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Authors: Dr Paul Offit

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Kelley used McQueen's celebrity to promote laetrile. Appearing on the national television show
Tomorrow
, hosted by Tom Snyder, he said, “Those doctors gave him no hope. But his chances are excellent. I believe with all my heart that this approach represents the future of cancer therapy. It took Winston Churchill”—one of the first people to be treated with antibiotics—“to popularize antibiotic medicine. Steve McQueen will do the same for metabolic therapy.” McQueen
echoed Kelley's enthusiasm; appearing on Mexican television, he said, “Mexico is showing the world this new way of fighting cancer through nonspecific metabolic therapy. Thank you for saving my life. God bless you all.”

The John Birch Society's manipulation of the media and the celebrated case of Steve McQueen influenced public opinion. Laetrile had moved into the mainstream. On December 14, 1978, the Saratoga County Department of Social Services appealed Judge Brown's ruling of six months earlier. The case went before Judge Sweeney of New York's Third District Court of Appeals, who reaffirmed the earlier decision: “We are of the view that there is ample proof to support the findings and determination of [Judge Brown's] trial court.”

Joey Hofbauer would continue to be treated by Michael Schachter.

T
he Saratoga County Department of Social Services still had one more appeal—one more chance to save Joey Hofbauer's life. The decision would be made on July 10, 1979. Fortunately for Joey Hofbauer, several events had been set in motion that would soon reduce the public's desire for laetrile. But Joey was getting sicker; the clock was ticking.

On May 26, 1977, Franz Ingelfinger, the distinguished editor of the
New England Journal of Medicine
, published an editorial titled “Laetrilomania.” Ingelfinger wrote, “As a cancer patient myself, I would not take Laetrile under any circumstances. If any members of my family had cancer, I would counsel them against it. If I were still in practice, I would not recommend it to my patients.” Despite his personal feelings, Ingelfinger
suggested a definitive study—one that would settle the argument once and for all. In December 1979, the FDA granted an “investigational new drug” license for laetrile, opening the door for a study. This was the first time in the history of the United States that the FDA had approved human testing of a cancer drug that had never been shown to work in experimental animals.

While researchers were designing Ingelfinger's laetrile study, other events were working on Joey's behalf. In July 1977, Senator Edward Kennedy of Massachusetts held a hearing to discuss the value of laetrile. Testifying in favor of the drug were San Francisco physician and laetrile proponent John Richardson, John Bircher Robert Bradford, and laetrile inventor Ernest Krebs Jr. Kennedy didn't buy it, saying, “There isn't a scintilla of evidence that [laetrile] provides any sense of hope in curing or preventing cancer.” During the hearing, representative Terrence McCarthy of Massachusetts was less politic. “The people selling laetrile are crooks, liars, and thieves,” he said.

Unfortunately, clear statements by the editor of the
New England Journal of Medicine
and Senator Edward Kennedy didn't convince the courts that Joey Hofbauer had received inadequate care. On July 10, 1979, in response to the Saratoga County Department of Social Services' final appeal, Judge Jasen ruled that he was “unable to conclude, as a matter of law, that Joseph's parents [had] not undertaken reasonable efforts to ensure that acceptable medical treatment is being provided their child.” It was Joey Hofbauer's last chance to receive the radiation and chemotherapy he needed. Jasen still considered laetrile, coffee enemas, pancreatic enzymes, and a “vaccine”
made from bacteria in Joey's urine to be “acceptable medical treatment.”

O
n July 10, 1980, ten-year-old Joey Hofbauer died of Hodgkin's disease, his lungs riddled with cancer. Although Michael Schachter acknowledged that Hodgkin's disease had killed Joey, he claimed partial success. “Most of the body was either free of Hodgkin's or minimally involved,” he said.

Four months later, America's most celebrated standard-bearer for laetrile, Steve McQueen, also died. After McQueen's appearance on Mexican television, Cliff Coleman, a longtime friend, had paid him a visit. “I walked over and there was this skinny old man,” recalled Coleman. “No more than a skeleton with dark eyes and a matted beard, sitting swallowed up in an armchair.” McQueen told Coleman, “I can't take it anymore.” One month later, McQueen was taken to a medical clinic in El Paso, Texas, where tests showed that cancer had spread from his lungs to his abdomen, liver, and pelvis. Within a few days, on November 7, 1980, during surgery to remove a massive abdominal tumor, Steve McQueen died of a heart attack.

One year after the deaths of Joey Hofbauer and Steve McQueen, cancer specialist Charles Moertel, of the Mayo Clinic in Rochester, Minnesota, led research teams at UCLA, the University of Arizona, and the Memorial Sloan-Kettering Cancer Center, in New York, in the clinical trial proposed by Franz Ingelfinger. They treated 178 cancer victims with laetrile and high doses of vitamins, finding that the combination didn't cure, improve, or stabilize cancers. “Patients died rapidly, with a median survival of only 4.8 months,” they wrote. “It must
be concluded that Laetrile [is] of no substantive value in the treatment of cancers. Further investigation or clinical use of such therapy is not justified.” Researchers also found that several patients had suffered symptoms of cyanide poisoning from laetrile. Within a year of the publication, laetrile sales dropped dramatically. In 1987, the FDA banned the sale of laetrile. (It can still be obtained from clinics in Mexico or illegally from the Internet. In recent years, more websites have appeared promoting the drug.)

I
n retrospect, the last best chance to save Joey Hofbauer had occurred in one court and one court only: Judge Loren Brown's family court. This was the only time that cancer specialists had testified. Lawyers working on behalf of Joey had done their homework. The doctors and scientists presented by the state had published hundreds of papers, written book chapters on Hodgkin's disease, chaired professional societies, headed research teams showing the value of radiation and chemotherapy, performed studies in experimental animals showing that laetrile didn't work and was dangerous, or headed the FDA's section on cancer treatments. They were, in short, the brightest, most accomplished members of their field.

The doctors and scientists offered by the Hofbauers also shared several characteristics: none were board-certified in oncology, hematology, or toxicology; none had ever published a paper in a medical journal; none had shown any reasonable evidence that their therapies worked; and most didn't even have hospital privileges. That Brown could rule in favor of the Hofbauers' choice to deny their son a proven, effective therapy is
unconscionable. But an explanation can be found in the record of the trial. In the section titled “Findings of Fact and Conclusion of Law,” Brown wrote, “This court finds that metabolic therapy has a place in our society, and, hopefully, its proponents are on the first rung of a ladder that will rid us of all forms of cancer.” Brown believed that his small family court in Saratoga County had witnessed a miracle—a breakthrough that would soon turn cancer therapy on its ear. To Judge Brown, the notion that laetrile and coffee enemas could treat Joey Hofbauer wasn't a matter of opinion; it was a “Finding of Fact.”

T
here was another force working against Joey Hofbauer in Judge Brown's courtroom that day—a force far more powerful than clinicians like Michael Schachter or laetrile promoters like Ernest Krebs Jr. or ideologues like Robert Bradford. It was revealed during an exchange between the Hofbauers' lawyer, Kirkpatrick Dilling, and Victor Herbert, a cancer specialist. Dilling was questioning Herbert about the value of bonemeal.

D
ILLING
: Calcium, is that an essential nutrient?

H
ERBERT
: Yes.

D
ILLING
: Are you familiar with the fact that bonemeal is very high in calcium?

H
ERBERT
: I'm familiar with the fact that bonemeal is a dangerous quack remedy because of its lead content and people have died from being given bonemeal instead of calcium properly in milk and milk products.

D
ILLING
: Isn't bonemeal widely available?

H
ERBERT
: Certainly is, your organization pushes it.

Dilling froze. His organization? Herbert had revealed something that wasn't evident to most in the courtroom that day—exactly who was paying for the Hofbauers' defense. Recovering, Dilling went on the offensive. “I want to state for the record,” he said, “that I'm proud to represent the National Health Federation and I would appreciate it if the witness would keep his views to himself.”

The National Health Federation (NHF) is an organization that represents the financial interests of the alternative medicine industry. At the time of Joey's trial, these therapies had become quite lucrative. Kirkpatrick Dilling was general counsel to the NHF. Against these powerful financial interests, Joey Hofbauer didn't have a chance.

Michael Schachter was never held accountable for his treatment of Joey Hofbauer. On the contrary, since Joey's death Schachter has thrived, directing the Schachter Center for Complementary Medicine, in Suffern, New York. In 2010, a promotional brochure claimed he “has successfully treated thousands of patients using orthomolecular psychiatry, nutritional medicine, chelation therapy for cardiovascular disease, and alternative cancer therapies.”

J
oey Hofbauer's story, while extreme, contains much of what attracts people to alternative therapies today: a heartfelt distrust of modern medicine (John and Mary Hofbauer didn't believe the advice of hematologists and oncologists); the notion that large doses of vitamins mean better health (Joey was given massive doses of vitamin A, which was likely to have been to his detriment); the belief that natural products are safer than
conventional therapies (the Hofbauers preferred laetrile, pancreatic enzymes, coffee enemas, and raw liver juice to radiation and chemotherapy); the lure of healers whose charisma masks their lack of expertise (Michael Schachter, a psychiatrist, convinced the Hofbauers he could cure their son, even though he had no expertise treating cancer); the power of celebrity endorsements (Steve McQueen was one of the most popular movie stars of his day); and, perhaps most of all, the unseen influence of a lucrative business (Kirkpatrick Dilling's NHF, still active today, is one of many lobbying groups that have influenced Congress to offer special protections to the fourteen hundred companies that manufacture alternative remedies in the United States).

Part I
DISTRUST OF MODERN MEDICINE
1
Rediscovering the Past: Mehmet Oz and His Superstars

Oh, no, my dear; I'm really a very good man, but I'm a very bad Wizard.

—
The Wizard of Oz

F
ew celebrities are more recognizable than Oprah Winfrey. At the height of her syndicated talk show, which attracted more than 40 million viewers a week, Oprah launched the career of a man who would soon become America's most recognized promoter of alternative medicine: Mehmet Oz, star of
The Dr. Oz Show
.

Like Winfrey's, Oz's show is also popular—more than 4 million people watch it every day. It's not hard to figure out why. It's the same reason that John and Mary Hofbauer were attracted to Michael Schachter, or Steve McQueen to William Kelley. Oz believes that modern medicine isn't always to be
trusted—that we should retreat to an age when healing was more natural, less cluttered with man-made technologies.

O
n the surface, Mehmet Oz would seem to be the last person to argue against modern medicine.

After graduating from Harvard University, the University of Pennsylvania School of Medicine, and the Wharton School, Oz climbed the ranks at Columbia University Medical Center to become a full professor in cardiovascular surgery. He performs as many as 250 operations a year and has authored 400 medical papers and book chapters. Six of his books have been on the
New York Times
best-seller list. Oz was voted one of
Time
magazine's 100 Most Influential People, the World Economic Forum's Global Leader of Tomorrow, Harvard University's 100 Most Influential Alumni,
Esquire
's Best and Brightest, and
Healthy Living
's Healer of the Millennium. He's not just famous; he's a brand (“America's Doctor”).

Certainly, no one appreciates the advances of modern medicine more than Mehmet Oz. He's a heart surgeon. He holds people's hearts in his hands and fixes them. Oz couldn't do this without anesthesia, antibiotics, sterile technique, and heart-lung machines. But there was one moment when it became clear that Mehmet Oz wasn't a typical heart surgeon. During an operation, “Oz jumped up on a standing stool, peered into the patient's chest, and said, ‘I knew we should have used subliminal tapes.'” Oz believed that surgery wasn't enough—success also depended on tapping into his patient's subconscious. Watching this scene was Jery Whitworth, a nurse who operated the heart-lung machine. Whitworth shared Oz's love of alternative
therapies. “After a few minutes we stopped,” recalled Whitworth, “because the operating room was totally quiet,” stunned into silence. Oz, Whitworth, and a group of believers later met secretly to discuss what would eventually become Columbia's Cardiovascular Institute and Complementary Medicine Program. “If the higher-ups had known about these meetings,” recalled Whitworth, “they would have disbanded us.”

Oz has used his show to promote alternative therapies ranging from naturopathy, homeopathy, acupuncture, therapeutic touch, faith healing, and chiropractic manipulations to communicating with the dead. To understand where Mehmet Oz is coming from, we need to understand where medicine has been.

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