Respectful Insolence

Do you believe in magic in medicine?

Sometimes, between blogging, a demanding day (and night) job doing surgery and science, and everything else, I embarrass myself. Sure, sometimes I embarrass myself by saying something that, in retrospect, I wish I hadn’t. More often, I embarrass myself by letting things slide that I shouldn’t. For instance, when friends send me a prepublication copy of their books, I should damned well read them, don’t you think? So it was that Paul Offit sent me a copy of his latest book, which just hit the bookstores and online outlets this week, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine, and I haven’t finished it. Oh, I’ve read a good chunk of it, but it’s not a huge book (around 335 pages); so I should have finished it by now, particularly since it’s quite good. However, my personal laziness (or lack of ability to prioritize) aside, I’m glad to see that the book’s getting attention in a large media outlet, namely USA Today, in an article by Liz Szabo Book raises alarms about alternative medicine. There’s also a companion piece How to guard against a quack. One of the people interviewed in that article might seem a wee bit familiar to regular readers of this blog.

People interviewed aside, it always warms the cockles of my heart when a major media outlet writes a (mostly) skeptical article about alternative medicine. I credit that to Dr. Offit, whom I consider a friend even though I haven’t actually met him in person yet (although I have spoken on the phone with him about various issues a few times). It makes me wonder if I should write a book myself, although I’m not sure that the angle I’m interested in would be as marketable as how Dr. Offit did it; it might well be too wonkish and hardcore. Be that as it may, I congratulate Dr. Offit for his achievement. What I’ve read so far is really good. The USA Today article is also, by and large, skeptical. At least, it’s more skeptical than most. I must admit that it did irritate me that Szabo ended up finishing the article with a quote from the Queen of Quackademic Medicine—excuse me, I mean the director of the “integrative” medicine program” at Memorial Sloan-Kettering Cancer Center saying:

Yet Cassileth, author of The Complete Guide to Complementary Therapies in Cancer Care, says non-traditional approaches can have a place in medicine, when modern medicine has little to offer.

As opposed to “alternative,” Cassileth prefers the term “integrative” medicine, which subjects nonstandard therapies to scientific tests. At Memorial Sloan-Kettering, integrative health researchers focus on alleviating pain and other symptoms. But they would never claim that nontraditional therapies can cure cancer, she says.

For example, doctors have had promising early results using acupuncture to restore salivary gland function in patients who receive radiation to the head and neck. Without functioning salivary glands, these patients can’t talk or swallow.

While critics counter that acupuncture treatments are simply placebos, Cassileth says, “if there is a placebo effect that brings back salivation to these people who can’t eat or talk, who cares?”

In response to which I want to shout to the rooftops that “integrating” quackery with real medicine doesn’t improve medicine. It’s the same as Mark Crislip’s famous 34 word definition of “integrative medicine, “If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.”

Or, as I put it, if you integrate quackery with real medicine, you do not produce better medicine. Instead, you turn quackery into medicine and medicine into quackery to the point where the line between the two becomes difficult to distinguish even for physicians. That is exactly what is happening now in academia, and Barrie Cassileth is a key example. That’s why she (or, more frequently, a study of hers) has been a not infrequent topic of this blog.

The focus of the article, wisely, begins with unregulated supplements. Because of the infamous (and Orwellian-named) Dietary Supplement Health and Education Act (DSHEA) of 1994, a law that more or less deregulated the supplement industry. Well, not exactly. As I’ve explained many times before, what the DSHEA did was to regulate supplements as food and basically tie the FDA’s hands over health claims, just as long as they were sufficiently vague. Not acceptable are claims that supplements will treat or diagnose specific diseases or conditions. Acceptable is almost anything else, which has led to supplement manufacturers becoming increasingly creative with so-called “structure-function” claims, such as “boosts the immune system” or “promotes prostate health.” Also true is the portrait of the supplement industry as big business, a $34 billion a year industry with aggressive lobbyists and its own Dietary Supplement Caucus and powerful legislators in its corner, such as Orrin Hatch and Jason Chaffetz.

Also noted is how the federal government spends nearly a quarter of a billion dollars a year researching alternative medicine through the National Center for Complementary and Alternative Medicine (NCCAM) and the National Cancer Institute’s office with one of the most unfortunate acronyms ever, the Office of Cancer Complementary and Alternative Medicine (OCCAM). Unfortunately, when interviewed by Szabo, Josephine Briggs wastes no time in the “bait and switch” of alternative medicine, in which Tai Chi is not represented as being anything more than just light exercise:

Briggs notes that research conducted by her center and others shows real benefits to certain alternative therapies, which doctors describe as “complementary” if they are used in conjunction with conventional medicine. Last year, for example, The New England Journal of Medicine published a study showing that people with Parkinson’s disease can improve their balance and stability by practicing Tai Chi, an ancient Chinese exercise system. A study published last month in the Journal of the American Medical Association found that intensive-care patients on ventilators experienced less anxiety, and required fewer sedatives, if they could listen to their choice of music.

Since when is exercise “alternative”? Didn’t we also used to call things that make patients’ stays in the hospital more bearable “supportive care.” I’m talking about things like—yes—music, along with art (which is now “art therapy), and visits from pets (which is now “pet therapy”). In fact, if there’s an aspect of the story that I wished to see but didn’t, really, it’s an explanation of how such supportive therapies are being “rebranded,” along with various science-based modalities such as diet and exercise, as somehow “alternative.” I suppose it’s a hard thing to explain to the average newspaper reader who doesn’t follow the issue the way readers of this blog do.

Worse, a supporter of quackademic medicine even gets away with the old “most so-called ‘evidence-based medicine’ is not evidence-baed” gambit:

Only about one-third of alternative therapies have safety and efficacy data behind them, critics note. Yet conventional doctors don’t always follow the evidence, either, says Adriane Fugh-Berman, an associate professor of pharmacology at Georgetown University in Washington and author of a textbook on herbs and supplements. Only about one-quarter of therapies used in conventional medicine are “evidence-based,” she says.

Nonsense. Steve Novella explains why. Nonsense, says Edzard Ernst. Nonsense, said Robert Imrie and David Ramey. And nonsense say I.

At least the harms are mentioned. Some previous subjects of this blog show up, including the example of chelation therapy killing a five year old autistic boy named Tariq Abubakar Nadama in 2005. There’s the example of harmful quackery for Lyme disease. There’s the example of Steve Jobs, although, as much as I hate to disagree with Dr. Offit, I have to say that I disagree. As I’ve said before, the nine month delay most likely didn’t make a difference in whether Steve Jobs lived or died of his cancer, although the delay certainly didn’t help him. There’s a chapter in his book about Steve Jobs, and I think the “alternative medicine killed Jobs” angle is played up too much. Interestingly, it is actually Barrie Cassileth who says that Jobs “essentially committed suicide.” No, he did not. He might have inadvertently contributed to his death, but, given lead time bias and the indolent nature of Steve Jobs’ tumor, probably the “cat was already out of the bag” when he was first diagnosed. It’s very odd for me to be less harsh on alternative medicine than Barrie Cassileth.

On the other hand, leave it to Andrew Weil to say something truly dumb:

Andrew Weil, one of the USA’s best known advocates of holistic medicine, says he also favors closer regulation of supplements.

“I would love to see the FDA set up a division of natural therapeutic agents,” says Weil, director of the Arizona Center for Integrative Medicine at the University of Arizona,

There’s no need for such a division within the FDA. The FDA as currently constituted is perfectly capable of handling the regulation of supplements if only the DSHEA were repealed or amended to give it the power to do so. Too bad that the readers probably won’t recognize Weil’s blather for the self-serving, disingenuous propaganda that it is. Other previous topics of this blog who pop up in this article include Stanislaw Burzynski, Mehmet Oz, Joe Mercola, and—talk about a blast from the past!—Rashid Buttar (about whom I’ mibht have more to say later this week).

Overall, it’s a good, but flawed effort, and USA Today should be given kudos for having published it. I also like how in both articles, quacks were called quacks. Although there was a bit of “false balance” sneaking in, in the current climate, this article is probably about as good as it gets. That’s not damning with faint praise, because the Szabo hit all the right notes. I just wish they hadn’t been interspersed with too much of the wrong notes letting the quacks speak.

Comments

  1. #1 prn
    June 19, 2013

    Looks to me Offit might be right at home here, trying to mix cow pie with other people’s vitamins. Of course, to protect them from themselves.

    reviewing the Caplan article:
    They want cash upfront.
    Keeps the administrative costs way down.

    Reputable doctors and hospitals charge only for services rendered, Caplan says. They don’t ask for deposits.
    Yeah, they just charge 3 – 50x more on the standard fake billings.

    Personal stories can be extremely misleading,
    They can also be starting points for investigation, as well as cautionary.

    look for … studies published in peer-reviewed medical journals.
    yes. Then decide how you might compare or test it.

    If treatments are only offered outside the country , that may be
    …because you may be long dead if you have to wait for the FDA to undo its protective trade barriers with our European or Asian “allies”

    When mainstream medicine says there is nothing more we can do, your best bet is to head into an clinical trial
    …if your critical thought pattern is linear and you have trouble with fractions and percentages. PETA loves you too.

    Science is about coming to consensus
    I’ve known some very disagreeable discoverer-inventor-scientists about that.
    “Science is belief in the ignorance of experts” – Richard Feynman
    This will raise a few hackles. Crichton waxed eloquently about CS:
    “Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus….
    There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period.”

  2. #2 cees renckens
    Hoorn, The Netherlands
    June 19, 2013

    I also belonged to the happy few who received a prepublication copy of Paul Offit’s new and excellent book and I already have been able to read it from cover to cover! Much of it was well known to me (being involved in the anti-quackery business since 1988), but quite a lot was new and revealing. I was struck by the stunning differences in culture between the Netherlands and the USA and I did not realize that there is so much legal space for quacks in the USA. Especially regarding the vitamins and supplements. Offit’s style of writing is fluent and it makes the reading of the book a great pleasure. I also liked the way in which he frequently closed the chapters with a very annoying fact, helpful to recruit much anger in the reader about such an injustice. I will write a review in the Nederlands Tijdschrift tegen de Kwakzalverij and I am sure it will attract and educate Dutch readers as well. Having said this all, I would like to make two comments, that do not in any way diminish my admiration for and enjoyment of the book.
    The first is Offit’s outspoken conclusion that Steve Jobs more or less killed himself by the patient delay of 9 months. As we could read here above the surgical oncologist David Gorski has a different opinion and wrote about it on 31 oktober 2011 in Science-Based Medicine: ‘Trust me when I say yet again that I really, really wish I could join with the skeptics and doctors proclaiming that “alternative medicine killed Steve Jobs,” but I can’t, at least not based on the facts as I have been able to learn them.’ I think that Gorski’s arguments are rather strong. Did Offit know of his opinion and if so, why does he see it differently?
    I have to strongly disagree with the author’s view that there is a difference between alternative medicine and quackery, which I think is not detectable. Of course it is all a matter of definition, but they share the lack of scientific proof of efficacy, the overpromotion, the medicalization and mostly also lack a plausible biological explanation. When the intention of the quack (good or bad) is left out of the definition, as it should be, then no difference remains. I give the definition we have successfully used in legal cases in the Netherlands:
    Quackery is any way of professional acting, providing advice or giving assistance in relation to the health of humans or animals – Which is not based, founded on verifiable logical or empirically sustainable hypotheses and theories, – Actively disseminated to the public, without prior verification within the profession on efficacy and safety – Which are often applied without contact and/or consultation with fellow practitioners of regular medicine.
    (The Dutch Society against Quackery (VtdK) emphasizes that the term “quack” or “quackery” does not necessarily imply the accusation of cheating or fraud.)
    In the policy of the Dutch Society against Quackery we aim to eliminate all kinds of alternative medicine and would like to outlaw all healers of that kind. So I was flabbergasted when I read on page 225 that Offit does see a place for both: mainstream and alternative healers. Do all those chiropractors, osteopaths , acupuncturists and naturopaths really add anything of use to the patients? I cannot really believe that Offit sees it that way. I have been thinking about this discrepancy between this final conclusion and the impeccable rest of this rich book. After some time I came to my best guess on this enigma. If I may suggest an ‘explanation’ for Offit’s very tolerant point of view, then I would think of the societal surrounding in which US doctors are working: a great number of semi-recognized quacks (mentioned above) and an awful lot of penetration of quackery into mainstream organizations like hospitals and universities. On top of this anti-trust legislation that forbids professional bodies to ‘discriminate’ against quacks and a climate where lawyers even question the use of guidelines (terrible!). That all seems to preclude a complete eradication of quackery within any foreseeable future so strongly that even the eminent dr. Offit did not dare to think about it. But would not he also feel that after all that still should be our ultimate goal?

  3. #3 Orac
    June 19, 2013

    “Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus….
    There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period.”

    Michael Crichton was not a scientist, and he was an anthropogenic global warming denialist, to boot. In brief, he was full of BS, and, quite simply, wrong.

    http://scienceblogs.com/insolence/2010/03/24/hostility-towards-a-scientific-consensus/

    Crichton was also prone to a lot of woo. From his autobiography quoted in Wikipedia:

    Reflecting on his career in medicine years later, Crichton concluded that patients too often shunned responsibility for their own health, relying on doctors as miracle workers rather than advisors. He experimented with astral projection, aura viewing, and clairvoyance, coming to believe that these included real phenomena that scientists had too eagerly dismissed as paranormal.[13]

    In brief, when it comes to science, particularly in his later years, when he had become an AGW denialist, Crichton knew just enough to write a rousing science fiction novel, but when it comes to how science actually works, he was oblivious.

  4. #4 Dangerous Bacon
    June 19, 2013

    Orac: “it always warms the cockles of my heart when a major media outlet writes a (mostly) skeptical article about alternative medicine.”

    Especially when that same major media outlet (USA Today) has a reputation for promoting quackery. Some years ago it hosted a series by one of its staffers promoting her journey through woo in an effort to cure her late-stage cancer, using such modalities as coffee enemas (the woo did not work, unfortunately for the writer, but USA Today was unapologetic about its heavily one-sided reports).

    USA Today also to this day happily runs banner ads for various quack supplements in its main news section. So their running the review of Offit’s book means they’re willing to play both sides of the street.

    I’m sure I’m not the first to support the idea of Orac writing his own book, wonkish and hard-core though it might be (an updated version of The Nuts Among The Berries* with a focus on Internet-related quackery is one idea). Just thinking of the reviews on amazon.com brings a pleasant tingle of anticipation.** ;)

    *Ronald Deutsch’s 1970s book on nutrition/health quackery, which got me interested in this whole sordid subject in the first place.

    **the section on acid-base flummery alone would be worth the price of the book.

  5. #5 Krebiozen
    June 19, 2013

    I read Crichton’s book ‘Travels’ a while ago: he also believed in spoon-bending.

  6. #6 Lawrence
    June 19, 2013

    I don’t think he was a very good author – I found the majority of his books had very contrived plots & stupid twists / resolutions that came out of left-field.

    He got lucky with Jurassic Park – a lot of his other stuff was simply garbage.

  7. #7 Dangerous Bacon
    June 19, 2013

    Speaking of “believing in magic”, we have the Clueless Celebrity sighting of the day – Melissa Etheridge, who’s criticizing Angelina Jolie for being “fearful” enough to have a double mastectomy due to her genetic susceptibility to breast cancer.

    “Etheridge, who was diagnosed with the same high risk BRCA gene mutation as Jolie, goes on in the interview to say that Jolie’s choice is “… way down the line on the spectrum of what you can do” and that those faced with the same set of facts should “really consider the advancements we’ve made in things like nutrition and stress levels.”

    That’s a woo wind a-blowin.

    http://abcnews.go.com/Health/melissa-etheridge-stands-fearful-jolie-comments/story?id=19430484#.UcGpb9iHNjs

  8. #8 Krebiozen
    June 19, 2013

    prn,

    Looks to me Offit might be right at home here, trying to mix cow pie with other people’s vitamins. Of course, to protect them from themselves.

    You keep making sweeping statements about vitamins and alternative treatments, and how ignorant doctors are about various things, and how none of them listen to them when you tell them they are wrong about everything, and demand unapproved treatments based on cherry-picked studies you have come across.

    When challenged to come up with evidence to support your criticisms you never do. Anecdotes about your own experiences are not convincing evidence, as you well know.

    Last year you were ranting about how stupid conventional doctors were not to prescribe dessicated thyroid, and complaining about the lack of recent research on it, when the matter was definitively settled decades ago. You also complained that guidelines for the treatment of thyroid disorders are blindly followed with no thought for whether they are correct or not, which is simply untrue. I mentioned this to a consultant endocrinologist friend of mine a couple of days ago, and she laughed. She has been researching thyroid treatment for decades, had published several papers and has contributed to changes in the recommendations (such as no longer giving enough T4 to suppress TSH).

    Please either provide evidence to support your criticisms, or stop making them. This is getting tiresome.

  9. #9 lilady
    June 19, 2013

    I mentioned on another thread that I met Dr. Offit, recently, when he did a presentation at the Cold Spring Harbor Laboratory. During his opening remarks he mentioned antineoplastons, but then did not follow through with Dr. Burzynski’s cancer treatments. I was somewhat disappointed…sigh.

    My husband and I arrived at the auditorium early and had choice seats (second row) for maximum viewing of Dr. Offit and to keep an eye on the only entrance to the auditorium to see if Dr. Offit’s stalker, Jake Crosby, was going to make an appearance…Jake was a “no-show”.

    Offit is an excellent speaker who did speak about the topics in his book and I *knew* that his opinion of Steve Jobs’ delay in cancer treatment, and a “softer approach” to some other CAM treatments, would evoke some response from Orac.

    The first person to pose a question to Dr. Offit during the Q & A period made some mighty strong statements…

    “Who pays your salary?”…then some ranting nonsense about the value of alternative medicine *practitioners* for “when Western/traditional medicine fails to meet patients needs, etc., etc”. Most of the other questions and comments from the audience, were not derogatory and were on point.

    When it was “my turn”, I told Dr. Offit that I was *disappointed* that he didn’t discuss antineoplaston cancer treatment. I also stated that I am a retired public health nurse and the parent of a special needs child and that I appreciate the wonderful care that he and the staff of CHOP provide to their patients, as well as his efforts to educate parents about vaccines and the serious, sometimes deadly, diseases that vaccines prevent. That elicited a round of applause from the audience…and a big hug for me, from Dr. Offit.

  10. #10 Renate
    June 19, 2013

    Regarding Melissa Etheridge (and several other artists)
    Sometimes it is nice to know as little as possible about the personal views of artists one might admire for their music or other arts.

  11. #11 Eric Lund
    June 19, 2013

    I don’t think [Crichton] was a very good author

    Neither do I. He was frequently polemical, and his political points of view interfered too often with his plot. Not just in his AGW book (which I never read), but in several others: Rising Sun about Japanese influence (which was already on the wane; it peaked with the Nikkei in 1989), and others about computers and nanotechnology. I’ve given away all of the Crichton books I’ve ever owned, as I considered his books a waste of my library space.

  12. #12 Mephistopheles O'Brien
    June 19, 2013

    I’ve enjoyed several of Crichton’s books including The Andromeda Strain, The Terminal Man, Jurassic Park, Disclosure, and Airframe (I was unconvinced by Prey).

  13. #13 sophia8
    June 19, 2013

    Sigh. Prn, do you ever bother to even think things through before you post? Feynman did indeed write that quote – in the context of how important it is to question everything and always test your assumptions.
    When was the last time you questioned your beliefs and tested your assumptions?

  14. #14 The Danish Salmon of Doubt
    In Sunny Dublin
    June 19, 2013

    When I saw Offit’s latest book announced I pre-ordered and got it delivered wireless on my ebook on the release date. It really is good. I was thinking of posting a review on Amazon of it when I have finished it, the only other time I did that was with Ben Goldacre’s Bad Pharma. The most impactful chapter so far I have read (I am just over halfway) was the one about “Dietary Supplement Health and Education Act” and how it was passed. Scary stuff. Anyway, he has a very engaging writing style, I agree he overdid the Steven Jobs thing, but overall I would recommend it and his previous books as well, although judging from the quality of comments and commenters on this site I guess many people already have a very deep knowledge of the areas treated. For relatively new lurkers his books are great (and Ben Goldacre;s, and Simon Singhs…..)

  15. #15 lilady
    June 19, 2013

    I’ve been posting on the CBS Philly blog about Paul Offit’s book, where Dachel and her groupies are commenting:

    http://philadelphia.cbslocal.com/2013/06/15/philadelphia-physician-dont-take-your-vitamins/#comments

    Krebiozen and I have been posting on another blog located in Ireland, where Dachel and the CEO of the Irish Health Trade Association (vitamin and supplement trade and lobbying group), have been commenting:

    http://www.newstalk.ie/Vitamins-are-good-for-you-right-

  16. #16 Denice Walter
    June 19, 2013

    Of course, AoA has already commented on Dr Offit ( via Dachel) and, as mentioned previously, Gary Null critiqued the book briefly on Friday ( volumes more are promised).
    I can hardly wait. Right.

    Supplements are attractive to consumers as a possible avenue of independence ( mostly imaginary) away from SBM- you can do-it-yourself and not need doctors ( see prn above, a classic example).

    Those who sell supplements professionally ( see PRN, Natural News, Mercola et al) present themselves as a personal friend, altruistically interested in the consumer’s welfare and therefore, expose the slimy, money-sucking leeches**, i.e. doctors, for what they really are: greedy charlatans after good people’s money.

    I seem to have noticed an abrupt up-tick in hate speech against doctors and other professionals that nearly coincided with the economic crisis of 2008-2009 and has continued unabated, picking up increasingly vehement political finger-wagging and economic doom-casting as well. ( see Gerald Celente on PRN)
    I wonder why that is?

    Here’s my scenario:
    people were afraid that they might lose their savings, investments, jobs and lifestyle during those dark days- perhaps many decided that supplements were not the most important items on their shopping lists and cut back on their purchases of expensive products from internet gurus- who felt the pinch.

    SO they ramped up the rhetorical excess and declared war on the powers-that-be, associating themselves with the down-trodden underdog consumers, pawns of the elites’ perpetual warfare.

    Which is interesting because these people earn tons of money: I’ve uncovered gross figures of 10 million USD for Null post-crash ( Spoke.com; Manta.com) and it’s fairly easy to find internet photos of homes owned by many of them ( the aforementioned, Adams’ place in Ecuador, Dr B, AJW ).
    No low rent districts at all here.

    ‘Sometimes a good offence’ and all that.

    At any rate, I’ve been intrigued by the economic issue of supplements as an INVESTMENT- if you buy now, you won’t get sick later and have to pay doctors.

    If we read TMR, we’ll notice that the denizens of that abysmal, whimsy-based coffee klatsch often bemoan how all of their money goes for supplements and ( mostly) non-SBM therapies and now they can’t have nice things. It’s a constant whine that must somewhat reflect reality. I would guess, that based on their own brag, their antivax cohort is primarily more affluent and more educated than is average.
    I would imagine that the average Autism One participant is not ‘poor folks’.

    An another alarming trend I’ve heard is that minority groups need *especially* protect their health through increased woo-besotten buying habits. On the average, in the west, minorities earn less than the median. At least one woo-meister targets specific minority groups by appearing where they live in NY and another puts out his woo in Spanish.

    For some reason, the concept of well-to-do people throwing away their money on useless products and woo-ful dreams doesn’t make me as sick as those who are financially strapped doing the same.

    ** deliberate allusion

  17. #17 Ren
    http://facebook.com/rene.f.najera
    June 19, 2013

    I got an extra copy of Dr. Offit’s book by mistake from Amazon. So I’m auctioning it off on my personal FB page. (Link above, in “location.”) Highest bidder gets the book, and myself and another “science mobber” will match that bid to donate it all to the Autism Science Foundation. So, if you don’t have a copy, this could be a way for you to get it.

    End shameless plug.

  18. #18 Lawrence
    June 19, 2013

    @Ren – excellent idea!

  19. #19 Bronze Dog
    June 19, 2013

    Supplements are attractive to consumers as a possible avenue of independence ( mostly imaginary) away from SBM- you can do-it-yourself and not need doctors ( see prn above, a classic example).

    I think supplements are also attractive for the same reason diet pills are. It’s lazy and it’s wish fulfillment towards what many people wish medicine was like.

    While there’s a lot of necessary focus on believers who will make big, absurd changes to their life for the sake of altie-hipsterism, there are a lot more people who are just willing and credulous enough to buy some bottles of supplements, thinking they can pill-pop their way to health. They aren’t harmed as much, but it still happens and costs them money that could be spent more wisely on other things.

  20. #20 Denice Walter
    June 19, 2013

    @ Bronze Dog:

    Of course! A woo-meister may enumerate the myriad esoteric vegetables, fruits, herbs and phyto-nutrients absolutely ESSENTIAL for life and delineate how to juice, creating arcane combinations of ingredients into drinks or how to ‘cook’ raw gourmet treats
    but THEN he presents his line of dried,powdered vegetables, fruits, super food blends, freeze dried, organic berries from the Amazon and perfected blends of the aforesaid ( see Gary Null.com/ NaturalNews Strore for product lists).

    I’ve noticed that alties promote ( organic, non-GMO only! svp) vegetables and fruits, wailing about how most people don’t get the recommended 12 ( or is it now 15?) servings per day and then conveniently offer powdered vegetables at al.
    A quick look through a woo-drenched RL store informs how much of what they sell is just FOOD-
    powdered or dried- vegetables, milk and plant-based proteins, fruits.

    Quicker and cheaper:
    frozen fruits and vegetables – as much as you like.

  21. #21 elburto
    June 19, 2013

    Ah look, prn and his n=1 studies are back. prn who accuses the immune-compromised of “whining”, and arrogantly assures them that b12 will prevent all that ails them. prn who conflates “the US for-profit healthcare system” with ‘science-based medicine’, and assures us all that’s it’s a scam, that IV ascorbic acid is a panacea, yet refuses to ever back up his spurious claims.

    Boring, boring, boring. No, he’ll just flounce off, until the next time he’s got his knickers in a twist because someone has dared to speak out about the harm quackery causes.

  22. #22 lilady
    June 19, 2013

    @ Ren: The bidding for Dr. Offit’s book is up to $ 30 …when I looked about a half hour ago.

    Unfortunately, I “don’t do Facebook” and I have the book on reserve at my local library.

    Fortunately, I have a credit card and I made a $ 30 donation to the Autism Science Foundation, in memory of my son. :-)

    https://npo.networkforgood.org/Donate/Donate.aspx?npoSubscriptionId=1004682&code=ASF%20Website

  23. #23 Jubilee
    June 19, 2013

    Not only was Michael Crichton a big fan of woo, he would have fit right in with the alties who compare doctors who don’t buy their anti-vax theories to Nazis. In response to New Republic editor Michael Crowley criticizing his climate change denialism, Crichton produced a character in his next novel named MICK Crowley who was a “spoiled” Yale graduate and Washington based political columnist, heir to a pharmaceutical fortune, and a less-than-well-endowed toddler rapist. Definitely the act of a man with a solid intellectual argument.

    link

    (frequent reader and lurker–having a handful of soft liberal arts degrese I generally don’t have too much to contribute here.)

  24. #24 Alan Henness
    United Kingdom
    June 19, 2013

    And here’s an ‘alternative’ review of Paul Offit’s book: Vaccine doctor Offit leads transatlantic attack on natural healthcare. I can’t wait to meet him next week and get my hands on a copy!

  25. #25 Alain
    June 19, 2013

    She has been researching thyroid treatment for decades, had published several papers and has contributed to changes in the recommendations (such as no longer giving enough T4 to suppress TSH)

    Did she write a book? I’d be interested into buying a book on thyroid treatment.

    Alain

  26. #26 Denice Walter
    June 19, 2013

    @ Alan Henness:

    That very awful as would be expected,coming from them.

    I know about RV and his work for a long time: when I saw “Ex. Director”- which I misread as ‘ex-director’. I WAS hoping…
    but no, he’s still around.

    A few fun facts about ANH:
    -where-ever you go, there they are- they work in Europe, N. America and globally
    – Verkerk has a trans-Atlantic mirror twin
    – they’ve been carrying on about “Codex” forever..
    – always looking for donations

    Any sceptic who doesn’t know of them SHOULD- you can start with the wiki article and peruse their own websites.

  27. #27 Delurked Lurker
    On a pale blue dot suspended in a sunbeam
    June 19, 2013

    Being a Saganite I feel compelled to post some of Carl’s quotes on this.

    “It seems to me what is called for is an exquisite balance between two conflicting needs: the most skeptical scrutiny of all hypotheses that are served up to us and at the same time a great openness to new ideas … If you are only skeptical, then no new ideas make it through to you … On the other hand, if you are open to the point of gullibility and have not an ounce of skeptical sense in you, then you cannot distinguish the useful ideas from the worthless ones.”

    “Science is […] a way of skeptically interrogating the universe with a fine understanding of human fallibility. If we are not able to ask skeptical questions, to interrogate those who tell us that something is true, to be skeptical of those in authority, then we’re up for grabs for the next charlatan, political or religious, who comes ambling along.”

    “Arguments from authority carry little weight – authorities have made mistakes in the past. They will do so again in the future. Perhaps a better way to say it is that in science there are no authorities; at most, there are experts.”

    Be wary of the consensus. I need only mention Barry Marshal and Robin Warren two very brave and determined scientists. They dared to challenge the consensus and stood by their claims that gastric ulcers were caused by H.Pylori despite the copious amounts of ridicule heaped upon them. Eventually the consensus crumbled and we have a new paradigm. This is science at work. I love it. :)

  28. #28 weirdnoise
    June 19, 2013

    The alties are trying to bury the book on Amazon with one-star reviews, all playing the pharma-shill/anti-vax gambit. If you’ve read the book, you might want to contribute a more positive review there.

  29. #29 Mewens
    June 19, 2013

    @Denice

    Cripes, those ANH people are nutjobs. Thanks for the name+shame. My favorite from the Wiki article:
    (Verkerk) also argues that people should be encouraged to look after themselves so that the fewer visits they make to their doctor, the less insurance they pay.

    What a noxious stance. How idiotic, self-serving and short-sighted this particular drivel is.

  30. #30 elburto
    June 19, 2013

    @Mewens – Wow, that’s very Calvinist of them, isn’t it? Those who live pure lives and follow the rules will be blessed with good health. Those in bad health must have done something to deserve it, ergo they are bad, and deserve ill health.

    Nowt said (is there ever, by these muppets?) of those born ill or disabled, or who develop idiopathic, autoimmune, or hereditary diseases, or are just bloody unlucky?

    These people need to remember that nobody is more than ten seconds from a life-changing disability. I’d bet my thumbs (and OMG they’re important!) that their attitude to sickness and disability would change then. Alties can’t quite grasp that all the dairy, gluten and meat free, calorie-controlled diets full of organic (lol) “superfoods”, all the cardio and yoga, the supplements, IV vitamin C, and chiropractic “adjustments” can’t stop a bus hitting them, or a freak slip or fall, a car crash or a flight down the stairs.

    Keeping their fortunate, financially stable bodies pure of all “toxins” can’t buy safety from illness or disability..

  31. #31 Denice Walter
    June 19, 2013

    @ Mewens:

    There is a loosely-based confederation of health freedom, natural health, anti-aging, life extension, organic food,anti-vax and diverse woo advocates that extends beyond national borders and works hard to oppose any regulation and supervision by so-called fascist governments- they have lobbyists and lawyers galore..
    AND they call US the cartel!

    @ elburto:

    They are out of their minds- some of us don’t lead pure lives and are shockingly healthy. Actually, most people I know don’t avoid woo taboos and are alright.

    The altie belief system is a way of averting the anxiety and fear that haunts all sentient beings- they deny that anything can harm them because of inordinate fear. Their scurrying about to insure the correct dietary, exercise, toxin-free regime will neither stop the hands of time nor the movement of errant motor vehicles. Nor wonky cell growth.

  32. #32 TBruce
    June 19, 2013

    They dared to challenge the consensus and stood by their claims that gastric ulcers were caused by H.Pylori despite the copious amounts of ridicule heaped upon them.

    Really? COPIOUS amounts of ridicule?
    Citation, please.

  33. #33 conspicuousCarl
    June 20, 2013

    Kimball Atwood’s description of why the h.pylori legend is BS:

    http://www.csicop.org/si/show/bacteria_ulcers_and_ostracism_h._pylori_and_the_making_of_a_myth/

    No, it wasn’t ignored or repressed (help! help!), and the heroic self-infection didn’t prove anything.

    Barry Marshall makes a lot of effort to spread his bullshoe legend. Even otherwise-skeptical people fall for it sometimes.

  34. #34 Delurked Lurker
    On the shore of a cosmic ocean
    June 20, 2013

    Carl and TBbruce

    Whoa there boys I am not an altie.
    TB this is part of history and I have had a hard day at work and quite frankly I thought you at least knew the story. You will have to wait for the links . Carl thanks for the link I am reading it now. I do understand you two jumping on this as you may have seen it to be giving succour to the woo merchants. That was never my intention.

  35. #35 Krebiozen
    June 20, 2013

    Delurked Lurker,
    We know you’re not an altie – it’s true that the microbial cause of gastric ulcers took a while to be accepted, quite rightly so. It is the picture of Warren and Marshall as brave maverick doctors struggling against a tide of ridicule that isn’t true, or is at least grossly exaggerated. I told that story myself before I learned the truth, including the part where Marshall infected himself with H. Pylori, developed an ulcer and had to be treated to cure the infection. This is not true; he developed mild gastritis, but no ulcer, and it resolved without treatment.

    As I have pointed out before, we humans love stories, and if they are not emotionally satisfying enough, we make them so.

  36. #36 Delurked Lurker
    Currently watching videos from the 2005 Nobel's
    June 20, 2013

    TB
    On the evidence I have seen so far I must retract the phrase “copious amounts of” and replace it with “some”. The view we had in Australia was from our media and they never let the truth get in the way of a good story.

    Carl
    Attwoods article was weak, style over substance. It’s becoming obvious in my readings that most of this ‘controversy’ was generated by the Australian media. This article does nothing to dispel the notion there even is a controversy to start with.
    “Barry Marshall makes a lot of effort to spread his bullshoe legend”
    Actually he doesn’t, he jokes about it really.
    http://www.achievement.org/autodoc/printmember/mar1int-1
    I totally reject the statement that Barry spends a “lot of effort to spread his bullshoe legend” as there seems to be no hard evidence I can find to back this up. Oh and by the way he really is a nice bloke, not the type you would expect to know how to shoe a bull as a living. Unlike someone like Stan B say.

    Anyway back to the research inspired by you two….I think there is basis of a book here somewhere :)

  37. #37 Delurked Lurker
    June 20, 2013

    Krebiozen @35

    Good reply…thanks :)

  38. #38 Dangerous Bacon
    June 20, 2013

    What the H. pylori-gastric ulcer story demonstrates is that mainstream medicine followed up rapidly on solid evidence with confirmatory studies, and changed diagnostic and treatment protocols accordingly.

    That should be a wake-up call for the woo crowd to stop flogging anecdotes and pseudoscience, and use facts to convince opponents (and more logically, themselves) of the truth – rather than endlessly chanting “Medicine wuz wrong before!” (as though that validates their nonsense).

  39. #39 TBruce
    June 20, 2013

    What the H. pylori-gastric ulcer story demonstrates is that mainstream medicine followed up rapidly on solid evidence with confirmatory studies, and changed diagnostic and treatment protocols accordingly.

    How can that be correct? After all, it wasn’t part of the Wisdom of the Ancients and used successfully in a Non-Western Culture for Thousands of Years.

  40. #40 bad poet
    June 20, 2013

    Only in the sense of magic being real, tested science that is something too difficult for me to understand. I haven’t gotten my UGoogle MD,.nor do I plan to.

  41. #41 Dangerous Bacon
    June 20, 2013

    Well, after publishing its article on health quackery, it took USA Today all of 24 hours to start _promoting_ quackery again – this time in a half-page front section ad touting Dr. Sinatra’s “little red pill” that “reels in” blood pressure and cholesterol plus it “improves blood flow in 1 hour!”

    Yes, the renowned “integrative cardiologist” Dr. Steven Sinatra has wrapped up the goodness of calamarine (squid) oil, CoQ10, resveratrol, L-carnitine and B vitamins to make a “5 in 1 Omega Wonder Pill” (free shipping!). There is a “preliminary clinical study” cited, but more importantly Mrs. Winter from Oregon confirms it’s effective in a testimonial. And anyway, there’s a Quack Miranda Warning at the bottom of the page.

    USA Today is also running a front page article on unnecessary surgeries, so all its bases are covered.

  42. #42 Denice Walter
    June 20, 2013

    In related news:

    T. Colin Campbell was a guest of Gary Null ( Progressive Radio Network- shows- Gary Null- today- starting at about 33 minutes in- to 56 or so): he has a new book, “Whole”- which is more than the sum of its parts; SBM is reductionalist and “the medical model is wrong”; “a cell is like a universe unto itself”; talk about tsunamis and paradigms ( sigh) “raise level of consciousness”; “The number one cause of death is nutritional ignorance”; genes ain’t everything; doctors scared Angelina into surgery ad infinitum.

    In case you ever doubted his position…

  43. #43 Paul
    Earth
    June 21, 2013

    You should have plenty of time to read books
    It’s not as if you can attract a woman looking like you do
    Even though you might earn some nice dollars I’m sure women would be repulsed by you
    So all you have is this stupid blog
    What makes a person blog anyway ?
    Do you think all of your thoughts are so important that they need to be shared ?
    But you weren’t man enough to put your name to them at the start were you ?
    You’re a creepy little insect
    YOU ARE NO EXPERT ON ANYTHING
    SO SHUT YOUR HOLE MORON

  44. #44 Paul
    June 21, 2013

    IT MUST MAKE YOU SO MAD
    YOU MUST JUMP UP AND DOWN LIKE A CHILD
    NOT TO UNDERSTAND EVERYTHING
    SCIENCE IS CRAP
    THINGS CAN’T ALWAYS BE EXPLAINED
    GET OVER IT
    MEDICAL SCIENCE CAN’T CURE ANYTHING
    IT’S A JOKE
    JUST LIKE YOU AND YOUR NERDY COKE BOTTLES
    WRITE ABOUT ALL THE DEATHS FROM
    BIG PHARMA DRUGS
    YOU PUSSY

  45. #45 The Smith of Lies
    June 21, 2013

    About #42.
    Whenever I hear (about) someone spouting such drivel I feel perverse urge to enact my own twisted variant of the game from Saw series – get such person into isolation, infect them with someting deadly but curable with modern medicine (bubonic plague maybe?) and force the choice: antibiotics and standard of care treatment or homeopathy, reiki, herbs and whatever other modalities you’d like to integrate into medicine?

  46. #46 Edith Prickly
    June 21, 2013

    @44 – groovy man, we have a Beat Poet troll! Go, go go!

  47. #47 Militant Agnostic
    At home since the Trans Canada Highway is cut by flooding.
    June 21, 2013

    So prn has previously cited a ID creationist and now quoted an AGW denialist and all round woo believer (Micheal Crichton). What does he have to do to complete the anti-science trifecta.

    @44 – Thanks for letting your unhinged misogynist freak flag fly. Your choice of the name Paul is appropriate.

  48. #48 Bronze Dog
    June 21, 2013

    Why are so many trolls obsessed with people’s dating and sex life? It’s perverse.

    I’m borderline asexual, so I’m really not all that interested in dating. It’s part of who I am, so baseless assertions that people who don’t date are ugly losers strike me as bigoted.

    Oh, and Paul, get a clue. Welcome to the information age.

    1. Many skeptics use pseudonyms because there are a lot of trolls out there who seem dedicated to seeing that no good deed goes unpunished, and some will issue violent threats. It’s especially bad for women skeptics. There’s also a desire to be able to relax by going offline and not have random loons disturb us. It’s not much different from people who prefer some separation between their work and home lives.

    2. It’s logically irrelevant. We aren’t using our identities to assert absolute authority the way woos cite their gurus for being gurus. Our arguments stand or fall on their own, and transparent subject changes to our identities won’t change what the scientific literature says.

    3. Orac’s real name is the worst kept secret on the internet.

    4. What’s so bad about blogging? Why not disparage writing and talking while you’re at it? What’s so inherently different about blogging that makes it an inherently inferior form of communication? Reminds me of a racist troll I had who asserted that playing D&D with friends wasn’t “real” social interaction, even though it involves a group activity, telling jokes, and getting to know each other.

  49. #49 Dangerous Bacon
    June 21, 2013

    So many alties seem to have anger issues these days.

    Isn’t chamomile tea supposed to prevent rampant hostility?

  50. #50 Mephistopheles O'Brien
    June 21, 2013

    Paul,
    I certainly hope
    that you one day recover from the
    industrial accident
    which I must suppose caused you to lose
    control of your shift key
    as well as contributing to your anger issues
    and your tendency to write in a stilted form of
    free verse.
    Just for reference
    I generally only jump up and down for exercise
    or would if I had a trampoline
    which might be fun
    but dangerous.
    Science currently does not know everything
    and people who practice science know it doesn’t know everything
    otherwise they’d stop.
    That does not mean you get to fill in the holes
    with any fairy story you like,
    As Dara O’Briain said.

  51. #51 Mephistopheles O'Brien
    June 21, 2013

    My apologies, I meant SHIFT key above instead of shift key.

  52. #52 Composer99
    http://composer99.blogspot.ca
    June 21, 2013

    Arguments against scientific consensus get my hackles up.

    There’s a scientific consensus about quantum physics.

    There’s a scientific consensus about special & general relativity.

    There’s a scientific consensus about plate tectonics.

    There’s a scientific consensus about electromagnetism.

    There’s a scientific consensus about evolution.

    (I can go on…)

    In each of these fields, it is certainly the case that there is ongoing research, debate, and disagreement about certain aspects, but pretty much everyone, at least so it seems to me, agrees on the basic, baseline stuff.

    Yes, sure, it’s possible that large swathes of modern scientific consensus could be overturned. It’s also possible I could win the lottery tonight.

    The argument against consensus strikes me as a bait & switch of sorts.

    I think everyone agrees, more or less, that in science an appeal to authority or to popularity is no good.

    Where the bait & switch happens is the characterization of scientific consensus as just such an appeal. Which couldn’t be further from the truth: scientific consensus arises because of what the evidence shows (up to the limits of the ability of scientists to collect and analyze it at any given time).

    And, true to form, as more and better evidence comes in, and as the tools to analyze it improve, if a scientific consensus is undermined or overturned, that’s what happens. But prn snidely quoting a crank engaged in bait & switch just doesn’t cut it.

  53. #53 Dorothy
    Oz--the other one
    June 21, 2013

    @cees renckens

    I enjoyed your post which I almost skipped due to its length. I’m glad I plowed in because I found every word worth the time.

    I am going to Europe soon, and while I had planned on some time in the Netherlands I will now attempt to gain asylum there!

  54. #54 jre
    Rational Boulder
    June 21, 2013

    Whoever gets his philosophy of science from the execrable Crichton is already lost to us. End of discussion.[1]

    As to Paul Offit, he is all the more heroic for being considered Satan’s spawn by the wackaloon tribe. His sturdy insistence on the truth regarding vaccines has earned him a gushing sewer of abuse and put him in personal danger — but you will never hear him complain about it. He is, by any standard, a mensch.

    I say this despite some annoyances in his earlier work. He has written approvingly of Steven “Junk Science” Milloy, and he did sign on to right-wing political theories about the Lancet’s Iraq mortality studies. But he is still a mensch. for all of that.

    [1] I wanted to make sure of who was the first to use the phrase “the execrable Crichton” before using it myself. I think it was James Annan.

  55. #55 Denice Walter
    June 21, 2013

    Or we could, perhaps,
    like mediaeval cartographers, who,
    uncertain about particular loci,
    on the borders of their known reality
    just fill in the blank with “here be monsters”,
    in spectacularly ornate calligraphy.

    We could also, of course,
    imitate altie med naturalists,
    who toss about phrases like “cytokine cascade’
    or “oxidative stress’ whensoever they they step into holes,
    plainly visible to onlookers,
    in their abtrusely inconsequential hypotheses
    concerning bioenergetics and
    biodynamic spirituality or suchlike.

    Obviously, when all else fails**
    they can pull out the concept of soul from wheresoever it exists – actuallly or created out of mindstuff-
    as very well it should be…

    At any rate, I am running out of as many ideas as the day is long
    And it is, being the solstice and all
    So have a good day and a short night.

    ** fill in the blanks………..

  56. #56 dingo199
    June 23, 2013

    IT MUST MAKE YOU SO MAD
    OFFIT SAYS DRINKING APPLE JUICE CURED HIS METASTATIC MELANOMA
    GONE WITHIN A YEAR AND NO RECURRENCE
    SCIENCE IS CRAP
    GET OVER IT
    ALIEN MALWARE CURED ORACS PILES
    YOUR FULL OF IT
    YOUR IDIOTS AND YOUR EVIL
    HOLISTIC ARE GREAT. THEIR THE BEST EVER
    THERE REMEDIES WORK UNLIKE YOURE SCIENCE CRAP

    How’d I do?

  57. #57 Khani
    June 23, 2013

    #56 The problem, Dingo, is that it’s virtually indistinguishable from the real thing. Because the real thing is so silly it’s virtually impossible to parody…

  58. #58 The Smith of Lies
    June 24, 2013

    @Dingo & Khani
    Poe’s Law strikes again: http://en.wikipedia.org/wiki/Poe%27s_law

  59. #59 TBruce
    June 24, 2013

    But you weren’t man enough to put your name to them at the start were you ?

    Says Paul from Earth (Hey, that really narrows it down).

  60. #60 Politicalguineapig
    June 24, 2013

    I’ve seen Paul before. He wandered here from Alternet, I think.

  61. #61 Edith Prickly
    June 24, 2013

    I’ve seen Paul before too – his older material was better ;-) http://youtu.be/GlkoQ4bUE5k

  62. #62 Politicalguineapig
    June 26, 2013

    Magic cookie please; just got internet connection back. Man, those storms were bad.

  63. #63 Rebecca Fisher
    That London
    June 27, 2013
  64. #64 Narad
    July 5, 2013

    Eesh, Offit is on Science Friday (with Victoria Maizes) and kicked it off by giving acupuncture a pass, including the implicit statement that it was the same sort of needling 2000 years ago.

  65. #65 Narad
    July 5, 2013

    The placebo effect is “incredibly powerful,” and people can “learn to upregulate their immune response.” It doesn’t help that Maizes is being allowed to ramble on at length. He also failed to defend against the Vioxx ploy.

  66. #66 Narad
    July 5, 2013

    Also failed to observe that yoga isn’t “alternative” once it was trotted out as an example of something that can’t be subjected to an RCT.

  67. #67 Shay
    July 5, 2013

    Except that…has someone tried to claim that yoga cures anything? I mean, it does wonders for my chronic lower back pain, but it’s more of a coping mechanism than a cure.

    (The only cure for my various orthopedic souvenirs, unfortunately, is permanent. I regret that I have only one sacroiliac to give to my country).

  68. #68 Mephistopheles O'Brien
    July 5, 2013

    Shay – I don’t know if anyone credible claims that Yoga cures anything, but a quick Google search of “Yoga Cures” finds yoga as a cure for multiple conditions including anxiety, cellulite, the flu, wrinkles, hangover, and “almost any disease under the sky”. A quick pubmed search shows:

    yoga may impact various aspects of cognition during and after chemotherapy administration as noted through quantitative measures. Women describe yoga as improving various domains of QOL through the treatment trajectory. This mind-body intervention may stave off CRCI

    Yoga, is fairly effective in managing menopausal symptoms

    Naturopathy and yoga helps in inducing positive health, alleviating the symptoms of disease by acting at physical and mental levels.

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