Respectful Insolence

I realize that I haven’t done an installment of Your Friday Dose of Woo for a while–well over a month, in fact. Because of the gap between woo installments, I had been thinking that today was the time. There are at least a couple of really good candidates (and a host of halfway decent ones) in my Folder of Woo. However, sadly, another installment in the unfortunately never-ending story of YFDoW will have to wait at least another week. You see, the Bat Signal went up (or should I call it the Woo Signal?), and duty calls. What is the particular instance of someone being wrong on the Internet that requires a loving application of a heapin’ helpin’ of not-so-Respectful Insolence. I’ll give you a hint.

It’s on that repository of quackery, anti-vaccine madness, and woo, The Huffington Post. Where else?

This time around, The Three Musketeers of Woo (Larry Dossey, Deepak Chopra, and Rustum Roy) have decided to launch a full frontal assault on science-based medicine in an outrageously stupid piece, chock full of logical fallacies, whining, false dichotomies, and just plain bad reasoning in a post entitled The Mythology of Science-Based Medicine (conveniently crossposted on Deepak Chopra’s Intent Blog). Think of a supernova of burning stupid meeting a black hole of ignorance. Which would win? Would the supernova of burning stupid be able to overcome the ignorance well of the black hole, or would the black hole suck all the burning stupid out of the supernova past its event horizon? Which would win?

I don’t know which would win, but I do know that, whatever does win such a monumental struggle, it won’t be the reader.

One thing I noticed is that, since the last time the Three Musketters of Woo attacked science-based medicine in the pages of HuffPo, it consisted of Deepak Chopra, Andrew Weil, and Rustum Roy, which makes me wonder; What happened to Andrew Weil? Why did the Musketeers have to bring in a ringer? Maybe Weil, being the “reasonable” face of the complementary and alternative medicine (CAM) movement, realizes that what follows is so blisteringly dumb that he doesn’t want to be associated with it. Weil’s always been the clever one, and he doesn’t usually launch such frontal assaults on the very concept of science-based medicine. Instead, he tries to subvert it by trying to infiltrate it with woo and assimilate it, Borg-like. So they brought in Andrew Weil’s dumber brother in the CAM movement to fill in, and he lives down to expectations, given his bio on HuffPo:

Dr. Larry Dossey is a former physician of internal medicine and former Chief of Staff of Medical City Dallas Hospital. He received his M. D. degree from Southwestern Medical School (Dallas), and trained in internal medicine at Parkland and the VA hospitals in Dallas. Dossey has lectured at medical schools and hospitals throughout the United States and abroad. In 1988 he delivered the annual Mahatma Gandhi Memorial Lecture in New Delhi, India, the only physician ever invited to do so. He is the author of ten books dealing with consciousness, spirituality, and healing, including the New York Times bestseller HEALING WORDS: THE POWER OF PRAYER AND THE PRACTICE OF MEDICINE, most recently THE POWER OF PREMONITIONS. Dr. Dossey is the former co-chairman of the Panel on Mind/Body Interventions, National Center for Complementary and Alternative Medicine, National Institutes of Health. He is the executive editor of the peer–reviewed journal EXPLORE: The Journal of Science and Healing. Dr. Dossey lectures around the world. He lives in Santa Fe with his wife Barbara, who is a nurse-consultant and the author of several award-winning books.

So Dossey’s the executive editor of EXPLORE? Truly, the woo is strong in this one. Remember, EXPLORE is the “journal” that publishes allegedly scientific papers on topics such as “distant healing” and, even more hilariously, imbuing chocolate with “intent.” His editorial standards, suffice it to say, do not impress me. Moreover, the very fact that he ever held any position whatsoever at NCCAM tells you all you need to know about the promotion of pseudoscience and woo by NCCAM, especially given the fetid load of dingo’s kidneys that he laid down with Brother Deepak and Brother Rustum. It’s based on a massive straw man argument and a whole lot of special pleading. But first, it starts with a false dichotomy:

The current healthcare debate has brought up basic questions about how medicine should work. On one hand we have the medical establishment with its enormous cadre of M.D.s, medical schools, big pharma, and incredibly expensive hospital care. On the other we have the semi-condoned field of alternative medicine that attracts millions of patients a year and embraces literally thousands of treatment modalities not taught in medical school.

Not exactly. Well, no, not really, but I’m sure Dossey would like the dichotomy to be this. However, I think that the use of this false dichotomy is intentional. If there’s one thing boosters of unscientific and pseudoscientific treatments want, it’s to be viewed as on par with science-based medicine, as an “alternative” but equal system. Framing the issue this way from the first paragraph is likely an intentional strategy to implant right from the beginning in the reader’s brain that there really is a dichotomy. My response, of course, is to repeat once again my oft-repeated favorite saying: There is no such thing as “alternative medicine.” There is medicine that is scientifically validated and there is medicine that is not. Of the latter, there is medicine that doesn’t work and medicine that has not been shown to work with science. Nearly all of the modalities falling into the “thousands of treatment modalities not taught in medical school” are in fact not taught in medical school because they fall into one of these latter two categories: The don’t work, or there’s no good evidence that they should, not to mention that there’s no good reason based in science to think that they would work.

Now, on to the whine:

One side, mainstream medicine, promotes the notion that it alone should be considered “real” medicine, but more and more this claim is being exposed as an officially sanctioned myth. When scientific minds turn to tackling the complex business of healing the sick, they simultaneously warn us that it’s dangerous and foolish to look at integrative medicine, complementary and alternative medicine, or God forbid, indigenous medicine for answers. Because these other modalities are enormously popular, mainstream medicine has made a few grudging concessions to the placebo effect, natural herbal remedies, and acupuncture over the years. But M.D.s are still taught that other approaches are risky and inferior to their own training; they insist, year after year, that all we need are science-based procedures and the huge spectrum of drugs upon which modern medicine depends.

Note the subtle use of the word “procedures.” Not “treatments.” Not “medicines.” Not “therapies.” Procedures. Note how that is then juxtaposed against “alternative medicine” or “indigenous medicine.” This framing intentionally makes another false dichotomy: Between “procedures” of science-based medicine and the nice, fuzzy, happy “treatments” of alt-med. And, of course, they’re “enormously popular,” leading to the classic logical fallacy of argumentum ad populum.

More importantly is the nonsense about medicine being unrelentingly hostile to alt-med. In fact, in a case of being so open-minded that its brains are falling out, academic medicine is embracing woo wholesale. How many times have I complained about just that right here on this blog, be it about NCCAM wasting $120 million of taxpayer money every year studying woo or the infiltration of woo into academic medical centers? The problem isn’t that “mainstream medicine” is hostile to alt-med. It used to be, but no more. The problem is that, at the same time mainstream medicine is promoting “evidence-based” medicine, it is also embracing non-evidence-based medicine. It is embracing a more “fluid concept of evidence” in order to allow CAM to obtain legitimacy.

The next part of the article consists of a whole lot of special pleading, topped off with some serious cherry picking and deception by omission. First up, The Three Musketeers of Woo make a huge deal out of the BMJ’s attempt to evaluate mainstream medical treatments and determine which ones have solid evidence to support them. Unfortunately, I do not have access to the website, and neither does my institution; so I can’t evaluate much of it. Be that as it may, the Musketeers make much of the observation that 46% of treatments were “unknown” in their effectiveness or that, if you believe BMJ’s analysis, only 36% are likely to help. Even if this were true, I notice one glaring omission. Notice how the Musketeers don’t mention comparable numbers for their treatments. Even if scientific medicine performed this poorly, it’s virtually certain that alt-med performs far more poorly. Moreover, I’d be willing to bet that the evidence base in favor of the woo that the Musketeers favor is pathetic in comparison to that supporting science-based medicine. In other words, this is a massive case of the pot calling the kettle black, except that the kettle isn’t even black in this case.

Then the Musketeers get really sloppy with the facts (surprise, surprise):

We all marvel at the technological advances in materials and techniques that allow doctors to perform quadruple bypass surgeries and angioplasties without marveling that recent studies indicate that coronary bypass surgery will extend life expectancy in only about three percent of cases. For angioplasty that figure sinks to zero percent. Those numbers might be close to what you could expect from a witch doctor, one difference being that witch doctors don’t submit bills in the tens of thousands of dollars.

This is deceptive in the extreme, as the Musketeers neglect to mention that these results are in patients with stable angina. In high risk anatomic subsets, both CABG and angioplasty prolong survival versus medical therapy alone. Moreover, they don’t discuss relief of angina symptoms. While survival is the most important endpoint, relief of symptoms is also quite important. Another deceptive statement made in the article is that anti-depressants don’t work better than placebo. There may be evidence that this is true for patients with mild to moderate depression, for severe depression even the meta-analysis cited supports the efficacy of anti-depressants, so much so that Dr. Scott Mendelson, no enemy of woo he, arrived in the comments to take the Musketeers to task for a huge straw man:

The second point is that while some psychiatrists and many primary care physicians may believe that antidepressants work simply by increasing the levels of serotonin and/or norepinephrine in the brain, no competent psychopharmacologist believes this. To suggest that experts in the field are either misleading people into taking medications they don’t need, or that we ourselves have been fooled by the pharmaceutical industry into believing that the underlying problem is a mere lack of neurotransmitter than can be reversed by antidepressants, is incorrect.

Then, of course, there’s the claim that “Dr. Barbara Starfield, writing in the Journal of the American Medical Association, estimated that between 230,000 and 284,000 deaths occur each year in the US due to iatrogenic causes, or physician error, making this number three in the leading causes of death for all Americans.” This figure has actually always bothered me, as it’s clearly the highest of the usual apocalyptic estimates for how many people doctors supposedly kill, and the reason is simple math. Each and every year in the U.S., approximately 2.5 million people die. If Dr. Starfield is to be believed, approximately 10% of all deaths are from iatrogenic causes, which would make iatrogenic death the third leading cause of deaths in the U.S. after heart disease and cancer. Patients in hospitals tend to be sick and more prone to complications. For one thing, Starfield counts 80,000 deaths from nosocomial infections in hospitals. Nosocomial infections (hospital-acquired infections) are a big problem, no doubt, but lumping them in with medical error and iatrogenic causes is rather questionable. Many nosocomial infections can’t be prevented easily and are not the fault of the physicians treating the patient. Moreover, nearly all of these numbers were derived from hospital studies. Similar considerations apply to non-error adverse reactions, which are said to claim 100,000 deaths a year. Remember, these were not medicines given in error. To compare this number honestly, you have to look at it in comparison to the number of lives saved every year by these medications. In other words, one has to compare the risks versus the benefits:

But there is a more important fact that should keep you from being scared away from real medicine.

Advances in the treatment of coronary artery disease, the number one killer of Americans, reduced the number of deaths by over 340,000 in 2000 alone. And that’s just one disease.

So, in one year, medical errors may cause a few tens of thousands of deaths (and these are preventable deaths), but real medicine, in one disease alone, saves an order of magnitude more.

Don’t get me wrong. We ought to be doing everything we can to decrease complications and death due to medical errors. The Institute of Medicine suggests the number may be from 44,000 to 98,000. By any measure this is far too many, but remember this: it wasn’t The Three Musketeers of Woo who did the studies to derive these estimates. It was not Dr. Dossey, and it was most certainly not Deepak Chopra or Rustum Roy. It was science-based physicians trying to improve the practice of medicine, and there is nothing even coming close to a similar dataset maintained by alt-med practitioners.

The Three Musketeers of Woo are really good with special pleading, though. Because they have no convincing evidence that their therapies are any better than placebo medicine, all they can do is to try to attack the efficacy of scientific medicine. They don’t dare go head-to-head with scientific medicine becaue they know the don’t have the goods. The day I see woo-meisters like The Three Musketeers produce studies similar to the IOM report on medical errors or honest appraisals of the efficacy of, say, homeopathy is the day I might take their whining and special pleading more seriously. Not before.

Comments

  1. #1 Mojo
    January 8, 2010

    While survival is the most important endpoint, relief of symptoms is also quite important.

    Ask a homoeopath, and they’ll tell you that “suppressing” the symptoms will only make matters worse.

  2. #2 Pablo
    January 8, 2010

    I’ve known of Rustom Roy since I was in grad school in the early 90s. He is the type of guy who seems to have an oddball opinion on everything, and thinks everyone cares to hear it. Unlike a blogger, who creates their own world and lets others who are interested come to visit, Roy insists on pontificating in the general public setting.

    Short answer: Even before he got into the woo, he was a recognizable blowhard.

  3. #3 Diane
    January 8, 2010

    I personally love the lumping of placebo effect with acupuncture and herbs. It’s an interesting admission to me that the woosters know that placebo is important to their claim of “effectiveness.”

  4. #4 JohnV
    January 8, 2010

    “What happened to Andrew Weil? Why did the Musketeers have to bring in a ringer? ”

    Maybe instead of the Three Musketeers they could be the 3 stooges, with Dossey as Shemp.

  5. #5 Dave Robinson
    January 8, 2010

    Yes there are two kinds of “medicine.”

    1) Medicine that has been demonstrated to work.
    2) “Medicine” that has not been demonstrated to work.

    People who want to get better should rely on the former.

    What’s truly sad is if the Woo-Meisters really wanted to get their burning stupid accepted by the scientific community they’d only have to do one thing: Prove it works!

    (Sadly for them, burning stupid doesn’t work – which is where we get the problem in the first place.)

  6. #6 Smrt Newfie
    January 8, 2010

    I’ve recently come to the conclusion that the CAM folks and the IDiot crowd must get together on a regular basis to discuss strategy. I bet the two of them could get together and write one hell of a high school biology text book. I think I’d actually buy one (a used copy of course).

  7. #7 Mojo
    January 8, 2010

    There’s a great comment from “dsws” on the Huffpo article, pointing out their misunderstanding of statistics in the statement “when you take your sick child to the hospital or clinic, there is only a 36 percent chance that he will receive a treatment that has been scientifically demonstrated to be either beneficial or likely to be beneficial.”

  8. #8 Orac
    January 8, 2010

    Maybe instead of the Three Musketeers they could be the 3 stooges, with Dossey as Shemp.

    Damn you! I wish I had thought of that line! JohnV wins the Internets today…

    I guess the question then becomes: In the next iteration of the Three Stooges of Woo, who will be Joe and then later who will be Curly-Jo? Of course, true aficionados of the Stooges know that Shemp was actually the original third stooge.

  9. #9 Pablo
    January 8, 2010

    “”when you take your sick child to the hospital or clinic, there is only a 36 percent chance that he will receive a treatment that has been scientifically demonstrated to be either beneficial or likely to be beneficial.””

    This is consistent with my experience. In the last month, I have taken my child to the doctor 3 times, and only got a scientifically beneficial treatment once.

    That is because those other two times, we brought him in because he has been having a persistent cough, and wanted to make sure that it has not developed into anything more serious than minor congestion. Since it hadn’t, the doctor sent us home with only some common suggestions (use a vaporizor in his room, elevate his head end of the bed slightly) that likely have not been examined in a clinical trial.

    Oooooh, the evil doctors….

  10. #10 Pablo
    January 8, 2010

    BTW, I forgot to mention, the one time we did get a scientifically beneficial treatment was when we got antibiotic for an ear infection.

  11. #11 Sir Eccles
    January 8, 2010

    I was just wondering if one took the Huffington Post and diluted it with say ten copies of the complete works of Shakespeare and shook it all up and put it on a sugar pill would it be more palatable to read?

  12. #12 Mojo
    January 8, 2010

    What’s truly sad is if the Woo-Meisters really wanted to get their burning stupid accepted by the scientific community they’d only have to do one thing: Prove it works!

    Instead of which they prefer to attack real medicine. Go figure…

  13. #13 Mark C. Chu-Carroll
    January 8, 2010

    Not to defend the woo’ers, but I did want to point out one thing which hits close to home for me.

    Nosocomial infections can certainly be counted as something caused by doctors error:
    My father died three years ago, of complications from an antibiotic resistant infection. The way that he got that infection was by being placed into a two-bed room with a patient who had multiple-antibiotic resistant pneumonia.

    I don’t know how the doomsday statistic was generated; I agree that it seems unreasonably large. But I also don’t think that the fact that it includes nosocomial infections as being caused by doctors errors is a reason for invalidating it: any tally of deaths caused by physician error should include the cases where errors led to an infection.

    (The hospital where my father died has a big, beautiful plaque hanging in the entry to their critical care ward, bragging about how they have gone N years without a single hospital-acquired infection in that ward. That’s where my father caught his infection. But the plaque is still there, and it’s been updated to add more years of no supposed hospital acquired infections, the dirty lying fuckers.)

  14. #14 Orac
    January 8, 2010

    Mark, I remember. Please note that I wasn’t claiming that nosocomial infections aren’t due to physician error, merely that many of them aren’t. That doesn’t stop the woo-meisters were assuming that every single one of them is. Nosocomial infections are more often due to systemic issues (note how check lists for central line placement can dramatically reduce the number of catheter-related infections), but sometimes they can’t be avoided. Certainly we should do everything we can to reduce the rate of nosocomial infections, but the nature of the beast (the hospital) makes this difficult. Really sick patients on multiple antibiotics over time produce a lot of nasty, resistant bugs.

  15. #15 DrWonderful
    January 8, 2010

    My God I cannot tell you how much I enjoy this.

  16. #16 Liz Ditz
    January 8, 2010

    Don’t miss this HuffPo parody

    http://comedy.com/files/2010/01/HuffPoFinal.jpg

  17. #17 Alareth
    January 8, 2010

    It could have been much worse. Instead of Dossey to round out the trio they could have gotten Ullman …

  18. #18 xinit
    January 8, 2010

    I just want them to agree never to seek “allopathic” procedures, ever. No heart surgeries, no transplants, no chemotherapy or invasive surgery.

    I’d sleep better at night knowing that they weren’t hypocrits.

    Well, and with the understanding that they’d likely die sooner.

  19. #19 Anthro
    January 8, 2010

    Orac, the hospital really should take down the plaque, or modify it–that is what sticks in Mark’s craw. I’m sure he understands the broader point about nothing being perfect.

  20. #20 Cheri
    January 8, 2010

    I found this blog after following a link from the NYT. I cannot agree more with your assessment of these so called ‘physicians’. Witch doctors is more like it.

    Back in the mid-90′s, I was involved with a young man named Randy. He lived with his parents in Nederland Colorado and I would classify them as an extreme example of ‘magical thinking’ gone awry. They were big fans of Deepak Chopra and other New Age superstars that seemed to have a book out every year and at first (never having really read his stuff) I was willing to go along with the idea that the mind had control over some aspects of physical health. To me it meant something like the placebo effect. To them it meant that levitation was possible. After about a year and a half, I and my boyfriend began to have some serious discussions about my diabetes. These discussions did not go well, as he kept brining up Deepak Chopra’s work with Type 2 diabetics, and how Chopra’s institute had managed to cure them via meditation.

    The fact I am a Type 1 diabetic, the victim of an autoimmune response when I was 10 and dependent on insulin for life, did not matter to my then-boyfriend. I tried to explain the processes and the reason that I had to inject myself with insulin multiple times a day and test my blood sugar. He told me I wasn’t being open to alternative medicine.

    Believe me, if there was ANY possibility that ANY alternative treatment could treat or cure my TYPE 1 diabetes, I would be all over it. However, such a treatment does not exist, outside of a pancreas and kidney transplant. He didn’t understand the differences between Type 2 diabetes, where people can appear ‘cured’ and can reduce the amount of medication they take if they are serious about making the necessary lifestyle changes, such as exercising more, eating less and in some cases, losing weight. But no lifestyle change will ever bring back my beta cells, the pancreatic cells destroyed by the immune system when Type 1 diabets presents itself. Without strict adherance to intensive insulin therapy, tight control over our diets and carb counting, blood sugar monitoring and taking the appropriate supplementary medications such as ACE inhibitors to slow the pace of cardiovascular deterioration and potential small blood vessel damage that can lead to retinopathy and kidney failure, Type 1 diabetics face serious consequences. Even when we do handle and manage things correctly, complications can show up. Hypoglycemia is one of them – frequent hypoglycemia is a sign that a Type 1 diabetic is actually following their medication schedule. I had several low blood sugar episodes while we were together and Randy acted as if I were the one at fault for them, as if I was too weak-willed just to simply not have them. I tried to make him understand, but it was like talking to a Libertarian about Social Security – a total brick wall.

    His family aided and abbetted his attitudes and New Age prejudices. His mother was the sort that espoused feminism and yet stayed home due to some unseen ‘disability’. She built compost heaps right next to the house and then wondered why she had ants in the kitchen and bears in the yard. When a doctor told her she needed to take lithium as a treatment for her depression, she went out and found a pendant made of some stone that contained the compound – I think it was some egg-shaped crystal of some kind. His father had a normal, well-paying job at a car dealership, but threw that away in an attempt to write bad New Age Fiction in the same vein as Chopra. I remember reading the draft he was going to send in to publishers and wincing at how bad it was. When he asked the family for a critique, instead of just telling Randy’s father how great the novel was, I actually tried to give him the same kind of critique a reviewer would give him, which wasn’t what he wanted to hear. As time went on, I was treated as an outsider for expressing my opinions, and eventually the relationship between Randy and I disintegrated. The differences between us finally came to a head on New Year’s Eve, 1997, while listening to an NPR story in the car about the legal defense of a child-molester who claimed the nine-year-old girl had ‘asked for it’. When I exclaimed a child molester was someone who should be taken out to a field and shot, Randy yelled back at me and stated ‘what makes you think that girl’s soul didn’t decided for this to happen so that she could work out karma from her last life?’

    Unbelievable. A month later, he told me to leave, saying that he had tried his best to make me see the light regarding his beliefs and he just couldn’t do it anymore. Plus, he wanted someone healthy, someone who wasn’t ‘married to their illness’.

    Chopra and his ilk exist because people like Randy exist – people with little education past high school, who are easily influenced by those who promise much for little and who reject science based on observation and proven testing methods in favor of a magic wand. Of course Deepak Chopra is going to malign traditional medicine – the more he plants the seed of doubt among sheep like Randy and his family, the more money he makes. I view them as the left’s version of the Christian evengelical preachers who put books out saying ‘God wants you to be prosperous and make lots of money – buy my book and learn all about it!”

    Randy wanted me to give up my diabetes, to simply will it away and insisted that I try. He became angry when my physician put me on an ACE inhibitor to try to prevent cardiovascular complications. He, of course, had no underlying health issues, hadn’t had to cope with a chronic incurable illness since childhood and I suppose that also cemented Randy’s sense of superiority as far as his own health was concerned. I find it interesting that few people in my position ever take people like Chopra seriously – we know too much about illness from having to live with it. We are realists who understand that some illnesses cannot be willed away, cannot be attacked by anything other than controlled experimentation and replication of results. Anecdotal evidence on the pages of a New Age tome that retails for $30 a pop won’t cure anyone, won’t ease the pain of anyone other than Chopra and his family, who I’m sure thank each and every one of their flock for their hard earned dollars.

    For my part, getting away from an environment filled with Kool-Aid drinkers devoted to Chopra was a blessing in retrospect. I went on to a career, earned an MBA and have prospered with my marriage to a man with some common sense. While I have serious gripes at how medicine is doled out and paid for in our society, I have no arguments with the validity of that medicine, nor the science that underlies it. I participate in studies meant to discover the origins of my illness, have donated time and blood to researchers looking for better forms of treatment, or perhaps even cures. I’ve signed the paperwork that allows me to donate my body for research into how and why Type 1 diabetes manifests. Hopefully my corpse will show some young future endocrinologist just what we as Type 1 diabetics suffer during our lifetimes. It will be my last gift, to try to help others afflicted with this condition. I don’t have Chopra’s money, I don’t have his influence over the idiot mindset of the American people and I fear that people like Chopra are going to become the de facto medical specialists for people too stupid to see that the only thing these men can offer is an empty wallet.

  21. #21 DrWonderful
    January 8, 2010

    @xinit- why do you say that? I really don’t think anyone is saying that medicine should be eliminated. God no. Why do you take the Us vs Them attitude? Why can’t you accept an Us and Them world? As atheists looking to assimilate more into a theist culture isn’t that what most of you desire? Or should I not ask…

    I’m a chiropractor and the very first place I would go for a serious or life threatening medical condition is my MD. I’d also look to integrate other options as well. For most non serious or non life threatening situations a combination of therapies is not only effective but very popular. Why are you so threatened by that? Why the vitriol? Would you believe about half of my practice comes from MD referrals now? This includes ortho’s, neuro’s and pediatricians. I currently count numerous MD’s, Dentists, and PT’s as my patients as well. They think what we do is, well, wonderful.

    The only people looking for exclusivity and omnipotent power in healthcare nowadays is y’all. The rest of us got over it decades ago. Maybe you should too?

    I think Chopra et al have an intersting point. The hypocricy point. Reportedly, only 36-40% of the procedures that you accept as being worthy of praise (literally) have the same level of evidence that you demand, quite forcefully I might add, from others. Wow, what a good point to raise. He must be reading what I’ve been writing here for awhile.

  22. #22 Todd W.
    January 8, 2010

    @Cheri

    Ouch. Thanks for sharing your story. You may have heard about this, but at Massachusetts General Hospital, Dr. Denise Faustman is doing research trying to find a cure for type 1 diabetes. My office does a fair bit of fundraising for it.

  23. #23 the_muteKi
    January 8, 2010

    “Those numbers might be close to what you could expect from a witch doctor, one difference being that witch doctors don’t submit bills in the tens of thousands of dollars.”

    CAM practitioners/advocates decrying witch doctors? I think *my* irony meter may require recalibration.

    Unless their point is that CAM is just that much cheaper because -it’s just tap water-. :P

  24. #24 Greg Fish
    January 8, 2010

    Would the supernova of burning stupid be able to overcome the ignorance well of the black hole, or would the black hole suck all the burning stupid out of the supernova past its event horizon?

    That would depend on the quantity of ignorance making up the black hole. We can find the size of the ignorance well by the following equation…

    rs = 2As / c2

    … where A is the attractive pull of the ignorance via the arrogance by ignorance factor, s is the overall level of ignorance achieved in the system, and c is the speed of light by which the ignorance spreads on the web. With Deepak Chopra in the mix, the results of this equation should yield a supermassive black hole of ignorance on par with Sagittarius A* and any supernova closer than a light year away will be swallowed.

    However, there’s a little twist in this case since the supernova in question is that of burning stupid. Since burning stupid and ignorance carry different charges, they form an intense attraction to one another by the law of inverse squares, that is, the power of burning stupid doubles near a well of ignorance when the distance between the forces is halved. Therefore, a supernova of burning stupid exploding close to a supermassive black hole of ignorance will create a blindingly bright accretion disk with jets of raw stupid radiating in a death ray that could effectively melt all irony meters within several tens of light years. Depending on the size of the supernova, it will eventually be consumed by ignorance and rearranged into nearly infinite quantum states within the singularity of sheer ignorance, an area where knowledge cannot survive for more than an instant.

    Hope that answers your question.

  25. #25 squirrelelite
    January 8, 2010

    I agree with Anthro’s point.

    I have worked at locations that post signs about how many consecutive days they have gone without a work-related accident. Since the signs change from time to time, I trust they really are keeping track of these problems.

    Mark C’s father’s hospital should have similar integrity.

    I would much rather go to a hospital where the staff know what some of their problems are and try to do something about it (like following checklists for central-line placement) than go to a hospital that pretends everything is fine and dandy when it isn’t.

    Unfortunately, most of the purveyors of alternative medicine fall into the latter category.

  26. #26 Wholly Father
    January 8, 2010

    @ Greg Fish

    I have submitted your thesis for peer review. One error in your math.

    “…by the law of inverse squares, that is, the power of burning stupid doubles near a well of ignorance when the distance between the forces is halved.”

    Actually, the power of burning stupid quadruples ….when the distance between the forces is halved.

    You’re Welcome.

  27. #27 BKsea
    January 8, 2010

    I though the last paragraph of the article was interesting:

    “We are not suggesting that Americans adopt any and all alternative practices simply because they are alternative. These, too, must demonstrate their effectiveness through objective testing. But alternative modalities should not be dismissed out of hand in favor of expensive and unnecessary procedures that have been shown to benefit no one absolutely except corporate stockholders.”

    So we should only accept “alternative practices” that have shown “effectiveness through objective testing”? Great – there’s a name for that approach: Science-based medicine.

    I would also add the additional staement that science-based modalities should not be dismissed out of hand in favor of expensive and unnecessary alternative procedures that have been shown to benefit no one other than charlatans and con artists.

  28. #28 blacksteel42
    January 8, 2010

    @ Greg Fish

    I’m reading Susskind’s ‘The Black Hole war’ and he hasn’t covered yet, but what kind of information would be radiated off once a supernova of burning stupid passes the event horizon of ignorance?

  29. #29 Skeptico
    January 8, 2010

    I can’t help thinking Chopra et al are phoning this one in. Nothing new here – just false dilemma (real medicine has some problems, therefore woo works) again. Nothing like the spectacular woo arguments Chopra is capable of. Hardly worth their effort.

    I suppose that’s good, in a way.

  30. #30 Scientizzle
    January 8, 2010

    We are not suggesting that Americans adopt any and all alternative practices simply because they are alternative. These, too, must demonstrate their effectiveness through objective testing. But alternative modalities should not be dismissed out of hand in favor of expensive and unnecessary procedures that have been shown to benefit no one absolutely except corporate stockholders.

    I’d like to see this Venn diagram:
    1. ‘alternative practices’ that have demonstrated effectiveness through objective testing
    2. the conditions for which mainstream medicine only offers “expensive and unnecessary procedures that have been shown to benefit no one absolutely” (absolutely? is that code for 100% success rate w/ no complications?)
    3. the intersection of 1 & 2 in which a (real) medical condition can only be reliably and effectively treated by a CAM modality

  31. #31 Fuzzzone
    January 8, 2010

    Cheri, I can’t believe you put up with that guy for as long as you did.

    Child molestation as karmic payback for past life peccadilloes?

    “Stop the car, you raving loon, I’m walking from here.”

  32. #32 Todd W.
    January 8, 2010

    @Fuzzzone

    Child molestation as karmic payback for past life peccadilloes?

    That kind of mentality was something I noticed in a lot of people who believe in “karma” and “reincarnation”, such as some of the folks I met in Soka Gakkai International, a Buddhist sect. Really put me off that they have a blame-the-victim mentality, particularly where the person had absolutely no control over what happened to them.

  33. #33 xinit
    January 8, 2010

    @DrWonderful

    I don’t believe you’re familiar with Choprah’s body of work, which focuses on the evils of western medicine.

    I believe there is serious danger in scaring people away from their MDs; which is what this article, and so many more like it from the HuffPo appear to be trying to do.

  34. #34 Joerg
    January 8, 2010

    It’s the Three Wooges!

  35. #35 Scott
    January 8, 2010

    I’d like to see this Venn diagram:
    1. ‘alternative practices’ that have demonstrated effectiveness through objective testing

    Of course, since this is by definition the empty set, the rest of the Venn is uninteresting.

    The argument is, though, since it demonstrates just how much MORE the Three Wooges (love that term, Joerg) would have to prove in order to have a legitimate case.

  36. #36 Smrt Newfie
    January 8, 2010

    @Dr. Wonderful

    Finally some who is making sense. We need both to compliment one another. This sort of thinking really needs to be taken to other industries as well. I think Mark Crislip had a great idea with this article.

  37. #37 Jeff Read
    January 8, 2010

    I’d like to see this Venn diagram:
    1. ‘alternative practices’ that have demonstrated effectiveness through objective testing

    Tim Minchin: “By definition, alternative medicine has either not been proved to work, or has been proved not to work. Do you know what they call alternative medicine that’s been proved to work? Medicine.”

  38. #38 DrWonderful
    January 8, 2010

    @Jeff Read- Really? Only medicine works? Weird. I could have sworn there were more than 35 excellent studies demonstrating the efficacy, safety and cost effectiveness of chiropractic spinal manipulative therapies. And not once did they call it medicine. Weird, huh? Medicine is trying to cop it, as we speak, but it’s not called medicine. And what do they call the other 60% of the procedures that are performed in Medicine that have no proven benefit at the same level you require of others?

    Also, Vitamin D…is that medicine? Green Tea extract is medicine? No way! Omega 3 benefits are medicine too, right? What about Milk Thistle?…more medicine, right? Niacin? Or have these only been proven to work when prescribed by the MD?

    Your cult of science is deceiving you. You’ve been tricked into thinking you are smarter, better and more valuable than those you criticize blindly. But you’re really not. I know you wanted so much to be the ebst but only to find you’re average. Yeah, it sucks but most of the medical community got over it decades ago.

  39. #39 Dangerous Bacon
    January 8, 2010

    Doc Wonderful sez: “The only people looking for exclusivity and omnipotent power in healthcare nowadays is y’all.”

    Holy Massive Strawman! The only “exclusivity” being sought by supporters of evidence-based medicine is for all therapies, whether “conventional” or “alternative” to be exclusively judged by the same standard – that they be demonstrated to work by established scientific criteria.

    I find it odd that you talk about the “cult of science” while simultaneously trumpeting “more than 35 excellent studies” allegedly vindicating the wonderfulness of chiropractic. If science is such a cult, why are you looking to it to give your profession credibility? :)
    Of course, this is the double standard that woo-ists employ constantly – on the one hand denigrating research they don’t like as being corrupted by Big Pharma or other Meanies, while jumping on the bandwagon of any study, no matter how poorly conducted, that seems to give credence to their woo (i.e. small studies in fringe journals, which probably are where most of Dr. Wonderful’s “35 excellent studies” come from – since pretty much all chiropractic has going for it is evidence of modest effectiveness in treating chronic musculoskeletal pain, on a par with conventional therapies like rest and NSAIDS, or non-chiropractic physical therapy).

    Nice try on tu quoquing your way out of the dilemma of being an apologist for unproven alt med treatments, but consider this: mainstream medicine actually reviews and discards treatments shown to be ineffective, while chiropractors and other alt medders seldom to never throw out useless and dangerous therapies and apparently have never heard of the concept of quality improvement.

  40. #40 ajerma
    January 8, 2010

    DrWonderful:

    35 excellent studies demonstrating the efficacy, safety and cost effectiveness of chiropractic spinal manipulative therapies.

    Link please. Also, what kind of spinal manipulation? The subluxations kind, or the skeletomuscular kind, which is basically a form of physical therapy and has been shown to possibly help lower back pain?

    Also:

    I think Mark Crislip had a great idea with this article.

    I quite agree, that article is quite good and rather funny. Although…I don’t think it means what you think it means. Irony meter score: 8/10

    Also, as Orac quite clearly stated above, the “modern medical establishment” is anything but opposed to CAM. Well, there are some pockets of resistance, but mostly stuff like acupuncture and reiki are being swallowed hook, line and sinker. That’s what happens when you have doctors not trained in the scientfic method, am I right?

  41. #41 ajerma
    January 8, 2010

    Hmm, anyone know why the blog substituted my name for that monstrosity down there?

  42. #42 Jeff Read
    January 8, 2010

    DrWonderful, I’ve plonked people whom I considered very close friends for making arguments such as yours. I won’t hesitate to plonk you.

    (For those of you who don’t know, “plonk” is Usenet speak for “ignore summarily”, usually by electronic means but given the nature of this blog…)

  43. #43 Troll Lord
    January 8, 2010

    I personally do not like the Huff and Puff Post either. However, there are alternatives to killer vaccines and dangerous medications. http://www.naturalnews.com is one of my favorites. There are many more. It’s a shame we have to live in a world of people who still refuse alternative medicine ass opposed to a prescription that may do more harm than good in the long run. Oh well.

  44. #44 Rogue Epidemiologist
    January 8, 2010

    Nice Poe, Troll Lord. I totally LOL’d.

  45. #45 Greg Fish
    January 8, 2010

    @Wholly Father, #26

    One error in your math… the power of burning stupid quadruples when the distance between the forces is halved.

    Ah that’s right! I swear, I make the silliest errors sometimes. Thank FSM for peer review and thank you for catching that.

    @blacksteel42, #28

    … what kind of information would be radiated off once a supernova of burning stupid passes the event horizon of ignorance?

    Quantum misinformation radiation. You can detect it by the abnormally high use of the term “quantum” completely regardless of context, generally used as a deus ex machina to stabilize the wake-fields of burning stupid which travels with it.

    In a reversal of general rules of astrophysics, the bigger the black hole of ignorance, the more misinformation radiation it emits. Hence the system is unstable overall, relying on constant feedings off burning stupid to hold itself together. Should it fail to accrete enough burning stupid, it simply dissipates with a whimper.

  46. #46 red rabbit
    January 8, 2010

    @ MCC#12- sorry to hear about your father. That’s a sad story.

    Technically the physicians have little choice over which room a patient is allocated. That’s an administrative and nursing decision in general.

    Which of course does not excuse the hospital having placed your father in such a position.

    Nevertheless, IMHO nosocomial infection is less a doctor problem than a system problem.

  47. #47 DLC
    January 8, 2010

    Even if the absurdly high levels of Iatrogenic deaths put forth by the Woo-Teers was exactly true, they would still have to explain why their hand-waving and patent nonsense nostrums do not exceed placebo effect in the best available clinical trials.

  48. #48 Interrobang
    January 9, 2010

    Joerg wins an internet with a side of fries for that atrocious pun; it’s not often I see something so bad I actually blurt “ARGH! ARGH! ARGH!” at the screen. Well done!

    And Orac wins an internet and a cherry Coke for some of the prettiest discourse analytics I’ve seen done by a non-practitioner in a long time. Nice shootin’, Tex. Speaking as the Friendly Neighbourhood Rhetorician (really), I practically needed a cigarette after reading that, and I don’t smoke. I think you’re utterly right about procedures, by the way; contextually, that word is so loaded it’s a wonder it didn’t break in half and fall on the floor…

  49. #49 Pareidolius
    January 9, 2010

    TollLord@43
    Ass long ass you’re at it, you might ass well mention whale.to.

  50. #50 TheoDarling
    January 9, 2010

    I’m a lurker, usually, but has anyone else heard about MMS (Miracle Mineral Solution)? It is apparently a miracle cure for everything from AIDS to cancer (of course, aren’t they all?) except, it’s actually just bleach, and it kills people.
    What makes me so angry, though, is that the “discoverer” – wow, he gets credit for discovering tap water, basically – thinks he has cured people in Africa of AIDS. And he claims that nausea and vomiting are “part of the healing process” not, you know, poisoning from drinking bleach.
    The Sydney Morning Herald (in Aus) has this article -
    http://www.smh.com.au/national/deadly-chemical-being-sold-as-miracle-cure-20100108-lyvl.html
    I’m so mad I could spit.

  51. #51 K
    January 9, 2010

    The Three Musketeers of Woo have added an addendum:

    http://www.huffingtonpost.com/dr-larry-dossey/addendum-to-the-mythology_b_416518.html

    “The Mythology of Science-Based Medicine” caused quite a stir in the HuffPost community. The authors would like to respond to specific criticisms raised against them, as well as clarify the issue further.

  52. #52 Kristen
    January 9, 2010

    @TheoDarling

    I just read the article you linked to. Dear Lord that has to be the very worst thing I have read about in modern quackery!

    ”It’s a bit like drinking concentrated bleach. They’ve had corrosive injuries: vomiting, stomach pains, diarrhoea,” the medical director of the NSW Poisons Information Centre, Dr Naren Gunja, said.

    And the SOB who peddles this concoction says:

    I don’t make any claims [in writing] about it to get around [regulations against using it as a medicine*],

    I think I am just about as angry as you.

    *second brackets are my own for clarification

  53. #53 riotnerd
    January 9, 2010

    Orac,
    While your argument is solid over all, you’ve made a pretty serious error in your use of the classic fallacies of reasoning. You attribute a whole series of “false dichotomies” to the various authors you’re going after but define false dichotomy incorrectly. A false dichotomy is not a rhetorical device whereby someone tries to legitimate their position by setting it up as the other side of a debate. For example, creationists no logical fallacy when they say, “either the universe came to be by natural or supernatural means.” They are correct because there is no third possibility that is allowed for by the laws of non-contradiction and the excluded middle.

    One commits the fallacy of false dichotomy when one asserts that there is not a third possibility when in fact there is. When, for example, we are told that we are either closed minded or must accept alternative medicine, we are being offered a false dichotomy. There are several third positions, i.e. I’m open minded but not stupid and etc.

    The question of whether or not a dichotomy is true or false is a purely formal one. If a dichotomy is set up which excludes all other possibilities, i.e. either A or not A, then it is true. Otherwise it is false. The dichotomies listed above almost certainly are false, but not in the way Orac describes them to be.

    your local logician,
    riotnerd

  54. #54 Daniel J. Andrews
    January 9, 2010

    Good one, Joerg–re: the three wooges. Now I will have to steal it. :)

    Of course, this is the double standard that woo-ists employ constantly – on the one hand denigrating research they don’t like as being corrupted by Big Pharma or other Meanies, while jumping on the bandwagon of any study, no matter how poorly conducted, that seems to give credence to their woo (i.e. small studies in fringe journals,…

    Exactly, Dangerous Bacon. This type of double-standard is seen in pretty much all antiscience type positions (e.g. moon landing was a hoax, creationism, global warming–in fact, there’s now a webpage detailing the double-standard arguments by these denialists, such as rejecting temp records that show warming as unreliable while trumpeting temp records that show cooling as proof warming has stopped).

    It might be useful to start collecting these type of double-standards in other areas that antiscience or alt-reality folks embrace. Their cognitive dissonance won’t let them see their errors, but people who are on the fence or looking for answers may find the blatant contradictions in the antiscience group more persuasive than our fact-based arguments.

  55. #55 Rincewind'smuse
    January 9, 2010

    @ 21,

    The only people looking for exclusivity and omnipotent power in healthcare nowadays is y’all. The rest of us got over it decades ago. Maybe you should too?

    Funny how anecdote and fact seem equivalent in your world….I’ve often gotten smug,vaguely ignorant repudiation of anything allopathic from chiropracters(not all). But because I don’t think everyone should be painted with the same broad brush I would have given you the benefit of the doubt if not for the implied ad hominem;it makes your world of fuzzy inclusivity an ironic joke.

  56. #56 hyperdeath
    January 9, 2010

    riotnerd@53:

    Orac is right.

    Chopra et al. imply that mainstream medicine is a monolithic, completely unified, take-it-or-leave-it whole, and then set up a false dichotomy between this portrayal and their woo. Their argument amounts to “these things about mainstream medicine are bad, therefore our woo is better“. This is a false dichotomy which ignores the third (and correct) option of “yes, mainstream medicine isn’t perfect, and many aspects badly need reform, however, your alternatives are still a load of bullshit“.

  57. #57 kausik.datta
    January 9, 2010

    Sometimes I wonder if there is something in the water in this country. How else do I explain the phenomenon of well-trained, well-accomplished physicians (yes, even Chopra was an endocrinologist in India before emigrating to the US) becoming myrmidons of extreme woo-woo, lapping it all up (along with healthy doses of Eastern mysticism), and eschewing all forms of critical and rational thinking in order to peddle their brand of nonsense? What happens here?

  58. #58 has
    January 9, 2010

    mainstream medicine actually reviews and discards treatments shown to be ineffective, while chiropractors and other alt medders seldom to never throw out useless and dangerous therapies and apparently have never heard of the concept of quality improvement

    Imagine if Woo ran Big Pharma… we’d still be dishing out Thalidomide, and blaming all the moms for not believing hard enough in little hands and feet.

  59. #59 DrRachie
    January 9, 2010

    @has

    Imagine if Woo ran Big Pharma… we’d still be dishing out Thalidomide, and blaming all the moms for not believing hard enough in little hands and feet.

    Brilliant.

  60. #60 alison
    January 10, 2010

    @ #50 – I blogged about MMS a while back (http://sci.waikato.ac.nz/bioblog/2009/03/more-on-sodium-chlorite-the-mi.shtml); had a couple of the usual ‘try it before you diss it’ brigade drop by… I’m disgusted that people can make money selling swimming-pool water to others desperate for a cure.

  61. #61 kill_13
    January 10, 2010

    First comment here.
    Came over from a link supplied by a poster at HuffPo. Have been commenting on the total trash (woo) in HuffPo’s “living” section for some time. If bad medical advice could fly HuffPo would be an airport! Just had to post here to let you know that just when you think things couldn’t get anymore extreme I find this one this morning.

    http://www.huffingtonpost.com/2010/01/08/the-healing-power-of-birt_n_416732.html

  62. #62 attack_laurel
    January 11, 2010

    Moreover, they don’t discuss relief of angina symptoms.

    Or any symptoms; quality of life doesn’t really count as medicine to them, apparently. My nerve damage that cannot be cured* disagrees.

    I’ve had people suggest copper bracelets and magnets as “cures”. I find managing the pain with the help of Big Pharma suits me just fine.

    *As in, it’s not going to go away. I can make it hurt a lot less, thanks to science.

  63. #63 HalfMooner
    January 11, 2010

    Inspired by the above, I’ve posted this spoof image for you to use as you may wish:

    http://www.skepticfriends.org/forum/topic.asp?TOPIC_ID=12546

  64. #64 Colin Day
    January 13, 2010

    @riotnerd #53

    What if the universe did not come to be at all, and simply always was/is/will be? Of course, our particular spacetime may have an origin, but the universe as a whole might not.

  65. #65 The Dissenter
    January 14, 2010

    It’s so amusing that commentators here have so little facts to defend allopathic medicine that all they can do is hurl childish insults at the ‘woo’. All I can figure is that allopathic doctors are so afraid of alternative medicine that they have to berate it using hyperbole and childish name-calling. It really sounds like a case of “The lady doth protest too much, methinks”.

  66. #66 Dissent?
    January 14, 2010

    Fantastic job presenting the facts in support of alternative medicine there, bucko.

    Pot…I’d like you to meet this kettle…

  67. #67 Kimberly
    January 15, 2010

    @cheri – Wow. Because you have a chronic illness and were using the best possible medicine to treat it, you were deemed “married to your illness.” I can’t imagine how furious that must have made you.

    But your comments bring something to light that alt-med types don’t want us to know, and that is that they honestly cannot deal with the fact that illness is a part of life. Human beings, by virtue of being alive, will suffer from illnesses, to one degree or another. Modern science-based medicine tackles this head-on and looks for cures, with the understanding that medicine sometimes cannot save a life or even improve it. There are times when a honest physician will have to say to someone, “There’s nothing I can do, and you are going to have to find a way to deal with this.”

    Woomeisters, on the other hand, are in such denial that they insist diets cure autism, crystals cure depression, and you can keep yourself from every getting sick by having positive thoughts. The alt-med types are horribly uncomfortable with sickness, death, imperfections, and the general human condition. They lack the character to understand that not everything in life is fixable. They’ll never advertise this, but there it is.

  68. #68 Kelly M Bray
    October 11, 2011

    I find it hilarious that at the the top of this page is an ad for Chakras Healing Dot Com. Asking “want to find out which of your chakras is weak?” Seriously? Two steps forward, one step back!

The site is currently under maintenance and will be back shortly. New comments have been disabled during this time, please check back soon.