Denialism Blog

Author: denialism_bv2x6a

  • A little HIV knowledge

    A few months ago, I gave you a short primer on the immunology of vaccines. It’s time now for another short, oversimplified primer, this time on the immunology of HIV. This was originally up on the old blog, but it will provide some necessary background for upcoming posts (I think).

    HIV denialists form a persistent little cult, and one of their newest leaders is Gary Null. Despite their small size and dearth of academic heavy-weights, they are quite loud, and can affect health policy.

    Let’s delve into the immunology, and, once again, please forgive the over-simplification.

    HIV—nasty non-critter
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  • Tangled Bank #105

    The new Tangled Bank is up over at The Beagle Project, and as usual, it’s a great read.

    Also, I want to give a quick shout-out to my internet buddy Ames who’s hit the blogosphere running, so to speak, with his first carnival post.

  • Medicine is fun!

    Well, I’m back from a great vacation, and buried under an avalanche of work. Just to give you a hint of what an internist actually does…

    My office schedule is full—really full. Everybody needs to see me, plus the various sick people I have to squeeze in. It’s great; being busy is fun, but it’s time consuming.

    Then there’s my desk. It is covered in lab results, home care orders to be signed, hospice orders, medication refills, prior authorizations…

    And of course, back to teaching, including evaluations, etc.

    So, it may be a bit quieter around here for a while, but I wanted to point out a few interesting things. MarkH is finally getting around to practicing some real medicine, that is, internal medicine, and he has discovered what I love about it—the mysteries (and it ain’t House, folks). One important point in particular he raised is how sick medical patients really are these days:

    The more realistic medicine patient would be someone over the age of 50 with at least 5 or 6 chronic problems, and just one (or two, or three) that has put them over the edge requiring hospitalization.

    Hospitalized patients are much sicker than they used to be. This may sound a bit odd, but many diseases are now successfully managed outside the hospital. Also, as hospitalization has become more costly, you have to be pretty sick to get in the door. For example, 25 years ago, it wasn’t unusual to admit someone for a “work up” of one kind or another. Now, patients must meet certain criteria of “intensity of service” and “severity of illness” to have an admission qualify for coverage. This usually isn’t a problem, but sometimes it is. Just something to think about.

  • Journalist becomes the story: Discover Magazine luvs teh denialists.

    HT erv.

    This is truly annoying because it is so patently wrong. It’s wrong in lots of different ways, but I’ll help point out some of the major flaws. What happens when journalist becomes the story, rather than reports it?

    You see, there is this journalist, Celia Farber, who apparently has been following the HIV denialists since the beginning. From reading this interview with her in Discover Magazine, it would seem that she is suffering from some sort of Stockholm Syndrome. Not only that, but the journalist interviewing her shows a complete lack of suspicion, and seems to be one of those modern journalists who thinks that everything has two valid sides to report on. Not everything does.

    Instead of chronicling the history of HIV denialism, she has truly drunk deep of the Flav-R-Ade. Ever wonder how to tell if a journalist has lost her objectivity? How about this?

    It’s changed in that so much of what the orthodoxy proclaimed has not come true. The paradigm has failed miserably on virtually all counts. So the orthodoxy right now is particularly venomous and vicious against anybody who is what they call an AIDS denialist.

    Uh oh. I sense someone begging the question. The interviewer follows up with a WTF.

    What are the failures of the paradigm?

    Good question, but I would have also asked, “WTF is the ‘HIV paradigm’?”

    Response? Right out of the HIV denialist handbook: (all emphasis mine, –PalMD)
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  • Skeptics' Circle #86—don't bitch to me about it

    It’s a really good edition up at Skepbitch (who is surprisingly nice). Don’t miss it!

  • What's in store for Burma?

    As the death toll in the immediate aftermath of Cyclone Nargis becomes clear, new dangers loom. Complete breakdown in essential services and sanitation will conspire to kill thousands more via disease unless the world moves quickly (and maybe, even if we do).

    Arthropod-borne diseases such as malaria and dengue fever are likely to flourish as standing water serves as breeding ground for mosquitoes. Malaria kills around a million people a year. Dengue is most often a disabling illness characterized by fever and severe pain, but in endemic areas it can lead to dengue hemorrhagic fever, a fatal illness resembling Ebola and Marburg viruses (but not as contagious).

    Diseases related to lack of clean water, such as diarrhea, cholera, and hepatitis A can be especially nasty with little fresh water available for rehydration.

    Tetanus, acquired from wounds, is a particularly grizzly death, and was seen frequently in victims of the Pakistan earthquake.

    As bad as the initial death toll is (perhaps around 100K), it can get much worse quickly. Hopefully the world will respond as it did after the Great Tsunami, and hopefully the Burmese Junta won’t stand in the way. If they do, they may not have much left to rule over.

  • Aye, there's the rub–open dream thread.

    I’ll admit right of the bat that I didn’t do any research before posting this one. I haven’t read any literature on dreams in years, but somehow discussion among some egghead-types turned to common dreams. Among these:

    –The one where you sign up for a class and forget about it until finals

    –The one where you are in class and notice you’re naked

    –The one where your teeth are falling out

    Now all of these have, in each person, all sorts of interesting associations, but I’m curious whether these particular dreams are more common in academic types. Do folks outside of academia have similar dreams, or are their anxieties expressed differently?

    Thread now officially open.

  • GINA—why we should make it irrelevant

    GINA, the Genetic Information Non-discrimination Act, has been passed by the House and the Senate, and will be signed by the president. Others have explained some of the implications of the bill, but the need for the bill is a grave sign.

    GINA is a symptom…a symptom of a diseased health care system. Health insurance works by pooling risk. Ideally, an insurer will take as many people as possible, regardless of their health histories, and the premiums of the healthy will support the care of the unhealthy few. Of course, insurance companies aren’t stupid. They would rather have the healthiest people possible…every penny the don’t spend is profit. That is why a small business, such as mine, will see rates skyrocket if someone gets sick. The risk isn’t being widely pooled, and the cost is being passed on to a few.

    GINA isn’t necessary in most of the world (forget for a moment that most of the world doesn’t have money to spend on genetic testing). Most industrialized nations have some sort of universal health care—risk is pooled widely, in fact the pool includes the entire population. There are problems with this, but one of them isn’t discrimination. Under our current system, people are penalized for being sick, poor, or unemployed. It is inefficient and expensive.

    Surely we can do better. If we make GINA irrelevant, many of our health care problems will also fade.

  • TEOTWAWKI!

    The end of the world is a common religious idea. The end of this planet and the end of time itself are ideas not unknown to cosmologists, but are not exactly an immediate threat.

    To certain religious groups, the threat is now, and is welcome. “Signs” are everywhere. Of course, we’ve been down this road before, in the 9th century, a few times in the 19th century, and of course in 2000.

    Turn on the TV any Sunday—there are plenty of preachers reading and reading and reading, and of course finding signs of the imminent apocalypse. Hey, there’s that whole “Left Behind” series of books reveling in the end of the world.

    Aside from the fact that no one has yet correctly predicted The End, there are a few problems here. First, if God wanted you to know when the end was coming, wouldn’t he have just written a date clearly in the Bible, like, “HEY, MORTAL FOOLS, REPENT! THE END IS NIGH! 8 PM, FEBRUARY 22ND, 2010. I MEAN IT!”

    Or perhaps he doesn’t want us to know, and to look for it would be a sin against him?

    Or maybe, just maybe, all of this “End times” stuff is just human interpretations of human works and human fears. After all, since God hasn’t bothered to inscribe it on the clear blue sky, or appear on ABC during “Desperate Housewives”, all predictions of the End must necessarily be those of people, not a supernatural being who would know such things.

    So, here we are, on our usually pleasant little globe, worrying about when it will end. That’s just lovely. But perhaps—just maybe—we should worry about what happens if it doesn’t end. Cyclone Nargis in Burma/Myanmar, Hurricane Katrina in the U.S., famines, floods, fires—all of these so-called natural disasters, while not entirely preventable, are things we can plan for. This type of large-scale planning (such as the Dutch flood prevention systems) requires casting ourselves far into the future, and actually sacrificing present comfort for future survival. Of course, if the end is near, who cares? Wait for God to take us bodily into his arms, and to Hell (literally) with everyone else.

    I, for one, can’t live with that. Just because some sweaty preacher in a studio says the world is ending doesn’t make it so. I have kids, and I care what happens to them, so it really pisses me off when others say, “just come to Christ, and all will be well.” It won’t. If you put your head in the sand hoping for immediate Rapture, you are admitting that you don’t care a whit for your fellow human beings. How Christian is that?

  • Never say "hopeless"

    I can’t tell you the number of people who complain to me about having their hope taken away. Exactly what this means, though, isn’t always clear.

    Sometimes an oncologist will tell them (so they say) that they have a month to live. Sometimes their cardiologist tells them (so they say) not to travel to their grandson’s Bar Mitzvah. Sometimes the spine surgeon tells them their back will always hurt, no matter what. So they say.

    Patients tell me a lot of things. I’m not always sure what other doctors really told them, but what is important is what the patient heard. The oncologist might have said “incurable” but followed it up by “but treatable for years.” I suspect after hearing “incurable”, not much else gets in.

    One thing I’ve finally learned after a number of years is that patients actually listen, even if you don’t think they do. What they hear is a different story. Depending on their mood and circumstance, they may hang on single phrases, subtle inflection, the way your eyes dart.

    To be an effective physician, you must also be an actor of sorts; not in the sense of pretense, but in the way you pay attention to everything your words and body do, and how your audience reacts.

    I had a patient a few years back, a very pleasant older woman, who came to me with difficulty in swallowing. There can be a number of different reasons for this. A radiographic study, however, showed a lesion in her esophagus that was almost certainly cancer. Normally, I won’t speak on the phone to people about such things, but she and I had decided for various reasons that this would be the best way to communicate. I told her about the results:
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