One major thing that differentiated science-based medicine (SBM) from alternative medicine and quackery is that in SBM there is a generally accepted standard of care. This was even the case back in the days before the proliferation of evidence-based guidelines, in which professional societies and expert panels try their best to synthesize what is often an unwieldy mass of sometimes conflicting studies into guidelines on best care practices for different conditions. True, back then there was wider latitude because each physician was largely left to fend for himself in applying the medical literature to individual patients’ conditions, but even so there was still a standard of care that physicians practiced within. These days, with many more guidelines, there is less reason for variation in practice. We who take care of breast cancer patients, for example, have access to the NCCN guidelines and ASCO guidelines, among others, and although there are some differences around the edges the major guidelines tend to have broad areas of agreement on how to treat breast cancer that evolve based on science. For instance, routinely doing a radical mastectomy is no longer part of the standard of care, nor is routinely removing all the lymph nodes under the arm in a patient without known positive lymph nodes. The former hasn’t been the standard of care for at least 40 years, and the latter, although the standard of care when I trained, hasn’t been the standard of care for at least a decade now.
My point here is not to dwell on what the standard of care is for treating breast cancer or how it's evolved through the decades, but simply to emphasize that there is a standard of care based on science and evidence. If a physician goes outside the standard of care without a very good reason for doing so, it can even be malpractice. With that in mind, consider the case of Dr. Daniel Kalb, a physician at Cool Springs Family Medicine (CSFM) in Franklin, TN. He made the news recently by loudly announcing that he will no longer administer vaccines at all. In essence, he proudly announced that he intended to begin committing malpractice:
On May 31, Dr. Kalb wrote an eight-point list (that has since been removed from the CSFM website but can be found here) about why CSFM will not offer vaccines to patients, noting his 15 years of experience with upset mothers who’ve shared their “vaccine injury stories.”“Don’t tell me that they are making it up or they are just reaching for an explanation, or that it was a coincidence or that they are just too stressed, or that they are uninformed,” he wrote. “All of those arguments are stupid.”
After writing that “we can do better,” and questioning the HPV vaccine Gardasil (“Are you kidding me? It is not safe”), he takes a moment to defend the father of the anti-vaccination movement, Dr. Andrew Wakefield. Wakefield’s infamous paper on the link between the MMR vaccine and autism was retracted by The Lancet in 2010.
No, all of Dr. Kalb’s arguments are stupid. One wonders why, as a Brave Maverick Doctor, he deleted his eight point manifesto explaining why he would no longer offer vaccines to his patients in the wake of the publicity that came his way after he made his announcement. Is he perhaps...embarrassed? Or perhaps he fears to have too much attention directed at the fact that he just publicly announced that he was going to practice far, far outside the standard of care. Maybe he was concerned that some who were alarmed by his antivaccine stand stated that they were contacting the Tennessee Department of Health. Of course, because the Internet never forgets, we can look at what Kalb wrote for ourselves.
First and foremost, Kalb believes the discredited claim that vaccines cause autism:
We will no longer be administering Vaccines at Cool Springs Family Medicine (CSFM).
How come?
1.Because they can cause Autism – yes, I’ve had 15 years’ experience in taking care of ASD kids, that’s a lot of vaccine injury stories from moms. Don’t tell me that they are making it up or they are just reaching for an explanation, or that it was a coincidence or that they are just too stressed, or that they are uninformed. All of those arguments are stupid.
No, I repeat, all of Dr. Kalb’s arguments are stupid and scientifically ignorant. For instance, later in his list he writes:
7.Dr. Andew Wakefield’s research was properly defended and vindicated 4 years ago. The Lancet paper stands: There is a link between the MMR vaccine and Autism.
No doubt he’s referring to the claim, common in antivaccine circles, that because one of Andrew Wakefield’s co-investigators, John Walker-Smith, regained his license it must mean that Wakefield himself was exonerated and his research therefore rendered valid. Wrong, wrong, wrong. As Brian Deer explains, the Walker-Smith appeal succeeded largely because of some unique features of British law regulating physicians. Basically, the General Medical Council (GMC) panel’s practice, dating back decades, of giving one-line of findings for each charge without setting out its reasoning. Also, Walker-Smith had been cleared of dishonesty and was already 75 years old. He had also had the case hanging over him for six years, and there was little public interest to be served in pursuing him. In other words, the fact that Walker-Smith succeeded on appeal in regaining his medical license has no bearing on the case against Wakefield, nor does his success “exonerate” Wakefield or his 1998 Lancet study, which is still retracted and will remain retracted.
But Kalb, being antivaccine, believes Wakefield. He also invokes the dreaded “toxins” gambit:
2.Polysorbate 80, Aluminum, formaldehyde, animal DNA with viruses, and many other ingredients in vaccines, are not good to inject into babies. Think of cancer, and autoimmune disease.
None of which are toxic in the doses administered in vaccines, nor do they cause cancer or autoimmune disease. You might recognize the dreaded “formaldehyde” gambit” (a variant of the “toxins gambit”), which is such an easily debunked antivaccine claim that most antivaccinationists don’t use it that often any more. Suffice to say that the amount of formaldehyde in vaccines is tiny and, through normal metabolism, an infant’s body makes more formaldehyde than he receives from vaccines. Similarly, polysorbate 80 is unfairly demonized based on rat studies using huge doses of the chemical, far more than is in any vaccine. Aluminum in vaccines, of course, has never been linked to the dire consequences that antivaccinationists claim.
My favorite line from Kalb’s little manifesto, one that shows he’s just making it up the way Deepak Chopra makes it up when he invokes the word “quantum” is this:
3.Epigenetics is a new science that explains exactly why, not every child is going to react the same way to vaccines, and sacrificing the few, for the many is not acceptable. Actually, if you understand the science, which many mothers with vaccine inured children do, you can see that it is actually many are at risk and are asked to be sacrificed for the few.
And this:
6.Vaccine development began in earnest in the 1930’s. Genetics, Epigenetics, the role of environmental toxins on the immune system, is much more recent than that. Guess what? We know a lot more now. Isn’t it time to incorporate that knowledge into the development of safe vaccines?
You know, if you substituted the word “quantum” or, more appropriately, “magic” for the word “epigenetics,” and you’ll get the same level of meaning and understanding. It sounds as though Kalb has been listening to too much John Rappaport, who is fond of invoking epigenetics in a very quacky way in pieces like Mandatory vaccination: California is ordering genetic alteration. I can only say to Kalb: Epigenetics. You keep using that word. I do not think it means what you think it means. I’m guessing that Kalb is invoking epigenetics as an explanation for how vaccines “cause autism” or for how different children can be more “sensitive” to the evil autism-inducing magic of vaccines but doesn’t know what he is talking about. No, wait. Strike that. There’s no guessing about it. He definitely doesn’t know what he’s talking about.
As for the bit about genetics and the role of environmental toxins on the immune system, Kalb is both correct and incorrect. He’s correct that we know a lot more about these things than we did in the 1930s. He’s wrong that this knowledge has supported the idea that vaccines cause autism or harm the immune system or made that idea any more plausible. As they say, if you can’t dazzle ‘em with brilliance, baffle ‘em with BS. Let’s just say Kalb laying down some stinky stuff.
After some typical misinformation about Gardasil, which, because it protects against a sexually-transmitted virus, antivaccinationists hate more than any other vaccine, with the possible exception of the birth dose of the hepatitis B vaccine, which, not coincidentally, also protects against a virus often transmitted through sex, Kalb lays down a real howler:
8.The argument that we will be thrust into the dark ages if we suspend the vaccine program is nonsense. There are many arguments against this, but, to make it simple, we are in the dark ages. We have a plague of autoimmune diseases including Autism. There is a plaque of Acquired Immune Dysfunction (ring a bell?).
Listen, I know I have been a little tongue and cheek about this, but really, I could wax on for a long time on any one of the 8 points that I brought up, and I’m sure I could list a lot more. I am not going to do that in cyperspace, I am not going to engage in internet battles, but, just as I have always done, as is my responsibility as a Family Physician, I will be an advocate for each of my patients as best as I know how. Also, I will always continue to respect the informed choices my patients make.
“Acquired Immune Dysfunction”? Oh, dear. Could Kalb be any more obvious? Be that as it may, he seems oblivious to the fact that the reason the incidences of vaccine-preventable diseases remains as low as it does is because we vaccinate against these diseases. Dr. Kalb’s reasoning abilities don’t seem too sharp, either, given that he buys into the “CDC whistleblower” conspiracy theory (just type “CDC whistleblower” or “William Thompson” in the search box of this blog if you want to know more about this particular flight of antivaccine fancy). And what persuaded Dr. Kalb of all these things?
He attended the yearly antivaccine quackfest known as Autism One.
To be honest, I have to wonder from the last paragraph if Kalb’s post was a joke gone horribly awry, given that he sounds as though he’s backing off on his announcement, using plausible deniability in the form of saying, I will always continue to respect the informed choices my patients can make.” Presumably that means that he would respect the choice of parents who choose to vaccinate according to the CDC schedule. of course, such parents would be very unlikely to want Dr. Kalb as their child’s doctor. So I suspect that Kalb meant what he said but was shocked by the backlash.
Of course, it’s not surprising that Dr. Kalb is antivaccine. He is a practitioner of “integrative” medicine, which means that he integrates quackery with his medicine. It’s all there, too. His clinic offers colon cleanses, hyperbaric oxygen, and “detox” programs. He advertises a lot of supplements from a variety of questionable companies. It’s not surprising that Kalb has now declared himself full-on antivaccine. Being antivaccine goes hand-in-hand with integrative medicine.
From my perspective, Dr. Kalb should be stripped of his medical license, as should all antivaccine pediatricians. A very basic standard of care for children is vaccination against common childhood diseases, and Dr. Kalb is violating that standard. In fact, from my perspective he has just announced that he will from here on out be committing malpractice. I might be able to concede a little bit of wiggle room for physicians who delay vaccines in order to hand hold antivaccine parents and ultimately get their children vaccinated, although that is less than optimal and is poor care. However, a physician who takes care of children who bluntly states that he will no longer administer vaccines at all has rejected the standard of care. He is a danger to his patients and a danger to his community. That ought to be more than enough reason to strip him of his license to practice. No doubt antivaccinationists will accuse me of being “intolerant,” but, from my perspective, if you’re a physician you have a duty not to practice in a way that will harm your patients, and if Dr. Kalb has rejected vaccines he is most definitely practicing in a way that will harm his patients, even leaving aside the pseudoscientific treatments he offers.
Let him go to naturopathy school and become an ND. He’ll be way more at home as an ND than he is as an MD. Fantasy with respect to vaccines is par for the course for NDs. It should be a disqualification for an MD.
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I have been an advocate of losing licensing for this since my first Microbiology TA experience, hearing a young woman in the crowd question Dr. Sidney Finegold about why he advocates for killing babies with vaccines.
I will take an even more intolerant stance on the subject than you Orac, I believe parents that refuse to vaccinate should be charged with child abuse, aside from the obvious various childhood illnesses that prevent it.
I wonder, did the state board contact him, upon being notified by an alarmed parent?
Or perhaps, did his malpractice insurance company announce to him that should he actually implement his stated intended action, they'd drop him like a chunk of glowing hot iron?
That said, there is one vaccine, no, two vaccines I'd love to see revisited. Love to see revisited to modern safety standards enough to actually give my own sparse money to see developed, as pitiful of an amount as that currently is.
The smallpox vaccine and OPV.
The former, as that vaccine still causes major injuries each year in service members and certain specific public health responders, while the risk is lower than the risk for morbidity and mortality from smallpox, it's still the highest risk vaccine in our arsenal and it has cross protection against a number of other pox virii that can infect humans, so it's invaluable in that aspect in the communities that require that vaccine.
OPV, as that critter has jumped out of its cage a few times already, it'd be wonderful to have something equally effective, but incapable of ever escaping its enclosure again.
I've used OPV in the past, to halt potential or even actual in progress breakouts, but I'd love to see an even safer form of that vaccine.
To the point of even paying out to help it out, hell, I'd even stop drinking to help it out and my intake of ethanol is legendary.
For, when imbibing, I don't remember my dreams, which is sanity saving at times. For many of those dreams are echos of *really* bad memories of our wars and actions I was involved in, one I earnestly wish to be able to reverse.
Would that Doctor Who were real...
Well, we all have our problems in life. :/
And wish in one hand, crap in the other, we all know which hand will get filled first.
Never trust a doctor who can't appropriately use commas. Reading his 'points' made my head hurt.
This guy has an MD, which as we know doesn't insure against wingnuttery, but he also claims to have an MPH.
This means that he should have had some advanced-level teaching in public health at some stage.
Maybe he missed the lectures where it would have been demonstrated that immunisation is one of the most effective public health interventions of the modern era.
I've done some digging at other sites and the one thing that never seems to get mentioned is that there is a lot of recent research working on the idea that Autism starts in the womb.
Please look at:
http://www.nejm.org/doi/full/10.1056/NEJMoa1307491#t=abstract
And have a browse through the citing articles.
I checked out his website, and his practice adminsters Botox injections.
I can imagine the scene now:
Mother with child seeing Dr Kalb: " I won't be injecting your child with any of those evil BigPharma toxins..."
Mother: "Thank God for that Dr Kalb. Now, will you inject my face with BigPharma-manufactured botulinum toxin to iron out my wrinkles?"
Dr Kalb: "Sure thing."
So I went and read the whole list.
All 8 points he makes are P.R.A.T.T.s. Many are ones I refute on my blog pages. He also repeats himself.
He didn't just drink the kool aid, he licked out the bowl.
*snark on*
I thought the Lancet paper never mentioned MMR vaccine and autism in the same sentence.
*end snark*
@ Orac
When I started reading the part about "a return to the dark ages", I was expecting a rendition of the old gambit "vaccines didn't save us, death from disease was decreasing before anyway". It's the usual dodge to our argument that vaccines are protecting us right now.
I haven't read the full manifesto, maybe the good doctor is more explicit in some other part.
@ Jay Onit
Sadly, a lot of antivaxers are impervious to the idea that faults in their DNA or their body is the cause of their offspring's autism. They want an external cause so much.
I already saw the dodge to this argument: sure, there is neonatal autism, starting in the womb, but then you also have regressive autism, starting after birth and triggered by environmental factors (read "vaccines").
Actually, the following part say it all:
To the antivaxers, the autism-vaccine link is simultaneously something affecting a minority of special children, so regular science is not going to catch it because the effects are hidden in the crowd of common people (never mind the big epidemiological studies with thousands upon thousands... - well, never mind).
And at the same time, it's an apocalypse, it's an holocaust, it's affecting every children in sight, honest doctors and warrior moms see it all the time.
It's a threat/an enemy simultaneously well-hidden and omnipresent. This is actually one of the hallmarks of conspiracy theories.
@ Helianthus
In a perfect world there'd be no antivaxxers, cause after being exposed to that inconsistancy they'd disappear in a poof of logic.
Cheers Helianthus, I can see them trying that dodge, one of the reasons why I'm not over at AoA lol.
The picture I've picked up from my Google Uni curriculum is that it is these "patches of Disorganization" that causes Autism and in my view Regressive Autism is just Autism picked up lately.
Somewhere else I've seen research suggesting that there will be a test available for Autism in the womb, as "Children with autism have elevated levels of steroid hormones in the womb".
I've coaxed a few antivaxers back from the abyss, by saying soon they can have their unvaxed VS vaxed study, as we will be able to remove the potential Autistics from a population, then vaccinate that group and when there is no incidence of Autism we will have our proof.
I usually finish, by pointing out that it is still Big Pharma to blame, with the invention of the Pill, infertility treatments and Viagra, that leads people to have kids at an UNnatural age, leading to a higher prevalence of Autism.
@ The Smith of Lie
This sentence is giving me some "Don't panic" vibes, if I get the reference right.
@ Jay Onit
There seem to be indeed a strong correlation between the age of the parents - and the quality of their gametes - and the happenstance of various disorders in their children.
From the Facebook page of ZDoggMD:
(Editor's note: a doctor who also takes care of some of the patients managed by the quack who runs this clinic reached out to me to mention that they have seen bleeds due to these parents refusing vitamin K injections for their newborns, and even refusing supplementation for their hypoglycemic newborns. This doctor mentioned that they are tired of appeasing the pseudoscience instilled in parents by this horrible clinic (vaccines are just the tip of the iceberg, according to this doc). Thank goodness there are real doctors and healthcare peeps fighting the good fight for the health and safety of our most vulnerable population.)
Three most dangerous words in medicine or science "In my experience."
@Yvette
Vitamin K refusal? Gah! What is wrong with these people? Why would they put their newborns at risk like that! The poor kids.
@ Todd W. / Yvette
An interesting position coming from people who are usually very sympathetic to extra vitamins and food supplements.
@Helianthus
Indeed. It's really all about the needle, I think.
But you don't understand. It's the evil injection of vitamin K.
But Vitamin K is a SHOT! And totes unnecessary if you're breastfeeding because breastfeeding is superpowers. Sometimes you can at least convince those people to give oral Vitamin K, but other times, nope. Only natural, organic, breast-is-best life. After all, we didn't used to give Vit K, and we did just fine, right? (what do you mean, the babies with brain bleeds just died or ended up in an institution?) /snark
From a satirical science-speak-to-English translation guide I read years ago (and have long since forgotten the source): "In my experience" means it happened once. "In case after case" means it happened twice. "In a series of cases" means it happened three times.
You know, for all that they go on about how fragile a newborn's brain is, you'd think they'd be all over something that helps protect their brain (vit. K). Then again, they also rail against a vaccine (MMR) that prevents an autism-causing disease (rubella).
Rather than derail the thread further on vitamin K talk, I'll just direct people over to Science-Based Medicine for an article by Dr. Novella.
IIRC “a return to the dark ages” is a direct quote from Jim Sears in Vaxxed -- what he says before he reads the Big Pile of Studies that show vaccines cause autism.
Afterwards of course he will never vaccinate again. Unless I'm mixing him up with Rachael Ross. The scene is toward the end of the movie and my ability to form coherent memories was becoming impaired.
I sometimes wonder if I will live to see any medical board summon up enough courage (and it really isn't a lot of courage to do this) to strip just one of these anti-vaccine quack physicians of their license--and I'm not even 50 (yet).
In other anti-vax news...
AoA continues digging its well-worn rut with more microbiome courtesy of Teresa Conrick and ANOTHER installment in Kanew's interview series.( Conte and Holland on vaccine court)
I am barely surviving reading Dan Olmsted's latest ' Polio in Brooklyn' tale.
TMR now has a thinking grandparents' book for sale.
VAXXED! was shown nearby and I didn't waste any money on it even though Del Bigtree was present.
Alas, my Californian friend has succumbed utterly to woo and infuriates me by posting nonsense about turmeric preventing cancer, etc. She wanted to homeschool last year, partly, I think, to prevent her kids from getting their booster vaccines, and I had a hard time containing my glee when she wound up sending the kids to public school (complete with government-mandated poisons running through their little bodies). The thing is, she's not stupid. How can she buy this garbage? How? But everything I say to refute her falls on deaf ears, so I hold my tongue and remember that she is my oldest, best friend.
@Heidi_storage: but you didn't say that her kids immediately came down with autism, ADHD, cancer, autoimmune diseases and needed years of detox! Do you mean her kids got the shots and stayed healthy? That's impossible!!
Dr. Kalb: "The Lancet paper stands: There is a link between the MMR vaccine and Autism."
Uh-oh. Kalb is violating one of the sacred tenets of Wakefield worship, which holds that Andy's paper never cited a link between the MMR and autism (he was Just Asking Questions).
Kalb would've been better off following the lead of another prominent antivax pediatrician, and touted his willingness to give a vaccine or two if parents talked him into it.
@MI Dawn: Well, she makes her own cleaning products and juices and uses essential oils and coconut oil, so I guess her detoxifying efforts have combatted the eeeevil additives in the vaccines. Sigh.
You can't reason someone out of a position she didn't reason herself into.
One of the good things about a world with internet is that facts are readily available to all. One of the bad things about a world with internet is that misinformation is readily available to all. In many cases, non-experts have trouble telling the difference. That's particularly so in cases like anti-vax arguments which have been thoroughly debunked, but people who have emotional (or even financial, as with Wakefield) investments in the position ignore the studies that refute their claims.
That doesn't excuse belief in things like homeopathy and reiki. Any reasonably intelligent person who has taken high school chemistry should know that homeopathy is bunk. For something like turmeric preventing cancer, which I would rate as "unlikely, but not completely implausible on its face," it's more understandable, assuming there aren't actual studies disproving the hypothesis. Anti-vax arguments fall in between those two extremes: they aren't completely implausible on their face, but the studies have been done, and those studies demonstrate that the arguments are false.
@MiDawn #18
If there were a way to deliver it by enema, they'd all be jumping at it...
Chris Hickie:I sometimes wonder if I will live to see any medical board summon up enough courage (and it really isn’t a lot of courage to do this) to strip just one of these anti-vaccine quack physicians of their license–and I’m not even 50 (yet)
If they did that, there'd be a severe shortage of young doctors, and California would only have a few hundred doctors trying to frantically cover the state.
@Eric Lund
You can't reason someone out of a position they sold themselves into.
Your statement still covers this, I just feel that this financial statement needs extra emphasis. ?
So many questions. Is Dr. Kalb pandering to the Maughmee Brigade or is he truly this ignorant? Will the TN medical board take a look at this lunacy? Has Dr. Kalb ever considered taking a remedial writing class or at the very least, hiring a copy editor? Why did Bon Scott have to die young? Why did Ryan Giggs have to be born in Wales and not England? So many questions.
Listen, I know I have been a little tongue and cheek about this
...
Alas, my Californian friend has succumbed utterly to woo and infuriates me by posting nonsense about turmeric preventing cancer, etc. She wanted to homeschool last year, partly, I think, to prevent her kids from getting their booster vaccines, and I had a hard time containing my glee when she wound up sending the kids to public school (complete with government-mandated poisons running through their little bodies). The thing is, she’s not stupid. How can she buy this garbage? How? But everything I say to refute her falls on deaf ears, so I hold my tongue and remember that she is my oldest, best friend.
Some folks appear to buy into the intensive parenting model because it gives them a sense of control. And/or as a means of justifying their time, particularly for stay-at-home parents/parents who don't want to enter or re-enter the workforce.
And others do it to show their privilege. Intensive parenting as status marker.
This. A family has to be quite well off to be able to afford a middle-class lifestyle on one income. Intensive parenting is difficult to pull off when both parents (or a single parent) have full-time jobs. So part of the reason these parents (usually but not always mothers) do intensive parenting is because they can.
I had not thought of it as a status symbol. This is a pretty worrisome form of keeping up with the Joneses then.
Then, you have Alex's parents: http://www.cbc.ca/news/canada/calgary/alex-radita-murder-trial-diabetes…
When I'm secretary of health at a state, or health officer in a county, I will make it my goal to make quacks very, very uncomfortable.
They'll wish there was a "Peparation-Ren," I'll make them so uncomfortable.
“For instance, routinely doing a radical mastectomy is no longer part of the standard of care, nor is routinely removing all the lymph nodes under the arm in a patient without known positive lymph nodes. The former hasn’t been the standard of care for at least 40 years, and the latter, although the standard of care when I trained, hasn’t been the standard of care for at least a decade now.
My point here is not to dwell on what the standard of care is for treating breast cancer, but simply to emphasize that there is a standard of care.”
Your point SHOULD be that just because a standard of care exists currently doesn’t mean that standard of care is right.
“If a physician goes outside the standard of care without a very good reason for doing so, it can even be malpractice.”
Did any of those women from 40+ years ago later sue for malpractice?
…………………….
Let’s take a break from the antivaccine obsession and take a look at something that affects ALL of us: salt intake.
From today’s WSJ:
“From Scientific American, “It’s Time to End the War on Salt,” by Melinda Wenner Moyer, July 8, 2011: For decades, policy makers have tried and failed to get Americans to eat less salt. In April 2010 the Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products; New York City Mayor Michael Bloomberg has already convinced 16 companies to do so voluntarily. But if the U.S. does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily.
This week a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure. In May European researchers publishing in the Journal of the American Medical Association reported that the less sodium that study subjects excreted in their urine—an excellent measure of prior consumption—the greater their risk was of dying from heart disease. These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.”
Orac, if there be quackery here, who’s practicing it?
Whose word should we take with an extra grain of salt?
Dr. Kalb's practice is allegedly cash-only, no insurance (I read it on Yelp, take it for what it is) and that made me think of someone else we know who espouses equally dumbass views on vaccines and only takes cash...I can't remember his name...pandering tool, also a terrible writer...ugh...
Another aspect of intensive parenting that someone (I think it was Denice Walter) once brought up is that it offers women a way to resolve to the conflict between the pressure to adhere to traditional gender roles and the pressure to be a modern, independent woman. The "warrior mother" is above reproach because she only takes on the traditionally male role of the warrior because circumstances beyond her control have forced her to in order to fulfill her motherly duty to protect her child.
@ Delphine
Well, OT, but...
The poor boy.
As one social worker said, so many people failed him, and not just the monsters which pretended to be his parents.
Leave it to SN to completely miss the point.
@See Noevo
I see what you did there. And it was a good try, but a logic fallacy that you lost yourself in.
A study once said that salt was bad for you. People adopted the principle and the study was later rebutted. The scientific evidence was reviewed and bam, changes happened. This is the procedure and process that finds things, whether they be medicines, or procedures, or vaccines, reviews them repeatedly and either considers something solved or it is rethought again. Salt is one of these. It is also a case of bandwagoning, a media sensationalized study that had mediocre results with journalists writing about them that had one undergrad lower class lab interpreting data.
Fast forward to your logic failure today. This same process, that found out salt may not have been as bad and found out that vaccines are not harmful, both exaggerated by the media and halfwits with no logic, followed the same process. You and your ilk are the only ones stuck in logic circles unable to move beyond them.
Yep.
Nor does the fact that the standard of care in medicine has changed in the past based on evidence in any way imply that it is going to change now to accept antivax views as the basis for a new standard of care.
Interestingly, when the quacks I hear discuss how RONG medicine has been in the past, they fail to explain how it takes in new information from research and CHANGES.
But seriously if it didn't self-correct through research how would THEY even know about it in the first place?
As if, they would do real research on their own.
...It is also a case of bandwagoning, a media sensationalized study...
If I could rid the world of this type of journalism I would. All it is does is give layman ammo to harp on other layman about how they are living their lives and make them more inclined to distrust science.
As I said to a roommate years ago when she told me it was ok to eat butter since they found it is not as bad for you as they thought "I eat margarine because I was raised on it and like the taste, plus it's cheaper. I don't eat it to avoid the harmful effects of butter."
As if, they would do real research on their own.
Great point! But after reading about the Vit K controversy, I'm convinced that they just wish to be contrary to whatever the current medical practice is. No research needed.
@SN
I do not know you. I do not know what you do for a living so I am going to make a small anecdote for you.
McDonalds concludes several studies on food preparation and decides to make changes to their procedures. These changes will enhance flavor and nutritional value while reducing food preparation times and food waste.
Your logic: McDonalds has two options; either A) Recook all previous hamburgers served through their entire history or B) Reimburse all of their customers because this new process is better than the previous ones.
Do you see your dumb yet?
"Do you see your dumb yet?"
I've done some web programming in the past, have been tempted to make a small widget for blogs, so that posters have to successfully complete a short IQ question or their post gets chomped.
Good idea yes/ no?
Wzrd1 @2:
There was just a huge, world-wide change in the OPV - it is now bi-valent rather than tri-valent, because polio-2 hasn't been seen in the wild in a long time, and it is the one that is most likely to revert to a pathogenic state. So yay updating the OPV!
As for vaccinia - I've had it (researcher) and you're right, it sucks. But it's a fantastic virus because it's so big, you can stuff anything you want in there, so it's popular as a vector for other vaccines. I think that now the vaccinia vaccine that's used is the MVA (Modified vaccinia Ankara), which is 'gentler' that the older strains.
Dr RJM @4: Sadly, several of my MPH classmates are pretty hard-core woo. Like, several acupuncturists. I've never quite gotten up the nerve to ask then why they are bothering to get an MPH since it generally goes against their stated principals. (Mostly I don't want to mortally offend someone who I might have to do a group project with.)
Justatech: Sadly, several of my MPH classmates are pretty hard-core woo. Like, several acupuncturists. I’ve never quite gotten up the nerve to ask then why they are bothering to get an MPH since it generally goes against their stated principals . (Mostly I don’t want to mortally offend someone who I might have to do a group project with.)
Go ahead and offend the dim. You'll have to do all the work yourself on a group project anyway, so why bother making nice?
PGP @52: Two reasons: In almost every group project everyone's contributed usefully (and had information I couldn't get). Even the gal who got super, super sick (twice) put in her fair share. (Everyone's a well-out-of-college adult, so it's not like high school.) Even the acupuncturist. (She was a PowerPoint wizard.)
Two: We're evaluated on our ability to work as a group, so it could affect my grade ("JustaTech insulted my entire profession!" would absolutely bring down my grade.)
Your logic: McDonalds has two options; either A) Recook all previous hamburgers served through their entire history or B) Reimburse all of their customers because this new process is better than the previous ones.
Whoa. I suppose this works for things like hamburgers, salt and butter but you know the consequences of eating/not eating those are usually not as benign as those faced in healthcare. There is potential for real harm when science and the medicine that bases its decisions on it are not correct.
@Jay#49
Oooops. That was supposed to say "Do you see the dumb yet?" but Siri in her wonderful autocorrecting that seems to happen without indication bubbles decided that the sentence was wrong and corrected it. Sigh. I really need to stop using this thing, I bought it because of the weight of laptops and now I have a laptop that weighs less.
Making an IQ test is really not going help the situation at all. Some of the biggest obstacles are people that have the intelligence to understand this stuff, they mostly refuse to. Also, in the high IQ societies like Mensa and Triple 9, there are actually groups that dedicate themselves to participating and doing as little as they can for humanity. One subject of them in Mensa spend endless hours scouring obscure laws in finance, welfare, etc etc, and do nothing but find ways and loopholes to exploit to do even less. One particular person in one of the SIGs in Mensa claims, and shows proof of his claims, that he makes a six figure income on welfare by exploiting loopholes in both welfare law and tax law. He then teaches these methods to others so they don't have to work or add anything to society.
@Not a Troll#54
That was an example used to explain a logic fallacy used earlier by someone. Their accusation, because I can't get quoting to work on here for some reason, was do women that received now contraindicated treatments for breast cancer get to sue for malpractice because techniques and medicine improved and those therapies are no longer used unless the situation is drastic.
Orac #45:
“Nor does the fact that the standard of care in medicine has changed in the past based on evidence in any way imply that it is going to change now to accept antivax views as the basis for a new standard of care.”
I agree.
But certainly you would NOT say that the fact that the standard of care in medicine has changed in the past based on evidence in any way RULES OUT that it is going to change in the future to accept antivax views as the basis for a new standard of care.
Or would you?
See Noevo:
Of course the standard of care might change. That's sort of the point. But while the vast set of possible futures may contain one where antivax views are accepted as standard of care, that same vast set may also contain a future where rubbing boiled pig entrails on your earlobes is performed to treat asthma. Are you going to propose rubbing boiled pig entrails on your earlobes, since the infinite set of remotely possible futures might somehow contain that option, even though absolutely nothing we know today suggests it's a sensible thing to do?
We all must make decisions based on what we know today, not what we might know tomorrow. Especially when it's something as deeply unlikely as "antivax views" becoming standard of care. Honestly? The only thing that could make antivax views the standard of care would be politics, since the science is very strongly against it. This isn't analogous to the subtle changes in treatment of breast cancer. This is more like suggesting we'll go back to geocentrism and epicycles someday. Because sure, we might, but it would only be through abandonment of science.
@See Noevo#57
You are correct. This one won't happen. Medicine will never "go back" and accept antivax views because when something has been disproven fully, it has been disproven fully.
However, on the off chance that a new technology comes out that we are able to find a connection, medicine will never contraindicated vaccines in general. Regardless of an autism link or not, the DEATHS of hundreds of millions was averted by vaccination. But thanks to you and people like you, we now have to start iron lung training and manufacture again. Ever see a kid in an iron lung? No you say? Because vaccines, that you are against. You profess stopping vaccines and now we have vaccine resistance and iron lungs.
I know none of this actually matters to you. To you, this is not about saving lives or being smart. This is about the emotional addiction your belief. You have not been over seas and seen the iron lungs. You have not been over seas and seen the people dying in the streets with families crying because they KNOW that had they just been born here, they wouldn't be crying. This makes you the dumbest person alive. You are too stupid to see the information, the real information, and too stupid to see what happens in countries without vaccines. I feel so bad for you. I can't imagine being that blind and dumb.
Good to see a state chapter of the AAP publicly speaking out, though I'd wish they'd called out this doctor by name directly:
"The continued spread of misinformation regarding vaccine safety is dangerous, not only to the children for whom vaccines have been refused, but also for the people around them who cannot receive them. Research needs to focus on understanding the true causes of autism, rather than continually needing to debunk the fraudulent work of discredited former physicians. The lives of children affected by autism hang in the balance while some groups put their trust in internet lore and pseudoscience. It's time to accept the science and make positive movement in autism research and treatment," said Michelle Fiscus, M.D., FAAP, TNAAP Immediate Past President.
http://fox17.com/news/local/franklin-doctor-refusing-to-give-vaccines-q…
Cool Springs/Franklin is in Williamson County TN, just South of Nashville. Per Wikipedia Williamson Cty. "ranked among the wealthiest counties in the country": 17th in raw numbers, but 1st "when the local cost of living was factored into the equation with median household income". In the last 3 presidential elections, it has voted an avg. of 71% R to 27% D. In this year's primary, 10,064 D votes went 60-39% Clinton over Sanders, and 41,684 R votes were split 31% Rubio, 27% Trump, 25% Cruz., 8% Kasich, 7% Carson. So The Donald got more votes than Hillary and Bernie combined.
Orac left out the most overtly wrong part of Kolb's post:
Cash-only practice, fact-averse/reality inversion, wealthy patients, right wing poltiics, stay-at-home moms, status parenting... A little bit of the OC in Tennessee!
But Kolb isn't just pandering to a privileged clientele. An earlier post (still up at: http://tinyurl.com/jek4u66) reveals he's an AV true believer, with a 17-year-old child on the spectrum, who apparently hangs out at AoA. Not only is there an endorsement of Plague by Kent Heckinlively and Judy Mikovits, but this howler:
Yup. Kolb thinks Dan Olmsted is some sort of Doctor!
Fun fact: A number of country music stars live in Franklin, and it's the hometown of Miley Cyrus.
Jay@49: There is a toungue-in-cheek version of what you are proposing. Though as a practical matter, the cure might well be worse than the disease. Autocorrect has been known to do some really strange things (as demonstrated by the existence of the "Damn you Autocorrect" website and its imitators). An example Orac quoted a few weeks ago had the word "interracial" where, as some of us figured out, the author probably meant "intracranial".
Some sites have a feature sometimes called a "twit filter" which lets users ignore posters who are trolls, clueless, or both. IOW, posters like SN above. If ScienceBlogs had such a feature and I knew how to enable it, SN would be in my filter.
To Another Antivaxx Slayer #59:
“Medicine will never “go back” and accept antivax views because when something has been disproven fully, it has been disproven fully.”
Finally!
(And where has Orac been hiding you?)
You must have some strong stuff, because science rarely uses words like proven/disproven.
But do show us one of the meta study, or whatever, which has “disproven fully” the antivaccine position.
@Another Antivaxx Slayer #56
I see it now. Although I didn't take him literately the first read and missed his point entirely.
But I'm glad you understood mine. My second to last sentence in that comment was a**backward. It should have read "...the consequences of eating/not eating those are usually benign as opposed to those faced in healthcare.
I hope you get your tech issues all worked out. I'm going to bed to hopefully get my cognitive issues worked out.
Please don't call this "alternative" or "integrative" medicine. You wouldn't refer to a black person as "colored", would you? It's functional medicine.
http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=57729
You really should stick to your core competence. And stay away from adolescents.
Sure, but then again, I live in an, erm, integrated neighborhood and so actually talk to "black persons" rather than referring to them. All bets are off!
^ Ah, broken link. Again, S.N.'s core competence.
http://www.usatoday.com/story/news/nation/2013/08/30/babies-suffer-blee…
A bleeding disorder in babies that is so rare that it typically affects fewer than one in 100,000 newborns is becoming more common in Tennessee because parents are refusing vitamin K injections at birth, according to pediatric specialists.
Since February, four babies with no signs of injury or abuse have been sent to Monroe Carell Jr. Children's Hospital at Vanderbilt University in Nashville with either brain hemorrhages or bleeding in the gastrointestinal tract. Robert Sidonio, a hematologist, diagnosed them with vitamin K deficiency bleeding.
@Jon H, that's a bit dated, I wonder what the numbers are since then, any idea if they've increased?
Err... It's the way a number of CAM proponents want to be called. You may want to discuss nomenclature with them directly.
As for functional, I don't know. Dysfunctional, maybe.
Why does anyone point to Wakefield's study as some kind of proof of the autism-MMR connection? It's a case series, a collection of anecdotes. The man couldn't even fake a convincing paper. Of course I know the answer - the list of papers to build this conspiracy from is fairly sparse. Though it's always still jolting when an actual MD dismisses numerous large trials and retrospectives in favor of a case series.
@Wzrd1 there have been more children since then, though updates are sparse. There is no regular reporting of VKDB in the US, so we only know what information hospitals volunteer. As of February 2014 there had been 7 cases at that same hospital in Tennessee (http://www.ncbi.nlm.nih.gov/pubmed/248422550). This disease looks frightening - 4 of the seven babies had intracranial hemorrhaging, and 2 required surgery. No updates since then, from research papers, the hospital itself, or the CDC.
Kind of incredible that a parent would be more concerned about a completely hypothetical and unproven harm caused by a shot than freaking BRAIN DAMAGE.
As far as case reports go, this is also apparently happening in Germany (http://www.ncbi.nlm.nih.gov/pubmed/26556811), where it was wonderfully referred to as a "Renaissance of a Preventable Disease".
A very interesting study was published on the subject, in which parents who refused vitamin K for their babies were asked to explain why (http://www.ncbi.nlm.nih.gov/pubmed/26711469). These parents were extremely likely to also refuse the hep B vaccine, and like antivaxxers, they tended to be white, educated, scared of synthetic chemicals, and concerned about "toxins".
Good for this doctor. Finally someone with balls to stand up against the cdc. It's about time. All you people think the CDC is in it for the "good" of the patient, think again. It's greed and control.
Denise: "It’s greed and control."
Yes, Dr. Kalb probably gets more money by botox injections than giving vaccines. Plus for a bonus he can charge extra when he gets treat kids with pertussis, mumps, measles, etc.
I was Dr. Kalb Nurse for 4 years and open this practice with him. But in these 4 years,seen the things he does. I had to get away from this.I am about saving lifes. I am also on board with Unicef.We saw many children in Kalb Offices their never had vaccines and had Autsim.Many things I saw. Here is my advise don't listen to this man. You can give vaccines to your child and break them up. I seen many children die in another countries, of pertussins and measles. The worst mistake I ever made work for this man. I am truly sad it took me 4 years to understand what he was doing. He can talk anyone in to anything. What he does is bad and dangerous,the money he charges. I witness many things in his practice. And am so happy to get away from this. Many parents that come there already have problems,and just trying to find exuses. Believe I know what am talking about.There no link to Autism at all.He treats Lyme with high doses of antibiotics,and patient get better for a few days and then even more sick then before. They spend thousands of dollars. I like to take all these irresponsible parents to other countries,where children die everyday because of vaccine shortage. How sad it is and in this country you have everything.
And most of his clients are rich. Many of these Moms suffer from Depression Anxiety but blaming vaccines. In the 4 years have been in his practice and worked. It torn me up he is a smooth operator. He would turn regular patients down that not have money to see him. Many of these moms suffering from OCD stay a home money and spoiled.
Doctors like this one and Dr. Sears are just trying to make money off the ignorance and fear of parents. It is all about greed and control. I don't know why I would be surprised by another antivaxxers celebrating opposite day every day
@Slayer#55 No worries on the Siri word change, not the reason I quoted that. I've never had formal English lessons and I'm dyslexic lol, to me that read fine.
Didn't know that about Mensa, kind of disappointing. I have a fondness for IQ testing as I work for an IT agency, they do a functional IQ test on all candidates, it's refreshing not to have to dumb down.
@Eric Lund#62 That's a great website, parallel development :) . To be quite honest, the autocorrect is saving my bacon at the moment, I'm not complaining.
@ Denise#73 Please understand that Vaccination is a massive global project, far bigger than the CDC. These vaccines have been used all over the world, the risks are well known and documented.
If you are still worried about your CDC and the influence of Big Pharma, check out the figures from Cuba, they're Commies, certainly not Big Business:
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1555-7960201…
Calli Arcale responding to SN
Don't give him ideas.
Too late; he's already rejected the Copernican principle at Ethan's (over and over), although he's too stupid to understand how.
*facepalm*
I should have known, really.
Could not get passed "kalib's stupid arguments", because it is the pot calling the kettle black, stupid that is! Anyone who cannot understand that the body is more than capable of handling natural diseases If they aren't eating poisoned food by food manufacturer's who are forcing cancer causing GMO's and herbicides and pesticides in our food, which by the way is the real problem for those who have a "gluton intolerance", try eating organic breads and watch the pains n the belly stop and the bloating (which is your body reacting to poisonous and sprayed wheat 5 days before harvesting! The writer here needs to educate themselves on "science" which is just another satanic cult and fraudulent medical system by the biggest reprobates and true Neanderthal's the rockerfeller's and rat-childs! These mutants are of the wicked as is their poisonous medicine and this article was written by the same esau Neanderthal blood of mutations!
Anyone who can't understand and comprehend that forcing poisons through your biggest and most PROTECTIVE organ, the skin is just wrong, especially when they are MAN MADE diseases, like HIV/AIDS, autism, shaken baby syndrome, auto immune disease, liver kidney and heart failure, cancer, diabetes, ETC!!!!!!!!!! So Neanderthal's who lurk behind this sceance web site, the truth is out and your nonsense only reveals what is behind this cult and Neanderthal site!
Oh and WHO MADE HIM TAKE IT DOWN, the Neanderthals' behind the judiciary system and medicine, guaranteed but no mention here because they are liars who hide like cowards spewing shit, like Neanderthal;s always have! They have to lie, they are too stupid to pull it off otherwise!
@Name, ah! So, the Black Death and Smallpox were all scourges brought on by GMO vaccines injected through the skin organ or something.
King Tut died from white bread, dipped in toxic antibiotics or something.
Reality and you are indeed strangers, aren't you?
Name @85: You said "the body is more than capable of handling natural diseases If they aren’t eating poisoned food by food manufacturer’s"
I've got two words for you: Black Death
Everything everyone ate in 1347 was super natural and organic. They still died in droves.
This is so full of win! I had no idea a "gluton intolerance" was caused by "poisonous and sprayed wheat" and all you had to do was get your wheat organically to avoid "gluton intolerance". Consider me educated on "science".
Gluten, by the way, is in all wheat. I know a couple of people with celiac, organic wheat would not do them any good. It's gotten to the point, where, well...
http://www.today.com/health/gluten-free-diet-cafe-s-post-demanding-doct…
Wish I still had my concert T-shirt.
the biggest reprobates and true Neanderthal’s the rockerfeller’s and rat-childs!
I am shocked, shocked! that an alt-health loon should prove to be an antisemitic sh1tweasel.
I thought they were lizard people or something. (Was just regaining my aunt this afternoon. Also Kris Kristofferson, which got the biggest laugh.)
@JP, thanks! I keep loosing track, lizard people or greys.
Sleestak or Asgard. ;)
As a person with 279 Neanderthal genetic variations, I find Name@85 to be very offensive to my people.
JustaTech:
Heck, even without the Black Death, those pesticide-free non-GMO crops weren't so awesome. Ergotism, anyone?
Yes, please.
On second thought, I'll stick with (corn) smut.
Some food was just bad (stored grains) even before genetic engineering and pesticides. But today we have the technology not only to test for ergot, but to ship fresh produce to the northern regions. Everyone could be super-healthy if there wasn't so many liars and profiteers confounding the human race with bullshit.
I agree with "Name" up to a point. Under ideal conditions, humans are nearly disease-proof.
There is only one thing worse then ergot infested grain, and that is genetically modified ergot infested grain. And the only thing worse then GM ergot-infested grain, is GM ergot-infested grain with Round-up® residues.
No doubt that GMOs would have added insult to injury during the Black Plague era.
How do you further insult someone physiologically after they're dead?
Indeed, for being so disease proof, a hell of a lot of people died of the Black Death, while being "disease proof"! More, from smallpox, while "disease proof".
Why, a hell of a lot died while "disease proof" in 1918! I guess it was the use of a time machine and GMO farts or something.
Especially since antibiotics weren't even invented yet (not that they'd do anything for a viral infection).
While one cannot be blamed for being born ignorant, one can be blamed for losing ground since birth.
@Gray Falcon, LOL! That's hilarious!
Also, it's so much fun to watch the shills and minions shred an ignorant post-and-run troll.
I find Name@85 to be very offensive to my people.
Exactly! Check your Homo sap privilege!
@herr doktor bimler #99 and @Johnny #94, I consider the use of verbiage, the overall phrasing, the lack of any significant medical, historic or scientific knowledge and simply consider the source one that has learned the word Neanderthal today and thinks that it's an insult, rather than a sub-species.
In short, a lengthy proclamation of ignorance, proof of that ignorance, announcement of pride with that level of ignorance and proudly using a new word learned that very day twice in two sentences, somewhat incorrectly at that, to top it off.
That's not even worthy of reaching into the cat box and offering a cookie to.
I spent a second trying to parse "...esau Neanderthal blood of mutations" (Biblical Esau? Some sort of autocorrect thing? Ersatz?), but stopped for disinterest.
Neanderthal even appears twice in one sentence toward the end.
And apparently now my body can react to wheat I haven't consumed yet, even five days before it's harvested.
So ultimately, I'm with Wzrd1: this troll smells too much of Poe to be worth anyone's time.