Nevertheless, most of the research community and the psychiatric establishment remain deeply unimpressed. Indeed, there isn't anything about Amen or what he does that his critics do like. Following the back-and-forth between them and him is like watching a bunch of increasingly infuriated boxers all trying to knock down an inflatable punching doll--the harder they hit, the faster he bounces back. They argue that Amen isn't competent to use scans because he's not board certified in nuclear medicine, didn't train in radiology (his several hundred hours of imaging training don't count), and doesn't follow science-based methods of differential diagnosis (using appropriate tests to differentiate systematically between distinct diseases with similar symptoms). He counters that he has the proper licenses to do his studies, teaches SPECT at a major medical school, has written or cowritten chapters about SPECT in three professional textbooks, has produced nearly two dozen peer-reviewed papers, instructs nuclear-medicine doctors who come from far away to spend weeks at his clinic, has chaired workshops on SPECT at the APA annual meeting, and, finally, just a year ago, received a Distinguished Fellow Award from the APA. "I have more experience with SPECT than anybody else in the world, and there are mountains of scientific literature backing up my clinical work--1,500 such studies are on my website alone."

They argue that he sits on a proprietary stash of 27,000 scans, like a miser sitting on a pile of gold bullion, and won't give researchers access to his data because he's afraid an independent look will undermine his claims. He contends that researchers are perfectly welcome at his clinic, to talk to his doctors, see how they interpret scans, and look at his database. But one leading researcher he invited out to see his scans hasn't followed through, and no one else has ever asked to see them.

They say, to quote Harvard's George Bush, that "he's unethically subjecting people, including children, to potentially dangerous ionizing medication in a diagnostic test of no proven benefit." He cites Michael Devous, a leading nuclear-medicine expert, who writes that "there are no data that have ever demonstrated any harm to humans by radiation exposure at diagnostic imaging levels." The average radiation exposure for one SPECT scan, Amen points out, is similar to that of an abdominal X-ray, which is routinely ordered for common childhood medical conditions, including constipation.

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