Respectful Insolence

Dr. Jay is back.

You remember Dr. Jay (namely Dr. Jay “I’m not anti-vaccine but I give vaccines only ‘reluctantly‘ and am convinced that they cause autism” Gordon), pediatrician to Evan, Jenny McCarthy’s son and frequent apologist for the antivaccine movement in the media. Specifically, he was most unhappy over my posts about Dr. Bob “too many too soon” Sears and about a child who died of Hib. If you peruse the comments in those two posts, you will see him once again disparaging science, touting his own personal clinical experience over the science failing to find a link between vaccines and autism. You will see him once again incapable of acknowledging that personal clinical experience and anecdotes are exactly what all too often led physicians astray for hundreds of years regarding bloodletting and purging with toxic metals and citing a fallacious “science was wrong before” justification for accepting his views as correct.

As usual, the banter went back and forth without Dr. Jay’s being able to produce any scientific evidence to support his (and, apparently, Dr. Sears’) belief that vaccines cause autism and that autistic children shouldn’t be vaccinated. Alas, my and my commenters’ failed to manage to get Dr. Gordon to see why anecdotal evidence can mislead, leading to Dr. Gordon’s contemptuously dismissing these commenters as being people “who’ve never taken care of a patient” and don’t have his years of experience practicing pediatrics as having no standing to criticize him. (Quite frankly, the “How dare you? I’m a doctor” defense doesn’t wash around here. I try very hard never to use it–although in the course of four years it’s possible I may have slipped up once or twice–and I don’t hesitate to call out commenters who use it.) Then Dr. Gordon did something that really annoyed me.

He pulled the “pharma shill” gambit out and used it again:

Pharmaceutical companies either directly or indirectly pay people to post on blogs like this. It’s illegal not to disclose if you are doing this.

(Orac: “Aah, the Pharmashill gambit.” Baloney, Orac. It’s real and you know it!)

Best,

Jay

http://tinyurl.com/crwdbe

http://tinyurl.com/crcqoc

http://tinyurl.com/mllnqb

http://tinyurl.com/lpth3t

http://tinyurl.com/d9q9hj

I was a little irked; so I felt that his invocation of the “pharma shill” gambit merited a response:

Dr. Jay, you’ve pulled this crap time and time again with me, and I’ve told you time and time again, both publicly in the comments of this blog and privately in response to e-mails, that I do not receive pharmaceutical company funding of any kind, either for my research, this blog, or anything else, for that matter. I also often facetiously ask things like, “Where do I get me some of this filthy big pharma lucre? I want in! Imagine how cool it would be to spend my days in sweats and a T-shirt blogging, instead of spending all that time seeing patients, doing research, and struggling to keep my lab funded!” In any case, Dr. Jay, you’ve responded on at least two occasions that I can remember that you believe me when I tell you this.

Then, any time I happen to annoy you with a post on this blog that you really disagree with to the point where you start diving into the comments to take me to task, almost inevitably you eventually start insinuating yet again that I’m somehow a pharma shill. I’m calling you out on it this time, because, quite frankly, it’s intellectually dishonest of you to keep doing this after you’ve said you believe my assurances to you that I don’t receive pharmaceutical company funding.

As for your links, I note that only one of them has anything to do with pharmaceutical companies paying for blog coverage. One of them had to do with accepting pay to give talks and serve on advisory boards and how more physicians are saying no to big pharma money for such services. The rest have to do with pharmaceutical companies and CME, whether it is ethically acceptable, and whether CME will become much more expensive as pharma underwriting of CME activities is increasingly scaled back as being a conflict of interest. In any case, perhaps you think pharma paid me to write posts like this:

Yes. I’m guessing pharma would pay me well for more articles like this. Don’t you think so, Dr. Jay?

So, Dr. Jay, I’m going to make a request of you: Put up or shut up. You think I’m a pharma shill? Prove it. Otherwise, stop pulling the “pharma shill” gambit on my blog and insinuating that I must somehow be in the pay of vaccine manufacturers. My assumption about you is that you are sincere and honest, but simply wrong about the science when it comes to vaccines. If you don’t think I deserve the same assumption from you, that says far more about you than it does about me.

Comments

  1. #1 Bob O'H
    June 6, 2009

    Hmmmm. Perhaps you should start looking into English libel law. :-)

  2. #2 ababa
    June 6, 2009

    I think the real question is how much Dr. Jay is being paid to write parts of Jenny McCarthy’s books and make appearances with and for her.

  3. #3 peter
    June 6, 2009

    When arguments fail, the scoundrel – like Dr. Jay – resorts to lies and insinuations.

  4. #4 Denice Walter
    June 6, 2009

    If I were to use the *schema* of “The Secret”,both you and PalMD must have sent out some *very* dodgy vibes to “attract” such vitriol as you both have recently(witness Gordon,Willoughby, Ullman,”youknowwho”).While I don’t subscibe to that poppycock,I think whatever you’re doing,keep it up!(oh,and I am totally *not* a pharma shill.)

  5. #5 dkmnow
    June 6, 2009

    I still contend that Big Pharma dearly loves “Dr. Jay” and the anti-vax cult. Why? For the same reason that the Pentagon loves crazed UFOlogists. For the same reason the psychiatric industry loves the Church of Scientology. In a word, distraction. The anti-vax cult, and their front-men like “Dr. Jay,” impose a spectacular distraction upon the public mind, diverting attention away from the very substantial crimes that have become standard operating procedure for the pharmaceutical industry.

    Let’s face it, when you’re trying to get away with something, there’s nothing that does more to boost your credibility than for your most vocal “opposition” to be composed of obstreperous zealots who reek of blind manic pathos.

    Sincere or not, “Dr. Jay” and his cohort are inherently disinforming. For that service alone, it is they who would should far plausibly be charged with being on the payroll of Big Pharma.

  6. #6 T. Bruce McNeely
    June 6, 2009

    Dr. Gordon does this at the same time he gets his knickers in a knot about “uncivil” posts and comments on Orac’s blog.

    What a hypocritical ass!

    (Ooooh, I called Dr. Gordon an ass! Let the pearl-clutching begin…)

  7. #7 dkmnow
    June 6, 2009

    “would should far plausibly”

    Could would inarticulate blunderingly me be? ‘Kay, let’s try that again:

    …it is [Dr. Jay and his ilk] who should far more plausibly be charged with being on the payroll of Big Pharma.

  8. #8 Skeptico
    June 6, 2009

    Jay must know he’s lost the argument if he’s reduced to lame ad hominem like this. If he had any evidence he’d present it.

  9. #9 Skeptico
    June 6, 2009

    Jay must know he’s lost the argument if he’s reduced to lame ad hominem like this. If he had any evidence he’d present it.

    btw Orac, thanks for the links. One more – Ad hominem – explains why it wouldn’t matter even if you were paid by the pharma companies: Jay would still have no evidence that vaccines cause autism.

  10. #10 Sami
    June 6, 2009

    Clearly, Orac, you are the master of an INCREDIBLY CLEVER gambit where you take no funding from Big Pharma, and write posts highly critical of Big Pharma, in order to build up your credibility as SECRET SHILL for Big Pharma.

    DIABOLICALLY CLEVER, ORAC. I now visualise you as a clear box of blinky lights stroking a white Persian kitten.

  11. #11 Pareidolius
    June 6, 2009

    If only I could hear the transperent, blinky-lighted, kitten-stroking box utter these words: “Ah, Mr. Gordon, you return with the dreadful inevitability of an unloved season”. This would be just before releasing the trap-door over the piranha filled moat.

  12. #12 D. C. Sessions
    June 6, 2009

    Jay must know he’s lost the argument if he’s reduced to lame ad hominem like this. If he had any evidence he’d present it.

    Jay knows he’s shooting blanks, and the proof is that he spends all that time replying to the “uncivil” comments and skipping blithely over the ones that politely ask him questions that are direct and to the point, but which leave him no room to avoid the fact that he’s talking out of his anal sphincter.

    When pinged repeatedly, he tries to make a lame joke (the usual kindergarten attempt to be “cute”) out of dodging the question. Such as his “I’m stuck on an escalator” attempt or his recent “nine” reply.

    Hey, if he wants to play stupid I’ll go along and take him at his word. If he thinks that one kid in nine getting smallpox is the optimal prevalence that we should try to maintain, we can discuss it.

  13. #13 Anthro
    June 6, 2009

    I try not to use any “woo” terms, but my question is becoming a “mantra”!

    What is to be done about MD’s who practice “woo”? Are any professional bodies willing to take this on?

    Many of them offer “woo” because they say it’s “demanded” by patients (this was the rolled-eyeball-excuse of my gynecologist who had a bunch of herbal concoctions on the table that I expressed alarm about). How lame is that? If you can’t get MD’s to resist this, how can you get the public to make judgements based on science?

    I’m all for “if it feels good, do it”, but it’s wrong to charge money for stimulating the placebo effect.

  14. #14 Doazic
    June 6, 2009

    I for one, would welcome any donations/bribes from Big Pharma.

  15. #15 Mephistopheles O'Brien
    June 6, 2009

    it’s wrong to charge money for stimulating the placebo effect.

    But you have to charge for it, otherwise you don’t stimulate the full effect!

  16. #16 tim gueguen
    June 6, 2009

    This discussion reminds me of this cartoon:
    http://questionablecontent.net/view.php?comic=1384

  17. #17 Joseph
    June 6, 2009

    Pharmaceutical companies either directly or indirectly pay people to post on blogs like this.

    Are there actually known instances of people who are paid to post comments on blogs, or is this an urban legend?

    What is the going rate per comment, BTW?

    I know there exist services like PayPerPost that are used for advertising in blogs. But you can smell these ad posts a mile away. Are there actually known instances of payed Pharma propaganda that was successfully disguised to look like a normal blog post?

    For that matter, is there any evidence that Pharma companies have spent PR money (say, like Generation Rescue does) in the vaccine-autism controversy?

  18. #18 Iason Ouabache
    June 6, 2009

    @Joseph: I know of several political groups and corporations that have been found guilty of astroturfing. I’ve never heard of a pharmaceutical company doing it but that doesn’t mean they haven’t.

    Having said that, there is no evidence that Orac has ever done that so Dr. Jay needs to put up or shut up. Stop throwing out ad hominems and bring some science.

  19. #19 Dedj
    June 6, 2009

    “Are there actually known instances of people who are paid to post comments on blogs, or is this an urban legend?”

    Possibly an urban legend, however, people such as our other favourite David (Kirby) have ‘somehow’ managed to blog using non-public information at a time that ‘just happens’ to be in the best long-term interests of interested parties who ‘co-incidently’ also happen to have that non-public information.

    As for actual pay-to-post, it’s much harder as people become qualified experts and retain employment precisely because they have an interest in thier work, thus pro-pharma posting are to be expected (which raises the question of why pharma would pay for something they get for free).

    Conversely, we already know there are anti-pharma people who are so devoted to it that they can and do track posters back to their own personal blogs just to argue the point.

  20. #20 Dave W.
    June 6, 2009

    A general question:

    If a licensed physician publicly, repeatedly and loudly declares that he refuses to practice to the standards of care, is there any reason to not report him to his state’s Board of Medicine? Or does it take a death or outright fraud to get a demonstrably dangerous physician delicensed?

  21. #21 khan
    June 6, 2009

    Dr Jay FID
    (Friend of Infectious Disease)

  22. #22 TexDoc
    June 6, 2009

    I beg Dr. Jay’s forgiveness, but I did get some free pens from drug reps back in medical school, and was plagued with guilt quite a while after. But then I went into Pathology and sold out to Big Formalin. I’ve continued to suppress the secret knowledge that tissue fixation is the true environmental toxin exposure responsible for the autism tsunami. Curse you Dr. Jay and your razor sharp deductive insights! I’m now but a Forma Shill, exposed. The horror, the horror….

  23. #23 khan
    June 6, 2009

    Does the good ‘doctor’ jay get paid/reimbursed for his appearances in support of infectious disease?

  24. #24 Militant Agnostic
    June 6, 2009

    TexDoc – Repent, change your evil ways and become a former Forma shill.

  25. #25 Laura
    June 6, 2009

    In the wake of my son’s dx, I would spend time on autism support message boards. And I too was accused of being a pharma-shill. It speaks more of them than it does of you.

  26. #26 Arnold T Pants
    June 6, 2009

    I am reminded of this from The Onion.

  27. #27 Zetetic
    June 6, 2009

    It does bring up the question about how much money is being spent by “Big Snake Oil” on blogs,promotion by doctors and celebrities.

    I suspect that such an analysis (especially in regards to autism) might be very revealing. Maybe then we could see who the real shills are.

  28. #28 Ramel
    June 6, 2009

    “Are there actually known instances of people who are paid to post comments on blogs, or is this an urban legend?”

    I don’t know about big pharma, but there are companies that do this sort of things to sell computer games: http://www.theglobeandmail.com/news/technology/article810751.ece

  29. #29 Lora
    June 6, 2009

    Crikey, I work for Big Pharma and all I ever get is an annual refresher training from Legal about how our lousy opinions on blogs are not the Official Company Opinion and not to be represented as such, and in fact IT would appreciate it if maybe I could do my job with an abacus and a slide rule because all these computers are really expensive. I wish I could get paid bonuses for blog opinions! Instead, I only get bonuses for patents. They used to have a program where we’d get $50 gift certificates for doing especially well on a particular project (yeah, $50–I’m not missing any zeros there), but they discontinued it in the name of The Crummy Economy.

    Most recently, we were told that we’re not allowed to charge business lunches anymore, everyone including visitors and interviewees has to buy their own sandwich. I’m not kidding. And we are no longer allowed to buy pens from Office Max, we have to use up all the sales rep pens and sticky notes that they aren’t allowed to give to doctors anymore.

    If Dr. Jay would be so kind as to let me know which of our competitors is paying folks to blog, I’d like to submit my CV to them. Maybe I could get an egg salad sandwich during the interview. And a decent set of Sharpie markers…

  30. #30 Alan Kellogg
    June 6, 2009

    Never trust any pharmaceutical company who would pay me to blog on their behalf.

  31. #31 pathgirl
    June 6, 2009

    Hey texdoc me too…except big-forma told me as long as I am their shill I will never die but if I do I probably be fixed enough not to require embalming.

  32. #32 Dangerous Bacon
    June 6, 2009

    Just a reminder that Dr. Jay (“No one knows your child better than you do”) Gordon* has not yet kept his promise made on Orac’s blog to delete the alt med nonsense he posted on his website about HIV and AIDS (which includes giving credence to the idea that anti-HIV meds cause HIV infection, and touting alternative treatments like chaparral (potentially devastatingly toxic to the liver), alfalfa and homeopathic medication).

    Dangerous Bacon M.D., ASCP, FS (Forma Shill), AGS**

    *If Mom knows best, why bother to listen to Dr. Jay?
    **American Gesneriad Society
    ***Still waiting for Big Pharma/Forma to send me my check for posting all these years to counter alt med silliness. At even just a buck per post I’m due enough to send me on several round-the-world cruises.

  33. #33 Ciaphas
    June 6, 2009

    What do you expect from a man recieving so much money from supplement companies and the anti-vax lobby? He just assumes everyone else does it too.

  34. #34 nenandcoopersdad
    June 6, 2009

    As a dad of a kid on the spectrum, I’m furious that Jay somehow put me on the side of big pharma. How did that happen? I swear, if he finds a way to make me side with my insurance company, it’ll be war! (Although at the moment, I can’t imagine what would make me side with Big Insurance.)

  35. #35 cass_m
    June 6, 2009

    @Lora – clearly you don’t work for a big enough BigPharma LOL

    I’m curious about the accusation of being a shill wrt vaccines. Surely preventing disease would not be in their best interest. And everything reputable I’ve read about autism advocates strong behavioural work so how does this benefit BigPharma?

  36. #36 Matthew Cline
    June 6, 2009

    @orac:

    So, Dr. Jay, I’m going to make a request of you: Put up or shut up. You think I’m a pharma shill? Prove it. Otherwise, stop pulling the “pharma shill” gambit on my blog and insinuating that I must somehow be in the pay of vaccine manufacturers.

    No, no, see, you’re a non-collapsed wave function, simultaneously a pharma shill and not a pharma shill, so there’s no inconsistency or flip-flopping on the part of Dr. Gordon.

    @cass_m:

    I’m curious about the accusation of being a shill wrt vaccines. Surely preventing disease would not be in their best interest. And everything reputable I’ve read about autism advocates strong behavioural work so how does this benefit BigPharma?

    Ah, you see, that’s proof that vaccines don’t work!

  37. #37 Jay Gordon, MD, FAAP
    June 6, 2009

    Hi Orac—

    No, I believe that you do not receive money from the pharmaceutical industry. I’ve said that before and I’ll say it again.

    I sincerely believe that some of the people who post here and elsewhere do. The docs who appear on television and write editorials and some who do drug research get money from the drug companies.

    I received nothing for writing the forward to Jenny’s book and when I appeared with her in Washington D.C. I paid my own airfare and all other expenses. I don’t get paid for blogging. I think some of you here might.

    That’s all.

    Jay

  38. #38 Jay Gordon, MD, FAAP
    June 6, 2009

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    My concern for that huge problem is far greater than my concern about your theories about measles epidemics

    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.

    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    Jay

  39. #39 Robert S.
    June 6, 2009

    Um, Orac? I hope you put the wrong link in to the “child who died of Hib” text because not only the article text, but your writeup on it clearly states Julieanna survived. In fact the only person who said she died in that thread AFAIK was Dr. Jay when he alleged medical medical malpractice.

    According the accounts of this case, treatment was delayed by at least 24 hours and maybe more. Most likely, the delay cost her her life. To answer your question, Dave, yes, this is malpractice.

    Is this a case where the opposition uses big lies and libel to cause a small mistake they made to be repeated by the reputable side? Or is this a case where I have reading comprehension fail? Jay obviously thinks carting around a corpse and dressing it up is perfectly normal.

    Flint went downstairs for breakfast while her fiancé, Jeff Metcalf, slept in. Afterward, Flint dressed Julieanna in the lace-edged purple princess dress she’d purchased for this day. She buckled the two-year-old’s white patent-leather shoes, and pulled her hair into two neat ponytails.

    I mean, he couldn’t possibly be exposing an internal belief that “brain damage” equals not really alive, right? Don’t the AoA folks keep getting in shit over saying autism equals not really alive? I’ll withhold further judgment of character, and assume it was just a slip up, but it does fit in a disturbing pattern of dehumanizing statements that should be noted.

  40. #40 Ciaphas
    June 6, 2009

    Calm down Dr. Jay, you’re typing, it’s ok to wait until you don’t sound so shrill and unhinged before you write.

    I think that if there is a real increase in autism it’s all caused by fairies. I’ve seen it myself. Prove me wrong.

  41. #41 Benjamin Geiger
    June 6, 2009

    Jay Gordon, MD, FAAP, OMG, WTF, BBQ:

    First, look up “burden of proof”. Second, show us a comparison study between vaccinated and unvaccinated children regarding incidence rates of autism. You complain about our “thimbleful of evidence”, but you have a metaphorical dust mote’s worth, and most of that was faked.

    (And FYI, I don’t get paid for blogging, or commenting, either. I may even have lost some promotion opportunities for doing so.)

    Alan Kellogg:

    No kidding. AoA should probably pay me to blog for ‘Big Pharma’.

  42. #42 Matthew Cline
    June 6, 2009

    The docs who appear on television and write editorials … get money from the drug companies.

    How do you know this?

    Also, since you’re for the “judicious” use of the HiB vaccine, how do you determine which children need it and which don’t?

  43. #43 D. C. Sessions
    June 6, 2009

    I don’t get paid for blogging. I think some of you here might.

    And I’m sure you have, right there in your hand, a list.

  44. #44 Tsu Dho Nimh
    June 6, 2009

    My concern for that huge problem is far greater than my concern about your theories about measles epidemics

    Jay … you have never seen a measles epidemic. Until you have, don’t dismiss it as being a trivial problem. Talk to Dr. Paul Offitt, who was a working pediatrician in the middle of a small measles outbreak, and ask him how it feels to see kids die who should never have been sick.

  45. #45 Scientizzle
    June 6, 2009

    I declare no conflict-of-interest in the writing of this comment.

    That said, Dr. Gordon, you are making an asinine statement:

    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.

    Dr. Gordon, I’m interested to see what your grant application to fund a study designed to “prove that vaccines don’t increase the incidence of autism” might have in it…How do you plan to prove a negative? What would your comparison groups be? If what you feel would be necessary is a vaccinated versus unvaccinated prospective study, have you considered the logistical and ethical implications of such a study (and you should definitely read this)?

    Moving on from that…would you please, Dr. Gordon, offer your “thimbleful of proof” that vaccines do increase the incidence of autism? This is the basic issue here. Do you disagree that Drs. Wakefield and Geier have been substantially discredited? Are you relying only on the anecdotal reports of your patients? Doesn’t the broadening of the diagnostic criteria account for a substantial portion of the rise in incidence?

    These are serious questions. I don’t get the disconnect here.

  46. #46 ba
    June 6, 2009

    Dr. J, wtfbbq exactly!

    And Friend of Infectious Disease WBAGNFARB.

  47. #47 PsyberDave
    June 6, 2009

    Dr. Jay,

    I just looked at your site and I notice you have a DVD for sale. Don’t you see irony (or hypocrisy) in accusing others of being shills, when you are shilling yourself?

    Being really honest with yourself, what part of your appearances on TV is self-promotional? Is it just that you want to share information with the world, or is there some desire to make yourself known? Maybe you want to build your practice and or sell your DVD? Have you attached yourself to Jenny McCarthy in any way to increase your profile?

    I don’t know the answers to these questions. They are genuine.

    You may be unaware of the rewards you get for taking your stances on vaccines as you do. It may very well be that you are rewarded for your stances despite your protestations of others “shilling” for a different stance.

  48. #48 PalMD
    June 6, 2009

    Pharmaceutical companies either directly or indirectly pay people to post on blogs like this. It’s illegal not to disclose if you are doing this.

    Illegal? Unethical maybe…

    About as unethical as implying that orac does this without any actual proof.

  49. #49 PalMD
    June 6, 2009

    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    Have you no sense of decency, sir? At long last, have you left no sense of decency?

  50. #50 autismnostrum
    June 6, 2009

    Dr Jay, aside from imaginary careers as pharma shills, you don’t know the background or professional expertise of everyone here, so spare me the appeal to authority.

  51. #51 Erika
    June 6, 2009

    After reading the comments Dr. Jay left on this and the earlier posts, I now want to go back to my new-mother self of 6 yrs ago and whup myself upside the head for listening to *anything* he said. After all, it’s not like he’s the only person out there that gives good bf’ing advice…

  52. #52 Zar
    June 6, 2009

    Dr. Jay Gordon, FAP, is a disease-spreading prostitute.

    There. Now you have a real reason to whine and pout, you money-grubbing plague rat.

  53. #53 Stop Jenny
    June 6, 2009

    Dr. Jay, once again, you’ve failed to properly respond to a legitimate criticism. If the evidence is so in favor of your position, why don’t you present that evidence? Why do you instead insist on ad hominem attacks and arguments from authority? And why do you insist on shifting the burden of proof? If I made a claim that hot fudge sundaes caused autism, would it be your job to 100% disprove it? Or would the burden of proof lie with me to prove my claim? What do you think?

  54. #54 A.J
    June 6, 2009

    AJ, I’ll try to get that debate starter written today or tomorrow. The problem is that honest civil discourse is as rare on this site as . . . measles in America.

    In reponse to:

    “And yes, I am not about to reverse me reluctance about the current vaccine schedule and the denial of severe side effects from vaccines.”

    Ok then. How about we just have an impromptu debate?

    Step #1. State you hypothesis in under 100 words. Must include a possible machination by which vaccines cause harm and possible autism. We’ll go from there.

    Still interested Dr.Gordon?

  55. #55 Chris
    June 6, 2009

    Dr. Jay:

    My concern for that huge problem is far greater than my concern about your theories about measles epidemics

    So can we assume you have lived in California for less the twenty years? You obviously missed the upswing of measles that killed so many children in that state (which was about the same time Dr. Offit was dealing with almost a dozen children from a medical-rejecting religious sect who died from measles). To refresh your memory, read Measles epidemic from failure to immunize.

    The first few sentences:

    During 1988 through 1990, California experienced its worst measles epidemic in more than a decade, with 16,400 reported cases, 3,390 hospital admissions, and 75 deaths. More than half of the patients were younger than 5 years; the highest incidence was among infants younger than 12 months. The epidemic centered in low-income Hispanic communities in southern and central California. The major cause of the epidemic was low immunization levels among preschool-aged children and young adults. Rates of complications, admission to hospital, and death were surprisingly high.

  56. #56 Matthew Cline
    June 7, 2009

    Dr. Jay, once again, you’ve failed to properly respond to a legitimate criticism. If the evidence is so in favor of your position, why don’t you present that evidence?

    His evidence is his clinical experience, so he can’t present it to us. Of course, he’s too smart and skilled to fall prey to the cognitive biases which could lead him to make false conclusions based on his clinical experience. So, sir, it’s only us mere mortals who fall prey to cognitive biases.

  57. #57 Chris
    June 7, 2009

    Matthew Cline:

    His evidence is his clinical experience,

    Which we know from a HuffPo post he wrote includes taking care of one child in his practice who was not vaccinated and ended up in the hospital with pertussis.

    This stemmed from an LA Times article, where Dr. Rahul Parikh wrote about a small child admitted with pertussis. There was no way us normal mortals could guess who the family’s pediatrician was since we would have no clue to the particulars of each of the 2000 doctors that used that hospital! But, no… he had to go and assume stuff, and in a sense admit that at least one of his patients has been hospitalized with pertussis. Read more at Ignorance is no defense for Dr. Jay.

  58. #58 HCN
    June 7, 2009

    Hey, Dr. Jay, one of my favorite books is being done as a play in Venice, CA! Go to it, and you might learn a thing or two:
    http://www.pacificresidenttheatre.com/mainpage.shtml

    Got the info from the author’s website:
    http://weekendstubble.blogspot.com/2009/05/not-even-wrong-hits-stage.html

  59. #59 Matthew Cline
    June 7, 2009

    Which we know from a HuffPo post he wrote includes taking care of one child in his practice who was not vaccinated and ended up in the hospital with pertussis.

    Maybe I’m misunderstanding the terminology in the article linked, but I read it as only saying that Gordon was the one to do the lumbar puncture. Did the baby’s parents refuse to allow anyone but their private physician do a lumbar puncture, so he was called in to do it?

  60. #60 Chris
    June 7, 2009

    Matthew, that is information protected by HIPAA, and Dr. Jay should know better than to reveal anymore information than he has. The only important thing is that one of his unvaccinated patients got to spend time in the hospital facing worse consequences than autism.

    And of course, the reaction that Dr. Jay thought the LA Times article was about him… like he is the only doctor it could have been about. As we know, with there are other doctors (many with the last name of “Sears”) who also do not insist that their patients be vaccinated.

  61. #61 ababa
    June 7, 2009

    Jsy said: And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    And exactly how are you slaving away “dealing” with this as a pediatrician? You getting writer’s cramp handing out prescriptions for chelation drugs and rigged heavy metal tests? You are Jenny’s best buddy, she has this autism thing licked – hooray it can be cured (and she will sell you a book to explain it)! You also know exactly what causes it, so simply tell parents to avoid vaccines and their kids will be autism free!

    Unlike all of those pharma shill doctors who have to tell parents that there is no cure or magic prescription to fix it. They have to tell parents the cause is likely unavoidably genetic and future children and grandchildren could be at risk as well. That must be frustrating. I can see why it would be enticing to throw cheap vaccines under the bus and sell desperate parents much more expensive “hope”.

    So tell me, the biomedical treatment industry has all kinds of things to sell people affected by this “autism epidemic”, and Big Pharma has nothing to make money off of after the vaccine you claim causes it. Now who do you think might have greater motivation to lie to protect their profits?

  62. #62 Whitecoat Tales
    June 7, 2009

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    Yes, us nasty, inexperienced theoreticians.

    Well I’ve done a little pediatrics, a little neuro and a little psych so far. Certainly noone can accuse me of being a theoretician. On all three rotations my attendings (who have a fair bit of practicing work between them, not so much being nasty inexperienced, or theoreticians themselves), say there isn’t an epidemic of autism. The older ones say that the number of patients between MRDD and ASD, has stayed roughly constant. The statistics actually gathered by people who care about data seem to agree with that.
    I’m fairly certain my peds attendings would be apalled to be lumped in with your statement when you talk about “we working pediatricians.”

    Despite this, argument from authority isn’t really appropriate. So lets go to science.

    …decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.
    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    Science… You’re doing it wrong.
    Paraphrasing some very intelligent Titmouse who posts on here, science is about what you reject, how and why you reject it.

    So what would cause you to reject the “autism is caused by vaccines hypothesis”?

    Of course we know the answer.
    Nothing would.
    You enjoy the adulation.
    You enjoy the money. (ha, the reverse pharma shill gambit!)
    You enjoy the attention.
    Mostly, you don’t really care about the truth. You’re being intellectually dishonest, and thats the most disappointing part of all.

  63. #63 Matthew Cline
    June 7, 2009

    Ah, from the original LA Times article:

    We began to worry about other serious infections. We called for an infectious disease consultation and ordered another round of tests: We stuck more needles into her tiny veins, and her doctor performed a spinal tap to make sure she didn’t have bacterial meningitis. [emphasis mine]

    From the Autism News Beat I thought that the LA Time article had merely mentioned that someone other than Dr. Rahul Parikh had done the lumbar puncture, not that it had been done by the baby’s personal physician.

  64. #64 Sami
    June 7, 2009

    For all the claims of a lack of evidence to prove a negative, I for one have yet to see any evidence that vaccines DO cause autism. Certainly no evidence that wouldn’t be equally convincing for “introducing solid foods and potty training” cause autism, since it all seems to be based on the age at which symptoms are recognised, which is the age at which an awful lot of changes are happening in the child’s development.

    If there were evidence for it, I honestly would be in favour of looking at why that connection exists, and what’s wrong with vaccines, but there is no evidence, and plenty of evidence showing a lack of causation – hell, a lack even of correlation.

    And in the meantime, children die. Frankly, Dr. Jay, your appeal to your authority as a paediatrician is unconvincing, given that, based on the comments you make, I wouldn’t trust you to treat my child for anything more serious than a scraped knee.

  65. #65 sophia8
    June 7, 2009

    Dr Gordon, since there is nothing that has been conclusively proven NOT to cause autism, can I take it that you don’t dispense any medicines or treatment of any kind to your child patients?

  66. #66 DLC
    June 7, 2009

    I’m still waiting for my invitation to be paid to post messages at blogs. Somehow I doubt it will ever happen.
    Meanwhile we have Dr Gordon (or someone appearing under his name) here saying they will never accept any study that dismisses a link between vaccines and autism. Charitably, I will assume you simply haven’t read the studies or looked at the authors. However, that still leaves the fact that no one has yet proposed a mechanism by which vaccines cause or contribute to the cause of autism. So how about it?
    Let’s see some hypotheses here.
    I won’t hold my breath.

  67. #67 Catherina
    June 7, 2009

    Actually, Bob Sears had an interesting post on his board a while ago about the notion that measles are no big deal:

    Minimization of the effects of measles by Wilbert Mason MD – posted on 4/3/2008

    As a pediatric infectious disease physician I feel I must comment on statements made in your March 27th commentary on the New York Times article. First, you infer that the cases in San Diego did not constitute an outbreak (“…if you can call it that…”). This is a highly contagious infection that spreads by small droplets that remain suspended in a closed room for over an hour. Indeed, 4 of the cases acquired the infection just by being in the pediatrician’s office at the same time as the first case. Three of these were infants and one of them had to be admitted to the hospital for dehydration.
    Elsewhere you have observed that “all of the cases of measles passed without complications, as is usually the case with measles”. Let me share with you our experience with measles at Childrens Hospital Los Angeles during the measles epidemic in 1990. We diagnosed 440 cases between January 1st and June 30th. Of these cases 195 (44%) had to be admitted for one or more complications of measles. We documented the complications in all 440 cases and they included 63% with ear infections, 45% with diarrhea, 39% with dehydration, 36% with pneumonia, 19% with croup, and about 3% with other bacterial infections. Three children died all of pneumonia. Measles is not a trivial infection as you inferred. We would not be having a debate about vaccines at all if people realized the tremendous costs in suffering and human life we incurred before vaccines became available. To adequately protect a population against measles >90% of the population must be effectively immunized against the disease. If individuals defer vaccines as you suggest we will rapidly fall below that level putting large numbers of infants and children at risk of an outbreak if measles is introduced into the community. This is a free country but we should all feel some responsibility to our fellow citizens and their children.

  68. #68 anonymous
    June 7, 2009

    …contemptuously dismissing those “who’ve never taken care of a patient” and don’t have his years of experience practicing pediatrics as having no standing to criticize him. (Quite frankly, the “How dare you? I’m a doctor” defense doesn’t wash around here.)

    I am glad to hear that you dislike “Argument from authority” and I don’t recall you pulling this yourself (one of the things that I very much appreciate about your writing). I would like others arguing for science based medicine (or just anti-woo) to stay away from it as well – no need to stoop to their level.

  69. #69 LW
    June 7, 2009

    One thing I’ve always wondered — and maybe Dr. Gordon can enlighten me — is how high does the Big Pharma conspiracy go? I mean, okay, every doctor in the U.S. (except Dr. Gordon and possibly Orac) is bought and paid for by Big Pharma, but what about doctors in, say Britain?

    Doctors in Britain work for the government and the government has a strong incentive to keep medical costs down. Why is the government allowing them to create additional burdens on society by intentionally causing autism? Why isn’t the government investigating the massive bribes that Big Pharma must be paying to those doctors? Why does the government of Britain rely on studies that any unbiased observer (like Dr. Gordon) can clearly see are fraudulent constructs created by Big Pharma? And not just the government of Britain, but also Canada, France, Germany …

    Is Big Pharma actually running the whole world? I’m afraid I went into the wrong industry (computer science), as I’d really like to be part of the most powerful institution ever developed by man.

  70. #70 Dr RJ
    June 7, 2009

    So let me get this straight. Dr Gordon wants us to believe that just because she has been in clinical practice for 25 years, this qualifies him not only to hold opinions that somehow are more valid than those who actively research autism and vaccine safety, and who actually understand epidemiology, just because he’s an MD?

    And then, in the next breath, he want us to accept that said experts are “pharma shills” because he “believes” this to be the case?

    As an physician/pathologist/research in practice for a similar period of time to Dr Gordon, I can tell you that seniority is absolutely no guarantee whatsoever that the person’s opinions are any more valid than the young up-and-coming doctor with a good training and a thorough understanding of current literature.

    The only two assets seniority reliably bestow on you is more familiarity with pattern recognition in individual cases in your specialty, and better understanding of the politics of medicine. To suggest otherwise is hubris at its worst; many doctors here will have had experience with colleagues such as this, who firmly stick to their outdated opinions/practices despite overwhelming evidence to the contrary.

    Additionally, if Dr Gordon showed up to a medical conference and tried his schtick on with his peers, he would be laughed off the stage, out of the venue, into the taxi, onto the plane and all the way home to California. He clearly preys on the weak, gullible and vulnerable layperson, and hauls them back to his evidence-free lair to tell them what they want to hear. He appears to have neither the brains nor the balls to take on a real scientist or clinician in debate.

    This is a actually pretty typical pattern amongst self-appointed “celebrity doctors” – they are happy to batting away the easy questions posed from the punters, and cannot stand having the opinions / beliefs challenged by those who actually know what they are talking about.

  71. #71 PalMD
    June 7, 2009

    What Dr. RJ said

  72. #72 pinky
    June 7, 2009

    “composed of obstreperous zealots who reek of blind manic pathos”.

    I love that sentance. I think I could use it for NCB folks too!

    Good post. Don’t let the man get you down Orac.

  73. #73 pinky
    June 7, 2009

    “composed of obstreperous zealots who reek of blind manic pathos”.

    I love that sentance. I think I could use it for NCB folks too!

    Good post. Don’t let the man get you down Orac.

  74. #74 daedalus2u
    June 7, 2009

    I think I know the reason why Dr Jay never heard about the measles epidemic in California that sickened 16,400 and killed 75 (yes 75 people died from their measles infection, not all of them children) that was cited above. From the abstract:

    ”The epidemic centered in low-income Hispanic communities in southern and central California. The major cause of the epidemic was low immunization levels among preschool-aged children and young adults.” [emphasis added]

    Where do Dr Jay’s patients come from? Not from low-income Hispanic communities. He draws his patients from the anti-vax crowd, mostly Hollywood celebrities who make enormous money pretending to be something they are not (aka acting). I think that is why they are drawn to Dr Jay, he makes a lot of money pretending to be a something he is not too, he is not an MD who reads all those papers and bases his recommendations on all that science and evidence and stuff. No, he bases his recommendations on what his clients want to hear, that and his “thimble full of knowledge.”

  75. #75 Dr. Jay Gordon, MD, FAAP
    June 7, 2009

    I resent being characterized as ab “obstreperous zealout who reek[s] of blind manic pathos”. I am well aware of my manic pathos, thank you very much.

    Dr. Jay Gordon, MD, FAAP

    ORAC NOTE: THIS IS NOT THE REAL DR. JAY. IT’S AN IDIOTIC AND NOT VERY AMUSING SPOOFER PRETENDING TO BE DR. JAY.

  76. #76 Lora
    June 7, 2009

    @ LW:

    Oh, but you can certainly work for Big Pharma! We are in desperate need of IT people to give me reason # 12,583,673 why I am allowed to purchase, install, and operate $2million worth of reactors to produce actual drugs that are going into people, yet I am not allowed to have a $500 laptop for a data logger.

  77. #77 LW
    June 7, 2009

    Lora, I was thinking they might need me for data-mining. How else can they keep tabs on every single doctor and researcher on the entire planet, to ensure that no one reputable sneaks out a report on the true cause and cure(s) for autism or stumbles upon the Cure for Cancer? I mean, given that Big Pharma very well knows that what these things are, but is keeping them under wraps.

  78. #78 Emp
    June 7, 2009

    Dr. Gordon,

    While I respect the fact that you are a doctor who truly believes you have seen evidence for an “autism epidemic” potentially caused by vaccines in your practice, you must recognize that this kind of observation is incredibly prone to bias. The human mind is great at spotting patterns – including those that seem to exist, but actually don’t. That’s why we need to employ the scientific method to address these types of questions.

    And we have. Millions of research dollars have been poured into this dead end, and every study with the exception of Wakefield’s research (methodologically flawed and now discredited due to undisclosed conflicts of interest) has shown no link between vaccines and autism. Many of these studies were not funded by drug companies. One need look no further than previous posts on this blog to find countless examples of this research.

    I won’t blame you for the outbreaks of measles and other vaccine-preventable diseases caused by this misguided movement, because I think you actually believe what you’re saying, but others might not be so kind. When you instill fear in parents – and you do – they will be hesitant to vaccinate, and that is a decision that has already taken too many lives.

    Oh, and please take note: I receive absolutely no funding from pharmaceutical companies. No one is paying me to write this – I wish they would. I am a poor biochemistry student and intern struggling to make enough money to buy cans of beans. If I could get one of those big pharma handouts right about now, I would appreciate it.

  79. #79 Orac
    June 7, 2009

    No, I believe that you do not receive money from the pharmaceutical industry. I’ve said that before and I’ll say it again.

    I sincerely believe that some of the people who post here and elsewhere do.

    Really? Who? What is the evidence? That’s a very serious accusation to be making, and it’s a damned irresponsible one to make without evidence, which is why I’m calling you out again and say: Put up or shut up, Dr. Jay!

    The docs who appear on television and write editorials and some who do drug research get money from the drug companies.

    No one is arguing that they don’t, but that is irrelevant to the charge you have made here, other than as an insinuation. Again, Dr. Jay, who here is paid by big pharma to comment on this blog, and how do you know? Or is it just because they don’t agree with you and tell you you’re spouting science-free antivaccine nonsense (which you are, by the way, no matter how much you paint yourself as “not antivaccine”) that you assume they can’t have come to their opinions by looking at the evidence themselves, that they must have been paid off?

    Gee, if that’s the case, what do you say about Age of Autism, which is sponsored by a compounding pharmacy that makes biomedical supplements for autistic children and a bunch of supplement companies?

    I received nothing for writing the forward to Jenny’s book and when I appeared with her in Washington D.C. I paid my own airfare and all other expenses. I don’t get paid for blogging. I think some of you here might.

    “Think” isn’t good enough for an accusation like that, Dr. Jay. Put up or shut up.

    Dr. Jay, I sometimes used to wonder if perhaps I was being too hard on you. I really did. After all, you come across as a nice guy most of the time who sincerely wants to help his patients but is, IMHO, very mistaken on vaccines and autism, and used to act like a whipped puppy when criticized. Occasionally, I even felt a little guilty. No more. I’m beginning to think perhaps I wasn’t hard enough. Under that nice guy facade, you are just as capable of flinging the ad hominem nastiness as any of the commenters you castigate. Disagree with Dr. Jay? Obviously you must be in the pay of drug companies? Criticize his assertions that vaccines cause autism? You’re obviously a nasty idiot who doesn’t have Dr. Jay’s decades of experience in pediatrics!

    Even though I’m not exactly religious, there is a scripture passage from Matthew 7:3-5 that I’m starting to think appropriate here:

    And why beholdest thou the mote that is in thy brother’s eye, but considerest not the beam that is in thine own eye? Or how wilt thou say to thy brother, Let me cast the mote out of thine eye; and lo, the beam is in thine own eye? Thou hypocrite, cast out first the beam out of thine own eye; and then shalt thou see clearly to cast out the mote out of thy brother’s eye.

    Making insinuations and charges without evidence that commenters here who disagree with you are in the pay of big pharma is about as nasty as it gets, although you wrap the hammer in the smooth, silky velvet of your nice guy personality.

  80. #80 daedalus2u
    June 7, 2009

    Orac, the passage two lines earlier than the corresponding passage in Luke is appropriate too

    ” Can the blind lead the blind? shall they not both fall into the ditch?”

    Dr Jay is demonstrating his “standards” are for believing something. No facts, data, logic or reasoning to back it up, just belief.

  81. #81 madder
    June 7, 2009

    Oh, come now. Dr. Jay is simply terrified that he’s wrong. After all, if he ever does admit error, then he’ll have to go back to being just another pediatrician*, instead of Pediatrician to the Stars!. Which means, of course, a reduction in income. So all of you meanies saying that he’s wrong are only doing that because you want him to be poor, and because you’re paid to do it. Oh, and you want kids to become autistic so that you can sell them all manner of (nonexistent) big-pharma treatments for the autism you caused. Or wait… maybe that was somebody else who profits from selling [phony] autism treatments. I’m sure the name will come to me eventually….

    *”Just another pediatrician” written with much intended irony, because my own kids’ pediatrician is simply awesome.

  82. #82 Doazic
    June 7, 2009

    @daedalus2u

    “Where do Dr Jay’s patients come from? Not from low-income Hispanic communities. ”

    There are plenty of low-income families that fall for the anti-vax nonsense, including minorities. Just do some Googling to see people mortgaging their homes for the latest quackery.

  83. #83 Orac
    June 7, 2009

    Correct. Plenty of low-income families doo fall for antivax nonsense, but these children are not Dr. Jay’s patients. He practices in Santa Monica and has a lot of Hollywood celebrities’ children as his patients.

  84. #84 D. C. Sessions
    June 7, 2009

    Dr Jay is demonstrating his “standards” are for believing something. No facts, data, logic or reasoning to back it up, just belief.

    d2u, you and Orac are quoting Matthew. It certainly looks like Jay is taking his lead from Tertullian: “Credo quia absurdum.”

  85. #85 Joseph
    June 7, 2009

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    And yet, when pediatricians are surveyed, the majority believe that the increase in the prevalence of autism is the result of broader ascertainment and services.

    Also, somehow, the prevalence of children in special education has been roughly stable since at least 1993. I’m sure pediatricians are seeing less children labeled with mental retardation and specific learning disability, and more children labeled with autism and developmental delay.

    I’ll make a prediction, and I’ve probably made it before. In 10 years, we will see that the number of developmentally disabled persons not living with relatives or independently has not increased. Certainly, the number of those labeled with autism will have increased, but when you look at developmentally disabled individuals as a whole, you’ll see the “autism epidemic” has had no impact.

    There are specific data trends that allow me to make that prediction.

  86. #86 Dangerous Bacon
    June 7, 2009

    Dr. Jay: And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.”

    This “I’m working to save children while you people are quibbling about science” argument would have greater force except for a couple of things, namely 1) the amount of time Dr. Jay spends jetting around to get attention as a celebrity pediatrician, hawking DVDs and trading barbs on message boards with “theoreticians”, and 2) omitting the fact that the vast majority of working pediatricians reject his inane views on vaccines, AIDS, medical conspiracies etc.

    Dr. Jay might also consider that his antivax efforts are increasing the chances that working pediatricians will have to deal with very real epidemics of preventable infectious diseases. I’m sure his colleagues love him for that.

    “None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.”

    Another drop further down the rabbit hole of altie craziness. The above statement could easily have come from “Health Ranger” Mike Adams or as a post on CureZone. Any research Dr. Jay doesn’t like is summarily dismissed as tainted, no evidence needed, same as the tripe about Orac’s sinister army of paid blog commenters. Meantime, where there _is_ actual evidence of sleaze masquerading as vaccine research (Andrew Wakefield’s anti-MMR paper bought by attorneys and touted without reference to his attempts to promote a competing, allegedly safer vaccine), we hear zilch from Dr. Jay.

    What could be next in Jay’s descent? An appearance at one of those “Health Freedom” conventions alongside Hulda Clark?

    Dangerous Bacon M.D., A.B.M.S., M.A., B.A., H.S., T.G.S.F.G.*

    *Two Gold Stars in the First Grade

  87. #87 TexDoc
    June 7, 2009

    I used to think that Dr. Jay was disingenuous, but after reading his comments here, I am now sure that he’s intellectually bankrupt. And a narcissist. There is no arguing with a narcissist, or confronting them with critical thinking or logic or data, because they make the facts. They are always right, because they say so. Period. End. This provides the perfect compliment for being an enabler of Juggs McAnti-vax, herself an intellectually bankrupt narcissist, and arming her with the weapons grade stupidity that spills out of her pie hole. This would be a mere annoyance, if it weren’t potentially threatening to innocent children. As a physician and father of an autistic daughter, Dr. Jay truly makes me want to puke.

  88. #88 Joseph
    June 7, 2009

    I sincerely believe that some of the people who post here and elsewhere do.

    I think that’s very paranoid. First, they must pay a lot, considering a lot of the regulars are “working” Sunday.

    Second, while I don’t think it would be impossible, I think it would be normally recognized as a mistake to use that approach. What is the likelihood that no one would ever find out? No whistle-blowers in 10 years? Conspirational activity like that would be a huge risk to any company.

  89. #89 LW
    June 7, 2009

    They’re keeping the causes and cures of both autism and cancer under wraps, and have been for decades without anyone finding out. Clearly a little thing like keeping people quiet about the money they get for blogging and commenting is nothing for them. (*holding hand out hoping for Big Pharma largess*)

  90. #90 sophia8
    June 7, 2009

    Sorry LW, but Big Pharma ain’t recruiting any shills this month. It’s the recession, ya know – everyone’s tightening their belts.

  91. #91 Lora
    June 7, 2009

    *hands LW a quarter*

    There ya go. Yer an honest-to-goodness Pharma Shill now!

    Jeez, the Big Pharma Conspiracy can’t even shut down all the “OMGZ Marty McKay is a douchebag lolz!” over at BioFind. I don’t doubt they would if they could, too.

  92. #92 Rogue Medic
    June 7, 2009

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    In the ranking of the authority of research, at the bottom is expert opinion. Since you claim to be an expert, but only capable of reciting anecdotal information, that refers to you.

    Your anecdotes are misleading. Most real pediatricians ignore your attempts to harm children.

    My concern for that huge problem is far greater than my concern about your theories about measles epidemics

    In other words, I, Dr. Gordon, will continue to pretend the problem is not a problem, until it is too big a problem to ignore.

    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.

    Maybe there will never be proof that vaccines do not in some slight way affect autistic patients. What is clear, is that the risk from vaccines is dramatically less than the risk of avoiding vaccines.

    That is a word Dr. Gordon should be familiar with.

    Dramatically.

    Look at me, Dr. Gordon. I, Dr. Gordon, make noise. I, Dr. Gordon, do not make sense, but I am dramatic.

    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    As long as you continue to demand that research be diverted from any real causes of autism, you are spreading this epidemic as well as your peers – Honest Jenny Killer McCarthy and the rest of Generation Revenue. You, and your peers, are probably the most dangerous people your patients will ever meet.

  93. #93 Dedj
    June 7, 2009

    Just a little snip : expert opinion is slightly higher on the hierachy of evidence than non-expert opinion, with both having sub-sets.

    This does not , of course, help Dr Gordon in anyway at all.

  94. #94 PalMD
    June 7, 2009

    anecdotal information

    Somehow I read that as “anorectal information”

  95. #95 Dr. K
    June 7, 2009

    I just happen to be one of those “working pediatricians” who deals a lot with autism (and takes no money from anyone for anything since I don’t matter at all) and I also happen to have just gotten back from the rehab hospital where one of my very real and formerly normal patients was taken down by strep pneumo meningitis (you know, one of those vaccine-preventable diseases). Dr. Gordon is either extremely naive or extremely hard-hearted to be able to ignore the impact of low immunization levels and the morbidity of the diseases which these vaccines were designed to prevent. I’d like to see him look into the eyes of this family whose child is now completely deaf and is reduced to an infantile state with no guarantee of recovery and tell them that it’s ok that their child became ill because the possibility of their child getting this illness was just theoretical after all and didn’t matter as much as the fact that Dr. Gordon doesn’t understand the scientific method. I used to respect Dr. Gordon for his breast feeding advocacy but I no longer have any respect for him. It will never be possible to prove that vaccines don’t cause autism. It just makes me very sad to think of the children who will end up like my patient-or worse-because someone didn’t understand that what really matters is the overwhelming LACK of evidence that vaccines do cause autism.

  96. #96 Matthew Cline
    June 7, 2009

    Is Big Pharma actually running the whole world?

    The lunatic fringe of the right-wing section of anti-vaxxers claims that whoever is secretly running the whole world (Illuminati, New World Order, etc) is also running Big Pharma, and is using Big Pharma’s vaccines to secretly inject us with [mind-control drugs/anti-fertility drugs/etc].

  97. #97 Daniel J. Andrews
    June 7, 2009

    ” anecdotal information

    Somehow I read that as “anorectal information”"
    —————

    Maybe you’ve had a hard day at the orifice, PalMD? :-)

    Sorry, couldn’t resist the old joke. sighhhhhh.

  98. #98 Benjamin Geiger
    June 7, 2009

    o/`
    We praise the colorectal surgeon
    Misunderstood and much maligned
    Slaving away in the heart of darkness
    Working where the sun don’t shine…
    o/`

  99. #99 SC
    June 7, 2009

    My assumption about you is that you are sincere and honest, but simply wrong about the science when it comes to vaccines.

    He’s provided a good deal of evidence, here and elsewhere, contrary to the first part of that assumption.

    Intellectually dishonest; sin vergüenza.

  100. #100 Orac
    June 8, 2009

    He’s provided a good deal of evidence, here and elsewhere, contrary to the first part of that assumption.

    Nice try. No, he hasn’t.

    Or perhaps you can point me to where Dr. Jay has shown “a good deal of evidence” other than his anecdotes and “personal clinical experience.”

  101. #101 SC
    June 8, 2009

    Nice try. No, he hasn’t.

    Or perhaps you can point me to where Dr. Jay has shown “a good deal of evidence” other than his anecdotes and “personal clinical experience.”

    Um, what the hell? How long have I been commenting here? “The first part of that assumption” referred to his supposedly being “sincere and honest.” Sheesh, Orac.

  102. #102 SC
    June 8, 2009

    Er, yeah, I guess that may not have read so clearly.

    Apologies.

  103. #103 Chris
    June 8, 2009

    I am really not sure who is quoting who. It helps to take note of that when commenting, because I have just lost track of what is going on.

    Intention is not intuitively obvious in print.

  104. #104 DLC
    June 8, 2009

    It appears to me as if SC quoted someone earlier saying that they believed Dr Gordon to be basically honest but incorrect.
    This statement SC refuted by saying Dr Jay had provided evidence here and elsewhere that he is not in fact honest.
    This Orac misinterpreted as saying that Dr Jay had provided evidence to back up his ideas regarding vaccines.
    This was not the case, but I can see how it could have been misconstrued. I had to read it twice, myself.

  105. #105 Jay Gordon, MD, FAAP
    June 8, 2009

    Posted by: Matthew Cline |
    The docs who appear on television and write editorials … get money from the drug companies.

    Actually, I used to appear regularly on network TV, was offered lots of money and incentives and that occurs to this very day.

    I’m not sure which children need the HIB vaccine. Medical indications and parental participation can make that decision.

    Posted by: Tsu Dho Nimh
    Jay … you have never seen a measles epidemic. Until you have, don’t dismiss it as being a trivial problem. Talk to Dr. Paul Offit, who was a working pediatrician in the middle of a small measles outbreak, and ask him how it feels to see kids die who should never have been sick.

    Of course I have. I began my training nearly forty years ago and saw plently of measles. Dr Offit’s measles outbreak bearly merits the name.

    Posted by: Scientizzle
    No proof on either side. No disproof on either side either according to most medical experts.

    Let’s write those grants, Scientizzle! I’ll work with you and live with the results even if they fall far afield from my thoughts going in.

    Posted by: PsyberDave
    I just looked at your site and I notice you have a DVD for sale. Don’t you see irony (or hypocrisy) in accusing others of being shills, when you are shilling yourself?

    Being really honest with yourself, what part of your appearances on TV is self-promotional? Is it just that you want to share information with the world, or is there some desire to make yourself known? Maybe you want to build your practice and or sell your DVD? Have you attached yourself to Jenny McCarthy in any way to increase your profile?

    I don’t know the answers to these questions. They are genuine.

    You may be unaware of the rewards you get for taking your stances on vaccines as you do. It may very well be that you are rewarded for your stances despite your protestations of others “shilling” for a different stance.

    The DVD loses money. Best case scenario, I will earn $2.45/hour for the time I spent making it.

    My medical practice stays very full because of the nature of the practice: one hour well child visits with an emphasis on growth and development, nutrition, safety, emotional development and more. A part of each visit is always spent discussing not just vaccines but many aspects of new medical news.

    I’m not sure that attaching myself to Jenny McCarthy is the best way to get my message out. I respect what she’s done and is doing. She has helped increase my visibility, but I was doing OK before and I’m not really sure how prominent I want to be in the world of medical media.

    Measured by a per visit fee, I get paid well. Measured against the hourly work some of my colleagues do, I am not the best paid pediatrician by far. I’m OK and get great satisfaction from the way I practice medicine. Like all of you out there, I feel privileged to deliver a significant amount of my medical care at reduced fees or pro bono.

    I’m truly sorry I you misunderstood me to be accusing Orac of be a shill for big Pharma. He says he’s not and I believe him. End of that.

    Posted by: PalMD

    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    Have you no sense of decency, sir? At long last, have you left no sense of decency?

    I love the McCarthy allusion (illusion, too) Not very logical but mildly clever because it shows you know there were times when mobs and dogmatic leaders attacked people who did no wrong. Well done! Own goal!!!

    I think Zar has topped you succinct unpleasantness though:

    Dr. Jay Gordon, FAP, is a disease-spreading prostitute.

    There. Now you have a real reason to whine and pout, you money-grubbing plague rat.

    Posted by: Stop Jenny
    Jenny! It is my job to discuss ice cream, cheese and autism. Are you implying a link between hot fudge and autism? I think people would continue to eat the sundaes. I’d have a new campaign. This old one is getting tedious because the hundreds of you haven’t put together a novel idea for months and many longer.

    Posted by: Chris | June 6, 2009 11:49 PM
    Chris! I was there.
    There were 75 fatalities related to measles. Certain ethnic groups got hit worse than others. It was a relatively small outbreak with tragic consequences for some families. May it never occur again. The way to prevent it is not to lie and bully parents into getting all the shots all at once with this cluster including vaccines they don’t need in combinations never proven safe.

    HCN, thank you! I will get tickets to that play immediately.

    The child discussed in the newspaper article was said to have pertussis. She did not. I had the parents permission to discuss aspects of this case as were need to refute the lie that she had whooping cough when proper bloodwork later showed she did not.

    Posted by: ababa | June 7, 2009 1:49 AM
    And exactly how are you slaving away “dealing” with this as a pediatrician? You getting writer’s cramp handing out prescriptions for chelation drugs and rigged heavy metal tests? You are Jenny’s best buddy, she has this autism thing licked – hooray it can be cured (and she will sell you a book to explain it)! You also know exactly what causes it, so simply tell parents to avoid vaccines and their kids will be autism free!

    No, ababa, I just practice general pediatrics every single day of the week. I have become a “second opinion” resource for many families unhappy with their pediatrician but I claim no great expertise about chelation. My books are, by accident, non-profit endeavors. I don’t sell supplements.

    Posted by: Whitecoat Tales | June 7, 2009 1:52 AM

    You are undoubtedly being taught by some learned docs and professors. Gather their information, evalute it objectively and draw your only conclusions. I have never claimed to have the best or the only answers. I jave the answers and questions which I like best and choose to disseminate to my patients and a wider audience when I can.

    Posted by: DLC | June 7, 2009 5:30 AM
    Meanwhile we have Dr Gordon (or someone appearing under his name) here saying they will never accept any study that dismisses a link between vaccines and autism.

    A lie. I will accept a prospective study showing the above.

    Posted by: Catherina | June 7, 2009 6:24 AM
    Let me share with you our experience with measles at Childrens Hospital Los Angeles during the measles epidemic in 1990. We diagnosed 440 cases between January 1st and June 30th. Of these cases 195 (44%) had to be admitted for one or more complications of measles. We documented the complications in all 440 cases and they included 63% with ear infections, 45% with diarrhea, 39% with dehydration, 36% with pneumonia, 19% with croup, and about 3% with other bacterial infections. Three children died all of pneumonia. Measles is not a trivial infection as you inferred

    Catherine, again, I was there! I trained at CHLA. I practice with Larry’s wife Linda. Measles is far from trivial but it’s also a lot farther from the major terrifying boogeyman people are making it out to be. (Tell Larry I said hi please.)

    Tired here. Too tired to look for even the most egregious typos. Good night, all!

    Have a lovely week.

    Best,

    Jay

  106. #106 Jutin
    June 8, 2009

    Dr. Jay,

    I have no credentials that matter in this debate (BA in film and video production, fucking worthless in the real world.) I have been lurking around debates like this for a while now, what can I say, this is more fun then reading Perez Hilton IMO. I read your stuff at AoA and other places, and I read Orac and other science blogs. I see a bunch of people linking to reports that contain science, and data. And I see you linking to… CRAP.

    I think in movie terms, you are Tim Roth in Pulp Fiction, and Orac is Samuel L. Jackson. You are a whiny little bitch, in a room full of people who know how full of shit you are. You are a pathetic starfucker, even with my limited experience in the “biz” you reek of it, like a hippy wearing patchouli. You are as credible as Pamela DesBarres (google it) in this debate, and it’s really obvious.

    Please, put up or STFU, because that BJ you got from Jenny is not worth other children’s lives.

    You are a douchebag.

    I apologize to the rest of Science Blogs if my post goes through. But Dr. Jay is just starting to piss me off. Orac is right, fuck his nice guy persona, Dr. jay needs to be bitch slapped at every available opportunity.

  107. #107 Matthew Cline
    June 8, 2009

    Gordon:

    Actually, I used to appear regularly on network TV, was offered lots of money and incentives and that occurs to this very day.

    Just because medical companies try to get doctors to shill for them doesn’t mean that the majority (or even a large minority) of the pro-vax doctors who appear on TV are shills. Is your position that the evidence of the harm of vaccines so overwhelming that (with rare exceptions like Orac) the only reason a doctor would be pro-vax is because they’re a shill?

    I’m not sure which children need the HIB vaccine. Medical indications…

    “Judicious”, to me, would mean vaccinating only when necessary. I am not a doctor, but as far as I know the only medical indications in relation to the HiB vaccine are when not to use it, and always giving the HiB vaccine except when the indications say not to isn’t what I’d call “judicious”. Is that what you mean by “judicious” (in which case aren’t most doctors judicious with the HiB vaccine)? Or do you mean that plus not giving it if the parents don’t want it (in which case doctors are injudicious when they try to change the minds of reluctant parents)? Or are there medical indications for giving the vaccine, in addition to medical indications for not giving the vaccine? If the latter, your call for the “judicious” use of the vaccine would seem to imply that most (or many) other doctors don’t use the positive indications (for giving the vaccine), but only the negative indications (for not giving the vaccine). Are these positive indications standard medical knowledge, but ignored by the other doctors? Or are the positive indications ones you’ve derived from your clinical experience? If they’re derived from your clinical experience, what are they?

  108. #108 Ben G-L
    June 8, 2009

    I am a logic professor at a small city college. One of the reasons I enjoy this blog so much is that it gives me an opportunity to look at, and present as examples in class, the often hilariously bad reasoning that marketers of woo employ without having to go to their actual websites; I can’t stomach prolonged high concentrations of pure woo.

    In any case, I have often considered writing comments on the more egregious and common fallacies committed by various quacks and nut-os. The entire industry seems to be built on a foundation made up of equal parts argumentum ad antiquarium, ad populum, ad ignorantium, ad vericumdium, hasty generalization, equivication, suppressed evidence, weak analogy, simple red herrings and a healthy dose of greed, sleaze, and stupidity.

    Dr. Jay is employing classic form of divisive, deceitful, and fallacious argument, the Ad Hominem(Circumstantial). The circumstantial variety of the Ad Hominem is a fallacy of relevance, which means it persuades by distracting from the argument being made by presenting information which is irrelevant but creates the impression of being pertinent due to a tangential relation between the information presented, usually something highly charged politically or emotionally, and the topic (but not the content) of the argument. In particular the Ad Hominem circumstantial proceeds by calling the motives of the person making the argument into question.

    The reason Dr. Jay’s insistence that Orac works for the pharmaceutical industry is fallacious is not because Orac doesn’t in fact work for them, rather it is fallacious because it wouldn’t matter if he did.

    Arguments and reasoning are good if the inference made from the information we started with relates to the conclusion arrived at in such a way that if the information we started with is in fact true than the conclusion must also be true. Thus, for example, the following argument is good:
    All ducks are computers
    All compuers have hearts of gold
    Therefor, all computers have hearts of gold
    while the following argument is bad:
    All ducks can fly
    All ducks live in the water
    Therefor, all ducks are water fowl

    The first argument is good because the conclusion follows from the premises, the premises and conclusion just happen to be false but all that means is that the argument is not very useful. The second argument is bad even though the premises and conclusion are all true because it is perfectly possible to fly and to live in the water without being water fowl. That is, the conclusion does not follow from the premises. There is no other standard for argumentation.

    If Dr. Jay were correct that Orac’s financial backing effected the validity of his arguments we would live in a strange world indeed. Let’s look at another example:
    Argument #1 Argument #2
    Jan is taller than Mike Jan is taller than Mike
    Mike is taller than Mindy Mike is taller than Mindy
    Thus, Jan is taller than Mindy Thus, Jan is taller than Mindy

    If Dr. Jay were correct, and one’s motivations are pertinent in evaluating arguments, it would be quite possible for argument #1 to be good and argument #2 bad! Let’s say I made argument #1 because I want all the good little girls and boys to know the truth about Jan and Mindy while some other guy made argument #2 because Watson Pharmaceuticals paid him to go online and discredit Dr. Jay. Would argument #1 be better than #2? Obviously not!

    The fact of the matter is that people always make arguments for the same reason, because they want someone to agree with some conclusion. It makes exactly no difference to the quality of argument why the other guy (or gal) wants you to believe the conclusion. Indeed, people who make these kinds of deceitful arguments usually do so because they know they can’t hold their own on the actual issues.

    This does not mean that one should not be on the look out for bias, or that one couldn’t be biased by a bribe. It means that a bribe is a reason someone might be biased, and a reason for a reader to be on the lookout. But a reason one might have a bias and a bias are entirely different things. Moreover, and this is the take home, biased arguments are often bad arguments because the conclusion doesn’t really follow from the premises, they are not bad because they are biased. That is, clear bias is a reason to be vigilant but it is not a reason to dismiss an argument. If an argument is good it is good no matter why it was made.

    And that’s what’s so great about science!! We don’t have to decide whether or not so-and-so is trustworthy. We never have to take anyone at their word. Unlike pseudo-science and other forms of woo, we can check ourselves and we are rarely biased in favor of believing crap.

    -Ben G-L

    P.S. Assuming I have not wildly underestimated the masochism of this blog’s readership and there is not an outcry for more rants about relatively straight-forward logical fallacies I shall refrain from putting you all through any more introductory logic lectures. Promise.

  109. #109 Shirakawasuna
    June 8, 2009

    Dr. Jay wrote: “My concern for that huge problem is far greater than my concern about your theories about measles epidemics
    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.
    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.”

    An extremely telling exposition…

    You still seem to think that your anecdotal experience trumps scientific study. Now you’re saying that those who require scientific study for antivaccine claims and pointing to ones which already exist and contradict the claims of antivaccinationists are merely pharma shills (you provide no evidence for this)? You seem to have messed up the burden of proof, which is *not* hard for a medically-trained doctor to do: you do not claim that the cause of a disorder is a treatment unless you have good, controlled evidence for that to be the case. Do you have it, Dr. Jay? Of course not: it’s why you’re trying to shift the burden of proof and say that until the scientific community disproves your unsupported, illogical notions, you’ll remain fearful. And, as mentioned before, that has *already happened* and all you can do is rationalize.

    If acknowledging the fallibility of anecdote and making a reasoned reading of the literature is ‘theorizing’, I prefer it every day over the dangerous rantings of a doctor who doesn’t understand the very first principle of scientific medicine.

  110. #110 Matthew Cline
    June 8, 2009

    The reason Dr. Jay’s insistence that Orac works for the pharmaceutical industry is fallacious is not because Orac doesn’t in fact work for them, rather it is fallacious because it wouldn’t matter if he did.

    Dr. Gordon wasn’t accusing Orac of being a shill, but your argument does apply to the pro-vax doctors on TV who he accused of shilling.

  111. #111 Matthew Cline
    June 8, 2009

    Or do you mean that plus not giving it if the parents don’t want it (in which case doctors are injudicious when they try to change the minds of reluctant parents)?

    Following up on that: perhaps you hold that that parents’ experience with their child will let them predict whether or not their baby’s immune system will be able to fight off a HiB infection without having had a vaccination? If so, I can’t see how the parents could know with their first baby, as presumably their first baby would be their learning experience which would inform their decision for the second baby. Even with their second baby, learning something from the first baby would require that the first baby to have been exposed to the HiB virus and for the parents to know about it. Unless parents can just intuitively know these sorts of things about their babies, in which case wouldn’t (for example) the parents of children who are allergic to peanuts have intuitively known to not give peanuts to their child?

  112. #112 LW
    June 8, 2009

    Dr. Gordon wasn’t accusing Orac of being a shill, but your argument does apply to the pro-vax doctors on TV who he accused of shilling.

    At least twice (that I recall) the conversation on this site has gone like this:

    Orac: Vaccination is important.
    Gordon: Pro-vax bloggers are pharma shills.
    Orac: I am not a pharma shill.
    Gordon: Of course I don’t mean you; pro-vax bloggers except you are pharma shills.

    Anyone happening upon the site and reading the first half of this exchange would assuredly say that Dr. Gordon called Orac a pharma shill, and I think he is disingenuous when he says piously that he wasn’t referring to Orac.

  113. #113 LW
    June 8, 2009

    *hands LW a quarter*

    There ya go. Yer an honest-to-goodness Pharma Shill now!

    Thank you, Lora. I’m saving up for my black silken cowl.

  114. #114 Ranson
    June 8, 2009

    Really? Who? What is the evidence? That’s a very serious accusation to be making, and it’s a damned irresponsible one to make without evidence, which is why I’m calling you out again and say: Put up or shut up, Dr. Jay!

    C’mon, Orac; we’ve know for years that daedalus is in the pocket of “Big NO”.

  115. #115 Grendel
    June 8, 2009

    I hardly consider myself qualified to enter into this debate except that I am a parent of a child with autism – and has Jenny has apparently already demonstrated this qualifies me as an expert on all things autism.

    Actually I don’t think I’ll elevate myself to that status.

    However, I do have the kind of mind that leads me to ask questions. When our son was diagnosed I wanted to know what was autism and how come he has it.

    Most parents seem to go through this phase – I probably took it a little further than most and have had an entire career change as a result.

    I have real trouble finding a paediatrician who will agree with Dr Jay, so much trouble that I haven’t found one yet. His views are considered to be so far outside that mainstream that were he a paediatrician in this country it is possible he wouldn’t be allowed to practice.

    My son showed signed of autism from an early age – well before vaccines came into the picture. I have followed the research from Wakefield onwards with considerable interest but I see nothing in the great body of research that follows Wakefield that supports his position, and more importantly replicates his findings.

    I think that point is crucial – the science must be repeatable. Wakefield’s is only repeatable if you fiddle the figures.

    Making this point does not make Orac a ‘shill’ for pharmaceutical companies, it just makes him just a good scientist.

  116. #116 Clay
    June 8, 2009

    Meanwhile we have Dr Gordon (or someone appearing under his name) here saying they will never accept any study that dismisses a link between vaccines and autism.

    A lie. I will accept a prospective study showing the above.

    Not a lie. A prospective study would be unethical to do, so you indeed say you will never accept any study that would be done.

  117. #117 D. C. Sessions
    June 8, 2009

    The fact of the matter is that people always make arguments for the same reason, because they want someone to agree with some conclusion.

    Refuted by your own post, Sir! I will point out that some arguments are advanced for pedagogical purposes (I’m sure you never imagined that could happen, eh?) and sometimes they are advanced in a dispassionate “let’s see where this leads, I’ll take position B” mode. Moot court comes to mind.

    P.S. Assuming I have not wildly underestimated the masochism of this blog’s readership and there is not an outcry for more rants about relatively straight-forward logical fallacies I shall refrain from putting you all through any more introductory logic lectures. Promise.

    Meanie. Then again, I always like rhetoric.

  118. #118 Deen
    June 8, 2009

    And that’s what’s so great about science!! We don’t have to decide whether or not so-and-so is trustworthy. We never have to take anyone at their word. Unlike pseudo-science and other forms of woo, we can check ourselves and we are rarely biased in favor of believing crap.

    In principle you are correct. In practice, however, we don’t have the time and knowledge to check every claim ourselves. In the end, we often do have to take someone’s word for it, or use some other form of heuristics to decide what’s plausible. Looking at the motive people have for making certain claims can be part of these heuristics, although it will very rarely be the deciding factor. Of course, you still need to have some evidence for these motives, and arguments for why they might invalidate a claim.

    However, it rarely is a good strategy for the people involved in the debate themselves to point at their opponent’s motives, as it still is a logical fallacy when used in an argument. It can also backfire in many ways, for instance by activating another heuristic in the bystanders: the first one to accuse their opponent of bad motives is likely out of real arguments and is possibly even projecting.

  119. #119 D. C. Sessions
    June 8, 2009

    Funny thing, isn’t it, that Jay has time for a shotgun counterattack on side issues, but still can’t find time to answer a serious question about how he routinely practices medicine. One might imagine that that would be something ready to hand without great research.

    For instance, the “when risks are low” control algorithm he uses for deciding whether vaccines should be used — when does he decide that the rate of a disease is too high and needs to be lowered, or too low and needs to be raised?

    Or how about the “HiB when indicated?” I’m very interested in knowing what the indications are for vaccination against HiB. It would appear that Dr. Gordon has unpublished research which allows him to pick, in infancy, those children susceptible to invasive HiB disease. Trade secret, maybe.

    Inquiring minds want to know, but Dr. Gordon is playing cute.

  120. #120 Tsu Dho Nimh
    June 8, 2009

    Someone said: Meanwhile we have Dr Gordon (or someone appearing under his name) here saying they will never accept any study that dismisses a link between vaccines and autism.

    He responded: A lie. I will accept a prospective study showing the above.

    Fine … make up a plan for this prospective study, which will require deliberately giving placebo vaccines to a large number of children. You would need about 10,000+ in each branch to spot 1 in 150 incidence with reliability. That means your study will require leaving a large number of children 100% vulnerable to a number of serious diseases for at least the first 5 years of their lives in order to give you the study you say is needed to convince you. Some of them will die from these diseases during those 5 years.

    Run your plan past the IRB at a large medical institution and see what they say.

  121. #121 SC
    June 8, 2009

    It appears to me as if SC quoted someone earlier saying that they believed Dr Gordon to be basically honest but incorrect.
    This statement SC refuted by saying Dr Jay had provided evidence here and elsewhere that he is not in fact honest.
    This Orac misinterpreted as saying that Dr Jay had provided evidence to back up his ideas regarding vaccines.

    Yes, precisely. (I was quoting Orac from the original post, which was admittedly odd since he had updated later in the thread, but I was frankly surprised to read the bit about the assumption of honesty in the OP.)

    This was not the case, but I can see how it could have been misconstrued. I had to read it twice, myself.

    Yes, it was unclear. Apologies again. Dr. Jay gets me riled, and I was falling asleep – a recipe for a garbled post.

  122. #122 Jay Gordon, MD, FAAP
    June 8, 2009

    Good Morning–

    This post is from the real “me.” Someone has presented a variation on my signature and has begun posting here. (He, or they, have placed “Dr” in front of my name. I’m not sure that this hasn’t been done before by making slight alterations in letters and punctuation marks.) This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science. I believe that Orac should have caught him, by the way.

    I’ll stop.

    Best,

    Jay

  123. #123 Pablo
    June 8, 2009

    I have real trouble finding a paediatrician who will agree with Dr Jay, so much trouble that I haven’t found one yet. His views are considered to be so far outside that mainstream that were he a paediatrician in this country it is possible he wouldn’t be allowed to practice.

    It is for this reason that I have been boggling at Gordon’s attacks on “TV appearances” by vaccine advocates. 99.99% of pediatricians are full vaccine advocates, and 99.99% of those have never written a book, been on tv, or even have a personal webste. So clearly these types of promotions have nothing to do with their vaccination positions. Moreover, even guys like Offit only wrote their book in response to the anti-vaxxers propoganda.

    Meanwhile, because anti-vax pediatricians are so rare, the few that are around show up everywhere.

    You don’t get on TV for adopting the conventional line. You have to be the maverick. Take an unorthodox (i.e. newsworthy) position. Find yourself a celebrity client to help promote it. And then accuse the others of being publicity hounds.

  124. #124 Orac
    June 8, 2009

    ood Morning– This post is from the real “me.” Someone has presented a variation on my signature and has begun posting here. (He, or they, have placed “Dr” in front of my name. I’m not sure that this hasn’t been done before by making slight alterations in letters and punctuation marks.) This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science. I believe that Orac should have caught him, by the way.

    Please show me which comment it is (or comments they are), and I’ll delete it/them. I just tried searching and couldn’t find it. When I get dozens of comments a day, particularly over the weekend, which included my wedding anniversary and lots of work for, well, work, plus a talk I had to prepare, then it’s easy for me to miss stuff like that.

  125. #125 Tom
    June 8, 2009

    @ Clay post 116

    Not a lie. A prospective study would be unethical to do, so you indeed say you will never accept any study that would be done.

    You could do a cohort study, enrolling children whose parent choose to vaccinate and children whose parents do not let their children be vaccinated. Given that there is no potential for selection bias in the reporting of the vaccination, you could also choose to do a retrospective cohort study based on GP or hospital records. Such studies have been done for MMR and found no link between MMR and autism.

    I am not familiar with the writings of Jay Gordon, but given that such studies have been done for the MMR vaccine and have shown no association between the MMR vaccine and autism, does he reject this link?

  126. #126 Tom
    June 8, 2009

    That would be post 75 on this thread?

  127. #127 bob
    June 8, 2009

    Not only has Jay Gordon not offered anything resembling a cogent argument, he also just gave himself a clever get-out-of-ludicrous-statements-free card by whining that someone is posting as him. He even found a way to make this Orac’s fault!

    Jay, you say you *believe* in big-pharma conspiracies? Well, I believe in the conspiracy that you paid someone to go to a public library and post as you. Now, you’re not tied to anything you say here. PROVE ME WRONG! YOU CAN’T, SO I’M RIGHT!

  128. #128 Dangerous Bacon
    June 8, 2009

    “Jay Gordon M.D.”: “This post is from the real “me.” Someone has presented a variation on my signature and has begun posting here. (He, or they, have placed “Dr” in front of my name.”

    I couldn’t find anything from this alleged “variation” poster either. Then again, how do we know that the person posting as Jay Gordon M.D. FAAP is really Jenny McCarthy’s stooge M.D. and not some Big Pharma invention dreamed up to make antivaxers look stupid? If this is the case, their evil plot is succeeding beyond their wildest dreams.

    Maybe it’s mere coincidence then that Dr. Jay’s website has finally deleted the goofball entry on HIV etiology and alt treatment. But who knows, maybe the entire website is the invention of someone trying to make the real Dr. Jay look bad? Perhaps the real Dr. Jay is so busy healing the sick that he hasn’t had the opportunity to refute the pathologic mini-Jays pervading the Internet in his name. It could be that he really is someone who accepts good science and sound principles of medicine, and is having his good works demeaned by imposters.

    It’s so confusing.

    Will the real Dr. Jay stand up and show himself as a man of integrity, as opposed to an addled altie, confused conspiracy-monger and hypocritical flinger of ad hominems??

    D.B., M.D., SABF*, former member of NAFEX**, OMG

    *Secrut Agent of Big Pharma
    **North American Fruit Explorers

  129. #129 Tsu Dho Nimh
    June 8, 2009

    @122 Jay says: it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

    Does that mean you will stop posting on Age of Autism?

    And please do explain your indications for vaccinating against HiB. How do you decide which of your patients need it?

  130. #130 Do'C
    June 8, 2009

    Dr. Gordon writes:

    I received nothing for writing the forward to Jenny’s book and when I appeared with her in Washington D.C. I paid my own airfare and all other expenses. I don’t get paid for blogging. I think some of you here might.

    That foreword was a joke.

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    Please, Dr. Gordon.

    You’ve already failed miserably at supporting your beliefs autism epidemiology.

    What Can Dr. Jay Gordon, Pediatrician, Tell Us About Autism Epidemiology?

  131. #131 TheBlackCat
    June 8, 2009

    I can’t help but notice that in his entire long reply, although he found the time to reply to a bunch of random questions and points from various people, Dr. Gordon has conveniently ignored the two questions that have been been consistently asked of him throughout the discussion and the only two questions that are actually relevant to the topic of this post: which commenters here are “pharmacy shills”, and what evidence do you have to back up this claim? To echo the point made repeatedly throughout this thread, “Put up or shut up”.

  132. #132 TheBlackCat
    June 8, 2009

    I can’t help but notice that in his entire long reply, although he found the time to reply to a bunch of random questions and points from various people, Dr. Gordon has conveniently ignored the two questions that have been been consistently asked of him throughout the discussion and the only two questions that are actually relevant to the topic of this post: which commenters here are “pharmacy shills”, and what evidence do you have to back up this claim? To echo the point made repeatedly throughout this thread, “Put up or shut up”.

  133. #133 Agoraphobic Kleptomaniac
    June 8, 2009

    yeah, comment #75 this thread, I saw this comment and thought it to be so out of character of Gordon that I ignored it.

    This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

    So someone makes a light-hearted joke about your “manic Pathos”, and you take your anti-vax ball and go home? “Dangerous” seems a bit over the top of something to label an entire group as, for such a minor grievance.

  134. #134 Pablo
    June 8, 2009

    Wasn’t Jay Gordon the one who said something about people not being able to take a joke? In some thread, he posted that.

  135. #135 Dedj
    June 8, 2009

    Re:

    “Dr Jay Gordon” vs. “Jay Gordon, MD”.

    It really does say something – and not something posistive either – that someone can parody “the real thing” and in doing so actually get mistaken for “the real thing”.

    I’m sure I’m not the only one who did not see anything that the “Dr Jay Gordon” doppelblogger posted that was inconsistant with the expected quality and mentality of the posts we have come to expect of the “Jay Gordon MD” persona.

  136. #136 bob
    June 8, 2009

    People have wondered about a alt-med version of Poe’s Law. Based on this situation, I think it’s clear that it ought to be called Gordon’s Law.

  137. #137 rrt
    June 8, 2009

    I do believe SB has tools that let blog owners identify a commenter reasonably well, false name or not.

  138. #138 attack_laurel
    June 8, 2009

    I’ve been a faithful reader since I found this blog, and now I do feel compelled to admit that I did get the most awesome mechanically expanding pen from a pharma rep once – it was left with some other stuff at work, and I snaffled it as soon as I realized what it was.

    I now realize that this makes me a shill*. But it is an awesome pen, and I still have it (you press a button, and it unfolds; it is poetry to watch).

    *I ams drippings vid sarcasm.

  139. #139 Marita
    June 8, 2009

    This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds..

    “Venom”? Doesn’t he mean “toxins”?

  140. #140 anonymous
    June 8, 2009

    The fake post Dr. Jay is referring to is #75, clearly.

  141. #141 pueblo pueblo
    June 8, 2009

    It’s definitely #75 that is the fake, because it’s the only one that doesn’t have the same properties as the others from Dr. J. Of course, all the Dr. Jay posts could be fakes … unless it’s another Dr. J … maybe it’s really Julius Erving, the original Dr. J … Nah, he wouldn’t make such stupid and dishonest posts unless he’s part of the Big Pharma plot to discredit the quack doctor too! Now my brain is really hurting trying to get through all the cunning subterfuges and dastardly ways that Big Pharma and its shills are working for/with Orac.

    Wait a second, there’s another possibility I haven’t explored. Maybe someone at AofA is working with the Australasian section of Elsevier to make Orac look bad when they expose him for being duped by Dr. Jay impostors on his site.

  142. #142 Joseph
    June 8, 2009

    This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

    It’s not good that someone impersonated you. Impersonations are like spam or threats of violence – they should get deleted.

    That said, your ad-hominem attack is groundless, Dr. Jay.

  143. #143 D. C. Sessions
    June 8, 2009

    This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

    And yet, there you are on AoA anyway.

  144. #144 Eric
    June 8, 2009

    Well, Dr. Jay inspired me specifically to start posting on my blog again (link in my name). I await my Pharma check.

  145. #145 Eric
    June 8, 2009

    The real question is *why* someone would bother impersonating Dr. Jay – it’s not as if he’s not digging the hole fast enough all by himself.

  146. #146 Tacroy
    June 8, 2009

    Two things:

    … it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

    Oh man, Dr. Jay! Now I can totally understand why you are convinced that vaccines cause autism! It’s patently obvious that the misbehavior of one person who disagrees with you clearly implies that everyone disagrees with you is a dangerous and venomous creature! Clearly, this is why you are such an inciteful[sic] person.

    And here’s a timeline of the events:

    1. Some idiot posts a two line, somewhat offensive comment in which he pretends to be Dr. Jay at post #75. This comment has no impact on the discussion at hand. (Honestly, I didn’t even notice it the first time around – I thought it was Dr. Jay admitting to being passionate about treating autistic children or something of the sort)
    2. About 19 hours later, Dr. Jay submits post #105, which means that by then he has at least skimmed all current posts up to and including post 64, which is the last post 105 responds to.
    3. People begin noticing the ridiculous “I will believe vaccines do not cause autism once a study is done that will never pass review by any ethics board ever” statement in post #105
    4. Instead of responding, perhaps explaining himself, Dr. Jay uses post #75 as an excuse to take his ball and go home.

    So now the question is: how likely is it that Dr. Jay saw post 75 while writing post 105?

  147. #147 LW
    June 8, 2009

    … it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science.

    Wow. Just … wow.

    This is downright dangerous? No one threatened Dr. Gordon directly or indirectly (“Will no one rid me of this pestilential pediatrician?”) Granted, someone put words in his mouth, but the words were not obscene or scandalous or threatening, and the cops aren’t going to come around demanding to know if he really committed those dreadful crimes. If he thinks an impostor putting polite (but unwelcome) words in his mouth is “downright dangerous” and makes it unsafe to post here, he clearly has no grasp of the concept of risk.

    Actually, when I read comment #75, I thought Dr. Gordon was engaging in a bit of self-deprecating humor. I kind of liked him there, for a moment.

    The rest of his comment is too reprehensible for words.

  148. #148 Derek Bartholomaus
    June 8, 2009

    Hello.

    As someone who works professionally in the television industry I can tell you that everyone who appears on a television talk show (not a news program) is paid for their appearance. By Dr. Gordon’s reasoning that would make every person ever appearing on a television talk show a shill for something, even though the payment is a legally contracted appearance fee that all programs have to make.

    As for Dr. Gordon’s “mythical” vaccine preventable disease outbreaks…

    45,596 Vaccine Preventable Illnesses
    174 Vaccine Preventable Deaths
    from June 3, 2007 to May 30, 2009
    http://www.JennyMcCarthyBodyCount.com

    I, also, am not a paid big pharma shill. I just made a website.

    -Derek

  149. #149 Derek Bartholomaus
    June 8, 2009

    Hello.

    As someone who works professionally in the television industry I can tell you that everyone who appears on a television talk show (not a news program) is paid for their appearance. By Dr. Gordon’s reasoning that would make every person ever appearing on a television talk show a shill for something, even though the payment is a legally contracted appearance fee that all programs have to make.

    As for Dr. Gordon’s “mythical” vaccine preventable disease outbreaks…

    45,596 Vaccine Preventable Illnesses
    174 Vaccine Preventable Deaths
    from June 3, 2007 to May 30, 2009
    http://www.JennyMcCarthyBodyCount.com

    I, also, am not a paid big pharma shill. I just made a website.

    -Derek

  150. #150 Derek Bartholomaus
    June 8, 2009

    Oops.

    Sorry for the double post. The browser was behaving badly.

    -Derek

  151. #151 Matthew Cline
    June 8, 2009

    It is for this reason that I have been boggling at Gordon’s attacks on “TV appearances” by vaccine advocates. 99.99% of pediatricians are full vaccine advocates, and 99.99% of those have never written a book, been on tv, or even have a personal webste. So clearly these types of promotions have nothing to do with their vaccination positions. … You don’t get on TV for adopting the conventional line.

    Devil’s advo-

    No, okay, no devil’s advocate, but rather, channeling a conspiracy monger:

    Exactly, you don’t get on TV for adopting the conventional line. So how did those pro-vax doctors get on TV? They must have had connections. But what kind of connections could get an average, boring doctor on the TV? Big Pharma must have supplied the influence. But if Big Pharma is going to get a doctor on TV, merely being pro-vax won’t be good enough for them; what if the doctor says something they don’t like? So Big Pharma will find a doctor who can be bribed into saying exactly what they want and get him a TV appearance.

    More conspiracy mongering: anti-vax pediatricians are actually a significant minority, and it’s only the shilling that makes it seem like its 99.99% pro-vax.

    LW:

    Actually, when I read comment #75, I thought Dr. Gordon was engaging in a bit of self-deprecating humor.

    Yeah, me too. At worst, the impersonator was rude. Dangerous? Even if we assume he meant “dangerous to his professional reputation”, a self-depreciating joke like that isn’t going to have any negative impact on his reputation.

  152. #152 Paul Murray
    June 9, 2009

    Wow. Just … wow.
    This is downright dangerous? No one threatened Dr. Gordon directly or indirectly

    Well, that’s paranoia for you. It’s right there in the DSM (or whatever it’s called).

    You know – I wonder if this “epidemic” of autism is much like the epidemc of MPD we had a few years back.

    Then again: maybe it’s actually all demon posession, and what we are seeing is Satan being especially busy because he knows that the apocalypse is just around the corner. Same as all the other times.

  153. #153 Richard Eis
    June 9, 2009

    Since i’m reading this in the UK, can we sue for libel now?

  154. #154 daedalus2u
    June 9, 2009

    It actually is dangerous for Dr Jay to post (and read) comments on blogs like this. Very dangerous; he risks what is called “narcissistic injury”

    http://en.wikipedia.org/wiki/Narcissistic_rage#Narcissistic_injury_.E2.80.93_the_cause_of_rage

    Avoiding narcissistic injury is why people like Dr Jay can’t read or look at anything that contradicts the ideas that they have hitched their egos too. The other anti-vaccine quacks have to avoid narcissistic injury too, which is why all the anti-vax websites censor comments.

  155. #155 Matthew Cline
    June 9, 2009

    Well, that’s paranoia for you.

    That’s what the reptilian aliens want you to think!

  156. #156 Pablo
    June 9, 2009

    Exactly, you don’t get on TV for adopting the conventional line. So how did those pro-vax doctors get on TV? They must have had connections. But what kind of connections could get an average, boring doctor on the TV? Big Pharma must have supplied the influence. But if Big Pharma is going to get a doctor on TV, merely being pro-vax won’t be good enough for them; what if the doctor says something they don’t like? So Big Pharma will find a doctor who can be bribed into saying exactly what they want and get him a TV appearance

    It’s so simple! I don’t know why I didn’t see it myself.

  157. #157 Rogue Medic
    June 9, 2009

    Dr. Gordon,

    If you are referring to comment 92 as impersonation, there was no attempt at impersonation, only parody. I forgot to include the html for italics to highlight that the ridiculous quotes are not to be taken any more seriously than anything that you write with the intent of being serious. Hand waving to accompany the italics would have been a nice touch, but I don’t know the html for that.

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    In the ranking of the authority of research, at the bottom is expert opinion. Since you claim to be an expert, but only capable of reciting anecdotal information, that refers to you.

    Your anecdotes are misleading. Most real pediatricians ignore your attempts to harm children.

    My concern for that huge problem is far greater than my concern about your theories about measles epidemics

    In other words, I, Dr. Gordon, will continue to pretend the problem is not a problem, until it is too big a problem to ignore.

    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.

    Maybe there will never be proof that vaccines do not in some slight way affect autistic patients. What is clear, is that the risk from vaccines is dramatically less than the risk of avoiding vaccines.

    That is a word Dr. Gordon should be familiar with.

    Dramatically.

    Look at me, Dr. Gordon. I, Dr. Gordon, make noise. I, Dr. Gordon, do not make sense, but I am dramatic.

    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    As long as you continue to demand that research be diverted from any real causes of autism, you are spreading this epidemic as well as your peers – Honest Jenny Killer McCarthy and the rest of Generation Revenue. You, and your peers, are probably the most dangerous people your patients will ever meet.

    Posted by: Rogue Medic | June 7, 2009 6:21 PM

    I had originally posted this in response (June 7, 2009 5:43 PM) to your post on Paying the price of vaccine refusal, but since it seemed that the conversation had moved here, I reposted that comment here.

  158. #158 Scientizzle
    June 9, 2009

    I had no illusions that my comment (#45) would be addressed by Dr. Gordon, particularly considering the sea of other comments deserving response. However, the flippant responses of #105 was stupider than just ignoring my questions.

    First off, I was apparently quoted or paraphrased as saying: No proof on either side. No disproof on either side either according to most medical experts. This is clearly not an accurate assessment of my post. It’s also not an accurate assessment of the vaccine-autism question either: there’s broad agreement that the scientific evidence is decidedly against a link.

    The doctor’s response:

    Let’s write those grants, Scientizzle! I’ll work with you and live with the results even if they fall far afield from my thoughts going in.

    I know this is a disingenuous offer. I also know that Dr. Gordon’s comments here and elsewhere indicate that he has no clue about a trial design, and has clearly not considered the ethical, economic, and scientific limitations of a prospective study. On the off chance that Dr. Gordon ever reads this post: READ THIS! Seriously. I’ll wait. Until you can comprehend this, perhaps offering an alternative design that would mitigate these concerns, even a lowly grad student like me would have severe reservations about any research collaboration opportunities with you.

    While I think that some of the comments here have been unfortunate and detract from any attempted dialogue, Dr. Gordon has yet to offer any substantive comment in reply to multiple valid questions.

    Drop the snark, diversionary nonsense and victim complex, Doc Hollywood. Explain the controlled scientific evidence that indicates a link between vaccination and autism spectrum disorders. Then explain how the studies that have been published in response to this concern have been inadequate. Finally, the explain how the inadequacies can be reasonably and validly addressed by future studies.

    Bet you can’t.

  159. #159 Pablo
    June 9, 2009

    Explain the controlled scientific evidence that indicates a link between vaccination and autism spectrum disorders. Then explain how the studies that have been published in response to this concern have been inadequate. Finally, the explain how the inadequacies can be reasonably and validly addressed by future studies.

    Bet you can’t.

    Perhaps I’m wrong, but I thought Gordon has already admitted that the science shows no link? It is just that he doesn’t care about scientific studies and thinks that his extensive experience is more relevant.

    So the “inadequecies” you ask for have already been provided. They are that the scientific results are not consistent with his expert opinion based his experience.

  160. #160 Scientizzle
    June 9, 2009

    Pablo, you’re probably right. If so, it makes his statetments that he would “accept a prospective study” (comment #105 here) refuting a vaccine-autism link all the more disingenuous.

  161. #161 Prometheus
    June 9, 2009

    Wow! A real example of Dr. Jay stalking off in a cyber-huff! Not that we haven’t seen that before.

    I wanted to go back to cover some of Dr. Jay’s earlier comments – before he had his ego bruised and promised – yet again – to never darken the doorway of RI again.

    No, I believe that you do not receive money from the pharmaceutical industry. I’ve said that before and I’ll say it again. I sincerely believe that some of the people who post here and elsewhere do.

    I don’t get paid for blogging. I think some of you here might.

    Well, Dr. Jay’s “sincere belief” and $2.25 will get you a ride on the “el”.

    Name them, Dr. Jay. Name one ‘blogger or commenter that is paid by the pharmaceutical industry to ‘blog or comment. Joe McCarthy at least had a list – don’t you have a single name?

    And by the way, while you nasty, inexperienced theoreticians toss insults back and forth, we working pediatricians have to deal with an extremely real epidemic of autism.

    So, you have data to support this claim of yours, Dr. Jay, or are you going to fall back on the “I’m too busy saving lives to research the facts!” gambit? Exactly how are you dealing with the “autism epidemic”? I don’t see so much “dealing with” as I see “profiting from”.

    And why is that everyone who disagrees with Dr. Jay labeled as “nasty” and “inexperienced”? Isn’t it possible that some of the people are at least as experienced as Dr. Jay when it comes to infectious diseases and autism? The “nasty” part is, obviously, just grade school name-calling.

    My concern for that huge problem [the alleged autism epidemic] is far greater than my concern about your theories about measles epidemics.

    Again, so what? Clearly Dr. Jay can’t see a bigger problem looming in the waning measles immunity of the population. That doesn’t make him correct, it simply means that – like most people – he forgets that things further in the distance look smaller than they actually are.

    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.

    Here is the “money quote” – one that I’m going to preserve for posterity. In this single sentence, Dr. Jay admits that he is not the slightest bit interested in data, fact, truth or reality. As long as it disagrees with him, no study can be valid.

    News flash, Dr. Gordon – the Universe does not revolve around you. You are not so special or so talented that you cannot be wrong. Get over yourself.

    Until that proof is found, I will worry about the very real epidemic of spectrum disorders while you concern yourself about theories.

    Go ahead and worry, Dr. Jay – the “nasty” “theoreticians” will do the dirty business of finding out what autism is (and is not) and what does (and does not) cause it while you are worrying your pretty head about it. Worrying about a problem doesn’t solve it – working on a problem is what will solve it. And whether Dr. Jay likes it or not, you can’t work on a problem without data.

    Apart from the entertainment value, is there any point in “debating” with Dr. Jay any further? He has definitively shown that he is not capable of accepting new ideas, nor is he willing to “show his work” and explain why he holds to his peculiar beliefs. Sure, he’s amusing and comical, but is it really worth the aggravation?

    Prometheus

  162. #162 Joseph
    June 9, 2009

    Also, Dr. Jay asserted that a potential measles epidemic due to vaccine refusal is theoretical, whereas the “autism epidemic” is fact.

    Reality is that the “autism epidemic” is hypothesis. The MIND Institute, for example, has attempted twice to provide evidence of this hypothesis. Both times, the results of said attempts have been so poor and mistaken that it’s difficult to describe.

  163. #163 Pablo
    June 9, 2009
    None of your numbers, pharma-shilled studies and politically-influenced court decisions amount to a thimbleful of proof that vaccines don’t increase the incidence of autism.

    Here is the “money quote” – one that I’m going to preserve for posterity. In this single sentence, Dr. Jay admits that he is not the slightest bit interested in data, fact, truth or reality. As long as it disagrees with him, no study can be valid.

    Exactly. Even though in this quote he appears to only be dismissing “pharma-shilled” studies, it doesn’t matter who does them because he will just accuse them of being pharma-shills or politically motivated, like he has here.

    Shoot, Jenny McCarthy herself could do a study showing no link and he would just dimiss it because she has links to Big Pharma through her breast implants.

  164. #164 Prometheus
    June 9, 2009

    I forgot to point out that Dr. Jay has also rendered moot his call that “Somebody needs to do a study!” on vaccines and autism. After all, if he – one of the most well-educated and open-minded members of the “vaccines-cause-autism” movement – flat refuses to accept any study that doesn’t show vaccines cause autism, then what is the chance that any of the other members of the movement will?

    Since there are already enough data showing that the “vaccines-cause-autism” hypothesis is without merit, I see no point in spending valuable time and money trying to “prove” something to people who have repeatedly stated that they won’t “believe” a study if it disagrees with their eccentric notions.

    What you’ve seen here – in Dr. Jay’s own words – is a mind slamming shut against new information.

    What a waste.

    Prometheus

  165. #165 Rogue Medic
    June 9, 2009

    Dr. Gordon wrote,

    OK. Maybe it was Dr. Gordon pretending to be Dr. Gordon, maybe it was Killer Jenny pretending to be Dr. Gordon, maybe it was another of his measles shills pretending to be Dr. Gordon, but these were posted as coming from Dr. Gordon, so I will take a chance that at least one of them came from a real personality that inhabits Dr. Gordon’s body. No I do not have any proof that any of these are true, but we have to comment about something and these seem to be consistent with statements that have come from what appears to be Dr. Gordon’s dominant personality. In other words, they would embarrass anyone with any self respect.

    No, I believe that you do not receive money from the pharmaceutical industry. I’ve said that before and I’ll say it again. I sincerely believe that some of the people who post here and elsewhere do.

    While it is probably not fair to ask for some evidence to support these beliefs you proclaim, since you clearly do not understand science or logic, please explain this belief.

    I don’t get paid for blogging. I think some of you here might.

    Should we believe him?

    Does he have a blog?

    Are there any advertisements on his blog?

    Does he promote things he sells?

    I have never been to the blog Dr. Gordon doesn’t get paid for. I read more than enough of Dr. Gordon’s misinformation in these comments.

    Why should I believe that Dr. Gordon’s statement, that he does not get paid for blogging, is true?

    Is Dr. Gordon honest?

    The only way to look at this is by comparison.

    Is Dr. Gordon honest?

    Compared to what?

    Compared to a used car dealer? No. The used car dealer is selling you a product that may be dangerous enough to kill you, but so is Dr. Gordon. This appears to be a tie.

    Compared to Osama bin Laden?

    Difficult to tell. Both have so many years of killing ahead of them. But the question wasn’t which one kills more. The question was, which is more honest?

    Clearly bin Laden is more honest. He does not appear to be lying about his desire to kill people and about his role in the deaths of thousands.

    What about compared to a compulsive liar?

    In order to make that comparison, wouldn’t we need to show that Dr. Gordon is not a compulsive liar?

    Good point. I wonder if anyone has ever caught Dr. Gordon telling the truth.

    Good Morning–

    This post is from the real “me.” Someone has presented a variation on my signature and has begun posting here. (He, or they, have placed “Dr” in front of my name. I’m not sure that this hasn’t been done before by making slight alterations in letters and punctuation marks.) This has made me realize that it’s downright dangerous to post among people with venom in their hearts and minds, no consciences and a dishonest attitude about science. I believe that Orac should have caught him, by the way.

    I’ll stop.

    Best,

    Jay.

    Apparently, we are supposed to assume that this dangerous is in reference to this blog.

    This blog does not censor Dr. Gordon’s comments. That is dangerous.

    But Dr. Gordon wrote that in a way that suggests that Dr. Gordon is in danger. Oh my.

    Has anybody seen any posts from Dr. Gordon since that comment?

    Obviously, we have enough information to convict and execute Dr. Orac. This is his blog. He knew it was dangerous. Imagine presenting valid ideas to encourage people to think. What if Dr. Gordon had a valid thought and it was just too much for his mind to handle. Dr. Orac! How could you?

    Wait! Dr. Orac’s lawyer raises and objection. There is another suspect. Dr. Gordon saw ahead of time that this was dangerous. He gave us a clue right there. Fore Sight in Greek is Prometheus. It is now a conspiracy.

    No! No! No!

    It isn’t a conspiracy. The jury has to convict one or the other.

    Wait! Another objection from the lawyer. Dr. Gordon saw this coming. Maybe it was suicide.

    Wow! An even bigger conspiracy. This conspiracy includes Dr. Orac, Prometheus, and Dr. Gordon. Everybody run for the hills. The comments are not safe. Save yourselves. AAAAhhhhh!

    Dangerous?

    Put the crack pipe down, Dr. Gordon. You are already enough of a crackpot without adding to the things you try to scare people about.

    Dangerous?

  166. #166 Rogue Medic
    June 9, 2009

    Back to some of Dr. Gordon’s statements that contradict themselves.

    Some contradictory comments from Dr. Gordon? Are you crazy. We don’t have all day to deal with his contradictions. Just pick one, for now.

    Good point.

    Posted by: Tsu Dho Nimh
    Jay … you have never seen a measles epidemic. Until you have, don’t dismiss it as being a trivial problem. Talk to Dr. Paul Offit, who was a working pediatrician in the middle of a small measles outbreak, and ask him how it feels to see kids die who should never have been sick.

    Of course I have. I began my training nearly forty years ago and saw plently of measles. Dr Offit’s measles outbreak bearly merits the name.

    The measles outbreak Dr. Offit experienced is trivial compared to what Dr. Gordon has experienced? How bad was the measles outbreak that Dr. Gordon experienced?

    First, let’s look at what deadalus2u wrote about the measles outbreak:

    I think I know the reason why Dr Jay never heard about the measles epidemic in California that sickened 16,400 and killed 75 (yes 75 people died from their measles infection, not all of them children) that was cited above.

    This measles outbreak killed 75 people, but Dr. Gordon thinks it is just a triviality? That is more than the recorded number of victims for any American serial killer. Most people consider serial killers to be kind of a bad thing. Not Dr. Gordon. To Dr. Gordon, serial killers are insignificant. Why do anything about that trivial amount of death. Only whiny people would make a big deal about that. Not Dr. Gordon. Dr. Gordon is much to pseudoscientific to worry about measles.

    75 dead? Is that all you’ve got?

    It is nice to know the kind of perspective that Dr. Gordon applies.

    It probably goes better with a Bo Diddly beat – Double digit deaths don’t do diddly, Dude.

    Well, if the refrain is Who do you love? For Dr. Gordon, the answer does not seem to be his patients, anybody near his patients, or anybody who cares about human beings.

    Maybe I am exaggerating his dismissal of a measles outbreak that killed 75 people. Dr. Gordon, any human being, would take that seriously, right? Any pediatrician would see this as a major problem, right?

    Of course I have. I began my training nearly forty years ago and saw plently of measles. Dr Offit’s measles outbreak bearly merits the name.

    Hmm. Not Dr. Gordon.

    This is the way I interpret Dr. Gordon’s comment. A mere 75 dead? I intend to bring about a much larger measles outbreak. I intend to make 75 dead an example of a minor measles outbreak. Dr Offit’s measles outbreak bearly merits the name.

    Clearly. Dr. Gordon understands that when it comes to vaccine denialism, 75 dead people is just a drop in the bucket.

  167. #167 D. C. Sessions
    June 9, 2009

    Hey, RM!

    Clearly. Dr. Gordon understands that when it comes to vaccine denialism, 75 dead people is just a drop in the bucket.

    Here’s one for you. Someone I know actually woke up sweating from this one:

    You are on first response near a ski area during the Christmas-New Years break with visitors from all over the Southwest and quite a few foreign countries. You’re called to the day care center, where one of the kids isn’t feeling well. On examination, you notice a dry cough, fever of 39C, runny nose, conjunctivitis, photophobia, and (on oral examination) little red spots in the oral mucosa.

    Your call, Patroller.

  168. #168 Rogue Medic
    June 10, 2009

    D. C. Sessions,

    That seems like a severe case of being a patient of Dr. Gordon. :-)

    Let’s hope the rest of the people at the facility have kept their measles vaccinations up to date.

  169. #169 Luna_the_cat
    June 10, 2009

    Actually, I’m still boggling over the last bit of comment #105, where Jay Gordon quotes the post about the 440-case outbreak of measles where 3 children died, and then responds “but it’s also a lot farther from the major terrifying boogeyman people are making it out to be.

    So the entirely unproven, entirely unsupported assertion that you might have a (absolute worst case) 1 in 150 chance of your child becoming autistic from vaccines is a big, scary thing which justifies you entirely in not getting vaccines, but 3 deaths out of 440 sick kids is no major terrifying boogeyman and entirely worth the risk.

    And this man practices as a pediatrician????????!

    W…T…F!

    Frankly, if I were “Larry”, I would not be pleased about having Gordon’s greeting passed on to me. I would not want to be associated in any way with such a “doctor”.

  170. #170 D. C. Sessions
    June 10, 2009

    Let’s hope the rest of the people at the facility have kept their measles vaccinations up to date.

    It’s a ski area during the holidays. The kids in there are all ages, in for the day, from all over the place, and no telling what the status of their parents etc.

    The question is, do you push the button?

  171. #171 Rogue Medic
    June 10, 2009

    I misunderstood your question.

    You are asking if I quarantine everyone (push the quarantine button). I do not know what the different states’ regulations are, but I do not have the authority to make that decision. I would call ahead to the ED and request an isolation room for the patient and family. I might point out to the staff that there is a communicable disease that might be measles (more comments on this later).

    As a paramedic, the way the EMS laws are written, I am not allowed to diagnose. This is a bit of legal doubletalk, since I am treating some things that would be dangerous to treat if misdiagnosed. However, the state laws in each state, where I have worked, are essentially the same. Diagnosis is outside of my scope of practice, and quarantining patients according to a diagnosis of communicable disease, is also outside of my scope of practice.

    I do not really disagree with this approach. EMS is not trained to deal with these diseases. EMS is trained to provide the kind of treatments that stabilize, possibly reverse, life threatening conditions. There is not a good reason to expand that training to include vaccination/communicable disease. We have a hard enough time covering the basics in enough depth to turn out competent providers.

    This gets into areas that would invite bad decisions. EMS does not see these diseases often. Unfortunately that is changing as Dr. Gordon and his peers bring their save the endangered species – measles, mumps, rubella, pertussis, . . . . campaign to gullible people everywhere. I think that a resurgence of vaccine preventable diseases is better handled in other ways. EMS should not be setting up quarantines. EMS should be consulting with the hospital emergency physician and allowing the emergency physician to make that decision. Or EMS, through the emergency physician, should be communicating with the CDC about quarantine. The final decision should not rest with EMS.

    EMS does not see enough of these diseases to do a good job of recognizing them. If that changes, there are better ways of handling this than giving EMS the authority to quarantine. Currently, I probably would be violating privacy laws (HIPAA really does not apply, since HIPAA applies to paperwork) by saying anything to anyone other than the parents, my partner, and hospital staff. The legal complications would take years to straighten out. Even the emergency physicians might not make this decision without a lot of consultation, including with the hospital’s lawyers (or the emergency medicine group’s lawyers).

    To summarize. I do not have the authority. I don’t think I should have that authority.

  172. #172 Marcus Ranum
    June 10, 2009

    The “pharma shill” gambit is stupid. Because, if there were pharma shills, someone could do “big pharma” tremendous damage by exposing them from the inside. If anyone believes there are “pharma shills” they should get a job as one – document and videotape and collect and write an expose like “marjoe” did. You get paid by the enemy to humiliate and expose them – can’t beat it. Except for the unfortunate fact that “they” aren’t actually hiring.

    I’m available to act as a “pharma shill” FWIW. Please email me to discuss my rates.

  173. #173 D. C. Sessions
    June 10, 2009

    You are asking if I quarantine everyone (push the quarantine button).

    The particular nightmare is specific to the area. For one thing, it’s on the Apache reservation (thus Federal jurisdiction, FWIW). For another thing, the first responders are (volunteer) employees of the Tribe.

    It’s certainly true that we can’t diagnose (whew!) but you can do a lot with a cell-phone camera. A call to IHS with details and a picture or two might do a lot to get the ball rolling.

    Or not.

    I don’t see any good answers to that one — the patroller who had the nightmare thinks it might make a pretty good screenplay.

  174. #174 Rogue Medic
    June 10, 2009

    Screenplays can be good for explaining things that some people are especially resistant to. Unfortunately, by the time it is final, the altie is probably the hero and the villain is some Big Pharma Mephistopheles.

    Fortunately here in Big Suburb, there are not enough of these child haters for us to be dealing with any outbreaks. Still, the novelty of cases of pertussis, measles, . . . is gone. People no longer think it unusual when these patients are in the emergency department.

    So far, I haven’t heard of any epiglottitis cases. That used to be an uncommon, but life threatening problem. Since the Hib vaccine, you don’t hear anyone mention cases of epiglottitis without starting out as – Remember when . . . or A long time ago I had a patient with . . ..

    It seems we will have a chance to appreciate the good old days, again. When men were men, women knew their place, and you had to have a bunch of kids if you wanted any to survive to become adults. It brings a tear to my eye.

  175. #175 MI Dawn
    June 11, 2009

    @ Rogue Medic: OMFSM. You HAD to mention epiglottitis. The illness that haunted my nightmares for years when my kids were young. I can remember clearly in my peds rotation being taught NOT to check the throat of a child suspected of having HIB because of the risk of epiglottitis until anesthesia arrived. We were shown a video of the epiglottis snapping down on a child and the emergency trach that had to be done. My entire class was in shock. I don’t want to see those days again.

  176. #176 Rogue Medic
    June 11, 2009

    MI Dawn,

    Epiglottitis is exaggerated. It is bad, but it is not instant death.

    In part, this is because of the advances made in airway management. This used to be something that was only understood by anesthesia, but things have changed. The view of other people intubating, such as emergency medicine and EMS has changed significantly. As anesthesiologists have seen other specialties behave responsibly with airway management, they have moved away from the poachers and dabblers attitude.

    A calming approach to a toxic looking child, while handing the child a nebulizer to help medically reverse the condition. Having the child hold the nebulizer helps them feel less afraid. We give ice chips to presurgical NPO patients all of the time, why not use temperature to counter the swelling, as long as the chips are handled by the patient?

    Avoiding looking in the airway depends on what is meant by loooking in the airway. Too many people have felt the need to poke and prod the swollen upper airway. This is the kind of thing that leads to forceful laryngospasm in an already swollen airway.

    Another improvement has been moving away from intubation as the only way to manage the less-than-stable airway. the goal is airway management and ventilation, not intubation. BVM ventilation may be effective. The LMA may be a useful airway, too. It may be possible to slide a lubricated tiny tube, with a stylette, into the airway to provide as much air movement as a surgical airway, but without the blood and hysteria. All airway management should be as gentle as possible.

    I would be prepared for epiglottitis to come back. Don’t panic about these patients and prepare as much as possible. Don’t rush to RSI a patient just to provide a better airway. If the airway is working, just try to keep it working. When the child is ready to stop breathing, that is the time to become aggressive, but you may be able to get anesthesia there long before that point.