SPECIAL REPORT The Maharishi Caper: JAMA Hoodwinked (But Just for a While) = ANDREW SKOLNICK

rom time to time, even the most prestigious science journals publish erroneous or Ffraudulent data, unjustified conclusions, and sometimes balderdash. Balderdash was the right word when the Journal of the American I 1 Medical Association (JAMA) published the article "Maharishi Ayur-Veda: Modern Insights Into Ancient Medicine" in its May 22-29,1991, issue. JAMA published a Discovering that they had been deceived by the six-page expos4 article's authors, the editors published a correction in the August 14 issue, which was on the people followed on October 2 by a six-page expose on who had the people who had hoodwinked them. hoodwinked By reporting its mistake in this lengthy report and drawing the media's attention to it with them. a news release, JAMA made itself an easy target, even drawing some friendly fire from Physician's Weekly and Science. As the person who discovered JAMA's error and wrote the expose, I also think the journal deserves some praise. The Maharishi Ayur-Veda article was osten- sibly about the traditional healing system of India known as Ayurveda. It was published in JAMA's international health theme issue as a "Letter from New Delhi" outside the journal's "main well" for scientific papers. The authors— , M.D., president of the Amer- ican Association of Ayurvedic Medicine, Lan- caster, Massachusetts; Hari M. Sharma, M.D., professor of pathology at Ohio State University College of Medicine, Columbus; and Brihaspati Dev Triguna, an Ayurvedic practitioner in New Delhi, India—represented themselves as disin-

254 SKEPTICAL INQUIRER, Vol. 16 terested authorities and had signed a cation date, when hundreds of thou- statement that they were not affiliated sands of copies were already in the with any organization that could prof- mail. At the time, I didn't know it by the publication of their article. anything about Maharishi's medical (JAMA's conflict-of-interest policy claims, but I was aware that the TM requires authors of accepted manus- movement widely uses deception to cripts to declare all such connections.) promote its $3,000 courses in TM- Subsequent investigation showed Sidhi or "yogic flying." TM promoters they were intimately involved with the claim that, by mastering this tech- complex network of organizations that nique, people can develop the ability promote and sell the products and to walk through walls, make them- services about which they wrote. They selves invisible, develop the "strength misrepresented Maharishi Ayur-Veda of an elephant," reverse the aging as India's ancient system of healing, process, and fly through the air rather than what it is, a trademark line without the benefit of machines. of "alternative health" products and In addition, TM promoters claim services marketed since 1985 by the that by yogic flying in large groups , the Hindu they can prevent bad weather, traffic swami who founded the Transcenden- fatalities, and even war. Former tal Meditation (TM) movement. members of the movement say that Maharishi Mahesh Yogi began his the practice of TM-Sidhi involves rise to fame and great fortune in the repeating a series of Hindu mantras 1960s when rock group during meditation followed by several briefly joined his following of wor- minutes of hopping up and down in shipers. Today the guru rules an the cross-legged "lotus" position. empire estimated to be worth billions Adherents claim that they are not of dollars and has many thousands of hopping but levitating and that they devoted followers, some of whom are have hundreds of scientific studies to prominent in science, medicine, edu- prove it. cation, and the news, information, and I called Stephen Barrett, M.D., and and entertainment media. The TM William Jarvis, Ph.D., of the National movement is considered a religious Council Against Health Fraud and cult by a number of authorities. asked what information they had According to longtime watchers of the about Maharishi Ayur-Veda. What movement, Maharishi Ayur-Veda is they told me made it clear that JAMA the latest of the Maharishi's schemes had been duped. After poring through to boost the declining numbers of the promotional TM materials they people taking TM courses through sent and talking with several former which he recruits new members. The TMers, I reported my findings to movement also stands to reap millions George Lundberg, M.D., editor of of dollars through the sale of its herbal JAMA, and suggested that we expose remedies, oils, teas, aromas, healing the authors and the movement they gems, Hindu horoscopes, books, tapes, represent in a JAMA Medical News and numerous services that carry the & Perspectives story. I was given the Maharishi's name. assignment, which took me almost three months to complete. The result- Copies Already in the Mail ing article, "Maharishi Ayur-Veda: Guru's Marketing Scheme Promises I first saw the Maharishi Ayur-Veda World Eternal 'Perfect Health,' " was article four days prior to the publi- published on October 2.

Spring 1992 255 Unusually long for Medical News Maharishi Ayur-Veda and by provid- & Perspectives, the expose on the ing Maharishi Ayur-Veda treatments. marketing of Maharishi Ayur-Veda (According to David Perlman's documents a widespread pattern of October 2 San Francisco Chonicle misinformation, deception, and ma- article, Chopra claims he gives 50 nipulation of lay and scientific news percent to 70 percent of his fees to media. This campaign appears to be the movement.) He also did not report aimed at earning at least the look of that he had been the sole stockholder, scientific respectability for the TM president, treasurer, and clerk of movement, while boosting the sales Maharishi Ayur-Veda Products Inter- of their extremely lucrative products national, Inc. (MAPI), the sole distrib- and services. (One example is the utor of Maharishi Ayur-Veda prod- herbal elixir known as Maharishi ucts. Although he no longer holds Amrish Kalash, which costs $1,000 for these titles, Chopra still has the same a year's supply.) office address and phone number as Chopra says everyone should take MAPI. the cure/prevent-all twice a day. Chopra claims the Ayur-Veda health Peer Review Not Foolproof care is far more cost-effective than conventional medicine. However, the JAMA's publication of the Maharishi annual cost of just this one Maharishi Ayur-Veda article brought a hail of Ayur-Veda product is equivalent to 40 angry letters from readers (also percent of the average per-capita published in the October 2 issue) along expenditure on all health care in the with some snickers from other pub- in 1989. The other lications. In its November 11 issue, products and services he recommends Physician's Weekly published an just to maintain health would cost account of JAMA getting "flim- thousands of dollars more each year. flammed by a swami." The October However, this total pales compared 11 issue of Science knocked ]AMA for with the cost of Maharishi Ayur-Veda publishing "shoddy science" and treatments in case of actual illness, getting itself into an "Indian herbal which can exceed $10,000 for the jam." performance of a ceremony to appease Science writers know that the peer- the gods or for the purchase of Jyotish review system of scientific publica- gems to restore one's health. tions is not foolproof. Drummond Upon discovering the deception, Rennie, M.D., deputy editor (West) of JAMA requested from the authors a JAMA, has written: "There seems to full account of their connections to be no study too fragmented, no TM organizations. The confusing hypothesis too trivial, no literature too statement they provided was pub- biased or too egotistical, no design too lished as a financial disclosure correc- warped, no methodology too bungled, tion on August 14 and represents only no presentation of results too inaccu- what the authors admitted. While it rate, too obscure, and too contradic- appears to hold the record in terms tory, no analysis too self-serving, no of length for a financial disclosure argument too circular, no conclusions correction in the journal, the account too trifling or too unjustified, and no is still incomplete. Among other grammar and syntax too offensive for things, Chopra did not acknowledge a paper to end up in print." Peer review that he collects hundreds of thousands determines where rather than of dollars from his seminars on whether a paper should be published,

256 SKEPTICAL INQUIRER, Vol. 16 Rennie says. However, from time to and Natural Products Research at time, "shoddy science" ends up in the Ohio State University College of most prestigious of journals. Medicine. Others associated with It may be hard to understand how Chopra include Steele Belok, M.D., a system so effective in sifting out and Amy Silver, M.D., both clinical errors in experimental design, statis- instructors at Harvard Medical tical analyses, and faulty conclusions School; Agnes Lattimer, M.D., med- could fail to catch blatant deceit. ical director of Cook County Hospital However, errors are usually easier to in Chicago; Kelvin O. Lim, M.D., spot than outright deceit. Journals do assistant professor of psychiatry and not have the staff and resources to behavioral science, Stanford Univer- investigate contributing authors and sity School of Medicine; Barry Mar- must rely in large part on trust. morstein, M.D., associate professor, Obviously, failure to disclose their University of Washington School of conflicts of interest is a serious Medicine; S. M. Siram, M.D., director betrayal of that trust. of the Surgical Intensive Care Unit The editors who handled the and Trauma at Howard University Maharishi Ayur-Veda manuscript did School of Medicine. not know about the history of decep- With the help of such well-placed tion associated with the TM move- physicians and academicians, the TM ment, but they did know that two of movement has been able to project a the three authors had excellent med- respectable front in its scheme to ical and academic credentials. In market Maharishi Ayur-Veda. In June, addition, the authors were able to cite the American College of Preventive studies that were published in peer- Medicine accredited Maharishi Ayur- reviewed journals to support their Veda courses for continuing medical claims. (One study listed in their education for physicians, for the references was published in the Jour- second time. The National Cancer nal of Conflict Resolution [December Institute is currently funding 11 1988], a prestigious Yale University studies testing the anticancer poten- publication. This study purported to tial of the concoction of herbs and show that a group of yogic fliers in minerals called Maharishi Amrit Israel was able to reduce the level of Kalash—even though its exact com- violence in war-torn Lebanon.) They position has not been revealed. The also could point to the National National Institutes of Health allows Cancer Institute research grants its facilities to be used for monthly awarded Sharma and others to study introductory seminars on Maharishi the herbal elixir, Maharishi Amrit Ayur-Veda. And for years, U.S. col- Kalash. leges and universities have allowed their facilities to be used by the TM Few people are aware of how far movement to teach yogic flying. the TM movement has been able to penetrate the halls of medicine and academia. According to the letterhead JAMA's Goof Nor Unique for the American Association of Ayurvedic Medicine, its research The TM movement has an extremely council and advisory council include aggressive public-relations operation physicians at many prestigious med- with a remarkable record in getting ical schools and institutions. Sharma favorable reports in newspapers, is professor of pathology and director magazines, and the broadcast media. of the Division of Cancer Prevention Like mushrooms after a spring rain,

Spring 1992 257 articles on Chopra, TM, and the ers were not informed that the author Maharishi's medicines keep popping practices yogic flying. Lambert wrote up in places like the Boston Globe, the JAMA a letter protesting my inves- Wall Street Journal, the Washington tigation and accusing me of "sleazy" Post, and even American Medical News and "deceptive" behavior. This letter (also published by the American was one of many sent to protest my Medical Association). Favorable inquiries. Among them were repeated reviews of Chopra's books on Maha- requests from Chopra and his attor- rishi Ayur-Veda have appeared in ney that they be allowed to preview many leading medical journals. Joanne my article before publication, along Silberner, medical reporter for U.S. with warnings that they may sue if News and World Report, says that Dean defamed. Draznin, former director of public In the February 1984 NASW News- affairs for Maharishi Ayur-Veda, used letter, Patrick Young wrote: "Report- to call her about twice a month with ing any story that might prove another angle to pitch. embarrassing to a publication is filled In August, Johns Hopkins Magazine with delightful irony. Editors, writers, published an uncritical profile on and others who believe in and argue Nancy Lonsdorf, M.D., medical direc- the public's right to know suddenly tor of the Maharishi Ayur-Veda react as any good group of company Medical Center in Washington, D.C. executives, government bureaucrats, Lonsdorf is the physician who, in a or union officials would in a similar fund-raising letter distributed to situation. They draw up the wagons members of the TM community, is in a tight circle." described as having recommended an When I reported my findings to my $11,500 yagya for a patient with a editors, I feared that they too might serious health problem. The Mahari- choose to circle the wagons. Instead, shi's yagyas are Hindu ceremonies to they asked me to recount how the appease the gods and beseech their journal had been deceived and backed help for ailing followers. me against a stream of protests and Despite the extraordinary costs of threats from Maharishi's followers these ceremonies, patients do not take and attorneys. part or even get to see them per- formed. (Chopra and Lonsdorf both Postscript, January 1992 deny that they recommend yagyas. Chopra insists that yagyas are not part Since the publication of JAMA's of the Maharishi Ayur-Veda program. expose, life has been anything but Nevertheless, I have a copy of another blissful for the Maharishi. The patient's health analysis from Cho- General Medical Council of Great pra's center in Lancaster, Massachu- Britain found two TM physicians setts, that recommends the per- guilty of serious professional miscon- formance of not one but two different duct for promoting Maharishi Ayur- yagyas.) Veda remedies as a treatment for In its September/October 1989 AIDS and ordered that their names issue, Harvard Magazine published a be struck from Britain's registry of cover story on Chopra by associate physicians. (The physicians are appeal- editor Craig Lambert that touted the ing the ruling.) Maharishi has Maharishi's wares. Reprints of this announced he is abandoning his article were widely circulated by the operations in Washington, D.C, and TM movement. The magazine's read- has ordered his minions to retreat to

258 SKEPTICAL INQUIRER, Vol. 16 Fairfield, Iowa. been planning to give one-fourth of Dozens of print and electronic the country's land to the TM move- news media have carried stories about ment. He credits JAMA's expose, TM's deception and JAMA's coun- which was widely distributed through- terblast. That coverage continues out Zambia, for helping to discredit more than three months after pub- and defeat the strongman in the lication of the expose. October 31 election. He also reports As a result of information uncov- that Maharishi's emissaries quickly ered by JAMA's investigation, TM's fled the country following Kaunda's operations are being investigated by defeat. the U.S. Food and Drug Administra- tion, the House of Representatives Subcommittee on Long-Term Health Andrew Skolnick is associate editor for Care, and the National Institutes of the Journal of the American Medical Health. The most surprising result, Association's Medical News & Perspec- however, may be the end of Zambian tives Department. This article is reprinted President Kenneth Kaunda's 27-year by permission from the Fall 1991 rule. According to a member of the ScienceWriters, the newsletter of the anti-Kaunda coalition, the dictator had National Association of Science Writers.

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