Denialism Blog

Denialism Blog

  • Freshpeople: Be Smart About Credit

    The new students have arrived at UC-Berkeley, closely pursued by hordes of credit card marketers. Right by my office is a bank that literally has 12 employees out front hawking credit cards and new accounts.

    Freshman friends, don’t get your first credit card from the guy on the street offering you a t-shirt or worthless, plastic (likely lead filled) bauble. Be smart about credit. Credit is an incredibly powerful consumer tool, but you must wield it carefully. If you ruin your credit, you will have difficulty in life getting a job (people with bad credit look like embezzlement risks to employers), starting basic utilities (like cable TV), and buying a home. You are not the federal government. You must live within your means. And yes, deficits DO matter!

    The most heavily marketed and easiest credit products to adopt are often the worse for you. These are cards with high interest rates and fees packed “to the back” of the card, meaning that the fees are hidden. So, they may have no “annual fee” but if you decide to pay by phone, or if you’re a millisecond late in your payment, expect outrageous penalties.

    Remember that the credit cards with your college logo are “affinity cards.” Your college gets a cut from those cards, and unfortunately, this profit motive causes many schools to market less than advantageous cards to their own students.

    If you’re going to get a credit card (and you should in order to start building your credit file), educate yourself and shop around. First, you should understand the concept of compound interest. Second, you should understand that if you only make minimum payments, you are at risk of being in debt nearly forever. Bankrate.com has a calculator that will help you understand that minimum payments equals maximum indebtedness.

    One of the best guides to acquiring a good credit card is Bankrate.com’s Credit Card Search. Another incredible resource is Consumer Action’s Annual Credit Card Survey. Good luck, and don’t allow the miracle of instant credit to bankrupt you!

  • Grand Rounds 49(4)

    Grand Rounds is up at Rural Doctoring…get thee hence!

  • In More Serious Evolution News…

    Gawker published this gem today.

  • Another Open Letter to Jenny McCarthy

    Dear Jenny,

    Thank you! Thankyouthankyou thank YOU!

    You see, my medical education had a few gaps. I was unfortunate enough to do my training during the last couple of decades, which means I never saw measles, pertussis, polio, and many other vaccine-preventable diseases.

    Well, last year, I saw three cases of pertussis! Sweet! And it looks like, if I play my cards right, I may get to see some measles.

    It’s not that I don’t know anything about measles. I mean, I’ve read Hippocrates, Rhazes, Osler, and all the other ancients. But to see the real thing, to experience the real fear, well, you just can’t buy that kind of education. I’ve never been able to experience the fear that my little girl–who loves to swim— might bring polio home from the lake. How am I supposed to relate to my older patients if I don’t know that fear?

    If I were in charge of awards for medical education, I’d give you one. But, alas, I’m not. I guess we’ll have to find some other way to honor all your hard work, education, and expertise. I mean, my four years of undergrad, 4 years of medical school, and 3 years of residency can’t hold a candle to your experience as a Mommy Warrior. I wish we could just bottle that. Or perhaps isolate it in northern Idaho.

    Anyway, if you’re on google doing research for your next cult, I have a few suggestions. First, try to find one with UFOs. UFOs are kinda cool. Second, find one that makes you cut off all your ties to the outside world. As much as I’d miss the educational opportunities of your public appearances, I’ll find a way to make up for it.

    So thanks, and good luck! Keep up the personal growth! Move on to the next issue!

    Please?

  • Mike Leavitt to patients: "F*** you"

    A number of us in the blogosphere have been outraged by Bush’s Department of Health and Human Services’ desire to put the arbitrary wants of doctors before the needs of patients. At first it was just a draft proposal, but now Mike Leavitt is pushing to implement the changes. Soon, it may be legally acceptable to deny you a needed health service because the health care provider thinks your decisions are immoral.

    I’ve already written several times about why there can be no “conscientious objectors” in health care. This law would essentially allow doctors to ignore the standard of care set by their professional organizations. Let’s hear a bit from Leavitt himself:
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  • Some days it's harder

    I’m a little down today. I’ve told you before that I take care of my own patients in hospice. I’ve also told you about watching patients and friends lose their battles with disease.

    This week I had serious talks with several people about end-of-life issues (the details of which I can’t really share at the moment). I’ve also had to tell someone about an abnormal lab result (a very bad one). In fact, the best news I’ve delivered all week was telling someone they had mononucleosis (rather than something worse).

    I’ve found, in my limited experience, that terrible illnesses don’t change people that much. If they were cheerful healthy folks, they tend to be cheerful (albeit appropriately sad and angry) sick folks. If they were curmudgeonly when well, they will usually be cranky when ill. Occasionally, some transformation will come over someone when they are confronted with a mortal illness, but I don’t think this is the norm. When thinking about these things, it is very tempting to wonder how I would deal with such a thing myself, but if I’ve learned one thing in the last decade as a physician it is this:

    Don’t go there!

    Empathy is a good thing, a necessary thing, but you cannot be an effective physician if your empathy turns into true identification. It is paralyzing. Everyone worries from time to time about what could happen to them if this or that illness struck, but doctors are in a bad position. We know too much. It’s far to easy to come up with realistic scenarios of our own demise. This is especially true when dealing with ill patients who are like is, in age, education, ethnicity, etc.

    We don’t really talk about this much. I mean, we talk about “not going there”, but we don’t often acknowledge to each other what it means to “go there”. As someone who teaches young physicians, I deal with their irrational fears all the time. Every lump, bump, cough, in the mind of a young doctor, is the seed of their own death. It takes a while to build up a bit of a skepticism about your own ability to evaluate your health. It also takes a while to find the right balance between empathy and identification—how to feel for the patient, without feeling like the patient.

    Still some days it’s harder. I was talking to a friend today (a fairly new friend, as it turns out) who is going through a particularly rough round of chemo. I grew up with her husband, she has a kid my kid’s age; it’s very easy to identify with her. If she were a patient, I would try to throw up that flexible fence with empathy on one side and pathological identification on the other. But she’s not my patient. Where do I build my fence?

    I don’t. Sometimes it’s possible to over-think things. She’s one of the “cheerful” ones. She’s not crazy, not stupid, not in denial, just a good person with a good attitude and a lousy disease. When it comes to friends and family, sometimes you’ve got to set aside the white coat and allow yourself to laugh and cry with someone, allow yourself to get close to someone even if you don’t know where life is heading.

    It’s not always an easy ride, but it sure is better than the alternative.

  • Anti-vaccination—old religion writ new

    I’m rather angry.

    Strike that.

    I’m furious. Indescribably outraged. Disgusted.

    The rise of the antivaccination cults is finally affecting public health. If you want details, go and read Orac, or Steve Novella, or some of my other writing. I’m too angry to deal with details today.

    Infectious diseases have stalked us across the millennia. Centuries of advances, from sewerage to inoculation to vaccination have saved billions of people from death and disability due to infectious agents. Having a child used to mean joy tempered with fear—fear that one of the “men of death” would come for your child, leaving them scarred, paralyzed, deaf, mentally disabled, or dead.

    We’ve been largely liberated from these fears. We are now free to fear obesity. We are free to worry about good schools, the environment, poverty. Infectious diseases aren’t the scourge they once were. Who would wish it otherwise?
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  • The latest scummy tactic of altie med – blaming medicine for celebrity deaths.

    A fellow medical student once asked me why I thought people become hostile to science-based medicine. Certainly our own failures contribute. When we have no treatments for a disease, or if the treatments themselves may also incur significant morbidity, it is understandable that patients will become disillusioned with what doctors have to offer.

    However there is another cause for this hostility towards medicine, and it isn’t the occasional crank scibling with an axe to grind against MDs. It’s the constant anti-science propaganda being spouted out by the hawkers of alternative medicine.

    Orac and others have despaired over the infiltration of woo into mainstream medicine under a banner of tolerance and the noble goal of avoiding confrontation with patients over deeply-held beliefs. However this has proved more and more a tactical error as we’ve seen that CAM and altie medicine do not seek detente but is at war with legitimate medicine and science itself. Besides the fact that there is no good reason to water down medical school with unproven nonsense and the latest placebo fad being sold by crooks, alternative medicine should not be taught because doing so is not just a failing to meet the barbarians at the gate, but is actively inviting them in to destroy everything we’ve worked for.

    As examples of the despicable attacks on medicine from altie-med practitioners, I say we start with that aggregator of woo-practitioners Natural News. A site started by HIV/AIDS denialist Mike Adams, he features writing from various alties ranging from reiki therapists to naturopaths to chiropractors. What unifies them is their contempt for science-based medicine. Take for instance their attack on science based medicine for the death of former White House Spokesperson Tony Snow and more recently Bernie Mac .

    Former White House press secretary Tony Snow died in July 2008 at the age of 53, following a series of chemotherapy treatments for colon cancer. In 2005, Snow had his colon removed and underwent six months of chemotherapy after being diagnosed with colon cancer. Two years later (2007), Snow underwent surgery to remove a growth in his abdominal area, near the site of the original cancer. “This is a very treatable condition,” said Dr. Allyson Ocean, a gastrointestinal oncologist at Weill Cornell Medical College. “Many patients, because of the therapies we have, are able to work and live full lives with quality while they’re being treated. Anyone who looks at this as a death sentence is wrong.” But of course we now know, Dr. Ocean was dead wrong.

    The media headlines proclaimed Snow died from colon cancer, although they knew he didn’t have a colon anymore. Apparently, the malignant cancer had “returned” (from where?) and “spread” to the liver and elsewhere in his body. In actual fact, the colon surgery severely restricted his normal eliminative functions, thereby overburdening the liver and tissue fluids with toxic waste. The previous series of chemo-treatments inflamed and irreversibly damaged a large number of cells in his body, and also impaired his immune system — a perfect recipe for growing new cancers. Now unable to heal the causes of the original cancer (in addition to the newly created ones), Snow’s body developed new cancers in the liver and other parts of the body.

    This is a rather stunning piece of scientific illiteracy in it’s own right, without being disgusting for the ghoulish use of this man’s death to attack those who were doing the best to keep him alive. We see of course toxin-woo (if anything there are fewer toxins in your body without your colon because the chyme is diverted earlier out into a colostomy), and a complete inability to understand the process of metastasis. The author makes the stunningly ignorant assertion that all the cancers that spread throughout his body were somehow unique and caused by the chemo, when we can use simple histopathology to determine the source of such cancers and we know that such a spread represents metastatic spread from a single source – the colon. Further we know that if cancer has already spread before surgical resection it may not be detectable and appear even after removal of the diseased organ, even if they did indeed resect Snow’s entire colon as opposed to performing a hemicolectomy. All this passage does is expose the promoters of this anti-doctor spite for their complete ignorance of even basic biology.

    The author goes on to accuse doctors using chemo of committing a criminal offense:

    Before committing themselves to being poisoned, cancer patients need to question their doctors and ask them to produce the research or evidence that shrinking a tumor actually translates to any increase in survival. If they tell you that chemotherapy is your best chance of surviving, you will know they are lying or are simply misinformed. As Abel’s research clearly demonstrated, there is no such evidence anywhere to be found in the medical literature. Subjecting patients to chemotherapy robs them of a fair chance of finding or responding to a real cure and deserves criminal prosecution.

    A pretty stunning statement no? Does anyone want to see some real data on what chemotherapy can do?

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  • Autism and Mitochondria

    Prometheus brings us the best article I’ve seen to date on why the new push for a mitochondrial basis for autism is total nonsense.

    Once I saw this push from denialists like David Kirby towards a link between mitochondria and autism I knew we were in for a world of trouble. If only because mitochondrial diseases are a relatively new area of study and there are enough unknowns that they’ll be able to milk this nonsense for a decade at least.

    Prometheus, however, does an excellent job showing how the likelihood of a mitochondrial explanation for autism is prima facie absurd. This is not surprising given the clear absence of evidence for a maternal pattern of inheritance and the non-progressive nature of autism which is usually described as a “static encephalopathy”.

    Keep the link handy for when you start hearing mito-woo from the DAN quacks.

  • Bill Nelson Wins the Internet

    I agree with our buddy Ben Goldacre when he says Bill Nelson wins the internet. I can not begin to describe the hilarity of this video but first a bit of background.

    Bill Nelson is a quack who’s been running a Rife-machine scam. That is, for many thousands of dollars you can purchase and use his quantum-mechanical machine (read box with blinking lights) to destroy whatever ails you. Fortunately, the FDA has banned its sale in the US, and made this guy:

    Bill Nelson (yes that’s him) a fugitive who has since fled our country. Unfortunately, other countries, including poor Ben’s, have been less successful in prosecuting this guy for the fraud that he is.

    This bizarre conflation of a total egomaniac, governmental “persecution” and an excess of ill-begotten funds has resulted in what I agree might be the most bizarre video on the internets. You’re welcome to suggest alternatives but I might be partial since it’s made by this crank. Check it, it’s his story, narrated himself sung to the tune of “Simple Gifts”.

    Thank you Ben for bringing this to our attention, and thank your deity of choice for the FDA for keeping this guy’s nonsense out of our country.