"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.)
About a week ago, I took note of what appears to be a new offshoot of the antivaccine movement known as the Thinking Moms' Revolution (TMR). At the time, I pointed out the toxic combination of hubris mixed with ignorance that resulted in a risible "declaration of independence" from "medical tyranny." In reality, it was one long antivaccine rant full of long refuted myths and pseudoscience combined with a demand for an unethical study of the current vaccine schedule verus placebo. In brief, to anyone with half a brain, it would have been embarrassing. Apparently the woman who wrote it lacks even that intellectual capacity, belying the name "thinking moms."
One thing that the "declaration of independence" was about more than anything else was hostility towards scientific medicine. Indeed, the "independence" demanded was, more than anything else, "independence" from science-based medicine, about "freedom" to refuse vaccination based on misinformed consent that paints vaccines as dangerous--deadly, even--and denies their proven efficacy in preventing morbidity and mortality from infectious disease. More of this hostility was on display over the last week or so in the form of two posts. The one I noticed first appeared yesterday and demonstrates the pure hostility towards medical science of these 'thinking moms" directed at an individual physician as a surrogate for the vaccines they hate and the science that shows the worthlessness of "biomedical" autism quackery. It's in the form of an open letter entitled The Letter I Wish I Could Send To My Old Pediatrician. And so it begins:
I'm sometimes criticized for referring to various people who are "anti-science" as, well, "anti-science." People, for whatever reason, have a hard time believing that anyone is anti-science; so when I point out how much, for example, antivaccinationists, alternative medicine believers, or creationists are anti-science, they have a had time believing it. This is particularly true because, just as antivaccinationists loudly protest that they are not "antivaccine," those who are anti-science equally loudly protest that they are not "anti-science." Such protestations are almost inevitably followed by statements that demonstrate beyond a shadow of a doubt that they are in fact anti-science.
That's why Mike Adams of the quack website NaturalNews.com is so useful. Whenever anyone doubts that there can be someone who is anti-science to the core, all I do is point him to Mike Adams. Last week, in fact, Adams provided me just such an example of his anti-science proclivities that I had meant to blog about at the time but didn't get around to it. In a way my not covering it when it was originally published was a good thing in that it gave Adams time to write a followup post that makes my point better than I ever could. I'll show you what I mean.
The first post appeared a little over a week ago and was entitled, histrionically enough, Human race being terminated by 'scientific suicide'. To call this post an example of crank magnetism liberally spiced with anti-science propaganda is a major understatement, all mixed in with a heapin' helpin' of pure arrogance:
I know that I'm not going to have a lot of control over my selection of blogging material for a given day when I see more than one or two requests for an analysis of an article. So it was, when links like these were showing up in my e-mail:
Last week, I pointed out that, when referring to a therapy and considering whether it should be tested in clinical trials, plausibility does not mean knowing the mechanism. Today, I intend to elaborate a bit on that. As my jumping-off point, I couldn't ask for anything better (if you can call it that) than an article by homeopaths published last week online in Medicine, Health Care, and Philosophy entitled Plausibility and evidence: the case of homeopathy. You'll get an idea of what it is that affected Orac like the proverbial matador waving his cape in front of a bull by reading this brief passage from the abstract:
Prior disbelief in homeopathy is rooted in the perceived implausibility of any conceivable mechanism of action. Using the 'crossword analogy', we demonstrate that plausibility bias impedes assessment of the clinical evidence. Sweeping statements about the scientific impossibility of homeopathy are themselves unscientific: scientific statements must be precise and testable.
Scientific. You keep using that word. I do not think it means what you think it means. Of course, his being a homeopath is about as close to a guarantee as I can think of that a person doesn't have the first clue what is and is not scientific. If he did, he wouldn't be a homeopath. Still, this particular line of attack is often effective, whether yielded by a homeopath or other CAM apologist. After all, why not test these therapies in human beings and see if they work? What's wrong with that? Isn't it "close-minded" to claim that scientific considerations of prior plausibility consign homeopathy to the eternal dustbin of pseudoscience?
Not at all. There's a difference between being open-minded and being so "open-minded" that your brains threaten to fall out. Guess which category homeopaths like Rutten fall into. But to hear them tell it, homeopathy is rejected because because we scientists have a "negative plausibility bias" towards it. At least, that's what Rutten and some other homeopaths have been trying to convince us. This article seems to be an attempt to put some meat on the bones of their initial trial balloon of this argument published last summer, which Steve Novella duly deconstructed.
Before I dig in, however, I think it's necessary for me to "confess" my bias and why I think it should be your bias too.
It's been a while since I've done a bit of Your Friday Dose of Woo, and I actually kind of miss it. It's not that there hasn't been anything that hasn't been worthy of this "honor" for a while. On the other hand, there hasn't been anything in a while that combines just the right proportions of pure woo, utter ridiculousness, and pure pseudoscience to provide the perfect "inspiration" to start me on a roll. Oh, it's out there, but for some reason I've let myself become bogged down by topics that are just too serious. It's time to lighten up, at least for a little while.
So it was when I came across something that would be scary if it weren't so obviously nonsense as I was in Scottsdale last weekend attending a meeting. Now, you might not know this (or you might very well know it), Arizona is woo central, so much so that it even licenses "homeopathic physicians" and even lets these quacks do surgery. Indeed, not within a couple of hours of where I stayed is Sedona, which might as well be the capital of crystal nation, and, the last I heard, the Health Ranger himself Mike Adams was living near Tucson, while the "Phaelosopher Adam Abraham" apparently lives in Phoenix. We last met him a few months ago when he was combining energy woo with The Secret.
One of my newer blogging interests is the "alternative" cancer doctor named Dr. Stanislaw Burzynski. Although I had heard of him years ago, mainly in the context of his desperate patients tapping into the generosity of kind-hearted strangers to pay for his "antineoplaston" therapy, I hadn't really written much about him until very recently. About six months ago, Burzynski came to my attention because of his clinic's use of an Internet legal thug named Marc Stephens, who threatened skeptical bloggers with legal action after they had criticized the Burzynski Clinic and then later disavowed him in apparent embarrassment with a classic not-pology. It was at that point that I posted a trio of articles about the dubiousness and lack of science behind Burzynski's therapy and his claims for it, starting with a deconstruction of antineoplaston therapy and Burzynski's propaganda movie, then moving on to a discussion of why his "personalized gene-targeted cancer therapy" is basically "Personalized Medicine for Dummies" incompetently administered with an "everything but the kitchen sink" approach to highly expensive targeted therapies mixed with chemotherapy, and finishing with how Burzynski has gravitated to overselling an orphan drug that shows mild promise in some cancers because it is a prodrug for one of his antineoplastons.
One thing I had been looking forward to after focusing my attention on Burzynski was his hearing before the Texas Medical Board. It was originally apparently scheduled for January 2012, but then apparently delayed to April 11, 2012. Unfortunately, it's been delayed again. Although it looked as though Burzynski might slither away from justice again, what I've learned is that there has simply been a continuance. There will be more legal wrangling, and eventually there will be a hearing. It can't come too soon, but unfortunately Burzynski continues to practice during the months of delay.
The thing that bothers me the most about Burzynski is how he offers false hope to patients with terminal cancer at a cost of tens--or, commonly, hundreds--of thousands of dollars. He offers his antineoplaston therapy under the auspices of clinical trials, but then requires that the patient pay exorbitant sums of money for drugs and treatments, even though requiring patients to pay to be in clinical trials is considered dubious at best and highly unethical at worst. These patients, desperate to grasp at what they perceive to be their last chance to live, then do all sorts of desperate things to raise the money, often including all sorts of fundraisers. Indeed, what piqued my interest was the reaction to the case of Billie Bainbridge, who raised loads of cash because various British celebrities took an interest in her case and participated in concerts for her charity. Meanwhile, Burzynski claims that he has higher success rates than conventional medicine, that he doesn't use chemotherapy (he does), and that his therapy is nontoxic (it isn't; it's quite toxic), selling it through interviews with credulous quackery promoters like Suzanne Somers. Elsewhere, on various patient discussion forums, Burzynski shills make it sound as though Burzynski is the only one who can save patients with stage IV cancer.
I tend to get lost in complexity from time to time.
I know, big surprise to my regular readers, but I suppose it's a good thing that at least I know that this is a weakness of mine. Indeed, it must be part and parcel of my seeming tendency to produce epic posts of ridiculous length that sometimes surpass 5,000 words, although, in all fairness, my average post length is probably less than 2,000 words, which is still too long for many people but not beyond the pale. Of course, part of the reason for this is that I like to leave no stone unturned. In particular, I tend to like to make my refutations of the various bits of pseudoscience, quackery, and antivaccine nonsense that serve as the fodder for Orac-ian Insolence, Respectful and otherwise, as comprehensive as possible. I imagine the various targets topics of this blog, stung by having their bad science, logical fallacies, and bad reasoning punctured, looking for a single weakness that they can attack, believing that doing so will cause my entire argument in a post to come tumbling down. That's why I try to construct many of my posts like the proverbial spider web, with intermeshing arguments weaving together into what (I hope) is a seamless whole, where, even if I made a mistake in one area, the rest of the web remains sound. My computer 'nym notwithstanding, I am actually human and do occasionally make mistakes from time to time that go beyond typos or the occasional fragment or run-on sentence.
So it's a rare treat when I find a bit of nonsense that is not only allows me to explain a nice, simple principle that quacks frequently try to misrepresent for their benefit but actually foreshadows a post I was planning to do in the near future, I can't resist. It's therapeutic. Maybe I can even keep this post under 1,500 words (although I'm sure some smart-ass will note that I've already used up over 300.) That nonsense is, not surprisingly, a defense of homeopathy. It is, however, a defense based on a single statement and entitled If Homeopathy Can't Work, Then Neither Can Anesthesia. Not surprisingly, it's written by Heidi Stevenson, a homeopath whom we've met before pontificating about how anecdotal evidence is better than clinical trials and making nonsensical attacks on Stephen Barrett, but her screed is so brain dead that it could well have been written by Dana Ullman. Let's take a look, shall we.
It's no secret that over the years I've been very critical of a law passed nearly 20 years ago, commonly referred to as the DSHEA of 1994. The abbreviation DSHEA stands for about as Orwellian a name for a law as I can imagine: the Dietary Supplement Health and Education Act. Of course, as we've pointed out time and time again, the DSHEA is not about health, and it's certainly not about education. Indeed, perhaps my favorite description of this law comes from blog bud and all around awesome internist Dr. Peter Lipson, who refers to it as a "travesty of a mockery of a sham." Rather, it's about allowing supplement manufacturers and promoters of so-called "complementary and alternative medicine" (CAM, with or without a preceding "s," depending on your taste) who do not want pesky things like government laws and regulations to interfere with their selling of pseudoscience to market various compounds as "dietary supplements" with near-impunity. As Harriet Hall once put it so accurately, the DSHEA is "a stealth weapon that allows the sale of unproven medicines just as long as you pretend they are not medicines."
The DSHEA accomplishes this by making a seemingly reasonable distinction between food and medicine and twisting it in such a way that allows manufacturers to label all sorts of botanicals and various other compounds, many of which have substances in them with pharmacological activity, and sell them as "supplements" without prior approval by the FDA before marketing. As long as the manufacturer is careful enough not to make health claims that are too specific, namely that the supplement can diagnose or treat any specific disease, and sticks to "structure-function" statements ("it boosts the immune system!"), almost anything goes, particularly if a Quack Miranda Warning is included.
Not surprisingly, given what a big business supplements have become in this country largely due to the DSHEA, manufacturers and CAM advocates fight tooth and nail against any attempt to update the DSHEA to correct some of its more unfortunate consequences. Led by supplement industry lap dog Utah Senator Orrin Hatch and Iowa Senator Tom Harkin, who together make up a bipartisan tag-team in defense of the supplement industry and do their best to block any effort to increase its regulation by the FDA. We saw that most recently when Arizona Senator John McCain, of all people, introduced a bill in 2010 to try to tighten up the DSHEA and was thoroughly slapped down by Orrin Hatch. More recently, not satisfied with how good things are for the supplement industry, another bipartisan team of woo-friendly legislators U.S. Representatives led by Utah's Jason Chaffetz (a Republican) and Jared Polis (a Democrat) introduced the Free Speech About Science Act, which basically seeks to allow the supplement industry to make more liberal claims about its products. All it will need is a "peer-reviewed" paper to support it (Mark and David Geier would do!), and you can claim almost anything. Anything to grow the supplement industry, which is currently around $30 billion a year.
As several of us have pointed out before, there are science-based roles for supplementation. For instance, in the case of nutritional deficiencies, and Martinez et al point out the very same thing:
One of the most inaptly named groups I've ever seen is called Thinking Moms' Revolution (henceforth abbreviated as TMR). Given the reality of what TMR really is, the word "thinking" applied to TMR is, as they say, so wrong it's not even wrong. As for a "revolution," what TMR really represents is nothing revolutionary at all, unless you consider antivaccinationism, run-of-the-mill antiscience paranoia, and big pharma conspiracy theories to be "revolutionary." I don't know about you, but I do not. I've followed such activities for well over a decade now, and in light of that experience, perusing the TMR website, I am struck less by anything resembling "thinking" or "revolution" than by a smug sense of self-congratulation at how its members are allegedly not "brainwashed" like everyone else.
Don't believe me? Then look at the web page in which the "Thinking Moms" introduce themselves. I mean, gag me with the proverbial spoon (as they used to say in the 1980s). We have members going by the handles of Dragon Slayer, Goddess, The Booty Kicker, Killah, Savage, Saint, Princess, Mountain Momma, The Professor, and several others that are equally nauseatingly self-congratulatory. How edgy. How "revolutionary."
How tiresome. (Yes, I know I use a 'nym, but my little affectation is so obscure that very few readers know its significance. Come to think of it, few readers care about its significance even after I explain where it comes from. Maybe I should rename myself "Quack Killah." Yeah, that's the ticket...)
Not surprisingly, there's a lot of cross-pollination between TMR and the antivaccine crank blog Age of Autism. In fact, AoA is where I saw the most hilarious bit of arrogance yet from TMR, as it was published on AoA first. Apparently the "Thinking Moms'" opinion of themselves goes beyond thinking that they understand immunology, vaccine science, pharmacology, toxicology, and drug development better than...oh, you know...actual scientists. Apparently the "Thinking Moms" view themselves as revolutionaries on par with the Founding Fathers, so much so that they have posted their very own Declaration of Independence from Medical Tyranny. I was going to say that "words fail me," but you know that would be a lie. If that were the case, this would post would be just a brief link with a suggestion that you all point and laugh. Instead, however, I see a great deal that reveals the mindset not just of antivaccinationists but of quacks and cranks in general.
Denialism. You keep using that word. I do not think it means what you think it means.
The story might be apocryphal, and it might not even be true, but it's often used as a metaphor. I'm referring to the "boiling frog" story. Basically, the idea is supposedly based on an observation that a frog, when placed in a pot of hot water, will immediately jump out. However, or so the story goes, if the frog is placed in room temperature water and the water is heated gradually enough, the frog won't notice and will eventually boil to death without trying to escape. The metaphor, of course, is designed to illustrate how people will almost always notice rapid change, but, if the change is sufficiently slow, might not notice it at all and will readily acclimate themselves to the new situation if given sufficient time. Of course, the phenomenon underlying this metaphor might very well not even be real, but it's still probably a useful metaphor.
Being in the skeptic movement and having been very active over the last seven years blogging about skepticism, promoting science-based medicine, and combatting the antivaccine movement, this metaphor might be the reason why I didn't notice a particular tactic being increasingly used by denialists of all stripes until relatively recently, which is also relatively late. It took Mark Hoofnagle, who had disappeared from the skeptical blogging front for a couple of years pursuing his general surgery residency, to be slapped in the face with it and comment to me that he had been noticing this phenomenon upon returning to blogging about science denialism on his very own denialism blog. He was right, but in fact denialists had been doing this for a long time, and it was only a shock to Mark because he had stopped paying attention for a while and then was, like the proverbial frog, thrown back into the water.
Part of what led me to think about this phenomenon was a doozy of a post published on--where else?--that wretched hive of scum and quackery (no, not The Huffington Post--I mean that other wretched hive of scum and quackery), the antivaccine crank blog extraordinaire, Age of Autism. The post is by someone whose name is not familiar to me as one of the regulars, Cathy Nevison, and entitled Autism and the Antarctic Ozone Hole. Yes, in this post, Nevison does exactly what the title implies and tries to liken "autism epidemic denialists" to anthropogenic global warming denialists. Before I delve into the numerous deficiencies in Nevision's crank arguments, I do have to pause to express amusement about a passage right in the first paragraph:
A recent Associated Press report that 1 in 88 American children has an autism spectrum disorder (ASD) asserts that, "Better diagnosis is largely responsible for the new estimate..." Another AP report, on a study finding that 1 in 38 South Korean children has an ASD, quotes the lead author as saying, "It doesn't mean all of a sudden there are more new children with ASDs. They've been there all along, but were not counted in previous prevalence studies." These are extraordinary claims and examples of autism epidemic denial. Equally remarkable is that the AP presents them as unquestioned truth, making no effort to counter them with dissenting viewpoints. In contrast, the media has been diligent about "balancing" articles on the threat of climate change with opposing views from "climate skeptics," which has contributed to climate change denial.
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 
