CAM and credulity

I was asked by a friend to take a look at this paper which he was surprised to see in a science journal. It’s a weird and unconvincing paper, a Case report of instantaneous resolution of juvenile macular degeneration blindness after proximal intercessory prayer. It’s actually a case of rummaging around in old medical files in order to report a “miracle” in 1972.

Here’s the story: an 18 year old girl lost her vision in 1959 over the course of a few months, with no identified cause. She was diagnosed with 7/200 vision, attended a school for the blind, and lived as a blind person for 12 years. Then, even more suddenly, her vision recovered fully after her husband prayed for her.

When the couple went to bed later than normal (after midnight), her husband performed a hurried spiritual devotional practice (reading two Bible verses) and got on his knees to pray. She describes that they both began to cry as he began to pray, with a hand on her shoulder while she laid on the bed, and with great feeling and boldness he prayed: “Oh, God! You can restore […] eyesight tonight, Lord. I know You can do it! And I pray You will do it tonight.” At the close of the prayer, his wife opened her eyes and saw her husband kneeling in front of her, which was her first clear visual perception after almost 13 years of blindness.

An examination in 2001 revealed that she had 20/40 vision, and that her retinas looked normal.

I can’t debunk this account, if that’s what you’re looking for. I could speculate about possible ways the story is misleading us, but we know nothing about the causes of the blindness or its cure, we don’t even know that there was a physical basis for the blindness, and I’m not going to diagnose an old medical condition — that’s what the authors of the paper are doing. All we’ve got are old records, and modern evidence that she can see, and no way to trace the actual history of her vision. It’s an anecdote. Maybe she was actually cured by a miracle! Unfortunately, there’s no way to analyze what actually happened.

I’m skeptical that prayer is actually effective, though. This woman was devout, came from a very religious family and community, and you’re telling me that the onset of blindness did not trigger a flurry of intense prayers from the woman, her family, and her church? Was that the first time her husband begged his god to restore her sight? It’s awfully hard to believe that something that was certainly done to no effect for years can be assigned a causal role in her abrupt recovery. But OK, I just have to shrug and say that’s some story.

How did it get published in a science journal? Well, it’s not a science journal, for one thing. It got published in Explore.

EXPLORE: The Journal of Science & Healing addresses the scientific principles behind, and applications of, evidence-based healing practices from a wide variety of sources, including conventional, alternative, and cross-cultural medicine. It is an interdisciplinary journal that explores the healing arts, consciousness, spirituality, eco-environmental issues, and basic science as all these fields relate to health.

It’s one of those alternative journals with standards so wide open the editors’ brains have fallen out. I’ll also note that the paper concludes with an empty statement.

The PIP [proximal intercessory prayer] may have been associated with a response in the ANS [autonomic nervous system] of the patient. However, research on the potential for PIP to affect the ANS and/or reverse vision loss associated with JMD is limited. Findings from this report and others like it warrant investment in future research to ascertain whether and how PIP experiences may play a role in apparent spontaneous resolution of lifelong conditions having otherwise no prognosis of recovery.

“warrant investment in future research”…how? You’ve got one poorly understood, anecdotal observation, so how do you propose to do “research”? By gathering more anecdotal self-reports from believers in this phenomenon, and looking at more half-century old medical records? I’m also concerned that the authors now want to find people with “lifelong conditions having otherwise no prognosis of recovery” and tell them to pray for a cure. Most of those people will say they’ve already been praying for years, so…pray harder? Pray to the right god? Pray with the right magic words? It’s not as if they’ve identified a repeatable treatment or specific mechanism that they can test and refine.

I do note one admission that they authors make.

Prayer is one of the most common complementary and alternative medicine (CAM) therapies.

That’s a confession that most of CAM is useless.


  1. Matt G says

    People pray for healing all the time – it should be easy to design trials for it. Of course it might be unethical to withhold prayer, so run it by your institution’s ERB first.

  2. robro says

    Apparently, the writers believe that using three-letter acronyms (TLAs) makes something look sort of science-y and technical (SST).

  3. stuffin says

    Prayer is one of the most common complementary and alternative medicine (CAM) therapies.

    That’s a confession that most of CAM is useless.

    Only one miracle from all those prayer CAMs, statistics would suggest it wasn’t the prayers.

  4. says

    At the close of the prayer, his wife opened her eyes and saw her husband kneeling in front of her,

    Okay, so my first thought is that this woman simply had her eyes closed for 12 years. That’s probably too easy, though.

    Was that the first time her husband begged his god to restore her sight? It’s awfully hard to believe that something that was certainly done to no effect for years can be assigned a causal role in her abrupt recovery.

    It’s obvious. Heaven is six light years away, and prayer travels at the speed of light, as does God’s healing power.

  5. says

    Could be conversion disorder (DSM-5) formerly known as “hysterical blindness.” It’s when your psychological states tell your brain “you can’t see!” and it can’t. A psychlogical “miracle cure” might work for someone who is primed for it.

    [disclaimer: as far as I am concerned a lot of psychology may as well be religion]

  6. wzrd1 says

    Macular degeneration is a very specific medical condition with a rather large variety of potential causes. It’s also quite irreversible, save if one regrows the retina. Macular degeneration can be “diagnosed” (it’s a non-specific diagnosis, as a cause isn’t apparent with the initial testing) with pupil dilation, illumination of the retina and a magnifier. Most cases are caused by ischemia, well, all really. Wet macular degeneration being leaky abnormal blood vessels in the macular region of the retina, dry macular degeneration being associated with yellow deposits called drusen forming and the blood vessels becoming brittle and leaking.
    The only thing I’ve ever observed prayer successfully grow, at 100% efficacy and at six sigma certainty is boredom, although I suspect mold can grow at approximately the same rate on the proper culture medium.

    So, we have a rather specific medical condition, only 10% of cases being wet macular degeneration, causing rather significant and profound blindness, alas, without any medical documentation.
    That’s right up there with a case of profound deafness associated with the patient hearing unicorn flatus.
    Then, a prayer and 100% resolution occurred. So, she either instantaneously regrew her retina, the diagnosis was utterly incompetent and evidence free or she is one of those unique individuals, with a case number of precisely zero, who can see well without a retina.
    Yeah, let’s just stick both in the unicorn fart pile.

    Marcus Ranum, I fully concur with your disclaimer. Hence, the entirety of my concerns over EP, which PZ has quite well covered the unicorn fart evidence for.

    Lemme guess, the actual prayer was:
    Ooo eee, Ooo ah ah, ting tang
    Walla walla, bing bang
    Ooo eee, Ooo ah ah, ting tang
    Walla walla bing bang
    Ooo eee, Ooo ah ah, ting tang
    Walla walla, bing bang
    Ooo eee, Ooo ah ah, ting tang
    Walla walla bing bang

  7. strangerinastrangeland says

    I prefer to call it “So-called Complementary and Alternative Medicine” – leads to a much more appropriate abbreviation. :-)

  8. mordred says

    Every time I read about one of these singular anecdotes about healing through prayer, I remember the time when someone on the net claimed Oberammergau as a proof that prayer works.
    As the story goes, Oberammergau in Bavaria was hit badly by the plague in the 17th century, until the residents prayed to god and promised him they would stage a passion play every ten years if he spared the rest of the villagers. Immediately the deaths stopped and the plague never returned to the place.
    They still do the passion play every ten years.
    Ignoring for now that there are no contemporary sources for the legend, this happened during the 30 years war, when the plague was killing large parts of the populace all across Germany. I’m pretty sure people prayed and tried to cut deals with their god pretty much everywhere, including in the two villages that used to be west of here.
    That you got only one miracle to show for instead of, say, 70% of all cases is really not convincing.

    It’s the same with the handful of healing miracles, considering there are probably millions of people praying every day to different gods to help them with all kinds of medical problems.

  9. says

    Here’s a review article from BMJ:

    Visual complaints without evidence of contributory ocular or non-ocular pathology are not infrequent presentations to the general Accident and Emergency department, and are said to account for approximately 1% of visual problems seen by the ophthalmologist.1 The wide spectrum of terminology used to describe visual disturbance without a physical basis, which includes ‘functional’, ‘hysterical’ (amblyopia), ‘conversion disorder’, ‘neurotic’,2 ‘supratentorial’,2 and ‘psychosomatic’, has resulted in considerable confusion. In this review we use the term non-organic visual loss (NOVL) to describe any visual disturbance where there is no detectable dysfunction of structures between cornea and occipital cortex.

    NOVL may be psychogenic, or the result of malingering. Psychogenic visual complaints result from a disturbance of higher cortical structures occupied with visual awareness, and patients with this form of NOVL do experience but do not control their visual symptoms. The malingerer, on the other hand, deliberately feigns visual loss for secondary gain. The term ‘malingering’ is in many ways a moral accusation rather than a clinical diagnosis, and consequently should only be used with extreme caution. In the vast majority of cases the distinction between psychogenic visual complaints and malingering is not made, and the term non-organic visual loss is used.

  10. says

    Yeah, there are a lot of alternative explanations, as you’ve all mentioned. I’m reluctant to propose them because all the evidence we have is in that one paper, by authors who don’t seem eager to pursue any alternatives, and I don’t want to accuse the woman (of lying, or hysterical blindness, or NOVL, or whatever) because we don’t know and we don’t have a way to find out.
    That’s my complaint — the authors don’t have a way of knowing, either. It’s a bad paper.

  11. call me mark says

    Meh. I’d be impressed if someone’s amputated limb grew back because of prayer*. This? Not so much.

    *How would they tell it’s “because of” and not just “after”? A double-blind test? How would you do a placebo prayer for the control arm? I have so many questions.

  12. larpar says

    She would have to go blind and be cured again in order for the study to be double blind. : )

  13. lanir says

    I think a trial would be unethical (I know it wasn’t a serious suggestion). It would be fine all on its own but a lot of the religious assholes through the years have carefully promoted the idea that their gods don’t answer prayers if you don’t believe enough. To the extent that even without telling anyone who was part of your study that they didn’t get cured because they’re not good enough, you’d still be telling them they didn’t get cured because they’re not good enough.

  14. nomdeplume says

    Extraordinary claims and all that…

    No case of “healing by prayer” has ever been demonstrated (although there are probably placebo effects, as in homeopathy, a very similar medical treatment to prayer). So the proposition that this one old poorly documented case is the first demonstrated example should make the authors of this paper and the journal editor hang their heads in shame.

  15. nomdeplume says

    Forgot to add that I’ve never seen any explanation of HOW prayer is supposed to work. Nor of why some sky being would choose to, say, repair eyes rather than prevent someone going blind in the first place.

  16. birgerjohansson says

    Prayer? Well, there is the respected Pakistani documentary “International Guerrillay” where the muslim heroes pray, and a koran levitates and starts shooting lighning bolts at Salman Rushdie.

    Anyway, omniscience means Dog already knows people’s innermost desires so praying is unnecessary. Or should be unnecessary.

  17. wzrd1 says

    There is one area where meditation and prayer do show peer reviewed efficacy, both at equal levels and superior to placebo.
    When properly applied and guided, stress management. It distracts from fixating on the stressor, thereby alleviating some of the physiological issues caused by chronic stress.

  18. birgerjohansson says

    If the Eschaton manifested a big cube with text to announce his existence I would pray to him (it) to please smite those dangerously ignorant.

  19. says

    @23 Of course someone knowing that they are being prayed for (by themselves or others) undergoes physiological changes in their brain state.

  20. wzrd1 says

    @25, yes, but nowhere to the extent that one meditating would.
    After all, if an anvil is crushing your foot, you’ll get no relief from someone praying that it comes off of your foot. Only removing that anvil will do that and one would assume that you accomplished that one by yourself.

    Yes, I’ve unintentionally placed a heavy object onto my foot. I also promptly pulled it back off and set it down in a much more suitable location.

  21. says

    but nowhere to the extent that one meditating would

    Right, but that’s to the point about prayer. You’re one who brought in “meditation and prayer” as if they were in any way equivalent.

  22. wzrd1 says

    Jim, they are roughly equivalent in the effects on brain and physiological changes, for much the same reason.
    Magic doesn’t effect healing or balancing stress, for magic belongs in the realm of love poetry.