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Removing science from anthropology: Parallels with medicine

I don't recall if I ever mentioned this before, but back when I was in college I had quite the interest in a couple of sciences that you might not have expected or guessed at, namely anthropology and archaelogy. Indeed, an archeology class that I took as a senior was one of the most memorable and fascinating classes I took during my entire four years in college. If I have one regret about my college years, it was my laser-like focus on getting into medical school. It was that intense focus that kept me taking far more classes related to chemistry, biology, and other sciences that I thought…

Francis Collins' "Five Themes" for the NIH

One of the advantages of hanging out around home on the proverbial staycation is that, instead of actually paying more attention to the news, I've paid less attention to the news. That's why I didn't notice some stories from earlier this week about what the new director of the NIH, Francis Collins, plans to do. Regular readers probably know that, other than the occasional snarky comment on other people's blogs, I haven't (much) engaged in the blogospheric kerfuffle over Collins' religion and the (in my opinion) vastly overblown fear in some quarters that he would inject his religion into his…

The precarious position of physician-scientists in academic medicine today

Jake over at Pure Pedantry pointed the way to an article in Science that I hadn't seen yet because of my absence. Just like yesterday's topic, this one too is right up my alley. Specifically, it's about something near and dear to my heart, namely the trials and tribulations of being a physician-scientist. The article paints a rather grim picture, with the observation that, although most MD/PhD's would like to remain researchers, many are dropping out in order to become straight clinicians, clinical instructors at medical schools, or industry researchers. Jake's commentary is certainly worth…

Wearing two hats, part 2

While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts.) These will appear at least twice a day while I'm gone (and that will probably leave some leftover for Christmas vacation, even). Enjoy, and please feel free to comment. I will be checking in from time to time when I have Internet access to see if the reaction…

Framing vaccines

Note: The central idea for this post is the same as that of a post I did a few months ago. However, given some of the assertions and comments made by Dr. Offit in Autism's False Prophets, I thought they were worth discussing again, especially given how many readers are around who aren't regular readers of mine. One of the major points made by Dr. Offit in Autism's False Prophets is how badly the media deals with scientific issues and stories in which science is a major component. Indeed, he devotes two full chapters, Science and the Media and Science and Society, to a lament that…

"Complementary and alternative medicine" (CAM) goes for the bandwagon fallacy again

It figures. Right around the time of my blogiversary yesterday, when I had intended nothing more than a brief by characteristically self-indulgent bit of navel-gazing twaddle (at which, I succeeded brilliantly, I might add; no one--and I mean no one--does self-indulgent navel-gazing twaddle better than I do), what should be there tempting me from my intended day off? Lots of news stories about a report published by the Centers for Disease Control about a yearly survey regarding the usage of so-called complementary and alternative medicine (CAM) therapies in the U.S. Predictably, headlines in…

Framing vaccines again

NOTE: This post, which is related to a discussion of Dr. Paul Offit's Book Autism's False Prophets, originally appeared over at The ScienceBlogs Book Club. However, now that the book club for this particular book has concluded, I am free to repost it here for those who may not have seen it and to archive it as one of my own posts. Besides, I know the antivaxers are more likely to see it here... One of the major points made by Dr. Offit in Autism's False Prophets is how badly the media deals with scientific issues and stories in which science is a major component. Indeed, he devotes two full…

Quackademic medicine infiltrates the New England Journal of Medicine

One of the things that disturbs me the most about where medicine is going is the infiltration of quackery into academic medicine. So prevalent is this unfortunate phenomenon that Doctor RW even coined a truly apt term for it: Quackademic medicine. In essence, pseudoscientific and even prescientific ideas are rapidly being "integrated" with science-based medicine, or, as I tend to view it, quackery is being "integrated" with scientific medicine, to the gradual erosion of scientific standards in medicine. No quackery is too quacky, it seems. Even homeopathy and naturopathy can seemingly find…

Your Friday Dose of Woo: Living water living free

A couple of days ago, I expressed my amusement at an e-mail sent to me by someone named "Carol." The amusement came primarily from the subject matter in the e-mail, which described something called a "biophoton ionizer," whatever that is. Knowing, as I do, how prevalent water woo is (after all, what is homeopathy but the grand daddy of all water woo?), I was naturally curious about what the heck a "biophoton ionizer" is. After all, what's the difference between a regular photon and a "biophoton"? What is the characteristic of the photon that makes it "bio," if you know what I mean. I was sure…

Animal Rights and Human Needs: Foundations of the debate (Part II)

Continued from Part 1 ... Animal rights are arbitrarily granted or assumed If human rights are arbitrarily assigned, so are animal rights. The argument has been made that animals with certain properties ... sentience (the definition of which moves somewhat), phylogenetic closeness to humans, or the ability to feel pain, etc. ... should share some protections against painful procedures, death, or being caged because of those properties. Sorry, but no. While it could be argued that the more human a non-human animal is the more like humans they should be treated, that simplistic view in and of…

Publication bias in clinical trials used for FDA approval

If there is one difference that defines scientific medicine compared to "alternative medicine" it is the application of the scientific method to health claims. Science and the scientific method require transparency: transparency in methodology, transparency in results, transparency in data analysis. Because one of the most important aspects of science is the testing of new results by other investigators to see if they hold up, the diligent recording of scientific results is critical, but even more important is the publication of results. Indeed, the most important peer review is not the peer…

Rats! My Academic Woo Aggregator is hopelessly out of date

My Academic Woo Aggregator has become even more out of date. You remember my Academic Woo Aggregator, don't you? It's my list of medical schools and major academic medical centers in North America that have adopted what Dr. R.W. once so famously dubbed "quackademic medicine" in that they've created divsions, centers, or departments of "complementary and alternative medicine" (CAM) or "integrative medicine" (IM), in which pseudoscientific or mystical woo is "integrated" with scientific medicine in the mistaken belief that it will somehow improve patient care. Whether it's for chasing money…

A high tech form of the same old "detoxification" woo

"Detoxification." Whenever I hear that term, I'm at least 90% certain that I'm dealing with seriously unscientific woo. The reason should be obvious to longtime readers of this blog or to anyone who has followed "alternative medicine" for a while, because "detoxification" is a mainstay of "alternative" treatments and quackery for such a wide variety of diseases and conditions. Of course, toxins are indeed a bad thing, and we close-minded reductionist "allopathic" physicians do indeed use detoxification when appropriate. What differentiates us from "alternative" medicine practitioners is that…

Even after the USA TODAY report, Stanislaw Burzynski manages to enlist cancer patients to his cause

Three weeks ago, USA TODAY published an expose of the Burzynski Clinic by Liz Szabo that was devastating in its scope and detail. Early on, Stanislaw Burzynski and his minions tried to do some damage control, with hilarious results given how inept and unconvincing his excuses were for all the violations of ethics and patient care and abuse of clinical trials detailed by Szabo. Later, Burzynski presented some abstracts at the Society of Neuro-Oncology meeting in San Francisco. Let's just say that the case report and his reports of a phase 2 clinical trial were...similarly unimpressive. Overall…

Children are not their parents' property

Yesterday's post about Sarah Hershberger, the Amish girl from northeast Ohio with lymphoblastic lymphoma who refused chemotherapy, prompting a court battle that led to the appointment of a medical guardian for her to make sure she receives treatment, got me to thinking (always a dangerous thing). Actually, I had to think back over the years about all the similar cases of unfortunate children with cancer whose misfortune was compounded by having been born to woo-loving parents, such as Daniel Hauser. These stories are depressingly similar, as are the arguments that go on over them. First, a…

"AutismFreeBrain"? Selling supplements to cure autism

You might find this hard to believe, but sometimes I find the antivaccine crank blog Age of Autism to be useful. Obviously, I don't find it useful in the same way that its editors think it is useful. Those paragons of the arrogance of ignorance and fetishism of hatred of science-based medicine don't actually teach me anything about vaccines and autism. The torrents of pseudoscience, quackery, conspiracy mongering, and hostility do, however, serve their purpose. They keep my finger on the pulse of the "autism biomed" movement and what the latest "autism biomed" quackery du jour is. It looks…

Can antivaccinationists knock it off with the autism Holocaust analogies already? (RFK, Jr. edition)

Robert F. Kennedy, Jr. is despicable. I just wanted to get that off my chest. (Do clear Plexiglass boxes full of multicolored blinky multicolored lights even have chests?) The reason for my outburst will become painfully apparent all too soon, but I just had to say that. There's also one other thing that I just have to say as well, and that's this. When the managing editor of the antivaccine crank blog to rule all antivaccine crank blogs gives me a blogging topic and practically begs me to blog about it, in general I usually blog about it because, well, how can I resist? Think of it this way…

Cutting, poisoning, and burning naturally

Not too long ago, a reader asked me about black salve, and then not too long later I saw a commenter mention black salve. It occurs to me that, in all the years I've been doing this blog and my other blog, I don't think I've ever actually written about black salve, except in passing. So I searched the blog, and my memory appears to be correct about this. I really haven't written much about black salve. It's been mentioned several times, but I haven't really dedicated a post to it, even though that wretchedest of wretched hives of scum and quackery, NaturalNews.com, has promoted black salve in…

Unexpected praise of the virtues of bacon by Joe Mercola

It is an indisputable axiom that everything tastes better with bacon. Well, almost everything. As much as I love bacon, whenever I watch one of those cooking competition shows on the Food Network, like Iron Chef America, in which the secret ingredient is bacon, I can't figure out how putting bacon in ice cream works. OK, so maybe it's almost an axiom. There are a few exceptions. But the fact remains that the vast majority of foods do taste better with some bacon. Of course, the problem with bacon is that it's widely accepted that it's not particularly good for you. Because it is a processed…

A "homeopathic physician" in Arizona versus science

I'm a cancer surgeon and have been since I finished my fellowship nearly 13 years ago. That is, of course, one big reason that, after I found myself drifting towards becoming a skeptic, it didn't take long for me to take an interest in "alternative medicine," in particular alternative medicine for cancer. Perhaps that's why I went a little bit crazy on Dr. Stanislaw Burzynski earlier this week for his "antineoplaston" therapy and his clinic's harassment of critical bloggers. As a result of that incident, I decided to keep my eye out even more than usual for clinics, websites, or practitioners…

Fighting the "acid" of negative (e)motions?

If there's one quack who both amuses and appalls me at the same time, it's Robert O. Young. You remember Robert O. Young, don't you? He's the guy who thinks that all disease is caused by excess acid. I've written about him quite a few times over the last several years. For instance, he amused me when he declared that cancers are all liquids, and this liquid is the "toxic acidic waste product of metabolism or energy consumption." In fact, he goes beyond that by saying that the tumor making up the cancer is the body's protective mechanism to encapsulate "spoiled" or "poisonous" cells. And what…

A one trick pony does his one trick

It's funny, but it's only been one week since I expressed extreme skepticism that that wretched hive of scum and quackery, The Huffington Post, had reformed itself. The reason, of course, was that HuffPo had announced that it was starting a science section. Even though on the surface it seemed that HuffPo was making the right moves, recruiting real scientists to blog for it, even asking Seth Mnookin to write an pro-vaccine article that was the very antithesis of the antivaccine idiocy that has run rampant at HuffPo from the very beginning and, with only rare interruptions, continuing during…

Your tax dollars at work: New clinical trial of chelation therapy, new and old quacks enrolling patients

Whenever I refer to quackademic medicine and how the infiltration of quackery into medical academia has led to unethical clinical that are not only pseudoscientific wastes of money but potentially downright harmful to patients, two always come to mind. The first is the trial that tested the late Nicholas Gonzalez’s protocol for advanced pancreatic cancer, comparing it to standard-of-care chemotherapy. His protocol basically involves a combination of supplements (up to 150 a day), various vegetable juices, and, yes, the infamous coffee enema—several a day, actually. It’s basically a mystical,…

Tribeca Film Festival wrap-up: Andrew Wakefield's "brilliance" and spies and Nazis, oh my!

Whenever a story like Robert De Niro's decision to choose an antivaccine film by Andrew Wakefield for screening at his prestigious Tribeca Film Festival followed by his decision to drop the film like the proverbial hot potato upon being shown just how full of misinformation, distortions, and pseudoscience the film is shows up, I not infrequently feel as though the topic takes over the blog. And so it often does. It's been the main topic here for the last week. That's why I thought I'd move on to something else, but then, seeing the reaction of the antivaccine crankosphere yesterday to the…

Basics: Vectors and Vector Addition

**pre-reqs:** trig Think of the following two things. Temperature and wind speed. These are two different things that you could measure, but there is one big difference. Wind speed has two parts to it - how fast and which direction. Temperature is just one thing (no direction). Temperature is an example of a scalar quantity (just one piece of information). Wind speed is an example of a vector quantity - multiple pieces of information. Here are some other examples: **Scalar:** mass, money, density, volume, resistance **Vector:** velocity (most physicist reserve the word "speed" to mean…

Sunday Sacrilege: Daughters of Eve

Half the people in the world commit this sin against god: they are born women. It's an astounding thing that any women at all accept Christianity, Judaism, or Islam; these are profoundly misogynistic faiths. Throughout the Christian Bible, women are treated as chattel to be abused and misused, and uppity women are regarded as the worst of the lot, fit only to be slaughtered. There are parts of the Bible that read like snuff porn — but it's all OK, because it's the Bible, God's holy word, and if God is gonna have to choke a bitch, who are we to question it? We can trace the attitude right back…

Fodor and Piattelli-Palmarini get everything wrong

People who don't understand modern evolutionary theory shouldn't be writing books criticizing evolutionary theory. That sounds like rather pedestrian and obvious advice, but it's astonishing how often it's ignored — the entire creationist book publishing industry demands a steady supply of completely clueless authors who think their revulsion at the implications of Darwinian processes is sufficient to compensate for their ignorance. And now Jerry Fodor and Massimo Piattelli-Palmarini, a philosopher and a cognitive scientist, step up to the plate with their contribution to this genre of…

Voter Suppression in Missouri

This story should, if you care at all about the rule of law, make your blood boil: I, Galloglas, went to vote today and encountered difficuly. And, it is important to point out that this was not the first time I've run onto problems this year. When I voted in Missouri's Presidential primary in February, 2008, I took the proper identification to my precinct and attempted to cast my ballot. The identification requirements are spelled out graphically on our Secretary of State's Web Site which can be found at http://www.sos.mo.gov/... /. And, as I am of the belief that the "Voter Fraud" question…

Clock Tutorial #6: To Entrain Or Not To Entrain, That Is The Question

This post from February 03, 2005 covers the basic concepts and terms on entrainment. Let's now continue our series of Clock Tutorials with an introduction to some phenomena (and related terms and concepts) observed in the laboratory in the course of doing standard circadian experiments. Such experiments usually involve either the study of properties of freerunning rhythms (check the old tutorials, especially CT2 and CT 4 for clarification of basic terms and concepts), or the analysis of entrainment of rhythms to environmental periodicities. Entrainment is a process by which a biological…

Dissecting lions and tigers: Inside Nature's Giants series 2, part III

I hope everyone has been enjoying my write-ups of Inside Nature's Giants (ING), series 2 (for comments on episode 1 go here, and for thoughts on episode 2 go here). Time to look at ep 3: the big cat one. Given that big cats are more popular (among the general populace) than are either sharks or snakes, it's predictable that this was the most discussed, most anticipated episode. Like the others, it was excellent [adjacent image © Windfall Films/Channel 4]. And let me say again how good the whole of ING series 2 was: well done to everyone involved, you left us wanting more. And to those who…

Clock Tutorial #6: To Entrain Or Not To Entrain, That Is The Question

This post from February 03, 2005 covers the basic concepts and terms on entrainment. This is also the only blog post to date that I am aware of that was cited in a scientific paper. Let's now continue our series of Clock Tutorials with an introduction to some phenomena (and related terms and concepts) observed in the laboratory in the course of doing standard circadian experiments. Such experiments usually involve either the study of properties of freerunning rhythms (check the old tutorials, especially CT2 and CT 4 for clarification of basic terms and concepts), or the analysis of…

Clock Tutorial #6: To Entrain Or Not To Entrain, That Is The Question

This post from February 03, 2005 covers the basic concepts and terms on entrainment. This is also the only blog post to date that I am aware of that was cited in a scientific paper. Let's now continue our series of Clock Tutorials with an introduction to some phenomena (and related terms and concepts) observed in the laboratory in the course of doing standard circadian experiments. Such experiments usually involve either the study of properties of freerunning rhythms (check the old tutorials, especially CT2 and CT 4 for clarification of basic terms and concepts), or the analysis of…

Clock Tutorial #6: To Entrain Or Not To Entrain, That Is The Question

This post from February 03, 2005 covers the basic concepts and terms on entrainment. This is also the only blog post to date that I am aware of that was cited in a scientific paper. Let's now continue our series of Clock Tutorials with an introduction to some phenomena (and related terms and concepts) observed in the laboratory in the course of doing standard circadian experiments. Such experiments usually involve either the study of properties of freerunning rhythms (check the old tutorials, especially CT2 and CT 4 for clarification of basic terms and concepts), or the analysis of…

The Ethics of Framing Science: Four Guiding Principles

When pundits like Richard Dawkins use the trust and authority granted them as scientists to denigrate religious publics, is it unethical? On issues such as climate change, nanotechnology, and evolution, research in the area of framing is being used to design and plan communication initiatives and to craft novel, accessible, and relevant narratives for nontraditional audiences across media formats. The intended outcomes include increased learning, dialogue, and public participation. Yet what's still missing is a clear outline of the ethical and normative imperatives that apply to scientists,…

The FDA really caves: Stanislaw Burzynski can do clinical trials again

It's hard for me to believe that it's been almost three years since I first started taking an interest in the Houston cancer doctor and Polish expat Stanislaw Burzynski. Three long years, but that's less than one-twelfth the time that Burzynski has been actually been administering an unproven cancer treatment known as antineoplastons (ANPs), a drug that has not been FDA-approved, to patients, which he began doing in 1977. Yes, back when Burzynski got started administering ANPs to patients, I was just entering high school, the Internet as we know it did not exist yet, just a much smaller…

The perpetuation of bad arguments

I thought I'd take a bit of a break for a change of pace. At the risk of falling flat on my face, I'm going to wander far afield from the usual medical and biological topics of this blog into an area that I rarely say much about. The reason is an incident that happened nearly two weeks ago when I was in Chicago. Lately, I've been becoming increasingly interested in how bad scientific arguments make it into the collective consciousness and stay there. While it's true that there are such things as astroturf campaigns and paid flaks whose job it is to get such messages in the medium and keep…

The Galileo Gambit

While I am on vacation, I'm reprinting a number of "Classic Insolence" posts to keep the blog active while I'm gone. (It also has the salutory effect of allowing me to move some of my favorite posts from the old blog over to the new blog, and I'm guessing that quite a few of my readers have probably never seen many of these old posts.) These will appear at least twice a day while I'm gone (and that will probably leave some leftover for Christmas vacation, even). Enjoy, and please feel free to comment. I will be checking in from time to time when I have Internet access to see if the reaction…

The Geiers humiliated?

I had tried to give the Dr. Mark Geier and his son David a rest for a while, as I suspected my readers may have been getting a little tired of my bashing them, no matter how deserved that bashing may have been. After all, they do shoddy science in the service of "proving" that mercury in vaccines causes autism. They concoct dubious IRBs riddled with conflicts of interest to "approve" their research. When the evidence that this is not the case becomes more and more compelling, they add a twist of a claim that many autistic children suffer from "precocious" puberty," which requires treatment…

Politics versus scientific peer review

In the United States, the federal government has long had a prominent role in funding science research. Be it the $30 billion a year or so that funds the National Institutes of Health or the $5 or $6 billion a year allotted to the National Science Foundation, the government funds a lot of basic and applied research, and this is in general a good thing. The number of discoveries and advances that have come out of this funding have well repaid the investment and much more. There is, however, a downside to this funding that's a pretty obvious consequence any time the government funds anything,…

The New York Times publishes fake news false hope in the form of a credulous account of dubious alternative medicine testimonials

[Editor's note: Sorry this is a few hours late. I forgot to change the status from DRAFT to SCHEDULE in WordPress last night. D'oh!] The single most persuasive strategies by which quacks sell their wares and believers in quackery persuade others to try the quackery they believe in is the personal anecdote. Indeed, I established very early on in the history of this blog a type of post that has become a staple that shows up several times a year. In these posts, I deconstruct "alternative cancer cure" testimonials, showing how the story as related doesn't provide convincing evidence that the…

Jill Stein and left wing antivaccine dog whistles

During the political battle last year over the recently implemented California law SB 277, which eliminates nonmedical exemptions to school vaccine mandates and then later during the campaign for the Republican nomination for President, I used a term regarding antivaccine views. That term was “antivaccine dog whistle.” In politics, as you probably now, a “dog whistle” is a term for coded messages that sound like advocating principles with broad acceptance but to a certain subgroup are recognized as code for something else. The analogy is obvious. Just as humans can’t hear much of a dog…

Role models: Martin Luther King, Jr. or Malcolm X?

Attention conservation notice: 3200 words attempting to correct what may be a fatally flawed analogy between New Atheism and Martin Luther King, Jr.'s approach to the civil rights movement. In replying to Jason's post the other day, I skipped over some important issues that were peripheral to my main point. But I want to double back on a comment he made that I've seen New/Affirmative/Extreme/gnu atheists toss out rather too often. The claim is that they are, in some sense, analogous to Martin Luther King, Jr. Jason, being sophisticated and smart, and knowing that using analogies on the…

Hooked on Hooking Up, Or What's Wrong With Conservative View Of Marriage

This is two years old (February 16, 2005) but still as provocative....(also my belated contirbution to the Blog For Choice Day) and I'll repost the second part of it next Friday. ----------------------------------------------- William Raspberry wrote an editorial in Washington Post last weekend (I picked a link to a syndication that does not require registration instead of dinosaurid WaPo) about the sexual practices of young people, mainly college people. This is not the first time he wrote on this topic. For instance, he wrote a column a few years ago, immediately after the release of the…

The Eagleton Delusion

The other day, I read this fawning review by Andrew O'Hehir of Terry Eagleton's new book, Reason, Faith, and Revolution: Reflections on the God Debate, and was a little surprised. I've read a smattering of Eagleton before, and the words "brisk, funny and challenging" or "witty" never came to mind, and the review actually gave no evidence that these adjectives were applicable in this case. I felt like ripping into O'Hehir, but was held up by one awkward lack: I hadn't read Eagleton's book. Who knows? Maybe he had found some grain of sense and some literary imperative to write cleanly and…

Why Pairing Science and Atheism is High-Brow

In 1922, John Dewey, pragmatist philosopher and champion of Progressive education, wrote an article in The New Republic entitled "The American Intellectual Frontier." The subject was William Jennings Bryan's attack on evolution that would later culminate in the Scopes trial. The argument that Dewey made was not what you would think, however. Though he was most definitely part of the the Northeastern liberal establishment at the time, he did not dismiss Bryan's attacks as indicative of rural ignorance. Instead, he made the argument that while he disagreed with Bryan, liberals had to take…

Lamenting Deadly Choices that endanger children

As hard as it is to believe after the pile of poo that was 2010, the year 2011 is starting out rather promisingly, at least from the point of view of science-based medicine. Its beginning has been greeted with the release of two--count 'em, two!--books taking a skeptical, science-based look at vaccines and, in particular, the anti-vaccine movement. First off the mark (for me, at least) is a new book by a man whom the anti-vaccine movement views as the Dark Lord of Vaccination, Sauron himself sitting up in Barad-dûr (apparently the University of Pennsylvania and Children's Hospital of…

Quackademic medicine marches on: George Washington University and the University of Toronto

Quackery has been steadily infiltrating academic medicine for at least two decades now in the form of what was once called “complementary and alternative medicine” but is now more commonly referred to as “integrative medicine.” Of course, as I’ve written many times before, what “integrative medicine” really means is the “integration” of quackery with science- and evidence-based medicine, to the detriment of SBM. As my good bud Mark Crislip once put it, “integrating” cow pie with apple pie does not improve the apple pie. Yet that is what’s going on in medical academia these days—with a…

NIH funding: The dreaded issue of conformity rears its ugly head again

For all the worship of "translational" research that is currently in vogue, it needs to be remembered that a robust pipeline of basic science progress upon which to base translational research and clinical trials is absolutely essential if progress in medicine is to continue. Without it, progress in SBM will slow and even grind to a halt. That's why, in the U.S., the National Institutes of Health (NIH) is so critical. The NIH funds large amounts of biomedical research each year, which means that what the NIH will and will not fund can't help but have a profound effect shaping the pipeline of…

Can the Cancer Moonshot do what its advocates promise?

The Cancer Moonshot. It’s a topic that I’ve been meaning to address ever since President Barack Obama announced it in his State of the Union address this year and tasked Vice President Joe Biden to head up the initiative. Biden, you’ll recall, lost his son to a brain tumor . Yet here it is, eight months later, and somehow I still haven’t gotten around to it. The goal of the initiative is to “eliminate cancer as we know it,” and to that end, with $195 million invested immediately in new cancer activities at the National Institutes of Health and $755 million proposed for FY 2017. My first…

Sayer Ji: Willfully misunderstanding overdiagnosis and misdiagnosis since...forever

If there's one lesson that I like to emphasize while laying down my near-daily dose of Insolence, both Respectful and not-so-Respectful, it's that practicing medicine and surgery is complicated. Part of the reason that it's complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can in the context of incomplete information and understanding. The biology of cancer, in particular, can be vexing. Some cancers appear to progress relentlessly, meaning that it's obvious that all of them must be…