“Detox” is obvious bullshit, but how well does Caulfield make the case?
Watching Timothy Caulfield braise his feet in a bucket of alarmingly brown “toxic” water is somewhat amusing; watching a nonchalant young woman sit and chat calmly with Caulfield with a tube up her butt as her liquefied feces stream through a clear viewing pipe in a large, technical-looking colonic lavage machine (warning sign: “Open Valve Slowly”) is . . . less so.
Timothy Caulfield’s 2017 Canadian series, A User’s Guide to Cheating Death, now streaming on Netflix, opens with an episode on “detox,” the pseudoscientific health fad that has earned billions by convincing the public that their bodies are pervaded by “toxins” (vaguely defined, or not at all), which have to be removed by any of a variety of medically dubious, sometimes dangerous, usually expensive, medicines, procedures, or health foods.
This episode sets the stage for the rest of the series: Caulfield approaches his subject with unmistakable skepticism, but from an informational, broad-brush perspective characteristic of the documentarian, rather than the polemicist. He interviews true believers, self-interested vendors, and alarmed scientific critics, assembling a panorama of viewpoints, but avoids staking out a clear perspective on the topic.
It quickly becomes apparent that, even on this topic, perhaps the quintessential example of organized medical-science fraud, Caulfield’s intention is to inform rather than persuade. For hardcore scientific skeptics, a more overt critical judgment may be desired, but Caulfield is an experienced media star and knows how to bring an audience along gently. In this and other episodes, he allows himself a bare two minutes at the end of the show to say what he really thinks, and even there he sometimes pulls punches.
Caulfield, director of the Health Law and Science Policy Group at the University of Alberta law school, is a prominent critic of health frauds and fads. He has written popular books focused on celebrity influence on the health-fad phenomenon (a topic that comes up repeatedly in User’s Guide), and another on the anti-vaccination trend. From his book Is Gwyneth Paltrow Wrong About Everything? and public presentations excoriating Deepak Chopra for his pseudoscientific medical gibberish, Caulfield has developed a reputation as a bulldog of quacks and quackery. But the User’s Guide series is not a debunking project, as such.
In the course of this first episode, we get to see Caulfield try a number of questionable fad therapies and “detox” treatments: tea, beer (“the best detox program!”), inversion boots (with a hilarious scene of Caulfield doing what looks like a wholly unsuccessful remake of the workout sequence from American Gigolo), magnets, infrared light, the “detox trampoline” (Caulfield boinging up and down on a tiny spring pad while leotard-clad women around him do intricate mid-air gymnastics), and a variety of cold-pressed juices. These different scenes provide a breadth of content, but they are also, in some cases, clearly intended to be entertaining – a smart choice for a TV show, but another example of underplaying the issues a more critical viewer might want to see explored in depth.
Caulfield interviews people who swear by each of the various therapies he reviews, as well as the vendors who promote and sell them. Invariably, the customers are bright and charming, and have a kind of self-confident satisfaction in their choices to, say, wear magnets on their face, or ingest huge quantities of grass and vegetable smoothies in place of a normal diet.
The adherents show very little interest in seeing their pet fads subjected to scientific validation. One “juicer” notes she is “interested in what science says, but also in what science isn’t saying,” by which she means that, because there are things science hasn’t investigated, she is entitled to believe that her unproven nutritional fad is useful. This is a literal example of Isaac Asimov’s characterization of democratic anti-intellectualism as “my ignorance is just as good as your knowledge,” but Caulfield doesn’t challenge her on it.
He also doesn’t challenge the purveyors of these strange and often ridiculous fad therapies. He politely listens to the leader of the “detox trampoline” session explain that jumping on a trampoline “opens and closes the valves in your lymphatic system,” with a long, detailed, and idiotic explanation of how that happens and how it moves “toxins” out of your body. (He does comment in a separate scene that this isn’t true, but he doesn’t say that to the woman who is, while he is talking to her, earning money from an eager class of jumping detoxers.) At one point Caulfield offers the neutral suggestion that jumping on a trampoline might just be good exercise, an idea which she predictably rejects.
The only place Caulfield really brings scientific rigor into play involves the “ionic footbath”: immersing his feet in a saltwater bath to which some kind of electrodes are connected, the bath slowly turns darker and darker brown, which he is assured is from the “toxins” being leached out into the water from ailing parts of his body. (“I’m told this is a kidney-ish color; maybe some joint involvement.”)
Director of the McGill University Office for Science and Society Joe Schwarcz, who has a doctorate in chemistry, calmly explains this is simple high-school chem-lab electrolysis — the saltwater conducts electricity, and one of the electrodes in the bath is made of iron, which is dissolved into the water by galvanic action, turning the water brown. Caulfield tests it by buying his own ionic footbath machine and letting it run in a bare tub of water, without putting his feet in. Sure enough, the water turns the same shade of brown as before, proving that the “toxins” did not come from his feet. Caulfield concludes in uncharacteristically strong terms, “This is total BS! This is ultimately nothing but a marketing scam!”
Sadly, this is the only empirical experimentation in the episode, though Caulfield does bring in other critical views in some places. Regarding the phenomenon of people paying to have non-medical-professionals perform invasive anal procedures involving pressurized water, gynecologist Jennifer Gunter has a salient comment: “Don’t let anyone do that!” Caulfield and Gunter bond over their common nemesis, Gwyneth Paltrow and her signature, widely-mocked, utterly bewildering procedure for “steaming your vagina.” Gunter pulls out a fluffy, stuffed vulva to show how vaginal steaming is neither plausible nor safe, and comments on the advisability of crouching naked with your labia just above a pot of boiling water.
By the end of the fast-paced, 45-minute show, Caulfield has thoroughly illustrated that for all the billions of dollars spent on “detoxification,” there is no actual definition of “toxin” used by that industry, only a vague sense that there are “bad things” in our bodies, it’s necessary to get them out, and that somehow some “good thing” (a natural food, a rare herb, a mysterious physical procedure) will do it. Such critical perspectives are doled out at intervals, but there are only hints of an overarching scientific framework to put this all in, with no clear statement about why the scientific procedure is used to validate health diagnosis and treatments, or how it does so.
At the very end of the episode, Caulfield does take a stand. He lets religion professor Alan Levinovitz make the most thoughtful and searching comment:
You don’t want to have to look out at, and live in, a world that’s fundamentally unclean and threatening, and that’s the kind of world that you almost ritually create through the detoxification ritual.
“Bottom line: detoxification is a science-free health trend driven by marketing, misinformation, and fear-mongering,” Caulfield concludes. “Just stop!”
The material leading up to this moment of scientific and moral clarity is interesting, funny, and informative, but more illustrative than persuasive. Scientifically literate or skeptical viewers will have no trouble following Caulfield to his conclusion, but his bending-over-backwards neutrality may end up giving the more credulous the excuse they need to leave their own beliefs unchallenged.
A User’s Guide to Cheating Death looks as if it will be an interesting review of many forms of elective health fads, with enough encouragement of critical thinking to keep from being a sell-out, but if you took the last two minutes off of this first episode, it might be difficult to tell which side of the issue it’s serving.