Hard conversations

Yesterday was long and rough, with the day spent desperately trying to finish a grant application and the evening spent in obedience training with our new dog Bailey, who, let’s face it, needs more than a bit of doggie discipline. By the time I got home, had dinner, and was checking e-mail, it was pretty late and–gasp!–I didn’t really feel like blogging. Yes I’m aware of that study that claims to link vinyl floors to autism that everyone’s been sending me; perhaps I’ll get to it tomorrow. Last night it was just too late and I was too tired to try to tackle reading a research paper and writing up a commentary.

In lieu of more of bestowing more of Orac’s scintillating (or overwrought) pearls of wisdom, upon his eager fans, I sometimes like to point out new and potentially interesting blogs. In this case, it’s a medical student who’s just started his blog up. At when a blog is at such an embryonic stage, it’s always difficult to tell if the blogger will stick to it, but in this case the initial posts look promising. The blog is called Beyond the Short Coat, and the blogger, Whitecoat Tales, has begun a series called Hard Conversations, which he describes thusly:

I want to be clear; there isn’t any scientific controversy in what I’ll be writing about, only media hype. I’m calling them “Hard Conversations” because I will be discussing things people hold strong and cherished beliefs about, in long, generally multi-part posts. Often we’ll be discussing things people hold responsible for their own pain and suffering. For example the first Conversation will be about vaccines and autism. I understand just how polarizing these issues can be. I’m not aiming to just shout at suffering people and say “Can’t you see the science! Don’t be stupid!” I think a lot of bloggers do that sort of thing much better than I would. Make no mistake though, I will not compromise science. Ethically, and morally, I have an obligation to explain these issues to the best understanding we have in the medical world. I’m not going to pander to people who specialize, knowingly or unknowingly, in giving people false hope or false beliefs to make money, or for their own perverse pleasure.

I can only hope that he doesn’t get the impression that I do the Orac schtick when I’m talking to patients. When I encounter a woman who is in the thrall of cancer quackery I certainly don’t go full Orac on her. Blogging is an outlet meant to satisfy my urge to write and (hopefully) educate about science, medicine, and skepticism. It’s a different media. That’s not to say that the message isn’t the same when dealing with such patients. I make no bones about it when explaining, for example, that homeopathy is bunk and why, but I do it gently but firmly.

And his first “Hard Conversation” is Vaccines and Autism, part 1. Please check it out and comment.


  1. #1 Sam C
    April 2, 2009

    Orac, slayer of myths and Vaccinator of Truth:

    I can only hope that he doesn’t get the impression that I do the Orac schtick when I’m talking to patients.

    Is Dr Jekyll and Mr Hyde required reading at med school?

  2. #2 Phoenix Woman
    April 2, 2009

    Speaking of heartbreaking — a little boy, diagnosed as autistic, is dead because his mother refused to treat his cancer with chemotherapy: http://news.aol.com/article/cancer-medication-case/409340

  3. #3 D. C. Sessions
    April 2, 2009

    I can only hope that he doesn’t get the impression that I do the Orac schtick when I’m talking to patients.

    I always figured that part of the reason for this blog is as an outlet for the things you can’t tell patients in “full Orac” mode.

  4. #4 Mu
    April 2, 2009

    Now you’ve done it, the poor guy got Dawn’ed the first day.

  5. #5 Landru
    April 2, 2009

    Whitecoat Tales did get Dawned right away. S/he pretty much invited it, though. Not that it’s my business; it’s his/her blog. I’m not all that enthralled by a blogger that categorically insists on treating the Dawns of the world with unearned (actually, in her case, forfeited) respect.

    Other than that, I think WT seems to be off to a fine start. And what I think about civility and respect isn’t WT’s problem.

  6. #6 Whitecoat Tales
    April 2, 2009

    Gosh, just a huuuge thanks Orac for the post, I hardly expected to get anywhere near this kind of response.

    Orac- I know you don’t talk to patients in full Orac Schtick, I’ve seen enough of medicine behind the scenes to know we all have alot of steam to blow off!

    Incidentally, I specifically invited Dawn, and if you will, the Dawn’s of the world. I disagree with her point of view, the evidence is on my side, but I think she argues out of passion for her child, not “insanity”. Infact I think most people who get sucked into the World Wide Woo-Web just want something they can hold on too, to fight.

    One only has to spend a day in a pediatric ICU, or a pediatric chronic care ward to see how much a sick child can affect a parents ability to look at statistics impartially, or be rational at all!

    My hope with the blog is to do exactly what I would do if I was seeing a patient (and probably similar to what Orac would do with a patient). I want to have compassion for people with problems, and I want to debunk their mistaken beliefs. We both know you won’t get someone to change thier mind by shouting that they’re an idiot.

    Maybe the post will descend into name calling and shouting and I won’t get anywhere, but maybe some parent who is on the fence will read Dawn’s blog, Orac’s blog, and my blog, and, if I’m lucky, maybe one parent somewhere will do the right, evidence based things because they didn’t see any vitriol in my post.

    If that happens, I’ll call the whole damn thing a success. If it doesn’t, I’ll keep writing anyway and maybe some people will get somethig out of it, that they wouldn’t have gotten otherwise.

    To all of you who have taken a look, thanks a bunch, I appreciate your time, and I’d love if you take another look now and again. I’m going to try to keep the posts on this series going every day or every other day, I’d get them out faster but I want these to be well researched.

  7. #7 Whitecoat Tales
    April 2, 2009

    Incidentally, as far as categorical respect is concerned – I’m not asking anyone to treat Dawn with respect as an advocate – her evidence is nonexistant, and I will be debunking most of her comments – I’m asking you to have respect for her as the parent of someone with a disease.

    I appreciate Landru’s point – respect doesn’t spring eternal – but I invited Dawn not for just Dawn, but for people who might stumble across this post and say “Well this has no relevance to me, its a bunch of people who I couldn’t possibly relate too”. The categorical respect isn’t really for her either, but for parents who would say “Oh well they don’t care about my point of view, why should I read this with an open mind”

    Hopefully it works, but if it doesn’t, I’ll learn from my mistakes

  8. #8 Orac
    April 2, 2009

    Whitecoat, you have more intestinal fortitude than I do. Dawn has more than worn out her welcome here. In fact, I forgot that I had banned her.

  9. #9 Landru
    April 2, 2009

    WT, I deliberately chose not to engage you on it at your site–the rules are yours to choose, and I walked away from commenting there because I’m not interested in testing your limits. I admit that I don’t entirely agree with you. As I noted earlier, that shouldn’t be your problem. I will note that a different person with the same name commented in my space a few weeks ago, and seeing that name in my comments section scared the willies out of me.

    While, in retrospect, it seems to me to be mildly snotty and maybe rude that I commented on it here, I had a feeling you’d see it, so I didn’t feel like I was gossiping behind your back. I’m glad you saw my comment. I accept your limits. I hope I’m a less delicate flower than those you’re explicitly trying to respect, but maybe not so much. To wit:

    You might take care with characterizing autism spectrum conditions as “disease.” Some ASD parents–myself included–are probably every bit as…uhm, I’ll just say “passionate”…about that terminology as other parents are about more scientifically settled issues. And it’s really hard to apply scientific principles to the semantics of the thing.

    Thanks to Orac for tolerating this discussion here, and to you, WT, for responding to my comment outside of your space. Really, I don’t hope that your Hard Conversations series degenerates into screaming or name-calling, and I’d be remiss if I didn’t salute your tenacity in taking on difficult topics.

  10. #10 D. C. Sessions
    April 2, 2009

    One only has to spend a day in a pediatric ICU, or a pediatric chronic care ward to see how much a sick child can affect a parents ability to look at statistics impartially, or be rational at all!

    The key word is, “can.”

    I’ve been that parent in NICU, and I’ve been the observer more than once (the ex was a NICU nurse.)

    It bears repeating that just as a medical education is not a bar to passionate concern, passionate personal concern isn’t necessarily a bar to sound reason.

  11. #11 Whitecoat Tales
    April 2, 2009

    You’re entirely correct, I really struggled over how to characterize it myself, and in retrospect using the word disease was a mistake.

    I didn’t think you were gossiping or anything like that, and frankly, I respect both your initial comment and you’re walking away.

    Thanks again for your commentary, and Orac thanks both for raising my profile, and tolerating our not-quite-insolence in your house!

  12. #12 Jake Crosby
    April 4, 2009

    You trust these references?
    1.Autism Spectrum Disorder: No causal relationship with vaccines DOI: 10.1111/j.1440-1754.2007.01239.x
    2.DeStefano F (2007). “Vaccines and autism: evidence does not support a causal association”. Clin Pharmacol Ther 82 (6): 756–9 doi:10.1038/sj.clpt.6100407. PMID 17928818.

    So reference two is made by Frank DeStefano who lied to the editor of a medical journal about his earlier VSD findings showing a stronger link between autism and thimerosal when he directed the CDC National Immunization Program. And reference one is made by Larry Pickering, the NIP director’s senior advisor. Let’s not forget that private contractor who was paid to destroy the raw data used by Verstraeten, who sent an email containing tables showing really high relative risks of autism from thimerosal exposure asking his collegues(including DeStefano) how to lower them, despite his efforts, and how the CDC also sent the rest of the VSD overseas to the Brighton Collaboration to avoid FOIA requests, held an illegal closed meeting with vaccine manufacturers, and conducted a series of drop-dead awefully bad epistudies including one done by Verstraeten while he was working for GlaxoSmithKline, using a failing HMO and another that was too small to show any associations, has an ACIP dominated by pharmaceutical company representatives, carries out projects paid for by pharmaceutical companies and at least up until recently worked under a presidential administration loaded with members who had strong ties to pharmaceutical companies, especially Eli Lilly, which invented thimerosal. You know, you don’t have to simply believe something just because the CDC says so. That’s what skepticism is all about, independent verifiability.

  13. #13 Whitecoat Tales
    April 4, 2009

    Why in the world would you post this on Orac’s blog instead of mine when you’re argueing about the content of my post? If you want a real discussion go to my blog instead of fouling Orac’s space with your gibberish. But know that the respect and cordiality we’re discussing here is for parents who don’t know better, not for fear mongers like yourself.

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