Denialism Blog

Author: denialism_bv2x6a

  • Why am I here again?

    Perhaps because I don’t blog anonymously, or maybe for other reasons, I don’t write that much about my personal life. That kind of writing can be self-important, insipid, and boring. But it can also have real power. A number of the anonymous bloggers here describe the intersection of the scientific life and family life with powerful relevance. Still, that’s not my talent, and I don’t do it much. One of my med school classmates, when I showed him one of my first pieces, said, “that’s good, Pal, but how do you feel?” That has always stuck with me (thanks, S!), and it’s in that spirit, and not the spirit of kvetching, that I’d like you to know that doctors are human. Yeah, I know, no surprise there, but still, sometimes patients forget it, and more important, sometimes doctors forget it. Besides, since no one reads the blogs on Sunday, it’s a good day for self-reflection.

    I come from a family of very smart people. Very smart—sometimes I feel like the village idiot (but in the best possible way). They are intellectually active professionals, all have advanced degrees, and many of them are musicians as well. Along with smarts, my family has been endowed with some unusual medical problems, so even the non-medical folks have used their formidable intellects to learn a little medicine. These are not “google scholars”—these are the real thing.

    So when my family challenges me about my skepticism, I have to take it seriously, not just because they’re my family and I love them, but because unlike some of the vacuous trolls that haunt this site, they’re very smart and well-informed.

    I have a number of good friends and family members with cancer. Is my hypertrophied skeptical sense depriving me of sharing with them “other ways of healing”? My sister, who is pretty good at reminding me that I don’t actually know everything, challenged me pretty rigorously on my medical skepticism. Of course, my wife and cousin had to help her out. These aren’t garden-variety challenges to my beliefs. A random blog troll can bring up the same canards and fallacies over and over, but when the people you love use good reasoning and good knowledge to call you out, you gotta take it a little more seriously. When the people you love have nasty diseases, it’s got that much more gravitas. Those of us who devote our intellectual resources to science-based medicine are often accused of lacking compassion, a charge I try very hard to avoid, not because it’s false (and it is), but because compassion is the great immeasurable, the ars longa in the vita brevis. Without compassion, science-based medicine might as well hand over the keys to the reiki shamans, the homeopaths, and other smiling quacks, because no matter how right you are, a doctor who lacks compassion can’t be an effective healer.

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  • Carnivalia, blog business, etc.

    Carnival of the Liberals is up at Capitol Annex

    Skeptics’ Circle 101 is up at Ionian Enchantment.

    You may have noticed the Friend Feed widget on the sidebar. I’ve added this as a sort of “mini-blog”, where we can post brief links or stories. I’d say it’s just out of beta at this point, but it seems to be working out. I’ll probably post links and carnivals there from now on.

    You may also have noticed the HONcode badge on the left sidebar. We receive our HONcode certification several weeks ago. We do our best to comply with the HONcode principles, which you can read about on their website. Basically, HON is an international organization to help ensure quality of online medical resources. They do not screen for content as such, but ask sites to adhere to certain principles, and they are generally pretty assertive about the certification process (it’s unclear how good they are about de-certifiying sites that violate the principles).

    Have a great weekend!

  • The Gay Mob Gets God's Goat

    I was tickled today to see a full-page ad running in the Times (Page A13) asking readers to reject the “Mob Veto.” What mob veto? The gay mob veto! The gays are engaging in “violence and intimidation” against the Mormons because of their support for Proposition 8 (California’s gay marriage ban.)

    I never thought I’d live to see a gay mob. Yes, there are many public events in San Francisco with many gay people, but they’re never violent, even when wearing scary biker gear.

    Maybe I take this more seriously if the authors of this advertisement (the Catholic League and other usual suspects) would take out a full page ad against the evangelical mob, groups like the Westboro Baptist Church.

  • tobacco and mental illness

    ResearchBlogging.orgAnyone who works with the mentally ill knows that they smoke more than other people. In fact, people with mental illness (hereafter, MI, not to be confused with myocardial infarction) are about twice as likely to smoke as people without mental illness, with smoking rates of 60-90%. One of my favorite stats is that “44% of the cigarettes smoked in the United States are by individuals with a psychiatric or substance-abuse disorder.” People with MI are also heavier smokers, and may even be better at extracting nicotine from the cigs that they smoke.

    Studies have shown that people with MI can in fact quit, but from a front line perspective, this is really, really tough. In fact, quit rates aren’t all that great for people without the added burden of mental illness, so any barriers to quitting are formidable ones.

    The reasons for high smoking rates in schizophrenics and others with serious mental illness are both socio-psychological and physiologic, with nicotine acting on CNS nicotine receptors and dopamine pathways. Smoking is sometimes viewed as a form of “self-medication”, but it can be difficult to differentiate the symptoms of nicotine withdrawal from symptoms attributable to the pre-existing mental illness.

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  • Smokers—what should we do with them?

    We sometimes treat them like second-class citizens. Or do we? Certainly smokers hate it when we force them out into the cold for a butt. Here in Michigan, we’re thinking about restricting smoking in a lot of public places. There benefits are supposed to accrue to three groups: the smokers themselves, their co-workers who are exposed to second-hand smoke, and the public, who pays more for health care because of smoking.

    I asked a simplistic question once about whether smokers should pay higher insurance premiums, that doesn’t really bring the same benefits to everyone as a more comprehensive approach. Now, outlawing smoking altogether seems foolish—you know, prohibition, black market, etc. But is it unreasonable to limit smoking to, essentially, the someones own private space?

    How do we justify a potential limitation of individual liberties? Smoking is the biggest cause of premature (and preventable) death in the U.S., leading to about half-a-million deaths yearly. Data from 1998 showed smoking was responsible for about 76 billion dollars in health care expenditures, plus productivity loses of about 92 billion dollars per year. Smoking sickens and kills people, and costs are (very crappy) economy a lot of money. For both economic and public health reasons, we must make smoking cessation a paramount societal goal.

    How do we do this?

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  • Where do you get your mercury?

    There is an ongoing discussion amongst our Sciblings regarding our German counterparts at scienceblogs.de. Apparently they have some odd folks as science bloggers over there, including people who think ayurvedic heavy metals are good for you. In the tradition of countering speech with speech, I’m giving you this repost. More to come, I’m sure. –PalMD

    ResearchBlogging.orgThe Infectious Disease Promotion Movement (let by such intellectual luminaries as Jenny McCarthy) may be worried about “toxins” in vaccines, but the real problem may hiding in plain sight.

    Today’s issue of JAMA has an interesting study of Ayurvedic (traditional Indian) medicines. It turns out that many of them contain a significant amount of toxic heavy metals.
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  • Choosing a Medical Specialty II—the view from above

    MarkH is going through the process of deciding what to what to do when he grows up. This is a much more difficult and important decision than many may realize. In order to understand the gravity of this process, I’ll have to refresh your memories a bit regarding medical education.

    In the U.S., to apply for medical school, you must have completed a (usually) 4-year bachelor’s degree from a university. During the final year, you take what amounts to an entrance exam (the MCAT), and send out preliminary applications (often with fees). If the schools like your preliminary applications, they will send you secondary applications which are more lengthy and involve more fees. If they like your secondary application, you will be invited for interviews. For those of you who may not be familiar with U.S. geography, this place is big—really big. When I went on my interviews, I typically crossed two or three time zones. I took the red-eye out of SFO for Washington National, leaving around 11 p.m. and arriving around 7 a.m. The process is time-consuming and expensive.

    After finishing the interview process, you may or may not receive invitations to matriculate. If you don’t get an offer, and you still want to become a doctor, you must repeat the entire process the next year. It is, needless to say, unwise to go through this process unless you’re pretty sure you’ll be happy with your decision to go to medical school.
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  • Thanksgiving thoughts

    This is my annual Thanksgiving post (“annual” because I wrote it last year and I’m reposting it this year. It’s companion piece is over at my old place). –PalMD

    It’s easy to see what Christmas means to an atheist—another day off work. What about Thanksgiving? This nominally secular holiday is practiced throughout North America by people of most faiths and cultures, and by those of no faith at all. But to whom are we giving thanks? Can “thank” be an intransitive verb?

    This question falls into the same category as many ethical questions about atheism, such as “where do atheists get their morals?”, but this is a little different. First, does celebrating Thanksgiving require “giving thanks”?

    I’d argue that it does not. To celebrate the joys of family, the harvest bounty, and just not working is enjoyable in and of itself. There is no moral imperative to “thank” anyone or anything. The pure joy of celebration is enough for many.

    But thanking people is a good thing. It cements social bonds, creates interpersonal harmony. It’s a good idea to thank your family, your friends, and anyone else who has helped brighten your days. Why do that on one particular day? Why not? Devoting a day away from work to simply thank those around us is probably a good thing.

    I am certainly not saying one should not thank God on Thanksgiving…that’s up to you. If you are one of those who believes in a deity, go for it. But remember that there are many ways to “thank” without having to believe in God. While you thank your God, you may also want to thank your atheist neighbor who, despite not fearing hellfire and damnation, returned your mower.

    So happy Thanksgiving to both my loyal readers. I’ll be with my family filling my belly—heaven on Earth.

  • Denialists' harvest—the AIDS body count in South Africa

    As a physician, few things frustrate and sadden me as much as preventable deaths. I see it all the time—the guy who kept putting off his colonoscopy and was later diagnosed with metastatic colon cancer, the woman who put off coming to the doctor with her breast lump until it broke through her skin, the heart patient who couldn’t stop smoking. They all haunt me. But what if the ghosts were numbered in the hundreds of thousands rather than dozens?

    That’s what it must be like to be Thabo Mbeki, that is if he has a conscience. It may (or may not) be bad “framing” to call someone a “denialist” but a new study seems to say that whatever you call it, denialism kills. When government leaders allow themselves to be duped by denialists murderers non-acceptors of truth sickfuckdenialistbastards….Damn it, I’m sticking with “denialist”. When government leaders allow denialists to guide their public health policies, people die, apparently in large numbers. I’ll have to leave it to my epidemiology colleagues to evaluate the quality of the study (which on my read looks OK), but even if it’s off by one order of magnitude, the results are horrifying.
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  • Link love, shameless promotion edition

    ResearchBlogging.orgIf you’re not yet familiar with researchblogging.org, you need to click the picture. It’s a blog-aggregator that pulls together posts about peer-reviewed research, and since the intersection of published research and blogging is getting a lot of play lately, this is a must-see.

    In addition, Dave Munger is launching a new forum to discuss research blogging where yours truly will be a janitor moderator.

    Next, I’ve started a new forum for the discussion of many of the issues seen in this space, at Science-Based Medicine, and any other interesting issues that come up. It’s set for moderated registration, as is the research bloggging forum, which simply means go there, register, and very shortly you will be in business, and you can have a few other places to waste your time online.

    And speaking of Science-Based Medicine, I’ve loved this blog since it debuted, and I very fortunate to have been invited as a regular over there. You should be reading it regularly. It’s good for the brain.

    Finally, ScienceOnline09 is fast approaching, and I will be moderating a session on beginning blogging and on anonymity online (along with Abel). If you are coming, or just interested in the topic, stop by the wiki and leave suggestions.

    That is all.