Medical Muddle : A Magazine Essay Has Triggered a Brouhaha Between Meditating Doctors and Guardians of the Scientific Method
It’s not the first time the berobed Maharishi has bumped heads with the gurus of modern American medicine, but never before have they collided with such enthusiasm and velocity.
In one corner, the followers of Maharishi Mahesh Yogi, who, with a little help from his friends the Beatles, brought us Transcendental Meditation. In the other corner, the prestigious Journal of the American Medical Assn., which every week reports the latest in medical research.
Welcome to medicine-for-a-new-millenium. With all the alternatives, it may get a bit crowded around the bedside, but it certainly won’t be dull.
At the center of the current controversy is the Maharishi’s latest revival-- ayurveda, a 6,000-year-old system of meditation, herbs and massage. Three Indian-born doctors wrote about it, and JAMA printed their essay. The latter, according to the Journal, should never have happened.
What began with that straightforward, though offbeat, article has exploded into a loud, colorful and none-too-scientific debate that involves meditating doctors, cult police, ancient healers and jealous guardians of the scientific method.
Ironically, the subject of all this noise is inner peace. Ayurveda (ay-ur-VAY-da) means science of life in Sanskrit, and its goal is to create and restore health by natural means, including the experience of personal happiness.
But according to JAMA, the goal of ayurveda’s practitioners is more than just achieving inner peace. It’s also selling it. The potential for “personal gain,” says Journal editor-in-chief George D. Lundberg, a medical doctor, is what caused his publication’s apoplectic response.
First came a half-page clarification/correction. In it, the Journal detailed just how the three doctor-authors were associated with the more modern and, JAMA charges, more commercial Maharishi Ayur-Veda. This despite the fact that the doctors openly described themselves as ayurvedic physicians in their article and in letters to JAMA.
The correction was followed by an unprecedented seven-page counterattack-cum-expose, written by associate editor Andrew Skolnick. An amateur magician, Skolnick shared results of his personal investigation into what has been called “The Maharishi Caper; or How to Hoodwink Top Medical Journals.”
According to Skolnick’s article, the Transcendental Meditation movement is “a cult” whose followers believe they can end war and crime, walk through walls, make themselves invisible and even change the weather.
Well, not exactly, demurs Dr. Deepak Chopra, the most famous of the three doctors who wrote the original JAMA article. A respected Boston endocrinologist and best-selling author of such books as “Quantum Healing” and “Perfect Health,” Chopra says Skolnick wasn’t talking about ayurveda when he described such phenomena.
Nor, Chopra adds, were he and his fellow authors talking about such feats when they attempted to introduce the essence of ayurveda to the American Medical Assn.
“What (Skolnick) did,” says Chopra, “was focus on one aspect of the yoga tradition, a highly subjective experience called ‘yogic flying.’ And in so doing, he instilled a good amount of fear in readers.” Such practices, adds Chopra, are “not relevant to ayurveda.
“This reaction to our article has surprised me by its intensity and by its violence. For a scientific journal to behave almost like a fundamentalist religion is very unscientific.
“When I was a small child and lived in India, my grandmother had some neighbors who had some very Westernized habits--drinking beer out of a can and having cookouts. And my grandmother would say to me, ‘Don’t go near those people. They belong to a cult.’
“So when they call this a cult, it is all a question, you see, of what you are accustomed to. But I thought that by the 1990s, we were more tolerant. . . .”
Before an article appears in the nation’s most reputable scientific journals, it must undergo a process of peer review. That is, it must be read, and sometimes researched, by a group of the author’s professional peers.
Chopra’s co-authors were Dr. Hari Sharma, who teaches at Ohio State University College of Medicine, and Brihaspati Dev Triguna, an ayurvedic physician from New Delhi.
Like most of the 400 to 500 medical doctors who practice ayurveda in the United States, they offer patients the regimen in concert with modern medical treatments that include the more traditional antibiotics and surgery when needed.
When their work was submitted for peer review, its controversial nature, possible conflicts of interest and other “deficiencies,” says JAMA editor Lundberg, were apparently overlooked:
“The problem was our peer review did not perceive a difference between ancient ayurveda and Maharishi Ayur-Veda, which has a national following and a great deal of economic impact. . . . These people did not make clear how they would gain financially from these (Ayur-Veda herbal) products they were writing about.”
Chopra and his co-authors say they do not benefit financially from Maharishi Ayur-Veda products. “I have a substantial--a very, very substantial--income from my books,” says Chopra. “I don’t need nor do I receive any money from Maharishi Ayur-Veda.”
But how did the essay get past the peer review panel of one of the nation’s premiere journals if, as Skolnick charges, it was nothing more than “balderdash?” That remains a subject of conversation in various medical and research communities.
Beneath the headline “JAMA Gets Into an Indian Herbal Jam,” a recent essay in SCIENCE magazine, for example, called the ayurveda incident “an ugly episode that has implications for all scientific journals.”
Dr. Herbert Benson, president of Harvard Medical School’s Mind/Body Medical Institute, probably believes as fiercely as anyone in the power of meditation. In his seminal book, “The Relaxation Response,” Benson documents the physiological changes brought on by meditative relaxation techniques.
“There is great validity in what (Chopra and his colleagues) are saying,” says Benson. “TM produces medically useful changes and has been proven useful in all stress-related disorders. But (the balance of) ayurveda, that’s another kettle of fish. It lacks the scientific documentation that the relaxation response has.”
The warm oil massages, special seasonal diets and aroma therapies that may be prescribed by ayurvedic physicians, says Benson, may have more to do with another well-documented medical phenomenon . . . “the placebo effect, where belief and expectancy can lead to truly remarkable medical improvements.”
“Modern medicine pays little attention to the patient as an individual, whereas many of the alternative medical therapies do. And so an ayurvedic physician who is warm and caring and listens to his patients is fulfilling a need many patients have.”
Even JAMA editor Lundberg agrees: “This interest in alternative medicine is not something we can ignore. Medicine is so expensive and so high-tech, it is good to ask whether there might be a better way to do something in a simpler manner. . . .”
