The scientific framework for the field of brain-body medicine is slowly but surely maturing. Yet the field remains mysterious enough that it carries a special attraction to the purveyors of unscientific complementary and alternative medicine otherwise known as woo. Recently Medscape reported on two well known speakers who addressed this topic at the annual session of the Heart Failure Society of America (note I didn't say scientific session). (“Brain-body medicine” seems to be a replacement for the old term “psychosomatic medicine” which nowadays is apparently too politically incorrect or not sexy enough).
Unfortunately the Heart Failure Society of America (HFSA) decided to offer a truly scientific treatment of the subject (Dr. Martin Samuels) alongside, in an apparent attempt to be “fair and balanced,” a woo based viewpoint (Dr. Deepak Chopra). If you're unfamiliar with these two speakers I have blogged about Dr. Samuels' work here. See here for a perspective on Dr. Chopra.
Dr. Samuels, whose major focus in this field is neurocardiology, has maintained the highest possible scientific standards for studying and teaching it. He has compiled extensive case studies (for obvious reasons population studies in this area are next to impossible and controlled experiments have ethical problems). Many of the lectures Dr. Samuels gives on this topic are entitled “Voodoo death.” I have heard him give this talk many times and from what I have observed Samuels' regard for scientific plausibility, thoroughness and rigorous scientific interpretation is impeccable.
To explain neurocardiology Samuels breaks the brain-body relationships down into their component parts. Some of these parts include the neuroanatomic circuitry, the neurochemistry, new information about the autonomic nervous system and even the unique histologic patterns in the heart. Some of these aspects have been characterized in exquisite detail.
Despite the fact that it would be impossible to understand brain-body relationships (or any other area of human biology for that matter) without examining component parts in detail, Dr. Chopra and other woosters dismissively swat this approach away, describing it by the simplistic use of the term reductionism.
Here's a sample of Dr. Chopra's remarks starting with the reductionism canard:
"The body is not a structure, but a process," he said. Second, "the mind is also a process." Last, the two are actually different aspects of one overarching system. "Your body's eating, breathing, digestion, metabolism, sensory experience, inner processing of thoughts, emotions, memories, and dreams--they are all a single process," according to Chopra. "As reductionist scientists, we try to separate these processes, but they are actually one...
"In Eastern wisdom traditions, unlike Western scientific reductionism, we look at the body as an integrated, holistic process, where everything is inseparably connected to everything else," he said.
This notion, that because medical science seeks to understand the human body at the level of its component parts it disregards patients as integrated organisms is one of the gigantic straw man arguments of modern medicine. The popularity of this patently absurd and empty position has always baffled me. I guess I shouldn't be surprised that the HFSA featured Dr. Chopra. It's just another example of how non-science based and implausible woo is metastasizing throughout medical schools, graduate medical education and the CME world, a trend now characterized by the term I originated a few years ago, quackademic medicine.
