Skepticism/Critical Thinking
oracknows | September 14, 2015[Note: My flight home from London was delayed until quite late; so unfortunately another "rerun" is in order. This one's from three years ago, and I actually consider it one of my "classics." It was also originally published at my not-so-super-secret other blog and represents the first time I tried to put together my concept of a "central dogma" of alternative medicine into a semi-coherent form. Ultimately, this lead to my talk The Central Dogma of Alternative Medicine, given at Skepticon last year. If you've been reading less than three years, it's new to you. If you haven't, you really…
oracknows | September 8, 2015I am fortunate to have become a physician in a time of great scientific progress. Back when I was in college and medical school, the thought that we would one day be able to sequence the human genome (and now sequence hundreds of cancer genomes), to measure the expression of every gene in the genome simultaneously on a single "gene chip," and to assess the relative abundance of every RNA transcript, coding and noncoding (such as microRNAs) simultaneously through next generation sequencing (NGS) techniques was considered, if not science fiction, so far off in the future as to be unlikely to…
oracknows | September 6, 2015This is a public service announcement—with skepticism. Orac needs a recharge:
Some of you might have seen it alluded to in the comments that I am on vacation this week. It is true, although it's not entirely a vacation. Basically, I was invited by a collaborator to give a talk at a two-day conference at Imperial College London, and my wife and I decided to make a vacation of it. What this means is that, depending upon my mood and the amount of time I have, there might or might not be new material this week. Worst case scenario, there will be reruns. Of course, if you're relatively new to…
oracknows | September 3, 2015You'd think that after all these years combatting quackery and blogging about science in medicine (and, unfortunately, pseudoscience in medicine) it would take a lot to shock me. You'd be right. On the other hand, Even now, 15 years after I discovered quackery in a big way on Usenet and ten years after the inception of this blog, I still have enough hope in humanity that even when I come across men like Jerry Sargeant, a.k.a. The Facilitator I am still capable of utter wonder that someone would advertise something as reprehensible and/or deluded as this. I half wondered if it were performance…
oracknows | August 23, 2015As hard as it is to believe after over ten years of existence and over 5,000 posts on SBM, every so often, something reminds me that I've missed paper that cries out for some not-so-Respectful Insolence. So it was a couple of weeks ago, when I saw a familiar name in a news story that wasn't about vaccines. You might recall a news story last month when a shadowy group with ties to radical antiabortion groups, the Center for Medical Progress, led by a man named David Daleiden, ran a highly questionable "sting" operation (complete with fake IDs) to "prove" that Planned Parenthood was selling…
oracknows | August 17, 2015A recurring topic on this blog involves my discussion of stories about children with cancer whose parents refuse chemotherapy, thus endangering the children's lives. These stories usually take this general form: The child is diagnosed with a deadly, but treatable cancer that has a high probability of cure with proper chemotherapy. The child receives the first round of chemotherapy. The parents can't deal with the side effects. If they are woo-prone, they make the decision to use "natural healing" or some form of alternative medicine. Sometimes it's in response to the child's request.…
oracknows | August 16, 2015The approval of new drugs and medical devices is a process fraught with scientific, political, and ethical landmines. Inherent in any such process is an unavoidable conflict between rigorous science and safety on the one side, which tend to slow the process down by requiring large randomized clinical trials that can take years, versus forces that demand faster approval. For example, patients suffering from deadly diseases demand faster approval of drugs that might give them the hope of surviving their disease, or at least of surviving considerably longer. This is a powerful force for reform,…
oracknows | August 14, 2015File this one under the category: You can't make stuff like this up. (At least, I can't.)
Let's say you're a die hard all-conspiracy conspiracy theorist and alternative medicine believer (a not uncommon combination). You love Alex Jones and Mike Adams and agree with their rants that there is a New World Order trying to suppress your rights. You strongly believe that vaccines not only cause autism, sudden infant death syndrome, a shaken baby-like syndrome, autoimmune diseases, sudden ovarian failure, and even outright death but are a depopulation plot hatched by Bill Gates and the Illuminati…
oracknows | August 10, 2015Alright, alright already! I get the message.
Over the course of the day yesterday I was bombarded by e-mails with a link to a New York Times article that shows a rather shocking lack of understanding of the science—more specifically, the lack of science—behind alternative medicine. Whenever something like this happens and I get so many requests to address a specific article, I'm always torn between my natural contrariness, which tempted me not to touch this article with the proverbial ten foot cattle prod (although something about this needs a cattle prod applied to it) and my desire to give…
oracknows | August 9, 2015I learned over the weekend that a historic figure in science-based medicine has died. If you know anything about the history of the Food and Drug Administration (FDA), you will know this woman's name, Frances O. Kelsey, MD, PhD. It turns out that Dr. Kelsey died on Friday at the age of 101. Somehow I missed the news on Friday, but once the story showed up in my news feeds over the weekend, I knew I had to make her today's topic. Here's the short version:
The sedative was Kevadon, and the application to market it in America reached the new medical officer at the Food and Drug Administration…
oracknows | July 31, 2015I frequently discuss a disturbing phenomenon known as "quackademic medicine." Basically, quackademic medicine is a phenomenon that has taken hold over the last two decades in medical academia in which once ostensibly science-based medical schools and academic medical centers embrace quackery. This embrace was once called "complementary and alternative medicine" (CAM) but among quackademics the preferred term is now "integrative medicine." Of course, when looked at objectively, integrative medicine is far more a brand than a specialty. Specifically, it's a combination of rebranding some…
oracknows | July 26, 2015Many are the lies and epic is the misinformation spread by the antivaccine movement. For instance, they claim that vaccines cause autism, autoimmune diseases, sudden infant death syndrome (SIDS), cancer, and a wide variety of other conditions and diseases when there is no credible evidence that they do and lots of evidence that they don't. One particularly pernicious myth, designed to appeal (if you can call it that) to religious fundamentalists, is the claim that vaccines are made using fetal parts. This particular claim reared its ugly head again in the context of a propaganda campaign…
oracknows | July 22, 2015My topic yesterday was When doctors betray their profession. In my post, I talked about some very unethical doctors representing tobacco companies in lawsuits against them seeking compensation for death and injury due to smoking, as well as to doctors and scientists peddling pseudoscience and quackery representing claimants in the Autism Omnibus action several years ago, in essence supporting the scientifically unsupported idea that vaccines cause autism. The reason I brought this up was to show doctors behaving badly in "conventional" and not-so-conventional medical-legal situations.…
oracknows | July 19, 2015Mammography is a topic that, as a breast surgeon, I can't get away from. It's a useful tool that those of us who treat breast cancer patients have used for over 30 years to detect breast cancer in asymptomatic women and thus (or so we hope) decrease their risk of dying of breast cancer through early intervention. We have always known, however, that mammography is an imperfect tool. Oddly enough, its imperfections come from two different directions. On the one hand, in women with dense breasts its sensitivity can be maddeningly low, leading it to miss breast cancers camouflaged by the…
oracknows | July 16, 2015I frequently call homeopathy The One Quackery to Rule Them All, but there are times when I am not so sure that that's the case. You see, there is...another. I'm referring, of course, to what is referred to as "energy medicine." What energy medicine modalities have in common is that they postulate that there is some sort "energy field" around humans that can be manipulated for therapeutic intent or that somehow practitioners can channel "healing energy" from elsewhere. For example, as I've discussed many times before, reiki is based on the concept that reiki masters can channel this…
oracknows | July 6, 2015Aside from deconstructing the misinformation and pseudoscience of the antivaccine movement, another of the top three or so topics I routinely discuss here is the infiltration of pseudoscience into medicine. In particular, I've found and discussed more examples than I can possibly remember of what I like to call quackademic medicine, defined as the infiltration of quackery into academic medicine. This quackery mainly insinuates its way into medical schools and academic medical centers through the emerging specialty known as "integrative medicine," which used to be called "complementary and…
oracknows | July 5, 2015There can be no doubt that, when it comes to medicine, The Atlantic has an enormous blind spot. Under the guise of being seemingly "skeptical," the magazine has, over the last few years, published some truly atrocious articles about medicine. I first noticed this during the H1N1 pandemic, when The Atlantic published an article lionizing flu vaccine "skeptic" Tom Jefferson, who, unfortunately, happens to be head of the Vaccines Field at the Cochrane Collaboration, entitled "Does the Vaccine Matter?" It was so bad that Mark Crislip did a paragraph-by-paragraph fisking of the article, while…
oracknows | July 2, 2015In the wake of the passage of SB 277 into law in California, the antivaccine contingent went full mental jacket. SB 277, as you might recall, eliminates non-medical exemptions (i.e., religious and personal belief exemptions) to school vaccine mandates. One thing watching the crazy was good for, at least for me, was to note how various antivaccinationists behaved. For instance, Jim Carrey, former paramour of the celebrity queen of the antivaccine movement, Jenny McCarthy, issued a series of Tweets in response:
Greed trumps reason again as Gov Brown moves closer to signing vaccine law in Cali…
oracknows | June 29, 2015Late last week, something happened that I never would have predicted, and it's all due to how the politics of the issue changed in the wake of the Disneyland measles outbreak earlier this year. The state that contains some of the most famous pockets of low vaccine uptake and some of the most famous antivaccine "luminaries," including pediatricians like Dr. Bob Sears and Jay Gordon, as well as actual celebrities like Rob Schneider, Alicia Silverstone, Bill Maher, Charlie Sheen, and Mayim Bialik, actually passed a law, SB 277, that eliminates non-medical exemptions to school vaccine mandates.…
oracknows | June 19, 2015Even if you're a relative newbie to this blog, you probably wouldn't be particularly surprised to learn that I don't much like Dr. Mehmet Oz, a.k.a. "America's Doctor." Of course, I refer to him as something slightly different, namely "America's Quack," for a whole host of reasons, including his featuring psychic mediums like John Edward and Theresa Caputo, faith healers, Ayurveda, homeopaths, dubious dietary supplements, and even antivaccine loons like Robert F. Kennedy, Jr. Indeed, when about a year ago Senator Claire McCaskill (D-MO) hauled him in front of her Senate committee over his…