"A statement of fact cannot be insolent." The miscellaneous ramblings of a surgeon/scientist on medicine, quackery, science, pseudoscience, history, and pseudohistory (and anything else that interests him)
Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued here, along with a DISCLAIMER that you should read before reading any medical discussions here.)
Remember last week, when I took note of how organized quackery's best friend in Congress, not to mention a shining example of crank magnetism, Representative Dan Burton of Indiana, was taking the opportunity of his having announced that he would not be running for reelection this year to write a typically brain dead post on his Congressional blog about the "autism epidemic"? In that post, Burton bought into the mythology of the "autism epidemic" and defended his previous efforts to root out that dreaded mercury in vaccines (and, of course, vaccines themselves) as the cause of this "autism epidemic."
And now, the antivaccine movement is taking advantage of this to paint autism as a "national emergency" and to demand hearings that would be a total waste of time and allow antivaccinationists to promote their agenda to a national audience. There's a press release from the Autism Action Network that I got, and, not surprisingly, the antivaccine crank blog Age of Autism is getting in on the action by reposting it:
I realize I repeat this a lot, but it bears repeating a lot. Vaccines are, without a doubt, one of the greatest advances in health care devised by the human mind. Arguably, vaccination campaigns have saved more lives and prevented more suffering and death than pretty much any other medical preventative intervention ever invented. I realize that I tick off antivaccinationists when I say that, but I don't care. Actually, I do care. I kind of like ticking off antivaccinationists using science. You didn't think I've been blogging for seven years purely out of a sense of duty to humanity, science, medicine, and ethics, did you? Maybe 90% duty, but I have to have a little fun as well.
Because vaccines have been so successful, for the most part health care professionals tend to view them in much the same way as most people view clean water and pure food; i.e., as unabashedly good and healthy things. And, except in rare instances, they are. Unfortunately, as we in medicine have demontrated since the time of Semmelweiss, we aren't always the best at doing what's best for our patients, such as washing our hands before seeing patients, but that's not so much out of opposition to handwashing or a belief that handwashing doesn't do any good. Rather, it's usually more due to pure laziness or carelessness. Unfortunately, all too often, the same cannot be said of health care professionals when it comes to basic vaccinations that protect both us and our patients, in particular the influenza vaccine. A friend of mine, Mark Crislip has a word for such health care workers (and, make no mistake, this group includes doctors, nurses, and many others): Dumb ass. (Or, for those of you who don't have access to Medscape: Dumb ass.)
Sure, I bet you do, at least if you've been a regular reader of this blog more than a year or two. If you're a really long-timer, you probably remember him even better. Let's just put it this way. Vox is a guy who has a much higher opinion of his intellectual prowess when it comes to science than is warranted by the bleatings that he calls a blog would warrant. I do have to thank him though. Besides giving me occasional material to apply some well-deserved not-so-Respectful Insolence to from time to time, on rare occasions he even points me in the direction of interesting studies. Of course, Vox being Vox and all, he usually completely misinterprets them, but that allows me the introduction I need to dive into the study itself and have a bit of fun puncturing his pretensions at the same time?
Fascinating. That's an 88.6 percent unreliability rate for landmark, gold-standard science. Imagine how bad it is in the stuff that is only peer-reviewed and isn't even theoretically replicable, like evolutionary biology. Keep that figure in mind the next time some secularist is claiming that we should structure society around scientific technocracy; they are arguing for the foundation of society upon something that has a reliability rate of 11 percent.
Now, I've noted previously that atheists often attempt to compare ideal science with real theology and noted that in a fair comparison, ideal theology trumps ideal science. But as we gather more evidence about the true reliability of science, it is becoming increasingly obvious that real theology also trumps real science. The selling point of science is supposed to be its replicability... so what is the value of science that cannot be repeated?
No, a problem with science as it is done by scientists in the real world doesn't mean that religion is true or that a crank like Vox is somehow the "real" intellectual defender of science. (I must admit, though, that that line about "real theology" trumping "real science" is a howler.) Later on, Vox doubled down on his misunderstanding by trying to argue that the study he so eagerly gloated over proves that science is not, in fact, "self-correcting." This is, of course, nonsense in that the very article Vox is touting is an example of science trying to correct itself! However, nothing ever seems to stop Vox from laying down serious nonsense whenever he thinks he's found "evidence" that atheists are wrong and science is leading us astray. None of this is surprising, of course, given that Vox has demonstrated considerable crank magnetism, being antivaccine, anti-evolution, an anthropogenic global warming denialist, and just in general anti-science. He's also known for being too much of a crank at times even for WorldNetDaily, as he so aptly demonstrated when he demonstrated incredible ignorance of basic history in his suggestion that Hitler's method of dealing with an unwanted population shows us that it's "possible" to deport 12 million illegal aliens. As I put it in taking down his nonsense, hey, it worked for Hitler.
Unfortunately, Vox is not alone. Quackery supporters of all stripes are jumping on the bandwagon to imply that this study somehow "proves" that the scientific basis of medicine is invalid. A minion of Mike Adams' writing at his wretched hive of scum and quackery, NaturalNews.com, crowed:
Almost exactly a year ago, I came across a bit of woo so incredible, so spectacularly stupid and unbelievable, that I dedicated one of the last segments I've done in a long time of Your Friday Dose of Woo to it. Basically, it was about a movie called Eat the Sun, which described a bunch of people who believe that they can imbibe the energy they need to keep their bodies going by "sun gazing," which involves, as the name implies, staring directly into the sun. The idea is to stare directly into the sun for as long as possible at sunrise or sunset, so as not to burn out your retinas by staring at the noon day sun. Sun gazers seem to think that mammals are like plants in possessing an ability to absorb energy directly from the sun. We're not, of course, as I explained in my inimitable way a year ago. Sun gazing also leaves out the fact that plants get the organic building blocks they use to produce their actual structures from the ground in which they grow. Humans have no such capacity. Even if humans could absorb enough energy directly from the sun to keep their metabolism going, they'd still be faced with the problem of what, exactly, they're made of. Food is more than energy. It's amino acids, sugars, fats, and other building blocks necessary to make proteins, DNA, and in general the very chemicals that make up the very structure and metabolism of our bodies.
In brief, sun gazing is a lovely fantasy, but that's all it is: A fantasy. Unfortunately for people who try to rely on sun gazing as a means of nutrition in a serious way, this is reality:
A woman starved to death after embarking on a spiritual journey which involved giving up food and water and attempting to exist on nothing but sunlight.
The Swiss woman, who was in her fifties, apparently got the idea after watching the documentary film 'In the Beginning, There Was Light' which features an Indian guru who claims to not have eaten anything in 70 years.
The Zurich newspaper Tages-Anzeiger reported Wednesday that the unnamed woman decided to follow the radical fast in 2010.
The prosecutors' office in the Swiss canton of Aargau confirmed Wednesday that the woman died in January 2011 in the town of Wolfhalden in eastern Switzerland.
A couple of months ago, I couldn't help but rejoice when I learned that Indiana Representative Dan Burton had finally, after twenty years in the U.S. House of Representatives, decided to retire after the end of this term. I thought that anyone in the U.S. who supports science-based medicine should rejoice, too, because I'm hard-pressed to think of someone in Congress who is more consistently antiscience, particularly anti-medical science, than Dan Burton. Worse, he put his politics where his beliefs were -- big time. Perhaps the most egregious example of Dan Burton's antiscience is his consistently rabid antivaccine tendencies. He completely bought into the myth that vaccine cause autism; in particular that the mercury-containing thimerosol preservative that used to be in many childhood vaccines (at least until it was removed at the end of 2001), and put his beliefs into action. He was also, along with Senator Tom Harkin, instrumental in foisting that government monument to quackery, the National Center for Complementary and Alternative Medicine (NCCAM) on the National Institutes of Health (NIH) and in stripping the FDA of most of its power to regulate supplements by championing the DSHEA of 1994. It's not for nothing that Steve Barrett of Quackwatch once referred to Burton as "organized quackery's best friend in Congress."
It's a title well earned. While it is true that there are others in Congress who champion quackery, they are not as egregious as Burton has been. For instance, Iowa's Senator Tom Harkin might be NCCAM's Congressional patron, champion, and protector, but if you talk to people at the NIH (and I have), you'll learn that he is widely viewed as one of the greatest Congressional supporters of the NIH, science, and biomedical research. It's unfortunate that support for quackery is mixed in with support for real science, but that's the way it is. None of us are entirely reasonable, and all of us have contradictions in our nature. Another promoter of quackery in Congress, Utah's Senator Orrin Hatch, appears not to be a true believer, unlike Burton and Harkin. Rather, he appears to be in it for the money and to keep his seat in that he represents a state that houses ground zero for the supplement industry in the U.S. It is an industry that has been very, very generous to Hatch's campaign, and his family and a former law partner are heavily involved in the supplement industry themselves. Similarly, the new kid on the block, Utah Representative Jason Chaffetz, co-chair of the Dietary Supplement Caucus, is a young gun looking to replace Orrin Hatch or to take his seat when he retires.
About two and a half weeks ago, I was disappointed to learn that Dr. Stanislaw Burzynski had somehow managed to delay justice again. At the time, I didn't know what had happened other than that his hearing before the Texas Medical Board, which had been scheduled to begin on April 11 and to which I had been greatly looking forward, given that Dr. Burzynski could well have lost his Texas medical license if the hearing had gone against him. Fortunately, in the comments, readers informed me that this was nothing unusual, a continuance was issued due to legal maneuvering on both sides. Contrary to the claims posted by Eric Merola, the major charges against Burzynski still stand. We're just going to have to wait longer than we had hoped. I suppose this shouldn't have surprised me. After all, Burzynski's hearing had originally been scheduled for January, and then it got delayed to April. Having it delayed a few more months is annoying, but the wheels of justice grind slowly.
Unfortunately, while those wheels are grinding slowly, Burzynski is still treating patients with advanced cancer with his antineoplastons, chemotherapy, "personalized, gene-targeted cancer therapy," and sodium phenylbutyrate. As I've explained in excruciating detail in the preceding links, antineoplastons are not any sort of "miracle cure" for cancer, and the way he does "personalized, gene-targeted cancer therapy" can best be described as "making it up as he goes along" (I don't mean that in a good way). Indeed, it's not for nothing that I refer to Burzynski's fumbling with genomic tests as being the equivalent of "personalized cancer therapy for dummies." Yes, Dr. Burzynski's cult of personality is -- well -- cultish to the point that it lures desperate patients to pay huge sums of money for his "clinical trials" that seemingly never end and for which he doesn't report results.
The U.S. is widely known to have the highest health care expenditures per capita in the world, and not just by a little, but by a lot. I'm not going to go into the reasons for this so much, other than to point out that how to rein in these costs has long been the proverbial political hot potato. Any attempt to limit spending or apply evidence-based guidelines to care runs into a buzz saw of criticism.
Indeed, most of the resistance to the Patient Protection and Affordable Care Act (PPACA), otherwise known in popular parlance as "Obamacare," has been fueled by two things: (1) resistance to the mandate that everyone has to buy health insurance, and (2) the parts of the law designed to control the rise in health care costs. This later aspect of the PPACA has inspired cries of "Rationing!" and "Death panels!" Whenever science-based recommendations are made that suggest ways to decrease costs by reevaluating screening tests or decreasing various tests and interventions in situations where their use is not supported by scientific and clinical evidence, whether by the government or professional societies, you can count on its not being long before these cries go up, sometimes eve from doctors themselves in the form of Ayn Rand-worshiping libertarian doctors who think that Medicare is unconstitutional, that doctors' autonomy should be virtually unlimited, and that there should be in essence no constraints on them.
My perspective on this issue is that we already "ration" care. It's just that government-controlled single payer plans and hybrid private-public universal health care plans use different criteria to ration care than our current system does. In the case of government-run health care systems, what will and will not be reimbursed is generally chosen based on evidence, politics, and cost, while in a system like the U.S. system what will and will not be reimbursed tends to be decided by insurance companies based on evidence leavened heavily with business considerations that involve appealing to the largest number of employers (who, let's face it, are the primary customers of health insurance companies, not individuals insured by their health insurance plans). So what the debate is really about is, when boiled down to its essence, how to ration care and by how much, not whether care will be rationed. Ideally, how funding allocations are decided would be based on the best scientific and clinical evidence in a transparent fashion.
The study I'm about to discuss is anything but the best scientific evidence. In fact, to me it appears to be a political hatchet job designed to cast doubt on the very concept of any sort of government-run health care system.
It's not infrequent that I come under fire from antivaccinationists for, ironically enough, calling them antivaccinationists. "Oh, no," they protest, "I'm not antivaccine. How dare you call me that? I'm actually a vaccine safety advocate." Of course, when you probe more closely and ask a few questions, almost inevitably you'll find that in reality they believe that no vaccine is safe, no way, no how, making the difference between their view of vaccine safety and being antivaccine a distinction without a real difference. Actually, it's more a delusion on the part of antivaccinationists, because any reasonable person who looks carefully at their views will see that there is often no vaccine under any circumstance whose use these "vaccine safety activists" will support. No matter how much you probe, you'll have a hard time getting them to support the use of any vaccine ever. Why?
Because in reality they're antivaccine, that's why.
What's often particularly revealing are the analogies that antivaccinationists will use to describe vaccines and the effects they believe them to be causing. In particular, the most common myth over the last fifteen years or so that's been driving the fear of vaccines among the antivaccine movement is the now scientifically discredited hypothesis that childhood vaccines (or the thimerosal preservative that used to be in childhood vaccines -- or both) cause or predispose infants and children to developing autism. In fact, I can't remember having encountered a single antivaccinationist active over the last several years who hasn't strongly believed that vaccines cause, contribute, or predispose to autism. Arguably, the key to the entire modern antivaccine movement is the concept that there is an "autism epidemic" due to -- you guessed it -- vaccines. It is not my purpose in this particular post to refute that concept given how often I've written about the issue before. Suffice it to say that issues such as the broadening of the diagnostic criteria for autism and autism spectrum disorders, diagnostic substitution, increased screening and awareness, and other factors quite likely account for much, if not all of the current apparent increase in autism and ASD prevalence. Indeed, when the CDC announced that autism prevalence is now one in 88, antivaccinationists went wild, pointing to it as "evidence" that there is an autism epidemic.
The analogies used in the wake of that report are most revealing, as you will see, and support the contention that, all their denials that they are antivaccine notwithstanding, "antivaccine" describes such denialists almost perfectly.
Last year was the worst year for measles in the U.S. in 15 years, health officials said Thursday.
There were 222 cases of measles, a large jump from the 60 or so seen in a typical year. Most of the cases last year were imported -- either by foreign visitors or by U.S. residents who picked up the virus overseas.
U.S. children have been getting vaccinated against the measles for about 50 years. But low vaccination rates in Europe and other places resulted in large outbreaks overseas last year.
And, yes, Virginia, it was the unvaccinated who were mostly responsible for this uptick in measles cases last year:
Generally, the Americans who got measles last year were not vaccinated. At least two-thirds of the U.S. cases fell into that category, including 50 children whose parents got philosophical, religious or medical exemptions to skip the school vaccinations required by most states, CDC officials said.
It just occurred to me that, even though there was news about it, I never mentioned what's happened recently with respect to California bill AB2109. As you might recall, I wrote about this bill about four weeks ago. In brief, this bill, if passed into law, would require that California parents seeking a "personal belief" exemption for vaccines to meet with a physician and have a physician sign off on what is more or less an informed consent form stating that the parents had been informed of the risks and benefits of vaccines and, more importantly for purposes of the personal belief exemption, the risks (many) and benefits (virtually none) of not vaccinating. Parents would still be able to refuse to vaccinate by claiming that vaccines are against their "personal beliefs" (whatever that means). They just wouldn't be able to do it by signing a form at school, no questions asked. In other words, the law would make it just a little more difficult to obtain a personal belief exemption, and that's a good thing, because right now in California it's easier to get a personal belief exemption than it is to actually have your children vaccinated. That means that it's not just antivaccine parents who use the personal belief exemption but parents who aren't antivaccine but are just too darned lazy or unconcerned to make sure their children are vaccinated.
It turns out that earlier this week, a hearing on AB2109 was held by the California Assembly Committee on Health. According to a local news report, the California Medical Association, the California Pharmacy Association, the Association of Physician Assistants, the California State Employees Association, the County Health Executive Association, as well as the doctors and dentists' unions all lined up to testify in support of the bill. In addition, Health care workers lined up to endorse the bill, including doctors, medical students, and nurses, as well they should. After all, primary care doctors, especially pediatricians, understand the value of vaccination more than anyone; that is, with one rather despicable exception. Yes, we're talking about Bob Sears:
"A free choice that is contingent upon finding another person to sign off on your free choice is not really a free choice at all," said Dr. Bob Sears, a pediatrician.
Sears is against the law. He joined protestors on the Capitol steps Tuesday, to argue against the rule change.
On Facebook, Dr. Sears was a bit less...restrained:
Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
