"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.)
A couple of weeks ago, I made the observation that there seems to have been a--shall we say?--realignment in one of the central arguments that proponents of "complementary and alternative medicine" (CAM) and "integrative medicine" (IM) make. Back in the day (say, a few years ago), such CAM practitioners and apologists used to try very, very hard to argue that their modalities had actual efficacy, that they had actual, measurable effects that made them medicine rather than woo. Never mind that even back then they had been trying for at least a couple of decades to come up with preclinical and clinical evidence that various magical CAM modalities worked, without any appreciable success. Worse for them, it's only gotten worse over the last few years. As I've documented here and elsewhere, the larger and better-designed the scientific study, the more likely it is that a CAM modality will show no efficacy detectably different than placebo effects. When we test a drug or medical device, finding no difference between the treatment arm and placebo arm leads us to conclude that the drug or device (or whatever intervention) does not work; i.e., does not have effects detectably different from nonspecific effects. When CAM practitioners find no difference between the treatment arm and placebo arm, they conclude that their treatment has promise. I love the double standard, don't you?
In any case, as more and more evidence comes in failing to find CAM modalities to be any more efficacious than placebo, the inevitable conclusion is that most of CAM is placebo medicine. Given that placebo effects have not been shown to have any detectable effect on the actual pathophysiology of disease, that they are variable, unreliable, and generally weak, and that invoking them requires deceiving the patient, it is considered at best ethically dubious and at worst completely unethical to treat patients with placeboes. They are not particularly effective, and a practitioner must, in essence, lie to his or her patient. Paternalism, although by no means gone in medicine, is soooo 1950s; it's slowly disappearing, and the disapproval of using placebo medicine is one part of that decline--except in CAM, apparently.
In any case, as I pointed out a couple of weeks ago, when faced with more and more evidence that the vast majority of CAM is placebo medicine, what do CAM pracitioners do? Do they do what a science-based practitioner would do, at least eventually, and give it up? Of course not! Instead, they double down and embrace the "placeboness" of their treatments by invoking the "powerful placebo" and claiming that they are "harnessing the power of placebo" to produce "powerful mind-body healing," of course!
I thought I was done with this topic, at least for a while, but then I found a post in--where else?--that wretched hive of scum and quackery, The Huffington Post by someone named Robert Schiffman, who is apparently a journalist and wants to tell us How the Placebo Effect Proves That God Exists.
Since I wrote about a man who is arguably the biggest seller of quackery on the Internet, namely Joe Mercola, yesterday, I thought I'd turn my attention to someone who is arguably another of the biggest promoters of quackery on the Internet, namely Mike Adams of NaturalNews.com. If Joe Mercola is proof positive that quackery sells, Mike Adams is proof positive that there are conspiracy theorists out there who are so reality-challenged that they'll believe virtually anything. Whether it's his despicable assaults on dead celebrities as having been "killed by modern medicine," his constant stream of antivaccine fear mongering, or his hilariously inept attempt to out-Chopra Deepak Chopra while mixing in liberal helpings of pure unadulterated fevered conspiracy mongering, truly no one brings home the crazy about alternative medicine the way that Mike Adams does. As a result, he's a major force on the Internet, at least in the realm of quackery and attacking science=-based medicine. True, he doesn't appear to be nearly as good at marketing wares for huge profits, but he sure does appear to be good at marketing himself. While Mercola is cold and calculating about how to make money; Mike Adams appears to be just as calculating, but he's more about stirring up emotion and conspiracy theories. Unfortunately, he seems to be pretty good at it.
I must admit that I have a bit of a fascination for Mike Adams. I have a rational mind (or, at least, I try to have a rational mind); so it's really hard to wrap my brain around the sheer lunacy that is Mike Adams. There appears to be no conspiracy theory too outlandish for him to buy into uncritically, no charge against big pharma too unbelievable. In fact, I have a hard time deciding whether Adams is a true believer who really lives his paranoid world view or a scammer with a talent for tapping into the paranoia of the more gullible. I suspect it's a little of both but leaning towards the former. After all, a man who can produce a video in which science is portrayed as an unrelenting force for evil probably must at some level believe that science is an unrelenting force for evil. Either that, or he's extremely good at lying and mimicking paranoia.
Whatever Adams' motivation, his penchant for bringing home the crazy was on full display last night in an article entitled Microsoft buys eugenics technology from Merck, becomes drug development partner with top global vaccine manufacturer. Somehow I ended up on Adams' NaturalNews.com mailing list a while back. Actually, I ended up on it twice, once per my two main blogging e-mail addresses, meaning that I get a double dose of crazy delivered to my in box every morning; so when this gem popped up I just couldn't resist. One of these days, fascination with this much concentrated misinformation might suck me past the event horizon of the black hole of crazy that is Mike Adams' website. Not today. Today, I take my amusement (and hopefully produce yours).
For as many benefits as the Internet and the web have brought us in the last two decades, there are also significant downsides. I could go into all the societal changes brought about by the proliferation of this new technology, not the least of which (to me, at least) is the newfound ability of someone like me to find an audience. After all, pre-Internet and pre-blog, I could try to write books, or I could try to get onto TV and radio, but those are very difficult things to do. Over the last seven years, steadily blogging, I've built up an audience. True, compared to the "old media" and the more popular examples of the new media, this blog is the proverbial tiny voice in the wilderness. Normally, I have to actively think about people such as Dr. Oz, Oprah Winfrey, The Doctors, and that wretched hive of scum and quackery, The Huffingto Post, just to remind me how small my influence is when compared to the forces arrayed against science-based medicine.
It's rather depressing, though, to have it rubbed in my face from a source I didn't expect.
I'm referring to an article that appeared yesterday in Chicago Magazine entitled Dr. Mercola: Visionary or Quack? Although I agreed with much of what was in the article, which featured some familiar people trying to provide balance to Mercola's pseudoscience, I must admit that I couldn't help but find the very title of the article is annoying. Putting the word "visionary" in the same title with the word "Dr. Mercola" is profoundly offensive to anyone who values reason, science, and science-based medicine. I realize the reporter was doing nothing more than being provocative, but it sets the tone in a way that makes it sound as though there is even a controversy over what the answer to such a question is. That answer, of course, is, in my not-so-humble opinion, that Dr. Mercola is a quack. Many are the posts I've written right here on this very blog spelling out in painful detail exactly why it is that I think this is so. For one thing, Dr. Mercola is antivaccine to the core, even going so far as to team up with the antivaccine group the National Vaccine Information Center (NVIC) to spread its propaganda. This article actually provides a tidbit of information that I didn't know about. In fact, it's a tidbit so juicy that I'm going to mention it now, even though it doesn't show up until late in the article:
Here's a rare bit of good news on the regulatory front. It turns out that Representative Dan Burton (R-IN) has finally decided to retire:
So Rep. Dan Burton (R-Ind.) is finally retiring, after two decades in Congress. He's got a notable record of craziness, having doggedly pursued President Bill Clinton during the Monica Lewinsky scandal while knowing full well he'd had an affair himself and even fathered a child out of wedlock. He famously claimed to have shot up a "head-like object" (likely a melon or a pumpkin) to try to re-create the alleged "murder" of former Clinton deputy White House counsel Vince Foster, who committed suicide. But Burton doesn't get enough credit for what may be his lasting legacy: helping turn Americans away from life-saving childhood vaccines.
One of the most common retorts that antivaccine activists like to make, usually in the most wounded, self-righteous tone with the most wounded, disgusted expression on their faces that they can manage, is that they are "not antivaccine but rather pro-safe vaccine." There may be a tiny minority of antivaccinationists who really are "pro-safe vaccine," but if they exist I have yet to encounter one yet. In any case, what maes an antivaccinationist and antivaccinationist is an unrelenting hostility to and fear of vaccines, coupled with an even more unrelenting refusal to admit that vaccines do any good and ann amazingly slippery avoidance of answering the question of what, exactly, it would take to convince them that vaccines are safe enough for their children. Periodically, I like to provide examples that help illustrate this difference and why the claims of antivaccine activists that they are not, in fact, anti-vaccine are nearly always bogus. So it was that I came across the website Vactruth.com and this gem of a post Excuse Me Waiter - There's a Fly in My Vaccine Soup!
A more blatant example of the "toxins gambit" with so much idiocy concentrated in one post that it's a veritable black hole of antivaccine information at least as dense as the last black hole of vaccine misinformation I encountered. Maybe the two of them will consume each other. Rationale people and the children endangered by antivaccine rhetoric should be so lucky.
In any case, it's hard not to consider how hilarious the name "VacTruth" is in the context of what is actually on the website in general and this post in particular. To get an idea of the "quality" of this article, just check out the first couple of paragraphs:
It's rare that I have much in the way of reluctance to leap into writing about a topic. Any regular reader of this blog should know this to be true, given the topics I regularly take on and how often my writing draws flak my way from various proponents of quackery and pseudoscience, in particular the antivaccine crowd. Still, sometimes a topic gives me pause, although, I must admit, the reason is that blogging about it will bring embarrassment to me. Usually, I can overcome this reluctance, as I have done in discussing, for example, how my alma mater, the university from which I obtained both my undergraduate and graduate degree, has an actual program in magic (i.e., anthroposophic medicine). Then there was the example of how reiki had infiltrated my old stomping grounds at MetroHealth Medical Center, one of the hospitals at Case Western Reserve University where I rotated during my general surgery residency. Then, just last week, there was the most embarrassing fact that I had to acknowledge, namely that the cancer center at Case has gone woo, even going so far as to host the 2011 meeting of the Society of Integrative Oncology.
So what more could embarrass me? One more thing, it would appear, so much so that it's time to get the paper bag out again; you know, the one I routinely used to get out when surgeons and other physicians spouted embarrassing things back in the day.
I had heard about this a couple of days before P.Z. Myers blogged about it, but had decided that I probably wasn't the one to blog about it. Then, P.Z. had to go and rub my face in the embarrassment of it all by writing about a paper published by a faculty member at the Case Western Reserve University School of Medicine named Erik Andrulis. He was, I have to admit, depressingly spot-on in pointing out that a comparison to jabberwocky is inevitable. I, however, have another comparison that I think more apt, as you will soon see. First, though, I must admit that I found it very surprising that someone like Andrulis would publish a paper like this. If you look at his publication list, with one glaring exception, it looks pretty respectable. Basically, he studies enzymes that metabolize RNA called RNases:
In the more than a decade since I first discovered, to my shock, that there are actual people out there who not only don't believe that vaccines are safe despite overwhelming evidence that they are but in fact believe that they don't work and are dangerous, I thought I had seen every antivaccine argument out there. After all, I just wrote about the tactics and the tropes of the antivaccine movement in which I reviewed, well, the tactics and tropes of the antivaccine movement. One of the favorite (and therefore most commonly used) tropes of the anti-vaccine movement is that vaccines are somehow "unnatural." There are many variants of this particular trope, for example the claim that "natural" infection is better than vaccination. This delusion sometimes reaches the point where some antivaccine parents will do something as stupid as to try to send lollipops licked by their children with chickenpox through the mail to other parents, the aim being to allow those parents to expose their children the chickenpox in order to give their children the "benefit" of "natural immunity."
Yes, I thought I had seen every variation of the "unnatural" trope so beloved by antivaccinationists that, I must admit, the following took me rather by surprise. It's on a website whose name GreenMedInfo.com tells you just about all you need to know about it. My brief perusal of the site reveals that it's chock full of "natural" medicine quackery. Consistent with this, it appears to be rabidly antivaccine, as evidenced by a little dittie by someone named Sayer Ji, who is the person responsible for this website, entitled The Vaccination Agenda: An Implicit Transhumanism/Dehumanism. it's a crank trifecta, combining antivaccine tropes, conspiracy mongering, and the natural fallacy in heaping helpings, all topped off with fear mongering implying that vaccines are somehow responsible for making us less "human." At this late date, having been in the trenches for a while, even I don't recall having seen a screed so full of crazy. It's perfect for a Friday, when, even though I rarely do "Your Friday Dose of Woo" anymore, this might have been a good candidate for it. You'll see what I mean right away:
It's been nearly a year since I last discussed a most unusual malady. Part of the reason is that the opportunity to discuss it hasn't occurred recently; usually I need some spark or incident to "inspire" me to write about something, and there just hasn't been any Morgellons news that's caught my eye since then. However, another part of the reason, I must admit, is that writing about this particular condition almost always brings sufferers out of the woodwork, castigating me the way antivaccinationists like to castigate me for challenging the scientific basis of their preferred pseudoscience. I catch enough hostility from the antivaccine contingent. Before I'm reading to leap into a fray that's likely to bring more hostility--who knows? I might even be graced by a visit from a certain particularly deluded and persistent advocate of this condition--my way from an entirely different contingent of woo-meisters. On the other hand, sometimes I need a change of pace, a new area to look at the application of science-based medicine to health and disease.
I'm referring, of course, to Morgellons disease. To recap (for those of you who are familiar with the condition) or to provide some background (for those of you who are not), people suffering (or claiming to suffer) from this condition complain of an intense itching, and the condition is characterized by a number of primary symptoms. These include:
Sponanteously Erupting Skin lesions
Sensation of crawling, biting on and under the skin
Appearance of blue, black or red fibers and granules beneath and/or extruding from the skin
Fatigue
Short-term memory loss
Attention Deficit, Bipolar or Obsessive-Compulsive disorders
Ha! I must admit, I've said probably about 50% of these things at one time or another, maybe more:
Hmmmm. Maybe I need to come up with new "shit."
Oh, and, by the way, I've been mentioned on PZ's blog more times than I can remember over the last seven years. So there! (Oh, wait. Does that mean PZ won't ever mention me again. Never mind. I take it back.)
If there's one thing about homeopaths, it's that they're indefatigable in their dedication to their unique brand of pseudoscience. They're also endlessly protean in their ability to induce their explanations for how homeopathy is supposed to "work" to evolve into endless forms not so beautiful. If it's not the claim that "like cures like" is some sort of immutable law of nature or that diluting a remedy somehow makes it stronger, it's pivoting to the claim that water has "memory." If it's not that, then homeopaths and homeopathy apologists invoke quantum entanglement that somehow works at the macro level, that "nanocrystalloids" are involved, hilariously off-base explanations of energy, or that there's somehow a quantum gyroscopic interaction between practitioner and patient. They also seem to have a hard time understanding that explaining exactly what homeopathy is, why it's pseudoscience, and why it's quackery is not a "misinformation campaign," as homeopath Dana Ullman has characterized it.
So when a reader e-mailed this little gem entitled Scientists investigate water memory, I couldn't help but take a look, particularly since there's this spiffy video to go with it:
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 
