|Volume 8 Number 4||www.ntskeptics.org||April 1994|
By Tim Gorski, M.D
Part One of Two Parts
It's time — well past time, actually — to address what is certainly the most successful and widespread form of medical quackery in America: the pseudoscience of chiropractic.
"Chiropractic" literally means "done by hand," and is said to have been discovered by grocer and "magnetic healer" Daniel David Palmer in 1895 when he cured a janitor of deafness by "adjusting" a bump on his spine. Palmer supposed that he had somehow released pressure on a nerve that went to the man's ear. Palmer went on to conclude that all diseases have a similar cause: that of dislocated bones ("subluxations") interfering with the body's nervous system through which "Innate Intelligence" flows.
In fact, it appears that not only did D.D. Palmer have a faulty understanding of anatomy, but he borrowed a number of his ideas from his contemporary Andrew Taylor Still, the founder of osteopathic medicine. But whereas Still's teachings were from the first commingled with what was then the beginnings of medical science (see The Skeptic, March 1993 article on Osteopathy), Palmer went his own way, opening his own Palmer School of Chiropractic a few months after his alleged "discovery."
The most accomplished of D.D. Palmer's students was his own son, B.J. Palmer, who bought the school from his father after D.D. was jailed for practicing medicine without a license. B.J. Palmer made the enterprise a great success, boasting that he had discovered that nothing could match the spine at "supporting the chiropractor!" Many of his graduates went on to start their own schools, some of which conducted classes by mail, and which typically had no prerequisites other than cash payment.
Because of political pressure, and perhaps in the hopes of fostering better standards of training and practice, the states began to license chiropractors in the early years of the century, a process which was completed when Louisiana finally did so in 1974. These licensing laws permit chiropractors to do the one thing of which chiropractic treatment consists: to "adjust" the human spine.
Meanwhile, the advance of medical science decimated the entire premise on which chiropractic was founded. Edmund S. Crelin, Ph.D., for example, an anatomist at the Yale University School of Medicine, took the trouble to dissect out the spines of three adults and three infants shortly after they had died, placed them in a drill press, and exerted various amounts of measured force. As reported in his 1973 paper (American Scientist 61:574-580), in every case he was unable to demonstrate any "pinching" of nerves without actually breaking the spine. The only response from a chiropractor was that the test was not valid because it didn't involve living subjects, a criticism which is self-defeating because living subjects do not readily tolerate excessive applications of force and tend to resist them with muscular contractions.
Most chiropractors take X-rays of their patients, saying that these tests help them identify the dislocated bones of the chiropractic "subluxation." But chiropractors themselves cannot agree about what "subluxations" are and whether and how they can be identified on X-rays. During the early 1960s, the National Association of Letter Carriers Health Plan paid for chiropractic care and received numerous claims for the treatment of cancer, heart disease, and other medical disorders. In 1964, a request for X-ray documentation of spinal problems for these claims brought hundreds of films, not one of which could be shown to demonstrate a "subluxation" when examined by chiropractic reviewers.
In 1986, a report from the U.S. Department of Health and Human Services Office of the Inspector General showed that little had changed. 84% of 145 chiropractors surveyed by telephone said that some "subluxations" are not visible on X-ray but nearly half said that they "could always find something" when billing Medicare. The report noted that Medicare payments to correct chiropractic "subluxations" had grown at a rate of 18.7% since 1975 and by 1983 such manipulation was the ninth most frequently billed procedure under Medicare. In 1990 Medicare paid $181 million for the chiropractic adjustment of these bony displacements of the spine called "subluxations" that are not demonstrable on X-rays.
At the same time, there has come to be a recognition that there is a limited role for physical methods, including spinal manipulation in the management of certain musculoskeletal conditions. The existence of hospital physical therapy units, the ancillary medical profession of physical therapists, and even the medical specialty of physical medicine and physiatrists attest to this.
The result is that today most chiropractors have become isolated by their continuing to harbor and promote the belief that their profession offers a more-or-less complete solution to the problems of human health and disease which offers an "alternative" to that of mainstream medicine. Polls show that a majority of chiropractors believe that Palmer's theory of "subluxations" has at least partial scientific support. But spinal manipulation, whatever its applicability in some conditions, is no more a complete solution than are drugs, surgery, or the various kinds of psychotherapy. This is undoubtedly why many chiropractors, the so-called "mixers" (as compared to the "straight" chiropractic die-hards) have turned to other questionable methods of health care.
These include the whole panoply of medical quackery and especially those which most resemble chiropractic such as applied kinesiology and other variations on muscle strength testing and massage. This can involve the use of hand-held magnets as a means of supposedly assessing a patient's electromagnetic field. Others have been known to have patients hold various herbal and vitamin supplements during muscle strength testing in order to determine nutritional deficiencies!
This information is provided by the D/FW Council Against Health Fraud.
For more information, or to report suspected health fraud, please contact
the Council at Box 202577, Arlington, TX 76006, or call metro 817-792-2000.
Dr. Gorski is a practicing physician, chairman of the D/FW Council Against
Health Fraud and a North Texas Skeptics Technical Advisor.
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NEWS AND COMMENTARY FROM THE WEIRD WORLD OF THE MEDIA
By Pat Reeder
Last month, I was complaining about a lack of material; this month,
the floodgates opened, and we are awash in wacky stuff. So, good evening
Mr. and Mrs. North and South America and all the ships at sea! Let's go
The most famous Loch Ness monster photo of all time is a big, fat fake! I'm sure you've seen it: taken in 1934, it shows a small head and long neck, reminiscent of Dino from "The Flintstones," sticking up out of the water. It set off a sensation at the time and has remained unexplained ever since (unless, like me, you have so little faith in your fellow human beings that you just looked at it and said, "Pretty good! How'd they do it?"). More trusting investigators have suggested over the years that it might be a tree trunk or an otter, but of course, it doesn't look like either one. Let's give credit where credit is due: it looks like a damn fine fake photo of a sea monster!
Britain's Sunday Telegraph broke the story. It seems that Christian Spurling, the last surviving conspirator in the hoax, confessed before his death last November. Spurling's stepfather, Marmaduke "Duke" Wetherell, a filmmaker and self-styled big game hunter, had been hired by the Daily Mail newspaper to find the monster, and not wanting to disappoint anyone, he asked his stepson to build one. Spurling said the "monster" was actually his 14-inch toy submarine fitted with a neck and head made of wood putty. They took it down to the shallows, floated it out, and took a picture of it. He claimed that their little joke created such an uproar, the hoaxsters were afraid to confess, so they just kept quiet all these years.
Speaking of heads made of wood putty, none of this, of course, will do a thing to slow down the hunt for Nessie. Adrian Shine of the Loch Ness Project told reporters that there are so many eyewitnesses (most of whom, not surprisingly, describe something that looks just like that famous picture), that the search must continue ... no doubt made possible by a generous grant from the Loch Ness Chamber of Commerce.
We skeptics have known about FMS for years. It is a key ingredient in "buried memories" of "childhood Satanic rituals" and "UFO abductions.” But what finally brought it to national attention was the recent, highly publicized bringing, then dropping, of charges against Catholic Cardinal Joseph Bernardin. A young man, gay and HIV-positive, went to a "hypnotherapist" who "uncovered" the memory of the Cardinal repeatedly molesting him as a child. The patient filed suit against Bernardin, blaming the childhood abuse for his homosexuality and illness. After the Cardinal's reputation had thus been sufficiently sullied, the man finally came to his senses, realized his memories were "unreliable," and dropped the charges.
This high profile case has at long last turned the spotlight on these charlatan hypnotherapists who are destroying their patients' lives and families. ABC-TV's Nightline devoted an episode to the subject (they interviewed a troubled young woman who blames all her problems on imaginary Satanic abuse by her parents, and her mother and father, who are devastated, heartbroken, and completely baffled by the charges) and the newspapers and magazines were filled with it. Good. Let's hope it's the first step to policing and stamping out this reckless, reprehensible quackery.
By the way, while I personally would NEVER advocate taking all these unscrupulous hypnotherapists, locking them into a boxcar, dousing it with lighter fluid, and setting it ablaze, I would like to point out that if anyone ELSE wants to do it, I have a very reliable Bic lighter they can borrow. Perhaps one of these therapists would like to help me remember where I put it ...
On March 1, they reprinted an article by Janet Weeks of the Los Angeles Daily News on whether memories dredged up by hypnotherapists are reliable or not (guess where I come down on that one). The article quotes University of Kentucky psychology professor emeritus Robert Baker, author of two books on the subject, who says, "Hypnosis is nothing except turning on one's imagination ... sort of a controlled, manipulated dream.” It also quotes Mister Bruce Goldberg (I use the title deliberately, to give you some idea of his level of medical training), who "helps" the denizens of Los Angeles overcome their eating disorders and other problems through "past life regression.” When confronted with the facts, he takes the usual cop-out: the facts don't matter. Goldberg says that whether the patients' memories are true or not is "irrelevant," as long as they believe in it and it helps them achieve their goals. Tell it to Cardinal Bernardin, pal.
A day or so later, the Today section carried a long article on UFO abductees,
which contained the usual nonsense from abductee counselors, who have the
miraculous ability to put anyone who walks through the door under hypnosis
and discover a UFO abductee. It also contained a marvelous diatribe by
a skeptical psychiatrist (the same Prof. Baker), who pointed out that there
isn't one thing about any of the abductee tales that isn't easily explained
by anyone who knows the first thing about psychology. Not that this will
stop the UFO abductee hypnotherapists. After all, there are many eyewitnesses,
so the search must continue.
<M>Morning News TV critic Ed Bark had an interesting column on February 28, touching on this subject. He traced the ever-changing stories of abuse told over the years by America's most beloved dysfunctional adult, Roseanne Arnold. Bark has been covering Roseanne for six years, and in that time, he's noticed a number of inconsistencies in her tales of victimization. To quote just one example, during her early press conferences, Bark notes that she spoke glowingly of her first husband, Bill Pentland ... whom she now portrays as "the devil incarnate.”
Bark also recounts one of Roseanne's many stories of abuse by her parents (only recently dredged up, of course, and stoutly denied by her parents and siblings, all of whom she has severed contact with) which is patently absurd. Roseanne claimed that her father once dangled her baby brother out of the gondola on the Swiss sky ride at Disneyland, threatening to drop him as he screamed and screamed. Bark quite reasonably points out that anyone who's ever visited Disneyland knows that there would have been hundreds of witnesses to this, and that Disney's notoriously tight security would have nabbed her dad the second the gondola touched down. But never mind the facts ... as long as she believes it, that's the important thing. Ask Cardinal Bernardin.
Hey, Roseanne: as long as you're packing your show with important social messages, how about doing an episode on the way families are being torn apart by false memory syndrome? I'll even provide the plot: the original actress who played Becky returns, and you realize that the second Becky was just a fantasy concocted by an incompetent therapist.
Just as I was foolishly starting to hope that the technology explosion might stir up interest in science, and therefore wise up a few chumps, along comes the March 15 issue of the Dallas Morning News, and the Today section article entitled "The Psychic Superhighway.” It informs us that between computer networks, 900 phone lines, psychic fairs, etc., practitioners of the ancient con art of fortune telling are using high tech to build a bright, prosperous future ... for themselves.
The article does contain some rational caveats from University of Texas at Arlington psychology professor Dr. William Ickes. But perhaps more enlightening are the reactions of reporter Laurie Wilson, who went to a psychic fair and received the usual, startlingly accurate readings (you are vivacious and creative ... you are prone to changing moods ... you will come into a lot of money sometime in the future). Who could argue with all this? Not Wilson, who writes, "Many of the personality predictions were very close to the truth. I was left several times with the vulnerable, but slightly exciting feeling that these people really knew me."
What they know when they see one is a sucker. I intend no personal insult to Ms. Wilson by that: I just mean that if she was there at all, they assumed she was a sucker. What they did is called cold reading, and if anyone from the Morning News ever wants to do an article on that, give NTS a call and we'll tell you how it's done in about half an hour.
In the meantime, considering the way psychics are using high technology to market their nonsense, I would like to suggest a brand name for their various computer and phone networks. What do you think of "The Misinformation Superhighway?"
I have a confession to make: I've had both these things on tape for almost a month, and I just haven't come up with the stamina to watch them. Oh, I've skimmed through them a bit, fast-forwarding liberally ("Ooh, a trash fire in the dark woods, obviously a crashed flying saucer" ... "Someone faxed a picture of an alien to a news show with no return address? Well, that's proof enough for me" ... "Oh no! They'd not going to drag out Jeanne Dixon and J.F.K. again, are they?! ARRGH! They ARE!" ... and so forth). But watching these things all the way through in real time would remove three precious hours from my life, hours that I simply can't spare this month, what with the warm spring weather and the Harold Lloyd festival on Cinemax. But I promise, I'll try to force them into my brain before next month and comment on them at length.
Believe me, I am ever mindful of the trust you place in me to be your eyewitness to all the B.S. churned out by the mass media. And I promise you: the search will continue!
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By Joe Voelkering
First of Two Parts
If one were to compose a product label to paste on Nobel physicist Richard
Feynman, it would probably look something like this:
An intriguing, rare and unique blend of perception, chutzpah, integrity, skepticism, candor, intelligence, showmanship, curiosity, independence, talent, charisma, unpredictability, humbleness, panache, humor, and irreverence. Can be used to win Nobel prizes, crack safes, teach theoretical physics, play bongo drums, develop nuclear weapons, draw nudes, investigate spacecraft disasters, write Chinese sayings, do DNA research and fix radios. Absolutely guaranteed not to be boring.
There are at least three good books detailing Feynman's escapades. Surely You're Joking, Mr. Feynman! and What Do You Care What Other People Think? are collections of stories by Feynman, taped for his friend Ralph Leighton. Genius is a biography by James Gleick, author of Chaos: Making a New Science.
To some degree, certain personal traits can be seen in all three:
(1) Feynman's firm belief that man's progress is tied to a never-ending search for better answers — and that a rational, skeptical, scientific process is the best one suited for that task; (2) an extremely strong "puzzle drive" (his own term) — that spanned a wide range of interests; (3) a compulsive intellectual honesty — with Feynman commonly noting unresolved issues within his own efforts, and; (4) a very high standard of personal excellence — which apparently caused Feynman to not formally publish much of his work because he felt it was still too provisional.
The books illustrate the methods used by true scientists, and — more importantly — the processes that all scientists should use. One would be very hardpressed to find a better role model than Feynman for both rational skepticism and bend-over-backwards scientific objectivity.
Each book has its own style. Surely... is somewhat light and witty. What Do You Care... starts in a like manner. It then shifts to a more serious tone for a long segment detailing the space shuttle Challenger investigation. That does not imply the Challenger section is one bit dull, however. In fact, it provides a delightfully candid view of what typically happens to scientific objectivity when it gets entwined with the political and bureaucratic process. The epilogue to What Do You Care is a thoughtprovoking essay on "The Value of Science" — with one of the best endorsements of rational skepticism I've ever seen.
Genius is similar to Gleick's Chaos. There's plenty of substance, but it's certainly not presented with concise brevity. To Gleick's credit, though, he includes many of Feynman's most perceptive and philosophical statements about how science is done — plus numerous like comments and observations by Gleick himself.
Gleick also paints a better picture of the objective manner in which Feynman seemed to view his own efforts. For example, he cites Feynman's description of the work that won him the Nobel prize: "I think that the renormalization theory is simply a way to sweep the divergences of electrodynamics under the rug. I am, of course, not sure of that." (My interpretation: It's probably little more than just a provisional step in trying to understand how electrodynamics really works. If so — WOW!)
Reading these three books confused me about one thing, however. Early on, I thought I'd discovered the proper way to pronounce "Feynman" — but Gleick's later book made me wonder if I was doing it correctly. In What Do You Care..., Feynman tells about being called "fainman-san" in Japan, so I pronounced it "Fainman." However, Gleick claimed Feynman's father used "the more standard variants: Fineman or Feinman." Did Gleick mean the family name is pronounced "Fineman" — or was he inferring that Richard Feynman used the non-standard "Fainman" variation, as suggested by the "fainman-san" reference? Gleick's book didn't elaborate.
Checking it out, I encountered two more variations — and many people that were, likewise, not sure. Finally, I called a science professor I know that lives near Caltech, where Feynman taught. He advised me that Richard Feynman, like his father, used "Fineman or Feinman." So, while Gleick's statement initially confused me, it managed to kill my on-going verbal faux pas.
For me, all three of these books are "keepers."
[Editor's note: The balance of Voelkering's review, a collection of quotes from the three books, will appear in next month's issue of The Skeptic.]
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I've been a member of The North Texas Skeptics for several years now. I've never attended any of your monthly meetings, but I want you to know that I enjoy your newsletters very much and share them with other friends of mine all skeptics as well! Where I'm employed [a major Dallas bookstore], I occasionally share NTS newsletters with fellow employees. One particular employee that I share my skeptical thoughts with manages the New Age/Metaphysical section — and wouldn't you know, she's psychic, too! She has in turn, shared her “paranormal newsletter” with me — [an example of] which I'm sending to you.
Now to the meat and purpose of my letter. Is NTS aware of The Eclectic Viewpoint? [Mr. Toole enclosed a copy of a Dallas-area group's newsletter for February, subtitled Forum of Extraordinary Science, Unusual Phenomena & Diverse Perspectives] Shall I continue to send a copy of their newsletters to someone on the NTS board? I cannot attend the February 11 lecture by Lloyd Auerbach [mentioned in The Eclectic Viewpoint] ... but perhaps in the future someone from NTS including myself can attend their “Psychic Get-Togethers” and report back to other NTS members.
Keep up the fabulous work at NTS! I appreciate all your efforts and hard work.
Mike Sullivan replies:
The “newsletter” Mr. Toole sent is just one example of the mountain of pro-paranormal materials that jam mailboxes around the world. As in this case, they are little more than sales brochures for lectures, tapes and seminars, all offered at handsome prices, by or through the publicizing organization. As one that has attended more than a few such “lectures” in the past, I can testify that the only prediction advertised in these lectures that always comes true is that you will be relieved of your admission fee.
The newsletter mainly comprises a press release for the lecture, a “Citizen's Alert” encouraging readers to write their legislators regarding an imagined FDA plan to “take away your right to buy vitamins, minerals and amino acids,” and a price list and order form for lecture tapes and books offered by the group.
Mr. Auerbach's lecture can be heard for $15, according to the newsletter, and Mr. Auerbach will also be available after his talk to sign copies of his books, also available for sale at the meeting. His press release states that he is a writer and editor for <M>Fate magazine, has appeared on such highly-regarded scientific and investigative programs as Sightings, The Oprah Winfrey Show, Hard Copy, The Joan Rivers Show, and Late Night with David Letterman, during which Mr. Auerbach led Mr. Lettermen through a “haunted house.”
Judging by this, it is doubtful that anything worthy of serious scientific inquiry would be discussed at a lecture given by Mr. Auerbach. A skeptic would wonder why, if Mr. Auerbach indeed has reliable answers to any of the tantalizing questions used as teasers in the lecture notice, he does not bring his evidence to the attention of the editors of Science or Nature or any of the hundreds of other reputable journals of scientific knowledge, instead of promoting his theories in Holiday Inn meeting rooms across the country as he does? Of course, many NTS members may look at it as an evening's entertainment for just $15, which would be the only rational justification any well-informed skeptic may get from this kind of lecture.
NTS has had little success in getting pro-paranormal folks to speak at our free, public monthly programs, or in getting their participation in claiming the $6,000 cash prize offered by three NTS members for the production of a paranormal effect under scientifically-controlled conditions. Both invitations remain open, as they always will, since objective evaluation of paranormal claims is the essence of rational inquiry.
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This column is the "readers' forum" introduced last month. It's open to any and all! Each piece will be individually signed — using the format displayed below — for the reader's convenience. Please send your items to the Editor by the 15th of each month for inclusion in the next month's issue.
— J.V. [Joe Voelkering]
Literally Allegorical--I found last month's exchange between Bill Gant and Deborah Boak in The Skeptic [March 1994, "Religious Faith and Scientific Skepticism"] both interesting and thought-provoking. Some additional clarification about the origin of their debate seems appropriate, however: Ms. Boak was the one that posed the initial question on " ... where, how, and why the line should be drawn between beliefs that are fair game for skeptical criticism and those that are properly left alone." [The Skeptic, November 1993] Mr. Gant answered with "There is no line which could be drawn." [The Skeptic, November 1993] Then, last month, Mr. Gant expanded his initial response into an article — with a reply by Ms. Boak.
Another clarification appears proper, also — in an effort to be completely objective about Roman Catholicism: The doctrine of transubstantiation was reportedly adopted late in the Thirteenth Century — when alchemy was regarded as valid — and may have been derived from that "science." According to a representative of the Diocese of Dallas, the Church's current doctrine as to communion can be characterized as " ... literally ... the mystical body and blood ... ." Mystical is defined as "allegorical" or "of a spiritual nature." Yes, I know "literally ... mystical" seems to be an oxymoron — and could be paraphrased as "authentic surrogate" — but the scientifically accepted term "virtual reality" suffers the same problem. In any case, Richard Dawkins (the instigator of the transubstantiation issue) appears to have attacked a doctrine that (currently) makes no claim of physical or scientific validity.
Interestingly, Dawkins was widely criticized for a lack of scientific objectivity in his book The Selfish Gene, with his work described as "reductionism carried to absurdity." His response to the critics included an admission that the emphasis was lopsided — but defended it on the basis that "it was important to encourage a [particular] perspective." (The quotes are from The Encyclopedia of Evolution, by Richard Milner.) The lesson here appears to be: independently verify claims by "authorities" — particularly if their track records are questionable.
Since Ms. Boak invites a critique, I'd like to "pick a couple of (very small) nits": Evolution is substantiated by an extremely large body of evidence (or proof) — but I do not personally feel comfortable with its characterization as "fact." (It can stand on its own merits without any "spin.") Also, banishing theology to "the world of make-believe" seems a bit harsh. I'd opt to concede the venue of ideology as a "safe haven" for religion to share with ethics, etc. — again, strictly as a personal opinion.
The debate between Ms. Boak and Mr. Gant has caused me to set up a personal "rule-of-thumb" about challenging theological-based claims. Both persons have had a positive effect on my thinking — so I appreciate their efforts. My new personal guideline is: When objective or realistic (scientific) evidence is rejected because it conflicts with a subjective or idealistic (philosophical) belief, that belief becomes "fair game." For example, so-called "creation science" (there's an oxymoron) clearly crosses the boundary. Thus, its underlying belief system becomes a subject open to critical examination. Faith-healers, etc., incur a like burden of objective proof.
The doctrine of transubstantiation does not overtly reject any scientific principles I'm aware of, however — so I see no reason to question its validity. Also, I understand that doctrines such as exorcism are currently being critically examined by Catholic theologians because of their conflicts with scientific principles (as opposed to a mere lack of scientific validity). Further, there are indications transubstantiation is very openly debated (and questioned) by a variety of Roman Catholics. That's certainly an encouraging move toward rationality. It's also far better than the treatment science gets from the creationist-fundamentalist types.
And — with that issue in mind, I'd like to point out that the Dawkins-type
approach is a real liability in the evolution-creation debate — since it
provides (both unwarranted and unintended) credibility to the contention
that evolution is "a conspiracy promoted by godless scientists."
Finally, a critique is invited — but let's continue this mini-series on a person-to-person level — rather than turning The Skeptic into a de-facto bulletin board.
Anyone have a fork? This subject seems to be done ...
However there's also some bad news: First, Chris Wallace hosted a <M>Nightline segment featuring a so-called "balanced" presentation. Then, Ann Landers did a virtual flip-flop on the issue — now that her friend, Bernardin, is off the hook. She's promoting the view that a huge number of "victims with repressed memories" really <M>were abused "when they were very young" — citing only her pile of letters from "victims." Let's hope it's not part of an expanding trend to provide "equal time" for any variety of irrational viewpoints under the guise of "fairness."
Finally, Laura sent us a 3-4 hour video of FMS presentations she's made on various talk shows, etc. — including a segment by her attorney, Skip Simpson. It rates "two thumbs up" — and is available from the "NTS video lending library."
In another Nightline segment, Catherine Crier, a former Dallas judge, described a questionable claim as not being likely to stand up to a polygraph test. Next, CBS ran an Eye on America segment that did question the reliability of polygraph exams — but it focused on "tricks" used to dupe all but highly skilled operators. Then, the Dallas Morning News editorial for March 19, 1994 noted: " ... there are question whether Mr. Ames effectively lied during a polygraph test or whether the polygraph examiner 'misread' the results ... ."
I've yet to see anyone point out that polygraphs are based on the presumption there's an involuntary physiological reaction to telling a lie. However, when one's ethical standards are such that "selling out" — in the manner Ames did — is no problem, why would he get upset over a few lies? I, for one, would not <M>expect Ames to get excited about (comparatively) trivial untruths. Yikes!
SN&V contributors: T.G. — Tim Gorski, M.D.; J.V. — Joe Voelkering.
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