In a (very) few short hours, Donald Trump will take the oath of office and become the 45th President of the United States. I realize that I don't normally blog about politics, at least other than that related to medicine, but I make no bones about it. I'm dreading 12 Noon ET on January 20, 2017. There is more than enough reason for dread given the likely effect on medical science, at the very least. Also, Donald Trump is antivaccine. He's shown it through meetings with Andrew Wakefield and Robert F. Kennedy, Jr, the former of whom spoke a year ago on a "Conspira-Sea Cruise" and the latter of whom is slated to speak at an anti-vaccination, chemtrails, chiropractic and conspiracy theory event later this year.
That's just medicine. Don't even get me started on the ignorant things Trump believes about, for example, climate science, the anthropogenic climate change denialists he's appointed, how he's appointed someone as Secretary of Education who is so clueless that she was completely blindsided by a simple question on one of biggest debates in education, whether to assess educational achievement by proficiency or by growth. There's just too much antiscience to go around now. That's why I'll concentrate mainly on what I know, which is medicine, and what I've been interested in, high on the list being vaccine science. After all, antivaccine activism is every bit as much a form of science denial as anthropogenic global climate change denial.
One of the retorts I heard when I wrote about Robert F. Kennedy Jr. meeting with Donald Trump a week and a half ago was that the commission on vaccine safety and/or autism that he might or might not have been asked to chair, was that this wouldn't matter. That federal vaccine policy is based in law and regulations, and that unless Trump spends political capital changing those we don't have any reason to be worried. Of course, that's only partially true. Yes, Trump can't just replace members of the Advisory Committee on Immunization Practices (ACIP) with Andrew Wakefield, Robert F. Kennedy, Jr., Barbara Loe Fisher, and a gaggle of other prominent antivaccine activists because there is a rigorous nominating process for membership, and vacancies are staggered, so that it takes several years to turn the membership over. It's also true that school vaccine mandates are a matter of state, not federal, law; Trump can't change 50 state laws. On the other hand, as was noted on STAT News, Trump can appoint a CDC director and agency staffers who have antivaccine proclivities, and such a director could change CDC priorities and policies. If he's willing to spend political capital, he could conceivably work with Congress to change or eliminate the Vaccine Court. He could cut back funding for the Vaccines For Children program or Section 317, a CDC-administered federal program that pays for vaccines, epidemiology, science, surveillance, the management of outbreaks, and more and has been called the "backbone of the US Immunization Program."
So, what Trump can do to vaccine policy is limited, at least initially. However, that doesn't mean he can't still do enormous damage. There's a reason why public health officials were appalled at his having met with RFK Jr. and would have been appalled had they known about his meeting with Andrew Wakefield before the election, and it's Presidential bully pulpit that Trump will have beginning this afternoon. As Olga Khazan wrote the other day in The Atlantic, there is a shadow network of doctors who encourage vaccine hesitancy who could be empowered by a President who openly questions vaccine safety based on no evidence. Her article brings up some excellent points, but unfortunately starts out with a massive fail that I have to point out because it irritates the crap out of me. The article begins:
When Andrew Brandeis encounters patients who are skeptical about vaccines at his family-practice clinic in San Francisco, he doesn’t toe the typical pediatrician party line—that the standard vaccine schedule is a must-do. Instead, he might help the patient delay or space out their child’s shots beyond the recommendations of public-health agencies, if they so desire.
“The earlier you introduce a vaccine to a kid, there is evidence suggesting various adverse reactions,” he said. He believes early administration of the Hepatitis B vaccine is linked to allergies, asthma, and multiple sclerosis—something doctors and health agencies vehemently deny. “The parents might say, ‘I’m just going to wait on that one,’ I’d say that’s okay.”
He doesn’t actively promote this delay strategy, and he said he administers more vaccines than he avoids. Still, his own 2-year-old daughter is unvaccinated, since as Brandeis sees it, “the risks outweigh the benefits.”
Most readers who see this would assume that Brandeis is a pediatrician or family practice doctor. Certainly I did. It's not until well into the article, the beginning of the second section actually, that we learn:
Brandeis is a naturopathic physician, or ND, a type of alternative medicine specialist who uses herbs, supplements, and lifestyle counseling alongside standard medical treatments. Most NDs get thousands of hours less formal training than do traditional family doctors, and 20 states license them to practice. Brandeis says other than the focus on holistic health, his practice resembles that of any other family physician—except that he doesn’t accept insurance.
Brandeis told me he has no opinion on Robert F. Kennedy or Trump’s vaccine commission, but “I’m looking forward to seeing if any new science is exposed. It’s really hard to get to the bottom of this one.”
Naturopaths are not physicians. They should not be called physicians. Their training does not warrant it, and naturopathy is a cornucopia of quackery mixing everything from homeopathy, traditional Chinese medicine, functional medicine, a variety of dubious medical tests and devices, and basically any form of quackery you can imagine. Yes, it is correct to point to naturopaths and other alternative medicine practitioners as a concerning source of antivaccine beliefs and the encouragement of vaccine hesitancy among parents. No doubt about it. However, contrary to the title about a "shadow network of underground antivax doctors," these are not real doctors and, compared to the number of pediatricians practicing, there aren't that many of them. That's not to say that there isn't a ""shadow network of underground antivax doctors" that includes naturopaths and their ilk. It's just that many of these "underground antivax doctors" are not so underground and are actually real pediatricians, family practice doctors, and physicians of other specialties who have embraced "holistic medicine" that includes antivaccine beliefs and thereby betrayed their patients. I'm talking "Dr. Bob" Sears and "Dr. Jay" Gordon, as well as "integrative" pediatricians who imbibe all sorts of quackery about "detox" to which antivaccine beliefs are a kissing cousin. Think of the physicians, such as Dr. Bob Sears, in California who are selling bogus "medical exemptions" to parents so that they can evade the vaccine requirements of SB 277.
In fairness, Khazan does come around to mention real antivaccine physicians, but it comes across as an afterthought when in reality it should have been the focus of the story:
And yet, it’s not just naturopathic doctors who doubt vaccines. Earlier this month, Daniel Neides, a medical doctor and director of the Wellness Institute of the Cleveland Clinic, wrote a column for the news site Cleveland.com that questioned the safety of vaccines, saying they come “at the expense of neurologic diseases like autism and ADHD.” After a PR firestorm, the Cleveland Clinic disavowed the column and said it would stop selling homeopathic treatments in its gift shops. (Neides declined to comment further.)
Jay Gordon, a board-certified pediatrician in Santa Monica, California, estimates that about 90 percent of his patients are not on a typical vaccine schedule. “I get vaccines,” he said, “but I don’t believe that the vaccine schedule that we have now is the best way of doing it.”
He said that he would, after a discussion, support a patient who didn’t want to vaccinate at all, though he realizes the patient would be contributing to the erosion of herd immunity. “One reason the risk [of infectious disease] is small is because of vaccines, and I don’t want things to change overnight,” he said. “I don’t want to abandon all vaccines, and I don’t like the anti-vaccine agenda.”
“It gives me the luxury of being disliked by both ends of the spectrum,” he added.
Here's a hint, Dr. Jay: Just because "both ends of the spectrum" don't like you doesn't mean that you're correct. Thats the fallacy of moderation. Sometimes there is a right and a wrong answer, and placing yourself in the middle between the two makes you still wrong. I also call bullshit on your "not liking the antivaccine agenda, given how much you align with it. You were Jenny McCarthy's son's pediatrician, for cryin' out loud, and you've spoken at antivaccine rallies and shown up as the "vaccine skeptic" in innumerable news stories. Yes, it's disappointing to see Dr. Jay still parroting the same antivaccine nonsense (and, yes, "too many too soon" is a familiar antivaccine trope) while, in a true Dunning-Kruger fashion shared by Dr. Bob Sears, placing his expertise above that of ACIP to determine a safe and effective vaccine schedule.
Dr. Jay aside and my irritation with missing the target on which medical professionals have more influence and are more responsible for fomenting antivaccine beliefs, Khazan does get it right near the end:
The Kennedy news sparked worries among some doctors that Trump will wrench responsibility for vaccines away from the CDC and hand the reigns to a pseudo-scientific panel, or that he will dismantle programs that protect vaccine makers from frivolous lawsuits.
In the meantime, he risks shaking the public’s trust in a vaccination schedule that has saved millions of lives and allowed Americans to live 30 years longer. As the recent wave of anti-vaccine alarm has shown, confidence in vaccines works similarly to herd immunity. It takes a universal acceptance of fact, and a rejection of conspiracy theories, to get every parent’s buy-in.
Last week, Kennedy told reporters, “Everybody ought to be able to be assured that the vaccines that we have ... [are] as safe as they possibly can be."
But doctors say even the hint that patients need such “assurance” is toxic. After all, people question vaccines because authority figures raise questions about them. Patients don't question whether it's the right choice to eat apples, because doctors and politicians have never suggested that the jury is still out on fruit.
Exactly, so much so that I mostly forgive Khazan and her editor for focusing on naturopathy way, way more than antivaccine pediatricians like Dr. Bob Sears. Naturopaths are still fringe, as much as they like to represent themselves otherwise, and they don't have nearly the cachet in medicine as real pediatricians because they are quacks. However, whether it's real doctors or quacks taking care of patients, it is quite reasonable to fear that Donald Trump will, just by questioning vaccine safety based on no good evidence and by cozying up to antivaccine activists prone to conspiracy theories like RFK Jr. will spread antivaccine ideas and give them the imprimatur of the President of the United States. No wonder antivaccine parents are furiously working to get their message to Trump using anecdotes and pseudoscience.
They see a kindred spirit in the White House, one with the power to give them at least some of what they want, fantasies that date back many years.
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“It gives me the luxury of being disliked by both ends of the spectrum,” he added.
It gives him the luxury of profiting from both ends of the spectrum.
Uh...I'm trying to forget that this is inauguration day.
There will be a lot of swearing today, unfortunately.
@ #2 Angela
I'll start drinking much earlier, today.
I'm in. Hope the therapist doesn't mind.
I unfortunately have to work today, and in any case am not the sort to attempt drowning my sorrows in ethanol. But I understand the sentiment.
I'm going to have to cut way back on my news consumption for the next four years. It's either that or go bonkers.
Trump will need cooperation from Congress to do the most serious kinds of damage. The problem is, he's likely to get it. Most of the Republicans in Congress are more afraid of being primaried by rabid Trumpistas if they don't toe the line than of losing a general election to a Democrat if they do. That will change the day President Scheisskopf[1] becomes more of a liability than an asset to their reelection chances, and not a day sooner.
[1]Yes, this is a Catch-22 reference. Like the character in question, our newly installed President is obsessed with military parades.
Sirchton, Narad:Thirded. My cold meds can go take a hike.
Eric: That will change the day President Scheisskopf[1] becomes more of a liability than an asset to their reelection chances, and not a day sooner.
The problem with the whole country going insane is that he can't do anything that's too crazy for the constituents. These are people who don't even want health insurance or clean water. Easiest thing to do is just make the cities inaccessible to outsiders. They don't want art, music or parks or zoos anyway.
I suppose I probably am a glutton for punishment ( but not a masochist thankfully) but I just had to watch the entire, twisted, insane sh!t circus of ineptitude.
Without going into much detail, ( because I venture that not everyone else has as strong constitution or remarkable powers of healing as I do)
- DJT wore a very expensive coat unbuttoned ( which made it less effective at hiding his paunch);
Mrs T and the daughters, DILs, girls wore regulalion well-to-do females' winter attire. Nothing spectacular or spectacularly wrong.
- his speech was 16 minutes of campaigneering aimed at his base supporters
- he gave The Power back to The People
- he mentioned Black People aby way of a rightie tribute to patriots
- he didn't mention his opponent's tough fight ( a usual nod) or his bromance with Vladimir
- he mentioned how bad the economy was ( despite 3 1/2 % growth and below 5% unermployment)
- the luncheon featured lobster
- he tweeted shortly thereafter
- he has two twitter accounts now I suppose
- they will probably blame low attendance on the weather
I believe that there are now officially three parties-
blues, reds and oranges ( he'll split the republicans more than they are already if that is indeed possible)
re Orac's OP- DJT's pick for education has already wielded her power in Orac's home state disastrously.
Wow- she is frightening.
re other picks-
although I believe that some of his gentlemen are skeevy and treacherous money monsters, I do think some of them smart enough to avoid ( respectively) either a nuclear war ( Mattis, Tillerson) or another economic meltdown ( Mnuchin)
re drinking
I suppose I should start soon since I have no lobster
PGP, I think that already areas like CA and NY are creating measures to block his effect on their citizens ( see Eric Holder) and other people are gearing up for a long fight.
@ Eric Lund:
* Au contraire* I think that we should bone up on news as self protection.
PLUS as I've said before, there may be much hilariousness ( if he doesn't start a war or a depression) AND good reporters and political analysts will compete to explain the madness.
Since I minored in Madness ( actually clinical), I foresee excellent opportunities for joking, satire and investigation.
Ever hear of David Cay Johnson?
Bill Maher will return- I wonder how he reconciles his vax-phobia and hatred for DJT?
AND -btw- we will survive and perhaps even thrive because we're liberals/ realists/ sceptics
and we absolutely need things to b!tch about -
he and his cronies will give us PLENTY opportunities to complain, criticise and think up ways to fix his errors.
So don't fret
I have work now
I just wanted to fully appreciate the event.
Yes, there is an official POTUS Twitter account, which is now in Pres. Scheisskopf's hands.
Mattis might be smart enough to avoid nuclear war. Tillerson and Mnuchin, along with DeVos and Sessions, are among the nominees I consider anti-competent. A merely incompetent Cabinet secretary will occasionally, by accident, do the right thing. These four are basically guaranteed to do the wrong thing. Mnuchin in particular made big bucks running a foreclosure mill--there are at least 300 million other Americans I'd rather have as Secretary of the Treasury.
Apart from Mattis, the only Trump nominee I know of whom I would not consider anti-competent is Elaine Chao for Transportation. She happens to be Mrs. Mitch McConnell, so she's merely incompetent--your garden variety party hack.
I think that would require hitting yourself on the head with a brick.
"President Trump"
I'm very sorry, but notwithstanding the human mind's amazing capability of dealing with cognitive dissonance, I just can't get my mind to actually process these two simple words as a coherent unity.
In layman's terms: it just doesn't make any sense.
DW: Only sixteen minutes long? Darn, I was hoping he'd pull a Harrison. Then all that would be left is to stock the White House pond with really big catfish and a bull shark and then 'accidentally' flood Congress.
Richard: I hear you. *raises glass of wine.*
DW: Lobster isn't necessary, wine goes with everything today.
I've never been so glad to bury myself in the lab as today. Ugh. Now I'm trying to decide between a cup of tea and a book about dragons (A Natural History of Dragons, very fun), or some kind of elderflower-syrup cardamom-bitters cocktail.
@PGP, wine is OK, if you like having an acid stomach. I figured yours would already be acidic enough, as mine is, to etch glass.
So, I'll stick with whiskey.
@Militant Agnostic, tried the brick to the head thing. Broke the brick. Tried an anvil, dented it into uselessness.
Got any suggestions?
I chose an all-Beethoven playlist today over alcohol. I thought a general theme of liberty triumphing over tyranny would lift my spirits. It's hard not to feel a little more chipper after the ninth.
Wzrd1 @17: Have you tried a gold brick with a lemon wrapped around it? I hear that's that very best.
@JustaTech, I'll have to wait for one of my rare near-missed disasters to crap out that gold brick. I liquidated the ones I previously, erm, produced to cover moving expenses.
I do keep lemon close at hand, great for marinades. :)
@Gilbert, I forgot about hot NaOH etching glass for some reason, thanks for reminding me! :)
HF does more than turn one's skin loose, it's notorious for going systemic and into the bones. Systemic, it wreaks havoc, especially in the nervous system. For the bones, well, if it eroded that far, it's likely unsurvivable.
Interestingly, it can be safely stored in beeswax containers. A weak acid, with some interesting reaction characteristics.
Makes a good mixer with CsOH. Just don't mix them when I'm around... ;)
A case where neutralization can create some quite unpleasant salts.
So, OK, I could dissolve a Nobel Prize with my stomach acid - within minutes.
Then, see the above about a brick.
@JP, get well soon. gastroenteritis sucks. Norovirus isn't uncommon at all, but is typically quite self-limiting to a few days of misery.
I would think Kindertotenlieder would be appropriate for the day.
@Wizrd1
I can think of only two substances that etch glass; Hydrofluoric acid** (which is technically a weak acid) and hot sodium hydroxide.
**Still, the difference between nitric acid and hydrofluoric acid is that nitric turns your skin yellow while hydrofluouric turns it loose.
RFKJr seemed to manage just fine.
Sleazy little twerp.
The repeal of the ACA also raises some concerns about vaccine funding.
Orac said:
"in a true Dunning-Kruger fashion shared by Dr. Bob Sears, placing his expertise above that of ACIP to determine a safe and effective vaccine schedule."
Dr. Offit writes in:
http://pediatrics.aappublications.org/content/123/1/e164
"Although Sears is correct that doctors do not often review all of the studies on vaccine science, safety, and efficacy, he ignores the expert committees that do, specifically the Advisory Committee on Immunization Practices, which advises the Centers for Disease Control and Prevention (CDC), and the Committee on Infectious Diseases, which advises the American Academy of Pediatrics. Collectively, these advisory committees and their parent agencies have the expertise in virology, microbiology, statistics, epidemiology, and pathogenesis necessary to review the studies that inform their recommendations. "
Now let's look at the "expertise in virology, microbiology, statistics, epidemiology, and pathogenesis" that went into the meningococcal immunization recommendations below:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6003a3.htm
"The goal of the 2005 ACIP meningococcal immunization recommendations was to protect persons aged 16 through 21 years, when meningococcal disease rates peak. At that time, vaccination was recommended at age 11 or 12 years rather than at age 14 or 15 years because 1) more persons have preventive-care visits at age 11 or 12 years, 2) adding this vaccine at the 11 or 12 year-old visit would strengthen the pre-adolescent vaccination platform, and 3) the vaccine was expected to protect adolescents through the entire period of increased risk. Meningococcal conjugate vaccines were licensed in 2005 based on immunogenicity (because a surrogate of protection had been defined) and safety data. After licensure, additional data on bactericidal antibody persistence, trends in meningococcal disease epidemiology in the United States, and VE have indicated many adolescents might not be protected for more than 5 years. Therefore, persons immunized at age 11 or 12 years might have decreased protective immunity by ages 16 through 21 years, when their risk for disease is greatest."
a) What kind of expertise do you need to come up with:
"more persons have preventive-care visits at age 11 or 12 years"
b) The ACIP ASSUMED in 2005 that immunizing at 11 will protect at 21. As expected, they were PROVED WRONG.
They have not heard of Murphy's law.
And no science behind the current booster recommendation below either. It is all driven by an OPPORTUNITY to inject than a NEED to inject:
"Optimizing meningococcal vaccination.
Despite the current low burden of meningococcal disease, the ACIP Work Group agreed that because of mounting evidence of waning immunity by 5 years postvaccination, vaccinating adolescents with a single dose at age 11 or 12 years is not the best strategy for protection through age 21 years. The Work Group considered two other options for optimizing protection: moving the dose from age 11 or 12 years to age 14 or 15 years or vaccinating at age 11 or 12 years and providing a booster dose at age 16 years. Although a single dose at age 14 or 15 years likely would protect most adolescents through the higher risk period at ages 16 through 21 years, the opportunities to administer vaccine at age 14 or 15 years might be more limited. Data indicate that as adolescents grow older, they are less likely to visit a health-care provider for preventive care (8). Adding a booster dose to the recommended schedule would provide more opportunities to increase vaccination coverage, while persons aged 11 through 13 years would continue to be protected. An economic analysis comparing the three adolescent vaccination strategies concluded that administering a booster dose has a cost per quality-adjusted life year similar to that of a single dose at age 11 years or age 15 years but is estimated to prevent twice the number of cases and deaths (CDC, unpublished data, 2010)."
As this shows, there's not much expertise at the ACIP or there is no incentive for them to use any expertise they may have.
Oh, look. Yet another uncited claim.
That was my plan, but instead I came down with the worst case of stomach "flu" I've had in quite some time. It's currently watered down juice and saltines for me.
Speaking of whom...RFK Jr. knows no depths of depravity when it comes to aligning himself with fellow anti-vaxxers:
https://reasonablehank.com/2017/01/20/robert-f-kennedy-jr-to-speak-at-a…
I'd say he's making an even bigger arse of himself but it just doesn't matter to his base or even the president.
As shown in my previous post, from 2005 to 2010, adolescents were unprotected against meningococcal disease when they needed the protection the most. They suffered the vaccine adverse events for no benefit. An example of the ACIP's SPECTACULAR failure. Even a bunch of Dunning-Krugers could have done a better job. And this is just the tip of the iceberg.
ACIP being experts is just another ASSUMPTION like so many other assumptions about vaccines.
Oh, look. Yet *another* uncited claim.
Oh wait, Saturday ends in 'y', for a third newslfash today.
Wzrd1: I like tannins and tannins seem to like me, so I've never had any complaints about most wines. (One rather memorable Christmas, me, sis-in-law and brother demolished a case of wines. I was sensible and quit after a bottle and a half.)
The one exception is Chardonnay; I find it a little sweet for me. The real problem for me is ciders. There's a cidery that just got started here, and one of their products-well, it's basically a slightly appley, bubbly gold brick. I have one of those and I'm done for the night. The label says it's 7% alcohol, but the label lies. There's also an insanely expensive rum that my family favors- we were introduced to it by one of Dad's contacts who came from Venezula.
ScienceMom: I’d say he’s making an even bigger arse of himself but it just doesn’t matter to his base or even the president.
I have reason to believe his state doesn't actually know his policies; they're just voting for his name.
Hrm, Imposter, the Birdcage, or MST3K.. decisions, decisions.
I have the Discreet Charm of the Bourgosie on order, thank god. You know how hard it is to find something when the only thing you remember is 'it's French and it's about a dinner party?"
Recall Orac's The new Secretary of Health and Human Services is a member of a fringe medical organization. Here’s what that means.
That's AAPS, strongly anti-vaxx.
AAPS is well-connected, see Anti-Science Associations: Rand Paul, Jane Orient, Art Robinson, Willie Soon And Friends, Plus HHS Nominee Tom Price & Funder Robert Mercer.
See What Kind of Man Spends Millions to Elect Ted Cruz?
But then he switched to Trump, hence Bannon/Breitbart.
So the anti-vaxx thread is potentially *much* stronger than a few meetings.
Ah, but a Senate committee in charge of health and science has come down hard against the antivax BS from Trump and his merry band of misfits.
That was my plan, but instead I came down with the worst case of stomach “flu” I’ve had in quite some time.
S'alright, JP, I'm drinking your share.
the only thing you remember is ‘it’s French and it’s about a dinner party?”
That does not narrow things down very much.
Wzrd1
tried the brick to the head thing. Broke the brick. Tried an anvil, dented it into uselessness.
I didn't realise you were Scandiwegian.
Actually, pure Sicilian-American, with an unnaturally hard skull.
Once, many years ago, my wife was joking around as if she was going to hit me in the head with a cast iron skillet. We were at the dinner table, she had just decanted food from the skillet and I was watching her reflection in the kitchen window.
Suddenly, I heard a crack from her wrist and the pan hit me in the head.
Both of our daughters looked up with eyes like saucers, I took a bite of food, then said, "What, did somebody say something?"", then went on eating.
My wife apologized and I pretended to not know what she was talking about. It wasn't as if she did it on purpose or hard, no injury and well, humor and food were and are important to me, turning the joke around to amplify it.
She went to make a sauce from the drippings in the skillet and the bottom fell out.
Priceless. True story too.
Alas, that was our best skillet, it was over a century old.
Which is likely why it was so brittle.
I understand from following the internet that the VaXXed team including Andrew Wakefield were at the inauguration. This does not bode well.
This is the sort of event that AndrewWakefield has been reduced to appearing at.
It's been a year since I quit drinking.
https://www.youtube.com/watch?v=v46plhmxXU4
Indeed they were. There are pictures on Facebook and videos on Periscope.
I will preface this by stating that everyone's relationship is different and that nobody really and truly knows what goes on between two people, except those two people, and even then, not really.
BUT DID YOU SEE Trump and Melania? Did you watch them dance, people? There is no warmth between them, no physical shorthand of the type of usually witnessed between long-term couples. It's not cold, either. It's just -- nothing. There is nothing there.
@Delphine - I have serious doubts that their marriage will last the full 4 years....
Great piece, Orac. And I'm pretty happy to find a broad area of agreement with you: We have a President who could harm our country in many ways. Major disruption of vaccination programs could create pertussis epidemics and perhaps a return of HIB meningitis which I vividly recall from residency and my early years in practice. No sane person could wish for that. I don't agree with all the details in your article but I share your feelings about an unscientific anti-vaccine agenda. The Atlantic writer misquoted me: What I actually said was "I get and give vaccines"
All my best wishes for this very difficult new year. To you, Orac, and all my old friend here.
Jay
Dr. Gordon,
"could create pertussis epidemics"
As you know, the acellular pertussis vaccine does NOT prevent transmission. It does not offer mucosal immunity. So those vaccinated can become colonized with the bacteria and these ASYMPTOMATIC carriers can spread the disease silently.
And worse, such colonization increases risk of multiple sclerosis.
https://www.ncbi.nlm.nih.gov/pubmed/26724970
So a pertussis epidemic in older children may actually be beneficial to the community.
And the acelullar vaccine is not even effective in most people.
http://pediatrics.aappublications.org/content/early/2016/02/03/peds.201…
Friends! Not "friend".
While it's gratifying to see Jay Gordon expressing concern about pertussis epidemics and the return of Hib meningitis, he should be aware that it's not just The Atlantic that's "misquoting" him.
Jay is supposedly worried that "Major disruption of vaccination programs could create pertussis epidemics"
However, drjaygordon.com says "I personally would prefer to start vaccines after the first 6-12 months of life even though I know that this would slow the development of immunity to whooping cough which may come back any year."
How shameful - Jay's own website is "misquoting" him.
In the same article on his website Jay says "I am very much opposed to the routine vaccination schedule in the U.S. There are too many vaccines given too early in a child’s life...
Vaccines have side effects. There can be rare severe problems, common minor problems and constant speculation about hidden problems."
Oo, the "hidden problems." :(
Old friend Jay continues to work both sides of the street in a lame attempt to appear balanced, but comes off as both uninformed and deceptive.
Bacon, start vaccines later, give them to all. Herd immunity retained.
You're too smart to believe I'm your enemy.
Dr. Jay Gordon,
It would be interesting to hear your understanding of the following:
https://iom.nationalacademies.org/Reports/2011/Adverse-Effects-of-Vacci…
Document Pg. 65 (pdf pg. 94 ):
“Adverse events on our list thought to be due to IgE-mediated
hypersensitivity reactions
Antigens in the vaccines that the committee is charged with reviewing do
not typically elicit an immediate hypersensitivity reaction (e.g.,
hepatitis B surface antigen, toxoids, gelatin, ovalbumin, casamino acids).
However, as will be discussed in subsequent chapters, the
above-mentioned antigens do occasionally induce IgE-mediated
sensitization in some individuals and subsequent hypersensitivity
reactions, including anaphylaxis.”
@ Eric Lund:
Agreed. They will work to further their own agendas not what is best for the country/ humanity.
BUT too smart to allow DJT to REALLY f@ck up the works- they will intervene to save their own skins/ interests.
The potential secretaries of education, energy, labor, EPA are the ones who are ideologues and working to dismantle agencies and programmes.
I'm not sure which is worse.
@ Delphine:
There is nothing there - except MONEY
PGP and JP- our youngsters- may be heartened to observe that many women ( and men) are protesting DJT in Washington and cities - NYC, SF and Oaktown.. .. that is, OAKLAND, amongst others
I note quite a few 'p@ssy hats' in the crowd ( see g--gle)
I'm not impressed by a video made on the mall, or a picture of Wakefield in a tux.
My father was a senior level federal employee. He went to the "inauguration" every four years for many inaugurations, as do many top level civil servants and military officers. There are a multitude of parties and gatherings surrounding the inauguration that are official and many of them are open to the public.
All they had to do was show up. It doesn't mean they have any kind of real "in."
Ah, but did your father get a personal, one-on-one meeting with the President during the campaign and arrive with the well-heeled Republican big money donor who had facilitated that meeting? :-)
Sort of :) A general my father worked with approached him and my mother at one of these get togethers and said, "Bob I want to introduce you to the next President of the United States." Mom and Dad met Gov. Bill and Hilary Clinton that day. It was GHW Bush's inauguration.
Do we have confirmation that Wakefield was actually at THE inauguration party, the one the President was actually at? Do we have a picture of him there, with the President? Unless someone shows me one, I rate Wakefield's attendance at about the same level as my Dad's. :)
Basically, at the table furthest from the cool kids table.
Normally, when the "good" Doctor Gordon shows up, while others give him hedoublehockeysticks about vaccines, I like to point out all the other pseudo-science on his site. But there's a new page of what Doctor Gordon calls "Helpful links to resources on the web".
http://drjaygordon.com/links?cat=Vaccines+and+Childhood+Diseases
What links do we find here? (I won't list them all, just a few of the worst examples.)
Under Basic Vaccine Information and Awareness we find links to The Australian Vaccination-skeptics Network Inc. (AVN), articles by Null and Mercols, an article entitled "'Only Safe Vaccine Is One That Is Never Used'", a link to NVIC, and (HA-HA) a link to whale.to
Under autism, we find 3 Mercola articles.
Under Flu, MMR, Cholera, Rabies, Smallpox (do you hand out many Smallpox shots there, Doctor), Travel Vaccines, Salk vaccine and Lyme all have (HA-HA) links to whale.to
Under a link to Personal Stories, there are 3 - all stories of how vaccines injured or killed children.
And there's more.
How long until he scrubs it, and blames it on someone on his staff? Because you know he aint brave enough to own it.
It's time for the old Denice Walter to come back, we miss you!
Has anyone noticed lately that her responses have been non-science gibberish?
#8 - She fixates on DJT's unbuttoned coat.
#9 - She talks about drinking and eating lobster.
#10 - She releases her political ideology.
#46 - She insinuates that money is Trump's love language.
#47 - She talks about ‘p@ssy hats’ in the crowd.
@ Minions,
Please talk to Denice Walter or get her some help.
Sincerely,
MJD
Says the man with his own entry in the Encyclopedia of American Loons....
Ha, ha, ha
Those things are adorable; knitted with love.
https://www.youtube.com/watch?v=wZZ7oFKsKzY
This is mildly interesting:
http://www.latimes.com/local/california/la-me-ln-measles-20170120-story…
For the lulz.
She fixates
You would know, wouldn't you.
C'mon Johnny, just because Jay Gordon thinks the AVN, Gary Null and Mercola are good sources of information on vaccination doesn't mean he's antivaccine.
If you look hard enough, he tries to say at least some good things about immunization, as in this statement on his website about the hepatitis B vaccine:
"I try not to give it to any kids. It does a very good job of preventing hepatitis B, no doubt about that, but it also hits the immune system pretty hard and possibly creates autoimmune problems. The French stopped giving this shot for a while because they thought they saw an increase in multiple sclerosis in recipients. Very few experts agree with this finding but the data were not bad. Other relatively reasonable docs think that diabetes or lupus might be on the rise because of the HBV."
See, he acknowledges it does a very good job of preventing hep. B. :)
Meantime, one wonders what percentage of his patients have gotten medical exemption letters following passage of SB277.
He has said "These exemptions will not be difficult to justify in most families".
In case anybody needs some cheering up after *gag* inauguration day, here's a Nazi getting punched in the face.
Made my day, personally.
I deplore violence.
But it couldn't have happened to a nicer guy.
On the Propriety of Punching Nazis, an FAQ.
ROFLMAO! I liked the FAQ nearly as much as the punch picture.
Sorry, but there are times when violence is justified. It's really a question of do you wait for the dog to bite you before you hit it with a stick?
Personally, as it starts to make its move, I want it to start figuring it out on the way to the ground that it was hit three times with that stick.
Wzrd1:Senate committee in charge of health and science.
Oh, yeah, they'll do a great job. *Rolls eyes* The House committee is chock full of Flat-Earthers and other dummies, so I can't say I have any great expectations there.
Jay Gordon: You’re too smart to believe I’m your enemy.
We are all smart enough to know you're a quisling. A person who plays both sides is worse than an enemy.
MJD: Oh, go screw yourself.
DW: Big protests here too in both cities. I, unfortunately, had to go punch things. (Willing partner, though I think I scared him.)
DW: Also, I'd be willing to bet that Trump's gonna marry Conway after he kicks Melania to the curb. I'm surprised it took him this long. Didn't he kick Ivana out like two years after she had kids?
@Dangerous Bacon--
Thanks for saving me the keystrokes on Gordon and his usual rubbish.
Not going to happen. When The Donald divorces his current wife to replace her with a new one, he always goes younger.
There's a reason they're called trophy wives. See also Gingrich, Newton Leroy, as well as various MOTU in business (in Bonfire of the Vanities Tom Wolfe referred to these younger wives/girlfriends as "lemon tarts"). When the current trophy starts to lose its shine, these men start looking for another, shinier one.
Some good news.
https://www.statnews.com/2017/01/18/donald-trump-vaccines-senators/
This is unrelated to the Trump story but I wanted to notify you of a debate going on now in Quebec.
http://www.cbc.ca/radio/thesundayedition/the-trudeau-vacation-saying-no…
I cannot find any article saying she is cancer free, but she is obviously creating a dangerous narrative here. Consider that we are a province that also saw a measles outbreak last year because of unvaccinated pockets in our childhood population. Help us bring Quebec back to the land of science please!
Science is corrupted when there is so much money involved. So we don't know which scientific studies/results can be trusted. The ADA was caught lying through their teeth about flossing. Every professional institution is likely corrupted like the ADA. May be chemo works in some cases. But is it better than ginger and turmeric? We will never know because there is too little money to be made selling people ginger and turmeric.
Ah, no day would be complete without an argument by assertion from Vinu.
Orac: I thought Conway was younger than Melania. Or did you mean right out of high school 'younger?
Eric Lund: That's one of the reasons I always knew Trump was lying when he said he 'respected' women and always thought he was a creep. Men who look for women 20+ years younger than them, especially younger immigrant women are usually predators and creeps. They aren't looking for a partner or someone they can respect. One of my rules of thumb is to be really suspicious of any man who marries an immigrant or is conspiciously older than his wife.
Julian Frost: The House Science comittee is choc-a-bloc with Flat Earthers and Creationists. What makes you think the Senate's commitee is any better?
Politicalguineapig: Ivana was about 28 when they married, Marla was about 30, and Ivana was about 35. By that progression his next spouse would likely be no more than 40 years old, which puts Ms. Conway well out of the running.
In fairness, none of Mr. Trump's wives (current or ex) was "right out of high school ‘younger'" when they married.
Oh, and Ms. Conway is 5 years older than Ivana.
Sorry, meant Melania.
Kellyanne Conway is 50 (and to me looks even older–I've seen a lot of closeups of her this week). Melania Trump is 45.
altho' I really hate to edit Orac ( # 70)
BUT I think ( if I may so bold as to suggest) that the funnier thing to say would have been -
" replace her with a new MODEL"
because his wives seem to all have been models.
( and yes, I do think that Conway looks older than her years-
it must be all of the prevarication)
Today Mikey writes about how 'the Prez' and 'Kellyanne' can defeat the left. ( Natural News)
Interestingly, one of the news sources I use ( I forget which - NBC/ MSNBC, Bloomberg, NYT WaPo ) suggest that DJT's anti-press actions ( including the move to an alternate building press room) will be to allow MORE reporters such as bloggers and alt media creatures to offset
SOOOOOOOOOOOOOOOOOOOOOO..
perhaps Mikey's and Gary's wildest wet dreams will be coming true-
their ilk will FINALLY be represented.
Melania is good looking for 45. She looks younger. Conway looks well, as we used to say in the ER, "rode hard and put up wet."
But she IS stupid, which might make her appealing to Trump. Oh, right. That's why he hired her.
I think it more likely Melania will kick Trump to the curb first. I suspect that's partly why she wants to stay in New York, and not live in the White House.
@Denice:
Indeed. To quote Trump:
He's not talking about sleeping with a brilliant PhD or a CEO...
In other news...
DJT seems to be the topic of choice amongst many alt med and woo sites which I survey-
- Jake is in his camp
- AoA tips their (collective tinfoil) hat
- Natural News has been bowing and scraping in his direction for some time
- Null/ prn.fm has now limited pseudoscience / woo to the first 15 minutes or so and spends the rest of his air time to delve into CT, Breitbart-ism and anti-establishment diatribes against the media, government and corporations ( ironic, no?) despite be supposedly against DJT.
The new Media has triumphed!
@ JP;
Yes he is rather sickening
And I know that many men ( and women, to be fair) do frequently think that way but most of them have enough sense to NOT say it publicly.
I can only imagine what he means by 'top women'
Something something medical records something.
Even the Weekly Standard, that ravenous conservative publication, is calling out Trump for his lies....stupid ones at that.
At this rate, I can't even imagine what next week is going to look like.
It took Nixon a few years to go full-on nut job...
Lawrence, I especially enjoyed his reps' blaming the media for 'under-estimating' attendance at his
festivities compared to Obama's DESPITE photos that clearly illustrate the difference.
He did refer to the 70s as his own personal Vietnam because of the risk of...
Not only that, but he ordered the Department of the Interior to stop tweeting after tweeting the photos. Full on authoritarianism on day one.
M'oB: That's surprising, as Trump seems like the type to have low patience for adult women.
Orac: Really? Her doppleganger on SNL is so much younger.
"[T]hey will probably blame low attendance on the weather."
Turns out they found a better excuse, one that doesn't even require looking out the window: baldface lies.
It was the most attended inauguration in history (unless you count all the others).
The Secret Service slowed the crowd's access with their magnetometers (You know, the kind that can only be seen by Fred Flinstone.).
There was a record number of individual fares on the DC Metro (if you don't count the 2009 inauguration, and, incidentally, Saturday's Women's March - one freakin' million fares. Way to go, sisters.).
I fully expect that one day Trump will declare that white is black and promptly get killed in a zebra crossing.
ORD: I fully expect that one day Trump will declare that white is black and promptly get killed in a zebra crossing.
Psst, big brother is watching. I personally had a plan involving Polish catfish, but that'll have to wait.
So instead of the emperors new clothes, we have the presidents new inauguration public.
http://www.volkskrant.nl/foto/bas-van-der-schot~p4368443/4312034/
PGP@94: ORD was making a Douglas Adams reference there. That was the in-universe fate of the author of (among other titles) Who Is This God Person, Anyway?
@ ORD:
" one freakin' million fares"
Whoa! I imagine that the tunnels there were packed. It's not like it's NY with miles of aisles.
I am impressed.
In other news...
Kim ( AoA, today) attempts to hang on to the coattails of current unity memes by adding a "vaccine choice" category as being victims of discrimination.
Someone should remind her that discrimination is treating like cases differently.
Vaccine-Deprived children, through no fault of their own, are not in the same situation as vaccinated children. They are at higher risk of disease, and when they congregate, they increase the risk of outbreaks.
Treating them differently is not discrimination.
Kids vaccinated with acellular pertussis may have to be discriminated against (including mine) ...
http://www.sciencedirect.com/science/article/pii/S0171298515301078
"Government data indicate increased MS mortality among elementary and secondary school teachers, compared with all other professional occupations (proportional MS mortality: 161%, p < 0.0001), which persists after adjustment for gender, race and age (Walsh and DeChello, 2001). Increased MS risk among health technicians and nurses’ aides has also been demonstrated (Walsh and DeChello, 2001). Finally, the 2:1 female:male incidence ratio of MS mirrors the 2:1 female:male ratio of adult pertussis (De Serres et al., 2000).
3. Biologic evidence
There is substantial biologic plausibility for subclinical BP colonization as a cause of MS. BP colonization is common in children, adolescents, and adults (Zhang et al., 2014 and Ward et al., 2005)."
A kid suffering whooping cough can be isolated from babies.
How do you isolate an asymptomatic pertussis carrier from babies?
From the cited article:
EBV and HHV6 are rather ubiquitous infections, most of humanity has been exposed to one or both. Both have been linked to various diseases, ranging from cancer to autoimmune syndromes.
But, this is also of interest:
I'll try to look into the entire thing later, although it is rather late. Whenever there is a potential conflict of interest, one must examine the claims and methodology much more closely.
But, this is notable:
That's before there was a vaccine and especially long before the acellular vaccine existed and it's talking about actual infection, not vaccination being linked to MS.
"Whenever there is a potential conflict of interest, one must examine the claims and methodology much more closely."
That will include almost 100% of vaccine safety studies.
"That’s before there was a vaccine"
No.
"Faroese BP epidemiology changed in the 1920s when whole-cell pertussis vaccination (wPV) studies immunized nearly 80% of those eligible (Madsen, 1933)."
The whole cell vaccine had some of the same limitations as the acellular vaccine.
@ Dorit Reiss:
I know.
Unfortunately, I've heard various woo-meisters and anti-vaxxers trying to claim the same previously.
Kim, you're not Rosa Parks.
DJT has demonstrated his profound lack of savvy/ person perception/ appreciation of reality, etc.
In just a few days, he has managed to show his continued disregard for BOTH the MEDIA and the INTELLIGENCE COMMUNITY.
I.e. people who have "gallons of ink" and
who are SPIES- that is, who can have the "dirt" on anyone.
And wow!- his enablers go on television yet with the same.
Even better ( worse?)...
Mikey ( Natural News, today) presents 10 ways to make America great again
including-
- getting rid of fake news, fake science, media lies
AND...
wait for it!
fighting intolerance against "whites" and "Asians" in academia
and the usual woo-fraught fol de rol
Stone is even dumber once you scratch the surface, but I've got way too much pressing stuff clanging around in my head to finish the disassembly at the moment. At very least, he apparently fails to grasp that the two-year-old item he's whining about isn't from the NYT.
@ Denice:
Touche!
Top women are golden to the Donald.
Antagonizing the CIA is, for any significant American politician (let alone POTUS) a land-war-in-Asia class blunder. And it's a measure of how far through the looking glass we are that I'm actually rooting for the CIA here.
I'm less optimistic about the press, given their track record, but there are signs some of them might be waking up. Of course, the dispute over the size of the crowd at Scheisskopf's inauguration is now the subject of a Downfall parody.
Denice Walter@53: I was one of those marching, and knitted several hats, including one while we marched. It was glorious. Upbeat, determined, intersectional, proactive. And very, very friendly.
You expected Vinu to show up without a leaking bag for a change?
Well, a broken clock is right twice a day. ;)
Primary Biliary Cirrhosis is associated with autoimmunity against pyruvate dehydrogenase (PDH).
Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome
http://insight.jci.org/articles/view/89376
Pyruvate Dehydrogenase Complex Deficiency
http://emedicine.medscape.com/article/948360-overview
https://www.researchgate.net/profile/Wahiba_Sakly/publication/5797990_A…
Anti-Saccharomyces cerevisiae Antibodies (ASCA) can bind/block PDH because:
Method
https://www.researchgate.net/publication/310021910_Significant_protein_…
Results
Pda1p [Saccharomyces cerevisiae R103]
Sequence ID: EWG96330.1Length: 355Number of Matches: 1
Related Information
Range 1: 3 to 314GenPeptGraphics
Next Match
Previous Match
Alignment statistics for match #1 Score Expect Method Identities Positives Gaps
382 bits(981) 1e-130 Compositional matrix adjust. 175/312(56%) 230/312(73%) 0/312(0%)
Query 48 EGPPVTTVLTREDGLKYYRMMQTVRRMELKADQLYKQKIIRGFCHLCDGQEACCVGLEAG 107
E P ++ ++ L+ Y+ M +RRME+ D LYK K IRGFCHL GQEA VG+E
Sbjct 3 EPPDLSYETSKATLLQMYKDMVIIRRMEMACDALYKAKKIRGFCHLSVGQEAIAVGIENA 62
Query 108 INPTDHLITAYRAHGFTFTRGLSVREILAELTGRKGGCAKGKGGSMHMYAKNFYGGNGIV 167
I D +IT+YR HGFTF RG SV+ +LAEL GR+ G + GKGGSMH+YA FYGGNGIV
Sbjct 63 ITKLDSIITSYRCHGFTFMRGASVKAVLAELMGRRAGVSYGKGGSMHLYAPGFYGGNGIV 122
Query 168 GAQVPLGAGIALACKYNGKDEVCLTLYGDGAANQGQIFEAYNMAALWKLPCIFICENNRY 227
GAQVPLGAG+A A +Y +D TLYGDGA+NQGQ+FE++NMA LW LP +F CENN+Y
Sbjct 123 GAQVPLGAGLAFAHQYKNEDACSFTLYGDGASNQGQVFESFNMAKLWNLPVVFCCENNKY 182
Query 228 GMGTSVERAAASTDYYKRGDFIPGLRVDGMDILCVREATRFAAAYCRSGKGPILMELQTY 287
GMGT+ R++A T+Y+KRG +IPGL+V+GMDIL V +A++FA +C SGKGP+++E +TY
Sbjct 183 GMGTAASRSSAMTEYFKRGQYIPGLKVNGMDILAVYQASKFAKDWCLSGKGPLVLEYETY 242
Query 288 RYHGHSMSDPGVSYRTREEIQEVRSKSDPIMLLKDRMVNSNLASVEELKEIDVEVRKEIE 347
RY GHSMSDPG +YRTR+EIQ +RSK+DPI LK +++ +A+ E+K D RK ++
Sbjct 243 RYGGHSMSDPGTTYRTRDEIQHMRSKNDPIAGLKMHLIDLGIATEAEVKAYDKSARKYVD 302
Query 348 DAAQFATADPEP 359
+ + A A P P
Sbjct 303 EQVELADAAPPP 314
Where did ASCA come from? Numerous yeast contaminated vaccines.
Inject milk and you create milk allergy.
Inject milk (folate receptor proteins) and you create autism.
Inject yeast and you create anti-saccharomyces cerevisiae antibodies (ASCA).
ASCA causes Primary Biliary Cirrhosis, ME/CFS, Crohn's, coeliac disease etc.
Food is to be EATEN, NOT injected. Ignore 100 year old wisdom and suffer the consequences.
@Denice Walter #89, and KellyAnne Conway calling out the media for "alternative facts"?
CNN's rebuttal to that was simple and on point.
The media reports alternative facts about vaccine safety all the time. Now Trump is giving them a taste of their own medicine.
@ Julian Frost:
I saw another network take her down.
-btw- she should also be served for wearing that ((shudder)) outfit
on Friday ( g--gle Kellyanne Conway outfit/ Gucci 3600 USD)
Oh sweet lord, kill me now.
It's full of holes - the middle line represents what's common between the queried sequence and the matched target sequence, a '+' denotes two similar but not identical amino-acids, like D (Asp) and E (Glu) -, hydrophile amino-acids are replaced by hydrophobe ones and vice-versa...
And the deluded m0r0n says it's the same thing. Same with the other sequences, here and at the 'method' link.
Cargo cult, or alternative facts. Your pick.
---------------------
'scuse me, now back to lurking.
Sorry, but you are DEAD WRONG!
I don't know why you picked only the last bit. The entire result is a single query.
Pandemrix induced narcolepsy when the sequence alignment match score between influenza nucleoprotein and human hypocretin receptor, was only 19.3 (pl. see the method link).
The match score here is a whopping 382!
Vinu "you are DEAD WRONG!" Arumugham loses with his first sentence:
"Ahmed et al. [PMID 26136476] demonstrated that Pandemrix induced narcolepsy was caused by molecular mimicry between influenza nucleoproteins (NP) and the human hyprocretin receptor (HCRT)."
Somebody's skipped several steps before BLASTing his underpants onto his head:
"Our findings lead us to propose a mechanism for influenza infection/pandemic vaccine-associated narcolepsy as follows: In subjects with genetic susceptibility to narcolepsy, the presentation of NP antigen during infection or after immunization with adjuvanted influenza vaccines containing increased amounts of NP may generate high titers of NP antibodies that can persist in the systemic circulation for months. During this time period, either the high titers of NP antibodies or inflammation related to an unrelated infection (for example, streptococcus) may alter the blood-brain barrier (46), allowing NP antibodies to cross-react with neural tissue expressing HCRT receptors [the direct role of adjuvants alone in triggering autoimmune disease in genetically susceptible subjects is less likely based on their inability to trigger or exacerbate disease activity in genetically susceptible patients with established or active autoimmune disease (5), respectively]. Binding of the HCRT receptor by cross-reacting NP antibody might modulate signaling to the cells responsible for producing the ligand (HCRT) and whose disappearance has been demonstrated in pathological investigations of narcoleptic brains (18)."
I'm not going to bother copying and pasting the references that go with the cite numbers.
http://www.medscape.com/viewarticle/855558
"In a recent paper in Science Translational Medicine,[1] researchers explained the difference between those two vaccines. The difference was that whereas Pandemrix contained a fair amount of influenza nucleoprotein, Focetria didn't contain that influenza nucleoprotein. And the nucleoprotein was the key because it appears that nucleoprotein has molecular mimicry with at least one of the receptors for hypocretin, the product made by cells in the hypothalamus that is associated with wakefulness. Apparently, it was a phenomenon of autoimmunity. Antibodies directed against the cells that produced hypocretin were made, and these antibodies destroyed those cells and caused the permanent disorder of narcolepsy."
Wzrd1
Well, a broken clock is right twice a day.
Shirley only once a day in your line of work.
Oh, dear L-rd:
Let that sink in.
and ...