It is a well-known, indisputable, and nearly universally ignored fact that anecdotes in medicine are unreliable when trying to decide which therapies work and which don’t. The experiences of individual patients don’t even reliably tell us what worked or didn’t work in that specific case, and they certainly can’t be trusted to guide our treatment decisions for other patients. Health and disease are complicated, with numerous factors operating simultaneously to affect the outcome of any one patient, and there are a nearly infinite number of ways we can be fooled into thinking something is helpful which does nothing or even makes the problem worse.
The classic example is bloodletting, which was acclaimed as a rational and effective therapy by the greatest minds in medicine for thousands of years despite being not only ineffective but dangerous, sometimes even fatal. But there are many other such examples, both ancient and modern, of how telling stories about single patients leads us into false beliefs. The success of modern medicine, and the dramatic improvement in the length and quality of our lives in the last couple hundred years, is due to the shift from reliance on experience, history, and anecdote and towards trust in rigorous scientific methods for making decisions about medical therapies.
Unfortunately, anecdotes are not only unreliable, they are deeply compelling psychologically. We are storytelling creatures for whom creating and sharing narratives is a powerful way of building and maintaining our beliefs. It is in our nature to trust the stories we hear, especially when those stories agree with beliefs we already hold. So the rational evidence that stories are untrustworthy usually loses out to the emotional impact such tales have.
The only thing more misleading in medicine than an anecdote is a stylishly produced anecdote on television. Yet this is precisely the intended format for a proposed new television program aimed at promoting alternative veterinary therapies. Humbly named “SuperVets,” this program sounds like the perfect storm for swamping reason and science in a flood of emotional storytelling.
According to an interview for the VIN News Service, the idea for the show came from a television producer who is a believer in so-called holistic veterinary medicine. After meeting a couple of veterinarians who offer some unconventional therapies, the producer decided to create a television show that highlights “specialty veterinary medical services that many pet owners don’t realize are available.” Given that the teaser for the program talks about acupuncture, Chinese Medicine, and hyperbaric oxygen therapy, it seems likely that many of these therapies are going to be alternative approaches which have little scientific evidence to support them and so rely primarily on anecdotes for justification.
The format of the show is apparently to present heartwarming miraculous recoveries due to unconventional therapies, with no discussion of the scientific plausibility or research evidence concerning these treatments or any of the reasons why such anecdotes might not accurately represent reality. The teaser focuses on an adorable retriever, with an equally adorable and loving family. Supposedly condemned to death for some unspecified neurological disease by three different veterinarians, the dog is treated by one of the SuperVets with hyperbaric oxygen therapy, and the trailer ends by parading the apparently completely recovered patient before a live audience.
The producer describes this format as a “genre-defying show…staged before a live audience as well as in the field [that] uses real cases to educate viewers.” My understanding of the difference between education and propaganda is that the former includes a reasonably thorough and accurate presentation of information and the limits of our knowledge whereas the latter presents oversimplified narratives with only one possible interpretation. Apparently, the folks behind the show and I use the word “educate” differently.
Of course, there is nothing wrong with using anecdotes to illustrate an idea. It would be foolish to ignore the impact personal stories have on an audience. The trouble is when one uses anecdotes to prove something or to make a case for an idea that scientific evidence suggests is false. Since the show hasn’t been made yet, I can’t be certain that there won’t be thoughtful and informative information about the pros and cons of veterinary therapies, both conventional and alternative. But the teaser doesn’t give any indication this will be the case. And in the words of one of the SuperVets, “through modern veterinary medicine and emerging alternative therapies such as acupuncture and hyperbaric oxygen therapy, there are enough amazing recovery cases to present on the show for an indefinite period.”
I would certainly applaud an effort to show, in an enjoyable and compelling way, that veterinary medicine can be a sophisticated and successful enterprise. However, simply showing a series of supposed miraculous cures brought about by alternative medicine when conventional methods have failed or not been tried is purely propaganda, not education in any honest sense.
It isn’t that an entertaining and compelling show couldn’t be made about scientific medicine, complete with acknowledgement of its failures and limitations as well as its enormous success. Carl Sagan’s Cosmos is the paragon of moving, poetic depictions of legitimate science. And folks like Neil DeGrasse Tyson and Richard Dawkins are keeping alive the tradition of simultaneously accurate and beautiful depictions of science. Unfortunately, this project looks does not look to be in that vein. It appears instead to be a case of true believers in unconventional therapies cherry-picking and crafting supporting anecdotes to show a very skewed picture of alternative veterinary medicine. I guess we’ll know for sure if the project eventually makes it to television.