AUDASE

The Operator

Is the most trusted doctor in America doing more harm than good?

by Michael Specter The New Yorker

One evening a few weeks ago, several members of a television film crew crammed themselves into a tiny examination room on the seventh floor of the Research Medical Center, in Kansas City. The sun had set and the light was fading. Two men, one hoisting a big camera and the other a sound boom, stood in a corner less than a foot from one another. The hospital’s chief of medicine, the head of its cardiology department, and a nurse were also in the room. All were watching as a heavyset forty-six-year-old woman, with cornflower-blue eyes, a sweet smile, and auburn hair parted neatly in the middle, struggled to keep pace on a treadmill. Earlier that day, she had complained of chest pains, and had reported a family history of heart disease. Now she was taking a cardiac stress test, and it wasn’t going well. After little more than a minute, her blood pressure spiked, at 184/92. There was a third doctor there as well: Mehmet Oz, the heart surgeon and host of “The Dr. Oz Show,” which is among the most highly rated daily television programs in the nation. He stood a few inches away, obviously worried but urging her on. “In five seconds, this treadmill is going higher,” Oz said, in the soothing voice that has become recognizable to millions of viewers. The crew was filming a future episode, and Oz stared into the camera as he spoke: “I have to say this is where the battle will be won or lost.” One of the other doctors, sensing that the test might not last much longer, said to Oz, “If you want to do that pre-commercial thing, you’d better do it now.” Oz nodded and said, “I am very concerned. Your blood pressure is sky-high already. Your heart rate is racing to the moon.”

He asked the woman if she could last thirty more seconds. It wasn’t easy, but she did. As the woman gasped for breath, he continued, “I’ve got to say that I am disappointed in how deconditioned you are.” With her blood pressure showing no signs of easing, the physicians stopped the test. The woman stepped off the treadmill, sat on the edge of an examination table, and began to cry. “What got you so emotional?” the producer asked, then pointed at Oz: “Tell him!” The rest of the medical team inched awkwardly to the side, so the camera could home in on Oz and his patient. “It just upsets me that I am so out of shape,” she said. “I want to hike. I want to run around the yard with my grandbabies. My grandmother is ninety, and she is in better shape than me. I miss the old me.”

Oz asked gently, “If we could find the old you, would that be saving your life?” The woman nodded, then began to describe her descent into obesity, but again the producer waved her off. The shot had failed, and they would need to repeat it. Oz started over: “If we could find the old you, would that be saving your life?” He assured her that he would help “chip away the part of you that you don’t want, and you will find that the old you, the real you, is hidden inside.” The woman, still dizzy with exhaustion, nodded gratefully. The producer said, “Cut,” and everyone filed out of the room. It was 8 P.M. and Oz had been on his feet for twelve hours. More than a thousand people had come to the hospital that morning for Oz’s “15 Minute Physical,” part of a nationwide tour during which Oz, aided by many volunteers, takes people’s blood pressure, weighs them, measures the size of their waists, then checks their cholesterol and glucose levels. Oz chose those tests because the results are available immediately, and the information is useful and easy to understand. High blood pressure can be addressed with medicine and, often, by altering dietary habits. The same is true for obesity and, in most cases, diabetes.

Oz has become used to crowds, to adulation, and to fame. That morning, when he arrived in darkness, hundreds of people, mostly women, already stood in line at the entrance to the hospital; many lacked insurance, a doctor, or medical support of any kind. There were screams of delight when he hopped out of the car. People had come for the free exam and for helpful advice, but also to see him. Oz is fifty-two and jauntily fit, with a perfectly tamed helmet of brown hair and lengthy sideburns. His scrubs, powder blue and cinched at the waist, fit so well they looked as if they had been run up for him on Saville Row. In promotional pictures, Oz, with a stethoscope draped like a scarf around his neck, looks eerily like Doug Ross, the character that George Clooney made famous on “E.R.” He worked the line like a gifted politician, hugging people as they flipped open their phones and tried to get a picture with him. Many had brought old copies of magazines to be signed: Time, Good Housekeeping, Prevention—all with Oz on the cover. “I worship you, Dr. Oz,” one woman told him. Another threw her arms around his neck. “I haven’t seen a doctor in eight years,” she said. “I’m scared. You are the only one I trust.”

Oz squeezed her shoulder and stared into her eyes. “I’ll see you inside,” he said. “We are going to get through this, and we will do it together.”

Oprah Winfrey first referred to Mehmet Oz as “America’s doctor” in 2004, during one of his earliest appearances on her television show. The label stuck. Oz was a rare find: so eloquent and telegenic that people are often surprised to learn that he is a highly credentialled member of the medical establishment. Oz graduated from Harvard University in 1982. Four years later, he received joint medical and M.B.A. degrees from the University of Pennsylvania. He then moved to Columbia and New York-Presbyterian Hospital, where, as a surgeon specializing in heart transplants, he has served as vice-chairman and professor in the department of surgery for more than twenty years. (He still performs operations there each Thursday.) Oz also directs Columbia’s Cardiovascular Institute and Integrative Medicine Program, which he established in 1994, and has published scores of articles on technical issues, such as how to preserve muscle tissue during mitral-valve replacements. He holds a patent on a solution that can preserve organs and one on an aortic valve that can be implanted without highly invasive open-heart surgery.

By 2009, after dozens of appearances on “Oprah,” Oz had become so popular that Winfrey offered him his own show, produced by her company, Harpo. “The Dr. Oz Show” has since won two Emmys and averages nearly four million daily viewers. Certainly, no American physician has greater influence over a larger number of people. Oz has been named one of Esquire’s 75 Most Influential People of the 21st Century, as “the most important and most accomplished celebrity doctor in history.” He ranks consistently in the top ten on the Forbes list of most influential celebrities, and has been included on a similar list of Harvard University alumni. In 2008, Oz received the Ellis Island Medal of Honor. And, along with Michael Roizen, who is the director of wellness at the Cleveland Clinic, Oz is one of the “You Docs,” having written, over the past decade, a series of books, including “YOU: The Owner’s Manual”; “YOU: The Smart Patient”; “YOU: On a Diet”; “YOU: Staying Young”; “YOU: Losing Weight”; “YOU: Having a Baby”; “YOU: Stress Less”; and “YOU: Being Beautiful.” There are well over a million “YOU” books in print.

Oz also presides over a rapidly expanding empire of social media. He recently launched You Feel, an app on his Web site that lets users “enhance” their response to the question “How are you feeling today?” by “adding an image from their computer, a picture from Facebook, or a YouTube video.” The You Feel community is an outgrowth of doctoroz.com, which has become a kind of Merck Manual for the layman, addressing nearly every imaginable ailment, but pitched particularly to those who feel constrained by the rules of conventional medicine. Thousands of videos are available on the Web site, and they deal with every issue of mind and body, from facts about stomach cancer to the value of shrink-wrap liposuction.

Oz’s popularity isn’t hard to understand: he speaks to Americans about problems that many find impossible to share, and he talks to them in ways that few other physicians would. Want to know how many orgasms you will require each year to prolong your life? Oz says two hundred—give or take. He also suggests how often we should move our bowels and what they ought to look like when we do (at least every other day, brown with a hint of gold, shaped like an S, he says, and “it should hit the water like a diver from Acapulco”). Oz likes to be in the news; he was on the air with students from the Sandy Hook Elementary School, in Newtown, Connecticut, three days after the shootings there. And you never know who his guests will be. Not long ago, Michelle Obama appeared on the show to talk about her effort to end the epidemic of childhood obesity. A few weeks later, Oz welcomed back Theresa Caputo, a Long Island-based medium who helps people commune with dead family members. “The last time she was here,” Oz told the audience, “her readings blew me away.”

“The Dr. Oz Show” frequently focusses on essential health issues: the proper ways to eat, relax, exercise, and sleep, and how to maintain a healthy heart. Much of the advice Oz offers is sensible, and is rooted solidly in scientific literature. That is why the rest of what he does is so hard to understand. Oz is an experienced surgeon, yet almost daily he employs words that serious scientists shun, like “startling,” “breakthrough,” “radical,” “revolutionary,” and “miracle.” There are miracle drinks and miracle meal plans and miracles to stop aging and miracles to fight fat. Last year, Oz broadcast a show on whether it was possible to “repair” gay people (“From Gay to Straight? The Controversial Therapy”), despite the fact that Robert L. Spitzer, the doctor who is best known for a study of gay-reparation therapy, had recanted. (Spitzer last year apologized to “any gay person who wasted time and energy” on what he conceded were “unproven claims.”) Oz introduced a show on the safety of genetically modified foods by saying, “A new report claims they can damage your health and even cause cancer.” He also broadcast an episode on whether the apple juice consumed daily by millions of American children contains dangerous levels of arsenic. “Some of the best-known brands in America have arsenic in their apple juice,” he said at the outset, “and today we are naming names.” In each of those instances, and in many others, Oz has been criticized by scientists for relying on flimsy or incomplete data, distorting the results, and wielding his vast influence in ways that threaten the health of anyone who watches the show. Last year, almost as soon as that G.M.O. report was published, in France, it was thoroughly discredited by scores of researchers on both sides of the Atlantic.

Addressing such issues, however, is part of what Oz describes as “the undiscussed conversation—the one we need to have but don’t.” He describes modern medicine as a “civil war” waged between conventional physicians and those who are open to alternative cures for maladies ranging from anxiety to cancer; he considers it his mission to walk the line that divides them. But more often his show seems to erase that line completely, with results that may be less benign than Oz and his many viewers realize. “I want no more barriers between patient and medicine,” he explained to me not long ago, as we sat in one of the show’s production offices, just outside NBC’s Studio 6A, in Rockefeller Center. “I would take us all back a thousand years, when our ancestors lived in small villages and there was always a healer in that village—and his job wasn’t to give you heart surgery or medication but to help find a safe place for conversation.”

Oz went on, “Western medicine has a firm belief that studying human beings is like studying bacteria in petri dishes. Doctors do not want questions from their patients; it’s easier to tell them what to do than to listen to what they say. But people are on a serpentine path through life, and that is the way it is supposed to be. All I am trying to do is put a couple of road signs out there. I sit on that set every day, and that is what I am focussing on. The road signs.”

Oz was brought up to be ambitious and aggressive, and, above all else, to win. “I grew up as orthodox and conventional as they come,” he told me. Oz’s parents immigrated to America from Turkey in the nineteen-fifties, after his father, a thoracic surgeon, received a scholarship to study in Cleveland. Mustafa Oz, who is now eighty-seven, practiced medicine in the United States until a few years ago, when he and Oz’s mother returned to Istanbul. He was born in central Turkey, near Konya, a center of Islamic piety—a fact, Oz says, that is critical to understanding his father’s approach to the world, and therefore his own. Mustafa Oz believed in hard work and little else. “The only question my father ever asked me was: Did anyone do better than you?” Oz said, with a wistful smile. “If I came home, proud and excited, with a ninety-seven on an exam, he would ask if somebody got a higher grade. And if George or Tom got a ninety-eight then I might as well have failed. When I made all-state football, which was a big deal for me, he didn’t ask me what it was or comment on it. He thought sports were a distraction. When his friends congratulated him at work the next day, he didn’t know what they were talking about.”

Oz, who has two sisters, became a doctor in large measure because his father was one. He made his initial decision at the age of seven, while waiting in line for ice cream in Wilmington, Delaware, where the family then lived. “There was a kid in line in front of me,” he said, “and my father asked him what he wanted to be when he grew up. The kid said, ‘I don’t know, I’m ten.’ ” Oz stopped, shrugged his shoulders, and smiled. “My father politely let the kid get his ice cream and move on, and, as I was going to get mine, my father turns to me and says, ‘Don’t you ever give me that answer. I don’t care what you are going to become and I don’t care if you change your mind a hundred times. But you always have to know what you want to be.’ ” Oz continued, “I still remember vividly going on rounds with him, and once seeing him take an eighteen-gauge needle and plunge it into a guy who was dying of pneumonia, injecting saline right into his trachea, which got him to cough up the plug that was choking him. It made me think I’d love to be able to do that.”

At Harvard, Oz played football and water polo. In his senior year, he won an athletic award for leadership. At the University of Pennsylvania, he was the president of his medical-school class. When he graduated, Oz was a deeply driven twenty-six-year-old. “I went to medical school firmly believing that if I studied hard I would learn everything I needed to know about the human body,” he told me. “All the answers lay in traditional medicine. I just needed to learn them.”

But he’d begun to sense the limits of that approach in medical school, as he spent more time around patients, and his outlook changed significantly when he met Lisa LeMole, who eventually became his wife. They have been married for twenty-six years and have four children; the oldest, Daphne, is one of the hosts of “The Chew,” the daily ABC show about food and eating. Oz told me that it was Lisa who suggested to Winfrey that she refer to him as “America’s doctor.” “That is what you are making him out to be,” Lisa told her. “That is what you are representing to people. So if you really believe that, say it.”

Lisa is intelligent, articulate, and unconventional; she eats no meat (Oz does), is wholly opposed to genetically modified foods (Oz is ambivalent), and has repeatedly expressed reservations about the value of some vaccinations. In 2009, when public-health officials urged Americans to vaccinate themselves and their children against the H1N1 strain of influenza, Lisa Oz said that she had no intention of doing so. That prompted her husband to explain publicly that, although he disagreed with Lisa, at home she was the boss. “I’m going to get it, but, I’ll tell you, my wife is not going to immunize our kids,” he said, on “Campbell Brown.” He added that he was powerless to reverse her decision, because “when I go home I’m not Dr. Oz, I’m Mr. Oz.” (Oz still disagrees with Lisa. In January, in front of an audience, he gave the CNN host Piers Morgan his first flu shot, and encouraged millions of viewers to get one as well. At home, however, the situation hasn’t changed. He remains Mr. Oz.)

Lisa’s father, Gerald LeMole, was a well-known heart surgeon who had trained in Houston with the surgical pioneers Michael Debakey and Denton Cooley. In 1968, LeMole served on the team that carried out the first successful heart transplant in the United States. The South African surgeon Christiaan Barnard had become a medical superstar just a few months earlier, when he successfully transplanted the heart of a young woman who was killed in a car accident. The recipient lived just eighteen days, but the feat was a milestone in the history of medicine. LeMole was traditional and successful but also offbeat—a combination that Oz had not imagined while growing up. “My father is passionate about medicine, and he still goes to the hospital every day,” Oz told me the first time we met. “He thinks what I’m doing is very fringe and he’s worried about me. He keeps asking me when I will be done playing around with this stuff and settle back down to medicine.” On another occasion, Oz described his father’s reaction to his growing interest in alternative approaches to health care as “suicidal.”

LeMole has no such reservations. He is often given credit for introducing rock music to operating rooms in the Northeast as a way to soothe the medical team and the patients, an innovation that earned him the nickname Rock Doc from Rolling Stone. The practice is now common, and many studies have demonstrated its value. In one, published in 2011 in the Journal of Anaesthesiology Clinical Pharmacology, researchers found that music consistently helped personnel approach stressful surgeries “in a more thoughtful and relaxed manner.” Patients were more relaxed, too, the study noted. LeMole was also among the first physicians to advocate a low-fat diet for his patients, which, although now routine, was ridiculed when he proposed it. His ideas about diet, exercise, and the importance of a positive mental attitude found an eager audience in Oz, who refers to him as one of his two mentors. (Winfrey is the other.) “I would probably say that my father’s best quality, which my husband shares, is this insatiable curiosity,” Lisa Oz told me. “Neither of them approaches anything he does with a closed mind. The similarities between Mehmet and my dad are mind-boggling.” She burst out laughing: “Freud would have had a field day with me.”

Oz quickly established himself as a heart-transplant specialist. He loved the surgical life and clearly still does. I accompanied him into the operating room one morning this winter and watched as he rebuilt a woman’s malfunctioning mitral valve. The surgery lasted five hours. Oz had come directly from an appearance on the “Today” show wearing a pin-striped suit over a pale-lavender shirt, its top two buttons open. When he arrived at New York-Presbyterian, he raced to his office and changed into scrubs. Before surgery, we toured the operating theatre. The hallways were stacked with drawers full of rotatable valves, stents, grafts, and rubber O-rings of every conceivable size—all hardware used to repair damaged hearts, neatly arrayed in Plexiglas boxes and arranged like the nuts and bolts on the shelves of a Home Depot. The operating room itself contained a maze of plastic piping that twisted though the air between the heart-and-lung machine and the operating table.

There are few more stressful occupations than that of heart surgeon. No matter how routine the procedure or how heavily the odds favor success, the moment the surgeon saws through a patient’s breastplate, inserts steel retractors to spread the ribs apart, then stops the heart, he literally has the patient’s life in his hands. Oz treats the operating room like a Cub Scout den, and he is its jovial but determined scoutmaster. He usually works with Michael Argenziano, an affable, bearlike man who is chief of adult cardiac surgery. (Oz trained Argenziano, and they have worked together for years.) I hovered in the background, watching the operation on one of the giant monitors suspended from the ceiling. At various points, Oz called me to the table to explain what he was doing. As the team of doctors, nurses, and technicians busied themselves draining blood from the woman’s heart, Oz insisted that I climb onto a step stool at the head of the operating table and gaze directly into the woman’s open chest cavity, where her heart, controlled by a machine and a team of masked surgeons, lay exposed. “What better view will you ever have?” he asked.

No surgeon gets as far as Oz has at New York-Presbyterian without talent and a compelling desire to lead; beta males choose other professions. Yet Oz has limited regard for what he considers the surgical personality. “Let me explain why surgeons are assholes,” he said. “Surgery is controlled arrogance. You think you can take a knife to someone’s chest and help him. Who thinks that way? Certainly no normal person. You need that confidence, that certainty to do it.” We were sitting in his office at New York-Presbyterian, shortly after the operation had concluded. Covers of various publications that have featured Oz were mounted on the walls, along with his diplomas from Harvard and the University of Pennsylvania. He produced a large bag of blueberries and offered me some. He is rarely without blueberries, almonds, or easy access to the “green drinks,” made mostly from cucumber, spinach, apples, and herbs, that he often mentions on his show. Oz doesn’t follow any of the miracle cures or fad diets that he trots out so regularly for his audience. He eats like a Paleolithic hunter-gatherer and exercises daily. He never takes an elevator when he can use the stairs; the one time I saw him do so, he told me he was embarrassed by his indolence, a word nobody else could possibly associate with him.

It didn’t take long for Oz to become convinced that a patient’s state of mind could be important to a successful surgical outcome. With his father-in-law’s encouragement, he began to explore music therapy, energy fields, and therapeutic touch, and he began to offer them to his surgical patients. Here, too, Lisa played a major role; she is a Reiki master, and Oz soon became famous at New York-Presbyterian, not to mention within the broader surgical community, for encouraging the practice of Reiki in the operating room. Reiki, the Japanese art of laying on hands, is based on the notion that an unseen, life-giving source of energy flows through our bodies. Oz hired a Reiki master named Julie Motz to stand in the operating room, where, she has said, she would attempt to harness “the body’s own energy to help patients survive risky operations, such as heart transplants.” Many of Oz’s colleagues, including some who worked directly with him, thought that permitting a Reiki master to enter the surgical suite at New York-Presbyterian was ludicrous. “She would come in and daven over the heart-and-lung machine for a while,” Eric Rose told me recently. In 1984, Rose made history when he performed the first successful pediatric heart transplant. He hired Oz in 1986 and then, several years later, when he served as chairman of the surgical department at New York-Presbyterian, assigned him to his transplant team. Studies of energy forces in our bodies have routinely shown that Reiki adheres to no known principles of science. In perhaps the most famous such review, a nine-year-old girl conceived and executed a test in which she demonstrated that twenty-one people who claimed to be skilled in the techniques of Reiki were nevertheless unable to detect her “energy field” more often than they would have by guessing. The study was eventually published in the Journal of the American Medical Association. In 2009, even the U.S. Conference of Catholic Bishops urged Catholic health-care facilities and clergy not to promote or support Reiki.

I told Oz that I was aware of no evidence showing that Reiki works. He cut in: “Neither am I, if you are talking purely about data. But this is one of the fundamental disconnects between Western medicine and what people often refer to as complementary medicine. Not everything adds up. It’s about making people more comfortable. I offer things like massage therapy, and offered Reiki if people wanted it. I did not recommend it, but I let people know it was their choice.”

Oz often says that he is just trying to present people with all their options, because they are sophisticated enough to make decisions for themselves. But some options are more beneficial than others, and medical experts are morally bound to explain the difference, as David Gorski told me recently. Gorski, an associate professor of surgery at the Wayne State University School of Medicine, is the managing editor of the influential blog Science-Based Medicine. “Oz has a huge bully pulpit, with the entire Oprah empire behind him,” he said. “He can’t simply dispense with facts he doesn’t find convenient.” Scientists often argue that, if alternative medicine proves effective through experimental research, it should no longer be considered alternative; at that point, it becomes medicine. By freely mixing alternatives with proven therapies, Oz makes it nearly impossible for the viewer of his show to assess the impact of either; the process just diminishes the value of science.

“I am guided by evidence above all,” Eric Rose told me recently, when I visited him in his office, at Siga Technologies, a biotechnology firm that develops treatments for highly lethal diseases like smallpox and Ebola fever. He is also a professor of surgery at the Mount Sinai medical school. Rose, who is sixty-two, is slim and thoughtful, with a casual elegance that suggests the head of an auction house more than the chief executive of a biotech firm. His office is framed from floor to ceiling in glass, with modern art on nearly every wall. I noticed a picture of Rose, posing with Oz, displayed on a shelf, above several Prouvé Standard Chairs. “I always liked to encourage surgeons to do what made them comfortable, and Mehmet is a particularly fine surgeon,” he told me when I asked why he permitted a Reiki master in his surgical program. “So when he told me he wanted to try Reiki I didn’t see why I should prevent him. Eventually, though, without any fanfare or difficulty, I suggested that it might be better if he knocked it off.”

By that time, in the mid-nineteen-nineties, anti-rejection drugs like cyclosporine had helped make heart transplants common. They were no longer front-page news, unless they involved notable people. When that happened, Rose was often asked to perform the operation. On October 25, 1996, Frank Torre, the brother of the New York Yankees manager Joe Torre, received a new heart at New York-Presbyterian. Rose led the team and Oz was his deputy. The transplant, which was a success, took place during that year’s World Series. The next night, the patient, who himself had been a successful baseball player and manager, watched from his bed as his brother’s team beat the Atlanta Braves to win the sixth game, and the Series. The publicity surrounding the operation was intense; a collage of articles about the event—“HEART OF THE YANKS,” the Daily News offered, in supersize type—still hangs in the cardiac-department offices at New York-Presbyterian. “I had my fifteen minutes of fame,” Rose said. “It was great for my career and for the hospital, but frankly I learned that it wasn’t something I enjoyed.” Oz had an entirely different reaction to the attention. The Torre transplant, Rose said, “was his first big splash of publicity, and he loved it.” Rose laughed and suggested that the experience helped propel Oz toward his current career. I asked Rose what he thought of his disciple’s work as a television host.

“I want to stress that Mehmet is a fine surgeon,” Rose said, as he did more than once during our conversation. “He is intellectually unbelievably gifted. But I think if there is any criticism you can apply to some of the stuff he talks about it is that there is no hierarchy of evidence. There rarely is with the alternatives. They have acquired a market, and that drives so much. At times, I think Mehmet does feed into that.”

I asked if he would place his confidence in a heart surgeon, no matter how gifted, who operated just once a week, as Oz does. “Well,” he replied, “in general you want a surgeon who lives and breathes his job, somebody who is above all devoted to that.” Again he mentioned Oz’s experience, but when I asked if he would send a patient to Oz for an operation, he looked uncomfortable. “No,” he said. “I wouldn’t. In many respects, Mehmet is now an entertainer. And he’s great at it. People learn a lot, and it can be meaningful in their lives. But that is a different job. In medicine, your baseline need has to be for a level of evidence that can lead to your conclusions. I don’t know how else you do it. Sometimes Mehmet will entertain wacky ideas—particularly if they are wacky and have entertainment value.”

The era of paternalistic medicine, where the doctor knew best and the patient felt lucky to have him, has ended. We don’t worship authority figures anymore. Our health-care system has become impersonal, mechanized, and hollow, and it has failed millions of people, many of whom want to find a way to regain control of their own medical decisions. As Oz likes to say, Marcus Welby—the kindly, accessible, but straight-talking television doctor—is dead.

Oz, however, functions essentially as Welby 2.0, presenting the ideal of a caring physician who has all the time in the world to discuss what ails you. His credentials permit him to perform the role of medical guide for the masses. But Oz fulfills an even more important role for his viewers. Like the most successful talk-show hosts who have come before him, he is a professional soulmate. “Phil Donahue did this really well when he had his daytime talk show,” Mindy Borman, one of the show’s two executive producers, told me when I met with her at the show’s offices. “He said, ‘I am going to talk about things that need to be discussed in this country, about things that are in the dark.’ I loved those shows; I grew up on them.” She tried never to miss an episode of “Donahue” or of “Oprah.” “They taught me that I had a voice, that I could be allowed to have an opinion,” she went on. “I grew up in Texas, and women were not supposed to have opinions. Those shows changed that, and I knew that Oz could do the same thing for health—that people would watch and then come in and say, ‘Hey, if I don’t want to have a stroke like my father, I’d better take care of myself.’ That I could walk into my doctor’s office and say, ‘I don’t know if I like that treatment’—that is a big, radical idea in this country.”

Lisa Oz takes some credit for launching her husband’s television career. “My favorite thing to do in the world is hang out with my husband and boss him around,” she said. “His favorite thing to do is to work. There was no way for me to go into the operating room and hang out with him, and he was spending all of his time there.” She went on, only half in jest, “So I had this scheme, about a television show where we would work together and I would be his producer, so I could boss him around.” Lisa then pitched a show to a friend who was starting a new job at the Discovery Channel. “The people there did a show with Mehmet called ‘Second Opinion.’ They envisioned it as medical school for the lay public. We had thirteen episodes, and there was a celebrity on each of them. When we did a show on obesity, Oprah was the guest. That was the beginning.”

Oz explains complex medical issues in ways that almost anyone can understand, and he knows how to work an audience. In an early appearance on “Oprah,” he showed up in scrubs, carrying a suitcase full of human organs. Wearing purple latex gloves, which became a trademark, he brought out a red, robust-looking heart. It was about the size of a softball, well-preserved and healthy, having come from a woman who had died recently in an accident. “The heart’s a very spiritual organ,” he told Winfrey. “It’s supple, and it’s firm, and it’s poetic. You want to feel the soul?” Winfrey said, “Sure,” and gave it a poke. Then Oz moved on to a badly damaged heart—bloated, white, and marbled with fat. The audience gasped as he cut into it with a scalpel; it looked like something that had been floating in water for weeks. He turned his attention to a pair of aortas. The first was pristine: smooth and clear, it had the texture of a clam. The other aorta was solid—it looked like gristle that had been discarded at a barbecue. “So that’s literally the hardening of the arteries?” Winfrey asked. She had summoned an overweight man to the stage. He asked Oz how he would know if plaque was building up in his heart and turning the aorta into an inflexible tube. Oz replied, “One of the ways that you’d know this is happening is from impotence. The fact that the blood vessels are not going correctly to the penis means they’re not going correctly to the heart, to the brain, to the kidneys. It’s a warning sign. It’s your dipstick.”

Oz strolled over to a flat-screen monitor and explained that he was about to present a graphic of what a heart attack looks like from the inside. Oz’s graphics are uniformly excellent. A giant simulated heart appeared on the monitor next to his head, and then there was a rush of digital blood flowing through an artery and across the screen; Oz narrated as red blood cells the size of grapefruits flew by. He became increasingly animated as he demonstrated how, after many years, plaque accumulates in the heart. His voice rose to a crescendo: “You are about to watch the leading cause of death in this country.” He pumped one gloved hand into the air: “Kaboom!” Suddenly, an artery became impossibly clogged. The audience was stunned, but Oz was just getting warmed up. He walked over to a table, reached under a cloth, and took out an enormous plastic bag containing human fat, orange and glutinous, that he had obtained from a liposuction patient. “Put it on your waist there,” he said, pressing the package against the belly of the man onstage. “You’ve got effectively twenty of these that you’re carrying around on your back.” The demonstration was hard to watch, but it was even harder to turn away. The autopsy video he showed next, of a man being sliced open and relieved of a thick layer of fat, was even more electrifying—and repulsive. “I am cured of my weight issue forever,” Winfrey said, optimistically, and to great laughter.

That approach became the template for “The Dr. Oz Show”: powerful graphics driven by a compelling narrative. Most days, Oz mines what he refers to as his go-to subjects: obesity and cancer. But both the show and his Web site concentrate on the type of weight-loss plans more commonly found on infomercials in the middle of the night: “Dr. Oz’s Three-Day Detox”; “Eat Yourself Skinny”; “Oz-Approved Seven-Day Crash Diet”; “Stairway to Skinny Workout.” Cancer, Oz told me, “is our Angelina Jolie. We could sell that show every day.” Typical themes have included “Five Fast-Moving Cancers”; “Four Body Pains That Could Mean Cancer”; “Three Cancer-Preventing Secrets”; and “What You Can Eat to Defeat Cancer.” Last year, in a show about weight loss, Oz introduced raspberry ketones, an herbal supplement, as “the No. 1 miracle in a bottle to burn your fat.” That set off a wave of panic buying throughout the nation. The supplement quickly vanished from the shelves of health-food stores. Oz told his audience that the product regulates the hormone adiponectin, which could help teach the body to be thin. But the only relevant research he cited had been conducted on laboratory rats and cell cultures—not on humans.

A similar buying frenzy followed his embrace, a few months ago, of “the miracle” of green coffee beans. “You may think that magic is make-believe,” Oz said at the beginning of the show. “But this little bean has scientists saying they have found a magic weight-loss cure for every body type. It’s green coffee beans, and, when turned into a supplement—this miracle pill can burn fat fast. This is very exciting. And it’s breaking news.”

None of those assertions turn out to be accurate. When coffee beans are roasted, the plant compound, chlorogenic acid, is broken down. Scientists think that the compound itself has an effect on limiting glucose absorption, which in turn helps reduce weight. While the beans are still green, the chlorogenic acid remains intact. In theory, that means the beans can aid metabolic regulation—but theory is not data. Oz based his announcement on a study that was presented at last year’s annual meeting of the American Chemical Society, in San Diego, where researchers reported that sixteen overweight men and women lost an average of seventeen pounds in twenty-two weeks when taking green coffee beans in supplement form. On the show, Oz did not mention that the study was funded by Applied Food Sciences, which makes green-coffee-bean supplements. But he decided to look into it further.

“We did our own study on this,” he said when I asked him about it. “It wasn’t a classical medical study, of course, but for a television show it was pretty darn good. We took a hundred people, randomized them, and showed what academic studies have showed: you are not going to lose a ton of weight, but you will probably lose a pound a week for a few weeks. That’s better than placebo.” Even those assertions are debatable, but his measured answer was almost exactly the opposite of the hyperbolic message he had broadcast into American living rooms. Oz never endorses specific brands, and he has a form, prominently displayed on his Web site, that viewers can use to report misleading advertisements that invoke his name. But his enthusiasm makes it hard to tell the difference, and, when it comes to sales, the words “as seen on ‘The Dr. Oz Show’ ” are often as valuable as the words “recommended by Dr. Oz.”

“Mehmet is a kind of modern evangelist,” Eric Topol said when I called him at the Scripps Research Institute, where he is a professor of genomics and the director of the Translational Science Institute. Topol, one of the nation’s most prominent cardiologists, founded the medical school at the Cleveland Clinic and led its department of cardiovascular medicine. “He is keenly intelligent and charismatic,” Topol said. “Mehmet was always unique, but now he has morphed into a mega-brand. When he tells people the number of sexual encounters they need each year to improve their lives in a specific way, or how to lose weight in three days—this is simply lunacy. The problem is that he is eloquent and talented, and some of what he says clearly provides a service we need. But how are consumers to know what is real and what is magic? Because Mehmet offers both as if they were one.”

He continued, “It all seems to be in the service of putting on a show. And, when you add it up, that seems like something other than medicine. It’s more like medutainment.” Topol was not the only voice to offer that kind of comment. One day, I asked Oz whether he minded that many of his medical peers criticized him for following the dictates of daytime television more than the demands of scientific truth. “I have always played offense,” he responded. “So I don’t care what people call me. I used to. I felt that to say I was an entertainer was dismissive. But it is part of what I have to do. I want to get my message across to people who are not going to get it in other ways. And I can’t do that if I am not palatable to the people who watch the show.”

Oz refers to the academic world as a “fortress,” and he is determined to tear down its walls. In the past, his enthusiasms, even when unsupported by data, have usually fulfilled the Hippocratic oath to do no harm. Lately, however, he seems to have moved more firmly into the realm of tenuous treatments for serious conditions. On one recent episode, “Dr. Oz’s 13 Miracles for 2013,” he included “a revolutionary new way to live years longer: it’s red palm oil.” He went on, “Its red color is perfect, because I think of it as a stop sign for aging.” I asked Oz several times why he promotes that kind of product, and allows psychics, homeopaths, and purveyors of improbable diet plans and dietary supplements to appear on the show. He said that he takes his role as a medium between medicine and the people seriously, and he feels that such programs offer his audience a broader perspective on health.

“Ultimately, if we want to fix American medicine we will need skeptical and smart patients to dominate,” he said. “They will need to ask the hard questions, because much of medicine is just plain old logic. So I am out there trying to persuade people to be those patients. And that often means telling them what the establishment doesn’t want them to hear: that their answers are not the only answers, and their medicine is not the only medicine.” But, when he tells his audience, with no credible evidence, that red palm oil may reduce the risk of Alzheimer’s disease, is he empowering people? Or is he encouraging them to endanger their health with another “miracle”?

On October 17th, Oz broadcast a program titled “GMO Foods: Are They Dangerous to Your Health?” Oz was not subtle. “You’re probably eating them right now and don’t even know,” he began, darkly invoking “the brave new world of food. Are they safe?” Oz then introduced Jeffrey Smith, the author of “Genetic Roulette,” who says that engineered foods may cause many serious diseases, including colitis, asthma, and cancer. Smith has also made a film version of the book; Oz, for the sake of full disclosure, noted that “my wife, Lisa, was a narrator in Jeffrey’s film.” He added that no scientists were willing to share the stage with Smith. “So today we are doing something we have never done before,” Oz said. “After Jeffrey makes his points, he has to leave the stage before we can speak with the scientists in favor of genetically modified foods.” Other than to say that Smith was controversial, Oz did not indicate why no scientists would appear with him.

When I asked Lisa about her involvement, she said that Smith presented a point of view that needed to be heard, and that the safety of genetically modified foods has not been proved. “I think Mehmet and I both feel, in general, that our mission is to empower the viewer or reader,” she said. “To give them the most information and the greatest number of tools they can use to make their own choices.”

On the show, Oz identified Smith as a scientist, but Smith has no experience in genetics or agriculture, and has no scientific degree from any institution. He studied business at the Maharishi International University, founded by the Maharishi Mahesh Yogi. Before the show aired, Bruce Chassy, a noted molecular biologist, wrote to Oz; he is a founder of Academics Review, a group of researchers who often debunk popular scientific claims. Chassy is professor emeritus in the department of food science and human nutrition at the University of Illinois. “As a public-sector scientist, researcher, and academic administrator with more than forty years’ experience, I am appalled that any medical professional would give a platform to the likes of Mr. Jeffrey Smith to impart health information to the public,” Chassy wrote. “His only professional experience prior to taking up his crusade against biotechnology is as a ballroom-dance teacher, yogic flying instructor, and political candidate for the Maharishi cult’s natural-law party.”

Graphic images of rats covered in tumors appeared on a monitor; the images were taken from a study, published in September, contending that the tumors were caused by genetically modified corn. The study was publicized widely throughout the world, but it was denounced by the European Union Food Safety Authority, rejected in a rare joint statement by the six French national scientific academies, and ridiculed by scores of scientists. None of that deterred Smith, who attacked the Food and Drug Administration for “ignoring” these problems. On the show, Oz never challenged him, although agricultural biotechnology has been under review by the F.D.A. for decades, and no agency, in the United States or anywhere else, has found evidence that genetically modified foods are metabolized by the body any differently from any other type of food.

There are many legitimate and articulate opponents of genetically modified products and, for that matter, of conventional medicine itself. But Oz has consistently chosen guests with dubious authority to argue those positions. Joseph Mercola, an osteopath, runs mercola.com, one of the most popular alternative-health Web sites in the country. Oz has described Mercola as a “pioneer in holistic treatments,” and as a man “your doctor doesn’t want you to listen to.” This is undoubtedly true, since Mercola has promoted such alleged experts as Tullio Simoncini, who claims that cancer is a fungus that can be cured with baking soda. Mercola has long argued that vaccines are dangerous and that they even cause AIDS. When Oz says that Mercola is “challenging everything you think you know about traditional medicine and prescription drugs,” it’s hard to argue. “I’m usually earnestly honest and modest about what I think we’ve accomplished,” Oz told me when we discussed his choice of guests. “If I don’t have Mercola on my show, I have thrown away the biggest opportunity that I have been given.”

I had no idea what he meant. How was it Oz’s “biggest opportunity” to introduce a guest who explicitly rejects the tenets of science? “The fact that I am a professor—one of the youngest professors ever—at Columbia, and that I earned my stripes writing hundreds of papers in peer-reviewed journals,” Oz began. “I know the system. I’ve been on those panels. I’m one of those guys who could talk about Mercola and not lose everybody. And so if I don’t talk to him I have abdicated my responsibility, because the currency that I deal in is trust, and it is trust that has been given to me by Oprah and by Columbia University, and by an audience that has watched over six hundred shows.”

I was still puzzled. “Either data works or it doesn’t,” I said. “Science is supposed to answer, or at least address, those questions. Surely you don’t think that all information is created equal?”

Oz sighed. “Medicine is a very religious experience,” he said. “I have my religion and you have yours. It becomes difficult for us to agree on what we think works, since so much of it is in the eye of the beholder. Data is rarely clean.” All facts come with a point of view. But his spin on it—that one can simply choose those which make sense, rather than data that happen to be true—was chilling. “You find the arguments that support your data,” he said, “and it’s my fact versus your fact.”

Oz is almost certainly the only cardiologist in American history with a full-time warmup comedian on his staff. Richie Byrne, a genial forty-nine-year-old who wears relaxed jeans and untucked shirttails, has been with the show since it began, in 2009. He is an emotional fluffer; his job is to keep the audience aroused while they wait for Oz to appear. “I’ve got a question for you,” Byrne shouts. “Are you readdddddy for Dr. Ozzzzzzzzz?” The audience, mostly women in their forties and fifties, bursts into applause. Byrne shows the audience when to laugh, when to clap, when to ooh and ah. Inspirational disco runs in a continuous loop: Donna Summer, Gloria Gaynor, and Patrick Hernandez’s hedonist standard “Born to Be Alive,” from the summer of 1979. “This is a show for you and about you,” Byrne calls out. “If you see something you want to react to, do it.” Once again, Byrne yells, “Are you ready for Dr. Ozzzzzzz??”

As the screams build, Oz emerges from the upper decks and strolls toward the stage, stopping to hug and touch his fans. That day’s episode, broadcast in December, was the biggest life-saving hour in Oz history, according to the narrator. It featured Oz’s visit to the Research Medical Center, in Kansas City. “From our very first day, we have had one simple mission for this show,” Oz began. “To empower you to take control of your health.” A brief clip flashed on the monitors, to show the free clinics that Oz has sponsored for thousands of patients throughout the country. At each stop, he administers the tests he gave in Kansas City, which he calls “the five essential health numbers you need to know to save your life.” On the monitors, Oz was shown talking to the woman with alarmingly high blood pressure whom he had filmed in Kansas City. “I’m hoping you can help me,” she told him, holding back tears. He replied, “Please don’t feel alone. I don’t want you living in fear and darkness. Can we do this together?”

Suddenly, the houselights went up: Oz and the woman were sitting onstage together. “It’s emotional to watch that, isn’t it?” he asked her. “Yes, it is,” she replied. The audience was rapt. Oz reminded her that her blood pressure was “toxically high,” explained that stroke was a significant risk, and stood up. “Come join me,” he said, walking over to a table that was draped with a blue cloth. “It’s going to emphasize what my big fears are.” Oz lifted the cloth to reveal a slice of a human brain the size and shape of a pie plate. The center was stained deep indigo, as if it had been colored with a Magic Marker. “This is someone who had a stroke, probably from high blood pressure, and died,” Oz said. The woman was stunned, the audience hushed.

Oz continued, “Big news: completely preventable. Instead of living in fear, you now have the control back.” Oz told the woman that he had put together a new life plan for her, involving a better diet and exercise—the details, he noted, could be found on doctoroz.com. “I’m not telling you to run a marathon,” he said. Then, like the host of a game show, he added, “I have a surprise for you. . . . Lee’s Summit Parks and Recreation board in your home town is giving you a yearlong gym membership!” The woman wept. Oz told her that she needed to have her blood pressure monitored daily, and that he knew she couldn’t afford it. “Now, look at me here,” he said, gazing into her eyes. “I don’t want you feeling ashamed because you don’t have insurance. I know you feel that. I can sense it and I can see it. It’s not your fault. We are going to take care of that.”

As Oz walked off the stage, after the show, he looked at me, smiled broadly, and said, “I could spend the rest of my life doing bypass surgeries, but what would that make me? A surgeon. With this show, we can do much, much more.” ♦