"What's wrong with this picture?" That familiar refrain came to mind as I was reading the paragraph, in Dr. Isadore Rosenfeld's August 16, 1998, Parade  magazine article about acupuncture, in which he describes an extraordinary Chinese operation witnessed by him in the 1970s. That same question echoed upon my inspection of the accompanying picture -- a documentary photograph of that operation, taken by the author himself.

Dr. Rosenfeld, a cardiologist and professor of medicine, has appeared on national TV talk/interview shows since the 1960s, and has authored several books, including the 1996 best-selling Dr. Rosenfeld's Guide to Alternative Medicine.  Upon locating the book, I found a discussion of the operation in question on pages 30-32. My quotations herein are from the Parade  article, the book, and several e-mail communications to me from Rosenfeld.

Accompanied on his China trip by several other prominent American physicians (now deceased), the Rosenfeld party watched as a 28-year-old female patient was wheeled into an operating room at the University of Shanghai and prepped for heart surgery to repair her mitral valve. But in lieu of standard anesthesia, a practitioner placed "an acupuncture needle in her right earlobe" (per Parade), with an electrode attached to supply a mild electrical current.

Rosenfeld observed as "the surgeon . . . cut through the . . . breastbone with an electric buzzsaw [and] her chest was split in two [and] spread apart with a large clamp to expose the heart" (per his book). Rosenfeld shortly thereafter snapped the photograph that appears in Parade  (it was not used in the book). Because Rosenfeld had denied me permission to reprint his photograph in the articles I was planning to write for The Scientific Review of Alternative Medicine and Skeptical Inquirer, TBS Report's  Don Addis has faithfully reproduced its image (see above), which is rotated 90 degrees counterclockwise. *

Only the patient's face and incision are visible through the gaps in the surgical sheets. Let us assume, as the photo appears to indicate, that her head is essentially "face up" as opposed to being significantly rotated right or left. (Her eyes are focused to her left, as if she is attempting to observe the operation but cannot rotate her head.) Drawing a vertical line down the midline of her body, the operative field appears to be displaced far to the patient's left, rather than being centered where the breastbone and heart are situated. In fact, it appears so far to the left as to exist beyond the border of the patient's body (see 2nd sketch by Don Addis). There does not appear to be any appreciable distortion in the photo such as might be encountered from the use of a wide-angle lens.

Rosenfeld says that this apparent leftward displacement "must be due to the angle at which [the photo] was taken" (per e-mail to me). He teased me with the fact that one of the others present (Dr. Wilbur Gould, ENT) had also taken photos and that his widow " . . . no doubt has all his . . . pictures in her possession." But he would not assist me in contacting her to obtain the photographs for review, saying that he did not wish to "participate in your project to prove that my four colleagues and I did not see what we saw."

In addition to the photographic oddities, I asked Dr. Rosenfeld how such surgery could have been performed without artificial ventilation: With the chest split open as described, the negative pressure produced by chest-wall expansion could not be created, the lungs would collapse, and the patient asphyxiate. I pointed out other problems as well, which are explored in a more extensive article on this matter that I have co-authored with Dr. Wallace Sampson, tentatively planned for publication in the Fall/Winter 1999 issue of The Scientific Review of Alternative Medicine.

I suggested to Dr. Rosenfeld that his party may have been taken in by a hoax perpetrated for propaganda purposes -- a well-documented propensity of the Chinese during the Cold War. But Rosenfeld scoffed at the notion (as he does in his book), and suggested that I contact Dr. Michael DeBakey, one of the world's foremost cardiac surgeons, who "witnessed a similar procedure one year later [and] can explain your legitimate technical questions about ventilatory support. I spoke with him yesterday . . . " (per his e-mail). I asked Dr. Sampson to speak with DeBakey on our behalf, and the results of that interview were quite enlightening.

DeBakey informed Sampson that despite his conversation with Rosenfeld of just a few days earlier, he had neither read Rosenfeld's accounts of the operation nor seen his photograph, and he was thus unconversant with the precise details that were of concern to us. As for his own experience in China, DeBakey recalled that the mitral valve surgery that he had witnessed involved a patient who, it turned out, had been given pre-op medication intravenously prior to having the acupuncture administered. Additionally, DeBakey told Sampson that artificial ventilation had not been needed in the operation that he saw because it had been performed through an incision between two right ribs, thus sparing one (the left) lung. He added that, in his opinion, a midline, split-breastbone approach, such as described by Rosenfeld, would likely cause both lungs to collapse, just as we had suspected.

Before I knew of Dr. Sampson's own interest in this case, at about the time I was initiating my correspondence with Dr. Rosenfeld, Sampson had written to Parade  editor Larry Smith (Rosenfeld is the magazine's health editor), pointing out some of the incongruities noted herein (and others) and asking how he might assist Parade  in rectifying "the incorrect impressions given by the article." Sampson, a professor of medicine at Stanford University and editor in chief of The Scientific Review of Alternative Medicine,  did not receive the courtesy of a reply.

A few additional observations are in order with regard to the precision of Dr. Rosenfeld's recollections and his attention to detail in recounting them. He acknowledged to me that, not being a surgeon, he actually "did not pay any particular attention at the time to the surgical technique used." He says in his book (contrary to the Parade  version) that "needles" (plural) had been placed in the patient's "left" (not "right") earlobe. He explained to me that this "was a typo, which was not picked up since I did not use the photo" in the book. But the image was presumably indelibly imprinted in his mind. From the book: "I took a color photograph of that memorable scene: the open chest, the smiling patient, and the surgeon's hands holding her heart. I show it to anyone who scoffs at acupuncture." Yet, the photo clearly shows the surgeon's hands to the lower-left of the patient's heart -- hardly another "typo."

Toward the end of our correspondence, Dr. Rosenfeld told me that, in publicizing the China story, his motivation had simply been "to draw attention to the possible use of acupuncture to alleviate chronic pain and suffering. . . . I thought acupuncture was worth looking into. I still do, as does a panel convened recently by the NIH. . . . I continue to keep an open mind on the subject." While I expressed my appreciation of that position, I also conveyed my concern that many of Parade's  80-plus-million readers could easily have drawn a conclusion that Rosenfeld says he did not intend -- that acupuncture appears to possess mysterious and unexplained, perhaps even supernatural, anesthetic properties.

To this point about the important role that authorities such as Dr. Rosenfeld play in educating the American public on health-related issues, he replied, "As far as your fear that my readers will opt for acupuncture anesthesia during heart surgery, I think I can reassure you not to worry about it." Oh. Well, never mind, then.

==========

Notes:

A version of this article appeared in the July/August 1999 issue of Skeptical Inquirer.

* The relevant portion of Dr. Rosenfeld's Parade article, including the photo, can now be seen on Gary Posner's website by clicking here and following the links.

[Note: Immediately below is correspondence received by TBS Report's  editor from anthropologist William Lyon. Following that is a response by TBS Executive Council member Jim Lett, himself a published anthropology professor.]

Editor: I happened across your website and have read your articles on Noreen Renier. I am a senior professor of anthropology and have being doing research for the past 25 years with Native American shamans. Of course, as a trained anthropologist with years of solid field work, I am much more qualified than yourself to speak on what you so quaintly refer to in Western civilization as "paranormal" activity. To the Native Americans such powers were quite normal. Furthermore, having an undergraduate degree in mathematics, I can also tell you that the logic you display is quite faulty.

It has been long known by anthropologists that Native American shamans can easily locate lost bodies, lost items, etc., via their shamanic powers, and I have seen this demonstrated myself many times during my fieldwork. One need read very little of the literature on Native American shamanism to readily understand that locating lost items is a very minor activity of powerful shamans who can heal, etc. I have just published the Encyclopedia of Native American Shamanism  (listed on Amazon.com) that is full of documented accounts of all those things you claim human beings are incapable of doing.

I must tell you that anyone who comes to "test" the powers of Native American shamans ends up being the one who gets tested in the final outcome -- best read pages 112-118 in my book entitled Black Elk: The Sacred Ways of a Lakota  (Harper San Francisco, 1990). That is, if James Randi's "Challenge" is fraudulent in the heart of Randi and the shaman submits to testing, then Randi will indeed bring great misfortune upon himself for living such a lie. However, if such is the case then I suspect the shaman will really not want to be bothered with messing around with some dummy who's publicizing a fraudulent claim.

This spring, the particular shaman I have in mind for testing will be coming here for a visit. I will get back in touch with you then.

Dr. William S. Lyon
Center for Religious Studies, History Department
University of Missouri at Kansas City
wlyon@cctr.umkc.edu

Jim Lett's reply:

Dr. Lyon claims that his anthropological credentials make him especially qualified to evaluate the paranormal claims of the peoples he studies. He is mistaken. The question is not whether researchers have been trained in ethnographic fieldwork and ethnological analysis, but whether they are willing to rely exclusively upon scientific standards of evidential reasoning in evaluating such claims. Despite his anthropological experience, Dr. Lyon clearly indicates that he is not willing to make an exclusive commitment to the use of reason. Further, he seriously misrepresents the discipline of anthropology and its position on the myriad paranormal claims of cultures around the world.

Dr. Lyon says that "it has long been known by anthropologists that Native American shamans can easily locate lost bodies, lost items, etc., via their shamanic powers." If by "shamanic powers" Dr. Lyon means powers of observation and deduction coupled with a knowledge of local circumstances and a penchant for interviewing witnesses, then his statement is correct. On the other hand, if Dr. Lyon means to suggest that shamans possess such abilities as telepathy, clairvoyance, spirit communication, or other putatively paranormal powers, then his statement is completely false. Anthropological textbooks do not endorse the objective validity of paranormal beliefs; on the contrary, they attempt to explain how such beliefs can persist in particular cultural contexts despite their falsity. A very small minority of anthropologists share Dr. Lyon's belief in the reality of paranormal phenomena; the overwhelming majority recognize that no paranormal belief offered by any culture anywhere in the world at any time in history has ever withstood critical scrutiny. I discuss the anthropological perspective on paranormal phenomena in detail in my chapter entitled "Science, Religion, and Anthropology," which appears in the book Anthropology of Religion,  edited by Stephen Glazier (1997, Greenwood Press).

What anthropologists have long recognized is that shamans around the world employ a standard bag of illusionist's tricks to convince their clients of their paranormal abilities. Those tricks include sleight of hand, misdirection, ventriloquism, and the like, and they are richly documented in the anthropological record. Evidently Dr. Lyon has himself been duped by those shamanic performances, but most anthropologists do not share his gullibility. It is true that ethnographic researchers attempt to acquire an intimate familiarity with the beliefs of the cultures they study, and doing so frequently requires a temporary suspension of the researcher's own perspectives and convictions. In anthropology, we call this taking the emic  perspective. At the same time, however, most anthropologists insist that ethnological analyses demand standard units of comparison, and to do that researchers must appeal to concepts grounded in objective reality as revealed by scientific standards of evidential reasoning. We call that taking the etic  perspective. Whereas most anthropologists strive to incorporate both emic  and etic  perspectives in their research, Dr. Lyon has evidently opted for exclusive immersion in the emic  point of view. For a more detailed discussion of emics  and etics,  see my entry entitled "Emic/Etic Distinctions" in the Encyclopedia of Cultural Anthropology  (1996, Henry Holt and Company).

Anthropology is an exceptionally diverse discipline, and it includes a number of widely divergent theoretical perspectives. While many anthropologists consider themselves to be scientists, and ally themselves with researchers in the natural sciences, others consider themselves to be humanists, and ally themselves with scholars in the fine arts. Among that group of self-professed humanists, there are some anthropologists who explicitly reject the canons of scientific reasoning, and it is those anthropologists who are most likely to advocate belief in paranormal phenomena. Dr. Lyon's sympathies are apparently with this small but vocal group. I discuss the logical errors of their position in my article "Interpretive Anthropology, Metaphysics, and the Paranormal" which appeared in the Journal of Anthropological Research  in 1991. Readers interested in more information about the schism between scientific and humanistic anthropologists will find a detailed discussion of the topic in my recent book, Science, Reason, and Anthropology  (1997, Rowman and Littlefield).

Finally, I must say that I find Dr. Lyon's warning of potential "misfortune" for anyone who tests a shaman to be, frankly, silly. Neither James Randi nor any rational person has any reason whatsoever to be fearful of paranormal retribution from a disgruntled shaman. The burden of proof rests upon Dr. Lyon. If he knows shamans who can perform paranormal feats, let him produce them. I will be happy to be personally involved in the design and administration of the tests. I will reluctantly predict, however, that the tests will never take place. Dr. Lyon seems to be already constructing his multiple out when he suggests that "the shaman will really not want to be bothered with messing around with some dummy" who's interested in seeing an objective demonstration of shamanic powers. The real dummy, I believe, would be anyone who takes Dr. Lyon's claims at face value.

James W. Lett, Ph.D.
Professor of Anthropology
Indian River Community College
Fort Pierce, FL
jlett@ircc.cc.fl.us

[Editor's note: Jim Lett's "A Field Guide to Critical Thinking" appeared in the Winter 1989-90 Skeptical Inquirer  and in our Spring 1990 issue of TBS Report.  It was also republished in The Hundredth Monkey and Other Paradigms of the Paranormal  (Kendrick Frazier, editor, Prometheus Books, 1991).

TBS hopes to participate later this year in a scientific test of Dr. Lyon's shaman, possibly in conjunction with the James Randi Educational Foundation. Even if this test ultimately does not take place, we will extend to Dr. Lyon the opportunity to respond to Dr. Lett's analysis.]

On Feb. 6, TBS's Gary Posner and Glenn Thompson were among the invited guests at the Tampa home of researcher Marshall Payn to witness an anticipated demonstration of "psychokinesis" by "Katie" of Vero Beach. Katie, who appeared some years ago on Unsolved Mysteries,  was recently profiled in Vero Beach  magazine.

Katie's only "success" that evening involved causing a small polished stone to seemingly jump out of the body of another invited guest (who was receiving hands-on "healing") and fall to the floor. However, this feat was indistinguishable from simple sleight of hand. All three of her attempts at "psychokinesis" failed when she was not permitted to touch any of the objects (two sealed containers and Posner's car keys).

Posner and Thompson were later invited by a disappointed Payn to fly to Marathon (in the Keys) to observe another acquaintance, Joey Nuzum (profiled in the same article), demonstrate his own even more amazing "psychokinetic" powers on March 22 and 23. Anticipating comparable "success," both declined, although TBS remains available locally to witness any more such attempts.