A few news items of import: Andrew Wakefield, formerly a licensed to practice medicine in England, has officially lost that privilege.  Others have covered this more comprehensively than I'd ever be able to, but this is big news.  Wakefield is the father of the modern anti-vaccine movement.  His study of a putative relationship between the MMR vaccine and autism led to mass rejection of vaccination and a resurgence in many vaccine-preventable diseases.  After decades of relative quiescence, anti-vaccination ideas became popular again, especially among the rich and famous, but also among…
Too many too soon: that's Jenny McCarthy's rallying cry.  The disingenuous activists of the antivaccine movement use this motto as a foot in the door, claiming that they are not truly "anti-vaccine", just pro-"safe vaccines".  This is despite the fact that vaccines have proved themselves to be one of the safest and most effective medical interventions in human history.  Pediatricians in the community are struggling with the fallout of the antivaccine propaganda, having to spend their finite patient-care hours trying to explain to parents why they should vaccinate their children properly. …
Of all the crappy things I eat, bacon is probably the crappiest. Thankfully, I eat it only rarely, but if you were to put a pound of cooked bacon in front of me, I would eat a pound of cooked bacon and ask for more. But since I want to live long enough to watch my kid grow up, it's better to wax nostalgic on previous bacon encounters than to accrue new ones. How can something so good be so bad? On Sunday mornings, my dad and I used to drive down to the car wash and then over to the bagel store. We'd pick up fresh bagels, and sometimes smoked fish, and usually, by the time we got home…
I hate writing about politics, but the mainstreaming of racism since the election of Obama makes writing about politics a moral imperative. We'll start with Dr. Rand Paul, who is running for one Kentucky's senate seats. The usual racist dog whistles are apparently too subtle for Paul, which is good. I'd rather a politician be explicit about his bigotry. What I really love about the Paul case is his attempt to make his bigotry an inevitable consequence of his other beliefs. This is good, and I'll tell you why. Paul says that he disagrees with the parts of the Civil Rights Act that forbid…
Dana Ullman, a Huffington Post blogger who never fails to bring the stupid, has now gathered all the idiocy he can find, put it in a wheelbarrow, and dumped it into his latest piece up at HuffPo. In this piece, he calls on readers to stop all medications (except, presumably, the voodoo potions he approves of). A lawyer probably got to him before posting because he inserted an asterisk after this idiotic piece of advice recommending consulting your doctor first. Which is it, Dana? Do the doctors have it all wrong, or should we consult them before "unplugging"? Dana suggests that this "…
If there were a parallel universe, and in that universe medicine, instead of being based on science, was simply a gemisch of various folkways and superstitions, medicine in that universe would be called "naturopathy". "Remember. Hey, how come this never works with water?" I've discussed the absurdity of naturopathy nux vomica ad nauseum, but a loyal reader mentioned hearing that naturopathy might be good for allergies. This will require a bit of science to start off (unless, of course, Spock's rocking the goatee). Seasonal allergies are caused by a pathophysiologic process called "type I…
Common osteoporosis drugs do not increase the risk of unusual fractures (probably): Bisphosphonates (such as Fosamax and Actonel), a class of medications used to prevent fractures in osteoporosis, are effective in preventing certain types of common back and hip fractures.  As we've developed more patient-years of experience with the drugs, we've found certain problems, such as damage to the esophagus (which has been reduced by developing less frequent dosing regimens) and rare episodes of destruction of the jaw bone.  Data has now accumulated that we may be able to give these medications for…
We're now fifty years into the history of oral contraceptive pills, and we've learned an enormous amount. We've learned about various therapeutic uses of the Pill and unanticipated risks. We've learned to adjust the amount of medication to a lower effective dose. We've given women the opportunity to very effectively control their own fertility in a safe, private, and effective manner. But we haven't ended the controversy. Leaving aside idiotic moralist rantings about the Pill, the alternative medicine movement has treated it harshly. The decision to use or avoid any intervention…
So-called "morgellons syndrome" is an interesting phenomenon. This syndrome is not at this point generally recognized by the medical community, but its sufferers describe many different systemic symptoms, such as "brain fog" and fatigue, and characteristic skin lesions which they describe as containing or extruding an unknown substance. The patients are most often diagnosed as having delusions of parasitosis, a diagnosis which understandably is not often acceptable to the patient. One of the most consistent facts to date about the disorder is that there has been no significant scientific…
You know that big oil spill in the Gulf of Mexico?  It turns out that the folks who drilled it, the folks who pumped it, and the folks who worked on it weren't at fault---at least according to their sworn congressional testimony.  And I sure as hell know it's not my fault.  I mean, I do commute to work alone in my car, and I do like my air conditioner.  And my livelihood depends to a certain extent on an auto industry whose mileage standards haven't really changed in the last few decades.  But it's not my fault. Anything as complex as drilling for oil a mile under the ocean thousands of times…
Last week I gave you a refresher course on the invalid arguments used by altmed boosters. The Turf Battle Fallacy and Pharma Shill Gambit are classics for a number of reasons. The most amusing thing about these gambits is their hypocrisy.   The alternative medicine movement is  essentially a collection of businesses selling unproven supplements and interventions (not "therapies", as Steven Novella aptly observes).   Of course, that's an incomplete analysis.   Altmed is also a religion, with zealous adherents.  The arguments made by these adherents are never about the data, but about beliefs…
Smallpox was one of the world's most devastating diseases, and its eradication one of medicine's most spectacular successes. Over the course of a couple of centuries, this disease went from killing and maiming millions (200-500 million in the 20th century alone), from helping to depopulate the Americas of their original populations, to an historical artifact. The history of the eradication of smallpox is generally pretty well-known. Most of us learned at some point about Jenner's discovery of smallpox vaccination and the eventual disappearance of the disease due to the efforts of the WHO…
Alternative medicine is very profitable. Herbs and supplements are a multi-billion dollar industry. The practice of primary care medicine is not terribly lucrative, and adding on some "integrative medicine" can turn that around. A primary care doc can significantly increase their income by selling supplements and offering unproven tests and treatments. These are not covered by insurance, so patients must pay cash---and who doesn't love cash? But how can you get your pigeons to fly in the door? The folks out there selling miracle cures and spreading the ideology to support them have some…
So I gave that talk yesterday at the Great Lakes Homeland Security Expo. It went better than I had expected, as the audience was willing to be interactive and ask tough questions. The audience was a mixed group of health care professionals, first responders, communications directors, and disaster planners. Most had facebook accounts, and many read blogs at least a few times a month. A few were familiar with twitter. I incorporated some of the ideas you folks sent my way, including issues of Twitter hashtag integrity, etc. Participants helped identify some interesting questions.…
Most mornings, I get up with my daughter, or more accurately, I wake her up. We have our little morning rituals---I turn on her lamp (or this time of the year, open her shade), pick her up and take her downstairs (something I might not be able to do for much longer). I turn on the TV and let her wake up slowly---she's not the morning person I am. Usually, there's a good deal of whining and moaning, stalling and kvetching. This morning, though, she was up and ready to go. Today, her family was coming to see her in a school play, and she had memorized her lines and just about everyone else'…
Many years ago, when fascist Jean-Marie Le Pen was riding a wave of racist sentiment in France, I was a young student out with friends on a perfect spring evening along the Seine. There was at that time always a vigorous national police presence in Paris. The CRS with their sub-machine guns were visible outside government buildings and patrolling the streets. Racism was a palpable presence in Paris. A popular deli, Jo Goldenberg's, had been bombed a few years earlier, and the nearby Holocaust museum had bullet holes in one of its glass walls. One time when I tried to order coffee at a…
I've been a bit busy lately and haven't been able to update you on some important developments in the field of imaginary diseases. Update 1: Chronic Lyme Disease So-called "chronic Lyme disease" (CLD) is a diverse constellation of symptoms which are often attributed to Lyme disease, but without objective evidence of infection with the organism that causes Lyme disease. Patient advocacy have been very active in insisting that reality conform to their beliefs, going so far as convincing the Connecticut Attorney General to investigate the Infectious Disease Society of America. As part of an…
Dana Ullman is an idiot. Or maybe insane. I'm not sure which, but his latest article at the Huffington Post reveals such a severe defect in rational thought that it must be one or the other (charitably speaking). He calls it "Lies, Damn Lies (sic), and Medical Research," and the point of it is quite clear: Ullman calls himself an "expert in homeopathic medicine" (which is akin to being a unicorn veterinarian) and since he has never been able to show that his particular health religion has any validity, he lashes out futilely at reality. His entire argument boils down to a profound…
I've never liked Gary Null. Early in my blogging "career" I wasted thousands of words expressing my incredulity at his horrible health advice, his paranoid rants, and his shameless hucksterism. Then I saw something shiny and forgot about him for a while. But now blog bud Orac has ruined my reverie. He informs me that Gary Null took a dose of his own medicine---and nearly died. As a compassionate human being, I can only hope he recovers quickly with no serious sequelae. As a physician, educator, and writer, I hope we can use this as an object lesson in the dangers of idiotic medical…
Thanks for all of your help since yesterday. Here's some of the data I've culled out from the first 24 hours: Blogpost visits: 654 Visitor sources:  24% of entrances to the post were from Greg Laden's blog. Feedburner (probably multiple sources): 165 facebook: 98 Retweets: 83 (probably) rationalwiki: 88 other