Denialism Blog

Author: MarkH

  • Why no one should take Nexium and it should never have been approved

    As Chris discussed Saturday the WSJ had a silly article in which a woman demands a prescription drug from a flight attendant, asking for the wrong drug to treat her problem acutely, and then shockingly was refused this service. Worse, Nexium is mentioned by name, multiple times, and Nexium is actually a drug which should never have even been approved by the FDA. It really is only prescribed because of intense marketing because, logically, it has no business on the market and is no different than an existing drug, prilosec. Why would doctors irrationally prescribe this drug then? Because advertising encourages irrational choices.

    So why is Nexium such a scam? Read below the fold.
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  • The New Yorker Ranks the Republicans vs. Science

    And get’s it wrong

    What’s amazing is they rank Newt first at the same time acknowledging he destroyed the Office of Technology Assessment.

    Jon Huntsman may have the most rational scientific and technological policies of anyone in the field, but Gingrich, sometimes called Newt Skywalker, has far more passion. As Kelefa Sanneh argues in the current issue, the philosophy of Gingrichism is nothing but a combination of the idiosyncratic views of the man himself–which include his beliefs in the virtues of space exploration and his opposition to regulating the Internet, even when it comes to porn. He was an early adopter of Twitter, and he once made the cover of Wired. He is ranked atop Scientific American’s recent “Geek Guide” to the 2012 candidates. As Sanneh notes, one of Gingrich’s manifestos about information policy includes a preface by the science-fiction writer Jerry Pournelle, declaring, “It’s raining soup, and Newt Gingrich has the blueprints for soup bowls.”

    His record is scarcely perfect. As Speaker, Gingrich abolished the Office of Technology Assessment–a move reminiscent of Nixon abolishing the White House’s Office of Science and Technology Policy. But, for the most part, Gingrich has moved policy in the right directions. And he gets extra credit for sitting on the couch with Nancy Pelosi to talk about global warming.

    So, he destroyed the office in congress that used science to evaluate legislation, as well as the efficacy of that legislation once enacted. He removed scientific guidance from the legislative branch, but because he’s passionate about the internets that doesn’t make him the worst thing to happen to science in the last 30 years?

    I realize we’re looking for the shiny turd in a cowpie here, but Gingrich? No way. Huntsman should be ranked first because he at least acknowledges global warming is real, a brave stand to take amongst a bunch of deniers. Whereas Gingrich dumped that chapter from his book after Rush Limbaugh suggested he might actually be on the side of reality. What’s going to matter more in the next 4 years? A president that took a brave stance on regulating internet porn? Or one that took a stance on global warming?

    None of these guys has any scientific chops but that seems too much to ask in politicians on either side these days. But this analysis by the New Yorker is embarrassingly superficial.

  • Carolyn Maloney (D-NY) and Darrell Issa (R-CA) sell out science

    I’m never shocked by what Issa can do in a never-ending downward spiral of serving business interests, but it’s sad that NY rep Carolyn Maloney has joined him backing a bill to sell out science. Once again the publishers are trying to destroy public access, and make everyone pay to read science you’ve already paid for with your taxes.

    The Research Works Act reads:

    No Federal agency may adopt, implement, maintain, continue, or otherwise engage in any policy, program, or other activity that–

    (1) causes, permits, or authorizes network dissemination of any private-sector research work without the prior consent of the publisher of such work; or

    (2) requires that any actual or prospective author, or the employer of such an actual or prospective author, assent to network dissemination of a private-sector research work.

    This really should be a settled issue but the publishers won’t let it go. They are allowed to limit access for a time to make profit for publishing research, but in the end, we’re talking about taxpayer funded research here. In the end, taxpayers should be able to read the results without paying again. It’s good for science too, especially internationally, because not every library can afford subscriptions to every journal in the universe. Open access will allow research to be more rapidly disseminated around the world.

    And what did it take to make Carolyn Maloney back the publishers over the public and advance this bill? About $9000 in donations from publishers (Issa only needed about $2000). It’s pathetic how cheap it is to get a member of congress to vote for an industry over the public.

    Here’s her email page if you want to send her a nasty-gram. Tell her to change position on H.R.3699 the “Research Works Act”.

    h/t it’s not junk

  • Don't mess with your neck doing yoga either

    For some reason the NYT is all about neck injury lately. In yesterday’s discussion of a possible chiropractic induced injury, Russell asked:

    But given all the other stresses people put on their necks, from accidents such as headbumps, from purposeful athletics such as whacking soccer balls, and from just craning one’s head in odd positions when performing various kinds of mechanical labor, it puzzles me that the risk from a chiropractor would be much greater than the risks from these other kinds of use/abuse. Of course, this is not excuse for the chiropractor, who is imposing that risk, likely on those more susceptible to injury, under false pretense or treating disease. It’s more a general lament that we each carry so much haphazard anatomy.

    Interesting he should mention this as today the NYT has an article How Yoga Can Wreck Your Body describing many ways that neck hyperextension during this popular exercise can also create similar injuries to the vertebral and carotid arteries.

    The mechanism is similar…
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  • Duesberg Strikes a blow for HIV/AIDS denialism

    When Duesberg was recently given space in Scientific American I think the blogosphere was rightly chagrinned that they would give space to a crank whose crackpot ideas are thought to be responsible for the deaths of hundreds of thousands. But it seemed at the time he had been keeping his denialism on the down low, maybe appearing to have given up on his crank view that HIV does not cause AIDS. Not so anymore. He’s back, and has secured publication of a paper denying HIV/AIDS in an Italian Journal.

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  • Think like a doctor, don't let them crack your neck!

    This week’s think like a doctor column in the NYT is great. It asks the question, if a woman goes to a chiropractor, gets her neck manipulated, and within hours and for the succeeding four years she’s had symptoms of severe headaches and a pulsatile sound in her ears, what is the diagnosis?

    You can guess what mine is…
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  • Is Huffington Post no longer a denialist site?

    Seth Mnookin has reasons to hope. It has been clear though for years that Huffpo was a clearinghouse for what I would describe as liberal crankery, which includes things like Jenny McCarthy’s anti-vaccine crankery, or Bill Maher’s anti-pharma paranoia.

    But now they have a new site, Huffpo Science, and after my head stopped ringing from that particular oxymoron I went and checked it out.
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  • New Years Resolutions

    As you can see, mine included blogging again. Fortunately, I’m in a brief research hiatus from surgical residency, so for the next year or so, I actually have some free time. Today I was inspired to start by the Huffington Post of all things, and with good news!

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  • The New Scientist Debates Denialism

    Luckily they don’t make the mistake of actually debating denialists. The feature of last weeks issue, “Age of Denial” is a series of articles by skeptics and one laughable rebuttal, discussing the nature of denialism and tactics to use against it. They do quite a good job covering the basics, starting with Deborah MacKenzie and her article “Why Sensible People Reject the Truth“:

    Whatever they are denying, denial movements have much in common with one another, not least the use of similar tactics (see “How to be a denialist”). All set themselves up as courageous underdogs fighting a corrupt elite engaged in a conspiracy to suppress the truth or foist a malicious lie on ordinary people. This conspiracy is usually claimed to be promoting a sinister agenda: the nanny state, takeover of the world economy, government power over individuals, financial gain, atheism.
    …
    All denialisms appear to be attempts like this to regain a sense of agency over uncaring nature: blaming autism on vaccines rather than an unknown natural cause, insisting that humans were made by divine plan, rejecting the idea that actions we thought were okay, such as smoking and burning coal, have turned out to be dangerous.

    Here she has it exactly right. Denialism starts with ideology, which most of us possess to some degree or another, and a conflict between that ideology and reality – at least so far as science allows us to understand it. In order to regain control of one’s beliefs, and protect them from being challenged, one has to prove that the science is wrong. And that requires one to believe in some form of non-parsimonious conspiracy theory, after all, how else could it be that science has come up with such an answer if not for the concerted malfeasance of thousands of individuals, all working together to undermine the TRUTH?

    Further she cites these as tactics of denialists:

    How to be a denialist
    Martin McKee, an epidemiologist at the London School of Hygiene and Tropical Medicine who also studies denial, has identified six tactics that all denialist movements use. “I’m not suggesting there is a manual somewhere, but one can see these elements, to varying degrees, in many settings,” he says (The European Journal of Public Health, vol 19, p 2).
    1. Allege that there’s a conspiracy. Claim that scientific consensus has arisen through collusion rather than the accumulation of evidence.
    2. Use fake experts to support your story. “Denial always starts with a cadre of pseudo-experts with some credentials that create a facade of credibility,” says Seth Kalichman of the University of Connecticut.
    3. Cherry-pick the evidence: trumpet whatever appears to support your case and ignore or rubbish the rest. Carry on trotting out supportive evidence even after it has been discredited.
    4. Create impossible standards for your opponents. Claim that the existing evidence is not good enough and demand more. If your opponent comes up with evidence you have demanded, move the goalposts.
    5. Use logical fallacies. Hitler opposed smoking, so anti-smoking measures are Nazi. Deliberately misrepresent the scientific consensus and then knock down your straw man.
    6. Manufacture doubt. Falsely portray scientists as so divided that basing policy on their advice would be premature. Insist “both sides” must be heard and cry censorship when “dissenting” arguments or experts are rejected.

    Sound familiar? That’s because McKee cites us in his paper. We’ll forgive her for not identifying the original source, after all McKee gives the credit.

    She does get a few things wrong, likely due to her unfamiliarity with just how absurd some denialists are. For instance when she says:

    The first thing to note is that denial finds its most fertile ground in areas where the science must be taken on trust. There is no denial of antibiotics, which visibly work. But there is denial of vaccines, which we are merely told will prevent diseases – diseases, moreover, which most of us have never seen, ironically because the vaccines work.

    This is demonstrably false, as we have encountered denialists who do deny the efficacy of antibiotics and all of Western medicine, as their particular ideology requires them to believe in the primacy of religion (Christian Science, New Age Nonsense) or in the magical properties of nature. She goes on to describe the work of our good colleague Seth Kalichman and the good things he’s done to fight HIV/AIDS denialism. Overall, a good summary of the problem. I also like how she stays non-judgmental and reflects on how pseudoscience is ultimately a complement to science:

    This is not necessarily malicious, or even explicitly anti-science. Indeed, the alternative explanations are usually portrayed as scientific. Nor is it willfully dishonest. It only requires people to think the way most people do: in terms of anecdote, emotion and cognitive short cuts. Denialist explanations may be couched in sciency language, but they rest on anecdotal evidence and the emotional appeal of regaining control.

    If imitation is the highest form of flattery, this certainly applies to pseudoscience. After all pseudoscience is a reflection of the authority science has as the arbiter of truth. If being on the right side of science wasn’t so important, cdesign proponentsists and global warming denialists wouldn’t fight so hard to warp it to fit their ideology, and by doing so, implicitly seek its approval.

    Jim Giles contributes an interesting article on an example of how a lie travels twice around the world before the truth gets its boots on with Unleashing a Lie, but then the series gets a bit more problematic with the contributions of noted skeptic Michael Shermer (also anerstwhile global warming denialist and persistent libertarian) and an amusing counterpoint from the otherwise wonderful Michael Fitzpatrick, a British GP who fights the good fight against autism quackery.
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  • Surgery

    I have now completed almost a year of surgical internship, and as I’m sure you’ve noticed from my sparse blogging, I’ve had little free time for writing. It’s a shame too because surgery is just so cool.

    Intern year is mostly about learning to manage surgical patients, basically people in varying degrees of health who have the added stress of having surgery recently performed on them. Although the 80-hour workweek and case requirements have pushed more exposure to the operating room into the process than previously existed, it’s still mostly medical management of patients at this stage. We are required to perform at least 750 cases in our 5 years of training. Of these cases, we are required to have exposure to a broad range of different surgeries with certain “defined” major cases counting towards specific quotas. For example, a recent requirement was added that we have at least 85 surgical endoscopy cases, including upper endoscopy and colonoscopies before we graduate. As a result, most of my day is spent dealing with medical issues with post-surgical patients, and if I’m lucky I get to go to the OR and, with an attending of course, learn some simple procedures.

    As your training progresses you take care of more critical patients, with your second year largely devoted to ICU care. You also are involved more extensively in complicated cases, so by the time you’re a third year you are able to help attendings with complex surgical cases, are responsible for evaluating surgical admissions, and begin to manage patients as a chief in some cases. In fourth and fifth years you are in charge of managing whole surgical services and are operating a majority of the time. By fifth year you are a chief, and you should be preparing for eventually operating on your own as an attending or for additional specialty training in a fellowship position.

    My day starts at about 5AM, when I pre-round on patients, collect the data from the previous day for the all-important list, and get signout (news on what happened overnight) from the intern who was on call. By 6AM the chief arrives, you round on the patients, and formulate a plan for the day. You’ve got to discharge patients who have recovered, manage the medical issues of your post-surgical patients, admit new patients and see the new surgical consults. Basically general surgeons get training to be excellent medical doctors who also learn to do surgery.

    The day ends around 5-6PM when you either sign out to the surgeon on call overnight, or take signout from the other services you will cover overnight. Surgical interns usually cover 3 services overnight, so I might be taking care of pediatric patients, plastic patients and urology patients, or emergency surgery, minimally invasive surgery, and surgical oncology patients for 12 hours until the next shift comes in the morning. This means you work for about 30 hours straight, the maximum allowed by the new hours limitations. You address any issues that come up in the night, staff any consults that can’t wait until morning, and every once in a while deal with some terrifying emergency that arises at 2AM. It’s not that bad, but after a full shift you sleep like the dead. Saturday calls are of course the worst, because you start at 6AM on Saturday and don’t go home until around noon the next day, basically losing your whole weekend. Usually we only have to take one Saturday call a month so we don’t lose our minds.

    So that’s why I haven’t been blogging. When not at work I’m usually eating, sleeping, or trying to keep my life in some kind of order. The goal though is to get back into this, to manage my time so we can still talk about medicine, and crankery, and the ever increasing tide of denialist movements. Not to mention TV shows. Anyone else seen Jesse Ventura’s new show? It’s like crank crack. Leave it to Ventura to figure out how to free-base illogical thinking.