Denialism Blog

Month: April 2008

  • How to deliver a message

    Bloggers are an odd bunch. Some are “serious journalists”, some glorified editorialists, but most are just folks with access to a computer. This was the genesis of the blogosphere—individuals writing whatever they wanted, not knowing (but hoping) that maybe a few others might read their work.

    As it turns out, there are some excellent writers out there that we might never have read were it not for the internet. But most still maintain an independence of spirit and of thought. Yes, there are “corporate” bloggers out there. For instance, one of the local hospitals has an internal blog by some corporate type. It’s very different from the blogs most of us are used to reading. It’s, um, very positive. And commenting requires entry of an employee ID number. It’s not exactly designed for the free flow of ideas.

    But most of the blogosphere isn’t designed for anything. It’s an emergent phenomenon, fueled by individuality.

    If your purpose as a writer is to influence large numbers of people, blogging probably isn’t your best choice. Op-ed columns, books, almost any medium gets a larger readership.

    And since bloggers are individuals, beholden to no one, they have no duties as such. They can write whatever they wish.

    Rarely, a blogger is read nearly as widely as a journalist, and PZ Myers is one of the few. Dr. Myers is a professor, and teaches at a University. In this capacity, his duties to transmit information are a bit more clear, and he has made it known on many occasions that his classroom is not a bully pulpit for atheism.

    A biologist can use the classroom to teach biology, but as a blogger, he can deliver any message he wishes.

    In my work, I have to frame messages in a certain way. I am communicating to individual patients, and I need to persuade them on the most intimate level that what I am telling them is the course they should follow. If they are futzing around with altie remedies, I can’t be overtly dismissive, or I’ll lose them immediately.

    But in delivering a message to a somewhat larger audience, I use a different tone, one of compassionate snarkiness, for example. I do this not only because it suits me, but because I feel that on some level it is effective.

    Scientists always have a duty to deliver the truth about their fields. The tone in which it is delivered depends greatly upon the medium and the audience. But most of all, it depends on the writer. Most bloggers of science have a fierce attachment to the truth which cannot be compromised for any reason, and if it happens to piss people off, so be it.

    I’m sure that a creationist student in a biology class might be uncomfortable, but since it is a classroom, they must learn the material to succeed. Our readers have no such obligation. Therefore, we have no obligation to kiss anyone’s tukhes.

  • Stupid news story

    There’s no such thing as a slow news day. There’s a war in Iraq, another in Afganistan, a genocide in Sudan, a presidential campaign, and probably some right wing blowhard having fun in a public restroom somewhere.

    So what the hell was the Times thinking with this one? The premise appears to be that blogging is so stressful, it can KILL!!111!one!! In fact the title is “In Web World of 24/7 Stress, Writers Blog Till They Drop”.

    Let’s examine that story. The premise is that some bloggers work so hard, under such pressure, that they just drop dead. There are many dangerous jobs out there—commercial fishing and coal mining come to mind. Epidemiologists can figure these things out by collecting data. Reporters can read epidemiology reports and tell us all about them.

    Or they can just make this shit up.

    According to the “journalist”:

    They work long hours, often to exhaustion…. [They] are toiling under great physical and emotional stress created by the around-the-clock Internet economy that demands a constant stream of news and comment…. In the last few months, two among their ranks have died suddenly.

    Further down he qualifies his comment:

    To be sure, there is no official diagnosis of death by blogging, and the premature demise of two people obviously does not qualify as an epidemic. There is also no certainty that the stress of the work contributed to their deaths. But friends and family of the deceased, and fellow information workers, say those deaths have them thinking about the dangers of their work style.

    Let’s compare this to my residents. They are working 80 hours a week, making life and death decisions every minute, and getting pennies for it. They are exposed to dangerous pathogens. I’ve seen one of my residents die, but my anecdote hardly qualifies as data.

    To add to his very informative story, the writer quotes one blogger as saying, “I haven’t died yet.”

    This is crap journalism. It tells us nothing, and implies a public health problem where none may exist.

    I do a lot of bad writing, but I’m an amateur. I’d still be embarrassed to have written this piece, and as an editor, I’d feel a little silly for letting it through.

    Anyway, I’m not sure how dangerous blogging could be. I do it all the time, and as they say, “I haven’t died yet.”

  • Presidential candidates and health care—watch them carefully

    Politically, I’m a leftie. That should be no surprise to anyone who knows me. But when it comes to science and medicine, my politics are irrelevant. Given that John McCain has already made some questionable public statements regarding vaccines and autism, this seems like a good time to see what the democrats are saying.

    Over at Hillary’s website, we can examine her positions on health care. She makes special mention of autism. Some of her recommendations sound quite reasonable and good, such as improving access to services for autistic children. But she repeats the questionable though popular idea that there is an “autism epidemic”, something that is far from proved. She makes mention of providing funding for evidence-based treatment, but also gives a shout-out to finding “environmental factors”, which is code for “toxins, mercury, vaccines” and all other kinds of hogwash. Sure, politicians have to appeal to everyone, but in appealing to everyone, it’s possible to appeal to no one strongly. Compromise over how to spend defense or highway money is one thing, but science should be guided by science, not the mercury militia.

    Obama’s statement on autism is far more vague.

    What I find interesting about both candidates’ websites is that they both feature autism prominently. That’s nice—we certainly need to learn more about autism. But why pick that over, say, heart disease, stroke, tobacco abuse, and cancer, which affect the health of far more Americans than autism ever will?

    So what of McCain? His health care info also focuses on economics, which is fine.

    McCain makes a very interesting statement about health education. He invokes personal responsibility, which is a common Republican phrase that happens to be important to health care. He then says:

    Childhood obesity, diabetes and high blood pressure are all on the rise. We must again teach our children about health, nutrition and exercise – vital life information.

    Does anyone see what he left out here? Sexually transmitted diseases are on the rise. What about sex education as part of health education? You can’t teach children about obesity, blood pressure, and diabetes, and then leave out one of the nations biggest health problems—unless you are trying to appease a certain constituency.

    And like the Dems, he has an entire link to autism, something he doesn’t have for heart disease, cancer, or anything else. In his blurb, he also gives lip-service to “environmental factors”.

    The point is not that autism doesn’t deserve funding. It most certainly does, as long as that funding is directed into evidence-based investigation, and not more studies looking at disproven hypotheses such as vaccines and “toxins”. The real point is that all three candidates, when speaking of health care, need to focus on what harms and kills most Americans. The Dems are actively speaking out on access. All three should at least include realistic plans to encourage health care initiatives that make use of evidence and not emotion.

  • Off to work…what micro-organisms will I encounter today?

    I’m off to the walk-in clinic in a little while. If past experience is a useful guide, I will see at least a dozen people with various respiratory viruses causing colds, conjuntivitis, bronchitis, and sinus infections (offending viruses include adenovirus, rhinovirus, and many others). Generally, the folks giving a home to these bugs need grandmotherly advice. Part of my job is to determine which of these patients might have an infection with Group A beta-hemolytic Streptococcus, Bordatella pertussis, Mycoplasma pneumoniea, Steptococcus pneumoniae, influenza, or other potentially bad actors.

    There will probably be a few cases of gastroenteritis, most caused by enteroviruses like echovirus and norovirus, but I have to keep in mind other possibilities like Clostridium difficile, and Salmonella.

    There will certainly be some sexually transmitted infections with organisms such as Neisseria gonnorrheaea, Chlamydia trachomatis, and Trichomonas vaginalis. That’s a fun one.i-9cce71fcd0e7cae0d792aad847f72795-Trichomonas_Giemsa_DPDx.jpgMost of the time, we have to make educated guesses as to which microorganism we’re dealing with, but we can see Trich right away under the microscope.

    Of course some of the friends I meet today might not be “micro”-organisms. Scabies and pubic lice sometimes grace my exam room.

    Often enough, I treat small abscesses. Community-acquired MRSA has become so common that I usually pick an antibiotic to which it is susceptible, rather than the usual MSSA coverage (although, sometimes removing the “good and laudible pus” is enough).

    Occassionally, I will meet a problem that can’t be dealt with in the clinic. Last week a man walked in with leg pain and shortness of breath. He had just returned from an extended car trip. His let was swollen, his lungs clear, and his EKG showed a pattern or right heart strain. We sent him straight to the ER where he was diagnosed with multiple pulmonary emboli and admitted to the hospital.

    And this is part of the fun of primary care medicine. Seening a large variety of problems, sorting out the small problems from the dangerous ones, and passing on that knowledge.

  • Smoke and mirrors—cult medicine's attack on science

    I generally enjoy Bill Maher. I mean, he seems like an ass, but I enjoy his shows—except when he talks about medicine. As any regular viewer knows, he regularly spouts the usual denialist canards about medicine. This week, he was interviewing Senator Arlen Specter, who, among other accomplishments, has survived Hodgkin’s Disease, a form of blood cancer. Maher had the bad taste to ask him is he was disgusted that health care is the third leading cause of death in the U.S. Had he said this to me, I would likely have responded, “Look, asshole, the American health care system just saved my fucking life!”

    This is of the more popular canards propagated by cult medicine leaders and their followers. According to the wackos, modern medical care kills and injures more people than, well, just about anything. Joe Mercola and Gary Null have very long articles on their websites bemoaning the dangers of medicine versus the safety of woo. They love to make statements like, “It is now evident that the American medical system is the leading cause of death and injury in the US.”

    What does this all mean? Should we, as the cultists suggest, abandon medicine for the cults of homeopathy, naturopathy, and chiropractic?

    Probably not. Why do I say that? Because I’m a paid shill for the Big Pharm/AMA/FDA juggernaut? Well, no. Abandoning modern medicine for the cultists doesn’t make sense, either medically or statistically.

    When cultists cite their terror statistics they leave out a few important facts. There is no doubt that medical errors, and even medical therapy without errors, can harm. No one would argue otherwise. The flip side is, it also helps—a lot. For example, one of the statistics often cited from the Institute of Medicine’s landmark study on medical error is that somewhere between 44,000 and 98,000 deaths yearly in the U.S. may be due to medical errors. Now, to put that in perspective, advances in the treatment of coronary artery disease reduced the number of deaths by over 340,000 in 2000 alone. And that’s just one disease. Of course there are risks to modern medicine—it’s active treatment, not placebo, so it can be expected to hurt some people. But it helps far more. Returning to the era of roots and berries is not likely to improve quality of life or longevity. Reducing medical errors is important, and is an active field of research. The solution to medical errors isn’t voodoo, it’s science. Anyone who tells you different is trying to sell you something.

  • Jenny McCarthy is an idiot—and I don't mean that in a nice way

    I have a certain amount of sympathy for any parent dealing with a sick kid. I also don’t think people should “suffer in silence”. If, for instance, your child is injured in an auto accident caused by a drunk driver, speaking out publicly is a public service.

    If, however, you are a fuckwit with no relevant education, and are famous only for being famous, leave the bully pulpit to others. Case in point, Jenny McCarthy. Many of us have been following McCarthy’s descent into woo-filled madness as she has dealt with her son’s growth and development. As a brief primer: Son diagnosed as autistic, McCarthy buys into anti-vaccination movement, re-invents word “indigo”, subjects child to bizarre dietary regimen, proclaims him cured, doesn’t shut up about it.

    OK, now that you’re caught up, the “not shutting up” continues, and this time CNN is giving her all the bandwidth she needs to show off her stupidity.

    I’m not a journalist, and as such, I don’t really have an obligation to, you know, the truth. Still, I’m a physician, and I have a reputation (of sorts) to maintain, so I do my best. I would think that CNN would have journalistic standards somewhat higher than your humble blogger.

    Not so much.

    McCarthy seems upset that the rest of the world isn’t knocking down her door to spread the word of her son’s “cure”.

    We believe what helped Evan recover was starting a gluten-free, casein-free diet, vitamin supplementation, detox of metals, and anti-fungals for yeast overgrowth that plagued his intestines…

    Lot’s of kids believe in Santa with the same level of evidence, but that doesn’t make him real. Where is the evidence?

    (more…)

  • More JPANDS lies—Godwin, here we come


    BPSDB    Once again, JPANDS, the mouthpiece of the AAPS, has it all wrong. The contradictory missions of the AAPS often lead to humorous juxtapositions of policy. For example, the AAPS wants the physician-patient relationship unsullied by any outside forces—unless that relationship pisses them off. They intervened in the Terry Schiavo case, they wish to make abortion illegal—in other words, they’re libertarians, unless AAPS disapproves of your decisions.

    Their big beef in the current article is that there has been a conspiracy to hide the dangers of oral contraceptives and abortion. You see, apparently these cause breast cancer and the NIH doesn’t want you to know. Straight to Godwin:

    The NCI Workshop on Early Reproductive Events is reminiscent of an event that occurred in Nazi Germany in the 1930s. Hitler was displeased because “Jewish” science was coming to prominence. The government assembled 10 physicists, including two Nobel laureates, to each write an essay against Einstein’s theory of relativity. The book was published as 100 Essays Against
    Einstein    . Einstein remarked to an inquiring reporter that were they correct, “it would have only taken one.” In a similar way, our government has interfered with the scientific process of conducting studies and relaying the relevant information to the general public.

    Wow. Let me clarify a few things here. First, the relationship between oral contraceptives (OCPs), and breast cancer is muddy to nonexistent. Huge studies have been conducted to try to clarify the issue of exogenous estrogen use and the jury is still out. There are a number of reasons to use both OCPs and HRT, and sometimes reason to avoid them. Most of these reasons have to do with blood clotting disorders rather than cancer.

    Anyway, the one issue that is not unclear is the abortion-breast cancer question. Here is a short list of citations for articles that have shown no link between abortion and breast cancer:

    1. NEJM 1997, 336, 81-5
    2. British Medical Journal 1989, 299, 1430-2
    3. Cancer Causes & Control 1997, 8, 93-108
    4. Lancet 2004, 363, 1007-16
    5. American Journal of Epidemiology 1988, 127, 981-9
    6. British Journal of Cancer 1982, 45, 327-31
    7. American Journal of Epidemiology 1987, 126, 831-41
    8. International Journal of Cancer 1991, 48, 816-20
    9. European Journal of Cancer 1999, 35, 1361-7
    10. Journal of Epidemiology & Community Health 2005, 59, 283-7
    11. Cancer Epidemiology, Biomarkers & Prevention 2003, 12, 209-14
    12. American Journal of Epidemiology 1983, 117, 35-45
    13. Epidemiology 2000, 11, 76-80
    14. International Journal of Cancer 2001, 92, 899-905
    15. Cancer Causes & Control 1997, 8, 841-9
    16. International Journal of Cancer 1996, 65, 401-5
    17. British Journal of Cancer 1990, 62, 122-6
    18. International Journal of Cancer 1993, 215-9
    19. Cancer Causes & Control 1995, 6, 75-82
    20. American Journal of Public Health 1999, 89, 1244-7
    21. British Journal of Cancer 1999, 79, 1923-8
    22. Epidemiology 2000, 11, 177-80
    23. Cancer Causes & Control 2000, 11, 777-81
    24. International Journal of Cancer 1998, 76, 182-8

    And here is a list of all the well-done studies showing a clear link:

    (crickets)

    So, why abortion and OCPs? Why not hormone replacement therapy? Why not smoking? Because the radical Cult Christians and quacks that run AAPS hate women. Period. They want to put control of women and their bodies back where it belongs—in the hands of Cult Christian manly men.

    Thankfully, the AAPS is a fringe cult group. But people do listen, and they hear what they want to hear. Shameful, really.

  • Autism cranks going after bloggers

    It’s time to open up a can of Streisand. The author of the autism blog Neurodiversity, along with many other blogs and other online entities, has been subpoenaed to produce what amounts to her entire life to aid in some frivolous autism suit. The only thing they didn’t ask her to do was submit to a speculum exam (don’t get any ideas, bastards!).

    This is truly outrageous. It is a clear attempt by a group of (forgive me, please PP) demented fucking wackaloons to intimidate a humble New Englander who enjoys writing.

    Time to get the word out!

    (Hat tip LizDitz)

    Addendum:

    Orac and others have pointed out that the lawyer involved is the real bad guy here. It’s hard to blame devastated parents, but this Clifford Shoemaker guy should be ashamed of himself.

  • Is that really a disease? Epistemology and crank-ism

    And out of the ground the LORD God formed every beast of the field, and every fowl of the air; and brought them unto the man to see what he would call them; and whatsoever the man would call every living creature, that was to be the name thereof. (Genesis 2:19)

    Human beings are great organizers. As far back as written history goes, people have named and classified what they observe. In fact, it forms the basis for modern science. Linnaean classification, based on observation of traits, predates modern cladistic and genomic classification of organisms, based on arguably more fundamental characteristics.

    The same is true of human disease. Hippocrates was a great observer of human disease and correctly described many conditions in ways easily recognizable to modern doctors. Today, where we know causes of disease, classification has become more precise. For example, we may divide diseases into those caused by bacteria, viruses, genetic defects, etc. When we don’t know the cause of a disease, we still rely on observation. We have various syndromes such as lupus where we do not know the cause, and must fall back on description. This is especially true of psychiatric diseases, where causes are largely unknown, but identifiable patterns of thought and behavior exist.

    It is of course most desirable to be able to describe a disease and know its cause, but being able to name less “concrete” disorders is also helpful. It allows researchers to identify cases and test interventions. Even though lupus does not have one easily identifiable cause, we can describe it well enough to study treatments, thereby helping design treatments.

    This all leads up to a larger epistemologic question: what is a disease?
    (more…)

  • Open letter to Deirdre Imus

    Dear Deirdre,

    Hi! How are you? I am sooo proud of you. I mean, when I have a serious personality flaw, I usually try to hide it, but you! You are willing to show the WHOLE WORLD how intellectually challenged you are (that means “stupid” LOL).

    Your recent article in the Huffington Post was so brave. Seriously, it’s pretty clear to insiders that there are problems at the CDC. But to get it so wrong took real guts.

    For example:

    These criticisms have been voiced for several decades. An example of how the agency can design a study so that it fails to link disease and pollution can be found in the way the CDC investigated the cancer clusters in Fallon, Nevada and Sierra Vista, Arizona…

    The CDC itself admits the agency repeatedly fails to identify, or connect, environmental chemicals to these clusters. Quoting from the CDC website, “From 1961 to 1982, CDC investigated 108 reported cancer clusters in 29 states and 5 foreign countries…The studies were begun in hopes of identifying a viral cause of cancer clusters. During these investigations, however no clear cause was determined for any of the reported clusters.”

    I love it! A failure to find the result Deirdre wants equals failure! The grandiosity—it’s so…Paris Hilton!

    But you saved your real courage for influenza. You showed the whole world that it doesn’t take brains or research to have an opinion. I mean, a conspiracy to inflate flu death statistics to raise money! Brilliant! OK, maybe it’s not original, but at least it’s, um…well, let’s see.

    I’ll quote you so I get it right:

    (more…)