When celebrities promote pseudoscience and quackery...

If there's one thing that's irritated the crap out of me ever since I entered the medical field, it's celebrities with more fame than brains or sense touting various health remedies. Of late, three such celebrities have spread more misinformation and quackery than the rest of the second tier combined. Truly, together, they are the Unholy Trinity of Celebrity Quackery.

The first two of them, of course, are that not-so-dynamic duo of anti-vaccine morons, Jenny McCarthy and her much more famous and successful boyfriend Jim Carrey. Having apparently decided that selling "Indigo Child" woo was not the ticket to fame and fortune, in 2007 McCarthy reinvented herself as a "mother warrior" fighting for a "cure" for autism, with which her son Evan had been diagnosed. All well and good, except that what she is warring against is the one medical intervention in all of history that has arguably has saved more lives than anything else produced by medicine, namely vaccines, even going so far as to lead a march on Washington demanding "green vaccines." Why? Because she has fallen for the misinformation of the anti-vaccine movement claiming that vaccines cause autism, and she blames vaccines for her son Evan's condition. Even worse, what's she's fighting for is the "biomed" movement, a movement of "alternative" medicine practitioners, many quacks and charlatans, who claim to be able to "recover" autistic children using all manner of scientifically dubious treatments ranging from mildly plausible but with no evidence of efficacy to pure quackery like homeopathy. Moreover, McCarthy advocates for "biomed" treatments using a misunderstanding of science that would be hilarious were it not so sad to contemplate the sorts of horrors to which autistic children are being subjected in the name of "biomed." Meanwhile, Jim Carrey demonstrates himself to be at least as dim a bulb as his girlfriend and even as dim as one of his characters from the 1990s, Fire Marshal Bill. (In fact, whenever I hear Carrey speak or see him write about vaccines I now find it comforting to picture whatever he is saying being in the voice of Fire Marshal Bill; it makes the material sound the way it should.) In any case, Generation Rescue, an anti-vaccine organization that used to trumpet that "it's the mercury [in vaccines], stupid!" but has now moved on to "too many, too soon" and "greening" vaccines, has been reborn as "Jenny McCarthy and Jim Carrey's Autism Organization," making this depressing duo the prom king and queen of the anti-vaccine movement.

The third of this unholy trinity is, of course, Suzanne Somers. Somers, of course, was a topic of this blog in its first month of existence as an example of how a "cancer cure" testimonial in which a brave maverick woo-lover eschews chemotherapy and lives to tell the tale, is often inherently deceptive. Of late, Somers has been pushing that principle (of deceptive personal testimonials) to new heights (or should I say depths?) of misrepresenting reality in her recent book, Knockout: Interviews With Doctors Who Are Curing Cancer and How to Prevent Getting It in the First Place. Not only does the book contain a testimonial on her part about a "whole body cancer scare" that is not what Somers thinks it is, but it carpet bombs the reader (just as Somers has been carpet bombing the media) with appalling medical ignorance and the promotion of dubious physicians and "practitioners, many of whom in my not-so-humble opinion would be far better characterized as quacks, such as Nicholas Gonzalez. Indeed, Somers doesn't even know that her "bioidentical" estrogens are steroid hormones or that her "bioidentical" cortisol is a corticosteroid that can suppress the immune system! All of this is why I truly fear what can happen to cancer patients who might actually believe Somers' dangerous quackery.

As 2009 draws to a close, you might think that I would be depressed. To some extent, I am, but I do see some reason for hope. An example of this hope came in a most unexpected place, too. I'm referring to articles in yesterday's USA Today entitled Are celebrities crossing the line on medical advice? (with a side bar entitled A "Knockout" punch from medical experts) and Don't believe medical advice from Internet, celebs when... Combined, these features manage to hit nearly all the right notes and avoid the pitfalls of such articles, all in a nice, compact, USA Today-length set of articles. Getting it right in such tight space constraints is very difficult, as you might know. Heck, if it were easy, Orac-length would mean under 1,000 words, not my usual 5,000+ word magnum opuses (opi?). Because it's Christmas Eve, I think I'll just hit the high points, and you can read the rest.

First, the reason why celebrity testimonials have such an effect, aside from just the sheer fame and power they wield:

Doctors say they can understand why patients sympathize with celebrities and closely follow their battles with serious illnesses.

"It helps people to realize that health problems they have affect even celebrities," says pediatrician Aaron Carroll, director of Indiana University's Center for Health Policy and Professionalism Research. "Knowing that a rich and famous person can have the same problem as you or me makes it seem more fair, maybe.

"It also can make it easier to talk about your own problem, because a celebrity has the same issue."

True enough. That, for instance, Patrick Swayze could end up dying of pancreatic cancer or Farrah Fawcett could die of anal cancer, as they did this year, could be seen as a leveling. No matter how wealthy, famous, or powerful a person is, he can't fight biology and is prone to the same sorts of ills that everyone else is. No one lives forever, and no one is immune from cancer or other dreaded diseases. Some seemingly very fortunate and successful people even end up dying quite young, as recently happened with Brittany Murphy.

One depressing part of the article is that Jenny McCarthy and her anti-vaccine message are clearly having an effect:

A USA TODAY/Gallup Poll of 1,017 adults found that more than half were aware of McCarthy's warnings about childhood shots. More than 40% of adults familiar with her message -- 23% of all adults surveyed -- say McCarthy's claims have made them more likely to question vaccine safety. The Nov. 20-22 poll had a margin of error of plus or minus 4 percentage points.

Moreover, as Paul Offit puts it:

Correcting that misinformation -- even with a mountain of evidence -- can be a challenge, says Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia. "It's much easier to scare people than to unscare them," Offit says.

By swaying parents to delay or reject childhood vaccines, celebrities could undermine efforts to protect newborns and other vulnerable children from devastating diseases, says pediatrician Martin Myers, executive director of the National Network for Immunization Information.

"I worry about these celebrities who confuse people," Myers says. "I don't think they know how much damage they can cause."

I would disagree. I think they are coming to realize how much damage they can cause. Clearly, the charges against them that I and many others level, namely that they are contributing to the resurgence of vaccine-preventable diseases that will lead to suffering and death down the road, are starting to bother them. However, as Jenny McCarthy did this year, their response is not to look at their own activities and ask themselves if they are doing harm but rather to blame anyone but themselves, as Jenny McCarthy did back in April in an interview with TIME Magazine. I find her words to be worth quoting again and again--with the profanity she uses--because they demonstrate better than anything her attitude of shifting the blame to anyone but herself, an attitude shared by the anti-vaccine movement:

TIME: Your collaborator recommends that parents accept only the haemophilus influenzae type B (HIB) and tetanus vaccine for newborns and then think about the rest. Not polio? What about the polio clusters in unvaccinated communities like the Amish in the U.S.? What about the 2004 outbreak that swept across Africa and Southeast Asia after a single province in northern Nigeria banned vaccines?

JM: I do believe sadly it's going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it's their fucking fault that the diseases are coming back. They're making a product that's shit. If you give us a safe vaccine, we'll use it. It shouldn't be polio versus autism.

In other words, in Jenny's world (and that of J.B. Handley, Kim Stagliano, Dan Olmsted, Mark Blaxill, Barbara Loe Fisher, and other luminaries of the anti-vaccine movement), your children are acceptable collateral damage in her war against vaccines. Yes, I realize that these same people will claim that the position of those of us who defend vaccines is that autism is acceptable "collateral damage," but there's a huge difference. There's no scientific evidence from good scientists and reputable sources that vaccines cause autism.

Finally, the article describing how to spot dubious health advice on the Internet or from celebrities is a pretty good distillation of some simple principles on how to identify quackery. I think that medical skepticism and education could be improved immeasurably if people could be taught this simple rule:

3. The promoter relies on anecdotes and personal testimonies.

An anecdote may generate a hypothesis, which could lead to a clinical trial, but anecdotes, on their own, prove nothing. That's because anecdotes -- including stories in which people made dramatic recoveries -- can be misleading, because they don't tell you anything about the larger picture. Though 10 people may have done well taking an herb, hundreds of others may have gotten much sicker.

There you have it, one major message of this blog boiled down to a short paragraph. Unfortunately, I have to illustrate it time and time again, which is why I am sure there will once again be plenty of material for this blog in 2010.