Skepticism/Critical Thinking
oracknows | June 6, 2016One 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…
oracknows | June 3, 2016After over 11 years at this blogging thing, I periodically start to fear that I’m becoming jaded. In particular, after following the infiltration of quackery in the form of “complementary and alternative medicine” (CAM), now more commonly known as “integrative medicine,” because it integrates CAM with evidence-based medicine. Of course, in reality, what “integrative medicine” really does is to integrate prescientific, pseudoscientific, and antiscientific quackery with real medicine, and that’s what I mean. I thought I had seen it all in academic medical centers and medical schools: the faith…
oracknows | June 2, 2016One common theme that has been revisited time and time again on this blog since its very founding is the problem of how science and medicine are reported. For example, back when I first started blogging, one thing that used to drive me absolutely bonkers was the tendency of the press to include in any story about vaccines an antivaccine activist to “tell the other side” or for “balance” to the story. So in a story on vaccines, on the one side you would have Paul Offit, a bona fide, legitimate vaccine expert, and on the other side you would have J.B. Handley, Jenny McCarthy, Andrew Wakefield,…
oracknows | June 1, 2016With a bill to license naturopaths (HB 4531) wending its way through the Michigan legislature supported by supplement manufacturers, its current status being in consideration by the full House of Representatives, periodically I feel the need to provide ammunition to the bill’s opponents, because we need to protect the patients in the state of Michigan from the naturopathic quackery that would be unleashed if this bill were to be passed into law.
If there is one area that naturopaths have been invading with a vengeance and even gaining enough seeming legitimacy to propose what they risibly…
oracknows | May 30, 2016Andrew Wakefield, his claims to the contrary, is antivaccine to the core. To be honest, I’m not sure if he was always antivaccine. After all, around 20 years ago when he was doing his “research” into whether the MMR vaccine causes autism, he was being generously funded by a barrister seeking to sue vaccine manufacturers and he was developing a competing measles vaccine (for which he filed for a patent) that would be unlikely to be profitable unless the MMR became discredited. In retrospect, knowing what I know now about these aspects of Wakefield’s “research,” I consider it highly likely that…
oracknows | May 29, 2016"Complementary and alternative medicine" (CAM), now more frequently referred to as "integrative medicine" by its proponents, consists of a hodge-podge of largely unrelated treatments that range from seemingly reasonable (e.g., diet and exercise) to pure quackery (e.g., acupuncture, reiki and other "energy medicine") that CAM proponents are trying furiously to "integrate" as coequals into science-based medicine. They do this because they have fallen under the sway of an ideology that posits a false dichotomy: To practice true "holistic" and "preventative" medicine, physicians and other health…
oracknows | May 27, 2016To say that I, as a cancer surgeon, am not a fan of Ty Bollinger is a massive understatement. He’s not exactly one of my fans, either, but I view the hatred of a man like Bollinger directed at me as a badge of honor. Indeed, if a man like Bollinger didn’t detest me, I would view my efforts as a failure because I view him as a quack whose desperately deceptive film series The Truth About Cancer has been correctly dubbed untruthful about cancer by Harriet Hall and whose message has led cancer patients into rejecting conventional medicine in favor of treating deadly cancers with alternative…
oracknows | May 25, 2016One of the more annoying health crazes going around right now is the gluten-free diet. While it’s a boon to the very small proportion of the population who have real celiac disease and thus truly cannot tolerate gluten, at the same time gluten has become the health demon that is touted as the cause of virtually all health problems, be they major or minor, with the cure—of course!—being the now nearly ubiquitous gluten-free diet. The gluten-free diet has become so popular that restaurants and food manufacturers ignore it at their financial peril. Indeed, restaurants that don’t have some gluten…
oracknows | May 23, 2016Sigh. Here we go again. Robert De Niro is letting his antivaccine freak flag fly again, this time even higher than usual, by revealing that in the wake of the antivaccine debacle at his Tribeca Film Festival he is going to make his very own documentary about vaccines. It’s the continuation of a process that, depressingly, revealed Robert De Niro to be perhaps the biggest A-list antivaccine celebrity out there.
First, a bit of background to bring newbies up to speed. A couple of months ago, science-based medicine advocates were scratching their heads over news that the Tribeca Film Festival…
oracknows | May 22, 2016Over the years, I’ve taken care of women with locally advanced breast cancer so advanced that it’s eroded through the skin, forming huge, nasty ulcers filled with stinky dead cancer tissue that’s outgrown its blood supply, leaving the patient in chronic pain. If the patient is fortunate, her cancer has not metastasized beyond her axillary lymph nodes (the lymph nodes under her arm), and her life might still be saved by a combination of chemotherapy, radical surgery, and radiation. If the patient is not fortunate, either the cancer has metastasized and she is doomed or hasn’t metastasized yet…
oracknows | May 19, 2016After yesterday’s epic mid-week rant about a man who thinks he knows what skepticism is but clearly doesn’t, it’s time to get back to business. The best way to do that is to go back to an article that came out the other day and that I had meant to blog about but temporarily shelved in favor of yesterday’s rant. It’s a topic that’s very relevant to me right now given that the Michigan legislature is considering a bill (House Bill 4531) that would give naturopaths a broad scope of practice almost the equal of that of primary care physicians, the only difference being that naturopaths wouldn’t…
oracknows | May 18, 2016Contrary to what some of my detractors think, I don’t mind criticism of my viewpoints. After all, if I never encounter criticism, how will I ever improve? On the other hand, there are forms of criticism that are what I would call less than constructive. One form this sort of criticism takes is obsessive repetition of points that have already been addressed and failure to pay attention to how they were addressed. This is the sort of criticism that will eventually provoke an exasperated shrug of the shoulders or even an angry—dare I say Insolent?—retort.
Another way criticism can get on one’s…
oracknows | May 15, 2016It is an unquestioned belief among believers in alternative medicine and even just among many people who do not trust conventional medicine that conventional medicine kills. Not only does exaggerating the number of people who die due to medical complications or errors fit in with the world view of people like Mike Adams and Joe Mercola, but it's good for business. After all, if conventional medicine is as dangerous as claimed, then alternative medicine starts looking better in comparison.
In contrast, real physicians and real medical scientists are very much interested in making medicine…
oracknows | May 13, 2016It’s been a while since I paid attention to the movie, but the publicity among the antivaccine movement for Andrew Wakefield’s and Del Bigtree’s movie VAXXED: From Cover-Up to Catastrophe continues apace. Sadly, I missed my opportunity to see Bigtree himself doing a Q&A for the movie when it rolled through Detroit a a week and a half ago, mainly (1) the evening Del Bigtree and Polly Tommey rolled through my neck of the woods happened to coincide with a day that I had to drive to Saginaw for a 7:30 AM talk (hint: it’s nearly a two hour drive from where I live) and then had to give a talk…
oracknows | May 12, 2016I’ve written a lot about the language issue with respect to alternative medicine. As I like to put it (at least in shortened form), first there was quackery. Quacks did not like that name at all, and thus was born alternative medicine. And the quacks did think it good—for a while. There was a problem, however. “Alternative” medicine implied (correctly, of course) that what was being discussed was not real medicine, and the quacks could not abide that. Thus was born “complementary and alternative medicine” (CAM).
And the quacks thought this very good indeed.
Unfortunately, it was not long…
oracknows | May 10, 2016It’s no secret that I’m a big fan of John Oliver. When my aging body allows me to stay awake late enough on Sunday nights and there’s a new episode on, I’ll almost always be watching. Since starting his own show Last Week Tonight With John Oliver on HBO, Oliver’s become quite the expert at using humor to explain and bring attention to injustices that are widely ignored and to skewer politicians and blowhards.
This Sunday, he turned his attention on science reporting:
I certainly would have written about this for yesterday, except that at 11:30 PM on Sunday night there’s only one place for…
oracknows | May 4, 2016As regular readers of this blog and related blogs know, over the last two or three decades there has been a successful effort to legitimize quackery in the form of what is now called “integrative medicine.” Three decades ago, modalities like homeopathy, acupuncture, much of traditional Chinese medicine, reflexology, chiropractic, and many other modalities based on vitalism, prescientific mysticism, and pseudoscience were rightly referred to as quackery. Then in the 1990s came “complementary and alternative medicine” (CAM), a term that sought to sand the rough edges of quackery off of the,…
oracknows | May 1, 2016If 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…
oracknows | April 29, 2016Three days ago, I noted a disturbance in the antivaccine Force.
Last night, I noticed that that disturbance continues.
The first time around, it was Brian Hooker, a biochemical engineer turned incompetent antivaccine “epidemiologist” completed the circle of clueless conspiracy mongering, who was at the center of the disturbance. His conspira-woo tapped into the Dark Side of the Force by taking a conspiracy theory that the antivaccine movement has been flogging for nearly two years now (as hard as it is to believe, it started in August 2014!), a conspiracy known as the “CDC whistleblower” and…
oracknows | April 27, 2016I hate these stories, because they so seldom end well. Unfortunately, this one is more messy than even the usual messiness of the typical story of this type. The type of story I’m referring to, of course, is one that I’ve told from time to time ever since near the first year of this blog’s existence, that of the child or teen with cancer who, for whatever reason, refuses curative chemotherapy in favor of some sort of quackery. The litany of names depresses me to contemplate: Katie Wernecke, Abraham Cherrix, Sarah Hershberger, Daniel Hauser, Makayla Sault...the list goes on. In the vast…