Denialism Blog

Author: MarkH

  • Bill Maher is a crank

    I must admit I have a love-hate relationship with Bill Maher. He is a funny guy, he is good at mocking some of the more ludicrous aspects of politics, and he has been an effective critic of this administration and some of its more egregious policies.

    However, I’ve also long held the position that both liberals and conservatives alike must own up to their own extremists. Liberals must own up to the fact that they don’t have a universally-solid grasp on scientific truth, and just like the right wingers, we have people and movements within the left wing that are cranky and denialist. I would say left wing crankery includes animal rights extremism, altie/new age woo, and anti-technology Luddites.

    Bill Maher is one of these cranks (he scores 3/3), and if the liberals want to represent themselves as truly pro-science we must make a concerted effort to reject the unscientific beliefs of these crackpots. We must call out Bill Maher on his BS (we have before as has Orac), and call him a crank for his unscientific, and frankly insane beliefs about medicine, disease, “toxins” and health.

    As PAL has already pointed out and I wholeheartedly agree, Bill Maher made an outrageous statement Friday night on his show Real Time. In an interview with Arlen Specter, who’s life was saved by medical science, he said:

    Because President Bush actually brings up a good point, because you can’t catch cancer, but people in this country treat it like you can. What you do is you hatch cancer by human behavior. Most cancer, there is of course some genetic cancer, but most of it is by behavior…

    But doesn’t that tell you something about our system, why do you have so much faith in Western medicine when they get it so wrong, when the third-leading cause of death in this country the health care system itself. Isn’t the paradigm wrong?

    Where to begin with such a pair of despicable statements? For one, this is a classic crank attack on medicine, using the IOM report, as PAL mentioned, to attack medicine ironically in the midst of one of its attempts to be self-correcting. The misunderstanding that anti-medicine cranks are exploiting in this report are that the overwhelming majority of “mistakes” in that report were things like failure to rescue (failing to recognize when a patient starts circling the drain) and hospital acquired problems like decubitus ulcers and nosocomial infection. What does that mean? That means the failure of medicine that the IOM is being critical of reflect failures to save the lives of people that are critically, critically ill. These are failures in saving people from death. These are mistakes in a population that are actively dying (failure to rescue), or so sick that they are unable to even move under their own power (decubitus ulcer), or immune compromised enough that they can’t defend against infections (nosocomial infections). These mistakes are a problem, and I don’t seek to diminish the importance of finding ways to avoid them. The IOM report represents the efforts of medicine to correct preventable failures in medical care that are very serious, and we’ve spent the last decade trying to resolve (we will likely spend many more). For example the recent War Games video I posted was an example of attempts to train medstudents and interns how to recognize and deal with rescue situations more quickly and effectively.

    But Bill Maher makes it sound like doctors are stalking healthy people in the streets and beating them to death with ball-peen hammers. You don’t go into your doctor’s office for a routine visit and acquire a c. difficile infection or MRSA or decubitus ulcers or a “failure to rescue” mistake. We’re talking about very sick people who often wouldn’t be alive in the first place without medical intervention, who doctors, albeit for some preventable reason, are failing to keep alive or inadvertently make worse. That doesn’t stop Maher from making it sound like we’re running people down in the parking lot, and I don’t appreciate the implication that doctors who sacrifice so much time and effort saving lives are heedlessly killing people.

    Further it is exceptionally ignorant for ignoring the incredible net contribution of medicine to extending and improving life. Why do we live longer on average than any generation in human history? Childbirth no longer represents a major threat to a woman’s life. Children don’t die from ordinary illnesses and infections. Major traumas like gunshots, fractures and massive blood loss no longer are an instant death sentence – we often can put people right back together after amazing injuries. How have we managed to cure diseases like polio, or cure Senator Specter’s Hodgkin’s lymphoma? Evidence-based medicine and the applied science of modern medical care is the answer to all those questions. No magic crystal, acupuncturists needle, or diluted tincture has accomplished these feats.

    Bill Maher is a Luddite, who has tried to blame the death of bees on cell phones has engaged in anti-vaccine wingnuttery, routinely complains of mysterious “toxins”, supports animal rights extremists, and generally has a disgusting “blame-the-victim” mentality towards health. Lung cancer may be a largely self-inflicted illness, but the other big cancer killers? Breast cancer? Prostate cancer? Pancreatic and colorectal cancers? Each may have a small environmental component, but most cancers aside from those caused by cigarettes have much more minor contributions from lifestyle and environment. That is not to say these contributions do not exist, but compared to cigarettes the relative risks of misbehavior are astronomically smaller. Most of these cancers have overwhelmingly genetic risk factors and the number one risk factor is almost always family history. Maher’s statement that cancers are “hatched” or that there is only “some” genetic component is typical of his ignorance of medicine, his blame-the-victim mentality towards disease, and is just as despicable as his depiction of medicine as a killer.

    Liberals have to own up to the fact that they have cranks in their midst as well. Bill Maher is the left-wing version of Dinesh D’Souza or Jerry Falwell. His views on science are no more elevated, and when in conflict with his ideology, no less hateful towards science, or the people he disagrees with.

  • A history of denialism – Part III – Global Warming Denialism

    Part III of our discussion of the history of denialist movements is on one that should tie things together and one I hope some of my fellow sciencebloggers will realize speaks to the necessity of challenging denialists on every front.

    My work in this instance is made extremely easy as Naomi Oreskes has done it all for me. Please watch her discussion on the history of global warming denialism, it takes a bit of time, but it is dead on and is one of the best discussions of the methods and strategy of denialism (not to mention free-market fundamentalism) I have seen to date.

    For those of you who follow this site and recent postings you will see some consistent themes:

    1) Well-funded think tanks are capable of derailing a scientific consensus, in this case the consensus on global warming which has existed for nearly 3 decades.
    2) The goal of denialists is not to propose an alternative theory that is explanatory and useful, but to create controversy and doubt where it does not exist.
    3) These attempts are highly effective despite a complete absence of controversy in the scientific literature. Attacks in the lay press are more than sufficient to create a false debate using an appeal for parity or balanced presentation of ideas.
    4) The same strategies used by the tobacco companies to deny the link between cancer and tobacco smoke, and in fact, some of the exact same actors are present in both cases.

    These efforts must not be ignored. The methods of denialists must be exposed and attacked, and the sources of denialism must be discredited.

    Part II – tobacco
    Part I – the ancients

  • Cell Phones and Cancer – Scaremongering from the Independent

    The Independent has yet another hysterical article about the potential link between cell phones and brain cancer. And I’ve been asked, what are we seeing here? Is this the early reporting of a potential public health threat? Or is it just more nonsense from a newspaper that wouldn’t know good science if it sat on it’s head? Both Ben Goldacre and I have felt the need to take on some piece of nonsense from the Independent, and their previous writing on “electrosmog”, a repeatedly disproven piece of crankery, diminishes their credibility on this issue.

    And guess what else diminishes their credibility here? Only about every single aspect of this article. For one they start out with an irresponsible claim about the risks of cell-phone use that I won’t bother to repeat since it will just reinforce an unproven statement.

    Second, where is this study? I looked for it. I searched for the author’s name in pubmed, and while he’s well-published, there’s nothing about cell phones.

    Yet they claim the study has been published:

    The study, by Dr Vini Khurana, is the most devastating indictment yet published of the health risks.

    But then we find out that this study isn’t “published”, the results are just on a “brain surgery website”. After a little more digging I found it here published on Dr. Khurana’s webpage. Just a little reminder for the Independent, putting a paper on a webpage does not make it “published” in a fashion equivalent to publication in a scientific journal, and they would do well to correct this in their article. I know they won’t because I’ve noted a total lack of journalistic responsibility in their science coverage, but one can dream. Then I see this:

    Professor Khurana – a top neurosurgeon who has received 14 awards over the past 16 years, has published more than three dozen scientific papers – reviewed more than 100 studies on the effects of mobile phones. He has put the results on a brain surgery website, and a paper based on the research is currently being peer-reviewed for publication in a scientific journal.

    Currently being peer-reviewed? This means this paper is unpublished and merely submitted for review. Further, it’s a very strange move to take a paper that is being considered for publication to put it into the public domain. This means that it’s either been rejected from wherever was supposed to take it, or the author doesn’t realize this will likely sabotage its chances of being published. I simply don’t understand this move. Dr. Khurana appears to be a legitimate scientist, but that doesn’t make this any less inappropriate a method of publishing such a result. Since he hasn’t gone through proper peer-review channels before making this article available I think this means it’s fair game for me to criticize, and there’s plenty of room for that.

    For one, he has an entire section on “Popular Press and the Internet” which consists of anecdotal reports of cancer clusters in the press, crank websites repeating false claims about cell phones and second-hand reporting on scientific articles. This is hardly a scientific approach to epidemiology or risk assessment, and should be dismissed out of hand as unworthy of discussion in a scientific paper. A review of the literature does not include citations of “www.EMF-Health.com”, no kidding, this is one of the sources he mentions. A website that sells the Q-link, a quack remedy for a nonexistent malady!

    Then I see this statement:

    In other words, if cell phones interfere with aircraft and hospital electrical equipment (even at quite a distance), how can it be that they don’t interfere with the electrical equipment of the head (i.e., the brain, when held for extended periods of time right next to this
    organ)?

    Who’s done with this guy now? Do you even have to go on after a statement so absurd? This reflects a fundamental misunderstanding of physics and biology and a terrible argument from analogy. It’s an especially bad analogy as the evidence seems to be that cell phones have no effect on plane equipment to the point the FAA has long considered dropping the ban. Finally there is very little physical basis for a carcinogenic link between these radiofrequencies and cancer, so what would be the mechanism? The EM bands used by cell phones are non-ionizing, and do not have a physically plausible mechanism for causing cancer.

    So far we only a couple pages in, have incredibly questionable sourcing and a terrible argument from analogy, l’ve already dismissed this as unworthy of consideration, should we bother to keep going? Ok, maybe a little further.
    (more…)

  • A history of denialism – Part II – Tobacco companies

    To continue to explain how terribly misguided Mooney and Nisbet are about ignoring denialist campaigns I think it’s time to go over the history of one of the most effective denialist campaigns ever. That is the concerted effort by the major tobacco companies (RJ Reynolds, Brown & Williamson, Lorillard, Phillip Morris, and British American Tobacco) to spread misinformation about the health risks associated with smoking.

    Fortunately for those who study denialism, one of the results of the Tobacco Master Settlement all the internal memos of four of the largest tobacco companies have been released to the public and exist as free searchable databases.

    Within these documents one can find some true gems of denialist strategy second only to Wedge Document for their unintentional disclosure of their dishonest tactics. For instance from “NEW DIRECTIONS” A presentation of the tobacco institute staff June 25th, 1981:

    i-fac1655243303280ce2b7882e30d59f6-tobacco1.jpg
    And:
    i-1a9245d57dc196193d0a2e4323cda010-tobacco2.jpg

    And this gem from Brown and Williamson “Smoking and Health Proposal” from 1969:

    i-0e77718d23a87e62f302d2b01d1cee1e-tobacco3.jpg

    Throughout these documents you see a similar theme every time. Science comes out that is harmful to their profits, such as the 1964 Surgeon General’s report on tobacco and health was to be opposed no matter what the results. The writing is schizophrenic, while they seem to be convinced of their righteousness and the safety of smoking, they write about actively pursuing and eliminating the carcinogens in tobacco smoke, making filters that will be safer, and consider strategies of admitting to the danger of cigarette smoke. As the science becomes more damning they just shift the message to one of righteousness of personal liberty while their own research confirmed the risks to nonsmokers from environmental tobacco smoke.

    What does this have to do with Mooney and Nisbet telling us to ignore the cranks like the DI or the Heartland Institute? It shows that even when the majority of people understand and believe the science – for instance the evidence showing cigarettes cause cancer has been believed by around 90% of Americans for decades – well-funded denialist campaigns can still be highly effective in disrupting appropriate regulation, legislation, and dissemination of accurate public health information.

    Global warming denialists using some of the same think tanks the tobacco companies used, and even some of the same shills such as Steven Milloy and Fred Singer (now working for the Heartland Institute) are capable of waging the same kind of war on legitimate science as they did for the tobacco companies. Only after years of work from public health authorities, scientists and interest groups, as well as vicious fighting over legislation, civil litigation and the actions of whistleblowers were the tobacco companies largely declawed in their campaign against scientific truth. It certainly wasn’t by ignoring them, and letting them act unopposed, or letting the polls dictate a non-existent victory that they were finally defeated. And that is the danger of the message we’re currently getting from the framers. It’s the worst possible strategy for opposing denialism, it’s dangerous, historically-ignorant, and will lead to disaster.

    Despite the fact that the majority of Americans believed in the link between cigarettes and cancer the the tobacco companies’ denialist campaign worked for a long time, and here’s how they did it…

    (more…)

  • Finally Free

    At long last I have finished my surgical requirements. After 12 weeks of nonstop surgery rotations, despite enjoying it thoroughly, I’m ready to try something else for a while. Or at least I’m looking forward to waking up at 6AM rather than 4AM for a few months. It seems like such a small difference, but it’s literally the difference between night and day. Especially during the winter, starting at 5 on the wards and finishing usually well after dark, you begin to wonder if you’ll see the sun again. Being able to walk into work when it’s actually light out is very appealing.

    My traffic has, of course, slowed. But I’ve still been thinking about good topics to write about this whole time. At the end of most days I’ve just been passing out rather than taking the time to mock crankery. Now I think my schedule will be a little more amenable to extramural writing, I have a backlog of things to discuss, and the first thing we’re going to be dealing with is this polling-based nonsense about ignoring denialism I’ve been hearing about lately. I’ll also talk some more about the fun things I’ve done, and if various people can avoid getting their panties in a bunch over little old me, I might be able to relate some more amusing things about medical education.

  • A history of denialism – the ancients

    This week I think I’m going to spend some time discussing denialism throughout history. In part inspired by the recent attacks on some of the most effective scientific communicators we have by by Mooney and Matthew Nisbet, and PalMD’s post on some modern thinking by “ancients” I feel like it’s time to provide some more historical context to debunking bullshit, and the long and honorable tradition of debunking by the world’s greatest thinkers and communicators. We’re going to start a little bit light with my nomination of Plato as history’s first debunker.

    You see, Plato had to deal with some BS artists in his day. They were known as the sophists, traveling teachers of the youth who purported to teach the sons of the wealthy knowledge and virtue. However there was a problem. The sophists weren’t so much interested in teaching the kiddies philosophy, or how to find truth and improve human understanding of the world, they were only interested in winning arguments at any costs. In other words, they would teach the children of the wealthy how to use any dirty rhetorical trick they could think of to win people over and gain power. Charming group really.

    So along comes Plato, student of Socrates, and he’s not happy. He believed that people should be interested in seeking truth and understanding of the world. In his eyes the sloppy rhetoric and moral relativism of the sophists was ultimately corrupt and unworthy. His criticisms of the sophists are therefore a source of joy for any student of denialism. In particular, I believe that we should single out Plato’s dialogue Gorgias for an early discussion of denialist BS, and perhaps the earliest refutation of quackery that I’ve seen.

    Socrates: You were saying, in fact, that the rhetorician will have, greater powers of persuasion than the physician even in a matter of health?

    Gorgias: Yes, with the multitude-that is.

    Soc. You mean to say, with the ignorant; for with those who know he cannot be supposed to have greater powers of persuasion.

    Gor. Very true.

    Soc. But if he is to have more power of persuasion than the physician, he will have greater power than he who knows?

    Gor. Certainly.

    Soc. Although he is not a physician:-is he?

    Gor. No.

    Soc. And he who is not a physician must, obviously, be ignorant of what the physician knows.

    Gor. Clearly.

    Soc. Then, when the rhetorician is more persuasive than the physician, the ignorant is more persuasive with the ignorant than he who has knowledge?-is not that the inference?

    Gor. In the case supposed:-Yes.

    Soc. And the same holds of the relation of rhetoric to all the other arts; the rhetorician need not know the truth about things; he has only to discover some way of persuading the ignorant that he has more knowledge than those who know?

    Gor. Yes, Socrates, and is not this a great comfort?-not to have learned the other arts, but the art of rhetoric only, and yet to be in no way inferior to the professors of them?

    Ha! What does that sound like?

    The debunkers of the world are part of a long and noble history of those who wouldn’t tolerate BS and were willing to stand up against it in any form. Plato certainly won the historical fight. Today sophist is used as an epithet, and to say someone is just using rhetoric (although unfair to the legitimate study of rhetoric) is the same as calling someone a bullshitter. Therefore today I recognize Plato as a founding father of debunking denialism.

    GORGIAS by Plato translated by Benjamin Jowett, available at GreekTexts.com.

  • War Games!

    One of the problems with medical education is that while you are intellectually trained to deal with medical problems and emergencies, actual experience with how to respond to emergent clinical situations is difficult to teach and usually only comes with experience. Further, real clinical experts make medical decisions almost by reflex. You see this in medical school that while you as a medical student have to actively think about what is going on in any given situation, medical experts act more by pattern recognition and have an instant reflexive response to clinical situations. And how do you teach reflexes?

    Here at UVA, Jeff Young, a trauma surgeon and researcher in clinical decision making has published on a new strategy of assessing and improving the response of doctors in training to high-risk medical situations. His strategy is rather than stressing cognitive experience, which much of medical school and resident training emphasizes, the goal is to build reflexive responses to critical situations. In an emergency, the ability to generate differential diagnoses and recall complex information is secondary to knowing how to acutely assess patients, resuscitate and stabilize them. Clinical experts do this without even thinking about it. Young’s goal is to train medical students, interns and residents by simulation of critical care situations so that when they end up involved in charge of a critical patient they will reflexively perform the correct actions to resuscitate and stabilize patients. After all, practice makes perfect.

    The result is what Dr. Young calls “War Games” – simulations in which students and residents are drilled in their responses to medical emergencies. By putting students under some stress and making them think fast about critical care, reflexive responses to emergent situations are drilled into the subjects, and hopefully when the situations are encountered in real life they’ll know what to do without even thinking about it.

    So enough talking about it. Here’s what one looks like – me being drilled by the chief resident on a patient presenting with hypotension.

    You notice that rather than going for diagnosis the goal is to start with the basics. First you evaluate the airway, breathing, and circulatory status, resuscitate the patient as necessary, gain IV access, get basic vitals and check tests. Only after you’ve stabilized a patient should you start thinking about what the exact diagnosis is, whether you need to operate etc. It also emphasizes things you don’t necessarily learn in class, like the need to call the attending when some disaster has occurred. It seems like things like this should be obvious (they probably are to EMTs and paramedics), but the reality is that these kinds of practical skills are difficult to relate in a classroom setting. You also quickly realize that when you are under pressure, it’s completely different from all those sessions you remember from 2nd year where you sat around thinking about differential diagnosis with 5 other people in the room. I clearly screw up a few times during the simulation, but hey, that’s why I’m in training and why I appreciate these sessions.

    This also demonstrates something I think we can appreciate about evidence-based medicine. Not only do we emphasize a scientific basis for the treatments we use, but we also actively use science to figure out the best ways to train doctors to be better clinicians. I found this strategy to be incredibly useful, and I hope other medical schools around the country also adopt War Games to help train their students to be better docs.

  • Please Welcome PalMD

    Everyone please welcome PalMD of WhiteCoatUnderGround.

    I’ve been enjoying his writing for quite some time and think that he gets what the mission of denialism blog is all about.

    He has of course introduced himself, and I think in just a few posts you’ll see why he’s a wonderful asset to the sb team.

  • Bad Charlottesville News II

    Well, since we first wrote about losing Plan9, Higher Grounds, Satellite Ballroom and Just Curry for a worthless CVS, the C-Ville has picked up the story (here too) as well as the Hook. Good for them. I take back my sniping comments about them ignoring the Corner district.

    A few things are clear from these articles. One is that Terry Vassalos is using weasel-talk. He says in the C-Ville article:

    “They look at the space, yes,” says Vassalos. “I cannot go into the details. There are a lot of people involved, the people that are there, the new people, and I cannot say anything about the details of the contracts.”

    Weasel words if I’ve ever seen them. If Just Curry is already moving out it’s clear he’s made them unwelcome in that space, with or without a worthless CVS moving in. Second, he says:

    Vassalos says he understands that some people might be upset about Plan 9, Satellite, and Just Curry loosing their leases, and points out that he’s been a steward of small business on the Corner for years. “But as a business man…,” he says with a shrug and a smile. Indeed, considering that CVS would probably pay a hefty price for the space, and would likely renovate extensively, a deal with the chain might be too good to pass up.

    “Besides, I don’t think the Corner should be all bars and restaurants,” Vassalos adds, echoing his past statements. “…more retail will be good for the Corner.”

    This makes no sense. It should be perfectly possible for a store to move into the Plan 9 space and not displace the best music venue in town (where I saw TMBG last Sunday and it rocked). Why not divide the space up and lease them separately? The Plan9 space is completely separate from Satellite and Just Curry and there is more than enough room in Plan9 for a convenience store.

    It’s clear that CVS or not, this isn’t just a business decision. Vassalos wants these businesses that Plan9 sublet to out of his building. And does CVS really qualify as “retail”? Sure, they sell crap, but it’s the same stuff that’s at the 3 convenience stores and student bookstore already on the Corner. All this will do is hurt local businesses – the three businesses already in the space, the three local convenience stores on the corner that will have to compete with a national chain, and the restaurants and bars that benefit from having a music venue to draw people other than students to the Corner.

    I’m irritated that a small-minded landlord like Vassalos is willing to do so much damage to the culture of the Corner, and just shrug it off as a business decision. I call bullshit. As long as I live I won’t frequent what he moves in there, or his other businesses like Tip Top Diner or the College Inn. I’ll also encourage everyone I know to do the same. We don’t need to encourage landlords like Vassalos to hurt our community for an easy buck by frequenting his establishments.

  • Say it isn't so

    Blogging on Peer-Reviewed Research

    The NYT reports on a this article by Tomas Grim of the Dept of Zoology at Palacky Univ purporting to show a negative effect on numbers of scientific publications for scientists correlated with increasing beer consumption.

    According to the study, published in February in Oikos, a highly respected scientific journal, the more beer a scientist drinks, the less likely the scientist is to publish a paper or to have a paper cited by another researcher, a measure of a paper’s quality and importance.

    The results were not, however, a matter of a few scientists having had too many brews to be able to stumble back to the lab. Publication did not simply drop off among the heaviest drinkers. Instead, scientific performance steadily declined with increasing beer consumption across the board, from scientists who primly sip at two or three beers over a year to the sort who average knocking back more than two a day.

    However, looking at the paper I’m somewhat confused, and not just from the willingness to generalize to all scientists from a single country’s avian ecologists. For one, the scales have to be a goof. Check out the first figure.
    i-4fd1c38060d2e0cc51fa3d5f3f89e27a-oik_16551_f1.gif

    Who drinks 2 liters of beer a year? That’s basically teetotalling. Even 6 liters a year (the high end of his effect) would be a very small amount. Is this just alcohol in the beer? At 18ml/12oz beer that would mean each liter corresponds to ~50 beers. At 6 liters that’s still only 300 beers or less than one a day. If instead the author means 2-6 liters/day/person/year that may make more sense. But 6 liters of alcohol a day? Maybe the Czech’s are worthy rivals for beer drinking but that’s now an unbelievably high amount for a non-hobo. How about 100-600 liters of beer a year? One liter is roughly 3 x 12oz beers. That would be a minimum of about 1 beers a day for the left side of the scale (although that starts at 2 so really about 1-2 beers a day is the lowest group), versus people who have about 5-6 beers a day.

    I’m having difficulties understanding the quantities of alcohol we’re talking about here. Can anyone enlighten me? If, as the NYT article suggests, the mid range was with 2 beers a day (which would fit with my 100L scaling above), I have even more trouble believing this silly hypothesis that the depressive effects of moderate alcohol negatively impact scientific work. After all the data is pretty level with a +/- bounce of 0.5 from 2-4 liters, or approximately 1-4 beers a day. Then there is a group of 5-6 beer/day drinkers who yank the line down giving it a pretty poor r-square value. I think this is a confusing paper with inadequate data and an improper line fit. At 5 or more beers a day you’re talking about pretty heavy use (not that I haven’t thrown back more than 5 in a day but not every day). Isn’t this really a study showing that alcoholic avian ecologists don’t publish as much as non-alcoholic avian ecologists?

    Tomáš Grim (2008)
    A possible role of social activity to explain differences in publication output among ecologists
    doi:10.1111/j.2008.0030-1299.16551.x