The Church of Christ, Scientist, frequently promotes its claims of thousands of cases of disease healing. Cases with any degree of medical documentation are rare, and those with clear medical confirmation are nonexistent. Claims such as those of Holly Zynda, presented on the A&E Television Network, are based on incorrect interpretation of disease events. In this case, prayer was inappropriately credited with healing of a benign, self-limited disease, immunologic thrombocytopenic purpura of childhood.
Holly Zynda’s Story was presented on a recent episode of the A&E Network’s Investigative Reports with Bill Kurtis, entitled “Healing and Prayer: Power or Placebo?” In 1985, 20-month-old Holly was bruising easily. Her mother, Deborah, was raised in the Church of Christ, Scientist, and did not want to take Holly to a doctor. However, a neighbor, Kim Brown, identified as a nurse practitioner, recommended that Holly go to a pediatrician. The child’s father, Tom Zynda, reportedly convinced his wife to proceed. The diagnosis of idiopathic thrombocytopenic purpura (ITP), was made based upon a very low platelet count.
ITP is a disorder of young children that leads to easy bruisability and, less commonly, major bleeding, all due to decreased numbers of platelets. In ITP an autoimmune reaction, often following a typical childhood viral infection, causes the body’s own antibodies attach to platelets, which are then removed from circulation. The remaining platelets are able to function, but their number is insufficient for normal clotting.
Most children do not need any treatment other than increased vigilance to reduce rough play, contact sports, and accidents. Those with severe bleeding symptoms and very low platelet counts may transiently benefit from treatment with steroids or intravenous immunoglobulin. Rarely, a splenectomy may be required if ITP becomes chronic.
Mr Kurtis narrated that Holly’s doctors said her “condition was considered critical” and prescribed prednisone (a steroid). Holly’s platelet count was indeed extremely low, in the range where most pediatricians would prescribe treatment. But, he reported, it didn’t seem to be helping at all. This prompted the Zyndas to stop care and turn to Christian Science (CS). Echoing CS explanations, Mr Kurtis said that “Deborah was determined to break through her own fear and conquer Holly’s disease through her faith.”
What is the evidence at this point that Holly’s treatment was failing? There is some reference to her bruising continuing or getting worse, but there is no objective evidence offered to support these 15-year-old recollections that treatment was not helping. The response of most children to steroids is rarely dramatic. Most important is that the disease is self-limited in over 95% of cases, remitting on its own within 2 to 6 months. After about 2 months under treatment, the Zyndas stopped Holly’s medication and sought healing through Christian Science. Mr Zynda then reports that within 30 days they noted “a real dramatic change.” The improvement over this time period is what physicians would expect in children with ITP.
As evidence to confirm the “miracle,” Ms Brown offered her opinion that when patients are taken off antiinflammatory drugs such as steroids, most of the time they get suddenly worse. But before Ms Brown would have expected improvement, she told the camera, Holly was running around and the bruises went away. Mr Kurtis further inflated the drama of the situation by stating, “Doctors say that ITP can become a chronic, lifelong illness. But 15 years after her battle with the disease, Holly is enjoying the life of a normal, active teenager.” He adds, “She’s never been to another doctor.”
Reality is less miraculous. By the time Holly was taken off prednisone, it was likely that her platelet count would have begun to improve. Unlike the case of more severe and chronic autoimmune disorders, stopping prednisone in childhood ITP would not necessarily cause a problem. A measured platelet count would be required to know with certainty. More important, the overwhelming majority of children with ITP get better on their own with time. Very few develop the chronic form, which lasts more than 6 months. For those who do, most do not have serious bleeding as an ongoing problem. They can remit at any time, most doing so within a few years. Mr Kurtis’s implication that severe lifelong problems from ITP are common is incorrect.
This story illustrates as well as any that an anecdote cannot be offered as proof of therapeutic efficacy. Physicians who understand the natural history of ITP would not reasonably conclude that divine intervention or the power of prayer helped Holly Zynda. Time and her own physiology were sufficient. Ignoring the natural course of a self-limited disorder is a typical error made by believers of unsubstantiated claims. Inflating severity and overdramatizing are other typical mistakes. While Holly’s platelet count was extremely low and could have been dangerous at that level, describing her condition as “critical” would not likely be something that a physician would do. Her need for treatment was immediate, but she was not in critical condition. She also had a very low likelihood of progressing to chronic ITP.
In addition to the story of Holly Zynda, the show presented other believers in faith healing as well as members of the medical community currently promoting prayer as an adjunct therapy. There was some attempt to balance these views with stories of Christian Science and faith healing failure, such as related by Rita Swan, and other skeptical medical opinions. But television tempts its producers to give weight to opinions or theories that haven’t earned it. Controversy is newsworthy. Failure to meet scientific standards of proof is relatively boring on the small screen.
Thus, Mr Kurtis describes Harold Koenig, a psychiatrist who promotes the integration of spirituality into medical care, as “a pioneer in the exploration of medicine’s next frontier.” While few would dispute that religious beliefs and practices are important to patients as they confront illness, there is little evidence, despite the hundreds of studies noted by Mr Kurtis, that prayer or ritual has any substantial independent efficacy. This is hardly medicine’s “next frontier.” Rather, faith healing, particularly as exemplified by the philosophy of the Christian Scientists, is a remnant of the 19th century. It recalls a time in which science had much less to offer than it does today. It was a time when the life expectancy in America was in the 40s, as opposed to the high 70s, as is the case today.
Holly Zynda was fortunate not that her mother had faith in Christian Science, but that she had a relatively benign and self-limited disease. As documented many times in medical journals, other children whose parents eschewed medical treatment and relied exclusively upon faith healing have not been as fortunate. When parents play Russian roulette with their children’s lives, sometimes they win. That doesn’t prove that the game is safe. Unnecessary deaths demonstrate that it is not.