Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski. That Orac has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 30 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

Respectful Insolence™ is a repository for the ramblings of the aforementioned surgeon/scientist concerning medicine and quackery, science and pseudoscience, history and pseudohistory, politics, and anything else that interests him (or pushes his buttons). Orac's motto is: "A statement of fact cannot be insolent." (OK, maybe it can be just a little bit insolent. Sometimes. OK, fairly often. Orac tries to keep his insolence respectful most of the time, but readily admits that he sometimes fails in cases of obvious quackery and pseudoscience, responding to personal attacks on him, examining poor critical thinking skills, bigotry or racism, and just general plain stupidity. When the stupidity to which Orac is responding reaches a certain very high level, he just can't help it and makes no apologies. You will know this is happening when Orac uses the phrase "the stupid, it burns" or some variant thereof.

To contact Orac: orac@scienceblogsllc.com

Choosing Wisely three years on

I like to point out from time to time that arguably the most striking difference between science-based medicine (and the evidence-based medicine from which we distinguish it) and alternative medicine, “complementary and alternative medicine” (CAM), or (as it’s called now) “integrative medicine” is a concerted effort to change practice for the better based on science…

I consider posts like the one I’m writing now to be public service, an obligation. There are times when I don’t want to do them, when they become so sadly, depressingly repetitive in overall outline (and, unfortunately, likely outcome) that it takes an effort to begin. However, given that October is Breast Cancer Awareness Month…

I was measured, science-based, and reasonable in yesterday’s post about the new American Cancer Society guidelines for screening mammography (which is obviously why that post garnered so few comments, thus teaching me my lesson yet again0, but regular readers know that I can be quite obnoxious and sarcastic and there’s a reason why this blog…

One of the things that feels the weirdest about having done the same job, having been in the same specialty, for a longer and longer time is that you frequently feel, as the late, great Yogi Berra would have put it, déjà vu all over again. This is particularly true in science and medicine, where…

If there’s one thing that’s amusing about the antivaccine movement, it’s the disconnect between its members’ perception of their own importance and the reality of it, which is that they tend to be a pretty pathetic, risible band. They post their blogs, full of the rage of Dunning-Kruger, thinking that they are putting forth the…

Two of the great “icons”—if you can call them “great” given that they’re icons but hardly “great”—of the antivaccine movement are Andrew Wakefield and Jenny McCarthy. Over the last decade, they have arguably been the most influential people in the antivaccine movement. The reasons are simple. Let’s look at Jenny McCarthy first. In 2007, when…

If there’s one thing I’ve been consistent about, it’s that, however ridiculous all the other woo I routinely discuss here is—homeopathy, reiki, reflexology, I’m talking to you and your friends—herbal medicine and supplements might have value because they might have a physiological effect that is beneficial in treating or preventing disease. Of course, if that’s…

Oh, no, Nature. Not you. Not again. It wasn’t enough that you were busted shilling for traditional Chinese medicine with a big, glossy advertising supplement a few years ago. I thought you had learned your lesson after that, as you didn’t do it again. Maybe I was wrong. Granted, your offense this time is not…

One of the more depressing topics that I regularly write about includes of analyses of news stories of children with cancer whose parents decided to stop science-based treatment (usually the chemotherapy) and use quackery instead. There are, of course, variations on this theme, but these stories take form that generally resembles this outline: A child…

When last I discussed the cruel sham that is the tide of “right-to-try” laws that has been flowing through state legislatures to become law over the last year and a half. “Right-to-try” laws, as I pointed out when I first noted the earliest ones being promoted in Colorado, Louisiana, Arizona, and Missouri, referring to them…

Last week, in response to the awarding of the Nobel Prize in Physiology or Medicine to Chinese scientist Youyou Tu, who isolated Artemisinin and validated it as a useful treatment for malaria back in the 1970s, I pointed out that the discovery was a triumph of natural products pharmacology, not of traditional Chinese medicine (TCM).…

Over the years, I’ve frequently made the points that the vast majority of physicians are not scientists and, in fact, that many of them suffer from a severe case of Dunning-Kruger when it comes to science. Even going back to the very early history of this blog, you can find examples, the most common of…

Yesterday, I wrote about the winner of the Nobel Prize in Physiology or Medicine, Youyou Tu, who, after screening 2,000 herbal treatments from traditional Chinese medicine (TCM) for anti-malaria activity, finally discovered Artemisinin. She isolated it from the plant in which it is found, using modern chemistry to isolate it, purify it, and later chemically…

Earlier this week, the Nobel Prize in Physiology or Medicine was awarded to Youyou Tu for her discovery of the anti-malaria compound Artemisinin, as well as to William C. Campbell and Satoshi Ōmura for their discovery of a novel therapy for roundworm. Artemisinin, as some of you might know, is a compound derived from traditional…

Anger is an energy, as a certain old punk sang back in the 1980s. It can even be a great motivator, such as when anger overtakes us for injustice or over crimes. Anger, however, is not a particularly good intellectual tool, nor does it help in analyzing science. Which reminds me: J.B. Handley is back.…

I’ve written many times about how the relationship between the early detection of cancer and decreased mortality from cancer is not nearly as straightforward as the average person—even the average doctor—thinks, the first time being in the very first year of this blog’s existence. Since then, the complexities and overpromising of various screening modalities designed…

Naturopathy is quackery. I like to start most, if not all, posts about naturopathy with that simple statement. The reasons are simple. First, it’s true. Second, most people—including doctors—are unaware of this simple fact. Finally, it irritates naturopaths and their fans. It also has the benefit of setting the tone I want to convey whenever…

One of the limitations constraining those of us who do human subjects research is that ethical considerations often prevent us from designing our clinical trials in what would be, from a strictly scientific standpoint, in the most methodologically rigorous way. For example, we can’t intentionally infect human beings with known inocula of deadly bacteria in…

I’ve spent a lot of time in Cleveland. Indeed, I lived there for eight years in the late 1980s and early 1990s, during which time I completed my surgery residency training, completed my PhD, and, even more importantly, met and married my wife. Even though I haven’t lived there for nearly 20 years—I can’t believe…

A week ago, I noted that one of the stranger and less credible conspiracy theories promulgated by quacks and their believers was still going strong nearly three months after the first death that triggered it, the death of autism quack Jeff Bradstreet, apparently by suicide. Basically, three months ago, Dr. Bradstreet, who has long been…

Yesterday, I wrote about how pediatric neurosurgeon turned presidential candidate Ben Carson is an excellent example demonstrating how the vast majority of physicians and surgeons, even highly accomplished ones admired as being at the top of their professions, are not scientists and how many of them are disturbingly prone to buying into pseudoscience. In Dr.…

Early in the history of this blog, I had a running gag that I’d use every now and then. Basically, it involved humorously extravagant descriptions of how I wanted to hide my face behind a paper bag in sheer embarrassment at the antics of fellow physicians, particularly fellow surgeons. Over time, the gag evolved to…

Our military veterans deserve the best medical care our nation can offer. Actually, I’d say they’re owed it, actually. After all, many of them put themselves in harm’s way for this country. Others have suffered grievous injury with permanent sequelae. Still others have paid the ultimate price. For those who served, the least we as…

Antivaccine quackery is arguably one of the worst forms of quackery. First, the pseudoscientific beliefs undergirding such quackery are based on the fear and demonization of one of the greatest medical advances in the history of the human race, the result of which are children left unprotected against preventable diseases that routinely used to populate…

Ever since late June, I’ve been intermittently taking note of a new conspiracy theory in the alternative medicine world. It began when notorious autism quack Jeff Bradstreet, one of the longest practicing, most prominent purveyors of the scientifically discredited notion that vaccines cause autism, was found dead in a North Carolina river on June 19.…