Respectful Insolence

It’s Christmas Eve.

I know, I know, it’s all supposed to be Peace On Earth, Good Will Towards Men (and Women), and all that jazz. Really, that’s exactly what I had intended for today and tomorrow. Indeed, my plan was to do nothing more than a quickie post today and a maybe a couple of brief (and hopefully amusing) Christmas-related posts this afternoon and tomorrow. Really, I had.

Then it came, and it came from a direction that I least expected. Yes, yet another “old friend” of the blog had to go and and not just ask but beg for a heapin’ helpin’ of not-so-Respectful Insolence. My readers know that I seldom turn down such heartfelt requests. I may be cranky, arrogant, and cantankerous, but I’m a benevolent box of blinking lights, and it is Christmas Eve. That creationist neurosurgeon with a love of pseudoscience and logical fallacies, that surgeon who embarrasses me with his frequent fusillades of misinformation about evolution, so much so that I have joked about wearing either a paper bag or a Doctor Doom mask to hide my face, that man with a knack for perseverating about the same misinformation over and over and over again no matter how many times he is corrected, Dr. Egnor, has gone off the deep end again, launching a direct frontal assault against me and fellow skeptical and science-based physician Dr. Steve Novella. My Christmas present to him is to give him the not-so-Respectful Insolence that he’s clearly asking for.

Now, you’d probably expect that, as usual, Dr. Egnor’s broadside would be about evolution (replete with his repetitive perseveration that the “only contribution” that “Darwinism” has ever made to medicine is eugenics) or about dualism and his belief that the physical brain and central nervous system are insufficient to explain the mind. Most recently, he was going on and on about how he has taught medical students for decades and how his experience as a physician and in clinical practice allows him to “recognize B.S.” when he sees it, in this case the claim that evolutionary biology contributes to medical advances. My words at the time (a mere two weeks ago) now seem prescient:

Actually, those who have been regular readers of this blog almost certainly realize that Dr. Egnor holds far too high an opinion of the utility of medical practice as an “effective check on b.s.” In fact, it is science that serves as a “very effective check on b.s.,” not medical practice. Indeed, I’ve argued that time and time again. Yes, it’s true that science is often wrong, that sometimes it takes a maddenly long time for incorrect paradigms to be overthrown by new experiments and observations, and that the process of correcting accepted scientific dogma with hypotheses that more closely fit the data and make better corrections can be incredibly messy viewed from the outside, but science is inherently self-correcting. Eventually, b.s. is cast out. Not so when it comes to pseudoscience like ID creationism and–yes, you knew I’d mention it eventually–unscientific medical practices.

After all, what is the whole concept of “complementary and alternative medicine” (CAM) but incredibly concentrated b.s.; yet medical practice seems to have no effect preventing so many physicians to believe in a variety of unscientific and ineffective treatments. Indeed, unscientific CAM has infiltrated bastions of scientific medicine, such as Yale, Beth Israel, and others. Medical practice didn’t stop Dr. David Katz or Dr. Andrew Weil from falling into pseudoscientific woo. It certainly didn’t stop Dr. Jay Gordon from deciding that his clinical experience leading him to believe that vaccines cause autism trumps the strong science and epidemiology that say they do not, from making brain-meltingly ridiculous claims that there are “toxins” in vaccines that cause all sorts of terrible complications, or even giving speeches to rallies organized by people and groups who are antivaccine. He even exasperates the normally mild-mannered Steve Novella.) Practicing medicine didn’t stop any of these people from diving headlong into pseudoscience, even in areas directly related to their medical practice.

And it certainly didn’t stop Dr. Egnor from falling headlong into the antiscience of ID creationism.

Sometimes I amaze even myself. I came so close to hitting on what Dr. Egnor would do next that I scare even myself. So, let’s see. We’ve seen Dr. Egnor deny evolutionary theory using pseudoscience and logical fallacies. We’ve seen him go through all sorts of logical contortions and twisting of evidence to argue that the brain is not sufficient to account for the mind. So what’s next?

That’s right: The full court press attack on scientific medicine and medical “arrogance.” Witness his post at the house organ for pseudoscientific evolution denial, Evolution News & Views entitled Advice to an Arrogant Medical Priesthood: Wash Your Hands.

True to Dr. Egnor’s form, it’s the single longest non sequitur I’ve ever seen. Despite Dr. Egnor’s denials that he supports “alternative medicine” or antivaccinationism, it’s also chock full of attacks on scientific medicine and the “arrogant medical and scientific priestcraft” that would not be out of place on Whale.to, NaturalNews.com, Mercola.com, or even Age of Autism. Get a load of it:

There is an internet cottage industry of physicians and scientists who regularly excoriate alternative medicine and other non-traditional or even fringe approaches to health or to scientific understanding. Steven Novella, Orac, and a host of other faux “defenders of science” decry the danger to the public from vaccine “denial,” homeopathy, acupuncture, chiropractic, among others.

Now, I’m more than proud to be part of this “cottage industry,” along with Steve Novella, Dr. R.W., PalMD, Mark Crislip, Harriet Hall, and other skeptical physicians. Occasionally, I get e-mails from people thanking me for helping them turn away from woo or for supplying them with ammunition to argue against woo with a family member or friend. These occasional e-mails are reward enough for what I do. If I can lead just one person to see the light and avoid falling into the clutches of quacks, the last four years of blogging will have been worth it.

Interestingly (to me, at least), I can’t help but notice that Dr. Egnor chooses to use the word “industry,” as though we’re all in this to make money. Doesn’t it have the connotation of a certain industry, big pharma, perhaps? Maybe I’m being a bit paranoid, but it sure sounds like an insinuation that we’re in “industry’s” pocket or that we’re somehow making money off of our efforts. Or maybe I’m giving Dr. Egnor credit for too much subtlety. In any case, to clarify, of all the skeptical physicians who blog, the only ones I know of who make any money at all for their efforts are PalMD and I, and, trust me, it’s not exactly a lot. Because we blog for ScienceBlogs, we are paid a small amount based on our traffic. It doesn’t matter; if ScienceBlogs didn’t exist or never invited me to join the collective, I’d still be doing this, either on my old (and currently mothballed) Blogger blog or on a different platform.

In any case, after insisting that he is not a “supporter of ‘alternative medicine,’” Dr. Egnor launches into a huge hunk o’ burnin’ stupid in the form of the silliest non sequitur I’ve ever seen. Really, there are lots of things Steve and I or the science-based medicine we routinely defend might be criticized for, but what Dr. Egnor latches on to is about as silly as it gets. Logic? Who cares? Science? Who cares? Dr. Egnor, desperate to brand Steve and me “hypocrites,” decides to fixate on…washing hands:

Yet there is an irony in the efforts of “defenders of science” to protect the public from treatments and theories that are outside of the mainstream of medical practice. The greatest iatrogenic danger to patients isn’t chiropractors or homeopaths or vaccine “deniers.” It’s the doctors, nurses, and other medical personnel working in the traditional medical paradigm.

The data is uncontestable. Each year in the United States, errors of traditional science-based medical practice kill at least a hundred thousand people, probably substantially more. These errors include medication errors, surgical errors and unnecessary surgery, preventable bedsores, infections caused by poor technique and the failure of medical personnel to practice good hygiene such as hand washing, and many others. Note that none of these deaths are caused by homeopaths, vaccine “deniers,” etc.

The harm done by traditional practitioners of medicine is one of the leading causes of death in the United States. Where is the introspection by “skeptics” and “science defenders” like Drs. Novella and Orac about the enormous harm done to patients by themselves — traditional medical practitioners? What hypocrites.

What a moron.

I’ve tried. Really, I’ve tried not to call Dr. Egnor a moron or to insult him. I’ve told him he’s wrong. I’ve pointed out his logical fallacies and statements that are simply not correct. Unfortunately, he now leaves me no choice. He calls me an arrogant hypocrite based on a huge logical fallacy? I’ll return the favor by calling him a moron, and an obtuse moron at that! Yes, he’s a neurosurgeon, and he possesses knowledge and skills that I don’t have and will never have. No doubt he is highly intelligent in some ways and skillful at what he does; unfortunately, aside from his surgical knowledge and skill, elsewhere his intelligence has apparently been placed in the service of his ideology and religion. In contrast, I’m a scientist and a cancer surgeon. I possess knowledge and skills that Dr. Egnor does not and will never possess, the most important of which are an understanding of the scientific method and a skeptical mind. That’s why, after Dr. Egnor’s ignorant broadside, I now feel justified in saying that, when it comes to science, Dr. Egnor is a moron.

Dr. Egnor gets it all wrong anyway. No one’s saying that doctors can’t be arrogant and lazy. They are human beings, after all, and human beings with power at that. Besides, it’s not science or science-based medicine that’s leading doctors not to wash their hands enough between patients. Indeed, science, and science-based medicine tell us that we should, that it decreases the chances of spreading pathogenic microbes from one patient to another. It’s a message that begins right in medical school. The problem isn’t that doctors don’t accept that washing their hands is important for infection control; they do. Ask any physician if it’s a bad idea not to wash his hands between patients, and virtually every single one will agree that it is. The problem is that physicians are human, and human nature makes it easy for them to forget to do it–even leading them sometimes to misremember doing it when an objective observer can see that they did not–especially when they are rushing busily about on rounds. That’s one reason why hospitals have tried to make it easier for physicians and other health care personnel to remember. These days, in most hospitals, there are dispensers of alcohol-based antibacterial lotion or foam outside of every patients’ room. Just a quick spritz between patients is all that’s needed, and it works.

Dr. Egnor also doesn’t earn much in the way of scientific style points for linking to a post from Mercola.com called Death By Medicine to make his point against Steve and me. The damned article is even co-written by über-quack, HIV/AIDS denialist, coffee enema maven, and antivaccinationist Gary Null! Really, Dr. Egnor should look into his sources a bit more closely before citing them. He couldn’t have chosen less credible or less reliable sources if he had tried (well, maybe if he had also included Mike Adams of NaturalNews.com). Besides, this article was thoroughly taken apart by Harriet Hall not too long ago, and Peter Lipson has also discussed the exaggerated claim that iatrogenic causes are among the top causes of death in the U.S. Finally, it should be pointed out that, besides being science-based, one area in which science-based medicine distinguishes itself from “alternative” medicine is in a rigorous, ongoing attempt to reduce medical errors, as Peter also discussed here and as I’ve discussed when I lamented the Office for Human Research Protections putting the kibosh on a test of a checklist for placing central lines.

In any case, just when I thought Dr. Egnor couldn’t sink any lower, he then pulls out the favorite of apologists for “alternative medicine” everywhere. That’s right. He likens defenders of science-based medicine to an “arrogant priesthood”:

Arrogance of scientists and physicians is an old scourge. Alfred Russel Wallace, who helped develop the theory of evolution in the 19th century and who confronted the scientific arrogance of his own day, famously commented on medical arrogance in a different context (i.e. eugenics), calling it

… an arrogant scientific priestcraft. (1)

Of course. Dr. Egnor can’t discuss medicine without invoking eugenics. He seems utterly incapable of not bringing up eugenics any time he discusses medicine. It seems to be in his DNA. I am, however, surprised that he did not bring up Ignaz Semmelweis, the physician who discovered 150 years ago that simple hand washing could prevent the spread of puerperal fever among women giving birth. I suppose I should be thankful for small favors. Or maybe Dr. Egnor isn’t familiar with Dr. Semmelweis. Suffice it to say that his results were not as controversial as quack apologists like to claim, and he brought some of the abuse he received on himself. Whatever the case, what comes next is painful to read, not because it cuts me to the quick or anything like that, but by how embarrassing it is to me as a fellow surgeon:

Far more damage is done to patients by doctors and other mainstream health care providers than is done by vaccine “deniers,” acupuncturists, homeopaths, etc. Fatal disease is much more likely to be spread by a doctor’s unwashed hands than by some (mostly misguided) parents who fear that a vaccine may harm their child. I’ve never known a patient to be harmed by a chiropractor. Tens of thousands of patients each year are harmed in preventable ways by their (usually well-intentioned) surgeons.

Dr. Egnor labors under the delusion that we who advocate science- and evidence-based medicine either aren’t aware, don’t care about, or don’t pay attention to the shortcomings of modern medicine. Nothing could be further from the truth. We do, as I pointed out above. Our patients demand no less. Science demands no less. I emphasize again to him that the very data about the dangers of physicians not washing their hands comes not from creationist neurosurgeons like Dr. Egnor or supporters of quackery like Gary Null or Joseph Mercola. Rather, they come from physicians doing scientific studies. They come from science- and evidence-based medicine. They come from the application of science to the question of identifying shortcomings in current medical practice and identifying ways to remedy them.

How unlike “intelligent design” creationism, for example!

I have to wonder: For all his protestations that he does not support “alternative medicine” or antivaccine fear mongering, does Dr. Egnor realize that the comparison of scientists and science-based physicians to a “priesthood” and of science-based medicine to a “religion” is straight out of the playbook of quacks? Dr. Egnor assures us in his post again and again that he does not support the quackery that is most of “alternative medicine,” but he seems blissfully unaware that he is using exactly the same rhetorical techniques that quacks and apologists for quacks like to use. There is, of course, a reason for that. The same rhetorical techniques are what Dr. Egnor routinely uses when attacking evolution and “materialist” neuroscience, and it’s probably very easy for him to slip into using them in this new context. Still, I’m guessing that Dr. Egnor doesn’t know that he’s echoing the rhetoric of the pro-quackery underground, but he is, especially with his next comment:

My advice to Dr. Novella, Orac, and other arrogant medical clergy: go easy on the parents concerned about autism from vaccines, even though the evidence suggests that their fears are unfounded. They’re not idiots, and they shouldn’t be treated with scorn. A little humility on the part of doctors, and some respect for the right of people to hold other views (even if those views are wrong), and to act on those views, would be a good thing. Respectful discourse with patients who disagree with our advice, not scornful excoriation, is much needed.

What Dr. Egnor is blissfully ignorant of is that none of us–and I mean none of us–attack typical parents who are fearful of vaccines, at least not the vast majority of these parents. Rather, we excoriate a small subset of these parents who not only believe that vaccines cause autism, but have taken it to the level of becoming leaders and activists in the antivaccine movement. I mean parents like Jenny McCarthy or J.B. Handley, not Joe and Jane Sixpack, who hear Jenny McCarthy’s idiocy or come across the Generation Rescue website and, without a scientific background and not knowing any better, wonder if there might actually be something to the hysterical claims that vaccines cause autism. I can’t speak for anyone else, but my contempt is not reserved for parents; it is reserved for the leaders and opinion shapers of the antivaccine movement, be they parents of autistic children (like Jenny McCarthy) or opportunists (like David Kirby and Robert F. Kennedy, Jr.). They are the ones who foment resistance to vaccination based on pseudoscience, not the parents these leaders scare. These frightened parents need evidence-based explanations of why Jenny McCarthy and her ilk are wrong. In essence, Dr. Egnor might as well be Robert F. Kennedy, Jr. ranting that those of us who oppose antivaccine pseudoscience hate mothers.

Dr. Egnor can’t resist finishing:

Doctors should be less arrogant with our advice and we should denounce faux “skeptics” like Dr. Novella and Orac who exhibit no skepticism about their own dogma and behavior and are coarsening this discourse because of their own ideological commitments rather than for any rational commitment to public health.

My irony meter just exploded, leaving nothing but a quivering, molten pile of circuitry, capable of releasing only the occasional whimper.

Ideological commitments? Faux skeptics? It was an ideological commitment to his religion over science that led Dr. Egnor to reject the science of evolution. It was Dr. Egnor’s lack of skepticism towards his own dogma and behavior that has led him to become the attack poodle of the Discovery Institute, which exists not for science but to push an ideology! If anyone’s “arrogant,” it’s Dr. Egnor. He has the arrogance of ignorance, at least about evolution. He seems to think that his “clinical experience” inoculates him from “B.S.” and that his education as a neurosurgeon provides him with sufficient knowledge and understanding to make pronouncements about evolution. Indeed, he is the most “faux” of faux skeptics in that his “skepticism” is nothing more than opposition that no amount of evidence can sway. I realize that Dr. Egnor will never believe me when I say this, but if, for example, well-designed scientific and epidemiological studies started to show a clear link between vaccines and autism, I would rethink my position. I really would. Ditto if good studies came out clearly supporting the efficacy of various alternative medicines above that of a placebo. In contrast, I’d ask Dr. Egnor the question: Is there any evidence that could ever make you change your mind about evolution or neuroscience? If so, what is it?

I think we all know the answer to that question.

Depressingly (for me, at least), Dr. Egnor appears to be branching out. No longer satisfied with just denying evolution and blaming Darwin for eugenics and the Holocaust, or even with espousing dualism when it comes to the mind, apparently Dr. Egnor wants to start defending antivaccinationists, homeopaths, and other quacks against justified attacks based on science. Worse, he does it not because he actually believes in the quackery but rather because such attacks are nothing more than a convenient tool for him to attack those who call him on his pseudoscience.

And, lest I forget: Merry Christmas, Dr. Egnor! Consider this loving application of not-so-Respectful Insolence a Christmas present from Orac to you. Clearly, judging by your post, it’s just what you wanted for Christmas. How else to explain a broadside against me and Steve a mere two days before?

Comments

  1. #1 Sigmund
    December 24, 2008

    “Attack poodle”?
    For some reason I tend to see him as the ‘attack duck’ of the Discovery Institute.
    What is it that ducks say again?

  2. #2 moneduloides
    December 24, 2008

    Now, the real question, do I respect the submission of Egnor’s recent musings for the upcoming (Darwin) edition of Grand Rounds, or do I choose the route of respectful insolence?

    I’ll have to think on it…

  3. #3 Mariah
    December 24, 2008

    I’m one of those that appreciates the ammunition–thanks so much. It really is helpful to have teh stupid cataloged and referenced.

    I don’t know where you find the energy for this. It is becoming clear to me on several fronts that we’ve reached a point of intractability. The “This American Life” show that you referenced earlier this week (which I have since cited and used elsewhere–thanks) demonstrated that. They continue to convince themselves they are right despite all data to the contrary.

    I’m doing battle where I can so that the unwitting Googlers will see the other side. But I don’t know if it does any good.

  4. #4 Orac
    December 24, 2008

    Now, the real question, do I respect the submission of Egnor’s recent musings for the upcoming (Darwin) edition of Grand Rounds, or do I choose the route of respectful insolence?

    I wonder where he found out about it.

    You could always include this post and a post from a couple of weeks ago:

    http://scienceblogs.com/insolence/2008/12/facepalm_thy_name_is_dr_egnor.php

    Or even a couple of my really old posts:

    http://scienceblogs.com/insolence/2007/03/dr_michael_egnor_the_gift_that_keeps_on.php

    http://scienceblogs.com/insolence/2007/03/the_energizer_bunny_of_antievolution_1.php

    Truly, I wish this Grand Rounds weren’t next week. Because of the holidays, I’m going to be very busy the next few days, and I’m not sure I could come up with something serious and up to the standards of Grand Rounds by then. (I may even–gasp! horror of horrors!–post a couple of reruns.) I’ll try, but no guarantees. If I fail, there are, of course, these very old posts by me that you might like, though:

    http://scienceblogs.com/insolence/2006/03/medicine_and_evolution_part_2.php

    http://scienceblogs.com/insolence/2006/03/medicine_and_evolution_part_3.php

  5. #5 moneduloides
    December 24, 2008

    It was a third-party submission.

  6. #6 MarkH
    December 24, 2008

    I can’t wait until I’m considered a skeptical physician. Three more months to go.

    Anyway, I read Egnor in my crank feed when he made this argument, and I couldn’t quite believe it. I think this is an example of crank magnetism but it’s even more than that. It’s part of a new attack in general that suggests that any criticism of other ideas of others is “arrogance”. A perfect cover for creationists who have some of the stupidest ideas of all.

  7. #7 Marilyn Mann
    December 24, 2008

    Thanks for being easy on us parents who don’t have a scientific background. As you know, my daughter has heterozygous familial hypercholesterolemia, and when I started researching FH, cholesterol drugs and so forth, I looked at some pretty unreliable sources on the web and wondered if what they were saying was true. Fortunately, I went and read some of the actual FH studies and consulted with some cardiologists and other knowledgeable physicians and eventually educated myself pretty well in the area (for a layperson).

  8. #8 Dianne
    December 24, 2008

    So…is Engor saying that alternative practitioners never forget to wash their hands or that, because they are alternative, they don’t have bacteria? Neither seems…likely.

  9. #9 Chayanov
    December 24, 2008

    So… isn’t Egnor a surgeon? Doesn’t that make him an arrogant hypocrite who spends his time killing his patients, by his own admission? So why should I listen to a thing he says?

  10. #10 Dianne
    December 24, 2008

    isn’t Egnor a surgeon? Doesn’t that make him an arrogant hypocrite who spends his time killing his patients, by his own admission?

    Ah, but Egnor is different. He’s a Mavrick(TM) and therefore you can trust him.

  11. #11 Prometheus
    December 24, 2008

    My! Dr. Egnor’s encyclical on physician arrogance just blew out all the irony meters in my lab. This is going to take weeks to repair! It took over an hour just to clear out all the smoke!

    Seriously, though, does Dr. Egnor not see how his arrogance – his absolute certainty that he is right despite over 150 years of scientific data supporting evolution – completely negates his entire “point”? Apparently, in the bizarre world of Dr. Egnor, his vast experience opening patients’ skulls trumps decades of work by thousands of dedicated scientists and yet he’s the one being arrogant?

    At least, being a surgeon, he washes his hands before he operates.

    I read his epic-length rant and came away with the impression that it is largely about how upset he is that we mere mortals (i.e. non-neurosurgeons) haven’t simply taken his word that he’s right and all the thousands of scientists over the past century and a half are wrong.

    That has got to sting. After all, isn’t he at the very pinnacle of the “Arrogant Medical Priesthood”, being a neurosurgeon? Shouldn’t we all prostrate ourselves before his towering intellect? Yet, perversely, we fail to acknowledge his self-evident rectitude and persist in our sinful, skeptical ways.

    Actually, I don’t feel that favoring evolution over Creationism (Excuse me! “Intelligent Design”) quite rises to the level of “skepticism”, any more than it is “skepticism” for an adult to not “believe in” the Tooth Fairy or the Easter Bunny (I’ll not mention a certain red-coated gentleman out of respect for the season).

    It sounds as though Dr. Egnor wants all of us to stop listening to the “Arrogant Medical Priesthood” – and, I suppose – the “Arrogant Scientific Priesthood, as well – because they won’t listen to him. From this latest Jeremiad, it would appear that he wants us to submit our minds and reason to the “Maverick Doctor Priesthood”, instead.

    He spins off on a long tangent about iatrogenic deaths and injuries without showing any sign that he is aware that “alternative” medical therapies have killed and injured, as well (and, as far as we can tell, do not have the efficacy of real medicical therapies). In fact, he completely ignores the fact that we know – in meticulous detail – the drawbacks, side-effects and failings of modern medicine because modern medicine (unlike “alternative medicine”) keeps records of its failures and tries to learn from them.

    Dr. Egnor’s argument seems to be that since modern medicine causes injuries and deaths, that it is inherently inferior to “alternative” medicine, which in most cases does nothing at all.

    Can he even smell the bullshit he’s shoveling? Is he still doing surgery? If so, my hypocrisy meters are in grave danger. I must remember to keep them unplugged when I surf the ‘net.

    Personally, I’d rather “believe” the work of thousands of scientists supported by reams of data over the fanciful religious delusions of a fringe group of pseudoscientists. Dr. Egnor offers us no data, no explanation and no support for his arguments and claims apart from his assertion that he knows more than we do. In his opinion, we should believe him because he is…well, because he know’s he’s right and we’re wrong.

    In essence, Dr. Egnor is telling us to trust him when he says that doctors can’t be trusted.

    Now that’s arrogance!

    Or a paradox.

    Prometheus

  12. #12 Dangerous Bacon
    December 24, 2008

    Don’t forget, Dr. Egnor is also a professor in the Dept. of Pediatrics at Stony Brook. Maybe he and “Dr. Jay” Gordon can get together at meetings to revel in their antiscience-based notoriety, while the other pediatricians cover their heads in embarassment.

    Egnor’s parade of tu quoque irrelevancy includes the statement “I’ve never known a patient to be harmed by a chiropractor.” Is Egnor really such a fool that he’s never stopped to consider how many people delay or forego effective medical therapy in order to pursue useless, expensive treatment for non-musculoskeletal conditions at the hands of chiropractors? Just googling “neck cracking” and “stroke” should disabuse him of his idiotic notions about chiro safety.

    I think I’d pay to see a tag-team debate between (on the one hand) Doc Egnor and Jay Gordon, facing Orac and Steve Novella. The first team to 100 logical fallacies is sentenced to having all their future medical care provided by Drs. Mercola and Hulda Clark.

  13. #13 Dianne
    December 24, 2008

    Egnor’s parade of tu quoque irrelevancy includes the statement “I’ve never known a patient to be harmed by a chiropractor.”

    Less than 5 minutes of searching on medline yielded numerous reports of people being harmed by chiropractors. For example, this one If Dr. Egnor hasn’t found any data suggesting that people can be harmed by chiropractors then either he’s never looked or he really doesn’t know how to use the internet.

  14. #14 Dr Aust
    December 24, 2008

    Am I missing something here?

    Surely the logic of Egnor’s view is that he should abandon neurosurgery (which like anything in medicine will have finite rate of complications, adverse effects and iatrogenic injury) and take up chiropractic… or even alternative neurosurgery. Actually, given his belief in Mysterious Divine Forces, a career in Neurosurgical Reiki (or even Faith Healing) must be beckoning.

    Over in the UK our Chiropractors are currently suing a well known science writer for having pointing out that their interventions have no demonstrable benefits (outside of treating lower back pain) and do have established downsides. I will be hoping that the British Chiropractors Association call Dr Egnor as an expert witness, at which point some highly paid and supercilious London libel lawyer would be able to question him about his beliefs on evolution and the nature of scientific evidence. Now there’s a tasty prospect.

  15. #15 Lurkbot
    December 24, 2008

    If Dr. Egnor thinks nothing the brain does can explain the mind, why does he bother operating on the brain? After all, Terri Schiavo was somehow still “in there” after her brain had disappeared, right?

    If Egnor can’t grasp the fact that minds are what brains do, then he can’t possibly agree that life is what cells do. So he’s a vitalist. The fact that we don’t know everything about the operation of the cell proves that there’s some “vital force” that runs the whole thing. We know even less about how the brain generates the mind, therefore there must be some immaterial agent, the “soul” in there, too.

    Is my understanding of his idiocy correct, or am I missing something?

  16. #16 PalMD
    December 24, 2008

    No, Lurkbot, that’s pretty much it.

  17. #17 thurgood
    December 24, 2008

    I have said this at Steve Novella’s place and will repeat some here. I am disgusted and outraged at E(I)gnor(e)’s defense of quacks, quackery, fakes and frauds. CAM has affected my near and dear – my father who was claimed by acupuncture (crudely alcohol sterilized needles->pinpricks->wounds->sepsis->toxic shock->multiple organ failure) and my mother-in-law who suffered for over 20 years from rheumatoid arthritis, and saw succession of quacks including chiropractors. I know at least one person who has and carry a withered arm all her life because her father – an extreme religionist – would not inoculate her against polio when she was a child. CAM kills, ask me. How can an ignorant moron be allowed to practice? I feel the seething rage my uncle expressed. Michael Egnor, you should be ashamed of yourself. Remember you can’t bring back me and wife our parents. So that is all your fake innocence is worth.

  18. #18 notedscholar
    December 24, 2008

    Interesting hit job. I admit that Doctor Egnor is weird, even crazy, but surely there’s something in his work worthwhile?

    NS
    http://sciencedefeated.wordpress.com/

  19. #19 Danimal
    December 24, 2008

    While it may not Dr. Egnor wanted for Christmas, that is some not-so-Respectful Insolence. I will take the opportunity to wish you, your family, and your readers a Merry Christmas, Happy Holidays, Happy Spaghetti Monster, or whatever else they are into. I look forward to reading your lengthy, sometimes over worded prose, but at time amusing to read prose in the coming New Year. All the best in the New Year!!

  20. #20 Kathryn
    December 24, 2008

    One piece of good news about doctors in the media: I was listening to KGOE 1480 earlier this week, and someone called in to Dr. Dean Edell asking on behalf of his father about some “alternative” cancer treatments at a Mexican clinic. The father had recently been diagnosed with a recurrence of his bladder cancer after surgery etc. and was hoping to avoid having his bladder removed.

    Dr. Edell calmly and concisely explained why these “cancer cures” you hear about on the Internet are just quackery, that there is no “highly lucrative cancer industry” suppressing the true cure. Not only did he explain that it would be very easy to just document the success of a treatment, publish, win a Nobel, and get rich, but that when physicians or their families get cancer, they go to a regular oncologist.

    The caller said this all made perfect sense and he would relay the information to his dad and steer him away from the quacks. I hope this made an impression on the rest of the radio audience, too.

    Have a wonderful holiday season, and good luck with the winter storms.

    –Kathryn

  21. #21 T. Bruce McNeely
    December 24, 2008

    notedscholar:
    Yes, there is something worthwhile about Dr. Egnor’s work. It is an excellent example of “your brain on creationism”.

  22. #22 Dangerous Bacon
    December 24, 2008

    “Not only did (Dr. Edell) explain that it would be very easy to just document the success of a treatment, publish, win a Nobel, and get rich, but that when physicians or their families get cancer, they go to a regular oncologist.”

    If they were thinking rationally, alties would realize that physicians want the same quality, evidence-based care for themselves as they do for their families, friends and patients. In conspiracy-fantasy land, though, docs are suppressing all the cheap, safe, effective natural remedies for the sake of money, even though it condemns them and their loved ones to death.

    Dr. Egnor would probably view the above statement as evidence of my “scorn” for people who use alternative treatments. I have a certain amount of scorn for quacks who exploit the vulnerable with their fakery and scams, but the highest level of scorn is reserved for health “professionals” who promulgate pseudoscience and give aid and comfort to quacks.

  23. #23 NP
    December 24, 2008

    It’s just another Egnorant diatribe from a Discovery Institute pawn. Never mind the huge non sequitur – but the very fact that he turns this into an attack on “materialism” (whatever the heck that is) once again proves that ID ideologues will misappropriate just about anything.

    And the man has no integrity – how can he on the one hand pretend to be against alternative medicine, and then portray quacks as people who present a genuine challenge to the “worldview” of sensible folks who rely on evidence-based medicine?

  24. #24 nomuse
    December 25, 2008

    Err, what? Am I not following Dr. Egnor’s logic here? I can stuff a homeopathic remedy down my throat any time. If I see the inside of a hospital, though, it is because there is something dangerously wrong with me. So who is surprised that there are more often negative outcomes in the latter case?!

  25. #25 Inquisitive Raven
    December 25, 2008

    Re: the arrogance of ignorance

    Never forget that Dr. Egnor’s name has become a synonym for that.

  26. #26 DLC
    December 25, 2008

    I read both Orac and Dr Novella’s blogs, as well as Science-Based Medicine. It was at one of these places I left the comment that willful ignorance of the scientific facts should be labeled “Egnorance”, and that one who exhibits these traits should be labeled as “Egnorant”.

    For Dr Egnor, in case he happens to read this:
    Doctor, you are entitled to your opinion, even if that opinion flies in the face of reality. No one is trying to take that from you, or stifle your voice. However, if you persist in denying our reality and substituting your own, you should expect being laughed at and derided.

  27. #27 John Fryer
    December 25, 2008

    I am currently at the sharp end.

    One child receives a vaccine on day one and has severe problems – screaming for hours and then developing jaundice.

    At age 8 weeks several more vaccines including round 2 of a vaccine for persons who may get into drug using or multiple sex partners. Again reactions are severe. Projectile vomiting, high fever, seizures and doctors who laugh when asked by the famlily if they would lodge an adverse reaction to vaccine report for them.

    At age 16 weeks several more vaccines including a yet another repeat of the one to protect the baby from any multiple sexual activities or drug using she might be involved in.

    The head blows up to a third bigger in less than a day.

    Baby dies and the last parent with the child gets forced to confess he has abused and killed the child and is in prison with the other parent aware she has indeed married a monster.

    But where, what or who is the monster?

    Why do we need to give Hep B at age one day to a healthy child who then gets so unhealthy that the doctors who told the family to go home had to rescind his order?

    Why do we need to repeat an inappropriate vaccine several times if vaccines are supposed to protect the first time round?

    Why do companies say there is not mercury in their vaccines when mercury still goes in through the gates of the factory?

    Why do people say this is definitely abuse when they look at the end result and havent the time to look at the family history?

    Why do we pretend the Nobel Prize winner for 1913 or so does not exist?

    The normal unwanted reaction to a repeat vaccine is DEATH.

    Merry Christmas but not to those anaphylactically killed by repeat toxic inappropriate vaccines or those put in prison by quack doctors only able to see their own arrogance and not able even to look at complete medical histories if its more than 1 day ago.

    And why dont we listen to parents who don’t have qualifications but do possess the same type of brain cells that their doctors have and aren’t indoctrinated but have open minds as they were obviously vaccine believers before their sad loss.

    Today this family might not repeat the same vaccine schedule but in free USA they have no choice.

    Take the lot or take none.

    What choice is that?

    Madness, indoctrination and death to the unlucky few. If 1 in 200 is the few?

  28. #28 T. Bruce McNeely
    December 25, 2008

    John Fryer:
    I’m not sure what you’re saying here.
    I get the sense of a horrible story about the death of a child and someone falsely imprisoned. However, I could be wrong.
    Who is the Nobel Prize winner that you mention? What is this stat 1 in 200 referring to? What do you mean: “I am currently at the sharp end”?
    I can at least say that jaundice in a newborn is common and has nothing to do with vaccines. That does make me suspect the entire truth of the rest of your story.
    Frankly, if you want us to pay attention to what you say, you could use plain English rather than rhetoric.

  29. #29 Mojo
    December 25, 2008

    Any idea why Egnor chose Orac’s account of the embarrassing (for CAMsters) episode of the SoH’s attempt to censor the Quackometer to link to?

  30. #30 Dawn
    December 25, 2008

    Merry Xmas, Orac. Hope you are enjoying the weather there. My mum says it’s not bad today.

    @T Bruce McNeeley: Almost sounds like John Fryer is using the antivaccinationist’s excuse that they tried to keep Alan Yurko out of prison for. The man battered his baby to death, then tried to blame it on the vaccines. Fortunately, the legal system had more brains then that. I don’t get the other references. As you said, jaundice is very common in newborns. I can’t imagine ANY MD laughing at a request to submit to VAERS if there was a true reaction. Besides, you don’t have to be an MD to submit to VAERS; anyone can do it.

    Egnor is very embarressing. I almost hate to admit I have a MSN from SUNY Stoney Brook since that’s where he’s located. He may be a super neurosurgeon, but I’d never go to him nor would I recommend family members to use him. I prefer to have my doctors grounded in science and logic as much as possible.

  31. #31 Dawn
    December 25, 2008

    Edit: I should have stayed polite (and checked my spelling).

    DR Egnor is very embarrassing.

  32. #32 Dangerous Bacon
    December 25, 2008

    The John Fryer who commented here appears to be the same character who runs around to various blogs posting similar antivax nonsense and identifying himself as “John Fryer MSc BSc Vaccine Adverse Effects Researcher”.

    I haven’t been able to locate any publications involving John and vaccines on PubMed, so maybe he can enlighten us as to what “research” he’s done on the subject, as opposed to pulling lurid scare headlines out of his nether regions.

    Merry Xmas to all.

  33. #33 notedscholar
    December 25, 2008

    Dangerous Bacon:

    Good catch. Although I don’t think scholarly publications makes someone automatically authoritative, it says something when a person fakes a publishing record! I’ve never published anything for example, but I wouldn’t claim I had just to bolster my arguments!

    NS

  34. #34 DLC
    December 25, 2008

    I’d comment on John Fryar’s poor logic, worse references and attempt to impress by anecdote and innuendo, but Casablanca (1942, Humphrey Bogart) is on.

  35. #35 D. C. Sessions
    December 25, 2008

    I’ve never known a patient to be harmed by a chiropractor.

    And I’ve never known anyone to be harmed by firearms. Therefore, by Dr. Egnor’s impeccable logic, firearms are harmless.

    In contrast, Dr. Egnor’s certainty regarding the horrors of medicine as practiced by, e.g. neurosurgeons, no doubt reflects the fact that such harm is commonplace in his practice. I’ll keep that in mind should I ever have need of one.

  36. #36 Dangerous Bacon
    December 25, 2008

    “Although I don’t think scholarly publications makes someone automatically authoritative, it says something when a person fakes a publishing record! I’ve never published anything for example, but I wouldn’t claim I had just to bolster my arguments!”

    To clarify, I didn’t suggest he was faking a record of publishing. He’s described himself as a “researcher”, his emphasis here is alleged vaccine dangers and a major point of research is to accumulate evidence and publish it for peer review. I couldn’t find any such vaccine research involving Mr. Fryer in Pub Med so I asked about it.
    I acknowledge referring in somewhat denigrating fashion to whatever efforts he may have expended in this area as “research”, mainly because I doubt that anyone characterizing the results of immunization as “Madness, indoctrination and death” is sane enough to contribute anything of value.

    These folks are the whacked-out Santa Clauses of the antivax movement, winging their way from forum to forum to drop their venomous turds down the chimney.

  37. #37 trrll
    December 26, 2008

    I knew a guy who was by all accounts an excellent neurosurgeon, clearly a brilliant man, who never seemed to meet a scam that he didn’t like. He got taken over and over. I’ve heard it said that con men love surgeons, because surgeons often, believe, like Dr. Egnor, that their expertise in the operating room carries over into other areas, and that they are possessed of a general ability to detect “b.s.”

    Although many physicians imagine themselves to be scientists, most actually receive only rudimentary training in scientific reasoning. They learn a great deal of biology, anatomy, and physiology, but they are learning the conclusions that have been reached by scientists–they get little training or experience in drawing their own conclusions from scientific evidence. Of course, there are physician-researchers such as Orac who have acquired such experience, but it is not something that is part of the standard medical curriculum, and for good reason–learning the practical intricacies of medical care is enough of a challenge without spending time learning how to do scientific research, something most doctors will never actually do.

    Medical practice itself is a curious mix of solid science and “old doctor’s tales” — therapeutic strategies that have been handed down from doctor to doctor, often based upon plausible physiological reasoning, but that have never actually been tested in a rigorous way. The very existence of the term, “evidence-based medicine,” reveals that much of medicine lacks a rigorous evidentiary basis. The notion that practical experience treating patients somehow renders physicians immune to such mechanisms of self-deception as confirmation bias and the placebo effect is belied by the history of medicine. Over and over, well-accepted therapies that have been used on huge numbers of patients have been found to be valueless or even harmful when evaluated in well-designed randomized controlled studies.

  38. #38 Citizen Z
    December 26, 2008

    Far more damage is done to patients by doctors and other mainstream health care providers than is done by vaccine “deniers,” acupuncturists, homeopaths, etc. Fatal disease is much more likely to be spread by a doctor’s unwashed hands than by some (mostly misguided) parents who fear that a vaccine may harm their child. I’ve never known a patient to be harmed by a chiropractor. Tens of thousands of patients each year are harmed in preventable ways by their (usually well-intentioned) surgeons.

    Only two people have been shot in my kitchen. Far more people have been shot and will be shot outside my kitchen. Thousands of people each year will by shot, likely by random gunmen, and the majority will not be shot by the crazy guy in my kitchen with a gun.

  39. #39 Mike
    December 27, 2008

    I suppose that Ignor accounts for the differences in the number of patients cared for in scientific settings versus those cared for by quacks. Of course he does.

    I’d also guess that far fewer quacks wash their hands than to ‘scientific’ caregivers. Wonder if I could get a grant to study this?

  40. #40 trrll
    December 27, 2008

    Far more damage is done to patients by doctors and other mainstream health care providers than is done by vaccine “deniers,” acupuncturists, homeopaths, etc.

    It doesn’t really take much smarts to see the flaw in Egnor’s argument.

    Consider an effective treatment that saves the patient’s life 99.9999% of the time, and harms the patient 0.00001% of the time.

    Compare it to an ineffective treatment that does absolutely nothing.

    What is the ratio of harm done by the effective treatment to that caused by the ineffective treatment? Why it is huge–in fact it is infinitely greater!

    Obviously, we should always prefer ineffective treatments to effective treatments.

    You know, being a crank on the subject of evolution is probably somewhat benign, at least for a surgeon. So long as he adheres to standard guidelines about the use of antibiotics, he probably won’t cause much harm to his patients.

    But in this case, Dr. Egnor’s argument calls into question his basic competence as a surgeon, because even a surgeon needs to assess and communicate to his patients the risks and benefits of surgical options. Anybody who would make such a basic and obvious error regarding benefit and risk lacks the fundamental competence to make any kind of medical decisions regarding patients.

  41. #41 Ryan Cunningham
    December 29, 2008

    I have to wonder: For all his protestations that he does not support “alternative medicine” or antivaccine fear mongering, does Dr. Egnor realize that the comparison of scientists and science-based physicians to a “priesthood” and of science-based medicine to a “religion” is straight out of the playbook of quacks?

    Not only that, how does the religious guy make “priesthood” an insult?