Nelson Mandela: A life in pictures
Nelson Mandela and his wife Winnie in this undated file picture.
The value of public television consists in its independent and often farsighted advocacy for ideas and information that elevate the public consciousness, lighten the heart and inspire the mind. Dr. Robert Burton’s Salon article, “PBS’s latest infomercial,” does a disservice by discrediting public television while ignoring shifts in scientific research on systems biology and medicine that hold the promise of solving the puzzle of chronic disease and relieving suffering for millions.
All new ideas encounter challenge and opposition. As Einstein astutely noted, “Great spirits often encounter violent opposition from mediocre minds.” Paradigms don’t shift quietly in the night. A true scientist seeks to understand and inquire into the nature of phenomena. Unfortunately, Dr. Burton seeks to discredit and destroy without an attempt to understand.
Dr. Burton is steeped in 20th-century ideas of reductionist medicine — concepts that no longer represent the fundamental understanding of biological laws and principles emerging in the genomic era. Rather than just describe the phenomena we observe and call by the name of disease, we are able to reframe what we see by mechanisms and cause, not symptoms. The separate specialty disciplines such as neurology or psychiatry describe and treat disease based on disease categories that are no longer relevant as we understand the underlying mechanisms and causes of those diseases.
As the director of the National Institutes of Mental Health, Thomas Insel, M.D., said to me, the “DMS IV” (the psychiatric diagnostic bible) has 100 percent accuracy but 0 percent validity. What he means is simple — the names we have for diseases help us describe groups of people with common symptoms, but tell us nothing about the fundamental mechanisms of, causes of or right treatments for those “diseases.”
Clearly I recognize the magnitude of suffering from mental illness, cognitive and behavioral problems and the burden suffered by so many. That is why I wrote “The UltraMind Solution” and created the companion public television special, to bring forth emerging science in a way that can be understood and acted upon by the public at large. Every statement or claim in the book (and the public television special) is supported by numerous scientific references (attached here).
Through explaining the new paradigm or model of systems medicine in lay terms, I sought to empower individuals to take advantage of emerging science to address the fundamental causes of their suffering. The role of lifestyle, nutrition and environmental toxins on mood and cognitive disorders is undisputed and overwhelming.
The concepts and science outlined in the show and the book are founded in research being done at the National Institutes of Health’s New Road Map Initiative on Systems Medicine, and were recently the topic for a summit of 600 leaders, scientists and educators in this field at the Institute of Medicine held at the National Academy of Sciences. I also recently was invited to testify on functional medicine (Applied Clinical Systems Medicine) before the Senate working group on healthcare reform and met with key officials in the White House. We are beginning a major research program in this field at one of the world’s leading medical institutions, the details of which will be finalized and announced within the next few months.
Rather than disregard present medical knowledge and research, as Dr. Burton suggests I do in my work, I seek to bring it front and center, not “cherry-pick” the research. Across every medical discipline and specialty, the role of inflammation is clear and beyond dispute. Cardiovascular disease, cancer, obesity, osteoporosis, depression, Alzheimer’s and autism as well as asthma, allergies and autoimmune disease are among the many chronic diseases linked by common underlying mechanisms including inflammation. The data is overwhelming. Unfortunately the “mainstream medical wisdom” that Dr. Burton seeks to protect often no longer reflects the emerging science. Clearly Dr. Burton has not reviewed the nearly 500 scientific references (quite a lot of cherries) in my book that link a few underlying mechanisms to nearly all chronic diseases.
He also seeks to distort and discredit scientific information. Dr. Martha Herbert has demonstrated larger brains of autistic children on MRIs and has linked those to inflammatory changes documented by Dr. Vargas. She is a personal colleague, friend and research collaborator. Her work overwhelmingly has linked immune dysfunction and inflammation to the enlarged brains of autistic children.
Note to Dr. Burton: Immune dysfunction, and diffuse inflammation in the brains of autistic children, is the cause of the swollen brains.
Confusingly, Dr. Burton contradicts himself, simply pointing out that there appears to be inflammation in brains of autistic children but not signs of inflammation in the circulation, so the brain inflammation is therefore irrelevant. That is certainly not the conclusion of Dr. Vargas. In her landmark paper, “Neuroglial activation and neuroinflammation in the brain of patients with autism,” she says:
We demonstrate an active neuroinflammatory process in the cerebral cortex, white matter, and notably in cerebellum of autistic patients. Spinal fluid (CSF) showed a unique proinflammatory profile of cytokines [inflammatory proteins] … Our findings indicate that innate neuroimmune reactions play a pathogenic role in an undefined proportion of autistic patients.
Note to Dr. Burton: Pathogenic (disease causing) role, not “association,” is what the research findings of Dr. Vargas shows.
In a surprising distortion of the basic thesis of systems biology, Dr. Burton suggests I say that inflammation is the cause of dementia, depression or autism. I never state that inflammation is the “cause” but the mechanism common to so many chronic diseases. The causes are myriad, including poor diet high in sugar and trans fats and processed foods, infections, allergens, toxins and stress. Those create disease and pathology through the mechanism of inflammation. Addressing those causes and modulating inflammation through diet, lifestyle and environmental modifications is how the doctors of the future will practice medicine. Hopefully the future will not be too far off. This is the model of science and medicine that is the foundation of the show, my book and the field of functional medicine. But what is functional medicine?
Functional medicine is not a unique and separate body of knowledge, but it does represent a different way of applying the scientific and clinical information that emerges from the research literature and from the clinical practices of many disciplines. It is a way of thinking about disease based on how all the body’s systems work together. It helps doctors find the cause and understand the mechanism instead of just treat symptoms while the underlying disease process continues.
Change does not come easy, and will certainly incite ardent detractors. It may be helpful to remember Schopenhauer’s words: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”
I am grateful for public television’s courageous stand for what is right, however difficult that may be.
Robert Burton responds here.
Nelson Mandela and his wife Winnie in this undated file picture.
Mandela is accompanied by his former wife Winnie, moments after his release from prison February 11, 1990 after serving 27 years in jail. (Reuters)
In this February, 1990 photo, shortly after his release from 27 years in prison, Nelson Mandela, gives the black power salute to the 120,000 supporters packing Soccer City stadium in Soweto, near Johannesburg. (AP Photo)
Nelson Mandela showed his passport in February 19, 1990, shortly after his release from prison. The South African government authorized an application for himself and his wife Winnie - (Juda Ngwenya / Reuters)
In this July 27, 1991 photo, Cuban President Fidel Castro, and Nelson Mandela gesture during the celebration of the "Day of the Revolution" in Matanzas, Cuba. (AP Photo)
In this July 4, 1993 photo, President Bill Clinton and Nelson Mandela listen during Fourth of July ceremonies in Philadelphia during which Clinton presented the Philadelphia Liberty Medal to the African National Congress president and South African President F.W. de Klerk. (AP Photo/Greg Gibson)
President of the African National Congress Nelson Mandela acknowledges cheers from the crowd as he prepares to unveil the ANC's official election platform in 1994. (AP Photo/David Brauchli)
African National Congress (ANC) leader Nelson Mandela greeted residents of Mmabatho in March 1994, during a visit after the nominal homeland came under South African control following the ousting of the former President Lucas Mangope. (Reuters/Howard Burditt)
South African President Nelson Mandela smiles with actor Sidney Poitier at a press conference in Cape Town in 1996. Poitier played Mandela in the film "One Man, One Vote" (AP Photo / Sasa Kralj)
South African President Nelson Mandela waves to crowds as he sits next to Queen Elizabeth II in a an open carriage on the way to Buckingham Palace.(AP/Louisa Buller)
Chairman of the Constitutional Assembly Cyril Ramaphosa, left, holds up a copy of the country's constitution which was signed by President Nelson Mandela, in December 1996. (AP Photo / Adil Bradlow / POOL)
Nelson Mandela at a news conference in Johannesburg in February 2000. (AP Photo / Denis Farrell)
South African rugby captain Francois Pienaar, right, received the Rugby World Cup trophy from President Nelson Mandela also wearing a South African rugby shirt, after South Africa defeated New Zealand in the Rugby World Cup , in 1995. (AP Photo / Ross Setford)