The Maharishi Caper: Or How to Hoodwink Top Medical Journals

From time to time, even the most prestigious science journals publish erroneous or fraudulent data, unjustified conclusions, and sometimes balderdash. Balderdash was the right word when The Journal of the American Medical Association (JAMA) published the article, "Maharishi Ayur-Veda: Modern Insights Into Ancient Medicine," in its May 22/29 issue. Discovering that they had been deceived by the article's authors, the editors published a correction in the August 14 issue, which was followed on October 2 by a six-page expose on the people who had hoodwinked them.

By reporting its mistake in this lengthy report and drawing the media's attention to it with 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 ostensibly 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, Deepak Chopra, MD, president of the American Association of Ayurvedic Medicine, Lancaster, Mass., Hari M. Sharma, MD, 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 disinterested authorities and had signed a statement that they were not affiliated with any organization that could profit by the publication of their article. (JAMA's conflict-of-interest policy requires authors of accepted manuscripts to declare all such connections.)

Subsequent investigation showed they were intimately involved with the complex network of organizations that promote and sell the products and services about which they wrote. They misrepresented Maharishi Ayur-Veda as India's ancient system of healing, rather than what it is, a trademark line of "alternative health" products and services marketed since 1985 by the Maharishi Mahesh Yogi, the Hindu swami who founded the Transcendental Meditation (TM) movement.

Maharishi Mahesh Yogi began his rise to fame and great fortune in the 1960s when the Beatles rock group briefly joined his following of worshipers. Today the guru rules an empire estimated to be worth billions of dollars and has many thousands of devoted followers, some of whom are prominent in science, medicine, education, and the news, information, and entertainment media. The TM movement is considered a religious cult by a number of authorities, including Cynthia Kisser, executive director of the Cult Awareness Network. According to long-time watchers of the movement, Maharishi Ayur-Veda is the latest of the Maharishi's schemes to boost the declining numbers of people taking TM courses through which he recruits new members. The movement also stands to reap millions of dollars through the sale of its herbal remedies, oils, teas, aromas, healing gems, Hindu horoscopes, books, tapes, and numerous services that carry the Maharishi's name.

I first saw the Maharishi Ayur-Veda article four days prior to the publication date, when hundreds of thousands of copies were already in the mail. At the time, I didn't know anything about Maharishi's medical claims, but I was aware that the TM movement widely uses deception to promote its $3000 courses in TM-Sidhi or "yogic flying." TM promoters claim that, by mastering this technique, people can develop the ability to walk through walls, make themselves invisible, develop the "strength of an elephant," reverse the aging process, and fly through the air without the benefit of machines.

In addition, TM promoters claim that by yogic flying in large groups they can prevent bad weather, traffic fatalities, and even war. Former members of the movement say that the practice of TM- Sidhi involves repeating a series of Hindu mantras during meditation followed by several minutes of hopping up and down in the crossed-legged "lotus" position. Adherents claim that they are not hopping but levitating and that they have hundreds of scientific studies to prove it.

I called Stephen Barrett, MD, and William Jarvis, PhD, of the National Council Against Health Fraud and asked what information they had about Maharishi Ayur-Veda. What they told me made it clear that JAMA had been duped. After poring through the promotional TM materials they sent and talking with several former TMers, I reported my findings to George Lundberg, MD, editor of JAMA and suggested that we expose the authors and the movement they represent in a JAMA Medical News & Perspectives story. I was given the assignment, which took me almost 3 months to complete. The resulting article, "Maharishi Ayur-Veda: Guru's Marketing Scheme Promises World Eternal `Perfect Health'," was published on October 2.

Unusually long for Medical News & Perspectives, the expose on the marketing of Maharishi Ayur-Veda documents a widespread pattern of misinformation, deception, and manipulation of lay and scientific news media. This campaign appears to be aimed at earning at least the look of scientific respectability for the TM movement, while boosting the sales of their extremely lucrative products and services. (One example is the herbal elixir known as Maharishi Amrish Kalash, which costs $1000 for a year's supply.

Chopra says everyone should take the cure/prevent-all twice a day. Chopra claims their health care is far more cost-effective than conventional medicine. However, the annual cost of just this one Maharishi Ayur-Veda product is equivalent to 40% of the average per-capita expenditure on all health care in the United States in 1989. The other products and services he recommends just to maintain health would cost thousands of dollars more each year. However, this pales compared with the cost of Maharishi Ayur-Veda treatments in case of actual illness, which can exceed $10,000 for the performance of a ceremony to appease the gods or or for the purchase of Jyotish gems to restore their health.

Upon discovering the deception, JAMA requested from the authors a full account of their connections to TM organizations. The confusing statement they provided was published as a financial disclosure correction on August 14 and represents only what the authors admitted. While it appears to hold the record in terms of length for a financial disclosure correction in the journal, the account is still incomplete. Among other things, Chopra did not acknowledge that he collects hundreds of thousands of dollars from his seminars on Maharishi Ayur-Veda and by providing Maharishi Ayur-Veda treatments. (According to David Perlman's October 2 San Francisco Chronicle article, Chopra claims he gives 50% to 70% of his fees to the movement.) He also did not report that he had been the sole stock holder, president, treasurer, and clerk of Maharishi Ayur-Veda Products International, Inc (MAPI), the sole distributor of Maharishi Ayur-Veda products. Although he no longer holds these titles, Chopra still has the same office address and phone number as MAPI.

JAMA's publication of the Maharishi Ayur-Veda article brought a hail of angry letters from readers (also published in the October 2 issue) along with some snickers from other publications. In its November 11 issue, Physician's Weekly published an account of JAMA getting "flimflammed by a swami." The October 11 issue of Science knocked JAMA for publishing "shoddy science" and getting itself into an "Indian herbal jam."

Science writers know that the peer-review system of scientific publications is not foolproof. Drummond Rennie, MD, deputy editor (West) of JAMA has written: "There seems to be no study too fragmented, no hypothesis too trivial, no literature too biased or too egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too self-serving, no argument too circular, no conclusions too trifling or too unjustified, and no grammar and syntax too offensive for a paper to end up in print." Peer review determines where rather than whether a paper should be published, Rennie says. However, from time to time, "shoddy science" ends up in the most prestigious of journals.

It may be hard to understand how a system so effective in sifting out errors in experimental design, statistical analyses, and faulty conclusions could fail to catch blatant deceit. However, errors are usually easier to spot than outright deceit. Journals do not have the staff and resources to investigate contributing authors and must rely in large part on trust. Obviously, failure to disclose their conflicts of interest is a serious betrayal of that trust.

The editors who handled the Maharishi Ayur-Veda manuscript did not know about the history of deception associated with the TM movement, but they did know that two of the three authors had excellent medical and academic credentials. In addition, the authors were able to cite studies that were published in peer- review journals to support their claims. (One study listed in their references was published in the prestigious Yale University publication, The Journal of Conflict Resolution [December 1988]. This study purported to show that a group of yogic fliers in Israel was able to reduce the level of violence in war-torn Lebanon.) They also could point to the National Cancer Institute research grants awarded Sharma and others to study the herbal elixir, Maharishi Amrit Kalash.

Few people are aware of how far the TM movement has been able to penetrate into the halls of medicine and academia. According to the letterhead for the American Association of Ayurvedic Medicine, its research council and advisory council include physicians at many prestigious medical schools and institutions. Sharma is professor of pathology and director of the Division of Cancer Prevention and Natural Products Research at Ohio State University College of Medicine. Others associated with Chopra include Steele Belok, MD, and Amy Silver, MD, both clinical instructors at Harvard Medical School; Agnes Lattimer, MD, medical director of Cook County Hospital in Chicago; Kelvin O. Lim, MD, assistant professor of psychiatry and behavioral science, Stanford University School of Medicine; Barry Marmorstein, MD, associate professor, University of Washington School of Medicine; S.M. Siram, MD, director of the Surgical Intensive Care Unit and Trauma at Howard University School of Medicine.

With the help of such well-placed physicians and academicians, the TM movement has been able to project a respectable front in its scheme to market Maharishi Ayur-Veda. In June, the American College of Preventive Medicine accredited Maharishi Ayur-Veda courses for Continuing Medical Education for physicians, for the second time. The National Cancer Institute is currently funding 11 studies testing the anti-cancer potential of the concoction of herbs and minerals called Maharishi Amrit Kalash -- even though its exact composition has not been revealed. The National Institutes of Health allows its facilities to be used for monthly introductory seminars on Maharishi Ayur-Veda. And for years, U.S colleges and universities have allowed their facilities to be used by the TM movement to teach yogic flying.

The TM movement has an extremely aggressive p.r. operation with a remarkable record in getting favorable reports in newspapers, magazines, and the broadcast media. Like mushrooms after a spring rain, articles on Chopra, TM, and the Maharishi's medicines keep popping up in places like The Boston Globe, The Wall Street Journal, The Washington Post, and even American Medical News (also published by the American Medical Association). Favorable reviews of Chopra's books on Maharishi Ayur-Veda have appeared in many leading medical journals. Joanne Silberner, medical reporter for U.S. News and World Report, says that Dean Draznin, former director of public affairs for Maharishi Ayur-Veda, used to call her about twice a month with another angle to pitch.

In August, Johns Hopkins Magazine published an uncritical profile on Nancy Lonsdorf, MD, medical director of the Maharishi Ayur-Veda Medical Center in Washington, DC. Lonsdorf is the physician who, in a fund-raising letter distributed to members of the TM community, is described as having recommended a $11,500 yagya for a patient with a serious health problem. The Maharishi's yagyas are Hindu ceremonies to appease the gods and beseech their help for ailing followers.

Despite the extraordinary costs of these ceremonies, patients do not take part or even get to see them performed. (Chopra and Lonsdorf both deny that they recommend yagyas. Chopra insists that yagyas are not part of the Maharishi Ayur-Veda program. Nevertheless, I have a copy of another patient's health analysis from Chopra's center in Lancaster, Mass. that recommends the performance of not one but two different yagyas.)

In its 1989 September/October issue, Harvard Magazine published a cover story on Chopra by associate editor Craig Lambert that touted the Maharishi's wares. Reprints of this article were widely circulated by the TM movement. The magazine's readers were not informed that the author practices yogic flying.

Lambert wrote JAMA a letter protesting my investigation and accusing me of "sleazy" and "deceptive" behavior. This letter was one of many sent to protest my inquiries. Among them were repeated requests from Chopra and his attorney that they be allowed to preview my article before publication, along with warnings that they may sue if defamed.

In the February 1984 NASW Newsletter, Patrick Young wrote, "Reporting any story that might prove embarrassing to a publication is filled with delightful irony. Editors, writers and others who believe in and argue the public's right to know, suddenly react as any good group of company executives, government bureaucrats, or union officials would in a similar situation. They draw up the wagons in a tight circle."

When I reported my findings to my editors, I feared that they too might choose to circle the wagons. Instead, they asked me to recount how the journal had been deceived and backed me against a stream of protests and threats from Maharishi's followers and attorneys.

Andrew Skolnick is associate editor for the Journal of the American Medical Association's Medical News & Perspectives Department.

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