Dr. Jacobs' Alternative Mission

By Anastasia Toufexis

"A teenage Navajo mother in blue jeans would come in with a baby who was suffering from a cold and ask for some medication," recalls Dr. Joe Jacobs, summoning up a scene from his days at the Indian Medical Center in Gallup, New Mexico. "She'd be accompanied by the grandmother in traditional hoop skirt, who kept silent." After examining the child, Jacobs would offer his prescription for soothing inflamed nasal passages: boil some sage leaves in water and have the youngster inhale the aromatic fumes. "When she'd hear that, the young mother invariably would give the grandmother a sheepish smile. It was just what the older woman had been urging her to do, and they'd been arguing about it."

Jacobs has a healthy respect for grandmothers' folk remedies and for unconventional therapies in general. He comes by it naturally. For though he is a conventionally trained pediatrician, he is also the son of a part- Cherokee father and full-blooded Mohawk mother, who used to break out the herbs and tonics whenever he and his two brothers and sister had a fever or bellyache. "There would always be long-necked bottles filled with liquids sitting on a shelf in the closet, and a few bags of dried leaves -- turtle socks and other things -- that could be brewed into foul-tasting teas." At the same time, Jacobs continues, "my mother recognized that more serious illnesses needed a regular physician."

That unusually broad experience led officials at the National Institutes of Health to pick Jacobs to head their new Office of Alternative Medicine. The office was created last year under pressure from a Congress alarmed by the soaring costs of high-tech healing and the frustrating fact that so many ailments -- AIDS, cancer, arthritis, back pain -- have yet to yield to standard medicine. In the breach, Americans have turned with growing enthusiasm to an array of unorthodox remedies, including hypnosis, biofeedback, homeopathy, acupuncture and herbs. According to the New England Journal of Medicine, a third of the population today consults alternative healers, shelling out nearly $14 billion a year for their services. Most is ^ paid out of pocket, since such treatments are rarely covered by insurance. "They could be just as good, cheaper and safer than many of the drugs and treatments we now use," asserts Jacobs, 46, "but they're still unproven."

To alternative healers, the effort is welcome news. "While a few worry that it's a plan to trap and discredit them, most look at this as a chance to be vindicated after years of being called lunatics," says Jacobs. The medical community has been cooler. Though the office's $2 million appropriation is a pittance in NIH's overall annual budget of more than $10 billion, critics resent that any sum is being diverted from traditional research. Some carp that the office will be a refuge for quacks -- a charge Jacobs flatly denies. "We're not created to rubber-stamp questionable practices."

With an M.D. from Yale and an M.B.A. from Wharton, Jacobs is a bona fide member of the Establishment. At the same time, his heritage has given him an outsider's perspective. Born in Brooklyn, New York, Jacobs spent part of his youth on Mohawk reservations upstate and in Canada, where "I was criticized by relatives and friends for being too educated." But he also lived in Anglo communities in New York and New Jersey, where "I was often the darkest- skinned child in my class."

Among his most piercing memories is watching his fellow Boy Scouts being inducted into the Order of the Arrow. "There I was, the only real Indian, and they were dancing around the campfire in loincloths," he recalls. "It was both ironic and offensive." To fit in, Jacobs largely rejected his Indian background during his adolescent years. Today, however, the Connecticut home he shares with two children and his art historian wife Mary Jane Clark ("a full-blooded Wasp," he notes) boasts a room filled with Indian keepsakes. The family will soon be relocating to the Washington area, where Clark will find an old schoolmate: her dorm counselor at Wellesley, Hillary Rodham Clinton.

Jacobs is already spending his weeks at the NIH campus. With a staff that includes a pharmacist, an immunologist and a psychologist, he is crafting standards for the 10 two-year research projects the office plans to fund at $100,000 each. Jacobs expects to steer clear of alternative therapies already being studied by other NIH departments, including the use of transcendental meditation for cardiovascular disease and acupuncture for substance abuse. "We may look at touch therapy, which is said to make patients better quicker," he says. "Or homeopathy, to relieve allergies, bronchitis or insomnia." He is also intrigued by wood ear, a tree fungus used in making moo shu pork, which is supposed to be a great blood thinner.

Treatments for cancer and AIDS are also high on his list. One healer, for example, claims to have isolated a substance in urine that turns tumor cells back to normal. The new office might also look into a faddish AIDS therapy that has patients paying up to $20,000 to be hooked up to dialysis-like machines that pump ozone into the bloodstream.

To evaluate such remedies, Jacobs will rely on both standard trials and an increasingly popular research technique: analyzing the outcome of differing therapies in matched groups of patients. Such a study, he explains, might compare the effects of bee pollen with conventional antihistamines in treating allergies. Since alternative healers are new to scientific studies, the office will take steps to monitor the validity of records and results. At a minimum, Jacobs hopes to provide a service to consumers. At best, he says, "we may help promote a revolution in thinking among practitioners and researchers. It's a bold new venture, sort of like being on the starship Enterprise. We're going where no one has gone before."

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CAPTION: Holistic Sampler