgeon Mehmet Oz heads up the Columbia research effort. He’s also a graduate of the Wharton School of Business, and that, he thinks, is no coincidence.
DR. MEHMET OZ, Cardiac Surgeon: I owe business school a tremendous debt in that it taught me to think about problems in a very different way than medical school did. And so when I encountered patients that I couldn’t take care of, I couldn’t cure using what I learned in my fairly rigid didactic education in medicine, I was able to look past that and say there’s something else going on here, something that might be beneficial and I need to look in that direction.
PAUL SOLMAN: Jery Whitworth co-founded and runs the so-called Complementary Care Unit. Having for years juggled twin careers in business and medicine, he helped convince Columbia to offer patients free a host of new therapies, in part to test them scientifically.
JERY WHITWORTH, Columbia Complementary Care Center: I have a retail store in upstate New York and through that experience of retail, it allowed me to hone my skills on satisfying what the individual wants, not so much what we want to give them but actually what do they need and how can we satisfy them?
PAUL SOLMAN: Now, Columbia’s cardiac customers tend to be white, upper middle-aged men, not a demographic given to sampling new age fare.
BOB GROER, Heart Bypass Patient: (talking to doctor) And last night I had a large dinner with as much as cholesterol as possible.
DOCTOR: Okay. Fair enough.
PAUL SOLMAN: This was Bob Groer minutes before his operation.
PAUL SOLMAN: Have you ever done any alternative medicine before?
BOB GROER: No. I am not that familiar with it.
PAUL SOLMAN: You don’t take Echinacea or any of that kind of stuff?
BOB GROER: I’ve never heard of it, nonetheless taken it. I’m a straightforward guy.
PAUL SOLMAN: But Groer’s also an agreeable guy, so he joined the touch therapy clinical trial.
BOB GROER: And what are you finding out now?
TOUCH THERAPIST: I’m just assessing your field to see where the higher and lower parts are. There’s definitely a change in the field from your chest and your legs.
BOB GROER: You actually feel something?
TOUCH THERAPIST: Yes, I can.
PAUL SOLMAN: And how is it working?
BOB GROER: I’m surprisingly a lot more relaxed than I thought I would be. I thought I’d be getting-I’d be kicking you guys out and getting-enough of this already, good-bye, you know.
PAUL SOLMAN: On the cardiac ward at Columbia are patients more stressed than Bob Groer: Long-termers, who may wait months for a heart transplant and sometimes die before they get one-an ideal group to test relaxation techniques. Hypnotherapy, for instance, which has a fairly long record of published clinical success.
HYPNOTHERAPIST: You can hear the waves and you can hear the sound of the sea gulls. Perhaps you even find a nice place on the shore, on the beach, where you can spread out a beach blanket or a towel, you know, just sort of stretch out and soak up some rays, you know.
PAUL SOLMAN: Now we’re not trying to hypnotize you; that’s the hypnotherapist’s sound machine you’re hearing.
HYPNOTHERAPIST: And you can see yourself. You can imagine floating forward in time, maybe a month or a year from now, you know, seeing yourself having gotten your heart and seeing yourself back home, your family, healthy and strong.
PAUL SOLMAN: Sal Davi was impressed.
SAL DAVI, Heart Transplant Candidate: I didn’t think that I had the ability to do that, till just this morning actually. I really felt something strange. It was very interesting.
PAUL SOLMAN: But positive strange?
SAL DAVI: Absolutely. There wasn’t a negative thing about it. I felt my wife and I sitting somewhere where we like to go, and I actually felt I was there.
PAUL SOLMAN: In a careful study Columbia’s hypnotherapy patients reported a statistically significant decrease in post-operative pain and anxiety. Then there’s massage, which has been shown to improve lymphatic drainage in animals and in humans, at least, it sure feels good.
MAN: That’s great.
PAUL SOLMAN: Now if this guy’s roommate looked envious, the patient undergoing reflexology, a form of soul-searching energy manipulation, shared his room with a skeptic, Charlie Gelfond.
PAUL SOLMAN: So you haven’t signed up for the reflexology course, I noticed.
CHARLES GELFOND, Heart Transplant Candidate: No, I have not.
PAUL SOLMAN: Why not?
CHARLES GELFOND: I don’t believe in it. My faith is in the doctors and the medical doctors, not the therapists with their-
PAUL SOLMAN: You can say it.
CHARLES GELFOND: Their shtick-with their shtick-
PAUL SOLMAN: Their mumbo jumbo?
CHARLES GELFOND: Right.
PAUL SOLMAN: Jery Whitworth, head of the new unit.
JERY WHITWORTH: We realized early on that not all patients wanted to explore these low-tech Eastern type of philosophies. Many of them felt as though when we mentioned the name “yoga,” that we were going to shave their head, dress them in orange, and start chanting, and burning incense, or many of them felt as though we were going to change their religion for some reason.
PAUL SOLMAN: But, in fact, Columbia has had such success it’s created a full department for alternative therapies and the hospital is funding further expansion to build a clinic. What started in cardiac surgery is now offered to every patient entering the hospital, about 700 a week. Why? To head of surgery Eric Rose these new therapies are a competitive advantage.
DR. ERIC ROSE, Columbia Presbyterian Medical Center: The thing that has changed is that people have choices. Fifteen years ago there were three centers within twenty miles, and now you can basically have heart surgery on demand probably almost anywhere in the United States.
PAUL SOLMAN: Competition among hospitals has heated up, especially with managed care forcing shorter stays and lower costs. Why not test cheaper alternatives, instead of just doing medicine as usual? After all, says Oz, much of what’s done in traditional medicine, like scrubbing scrupulously for a full five minutes before surgery, has never been scientifically evaluated.
DR. MEHMET OZ: There’s no way for me to sterilize the skin, impossible. You cannot sterilize skin with scrubs. So you’ll notice in the operating room we’ll be very attentive to the gloves, because the only real sterile barrier we have is the gloves.
PAUL SOLMAN: And so all this scrubbing your best guess is that it’s not actually doing anything at all?
DR. MEHMET OZ: No. I think this is all-
PAUL SOLMAN: Hooey.
DR. MEHMET OZ: Hocus. Hocus.
PAUL SOLMAN: Hocus pocus.
DR. MEHMET OZ: Exactly. And I point that out because much of what we do in clinical medicine is just like complementary medicine, extremely unclear.
PAUL SOLMAN: Mehmet Oz is obviously more open minded than many of his patients and colleagues.
DR. MICHAEL SIMON, Anesthesiologist: When I go see a patient out in the holding area before surgery and they’re out there talking to the patient and getting a headphone set, I’m just like, please, we don’t need to waste time doing this. This is nonsense!
PAUL SOLMAN: Anesthesiologist Michael Simon was irked when relaxation tapes played under deep anesthesia were introduced to the OR.
TAPE: You hear my voice clearly and you remain deeply and totally asleep.
DR. MICHAEL SIMON: I would say this is ridiculous. He is deeply anesthetized; there is no way he could be hearing any of this stuff.
PAUL SOLMAN: But then tests showed that patients responded hours later to words they’d heard while deeply anesthetized.
TAPE: Let the others help you restore your balance, restore your balance-
DR. MICHAEL SIMON: If that, indeed, is totally true, then it really opens up the arena for complementary care.
PAUL SOLMAN: If ten is the most skeptical you could be and one is a true believer, where were you?
DR. MICHAEL SIMON: Initially, I’d say ten.
PAUL SOLMAN: A ten?
DR. MICHAEL SIMON: Initially.
PAUL SOLMAN: And now where are you?
DR. MICHAEL SIMON: And now I have to be leaning more towards somewhere between a four and a five.
PAUL SOLMAN: Is that right?
DR. MICHAEL SIMON: Yes.
PAUL SOLMAN: That’s coming a long way for doctors trained in the mechanics of medicine, as opposed to the mystical handiwork of a Nancy Delushia. We asked Mehmet Oz about it.
PAUL SOLMAN: What good do you think Nancy is doing there?
DR. MEHMET OZ: I don’t know. That’s one of the big questions that I have also. But totally-a lot of patients are very happy with interactions they’ve had, so he may feel great.
PAUL SOLMAN: But if he feels great, why doesn’t he just feel great because Nancy’s a really nurturing person?
DR. MEHMET OZ: Absolutely, absolutely. He may feel great because he’s got a friend in the wilderness.
PAUL SOLMAN: Now this brings up an important issue, the so-called “placebo effect.” Tell patients you’re giving them a real treatment and a third of the time they’ll improve, even if you’ve actually administered flavored water. Critics like Dr. Victor Herbert think that’s what’s going on in Mehmet Oz’s operating room.
DR. VICTOR HERBERT, Bronx V.A. Medical Center: Because it’s all the effect of suggestion. All she and Oz had to say to the patient was you will do better after surgery with me than after surgery with someone else, I promise you.
PAUL SOLMAN: Dr. Herbert’s office at the Bronx Veterans Hospital is a testament to scientific skepticism. A noted blood and nutrition specialist, Herbert’s been on an anti-quack campaign for decades. And he points to a recent, much-reported therapeutic touch experiment as new evidence–nine-year-old Emily Rosa’s experiment in which 21 self-described “touch therapists” couldn’t sense her hands’ presence more than 44 percent of the time, that is, less than chance.
DR. VICTOR HERBERT: Therapeutic touch is a 5,000-year-old delusion that there’s a vital life force, which doesn’t exist, which nobody can measure, but which you can bend to your will.
PAUL SOLMAN: Now to Mehmet Oz and others the experiment may prove only that certain self-selected practitioners can’t detect one young skeptic’s energy field. But to Dr. Herbert it suggests that the new competitive environment for medicine is pushing the industry toward quackery.
DR. VICTOR HERBERT: Oz is a superb surgeon, but he takes customers away from other superb surgeons by saying, “I’ve got therapeutic touch.” It’s a big seller for him. It brings him a lot of patients he would never otherwise get. So he makes a lot of money from it.
PAUL SOLMAN: Columbia counters that it’s subsidizing Oz and his research and performing a public service by trying to evaluate alternative techniques that Americans currently spend and may be wasting some $15 billion a year on, not knowing if they work or not. But wait a second. Even healing blood cells in the OR?
DR. MEHMET OZ: I’m skeptical of all that. That’s part of my job, is not to advocate but to evaluate. And, therefore, if you have a treatment that may be of benefit, I can’t just cut you off without giving you at least the option of some type of trial certainly equivalent to how I would treat western conventional medical ideas when they came across my desk.
PAUL SOLMAN: Under the possibly wondering gaze of surgeons past, Oz and colleagues meet each Tuesday morning to grapple with proposed and ongoing studies, for example, which fragrance to use in a test of aroma therapy’s effect on heart rate and blood pressure.
DR. RICHARD SLOAN: Recent evidence suggests that the principal constituent of nutmeg oil that may have its effect is hallucinogenic, and so we’re not going to be able to use it.
PAUL SOLMAN: And how might results from music therapy be skewed? Patients were asked to pick their favorites.
DR. MEHMET OZ: You may want to have, you know, Nat King Cole, but when you get to the recovery room, maybe the new age stuff is really want you want to have.
PAUL SOLMAN: Finally, how do you replicate the healing practices of the Jewish mystical tradition, the cabal on Columbia’s heart patients? That one had psychiatrist Richard Sloan cracking wise.
DR. RICHARD SLOAN: What are you going to do, treat them with guilt? You had French fries for dinner? (laughter among group)
PAUL SOLMAN: In other words, it’s hard to test any new therapy, especially given the placebo effect. But in the lab they’re studying the Chi Gang practitioner, Frank Ho’s power’s, without human beings at all.
DR. MEHMET OZ: And so the first thing we said was let’s take a simple enzyme reaction, something that we know from chemistry occurs at a certain rate. Can we alter that using some of these different energies?
PAUL SOLMAN: Next, bacteria colonies.
PAUL SOLMAN: Are you trying to kill them, or make them grow faster?
SCIENTIST: Kill them.
PAUL SOLMAN: Now, so far, Oz says, the results on enzymes and bacteria are ambiguous but that Ho has made statistically significant progress against cancer cells.
DR. MEHMET OZ: The majority of the time we had less tumor cell growth in the cells that Frank treated than the controls. I’m not going to claim that’s a cure to cancer. All it means is that we saw an aberration in what we would anticipate would occur if me and you both held tumor cells in our hands.
PAUL SOLMAN: Well, we had one short, final visit to make, to heart bypass patient Bob Groer, 24 hours out of surgery.
PAUL SOLMAN: So do you have any way of assessing the effectiveness of the touch therapist?
BOB GROER: None whatsoever. I have no way of knowing.
PAUL SOLMAN: Weeks later, when we called him, Groer was doing just great, he said, his ordeal long over. He still didn’t know if touch therapy had helped, but he didn’t think it had hurt any. And as long as people are already paying billions of dollars for treatments like it, small wonder the industry is looking harder and harder at economic alternatives to traditional medicine, even in sanctums of science like Columbia Presbyterian.