Archive for: June, 2009

Off to the pharmacy

Jun 16 2009 Published by under Medicine

The last month has been pretty busy at the office, with lots of H1N1 influenza. I've been quite lucky, but the last couple of days I've had some pretty close exposures. The other day I gave a nebulizer treatment to a patient with wheezing who turned out to have the flu (I was not wearing a mask), and I've seen about a half-dozen others with it.
So today I'm off to the pharmacy to pick up my prophylactic course of oseltamivir. Whoopie!

19 responses so far

Hey, fake autism experts---put up, or shut up!

Jun 15 2009 Published by under Absurd medical claims, Medicine, Vaccination inanity

It's just disgusting.  Autism spectrum disorders are an important health problem (although not the "epidemic" claimed by some).  While real scientists and clinicians (and parents) are looking for causes and treatments based on evidence, fake experts are pulling "answers" out of their backsides.  Studies of families with autism have shown specific genetic defects associated with autism, and while this applies only to a small percentage of cases, it is an example of a good lead.  Even if a minority of people with autism have similar genetic defects, these findings can lead to more generalizable concepts.

Or you can just make shit up.

Jay Gordon, an anti-vaccination pediatrician (yes, that is somewhat oxymoronic), has another piece in the Huffington Post where he not only makes it up, but tries to invalidate all real research by the stroke of a pen (or keyboard).  Part of this goes back to a recent HuffPo article by Harvey Karp, an article which was just terrific in some ways---it acknowledged the insanity of the autism-vaccine manufatroversy, but then went off the deep end by blaming "endocrine disrupting chemicals".  What's with these pediatricians and making stuff up?  Seriously!

Anyway, Gordon responds to the crazy the only way he knows how---by turning the crazy up to "11". 

Studies showing that vaccines and their many constituents do not contribute to this problem are flawed, filled with specious reasoning and, for the most part funded by the pharmaceutical industry. Even articles in reputable medical journals are often written by doctors with an economic interest in continuing the vaccination program's status quo. This does not invalidate all of these studies but it certainly makes them suspect and a poor foundation for an argument excluding vaccines from the list of environmental influences on the increase in autism in America and elsewhere.

Wow, that's a whole lotta crap in one small paragraph.  Let's review:  "flawed"---argument by assertion, or begging the question; "specious reasoning"---ad hominem fallacy; pharma shill gambit---argument by paranoia, another flavor of ad hominem.   As usual, the only argument Gordon has for his failure to follow standard of care is that he just trusts himself more than the rest of the medical and scientific community. 

He goes on to spout his usual inanity:

Asking that cars be manufactured with more attention to safety and that driving is best when done safely does not make one "anti-car" or anti-driving. Asking for safer vaccinations and more judicious use of those we have does not make me or anyone else "anti-vaccine."

Since the premise is false, his argument is absurd.  We don't need "safer" vaccines, since the ones we have are 1) already safe; and 2) constantly being monitored for continued safety.  If Gordon had better morals and better reasoning skills, and wasn't wedded to anhistorical thinking, he would realize that not only are the vaccines we have safe, but that they are several orders of magnitude safer than the alternative. 

So anyway, he get's all mad at Karp for trying to be a different kind of crazy:

Dr. Karp, if you are going to talk and blog about kitchen cleaners, furniture polish, pesticides and other toxins, how can you possibly ignore the 30-40 injections of potentially risky material we give children in their first 24 months of life?

Fanatics are nothing if not ideologically pure.  "IT'S THE VACCINES SO DON'T BOTHER ME ABOUT YOUR STUPID ENDOCRINE DISRUPTORS!!"

When doctors are arrogant enough to "go with the gut" rather than the evidence, patients are harmed.  Gordon even admits that he doesn't know what he's talking about, but then disregards it:

I have no proof that vaccines cause autism and would be very excited to have my large group of extremely healthy mostly unvaccinated children studied someday. It would be disingenuous to imply that non-vaccination might not lead to an increased incidence in vaccine-preventable illness. It would be equally disingenuous to state that this possibility poses a great threat to America's children. The risks of vaccinating the way we do now exceeds the benefits of this vaccine program. "Scientists" who suggest that experienced doctors ignore their eyes and ears are wrong. Detractors who say that we should ignore parents who are certain that vaccines caused their children's autism are wrong and often quite mean-spirited.

So he has no proof, but it just seems right to him, and anyone who doesn't agree is a big meanie who ignores parents.  I have news for Jay: it's possible for a patient and a doctor to be wrong.  That doesn't mean their experiences are invalid, just their conclusions.  But science by assertion is distracting from real research into autism.  If people like Gordon, Karp, or David Kirby really wanted to help, they would support scientists and physicians who are doing real autism research.  Fake experts make for fake science, and in medicine, fake science kills people. 

56 responses so far

Unsafe at any...er...

Jun 13 2009 Published by under Medicine

People in my profession are at increased risk for acquiring certain diseases: tuberculosis, HIV, hepatitis B and C, and some others. We vaccinate against the ones we can (primarily hepatitis B) and exercise universal precautions, which involves careful attention to bodily fluids and other infectious tissue. The basic rule is, "assume everyone has a blood-borne infection." We don't make the same assumptions for other illnesses such as tuberculosis as these usually have symptoms when they are infectious, as opposed to HIV and hepatitis. Even with these precautions, health care workers are frequently exposed to blood-borne infections.

Now imagine a job where you are intentionally exposed to infectious bodily fluids, perhaps containing HIV, hepatitis B or C, syphilis, or any combination of these.  There is an entire industry in Southern California where this happens on a daily basis.  The San Fernando Valley is home to America's mutli-billion dollar pornography industry.  This industry has made attempts at regulating itself but these attempts are falling far short.

According to the New York Times, 22 pornography actors have contracted HIV in the last 4 years.  The details of these infections are unclear, and whether other infections such as syphilis or hepatitis are also spreading has not been reported. 

No industry should tolerate this level of preventable occupational injury.  None. But how do we encourage prevention?  Pornography is already a "grey market" industry, and if more tightly regulated, I'm sure most would slip back into the black market.  I don't know what the solution is, especially among workers so prone to being exploited, but shining some light on the issue will hopefully help. 

30 responses so far

Hate-filled, treasonous rhetoric continues on Right

Jun 12 2009 Published by under Politics

We already know the hate-filled bag of right-wing goatfuckery, Rush Limbaugh, wants the head of state of the USA to "fail". There was a lot of argument from idiots about what that meant. The excuses were flying: "fail" meant his "socialist agenda", not his goal of saving the US from this recession, and other such nonsense. But the meaning was clear. If we are to climb out of this recession, Rush very much cares how we do it, and would rather we fail as a nation rather than have his putative anti-Christ carry the mantle of success. But he never said he wanted Obama to drop dead.
That honor was left to former presidential candidate Alan Keyes' running mate from last fall, one Wiley Drake, a Southern Baptist Minister. In an interview, he rendered Fox's Alan Colmes nearly speechless:

"Are you praying for [Obama's] death?" Colmes asked.
"Yes," Drake replied.
"So you're praying for the death of the president of the United States?"
"Yes."
[...]
"You would like for the president of the United States to die?" Colmes asked once more.
"If he does not turn to God and does not turn his life around, I am asking God to enforce imprecatory prayers that are throughout the Scripture that would cause him death, that's correct."

I know the wackaloon trolls will be coming by any minute to say how Chis Matthews or whomever is just as bad as Rush et al, but really, how deeply must you deceive yourself to believe that? They'll also say that the killer of Dr. Tiller, or the Holocaust memorial shooters were "loners", but how many "loners" makes a crowd? In a different economic or political atmosphere, these wackaloons would be practicing a bitter but lonely Onanistic exercise in hate. But in this climate, people are listening. And they are acting.
The Responsible Right (if such a thing still exists) needs to show itself, needs not to distance itself from hate, but to acknowledge it, then condemn it. Instead, the mouthpieces of conservatism are finding excuses.
But they don't get a pass for their excuses, for being "patriotic" or whatever else. They don't get to use tu quoque arguments to justify their own bigotry. They need to remember one of their favorite buzzwords: "responsibility". They will be held accountable for their words and actions one way or another, so they might as well own up to them.
But I don't really care if the right manages to crawl out of the gutter and reclaim the mantle of legitimacy. That's their problem.

30 responses so far

Rush Limbaugh---America's spewing rectum of idiocy

Jun 11 2009 Published by under Absurd religious wingnutery, Politics

I know, I know, I don't usually do politics, but Rush is really chapping my ass right about now. His comments are always outrageously hate-filled diatribes, and he's getting harder to ignore every day. What's worse, his followers eagerly suckle at the teat intolerance, finding solace in his affirmation of their own bigotry. And finally, he is cynical beyond any hope of redemption.
First, he is virtually a Holocaust denier, and as we know, Holocaust denial is always a manifestation of hatred of Jews.

"He [Obama] is beating Germany up. He is ripping them to shreds over something they did 60 years ago. One day after praising all of Islam. Now can you imagine, there's of course Elie Wiesel gets up there and he does his thing but it's 65 years here or close to it...He's up there and he's ripping Germany for what it did 60 or 65 years ago, blah, blah, blah, blah. One day after praising to the hilt Islam, and talking about Islam, how America is a Muslim nation, so forth."

The German people have been rather careful to avoid forgetting their not-so-distant past, and I don't think they need Rush to tell them to "get over it". When your nation is responsible for a massive genocide committed in living memory, forgetting is rather dangerous. But Rush can play both sides of this one. Regarding the attack at the Holocaust Memorial:

The Weekly Standard, a conservative magazine, may have been one of the shooter's targets. You know why? Because the Weekly Standard is edited by "neocons," Jewish people who are big on US foreign policy and defense of Israel. Leftist-type conspiracy theories. This guy may have been targeting a conservative publication.
[...]
A hater, a nutcase who hates neocons -- i.e., Jews -- this von Brunn guy, attacks the Holocaust museum and has in his possession the address of the Weekly Standard, a publication that is run by neocons, a term invented by liberals as a code word to describe Jews who run American foreign policy for the express defense of Israel. So this hater of neocons, hater of conservative Jews, von Brunn, attacks the Holocaust museum. There is another guy who hates neocons. His name is Chris Matthews. And he works at MSNBC, which is a network of endless hate.

Somehow, in Rush's opiate-addled mind, neocon=Jew, and an attack on Jews is an attack on neocons, meaning that the attacker is a liberal. Got that?
I've got news for you Rush. The Jewish people aren't new at this. We can recognize exploitation pretty easily, and your tortured reasoning reveals your own bigotry. "Neocon" is not the same as "Jew"---it is a common trope touted by isolationist antisemites. Also, neocon views are not a common "Jewish value". The fact that some prominent neocons are Jewish and that you exploit this fact for your own political ends, makes you an idiot and an antisemitic bigot. And the Standard wasn't targeted (if it was even targeted) because it is conservative. If it was targeted, it was because, in the hateful mind of the shooter, the Standard=Jews---neocons are the "collateral damage", not Jews. Violent antisemites target Jewish victims, some of whom may be conservative. They do not target conservatives, some of whom happen to be Jewish. If you read the twisted writings of the shooter (whose name isn't fit to be typed), he was a violent bigot, not an MSNBC-driven hunter of neocons.
He's got a lot in common with you, Rush.

93 responses so far

Righteous Among Nations

Jun 11 2009 Published by under Absurd religious wingnutery, Politics

remembrance-hor-flame-330-111908.jpg

"Whosoever saves a single life, saves an entire universe"

In Memoriam Stephen T. Johns, Righteous Among Nations

6 responses so far

My head just asploded! Twice!

Jun 10 2009 Published by under Absurd medical claims, Medicine, Vaccination inanity

The Huffington Post put up a good piece about vaccination. It's by Dr. Harvey Karp, and he does an especially nice job looking at some of the "scary numbers" used by the infectious disease promoters.
He's also getting swamped with wackaloon comments, so if you don't mind giving HuffPo your clicks, you might want to check it out.
BTW, JB Handley has written that Karp is, "a completely arrogant asshole with little grasp of the facts," so you know his creds are legit.
Addendum:
Holy Karp! My head re-asploded! Thanks to our alert reader below, I see that Karp only made a little sense. I guess I should have realized things were gonna go wrong when he invoked terrorism and used scare stats, but the rest seemed so good... except it's like...well...it's like this.
Imagine you're lost in a strange, frightening place, say a 19th century insane asylum. You finally run into someone who is well-groomed, and speaking sensibly. He acknowledges that you have been locked up in error, and that the place is crazy, and you feel relief, hope. Ah, an ally! Then he tells you that your salvation is coming, you shall be released from your confinement. Just show up on the roof at eight o'clock. That's when the aliens are landing.
So this line sneaked into Karp's piece:

In this 3-part blog, I'd like to discuss in detail the reasons why shots are very safe - and super important - and to present some fresh ideas about a more likely cause of autism: an invisible soup of toxins we're exposed to every day...endocrine disrupting chemicals (EDCs).

Arghhh!!!!

your-head-asplode.jpg

15 responses so far

What is disease? Diabetes, diagnosis, and real science

Jun 09 2009 Published by under Medicine, Science-y stuff

ResearchBlogging.orgOne of the concepts we often discuss around here is "what is disease?" As we've seen in the discussion of Lyme disease and so-called Morgellons syndrome, this is not always an easy question to answer. Knowing what states are disease states does not always yield a black-or-white answer. The first step is usually to define what a disease is. The next problem is to decide who in fact has that disease. The first question is hard enough, especially in disease states that we don't understand too well. The second question can be equally tricky. To explore the scientific and philosophical issues of diagnosing an illness we will use as a model diabetes mellitus (DM). This won't be quite as boring as you think, so don't click away yet. (Most of the information here refers more specifically to type II diabetes, but most of it is valid for type I as well.)

Continue Reading »

18 responses so far

HuffPo gets it wrong about Oprah. Surprised?

Jun 08 2009 Published by under Absurd medical claims

To wear the mantle of Galileo, it is not enough to be persecuted:
you must also be right.
---Robert Park

As a physician, it's hard for me to support the absurd media fashion of presenting two, equal sides to every issue. In politics, perhaps, many debates have two equally-valid viewpoints, but this isn't so in science and medicine. A treatment is either proven to work or proven not to work. Occasionally, plausible ideas are sitting somewhere in between hoping for evidence to push them one way or the other. Notice the word "evidence"---not waiting for the verdict of a TV talk show, not waiting for a news anchor's opinion, but waiting for evidence. That's why there is no such thing as "alternative medicine"; there is only that which has been shown effective, and that which has not.
In the latest "Oprah Wars", the mainstream media have finally noticed that the Daytime Diva actively promotes quackery. Some folks are unhappy about the "unfair attacks" on their best TV friend. Those who think that Oprah is revealing secrets long suppressed by some Cabal of the FDA and Big Pharma are beyond reason. But those who think that Oprah is actually performing a service need some education.
One such person is Lee Schneider, writing at the Huffington Post. He basically falls for the infamous "Semmelweis Fallacy" also known as the "Galileo Fallacy". This error in reasoning represents some fundamental misunderstandings of how science works (not how "they" say it should work, but how it actually accomplishes its successes).
According to Schneider:

Newsweek portrays her as laughable, but I agree with Oprah - [Suzanne] Somers might be a pioneer. Self-experimenters have often advanced science. At the age of 22, Sir Isaac Newton nearly blinded himself by staring at the sun in a mirror because he wanted to study the after-images it left on his retinas. Australian physician Barry James Marshall swallowed some foul-smelling bacterial crud to show that Helicobacter pylori caused ulcers. Sir Issac ended up with marks on his eyelids; but Marshall ended up with a 2005 Nobel Prize for linking the bacterial crud, H. pylori, to ulcers. I'm not saying Suzanne Somers is going to surprise us with a treatise on gravity, but she has courage.

Suzanne Somers, promoter of dangerous women's health advice, will never win a Nobel Prize, and not because she is an idiot. She will never win a Nobel (or a Lasker) because she is no scientist. The Dr. Marshall to whom Schneider refers actually had a plausible hypothesis and collected data. Somers has no plausible hypothesis for her bioidentical voodoo, and wouldn't know real data if it jumped into her notebook.
Schneider further opines:

Newsweek is going backward, contributing to the backlash against new medicine. Oprah is going forward by supporting medical pioneers. While looking into the sun, drinking crud or shooting up in the vagina may not seem so brilliant, breakthroughs come from acts of courage or folly and sometimes both.

Science is a system of understanding the real world. It's a system that, though it has imperfections, has served us well. Simply asserting that something is so is not "being a pioneer"---it's being a crank. To show that something is so, even something strange, one must actually study it systematically, not go on TV and assert that it is true. To assert requires no courage, only folly. And in medicine, folly kills.

26 responses so far

Town declares science wrong, science not impressed

Jun 07 2009 Published by under Absurd medical claims, Medicine

A "fan" on twitter sent me the crushing news that all I believed about the science of Lyme disease is wrong. Unlike many fans, he cited a source, a well-known New England publication. The New England Journal of Medicine? Nope. The Darien (CT) Times.
According to the headline, "surveys refute national Lyme disease findings." So they must at least be quoting a science publication. Right?
Actually, they are quoting the famous work of one Kent Haydock, chairman of the Deer Management Committee. How did he accomplish this astonishing first act in what will no doubt be a stunning scientific career?
He showed the agitprop Lyme advocacy film Under Our Skin to 41 local families and then asked them if they had signs of Lyme disease and if it was ruining their lives. Not surprisingly, the answers to both questions were "yes" a remarkably high percentage of the time.
Once I stopped laughing at the credulity of the reporter, I sat amazed, staring at the screen---amazed not just that a paper could print such a thing without even a winking smiley, but shocked that the paper thinks so little of Connecticut's readers. That anyone thinks that a cheap propaganda piece by the "deer committee" is anything resembling evidence shows a big gap in our system of science education. In the discussion of Lyme disease, this article not only adds nothing, it "endumbens" the dialog. For shame.
(I can't wait to get a copy of Sheril and Chris's new book!)

77 responses so far

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