"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 month ago I wrote about how the grande dame of the anti-vaccine movement, Barbara Loe Fisher, is using the legal system to try to silence and intimidate Dr. Paul Offit. In it, I described an earlier lawsuit in which Dear Leader J.B. Handley sued Dr. Offit, and Dr. Offit ended up settling. Unfortunately, I made the mistake of taking Dear Leader's word for what the settlement was, and Dr. Offit has corrected me:
Thanks to Respectful Insolence for the support in the upcoming lawsuit filed against me by Ms. Fisher. I would point out only that the details of the "settlement" with Mr. Handley are incorrect. Both Mr. Handley and I each agreed to contribute $5,000 to an autism charity of which I approved. (This was my idea). The charity was the Center for Autism Research at UCLA, which, as far as I know, is not Ms. McCarthy's favorite charity. I assume that Generation Rescue is her favorite charity. Further, Mr. Handley argued with the context, not the accuracy, of his quote in my book. I put the quote in context and wrote a letter simply acknowledging that I had done so. I did not accede to Mr. Handley's demands of a mea culpa. His case was going no where and he knew it. So he settled for nothing.
Correction noted, and I won't make the same mistake again.
If there is one aspect of "complementary and alternative" medicine (CAM) that can puzzle advocates of science-based medicine, it's why, given how nonsensical much of it is given that some of it actually goes against the laws of physics (think homeopathy or distance healing), CAM is so popular. Obviously one reason is that there are conditions for which SBM does not have any "magic bullet" treatments. Diabetes, heart disease, other chronic illnesses, SBM can manage them quite well, but it can't cure them. Then there are conditions that science doesn't understand very well, conditions like, for example, fibromyalgia. It would be less than honest of me (or any other supporter of SBM) not to acknowledge that SBM sometimes has little to offer some patients. Of course, there's no evidence that CAM has anything therapeutic or concrete to offer these patients either, although certainly CAMsters would like you and their other marks to believe that they do.
Actually, that may not be entirely accurate. There does appear to be something that CAMsters offer patients that we practitioners of SBM appear to have a problem providing. It's unfortunate that this is true, but it does appear to be, and what it is should be fairly easy to guess. Basically, it's time. Anecdotally, most of us who pay attention to the issue of CAM and the infiltration of pseudoscience into medicine have suspected this, but there hasn't been a lot of data one way or the other to determine whether this is indeed the case and, if so, what the difference is. Last week, however, Dr. RW pointed me to a study that takes a stab at answering that very question. Published by a Dutch group, the study examined the practices of conventional physicians and CAM practitioners in terms of diagnoses seen and time spent with patients. The CAM practitioners included physicians practicing homeopathy, acupuncture, and naturopathy. A total of 5919 visits in 1839 patients were studied for diagnoses and time spent with each patient. These data were then compared with data from general practitioners (GPs) participating in the second Dutch national study in general practice (DNSGP-2). One result of this study was not surprising:
It looks as though Generation Rescue's bubble-brained spokescelebrities Jenny McCarthy and Jim Carrey have finally found their niche. Can you guess where it is? Come on, take two guesses! That's right. They've made it into NaturalNews.com, crossposted from a post they had their handlers make to Age of Autism, entitled A Statement from Jenny McCarthy & Jim Carrey: Andrew Wakefield, Scientific Censorship, and Fourteen Monkeys. Truly, it is one of the most hilarious things I've ever seen on AoA or NaturalNews.com. You'll see why in a moment. Suffice it to say that Jenny and Jim have the most fascinating conspiracy theory, a "real" explanation as to why The Man (a.k.a. big pharma and the CDC) made sure that the British General Medical Council decided to find Andrew Wakefield guilty of numerous charges relating to dishonesty, abuse of public funds, and lack of ethics in research and that the editors of the Lancet decided to retract his incompetent and unethical 1998 study. Well, not really Jenny and Jim. Given their writing and scientific "prowess," it is painfully obvious that neither could compose something anywhere near this coherent, and even then it's not very coherent. One wonders if either Dear Leader J.B. Handley wrote it or perhaps his MBA scientist wannabe Mark Blaxill. Maybe it's very incoherence is why Mike Adams decided their statement was worthy of being featured on NaturalNews.com.
About five months ago, I blogged about a true miscarriage of justice, the sort of thing that should never, ever happen. In brief, it was the story of two nurses who, disturbed at how a local doctor was peddling his dubious "herbal" concoctions in the emergency room of the local hospital when he came in to see patients, reported him to the authorities. Moreover, they had gone up the chain of command, first complaining to hospital authorities. After nothing happened for months, they decided to report the physician, Dr. Rolando Arafiles, Jr., to the Texas Medical Board because they honestly believed that this physician was abusing his trust with patients and behaving unethically by improperly hawking herbal supplements that he was selling in the rural health clinic and the emergency room of Winkler County Memorial Hospital.
Even though under whistleblower laws the identities of these nurses should have been kept secret, after he learned that a complaint had been filed against him Dr. Arafiles went to his buddy the Winkler County Sheriff Robert L. Roberts, who left no stone unturned in trying to find out who had ratted out Dr. Arafiles:
My adopted alter ego may be nothing but a computer played by a box of colored blinking lights, but those few who are actually familiar with the 30 year old British SF TV show that featured Orac beginning in the last episode of its first season know that Orac is an arrogant and vain computer. Given that, how could I fail to notice a couple of accolades that came my way last week.
Then, earlier in the week Eureka Zone included Respectful Insolence in its list of the Top 30 Science Blogs.
Too many accolades can go to the head of even a cranky computer.
Finally, before I sign off, I know I promised I'd try to leave the Wakefield case alone next week, but AoA and NaturalNews.com posted some stuff that I may not be able to lay off of. If I am weak, I ask your indulgence for one more day on Monday.
Thanks to Andrew Wakefield, it's been pretty much vaccine week for me. Well, mostly anyway, I did manage to have some fun with Mike Adams and the immune system, but otherwise it's been all vaccines all the time this week. As I mentioned yesterday, at the risk of dwelling on one topic so long that I start driving away readers, I've just decided to ride the wave and go with it until it's over. Unless something blows up over the weekend, I rather suspect that, for all intents and purposes, it'll be over as of today and I can move on to other topics starting Monday. At least I hope so.
But there's one more issue related to the Andrew Wakefield case that I feel I'd be remiss not to cover, as it's a very important issue. I was reminded of it by Chris Mooney in a post entitled Will the Vaccine-Autism Saga Finally End? He and I both know the answer to this question (no), but in discussing why neither the General Medical Council's finding Andrew Wakefield to have behaved dishonestly and unethically in doing the "research" that led to his 1998 Lancet paper that launched the MMR scare in the U.K. nor the decision of the Lancet's editors to retract said 1998 paper would end the vaccine autism manufactroversy, Mooney suggested a way out of this problem that is profoundly misguided, naive, and reveals a profound misunderstanding of the anti-vaccine movement.
Before I explain what it was he said and why I find it so problematic, let me just point out that I was actually surprised at his post, because Chris has done good work before. I like Chris, by and large. I've gone drinking with Chris before (in Washington, DC three years ago, when I was at a conference). Moreover, last year Chris published an excellent overview of the anti-vaccine movement and why it is a danger to public health for the June issue of Discover Magazine, entitled Why Does the Vaccine/Autism Controversy Live On? (In the interest of full disclosure, I'll point out that Chris interviewed me for the article, and I did my best to give him as much background as I could, but he also interviewed numerous other people.) In rereading it, saw the germ of a promising idea for how to try to restore public confidence in vaccines, but in reading Mooney's latest, I wonder if he's taken that idea too far. I'll explain.
I realize I complain periodically about when I get into what seems to me to be a rut in which I'm writing pretty much only about anti-vaccine lunacy. This is just such a week, when the news on the vaccine front has been coming fast and furious, first with Andrew Wakefield's being found to have behaved unethically and dishonestly by the British General Medical Council, only to be followed up a few days later with the news that the editors of The Lancethad retracted his 1998 paper, the paper that started the MMR scare in the U.K. and launched a thousand autism quacks. Meanwhile, the cranks will leap to the defense of their hero, providing additional blogging opportunity. Sometimes these events will stretch out for several days or even a week when it appears that the only thing I'm writing about is vaccines. Depending on my mood, I'll rail against fate and resist, often with Godfather, Part 3 references, before reluctantly charging back into the fray. Sometimes, when I'm in the mood for some seriously not-so-Respectful Insolence, I'll just go with the flow and ride the wave for as long as it lasts before moving on to other topics.
This is one of those times.
Seeing the patron saint of the anti-vaccine movement, the man who started it all in the U.K. (at least the most recent incarnation of the anti-vaccine movement) finally forced to answer for his misdeeds by potentially having his U.K. medical license struck off and actually having the original source of his influence expunged from the scientific literature, demands nothing less. This is what I do in the blogosphere, and I want to make sure that there is copious explanation of what's going on and why. If I can't always resist indulging in a little schadenfreude at times, well, the blog pseudonym notwithstanding I am still human. Even so, I have to prioritize. Even though I rather miss our old friend, pediatrician to the anti-vaccine stars and apologist for the anti-vaccine movement Dr. Jay Gordon, has resurfaced in the Huffington Post just asking for a heapin' helpin' of not-so-Respectful Insolence, something else demanded my attention first. The reason is quite simple. It epitomizes what is most wrong with science journalism. That's why I hereby list the two worst offenders for execrable reporting of the Wakefield Lancet retraction.
You know I'm a sucker for a heartfelt plea from an anti-vaccine activist. That's why, upon seeing Kim Stagliano write in Age of Autism:
Hi, I'd appreciate your comments over at HuffPo on my post, The Censorship of Autism Treatment" HERE.
I had to admit that I heartily agree. That's why I'm asking my readers to take Ms. Stagliano up on her offer and head on over to comment on her post! Who says Orac is not a kind and benevolent box of blinking colored lights?
Support Dr. Wakefield and his colleagues and share your own story there, please. Thanks.
Clearly, Kim has no sense of self-awareness at all. It makes me wonder if the Huffington Post will "censor" anyone who doesn't support Andrew Wakefield, it does. In any case, I'd just like to say to Kim and others of the merry band of anti-vaccine fighters at AoA: "Censorship. You keep using that word. I do not think it means what you think it means."
The martyrdom of brave maverick Saint Andy continues apace, it would appear.
As you recall, last week, after an interminable proceeding that stretched out over two and a half years, the General Medical Council in the U.K. finally ruled on the question of whether Andrew Wakefield, the man whose incompetently performed, trial lawyer-backed study published in the Lancet in 1998, acted unethically. The answer, not surprisingly, was a resounding yes, or, as Mark Slackmeyer would put it, "Guilty! Guilty! Guilty! Guilty!" True, not all the counts against Wakefield were ruled as proven, but most damning of them were, including misuse of public funds, performing invasive procedures on children for research purposes without proper ethics panel approval, and, worst of all from my perspective, acting not in the best interests of the children under the care of his research team. That last one, quite frankly, is unforgivable--every bit as unforgivable as wrong site surgery or mistakenly giving overdoses of radiation. Its manifestation was the performance of medically unnecessary invasive procedures, such as colonoscopies and lumbar punctures, on autistic children.
I won't lie. When I heard of the ruling last week, it brought a smile to my face, even though it was announced on the very day before my grant deadline, the very day I was in the midst of pulling an all nighter to get the grant done, the very day I was in a pretty lousy mood--tired and even more cranky and cantankerous than usual. Hearing that the man whose bad science launched a thousand quackeries had finally been declared unethical and dishonest and was on the verge of having his U.K. medical license yanked (or, to use that wonderfully British turn of phrase, struck off) brought joy to my heart, the joy that comes with seeing justice done. True, it was justice delayed--by several years, given that evidence of Wakefield's dishonesty and conflicts of interest had been published by Brian Deer back in 2004--but it was justice nonetheless.
Yesterday, there was a bit more justice laid down upon poor, poor, pitiful Saint Andy. Yesterday, what minuscule bit of seeming scientific credibility Wakefield had left was taken away from him. Yesterday, The Lancet decided to retract Wakefield's 1998 paper, the paper that started the whole MMR scare nearly 12 years ago. For, yesterday, published online on The Lancet's website was this brief message from its editors:
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 
