Respectful Insolence

I’m beginning to fear for Kathleen Seidel.

No, I don’t fear for her safety, but I do fear for her sanity. You see, she’s spent way too much time delving into the house organ of the Association of American Physicians and Surgeons (AAPS), namely The Journal of American Physicians and Surgeons (with the unfortunate abbreviation JAPS, which is why they probably insist on using JPANDS), formerly known as Medical Sentinel. I’ve written about JPANDS before, pointing out that its claim of peer review is a sham and that it has an explicitly antivaccine agenda, not to mention its far right wing politics. It only took sampling a few of its articles for me to conclude that JPANDS is useless as a source of valid scientific articles.

But Kathleen dug deeper and found that JPANDS is even worse than I had feared, which is why I hope that she takes a break to let her neurons recover before diving back into the fray again, as the Pooflinger was forced to do to maintain his sanity after delving too deeply into creationist idiocy for too long. In her reading, she’s dug way deeper into JPANDS, reading far more of its articles than even I have dared, even going back to its predecessor Medical Sentinel to find more examples of its flagrant wingnuttery.

It’s not a pretty sight. Kathleen did a pretty comprehensive takedown of AAPS and JPANDS, listing all of their positions and many of the reasons why JPANDS should not be taken seriously as a scientific journal. She also makes the ironic observation that liberal icon RFK, Jr. has used JPANDS as a source for much of his thimerosal conspiracy-mongering. Because Kathleen has done such a thorough job, I’m only going to comment a bit more on three areas of JPANDS: its politics; its stance on vaccinations, and its stance against evidence-based medicine.

Kathleen begins by pointing out that many of the purveyors of the hypothesis that autism is a “misdiagnosis for mercury poisoning” or that autism is due to mercury in childhood vaccines publish in JPANDS, chief among them Mark and David Geier, whose pseudoscience was featured as the lead article in the very first issue of JPANDS in Spring 2003:

Promoters of the hypothesis that autism is a common adverse reaction to vaccination rely heavily upon articles published in the Journal of American Physicians and Surgeons (JPandS, originally Medical Sentinel). Previous perusals of JPandS tables of contents left me with the general impression that its sponsors tended toward the conservative end of the political spectrum. I therefore decided to make a comprehensive survey of the website of the Association of American Physicians and Surgeons, to get a sense of the convictions driving its editorial policies.

Heh. “Tended toward the conservative end of the political spectrum”? That’s an understatement. David Touretsky once said, “I’m a libertarian with a small L. The big-L Libertarians are anarchist loons.” The editorial philosophy of JPANDS reveals it to be a magazine dedicated to big-L Libertarianism in italics and bold. As the AAPS website states:

AAPS members believe this patient-physician relationship must be protected from all forms of third-party intervention. Since its founding in 1943, AAPS has been the only national organization consistently supporting the principles of the free market in medical practice.

It sounds innocuous enough, but why should medicine be “protected from all forms of third-party intervention”? No industry or profession is so protected. One can argue about the level of government oversight that is appropriate in a free nation, but to argue that there should be no oversight or intervention puts far more faith in physicians than even I as a physician have. Indeed, AAPS is explicitly opposed to any form of government regulation of health care; considers the FDA and Health Care Financing Administration to be unconstitutional; is utterly opposed to Medicare; urges physicians not to participate in Medicare; describes public health programs as “tyranny“; and liberally quotes Ayn Rand.

Kathleen aptly describes the philosphy of AAPS as “ultra-conservative-libertarian-individualist — with a generous helping of conspiracism thrown into the mix — reminiscent of the philosophy espoused by the John Birch Society.” However, the Libertarianism of AAPS is not quite without limits. Most Libertarians regard abortion as an individual right that the state should not interfere with except after fetal viability, arguing that a woman should have a near absolute right to control her own body. Not AAPS. It explicitly opposes abortion. Similarly, many Libertarians support open immigration. Not AAPS. It is explicitly for “closing the borders,” and has even published a racist anti-illegal immigrant screed that begins:

Illegal aliens’ stealthy assaults on medicine now must rouse Americans to alert and alarm. Even President Bush describes illegal aliens only as they are seen: strong physical laborers who work hard in undesirable jobs with low wages, who care for their families, and who pursue the American dream.

What is unseen is their free medical care that has degraded and closed some of America’s finest emergency medical facilities, and caused hospital bankruptcies: 84 California hospitals are closing their doors. “Anchor babies” born to illegal aliens instantly qualify as citizens for welfare benefits and have caused enormous rises in Medicaid costs and stipends under Supplemental Security Income and Disability Income.

What is seen is the illegal alien who with strong back may cough, sweat, and bleed, but is assumed healthy even though he and his illegal alien wife and children were never examined for contagious diseases.

By default, we grant health passes to illegal aliens. Yet many illegal aliens harbor fatal diseases that American medicine fought and vanquished long ago, such as drug-resistant tuberculosis, malaria, leprosy, plague, polio, dengue, and Chagas disease.

What is seen is the political statistic that 43 million lives are at risk in America because of lack of medical insurance. What is unseen is that medical insurance does not equal medical care. Uninsured people receive medical care in hospital emergency departments (EDs) under the coercive Emergency Medical Treatment and Active Labor Act of 1985 (EMTALA), which obligates hospitals to treat the uninsured but does not pay for that care. Also unseen is the percentage of the uninsured who are illegal aliens. No one knows how many illegal aliens reside in America. If there are 10 million, they constitute nearly 25 percent of the uninsured. The percentage could be even higher.

It goes downhill from there:

Illegal aliens perpetrate much violent crime, the results of which arrive at EDs. “Dump and run” patients, often requiring tracheotomy or thoracotomy for stab or gunshot wounds, are dropped on the hospital sidewalk or at the ED as the car speeds away.

And:

American hospitals welcome “anchor babies.” Illegal alien women come to the hospital in labor and drop their little anchors, each of whom pulls its illegal alien mother, father, and siblings into permanent residency simply by being born within our borders. Anchor babies are citizens, and instantly qualify for public welfare aid.

I’ve always been in favor of immigration reform that increases the number of legal immigrants permitted and dramatically clamps down on illegal immigration, but the sheer racism apparent in the above passages sickens me. The rest of the article is no better. It portrays illegal immigrants primarily as not-too-bright carriers of disease and crime that are a blight upon our nation and a threat to our health care system. (I almost expected an argument for eugenic measures to follow.) While it is true that unreimbursed care of illegal immigrants is a significant problem in some border states, rhetoric such as in the above article provides much more heat than light on the issue and seems more designed to inflame anti-immigrant sentiments than to suggest solutions to our current predicament.

Now that we’ve established that AAPS and JPANDS are motivated by a far right-wing political orientation, the reader may ask: So what? Although the explicitly political advocacy of AAPS certainly casts doubt on the editorial objectivity of JPANDS, in and of itself that advocacy doesn’t necessarily mean that JPANDS is not a reliable medical journal–that is, unless one looks a little more closely at how that very political orientation influences the choice of publications appearing in JPANDS. One area in which JPANDS departs from the medical mainstream is in its explicit stand against mandatory vaccination and its call for a “moratorium” on vaccine “mandates.” Not surprisingly, JPANDS has been receptive ground for antivaccination articles, including, but not limited to, the Geiers’ publications linking autism with mercury in childhood vaccines. Going back to Medical Sentinel and proceeding to this very day, AAPS has consistently viewed mandatory vaccination as a “tool of the state” and a threat to physician autonomy, while minimizing the contribution of mass vaccination to the elimination of various infectious diseases.

Kathleen lists a number of explicitly antivaccination articles that have appeared in JPANDS over the last three years. Titles range from Is Vaccine Dissent Dangerous? to World Health Organization Vaccine Recommendations: Scientific Flaws or Scientific Misconduct? All have two things in common: First, they do not just question the risk-benefit ratio or complication rates of various vaccines, as “conventional” doctors do all the time; rather the agenda behind these articles is either explicitly or implicitly antivaccine. Second, they are either editorials or “scientific papers” in which the science is consistently of the same poor quality as that found in the Geiers’ most recent article, which I deconstructed last week. Advocates of a link between mercury and autism will no doubt claim that the clear editorial stance of JPANDS does not necessarily invalidate what is published there. True enough. The shoddy science does a good enough job of invalidating it, and JPAND’s editorial stance is merely icing on the cake, not to mention a likely explanation why JPANDS would publish such poorly designed and conducted studies in the first place.

Particularly disturbing is the way in which the authors publishing in JPANDS will use antivaccination rhetoric for truly odious purposes. For example, JPANDS has become a major promoter of the claim that many cases of “shaken baby syndrome” are in actuality due to “vaccine-induced” encephalitis and frequently publishes articles making this argument. Indeed, the most recent issue of JPANDS has three articles devoted either to casting doubt on the concept of shaken baby syndrome or trying to blame many cases on vaccine complications, or both. This is the very defense that Alan Yurko, a man who was convicted of shaking his girlfriend’s ten week old baby son Alan to death in 1999 in Florida, used in his appeals. Strangely enough, he became a hero of the antivaccination movement, which mobilized behind him in a bizarre “Free Yurko” campaign that claimed that baby Alan’s death was due to “vaccine-induced encephalitis,” not Yurko’s violent shaking. As Peter Bowditch describes it:

Murderer Alan Yurko is to serve only 2317 days in prison for beating his girlfriend’s baby to death, after Circuit Court Judge C. Alan Lawson ruled that problems with the baby’s autopsy report justified a new trial. The autopsy report seems to be an extremely sloppy document, prepared by a medical examiner with a history of carelessness, and the judge correctly ruled that the jury in Yurko’s original trial might have come to a different conclusion if the autopsy evidence had been presented differently. (In an interesting example of doublethink, Yurko’s lawyers claimed at one point in the hearing that the examiner had mixed up the parts of two bodies which were being autopsied at the same time, and at another point stated that there were no other autopsies carried out for a week either side of the one for Yurko’s victim. That must have been one very messy and untidy morgue.) Despite what Yurko’s supporters are claiming, the judge did not declare him “innocent”, and the quashing of the conviction did not support the insane idea that vaccination had anything to do with the baby’s death. In fact, the judge quite explicitly rejected the testimony from the usual collection of demented anti-vaccination doctors who appeared before him to tell him why Yurko could not possibly have hurt the child.

Prominent among Yurko’s defenders was Dr. Harold Buttram, who–surprise, surprise!–published an argument for this very concept of shaken baby syndrome as being due to vaccine injury in Medical Sentinel back in 2001 and in JPANDS in 2004. Also prominent among Yurko’s defenders was veterinarian toxicologist Dr. Mohammed Al-Bayati, who, although not a pathologist, wrote a dubious “report” in which he purported to demonstrate that baby Alan’s cerebral hemorrhages were not due to violent shaking but rather to a combination of antibiotics and vaccination injury. Sound familiar? It should. We’ve met Dr. Al-Bayati before, when he performed a similar service for Christine Maggiore, the HIV-positive AIDS “dissident” who does not believe that HIV causes AIDS, a belief that likely contributed to the death of her daughter from AIDS-related complications. Dr. Al-Bayati’s “report” blamed Eliza Jane’s death primarily on an allergic reaction to amoxicillin and a parvovirus infection, rather than on Pneumocystis cariini pneumonia and HIV encephalitis, which is what the L.A. County Coroner had identified as the cause of death. The Al-Bayati “report” has been thoroughly debunked by me and others as an example of bad medicine and bad science based on speculation without a foundation in the autopsy findings or in what is known about parvovirus and allergic reactions to amoxicillin. Naturally, this report is being held up by HIV/AIDS “dissidents” as “proof” that EJ did not die of AIDS, as his earlier, equally dubious, report is represented by antivaccination activists as “proof” that vaccines are responsible for many cases of shaken baby syndrome.

Is there a common thread here, besides an extreme political orientation and a willingness to ignore evidence that doesn’t conform to the preconceived beliefs espoused by AAPS? I believe there is and that Kathleen found it when she quoted this article by Editor-In-Chief of JPANDS and former President of AAPS Lawrence Huntoon:

Inescapably, the herd is a force to be reckoned with in all of our professional lives. We must be prepared to travel with it or alongside it, to one degree or another, without being trampled or singled out for extermination. And, for those few physicians who still believe in individual-based medicine practiced according to the principles of Hippocrates, and in watching out for one another when one of our own is attacked, fortunately we have the AAPS. We are a fellowship of “different doctors,” and the distinction is apparent.

“Singled out for extermination” as a maverick? That’s a bit overblown, but that’s the attitude at AAPS. “Different doctors”? Well, it’s hard to argue with that, but it is unclear whether “different” means “better.” What is clear is that the AAPS values “maverick” status and total physician autonomy almost above all else. There’s not necessarily anything inherently wrong with prizing “maverick” status or bucking the status quo, at least to a point. That’s one way in which science advances. (The incremental building upon what has gone before is, however, actually the predominant manner of scientific progress.) Mavericks buck the status quo, and do sometimes lead to the overthrow of existing paradigms and the acquisition of new scientific knowledge. One commonly cited example is that of Robin Warren and Barry Marshall, the discoverers that Helicobacter pylori is the cause of most duodenal ulcers. Here’s the rub, though: Mavericks follow the wrong path far more frequently than they follow the right path. As Michael Shermer has said, “Heresy does not equal correctness,” and continued in his book Why People Believe Weird Things:

For every Galileo shown the instruments of torture for advocating scientific truth, there are a thousand (or ten thousand) unknowns whose ‘truths’ never pass scientific muster with other scientists.

Indeed.

As I wrote a long time ago in a blog far, far away in a post entitled The Galileo Gambit:

For every Galileo, Ignaz Semmelweis, Nicolaus Copernicus, Charles Darwin, Louis Pasteur, etc., whose scientific ideas were either ignored, rejected, or vigorously attacked by the scientific community of his time and then later accepted, there are untold numbers of others whose ideas were either ignored or rejected initially and then were never accepted–and never will be accepted. Why? Because they were wrong! The reason the ideas of Galileo, Semmelweis, Copernicus, Darwin, Pasteur, et al, were ultimately accepted as correct by the scientific community is because they turned out to be correct! Their observations and ideas stood up to repeated observation and scientific experimentation by many scientists in many places over many years. The weight of data supporting their ideas was so overwhelming that eventually even the biggest skeptics could no longer stand. That’s the way science works. It may be messy, and it may take longer, occasionally even decades or even longer, than we in the business might like to admit, but eventually in science the truth wins out. In fact, the best way for a scientist to become famous and successful in his or her field is to come up with evidence that strongly challenges established theories and concepts and then weave that evidence into a new theory. Albert Einstein didn’t end up in the history books by simply reconfirming and recapitulating Newton’s Laws. Semmelweis and Pasteur didn’t wind up in the history books by confirming the concept that disease was caused by an “imbalance of humours” (although Semmelweis probably did hurt himself by refusing to publish his results for many years; his data was so compelling it remains puzzling why he did not do so). I daresay that none of the Nobel Prize winners won that prestigious award by demonstrating something that the scientific establishment already believed. No! They won it by discovering something new and important!

It’s also hard not to point out the arrogant tone of Dr. Huntoon’s article. To him, the AAPS is devoted to “different doctors” who don’t meekly follow evidence-based guidelines, as the rest of what he views to be the “herd” does or adhere to nitpicky little things like the careful science that leads to those guidelines. No! These doctors are different and, by inference, better, more capable of independent thought than the rest of us poor, pathetic “sheep.”

How Ayn Randian of him!

The leadership of the AAPS and apparently many who publish in JPANDS seem to be a bit too enamored of their self-proclaimed “maverick” status and give the appearance of thinking that, like Ayn Rand’s hero, they’re “supermen” whose egoism and genius will inevitably prevail over timid traditionalism and social conformism. Reigning them in with evidence only interferes with their autonomy and prevents them from exercising their genius for the good of their patients. If only the “herd” could appreciate that! No wonder JPANDS has published several articles with titles such as Evidence-based Guidelines: Not Recommended, The Effect of Peer Review on Progress: Looking Back on 50 Years in Science (featuring another scornful dismissal of the “herd instinct” and “conformity” and a fair amount of exaggeration of how much scientific progress is due to “violent confrontation” of old paradigms and how much is due to the slow accumulation of knowledge), and editorials attacking evidence-based medicine. To AAPS, evidence-based guidelines appear to be unacceptable limits on the autonomy of doctors, as are any government regulations or third party payer systems.

Does any of this also sound familiar? Cranks and pseudoscientists often have the same attitude, along the lines of: “Damn those pesky ‘conventional’ scientists, with their insistence on careful observation, hypothesis generation, and experimentation! They don’t have the insight to see that I am right!” Although many of the authors publishing in JPANDS are probably not cranks, it’s clear to me that the AAPS appears to be an organization custom-made to attract cranks, regardless of their political orientation. Even those opposed to the far right wing core beliefs of AAPS could well be attracted by its promise of restoring a golden time when the authority and autonomy of physicians was not questioned and its attitude that there should be no outside constraints on the practice of medicine by physicians, whether those constraints come from the government or from evidence-based medicine. Those who view themselves as “mavericks” in their fields might also be so attracted, even if they don’t buy all the political baggage that comes with AAPS.

This attitude towards evidence is in conflict with true science. The true scientist always doubts, always wonders if he is correct. The true scientist is always testing his hypotheses against the data and wondering if there was something he might have missed. It involves careful experimentation and interpretation of the results of those experiments in a cautious light, with knowledge of what science has found before. Yes, sometimes there’s a bolt out of the blue and an existing paradigm must be overthrown, but more often science builds on what has gone before.

No wonder JPANDS is not indexed in MEDLINE, and no wonder so much quackery somehow manages to appear there first. If I were a quack, it’s one of the first places I’d send my papers–as a “maverick,” of course.

ADDENDUM: Joseph over at Autism-Natural Variation has had a rather interesting e-mail exchange with Dr. Huntoon, the Editor-In-Chief of JPANDS:

Open Letter to Journal of Physicians and Surgeons
JAPANDS Dismisses Retraction Request – Offers to Publish Letter to Editor Instead

No surprise that Dr. Huntoon doesn’t see the problem brought up in Joseph’s letter.

Comments

  1. #1 TheProbe
    March 14, 2006

    I have it on good authority that Kathleen did what any normal woman would do after she posted that incredible expose…she went shopping.

  2. #2 ebohlman
    March 14, 2006

    There appears to be something rather strange about medical examiners in Florida, and there seems to be a bunch of synchronicity associated with this post. You mentioned David Touretzky, which reminded me of how the ME in the Lisa McPherson $cientology case suddenly changed her mind and decided that Lisa died of an embolism caused by a clot behind her knee (the result of a minor traffic accident) rather than the prolonged dehydration that was listed as the original cause.

    Then just yesterday, a second autopsy was done on Martin Anderson, the 14-year-old boy who died in a Florida “boot camp” for juvenile offenders. The initial autopsy concluded that he died of internal bleeding caused by the sickle-cell trait (i.e. heterozygous carrier, not sickle-cell anemia) and that the 20-30 minute beating that he experienced immediately prior to hospitalization had nothing to do with his death. Nobody could ever recall a similar case (there’s some evidence that the sickle-cell trait may increase the risk of rhabdomyolysis in the presence of severe heat exhaustion, but nobody claimed the boy had rhabdomyolysis or heat exhaustion). All except yet another Florida ME, who thought it looked like a classic case of sickle-cell death after reviewing the report. This latter ME, was, guess what, the same one who performed the autopsy on Terri Schiavo!

    But going back to the previous ME (the one who initially posted the boy; it’s getting hard to keep track of the cast of characters here): it turns out that a few years ago, he signed the autopsy report for a woman who was killed by a tornado associated with Hurricane Ivan. The report included a rather interesting set of findings:

    –Appendix smooth and tan
    –Gallbladder not distended
    –Uterus not enlarged
    –Ovaries and Fallopian tubes unremarkable
    –Prostate gland and testes unremarkable

    The deceased had a medical history of appendectomy, cholecystectomy, and hysterectomy/oophorectomy (but not, apparently, prostatectomy or orchiectomy). Her father was also killed by the tornado, and the report indicated no scars, despite fairly recent major spinal surgery. This led the mother/widow to utter one of those sentences that could normally only be produced by an infinite number of monkeys typing on an infinite number of keyboards: “I was extremely upset about my daughter having testicles – any mother or daddy would be.” (She also said “`He said my daughter had testicles. She didn’t. I washed her from the day she was born and, trust me, she didn’t have testicles. He said my husband had no scars. He did. He had a seven-inch scar on his back that even a blind person could see.”)

    Oh, and finally, at the time he signed the boy’s autopsy report, his legal status was something that Tim Bolen coined a word for (he had “merely” forgotten to renew his license).

    Despite the tragedy of it all, I was laughing uncontrollably when I read it; it really reminded me of the “actual entries from patients’ charts” bit of apocrypha that floats around the ‘net.

    Talk about weird connections: $cientology, the boot-camp beating, Terri Schiavo, the Yurko murder, and the Katrina disaster (since FEMA was extremely generous to the victims of Ivan, even reimbursing Miami residents for ice/snow damage) are all, however tenuously, interconnected.

  3. #3 Dad Of Cameron
    March 14, 2006

    Joseph over at Autism – Natural Variation has apparently received word back that JAP&S will apparently request a response from the Geiers.

  4. #4 Ktesibios
    March 14, 2006

    I wonder, does “AAPS members believe this patient-physician relationship must be protected from all forms of third-party intervention.” extend to opposing the licensing of physicians?

    If so, I wonder how the AAPS members would feel about working in a high-rise building or driving across a bridge designed by someone who never had to fulfill the requirements for a structural engineer’s license.

  5. #5 Chris
    March 14, 2006

    This Journal is used in court cases involving child abuse. Many of the authors in JPANDS make their living traveling from court to court. The most recent edition (which you cited) include examples of papers which are used to propose alternate explaination for brain injury or fractures which are seen in abusive trauma. Occasionally they will cause a hung jury. This is well beyond scientific inquiry and enters a sinister realm.

  6. #6 Fore Sam
    March 14, 2006

    Quacks who would like to prevent autistic children from being cured are spending lots of time knocking the philosophies of magazines. Too bad they can’t spend some time telling the truth about their negligent colleagues who shot up infants with way too much mercury.

  7. #7 Prometheus
    March 14, 2006

    Fore Sam seems to be confused. People who want parents to hear “the other side” of the argument (you know, the side with the data) are not opposed to autistic children getting better.

    In fact, we are very interested in autistic children getting better – or at least not getting worse (i.e. dead). We’re also interested in seeing that the parents of autistic childrren aren’t exploited by people who offer them hypotheses (and weak ones, at that!) disguised as data and suppostition disguised as “research”.

    I can’t recall anyone calling for the proponents of the autism-mercury “connection” to be silenced. We just want parents (and the public) to know how little (i.e. zero) data there is supporting the ideas that Fore Sam and his ilk are promulgating.

    Fore Sam and his compatriots are trying to drown out the quiet, rational voice of reason and science with a cacophony of baseless accusations, unsupported assertions and wild supposition.

    So, who’s trying to help autistic children and their parents?

    Prometheus

  8. #8 BronzeDog
    March 14, 2006

    He’s also trying to confuse the issue with his good old standby, equivocation.

  9. #9 Fore Sam
    March 14, 2006

    Prometheus;
    If you’re so interested in seeing autistic kids get better and not dead, why don’t you have something to say about mercury induced crib death, otherwise known as SIDS?

    Fore Sam and his compatriots are trying to drown out the quiet, rational voice of reason and science with a cacophony of baseless accusations, unsupported assertions and wild supposition.
    Describe how it is rational for an MD to state that chelation is the proper treatment for mercury poisoning but won’t work with autism in spite of kids being cured with it. Does that sound like the voice of reason or pure bullshit?

  10. #10 BronzeDog
    March 14, 2006

    Describe how it is rational for an MD to state that chelation is the proper treatment for mercury poisoning but won’t work with autism in spite of kids being cured with it. Does that sound like the voice of reason or pure bullshit?

    Provide evidence of kids being cured by it. Anecdotes without controls for natural improvement obviously don’t count.

  11. #11 Joseph O'Donnell
    March 14, 2006

    I’m pretty sure that Fore Sam isn’t actually real and is just a bot that randomly throws words together.

  12. #12 Fore Sam
    March 14, 2006

    Bronze Dog;
    Crying about anecdotes doesn’t prove your MD competent to say anything about autism. You always have excuses to avoid giving answers.

  13. #13 BronzeDog
    March 14, 2006

    Funny. Crying about my refusal to accept sloppy “evidence” isn’t going to prove your case.

    And who cares what my MD says? That’s outside the bounds of this topic.

    Also, you’re the one avoiding answers. You refuse give me more information about your anecdote, like the observational protocols.

    As for “excuses,” by your apparent logic, you would consider “I don’t have a wife” to be an excuse to not answer “Do you still beat your wife?

  14. #14 Fore Sam
    March 14, 2006

    Bronze Dog;
    Do you understand that crying that anecdotes aren’t proof does not mean parents who have cured their kids are liars? Will that ever sink in? It is obvious from your attempts to obfuscate the matter that you are opposed to helping children. Why won’t you tell us why you want these kids to remain autistic?

  15. #15 BronzeDog
    March 14, 2006

    Do you understand that crying that anecdotes aren’t proof does not mean parents who have cured their kids are liars?

    Do you understand that I’m not calling them liars?

    Will that ever sink in?

    Will it ever sink in that I’m not calling them liars?

    It is obvious from your attempts to obfuscate the matter that you are opposed to helping children.

    Says the person who resorts to accusations when his indefensible arguments are shown to be indefensible.

    Why won’t you tell us why you want these kids to remain autistic?

    COMPARE:

  16. #16 BronzeDog
    March 14, 2006

    Looks like part of my post got cut, probably because of an html slip:

    COMPARE:
    “Are you still beating your wife?”

  17. #17 Fore Sam
    March 14, 2006

    Bronze Dog;
    I’ll bet you were good at Dodge Ball in gym class.

  18. #18 BronzeDog
    March 14, 2006

    This, from someone who hand-waves away legitimate criticisms of his logical fallacies as “excuses.” Do you think you can fly that way, Fore Sam?

    Do you even understand my objections?

  19. #19 Fore Sam
    March 14, 2006

    Bronze Dog;
    Hey, where’s HCN and Clone? Aren’t they supposed to help you run interference for this guy that’s allegedly a surgeon? Legitimate criticism are one thing but they aren’t answers to legitimate questions. So, let’s get back to addressing this point: Describe how it is rational for an MD to state that chelation is the proper treatment for mercury poisoning but won’t work with autism in spite of kids being cured with it. Does that sound like the voice of reason or pure bullshit?

  20. #20 HCN
    March 14, 2006

    Just read what BronzeDog said.

    And I agree that Fore Sam must be some kind of comment ‘bot. He keeps repeating the same silly stuff even though he has been told over and over and over and over again and again and again what the logical and factual errors are. For instance the autism in China 1999 bit… he pulled that just recently, even though we’ve told it is patently FALSE.

    The only rational MD’s are those who are advocating chelation for REAL mercury poisoning (like the “Pink Ladies” who were given a teething powder from India full of mercury). Even after chelation their neurological status was still compromised. Since none of the autistic kids have measured for mercury poisoning from a real local laboratory, then chelation is not a viable treatment.

    That has been told to John Best, jr several times… and he still does not get it. This indicates that he is uneducatable, and not really worth much of my time.

  21. #21 Fore Sam
    March 14, 2006

    HCN;
    China doesn’t have anything to do with my statement. Calling me a comment bot and uneducable doesn’t have anything to do with it either. Claiming no kids were tested or that the ones who were used a lab you don’t like doesn’t seem relevant. So, HCN, you said some words but didn’t say anything useful. Where’s that Clone? We know Orac doesn’t like this question. You need reinforcements to keep up the obfuscation.

  22. #22 Gray Falcon
    March 14, 2006

    Note to readers: We’re not trying to obfuscate. The thing is, if you make impressive claims, you need equally impressive evidence to back it up. For example, take a look at the following statement:

    Fore Sam, you’ve done a suprisingly good job hiding your physical form, but your true nature is visible in your arrogance. Do you really think you can succeed in your goals? This is the world of humanity now, so deal with it!

    If anyone wanted to obfuscate the issues, that would be the best way to do it.

  23. #23 Cornelia guest
    March 14, 2006

    Some genuine mercury parents are upset at Doctor’s Data lab for misleading them. I don’t think that’s a problem with Bronze Dog or HCBN or anyone else, not “liking” the labs. The labs are corrupt. The labs selling garbage misleading information for a pretty penny.

    Without these criminal labs there wouldn’t be criminal doctors criminally prescribing chelation for kids who don’t need it.

    How ’bout them Geier’s their pushing chelation and Lupron on teenagers now.
    You going to stand by these creeps so you can have your lawsuit payoff? “Fore Sam”?

  24. #24 Fore Sam
    March 14, 2006

    Gray Falcon;
    Thank you, that’s one more opposed to addressing my simple statement. No answers but more obfuscation.

  25. #25 Gray Falcon
    March 14, 2006

    Clarification: I was not trying to answer anything of Fore Sam’s, I was demonstrating his style: ignore everything, post an accusation without evidence. His statements have been answered repeatedly, he simply lacks the humility to acknowlege anyone’s opinions but his own.

  26. #26 clone3g
    March 14, 2006

    Yeah, where’s clone…..

    Bored to tears reading the same idiotic arguments from Forsambot.

    John, say something new, say something factual, and for God’s sake demonstrate a capacity to learn and respond to your environment in some way. Even a sunflower or a slime mold can do that much.

    If we all pass the hat and scrape together enough money for an MRI, will you please have someone check for the presence of a corpus callosum? Your personality is evidence of absence.

  27. #27 BronzeDog
    March 14, 2006

    Legitimate criticism are one thing but they aren’t answers to legitimate questions. So, let’s get back to addressing this point: Describe how it is rational for an MD to state that chelation is the proper treatment for mercury poisoning but won’t work with autism in spite of kids being cured with it. Does that sound like the voice of reason or pure bullshit?

    I fail to see a legitimate question in there.

    One is a request that commits the fallacy of many questions and/or begging the question: It presumes, a priori, without evidence that chelation cures kids. It doesn’t. At least, that’s the null hypothesis that hasn’t been falsified yet, and Fore Sam’s whining about me not taking unverifiable just-so stories cherry-picked from the internet with non-sequitur conclusions (usually subtype: Post hoc) isn’t going to change any of that.

    The second is illegitimate because it presumes the first is a legitimate request.

    I think we can conclude that Fore Sam is the voice of pure bullshit.

  28. #28 Fore Sam
    March 14, 2006

    Not bad, guys. Gray Falcon says I’m not humble enough for him and he wasn’t trying to answer anything. Clone calls me a bot, uses some Latin phrase and says I need an MRI. I did sprain my ankle but it’s almost healed so I probably don’t need to waste that cash. Bronze Dog also uses Latin, mentions a couple of fallacies and says the question is illegitimate but still no stab at an answer.
    Collectively, that’s all just more obfuscation. But, Bronze Dog reaches a conclusion while avoiding an answer. His conclusion says I am a liar but he previously stated that he wasn’t calling anyone a liar. Maybe he’s just confused.

  29. #29 BronzeDog
    March 15, 2006

    How about this for an answer to your obfuscating, propagandistic nonsense question: Mu, which also happens to be the correct answer to “Have you stopped beating your wife yet?” for people who have never beat their wives, or never had a wife.

    General tip: Don’t ask questions that are inherently unanswerable.

    His conclusion says I am a liar but he previously stated that he wasn’t calling anyone a liar. Maybe he’s just confused.

    Maybe you’re just confused. I still haven’t called you a liar. I personally think your paranoia has just run wild, making you unconsciously insert things into my text that I didn’t type.

  30. #30 HCN
    March 15, 2006

    You are incredibly boring.

    Get a new routine.

  31. #31 Kev
    March 15, 2006

    “Describe how it is rational for an MD to state that chelation is the proper treatment for mercury poisoning but won’t work with autism in spite of kids being cured with it. Does that sound like the voice of reason or pure bullshit?”

    I can’t believe I’m going to once again try and engage you on an intellectual level but what the hell – hope springs eternal.

    I promise I will try and answer your question when you can support your assertion that autism can be cured by chelation. The proof I require must meet a good standard of science.

    The reason I require this is because without it, what you are offering is merely your opinion. You might be right, you might be wrong.

    I don’t believe its possible to address the matter any more clearly.

  32. #32 Fore Sam
    March 15, 2006

    Chalk up another name call for Clone while Kev asks for proof. Hey Kev, my sprained ankle’s healed. I woke up this morning and I could walk fine. Do I need an MRI and a doctor’s note to prove I’m walking without pain? I could give out names of parents with cured kids but they might not like me giving their names to you. If I did that, would you just call it anecdotal evidence if they didn’t also provide you with a doctor’s note? Stop pretending your some sort of intellectual and answer the question.

  33. #33 Regan
    March 15, 2006

    “Describe how it is rational for an MD to state that chelation is the proper treatment for mercury poisoning but won’t work with autism in spite of kids being cured with it.”

    Show or cite a study with baseline using objective measures–such as AEPS, Vineland, ABLA, TONI-2, etc. by trained non-biased observers, preferably with an interobserver reliability check, against control groups (non-chelated and typical children), with a defined protocol, samples sent to multiple independent certified labs, corrections for maturation effects, outcome measures using again non-biased observers and objective assessment tools and long-term followup data that demonstrates that a significant portion of children over those that spontaneously achieve indistinguishable neurotypical functioning because of maturation or other natural effect and I might have some inkling that the word “cure” is applicable.

    If there was a paper on that basis, the point wouldn’t have to be argued on some blog…it would be world news.

    I get the sense that the reason that the debate is so heady is because the evidence base is so low. I will be charitable and add, at this time.

    And I’m not going to trade insults—as Groucho Marx said, “You keep yours and I’ll keep mine”. Post that study.

    Regan

  34. #34 Fore Sam
    March 15, 2006

    Good try, Regan. Verbose and demanding seeking all sorts of specific proof. You even want control against maturation. That could mean solitary confinement with a peep hole so someone can check for signs of life. Add one more to the growing list of pseudo-intellectuals who won’t answer.

  35. #35 Orac
    March 15, 2006

    Fore Sam proceeds from a false premise.

    Because he believes it, he implicitly assumes that chelation “cures” autism, even though there is not a whit of evidence that it does that would pass even relatively lax scientific muster. To him belief is fact. He then does what cranks since time immemorial have done and reverses the standard of evidence, asking us to “prove” that chelation does not cure autism, rather than presenting decent scientific evidence that it can.

    He’s like the Energizer Bunny; he keeps going and going and going and going, making the same tired and easily refuted arguments again and again. Unfortunately, in doing so he pollutes my blog with his illogic, and, quite frankly, I’m starting to get tired of it. People have asked me why I’ve put up with him so long. I’m beginning to wonder myself. I used to tell myself that it was my complete dedication to never censoring anybody, but he hijacks so many discussions onto such unproductive and repetitive (and, quite frankly, boring) paths, that it’s hard not to conclude that he’s either one of these (or a combination):

    Ferrous cranous
    Filibuster
    Troller

    I understand why Kev banned him.

  36. #36 Kev
    March 15, 2006

    “Hey Kev, my sprained ankle’s healed. I woke up this morning and I could walk fine. Do I need an MRI and a doctor’s note to prove I’m walking without pain?”

    I actually felt some neurons screaming in pain and dying in their attempt to process that as a good comparison.

    “I could give out names of parents with cured kids but they might not like me giving their names to you. If I did that, would you just call it anecdotal evidence if they didn’t also provide you with a doctor’s note?”

    John, its really not difficult. Every so often you or JB pops up and quotes these hundreds/thousands of recoved/cured kids but I’ve seen nothing that indicates that a) they’re recovered or cured or b) chelation might have been responsible for that or c) that they exist anywhere other than yours and JB’s imagination.

    Autism is classed as having a developmental delay, not a developmental halt. You need to provide decent evidence that chelation used in isolation ‘cured’ an autistic person, then demonstrate the ‘cure’ could not be attributable to normal development.

    “Stop pretending your some sort of intellectual and answer the question.”

    Until you provide some evidence that what you claim is true, your question is meaningless as it proceeds from a false or unsubstantiated premise.

  37. #37 Fore Sam
    March 15, 2006

    Not bad, Orac. Claim it’s a belief and not a fact that I and many others have seen chelation help our kids. Although I didn’t ask you to prove chelation doesn’t cure autism, it’s a good ploy to claim that. What I asked was for you to admit that chelation cures autism since autism is mercury poisoning which you’ve told us is cured with chelation. I understand that you consider calling me names and using your joke links to evoke laughter is an easy refutation. Unfortunately, the kids keep improving which nullifies your jokes and name calling.
    If you’re ever near Boston, I’m only 50 miles away and I invite you to come to my house and see my evidence. Bring Prometheus with you and I’ll show you how I found Giacomo last year so you gain an understanding of how to use statistics while you’re here. I didn’t keep my son in solitary confinement so you can claim on your blog that I contaminated the data but, maybe you can advise some of your pediatrician friends in private that they can reverse the damage they caused with their negligence. Who knows, lots of us might drop the lawsuits if the medical profession would just tell us the truth and help us help our kids. I’ll let you have the last word now. Go ahead and call me a degenerate gambler who practices medicine without a license. I think that will smear me good and void everything I have to say about curing kids.

  38. #38 BronzeDog
    March 15, 2006

    Good try, Regan. Verbose and demanding seeking all sorts of specific proof. You even want control against maturation. That could mean solitary confinement with a peep hole so someone can check for signs of life. Add one more to the growing list of pseudo-intellectuals who won’t answer.

    Fore Sam, you should know by now that’s not how you control against maturation. Ever heard of placebo? You should have. I think I’ve told you twice. Hiding from placebo trials by making up acid-trip absurdist trial conditions isn’t going to work.

    Speaking of acid-trips, we already told you plenty of times already: Your question is unanswerable. If I thought you were dishonest (with us, not just yourself), I’d say it was designed to be unanswerable. It’s also obfuscating because it assumes something that we disagree about. Because of that, the question is as meaningless as “What color is time?” when we haven’t agreed that time has a color.

    I’m unable to answer your question for the same reason I’m unable to answer the question, “Are you still beating your wife?

  39. #39 BronzeDog
    March 15, 2006

    I’m suddenly reminded of an episode of the Simpsons: Lisa was introducing Bart to Zen koans.

    Lisa: “What is the sound of one hand clapping?”
    Bart: “Easy.” He starts clasping his hand so that his fingers slap against his palm.
    Lisa: *starts sputtering* “That question is supposed to be one with no answer!”

    Of course, it’s kind of the opposite of this scenario: We point out that Fore Sam’s koan is unanswerable (in the real world, at least), he insists that it’s answerable, and does nothing to demonstrate its answerability.

  40. #40 TheProbe
    March 15, 2006

    ForeSam said:

    Do you understand that crying that anecdotes aren’t proof does not mean parents who have cured their kids are liars? Will that ever sink in? It is obvious from your attempts to obfuscate the matter that you are opposed to helping children. Why won’t you tell us why you want these kids to remain autistic?

    No, FS, the parents are not liars, just people who are angry over being dealt a difficult child and then were lied to by scam artists and those with an agenda to end vaccinations.

    NO ONE is opposed to helping children with autism. Chelation, etc. does not help them. Even assuming that mercury is the cause, you cannot repair nerve damage with is.

    And, the only people who would rejoice in these kids remaining autistic are those who need the bogeyman of autism to push their anti-vaccination agenda. If a cure for autism was found today, these swine would find another bogeyman.

    Your post was highly offensive to those of us parents who went past useless anger to true acceptance and loving of our children.

  41. #41 BronzeDog
    March 15, 2006

    No, FS, the parents are not liars, just people who are angry over being dealt a difficult child and then were lied to by scam artists and those with an agenda to end vaccinations.

    My view of the whole thing doesn’t even need liars, though some can and probably do contribute a lot:

    “When dealing with an apparent conspiracy, don’t attribute to malice what can just as easily be explained by stupidity.”

    Pointing out his lack of control for natural improvement/maturation (which, btw, are controlled by employing a placebo control group who receive a fake treatment, not by sticking the experimental group in an obliette) isn’t calling him a liar. If anything, I’m calling him foolish for not eliminating/reducing the possibility of a known explanation. All he does is hand-wave it away, and hand-wave away any attention paid to his hand-waving.

    NO ONE is opposed to helping children with autism.

    Got that right. I think Fore Sam’s just unknowingly doing the wrong thing, though he’s doing it for the right reason.

  42. #42 Scott A
    March 15, 2006

    I was immunized and I’m not autistic. Neither is my ten year old son. Or my eight month old daughter. Or any of my many friends with many children. So, mercury causes autism or it doesn’t. Or only in certain cases. Or. Or. Or. You’re a one trick pony, fore sam.

    Thank you Orac. I was close to not immunizing my daughter because of all the anti mercury mis-information. My sister in law has been a nurse at Phx childrens hospital for over twenty years and she was very adamant about her getting immunized. I actually started investigating the whole issue myself, being anti vaccination at first, but when my head popped out of my ass I found the whole mercury “link” lacking, at best. Fore sam, you and your lot are doing a disservice. I only wish that somehow you could be held accountable for the crap that you spew. You leave people no other choice but ad hominem attacks because the only think lacking from your posts are “nyah nyah nyah”.

  43. #43 Orac
    March 15, 2006

    Fore Sam:

    Claim it’s a belief and not a fact that I and many others have seen chelation help our kids. Although I didn’t ask you to prove chelation doesn’t cure autism, it’s a good ploy to claim that. What I asked was for you to admit that chelation cures autism since autism is mercury poisoning which you’ve told us is cured with chelation.

    And, yet again, chelation does not cure autism because autism is not mercury poisoning. There is nothing for me to “admit,” and there is no contradiction to my statement that chelation is an appropriate treatment for acute mercury poisoning but a useless treatment for autism.

    Second, as Mark points out, anecdotal evidence is not enough, particularly with a condition that has a fairly high rate of improvement without any intervention. You need a control group to make sure that any improvements observed are actually due to the treatment and not to natural fluctuations of the course of the condition.

    As for my description of you using those links, well, you’ve earned it many times over.

    But tell me, Fore Sam, what do you think of the Geiers’ latest quackery, in which they propose chemically castrating autistic children with Lupron in order to treat them and–they claim, without good scientific evidence–make the mercury that you and they believe “poisoned” them “more easily removed” by chelation?

    Even you should be able to see how irresponsible it is to shut down the production of sex steroid hormones in children with no evidence to suggest that it will do any good. The risk-benefit ratio is so far out of whack towards risk that the proposal is incredibly irresponsible.

  44. #44 Kev
    March 15, 2006

    Why won’t you tell us why you want these kids to remain autistic?

    Well, I’m quite happy for my child to remain autistic :o)

    I don’t see autism as an illness to be cured. I doubt AutismDiva requires a cure, or ballastexistenz, or Jim Sinclair or Temple Grandin or any of the other autistics once categorised as low functioning (whatever that means) who proved that developing from childhood to adulthood is the best sort of ‘cure’ there was.

    My child rocks – literally and figuratively – and long may she do so.

    Your mistake (well, one of them John) is to equate some autistic childrens medical comorbidities (such as epilepsy, constipation etc which definitely need addressing) with their autism as a de facto ‘package’. They’re not. My daughters Asthmatic. Your son (I believe) is not. Asthma ia comorbidity of autism but does that mean your child is not autistic? Of course not. Asthma cannot be used to define or diagnose autism and neither can a set of symptoms that bear no relation to either autism or mercury poisoning.

  45. #45 BronzeDog
    March 15, 2006

    Claim it’s a belief and not a fact that I and many others have seen chelation help our kids.

    How do we know you didn’t just see what you wanted to see? How do we know it’s not coincidental natural improvement? Coincidences happen all the time, especially when you take truly large numbers into account… Especially, what, 40% natural improvement rate?

    Here’s what I think you really saw: Your kid wasn’t improving. Then you chelated him. Then you saw improvement.

    Kind of the same as “I saw a black cat cross my path. Then I saw something bad happen to me.”

    What you saw doesn’t warrant your conclusion.

  46. #46 Fore Sam
    March 15, 2006

    Orac;
    I said I’d let you have the last word so I won’t comment on your reply but, I will answer your question about the Geiers. When I first learned of their work with Lupron, of course, I was interested. They said it should only be used on kids up to a certain age before they hit puberty. They talked about the testosterone level coming back up after first using lupron and I think they said they used it again to get that level to zero. They reported no side effects, as is common with just using DMSA and ALA which seems to be a good thing to me. I don’t see how this could be considered chemical castration in a kid whose reproductive organs weren’t yet functioning as such. I did wonder if my son might grow breasts if I tried it. I don’t know if that’s a good question to ask or not. I’d like to know how fast the body replenishes the testosterone. I suppose it could just be replaced if needed after one figured the mercury had been completely removed. I have not tried Lupron. Some have claimed I did. I’d like to know if there is any reason to worry about a short term lack of testosterone before puberty causing problems after puberty. Maybe you can answer that.

  47. #47 Theodore Price
    March 15, 2006

    Fore Sam, May I suggest you read the Institute of Medicine Review of vaccine safety as it relates to autism. It can be found here: http://www.nap.edu/catalog/10997.html and the sample PDF of the entire review is available for free. It is a comprehensive review of the available data and it shows clearly that there is no causal link between MMR vaccination and/or thimerosel-containing vaccines. As for chelation working for some children, that need not have anything to with vaccines, although I have to say I have never seen convincing data to show it works. Anything will always work for some people, thats why we run clinical trials.

    As for your comment on testosterone. I recently read an article in Medical Hypothesis on using testosterone antagonists to combat the increased mercury toxicity effects that are associated with testosterone. While it is true that testosterone increases mercury toxicity, I reject their premise because there is no reliable data showing that mercury toxicity causes autism. As for dangers of testosterone lowering in pre-puberty boys I have the following word of caution. Estrogen is vital for the growth of neurons and the development of the brain which continues well into puberty all the way from long before birth. This is going to sound crazy, but the major (and I mean MAJOR) source of estrogen for boys is testosterone. It is converted to estrogen in the nervous system. Now if the drug is going to lower testosterone levels greatly, this sounds really dangerous to me — for the sake of the brain. If it is a testosterone receptor antagonist it might not be so bad (because it doesn’t decrease testosterone levels, just blocks its effects). However, anything that messes with levels of a hormone as important as testosterone at any point in boys or men doesn’t sound like a good thing to me.

  48. #48 Fore Sam
    March 15, 2006

    Ted;
    I take your point about testosterone and brain development. The IOM was told to find no connection by the CDC and there position is compromised.

  49. #49 BronzeDog
    March 15, 2006

    The IOM was told to find no connection by the CDC and there position is compromised.

    Evidence?

  50. #50 Fore Sam
    March 16, 2006

    Clone3G Said so.

  51. #51 outeast
    March 16, 2006

    NO GET BACK ON TOPIC, does anyone know if any of the PubMed databases have ever explained why they don’t list JPandS?

  52. #52 ebohlman
    March 16, 2006

    Theodore: Lupron isn’t a steroid-receptor antagonist.; it inhibits the release of gonadotropins (LH and FSH) which signal the testes/ovaries to produce steroids. Thus its use will result in extremely low levels of both testosterone and estrogen, regardless of the sex of the patient. Note that some of the loopy-for-Lupron crowd have asserted that testosterone inhibits mercury detoxification whereas estrogen enhances it, and are also promoting Lupron’s use in girls; this isn’t even consistent with their speculations, as girls have more estrogen than testosterone and if the speculations are true, it would inhibit detoxification.

  53. #53 Orac
    March 16, 2006

    Also, because Lupron is a GnRH agonist, when it is first given, it actually stimulates the receptors, resulting in a brief surge of steroid hormone synthesis (known as a “flare”) before it downregulates the GnRH receptors and shuts down steroid hormone synthesis. If the Geiers’ crazy “testosterone” concept were correct, you’d expect to see a worsening of the behavior of autistic boys shortly after being placed on Lupron before you’d see improvement.

    As for why JPANDS is not listed in Medline, I think that should be obvious. Given that a fair number of crappy journals are nonetheless listed in Medline, the fact that JPANDS is not should tell you something.

  54. #54 Pigilito
    March 16, 2006

    I was unable to locate the journal on a website that tracks impact points. Must be a truly dismal journal not to be able to boast even a fraction of an impact point.

  55. #55 Joseph
    March 17, 2006

    I’m of the opinion currently that the paper will be retracted in some manner. I explain why in this posting.