Respectful Insolence

Comments

  1. #2 trrll
    December 3, 2008

    For quite a few years, I sat on a medical school Appeals Committee. Often, the Committee handled cases of students who were in academic difficulty and who were on the point of being dismissed from medical school. Dismissal from medical school is not something that an institution does lightly. From a practical point of view, it means a financial hit for the institution. Medical school transfers being uncommon, the school will probably not be able to fill a second or third-year slot, so the potential tuition income is lost. Moreover, these are often very committed, dedicated students. Often, they have an obviously sincere desire to help people. Being a doctor is the only thing they’ve ever wanted, and now they’re being kicked out with a couple of years of medical school debt to boot. It is very hard to say to these students, “No, you have to leave.” They always have some plan as to how they will improve their study habits to pick up those few points they need to pass. And one sometimes wonders, “Just how relevant is the basic science that students receive in the first two years to actual medical practice? Are we turning away somebody who would be a sensitive, caring doctor?”

    But Dr. Gordon certainly provides a cautionary tale of the potential harm that can be done by letting a student graduate with an MD, but without an adequate grounding in basic biochemistry or scientific reasoning. One of the “toxins” cited by Dr. Gordon is formaldehyde:

    they contain tiny bits of formalin [an aqueous solution of formaldahyde]

    The first time I heard this complaint, my basic, if somewhat hazily remembered, biochemical knowledge kicked in: “Wait a minute! Formaldehyde is a very simple molecule. It’s all over the place. How much formaldehyde can a vaccine shot contain anyway? I’ll bet your body even makes a bit of the stuff.” Five minutes of research confirmed it. In fact, normal blood levels of formaldehyde are on the order of 0.1 mM. That’s quite a bit–there is simply no way that the tiny amount in a vaccine could make an appreciable impact on that. It seems to me that anybody qualified to be a physician should be capable of this kind of elementary reasoning.

    Dr. Gordon never seems to cite the published literature. I can’t help suspecting that like some other medical students I’ve encountered, he managed to slide through medical school based upon simplified summary texts, without ever acquiring the skill of reading and evaluating the original literature. Certainly his reasoning that polio vaccination is unnecessary due to the low risk of polio in vaccinated populations suggests that he never learned the basic principles of benefit-risk analysis. His pronouncements about vaccines make me feel a little bit better about the students that I voted to dismiss–and make me worry a bit more about the ones that I voted to allow to stay.

  2. #3 wfjag
    December 3, 2008

    Maybe someone can answer a couple of obvious questions — either here or on Dr. Novella’s site:

    Summary of facts: Dr. Gordon’s letter is being circulated by anti-vax organizations and bloggers and he’s a bit of a hero in those circles. He is also “the pediatrician to Jenny McCarthy’s son, Evan (who she claims was injured by vaccines)” (a fact noted by Dr. Novella, but not apparently by Dr. Gordon). According to Dr. Gordon, starting in about 1980, he stopped giving vaccines according to the schedule after being told by some parents that after receiving the vaccinations their children changed. He has identified quite a few reasons he believes many childhood vaccinations are unnecessary and pose greater risk and any benefit. Yet, sometime in the last few years McCarthy’s son apparently received the vaccinations from Dr. Gorgon that many of the people and organizations circulating Dr. Gordon’s letter object to giving. All of this lead to the questions:

    Why has he not explained his clinical experience in the case of McCarthy’s son — who is likely his most famous patient? Since his decision to vaccinate or to not vaccinate is based on his clinical experience, it would be quite helpful to descibe what he looks for — and why he vaccinated McCarthy’s son? (e.g. Were the key signs missing? Did she insist on the vaccinations? Do indigo children not show the key signs that are contraindications for vaccination? Did he see the clinical signs he believes contraindicate vaccination and say “The hell with it, let’s vaccinate anyway? Given what he says in his letter, it seems like there is are obvious inconsistencies between what he now says and with how his most famous patient was treated.)

  3. #4 Joseph C.
    December 4, 2008

    How long before Doc Jay comes crying on here about Orac being a demagogue, according to his usual fashion?

  4. #5 mandydax
    December 4, 2008

    Yeah, when I got that thru the RSS, it didn’t have the byline, and I thought it was one of your posts. Go, go, Dr. Novella!

  5. #6 Jennyj0
    December 28, 2008

    “Certainly his reasoning that polio vaccination is unnecessary due to the low risk of polio in vaccinated populations suggests that he never learned the basic principles of benefit-risk analysis.”

    And this is a doctor, saying this?! This is so shocking, I’m lost for words.
    And all these parents, why do they believe all this nonsense just like that, no questions asked? Don’t they ever read a book?
    It can’t be their intelligence, as far as I can see most of them have at least average intelligence, so it must be something psychological.

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