Archive for: December, 2009

Why is health reporting so hard?

Dec 16 2009 Published by under Medicine

C'mon, Times, it's not like you're some kind of penny-ante operation. You've got at least modest resources, you know like the internet and telephones to call up experts. Right?

I don't know whether it's a lack of resources, laziness, or ignorance that allows pieces like this one into the paper, but it doesn't change the craptastic nature of the piece.

The byline says:

Anahad O'Connor, who writes the Really? column for The New York Times, explores the claims and the science behind various alternative remedies that you may want to consider for your family medicine cabinet.

I also "explore the claims and the science behind various alternative remedies" and I do it without the resources of a major national newspaper---and my pieces aren't half as credulous.

Continue Reading »

67 responses so far

Death of a scam artist

Dec 16 2009 Published by under Absurd religious wingnutery

Oral Robers, a man infamous for his televangelism and faith healing, died yesterday. The coverage of his life helps remind me why I'm a skeptic. There are many wonderful skeptical bloggers out there---I'm not one of them. Sure, I aim a skeptical pen at improbable medical claims, but my posts aren't dripping with skepticism in the same way some of my favorite blogs are. But from time to time, it's good to remember why skepticism is a very good way to approach the world.
Oral Roberts was a scam artist. He built an evangelical empire on the wallets of his victims. He famously told his marks that God would strike him dead if they didn't send him eight million dollars. The man was no better than a drunken carny keeping teddy bears from toddlers, but he had significantly greater reach.

Continue Reading »

6 responses so far

Swine flu---unequal killer

Dec 15 2009 Published by under Medicine

One of my favorite publications is the Morbidity and Mortality Weekly Report (MMWR). It's put out weekly by the CDC and allows for rapid communication of emerging or interesting health trends. This week the CDC is reporting an extraordinary death rate from influenza in American Indians/Native Alaskans (AI/NA). Collecting data like this presents several challenges, including under-reporting of AI/NA ethnicity and under-reporting of H1N1 as a cause of death, which makes the data even more sobering.
The death rate from H1N1 among AI/NA is 3.7 per 100,000 population, compared with 0.9 per 100,000 for all other ethnicities combined. This is probably an under-estimate.
Many native populations carry a high burden of high-risk health problems such as diabetes which are associated with complications of influenza. In fact, NA/AI have twice the rate of diabetes as the rest of the population (over 45%). However, the trend of H1N1 mortality is also true for other indigenous populations, such as native Australians. This would seem to implicate poverty, marginalization, and other social factors in the disparity in mortality.
In some ways, this is a good thing. We can't change genetics, but we can improve social disparities---if we really want to.

10 responses so far

More dangerous naturopathic nonsense

Dec 14 2009 Published by under Absurd medical claims, Medicine

After reading the Canadian Association of Naturopathic Physician's idiotic flu handout I decided to see what our American naturopaths had to say about flu. It's not good. The most effective way to prevent influenza is through vaccination. Good hand hygiene probably helps. Nothing else really does, but that has never stopped quacks from making wildly bogus claims.

Continue Reading »

20 responses so far

Naturopaths getting it wrong in Canada

Dec 14 2009 Published by under Absurd medical claims, Medicine

Over at Skeptic North there has been an ongoing discussion about naturopathy. Since it looks like naturopaths are going to get prescribing privileges in Ontario, it's reasonable to subject their practice to some pretty intense scrutiny. One naturopath left some interesting comments about treatment of heart disease, citing relevant literature, but failed to show an actual understanding of the clinical realities of treating heart disease. This is not surprising given that naturopaths aren't required to do residencies like real doctors are.
Another comment referenced the Canadian Association of Naturopathic Doctors (CAND) information statement on swine flu (the original was apparently pulled down by CAND. Here is a copy). Its idiocy was downright surreal. It read like a fifth grader's poorly done book report. It is not only incorrect, but internally inconsistent. For example:

Continue Reading »

17 responses so far

Just a bit more on Merry Xmas

Dec 11 2009 Published by under Absurd religious wingnutery

I guess I hadn't realized how attached people are to their holiday greetings. There are a number of comments that deserve some examination here, at least if you have any interest in living comfortably in a multi-cultural society. Since it's my blog, I get to yank the comments out of context and focus on some misconceptions.

  • "Christmas has become as much a cultural holiday as a religious one."  

    That is an opinion that may be shared by many majoritarians. But for many Jews for example, there will never be anything secular about Christmas. Sure, there are Jews who get Christmas trees and give presents as a secular winter celebration, but that's not the norm. I am not delivering an indictment of Christmas, holiday wishes, or Jews who do Christmas but simply letting you know that not everyone is the same as you.

  • "I think I'm beginning to get it. If the majority of people celebrate a cultural thing, it's bad because it's not sensitive to those who don't celebrate it."

    No, that would be stupid, and I suspect that this is a deliberate, defensive posture taken by many majoritarians when people point out that their assumption of a normative status actually has an effect on other people. People who are part of a minority get that they are a minority. We get that most people do things differently and always will. Many of us hope, however, that the majority will try to be sensitive to the fact that not everyone is the same. I strongly suspect that most African Americans don't expect white people to turn black, but would like the majority to recognize that being black comes with a different set of societal assumptions and experiences than being white, and that being white often confers a set of privileges not immediately available to others.

  • "I never understood why it would be bizarre or uncomfortable to wish someone a happy [your holiday but not theirs]. If you get a different happy [their holiday but not yours] back, it means you will have been wished an EXTRA happy day..."

    Yes, that's pretty much the point. If you grow up as part of the majority culture, you are unlikely to intuitively "get it", and there's nothing wrong with that. It's considered a polite part of living in a civilized society to try to "get it". I hope and suspect that most "Merry Xmas's" are benign and meant to convey a kind word. I also know that motives are not always benign.

I am trying to help you of the majority understand what we of the minority often understand: that when you assume that Christmas is some sort of normative default, you are implying, whether you mean to or not, that the rest of us are "other" or "abnormal".

I'm cool with being other. I'm part of a minority and I have no intention of changing that to increase my comfort level among majoritarians. Neither do I expect the majority to stop celebrating Christmas or stop saying "Merry Christmas". But, as a member of a diverse society, I would respectfully suggest that people try to be aware.

45 responses so far

Happy Blogiversary to Orac!

Dec 11 2009 Published by under meta-blag

One of the blogosphere's best known skeptics hit a milestone today. Orac at Respectful Insolence has now been fighting ignorance for five years. That's like, oh, about 30 in blog years. Why don't you go over there and wish him a happy blogiversary. He deserves it. Folks like Orac who publicly call out quacks get a lot of online and real-life harassment. It's nice to get well-wishers coming by once in a while.

No responses yet

Merry Chirstm--er--

Dec 10 2009 Published by under Fatherhood

It's not always easy to figure out that you are not normative. If you grow up in an ethnic enclave, when you're young you probably think everyone is black/Spanish-speaking/Korean. When I was a little kid one of my parents' friends remarried. I remarked on how the new wife was Jewish. My mom corrected me.
"But Mom, she talks Jewish."
"No, honey, she's just from New Jersey."
If you're visibly different from the majority, or you speak a language other than English, you learn pretty quickly what "normal" is supposed to be---and it's not you. My daughter has grown up in an area of mixed ethnicity, with the majority of our neighbors being white and Christian, but she is around other Jewish families a lot. She understands that there are "Channukah people" and "Christmas people". When we were at the hospital last week I showed her the big tree and all the decorations. She said, "Daddy, where is the Channukah suff?"
I'd never really thought about it. I've known for a long time that ethnically (and politically) I'm a minority. I looked around the first floor of the hospital and found a small Channukah menorah in a cabinet in one of the side hallways.
I've long since figured out how to respond to the constant litany of "Merry Christmas" and the uncomfortable looks of people who start to say it an pause. For her, it's all new. I wonder how she's going to integrate all of this.

84 responses so far

Medical nihilism

Dec 10 2009 Published by under Medicine

Human medicine advances in the way much of science does. People make systematic observations, form plausible hypotheses, and collect data. One of the more important questions in medicine is how people are affected by certain exposures. When that exposure is a medicine, we prefer data from double-blinded, randomized controlled trials. Other types of exposures (such as cigarette smoke) are less amenable to RCTs and we must rely on case-control, cohort, and other studies that examine correlation.

But before we can run RCTs on human subjects we need more than just a plausible hypothesis; we need to know that the medicine appears to be safe and effective in a biological system. Usually, we use animal models, with the choice of species being dependent on the study design and the biology of the drug and the disease. By choosing this approach, we have made a value judgment: human health is important enough to allow us to test drugs and procedures on non-human animals. Our alternatives are limited: either we test drugs first on humans, or we don't develop new drugs.

So I was watching my local PBS station yesterday (perhaps for the last time) and I came upon Dr. Neal Barnard shilling some book or other on curing diabetes. That pissed me off enough to go to his website and check him out, but before I got into the other details I see that he founded something called the Physicians Committee for Responsible Medicine (PCRM). I vaguely recall hearing about this group during medical school. There were some students who joined as advocates of "ethical animal research", apparently unaware that ethics are already a big part of animal work. Since then, I haven't thought about the group.

Until now.

Continue Reading »

19 responses so far

Primary Care Challenge, Part II

Dec 08 2009 Published by under Medicine, Morning report

Some time ago I issued a naturopath challenge in which I invited naturopaths to analyse a typical primary care problem. Today, I'd like to issue a broader challenge.
With health care reform in the works, it would be wise to look north (or in my case, south) to our Canadian neighbo(u)rs, but not for the reason you think. Assuming we are able to extend health insurance coverage to millions of more Americans, we will need primary care practitioners (PCPs) who can care for these new medical consumers. In Canada, legislation to deal with a shortage of PCPs by giving modest new powers to other practitioners was hijacked. Naturopaths, a cult of "alternative" healers, managed to sneak in a provision to give them prescribing powers. As we deal with our own shortage of PCPs here in the States, we need to maintain our vigilance.

Continue Reading »

60 responses so far

« Newer posts Older posts »