Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Happy Darwin and Lincoln Day 2019

 

Today we celebrate two 210th birthdays. Both stood up to right wing religious fanatics and were attacked for it. One was assassinated.

The first birthday boy is Abraham Lincoln, who might have been the most famous aggressively pro-civil rights, do gooder, Social Justice Warrior president – except that secession began before Lincoln even took office. The slave states were so afraid of what Lincoln might do that they didn’t even wait to find out. They didn’t use any valid legal means to try to win their case, but essentially stated, We’re leaving and we’re taking these parts of America, because we believe they belong to us and secession is 9/10ths of the law. We double dog dare you to enforce the law – and just to comply with the wording of the Constitution of the United States, we are going to open fire on the United States Army. The hurt themselves and the rest of America by promoting secessionists’ devotion to enslaving those not white and the secessionists’ adamant opposition to states’ rights. Yes, the secessionists’ claimed to be fighting for states’ rights, but liars lie.
 

Treason against the United States, shall consist only in levying war against them, or in adhering to their enemies, giving them aid and comfort. No person shall be convicted of treason unless on the testimony of two witnesses to the same overt act, or on confession in open court.

The Congress shall have power to declare the punishment of treason, but no attainder of treason shall work corruption of blood, or forfeiture except during the life of the person attainted.[1]

 

Ironically, those who seceded were Democrats, but the parties have flipped and the Republicans are now the anti-civil rights party.

The following statement is from Sen. Barry Goldwater, who was the 1964 Republican and Conservative candidate for president, but now would be rejected by the Conservatives and the Republicans.
 

Mark my word, if and when these preachers get control of the [Republican] party, and they’re sure trying to do so, it’s going to be a terrible damn problem. Frankly, these people frighten me. Politics and governing demand compromise. But these Christians believe they are acting in the name of God, so they can’t and won’t compromise. I know, I’ve tried to deal with them.[2]

 

Modern America has moved so far to the right, that Goldwater would probably be accused of being a socialist and a communist by various members of the right wing media. Sen. Goldwater also opposed government intrusion into the personal lives of LGBT people, because he was opposed to the big government that much of the right wing wants to use to force their lifestyle on everyone.

At that time, the right wing media being condemned by Sen. Goldwater was just beginning a resurgence. The ironically named Moral Majority was preaching its Christian sharia law to gather a lot of followers. Jerry Falwell, Sr. was their leader and Barry Goldwater condemned that earlier, less powerful, Falwell. His son, Jerry Falwell, Jr. seems to be able to tell our current president what to do, but a lot of people manipulate the president.
 

I think every good Christian ought to kick Falwell right in the ass.[3]

 

Since the Civil War, the propaganda machine of the secessionists has been more successful. They have been able to place statues of the traitors throughout the states they led in treason to show everyone that the secessionists still maintain power in spite of being defeated on the battlefield. Why don’t we have statues of Benedict Arnold?

We could celebrate Robert E. Lee for his opposition to secessionists after the war and for Lee’s unintentional(?) destruction of his cavalry at Gettysburg. Pickett’s Charge may have been the final straw for the Army Promoting Expansion of Slavery.

The second 210th birthday boy is Charles Darwin, who is remembered for explaining the diversity of life on Earth. Evolution explains the evidence showing the progression from the simplest life form to the current diversity of life – a diversity which appears to be decreasing due to our failure to value our children above our politics. Extinction is a part of that explanation. Extinction was once thought to be an argument against evolution, because it would violate God’s perfect plan, but eventually, extinction became undeniable, too. Oddly, people still deny biology. Evolution is so essential to biology, that Theodosius Dobzhansky wrote a paper titled, Nothing in Biology Makes Sense Except in the Light of Evolution.[4]

It is interesting that the science denial that affects biology, Creationism, is promoted most aggressively in the same slave states Bible Belt that fought against the United States of America in favor of treating diversity as a justification for violence.

It was science that helped the liberal Christians to convince the rest of America that slavery is wrong – something that much of the often less Christian rest of world already understood.
 

Book that Changed America - cover 1
 

As I wrote in 2017:

Darwin provided scientific evidence for a common origin, which gave a scientific argument to those criticizing slavery. How is it moral to enslave other humans? Well, the Bible repeatedly endorses slavery and Jesus never criticized slavery. Jesus actually used slavery as an analogy for belief in God, with believers as slaves and the slave owners as God.

Contrariwise, those who focused on the good parts of the Bible and avoided the bad parts, used Darwin’s book as the basis for advocating for a more moral approach to our fellow humans. Those who read the Bible differently from the advocates of slavery saw that they were not along. Science also opposed the moral abyss of slavery.

Not to spoil the ending, but the abolitionists were not successful at reasoning with those in the Bible Belt to end slavery in America. We ended up with over 600,000 Americans dead over different interpretations of the Bible on how to treat humans.[5]

The anti-science of Young Earth Creationism, the most basic form of Creationism, is the belief that the particular version of the God of that sect of believers literally just poofed itself into existence, then created life in its current diversity and that mutation can never produce a beneficial outcome.

For some bizarre reason, this God has organs of evolution. A true only one of its kind creature would not be male, nor would it be female, but the plot holes are numerous and demonstrate the impossibility of the story, when promoted as accurate. What other creature(s) God need sexual organs for? How did this God evolve them? Most Christians seem to view the two contradictory Creation stories in Genesis (Genesis 1 vs. Genesis 2) as metaphorical. How else do you defend something that dramatically changes when you turn to the next page? Hallucinogens? Hypoxia? Dementia? Metaphor – it is poetic, rather than literal. At least, that is the only reasonable approach.

Some Creationists take a shot at creating a middle approach. These not-so-literalists claim that microevolution is real, but macroevolution is impossible. These are real terms, but not the way the not-so-literalist Creationists use them.

These Creationists see that microevolution is undeniable, so they try to move the goalposts to try to protect their belief in Separate Creation.

Here is a further irony. These not-so-literalist Creationists claim that while they cannot deny that evolution happens on a small scale, they absolutely refuse to accept that it continues. Evolution is required to stop. Although they cannot provide any kind of evidence to support their claim and scientists provide plenty of evidence that evolution is not stopped, they continue to make this claim.

The irony gets even greater, because when you are dealing with apologists, the excuses will differ, thus the increasing disagreements among the dozens/hundreds/thousands of flavors of Creationism. Some of these micro yes, macro no Creationists claim that the restriction on evolution prevents the development of any new species, because they just can’t seem to understand that a lot of change can produce a dramatic difference. Other micro yes, macro no Creationists claim that this restriction prevents the evolution of any new genus. They claim that the story of the Ark saving 8 people from the murderous God of the Bible is the reason. This story is borrowed from the Babylonians, who taught the Israelites to write during the Babylonian captivity.[6]

Anyway, the story of the Ark mentions 19 Every beast, every creeping thing, and every fowl, and whatsoever creepeth upon the earth, after their kinds, went forth out of the ark.[7] This is a justification for being able to put billions of creatures on one supposedly seaworthy vessel. Not everything had evolved at the time, some evolved after their kinds after they disembarked. Two contradictions attacked with one excuse. Brilliant!

Some of the not-so-literalist Creationists accept that evolution is possible, as long as it does not produce a new species, because that would be too much. They insist that there must be an artificial limit on evolution.

Other not-so-literalist Creationists accept that evolution is possible, as long as it does not produce a new genus, because that would be too much. They insist that there must be an artificial limit on evolution.

Still other not-so-literalist Creationists accept that evolution is possible, as long as it does not produce a new family, because that would be too much. They insist that there must be an artificial limit on evolution.
 


Taxonomic Rank, from Wikipedia page
 

No matter what they have to invoke, all flavors of Creationist insist that there is some sort of artificial limit on evolution. Some Creationists insist that all evolution is prevented, while others accept varying amounts of evolution, rather than try to reject the overwhelming evidence.

We flawed humans must be explained, but their ambiguous creator must just be believed in all of its million different interpretations, and with all of its impossible contradictions – and all of the other Gods are just made up by people.

Footnotes:

[1] Constitution
Article III, Section 3
The Legal Information Institute
Article III

[2] Barry Goldwater
Wikiquote
 

Said in November 1994, as quoted in John Dean, Conservatives Without Conscience (2006).

 

[3] Barry Goldwater
Wikiquote
 

Said in July 1981 in response to Moral Majority founder Jerry Falwell’s opposition to the nomination of Sandra Day O’Connor to the Supreme Court, of which Falwell had said, “Every good Christian should be concerned.” as quoted in Ed Magnuson, “The Brethren’s First Sister,” Time Magazine, (July 20, 1981).
According to John Dean, Goldwater actually suggested that good Christians ought to kick Falwell in the “nuts”, but the news media “changed the anatomical reference.”
Dean, John (2008). Broken Government: How Republican Rule Destroyed the Legislative, Executive, and Judicial Branches. Penguin Group. “I know because I was there when he said it.”(2006).

 

A further irony is that there is nothing in the Bible that is even slightly critical of abortion, but the Bible thumpers lie about this. If you claim that Thou shalt not kill applies to abortion, you have to find someplace – any place where the Bible refers to abortion as killing. The Bible does not make that claim. The Christian sharia promoters make far more judgmental claims (judge not, lest ye be judged), because irony knows no bounds among fundamentalists.

The Bible states that life begins with the first breath. Genesis 2:7 and Job 33:4 and that a fetus is not a person Exodus 21:22. The Biblical literalists need to reinterpret the words to massage the meaning to be able to come up with something that allows them to claim their interpretation of their God agrees with them.

There is condemnation of divorce, by Jesus, but the religious right has chosen to vote for divorced leaders in order to get the political power that they want. Almost everything Jesus says in the Sermon on the Mount (Matthew 5-7) is a condemnation of the goals of the religious right in America today, but that is not the only place where Jesus condemns the religious right in America today.

Why do so many right wing Christians hate Jesus so much that they blaspheme Jesus?

If you want more information than provided above, read these:

The ‘biblical view’ that’s younger than the Happy Meal
February 18, 2012
Fred Clark
Article
 

In 1979, McDonald’s introduced the Happy Meal.

Sometime after that, it was decided that the Bible teaches that human life begins at conception.

 

and

The Not-So-Lofty Origins of the Evangelical Pro-Life Movement
February 5, 2013
Jonathan Dudley
Religion Dispatches
Article
 

Although evangelicals were mostly silent on abortion after Roe v. Wade, they were not silent on other political issues. Paul Weyrich, one of the evangelical right’s most influential founders, recalls that the movement initially emerged to defend racially segregated Christian schools from government intrusion:

 

Abortion was chosen as the rallying cry, because the religious right were losing ground defending segregation. Now abortion is the headline, while the religious right still work for segregation by more politically correct means.

[4] Nothing in Biology Makes Sense Except in the Light of Evolution
Theodosius Dobzhansky
The American Biology Teacher, Vol. 35, No. 3 (Mar., 1973)
Article in PDF format
 

I am a creationist and an evolutionist. Evolution is God’s, or Nature’s method of creation. Creation is not an event that happened in 4004 BC; it is a process that began some 10 billion years ago and is still under way.

 

Does the evolutionary doctrine clash with religious faith? It does not. It is a blunder to mistake the Holy Scriptures for elementary textbooks of astronomy, geology, biology, and anthropology. Only if symbols are construed to mean what they are not intended to mean can there arise imaginary, insoluble conflicts. As pointed out above, the blunder leads to blasphemy: the Creator is accused of systematic deceitfulness.

 

[5] The Book That Changed America: How Darwin’s Theory of Evolution Ignited a Nation
Randall Fuller

Read ‘The Book That Changed America’ for Darwin Day 2017
Sun, 12 Feb 2017
Rogue Medic
Article

and

Kirkus Review

and

January 24, 2017
Randy Dotinga
Christian Science Monitor
Review

[6] The Ark Before Noah: Decoding the Story of the Flood
Irving Finkel

Kirkus Review

and

How the ark changed shape
13 February, 2014
Will Gore
Catholic Herald
Article/Interview

Here is part of that interview with Irving Finkel from Catholic Herald:
 

We also discuss the negative reaction that his theories might provoke in some Christian quarters. He admits that those who tend towards a literalist reading of the Bible will never be persuaded of its links to the Babylonian era.

He hopes, though, that he is handling the topic sensitively. He is at pains to point out, for example, that, despite what some headlines have suggested, he is not claiming the Bible story to be wrong and that Noah’s Ark should be round. He has, he says, simply traced the origins of the story found in Genesis.

Finkel has resolved to make sure he maintains a sense of humour when dealing with critics. He’s obviously very content with the conclusions he has drawn. Behind that big beard it’s not hard to detect a smile as he says: “I can’t imagine somebody will find something that proves my ideas wrong, so if people reject them it doesn’t matter. People often reject things they don’t like and not necessarily on logical grounds. If I give a lecture and people throw vegetables, then so be it.”

 

Here is a video of a presentation by Irving Finkel.
 


 

[7] Genesis 8:19
King James Version
Verse at BibleHub in all versions

.

Anti-Vaccine Means Pro-Corruption

 

Can you be opposed to vaccines and not be supporting corruption? What does it mean to oppose vaccines?

Vaccines are probably the safest and most effective medical intervention available. Anti-vaxers oppose that.

Vaccines save millions of lives every year. Anti-vaxers oppose that.

If you disagree, provide valid evidence that anything else is as safe as vaccines and provide valid evidence that anything else is as effective as vaccines. There is the small possibility that I am wrong and that vaccines are only second, or maybe even third, among the safest and most effective medical interventions available.

But aren’t the anti-vaxers trying to protect children from unnecessary risk?

That is one of many anti-vaccine claims, but it is just another anti-vax lie.

Look at these heroes of the anti-vaccine propaganda industry. Mark and David Geier.

David Geier pretends to be a doctor, even though he never has been a doctor, or even been enrolled in a medical school.
 

As explained above, the Board concludes that David Geier practiced medicine in Maryland without being licensed by the Board to practice in violation of section 14-601 of the Health Occupations Article.[1]

 

Mark Geier did become a doctor, but the corruption of the anti-vax propaganda and treatment business led him to violate his responsibility to protect his patients. If you see Mark Geier working as a doctor, call the police.
 

Since 2011, Geier’s medical license has been suspended or revoked in every state in which he was licensed over concerns about his autism treatments and his misrepresentation of his credentials to the Maryland Board of Health, where he falsely claimed to be a board-certified geneticist and epidemiologist.[4] [2]

 

What is so bad about the Geiers and why do anti-vaxers continue to worship the Geiers?

Mark and David Geier castrate children with a chemical that has been approved for some medical uses, but definitely not to treat autism. The chemical has never been shown to be safe or even slightly effective for that purpose. If you think that autism is the worst thing ever – worse than smallpox, measles, polio, pertussis, et cetera, you may think that it is morally acceptable to torture children and to have faith in these quacks.
 


 

The fake doctor (David) is on the left and the revoked license doctor (Mark) is on the right.

But isn’t it an exaggeration to call this chemical castration.
 

Speaking about one teen he put on the drug, Mark Geier said: “I wasn’t worried about whether he would have children when he is 25 years old. If you want to call it a nasty name, call it chemical castration. If you want to call it something nice, say you are lowering testosterone.”[3]

 

For those who claim that this would be a short-term treatment, and the side effects would be minimized, that’s not the way quacks work – especially with paying customers. These are not reasonable people. Quacks will be expected to keep giving the magic treatment, possibly increasing the dose several times, until that treatment works, because they think that they know believe that it works. Reasonable people would be expected to stop never start this unapproved and dangerous treatment to begin with. Since the treatment does not work, and is expected to make the patients’ conditions worse, these people would not be expected to stop. As with other alternative medicine, treatment failures are blamed on the patient, or on the family. Quacks do not take responsibility for the incompetence of using chemicals that are dangerous and ineffective.

But what if it really does work?

Almost every proposed treatment, regardless of what it is, will be found to be more harmful than beneficial. Most are discarded long before they get to the point of being tested on actual humans. Poisoning patients, based on What if it works? is dangerous, unethical, and irresponsible.

If you have an autistic child, do not let the Geiers chemically castrate your child for fun and profit.

How do the same anti-vaxers, who claim that they are protecting their children from what is probably the safest and most effective medical intervention available, support this dangerous, unethical, and irresponsible treatment?

That is the way anti-vaxers think. Anti-vccine claims are arrogant rejections of competence, science, and reality. Protect your children from anti-vaxers.

Footnotes:

[1] In the matter of David A. Geier before the Maryland State Board of Physicians
Case Nos. 2008-0022 & 2009-0318
Maryland Department of Health
Final Decision and Order in PDF format.

[2] Mark Geier
Wikipedia
Article

[3] ‘Miracle drug’ called junk science
Trine Tsouderos
Tribune reporter
May 21, 2009
Article

.

Anti-Vax Doctors Lack Competence and Ethics

 
 

Effective July 27, 2018, the latest anti-vax doctor to have his license revoked will be Dr. Bob Sears. Yes, he promotes his image as Dr. Bob.

Who are the dangerous doctors Bob Sears will be joining?

Andrew Wakefield‘s fraudulent research, unnecessarily painful research on children, lack of ethical approval for research, and other corruption, convinced the British General Medical Council to revoke his license. Wakefield was also trying to sell a vaccine of his own, to compete with the MMR (polyvalent Measles, Mumps and Rubella) vaccine. Wakefield’s attempts to discredit the MMR vaccine would have helped him to sell his own competing vaccine.
 

the lawyers responsible for the MMR lawsuit had paid Wakefield personally more than £400,000, which he had not previously disclosed.[67] [1]

 

Andrew Wakefield claims that he is not a fraud and sues a lot of people.

All of the cases have been thrown out by the courts or have been withdrawn by Wakefield.[2]

Do those who claim to be trying to protect their children, by avoiding vaccines, based on a trust of this fraudulent doctor, know what Wakefield has done?

The kiddie castrators – David Geier and Mark Geier.

David Geier was never a doctor, but has been caught faking it.[3] In the make believe world of anti-vaxers, why let reality get in the way of pretending to have credibility?

Mark Geier was a doctor, but had his license revoked in every state where he had a license (Maryland, Washington, Virginia, California, Missouri, Illinois, and Hawaii). Why do the Geiers castrate children? Chemical castration is an approved treatment for some rare conditions. Mastectomy is an approved treatment for some breast cancers, but that does not mean that it is at all ethical, or competent, to recommend mastectomy as treatment for other medical conditions. The Geiers claim to believe that castration cures autism. There is no valid evidence to support their hunch.

Consider this. You have an autistic child and someone tells you there is a cure. The person says that they know their expensive chemicals work. The person may even say, I’ve seen it work.[4] All you have to do is give permission for this doctor (before his license was revoked), and his son the fake doctor, to use chemicals to castrate your child.

Do you ask for evidence?

Their is no valid evidence. You just have to trust the castrators and their excuses for the absence of evidence.

The “evidence” has been retracted, because the research is junk science. All human research has to be approved by an independent IRB (Institutional Review Board) to make sure that there are not any conflicts of interest or unnecessary risks to the children participating in the research. The members of the independent IRB were the Geiers, the Geier’s employees, and the Geier’s lawyer. That is not independent.

If chemical castration doesn’t work, the Geiers can sell you other expensive and dangerous treatments that do not work, such as chelation. Chelation is the use of chemicals to remove heavy metals from the body, based on the assumption that mercury causes autism. Chelation is harmful, so it is only indicated, when there is a good reason to believe the benefit will be greater than the harm. There is no valid evidence to support this hunch of the Geiers.

The motto of the company run by the Geiers is First do no harm. Are they completely unaware of the harm they cause, or so dishonest that they tell the boldest lies? Does it matter why they harm children?

What did Bob Sears do to get his license revoked? He claimed to assess patients, but did not keep records of what he claimed to do. His incompetence/negligence endangered patients.[5] ,[6]

For example, a mother frequently brought J.G., a 2 year old, to see Dr. Bob. One visit was for a head ache a couple of weeks after the child’s father hit the child on the head with a hammer. The only apparent concern of the mother and Dr. Bob was to prevent the child from receiving vaccines. There is no record of any neurological assessment, or referral to a competent doctor for a neurological assessment.

J.G. had visited Dr. Bob the previous month for constipation. Assessment and treatment plans were documented. Constipation can be very serious, but so can hitting a child on the head with a hammer. The reason for the difference in approaches was determined to be gross negligence. Another visit, following apparent resolution of otitis media following treatment with Omnicef (cefdinir), there was a diagnosis of a sudden onset of flu, with a prescription for Tamiflu (oseltamivir), so there is no apparent hesitation to use ineffective, or minimally effective, treatments. Is J.G.’s last name Munchausen, or is he just unlucky in his choice of parents?

Bob Sears does not appear to be hesitant to prescribe drugs based on hunches, but he does appear to recognize that being anti-vax can be very profitable. Sears has written 4 books, but still fails to document assessments.

Bob Sears will have to be monitored by another physician for 35 months, following this revocation, to be able to get his license reinstated. He must follow all laws, not be negligent, and not deviate from the standard of medical care. He cannot just take the 3 years off and write books, because he has to be monitored while working to get his license back.

It looks like Bob Sears will be vaccinating children, just as real doctors do.

Vaccines save millions of lives every year.

Vaccines are probably the safest and most effective medical intervention we have, and anti-vaxers hate that.

If some of us do not see the need for vaccines, it is because of the success of vaccines. Vaccines are an important part of the reason that the average life expectancy has doubled in a little over 100 years.

For a great review of the effect of vaccines on vaccine-preventable illnesses, there is a study in JAMA (Journal of the American Medical Association), which shows how the rate of each illness, and deaths from each illness, declined after the introduction of each vaccine. There are anti-vaxers who claim that it wasn’t the vaccines, but sanitation that stopped these illnesses. Don’t fall for that.[7]

Sanitation is important at preventing the spread of illnesses, but sanitation does not wait for each different vaccine to be introduced for each different vaccine-preventable illness to change the illness and fatality rates.

Look at the evidence.

Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States.
Roush SW, Murphy TV; Vaccine-Preventable Disease Table Working Group.
JAMA. 2007 Nov 14;298(18):2155-63.
PMID: 18000199

Free Full Text Article from JAMA.

Footnotes:

[1] Aftermath of initial controversy
Andrew Wakefield
Wikipedia
Article

The referenced article by Brian Deer is:

Huge sums paid to Andrew Wakefield
The Sunday Times
December 31 2006
Brian Deer
Article

Andrew Wakefield has repeatedly sued Brian Deer and lost or run away every time.

[2] Deer counter-response
Andrew Wakefield
Wikipedia
Article

[3] Medical licenses revoked
Mark Geier
Wikipedia
Article
 

In 2011, his son David Geier was charged by the Maryland State Board of Physicians with practicing as if a licensed physician when he only has a Bachelor of Arts degree in biology,[42] and was fined $10,000 in July 2012.[40]

 

Charges by the Maryland Medical Board
In the Matter of David A. Geier before the Maryland State Board of Physicians
Practicing without a license
PDF document of charges
 

The Respondent is not and never has been licensed to practice medicine or any other health profession in the State of Maryland or any other State.

 

[4] I’ve Seen It Work and Other Lies
Tue, 21 Jun 2011
Rogue Medic
Article

[5] Antivaccine pediatrician Dr. Bob Sears finally faces discipline from the Medical Board of California
Respectful Insolence
Orac
June 29, 2018
Article

[6] Stipulated Settlement and Disciplinary Order
Decision of the Medical Board of California
Department of Consumer Affairs
State of California
Case No. 800-2015-012268
OAH No. 2017100889
PDF of Decision

[7] “Vaccines didn’t save us” (a.k.a. “vaccines don’t work”): Intellectual dishonesty at its most naked
Science-Based Medicine
David Gorski
March 29, 2010
Article

.

Dr. Edward Tobinick Sues Barbara Streisand – or something equally foolish


Dr. Edward Tobinick might not be a quack, but his behavior suggest otherwise.
 

Having a medical degree does not mean not a quack.

Using FDA (Food and Drug Administration) approved drugs does not mean not a quack.

Having a medical web site that does not have the word “quantum” all over the place does not mean not a quack.

Threatening to sue people for writing about the lack of evidence for his treatments does not mean not a quack.
 

Dr. Edward Tobinick is suing Science-Based Medicine for writing about Dr. Edward Tobinick’s dubious medical practices.

That strongly suggests that Dr. Edward Tobinick is a quack.
 

The claims and practice of Dr. Tobinick have many of the red flags of a dubious medical practice, of the sort that we discuss regularly on SBM. It seems that Dr. Tobinick does not appreciate public criticism of his claims and practice,[1]

 

Essentially, what Dr. Edward Tobinick is saying is, Your valid criticism of the way I apparently take advantage of patients might discourage patients from shelling out money for my untested treatment.

or –

Your valid criticism of the way I apparently take advantage of patients might encourage patients to ask reasonable questions about my untested treatment – questions that I cannot honestly answer.
 

Etanercept might work, but so might steroids, or ribavarin, or eye of newt, or a kick in the groin.

All of these treatments are equally valid. Oddly, the patients receiving a kick in the groin will probably report the fewest symptoms after treatment. 90% of the kick in the groin patients claimed to be cured and not in need of any further treatment.

Without evidence, and with his opposition to evidence, Dr. Edward Tobinick is just a quack with a brainstorm. Nothing original there.
 

Dr. Edward Tobinick injects etanercept (Enbrel) around the spine. This is not something he covered in his dermatology residency, so has he injected etanercept into the spine yet?

Why etanercept? Etanercept is an immune suppression/anti-inflammation drug. Inflammation is a problem with everything, so preventing/reversing inflammation is the simplistic cure. If this worked in real people, and not just in the hypotheses of pathophysiologists, steroids would have cured everything decades ago.

Perhaps Dr. Edward Tobinick is imitating Dr. Michael Bracken, who is able to produce improved outcomes with steroids (anti-inflammation drugs) for spinal injury, but only when he is in charge of the data.[2]

At least Dr. Michael Bracken published some research to support his claims. Dr. Edward Tobinick just wants us to believe that his interpretation of pathophysiology is miraculously prescient.
 

Evidence? We ain’t got no evidence. We don’t need no evidence! I don’t have to show you any stinkin’ evidence!
 

Maybe Dr. Edward Tobinick does have some valid evidence.

Maybe Dr. Edward Tobinick is just hiding the valid evidence because it is proprietary. 😉

Here are a couple of comments by Dr. Novella on science and the importance of evidence. They probably were not directed specifically at Dr. Edward Tobinick, but they do apply to him.
 

What do you think science is? There’s nothing magical about science. It is simply a systematic way for carefully and thoroughly observing nature and using consistent logic to evaluate results. Which part of that exactly do you disagree with? Do you disagree with being thorough? Using careful observation? Being systematic? Or using consistent logic?

 

Science is the way we learn what works.

Dr. Edward Tobinick’s criticism is evidence that he does not understand science.

Is any treatment, that is not based on evidence, likely to provide a benefit to patients?
 

History is strewn with ideas that were intuitive and made sense at the time, but were also hopelessly wrong.

 
Alternative medicine, opposition to EBM (Evidence Based Medicine), and opposition to SBM (Science-Based Medicine) are all the same mistake – evidence denialism.

Evidence denialism is devotion to being hopelessly wrong and remaining ignorant of being wrong.
 

Barbara Streisand?[3]

Footnotes:

[1] Another Lawsuit To Suppress Legitimate Criticism – This Time SBM
Posted by Steven Novella
July 23, 2014
Science-Based Medicine
Article

[2] Cochrane and a Significantly Biased Review of Steroids for acute spinal cord injury
Fri, 25 May 2012
Rogue Medic
Article

[3] Streisand effect
Wikipedia
Article

Maybe there is no such thing as bad publicity for a quack, but the publicity associated with this law suit means that people will associate the name quack with Dr. Edward Tobinick, or vice versa.

Dr. Edward Tobinick is stating I am not a quack.

Reasonable people are hearing –

I, Dr. Edward Tobinick, am a quack.

.

Comment on ‘No More Comments on Popular Science’

 

In the comments to No More Comments on Popular Science is this from Duke Powell
 

Rogue Medic says Epinephrine is no good.

 

I have been critical of epinephrine because we are routinely giving epinephrine in cardiac arrest, but we do not have any evidence that epinephrine improves any outcome that matters. ROSC (Return Of Spontaneous Circulation) is not an outcome that matters. Epinephrine does improve ROSC, but there is no increase in people leaving the hospital with good brain function (the outcome that matters and surviving for more time is better). There is evidence of harm.[1] The evidence of harm is not great, but the evidence of benefit does not exist.
 


 

More ROSC, but fewer survivors. That is not a benefit.

I do not claim that epinephrine is good, bad, or neutral. I point out that there is probably a subset of cardiac arrest patients who do benefit from epinephrine, but we have no way of knowing who those patients are.

I describe the lack of evidence of benefit and explain that standards of care should be supported by valid evidence of improved outcomes.
 

He says backboards are no good.

 

There is also no valid evidence of improved outcomes with backboards for unstable spinal fractures.

Where is the evidence that using backboards on patients with unstable spinal fractures results in fewer disabled patients (the outcome that matters)? There is evidence of harm.[2] The evidence of harm is not great, but the evidence of benefit does not exist.
 


 

Rogue Medic disagrees about a lot of things that scientists have said are “best practices” for EMS.

 

Scientists?

What scientists?

I disagree with using treatments that are not based on valid science.

I disagree even more strongly with standards of care that are not based on valid science.

I am also very critical of bad science, even if the results agree with what I think is true.[3],[4]
 

In most instances this medic with over 40 years experience agrees with Mr Rogue Medic. Not because of the science, but because of my experience.

 

That is not a very good reason for disagreeing with standards of care. It is a good reason for asking questions of the people who would know about the evidence, but even a 40 year career is just a series of anecdotal experiences. What kind of control has been used to minimize the effects of bias?

What has been done to make sure that confirmation bias does not limit recollection to those anecdotes that support individual bias?
 

But disagree with him on global warming? He calls you a science denier and says you can’t think for yourself.

 

I described some of the reasons you appear to be a science denialist above. That is science denialism on the topic of EMS.

You would get the same responses to EMS science denialism if you understood climate change. There are people who are willing to agree with science when it agrees with their prejudices, but are science denialists when science does not confirm their prejudices.

The problem is with the people, not with science.

Science does not care about prejudices.

Science just tells us what is real.

Science is not perfect.

Because science is not perfect, it depends on confirmation by different methods and by replication (preferably more than once). And most of all, science depends on rigorous attempts at objectivity, because everyone has biases.

Science does not exist to confirm biases.
 

Fact of the matter is, I am thinking for myself in terms of climate change. I’m not the guy following the crowd. Just as you are not the guy following the crowd with EMS best practice.

 

I am the guy basing decisions on science.

You appear to be the guy claiming that science does not matter. You appear to be the guy basing decisions on politics.

It isn’t the decision that matters, but the way we get there. Political decisions should be made based on valid science, rather than denying science or trying to make science fit political goals.
 

BTW, make sure your furnace is working, things are about to get colder, starting tomorrow.

Ha!!

Now you are discussing weather.

You do not appear to know the difference between weather and climate, but you seem to think that you know enough to tell scientists that they are wrong.

Thank you for reinforcing my point.

Footnotes:

[1] Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest.
Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, Miyazaki S.
JAMA. 2012 Mar 21;307(11):1161-8. doi: 10.1001/jama.2012.294.
PMID: 22436956 [PubMed – indexed for MEDLINE]

Free Full Text from JAMA.

[2] Out-of-hospital spinal immobilization: its effect on neurologic injury.
Hauswald M, Ong G, Tandberg D, Omar Z.
Acad Emerg Med. 1998 Mar;5(3):214-9.
PMID: 9523928 [PubMed – indexed for MEDLINE]

Free Full Text from Academic Emergency Medicine.

[3] Prehospital Intravenous Fluid Administration is Associated With Higher Mortality in Trauma Patients – Part I, Part II, and Part III
Rogue Medic

02/20/2011
Part I

02/22/2011
Part II

03/01/2011
Part III

[4] Prehospital Intravenous Fluid Administration is Associated With Higher Mortality in Trauma Patients: A National Trauma Data Bank Analysis.
Haut ER, Kalish BT, Cotton BA, Efron DT, Haider AH, Stevens KA, Kieninger AN, Cornwell EE 3rd, Chang DC.
Ann Surg. 2010 Dec 20. [Epub ahead of print]
PMID: 21178760 [PubMed – as supplied by publisher]

Full Text in PDF format from www.medicalscg

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No More Comments on Popular Science


 

Why use Rush Limbaugh and his liberal twin, Michael Moore, as examples?

Because these two are irresponsible in their presentation of information and they have a lot of gullible followers.

Rush Limbaugh is actually known for followers who are too ignorant to have thoughts of their own. They call themselves ditto heads.

Popular Science is eliminating comments from their stories, because there is so much nonsense in the comment section that it detracts from the science reporting.[1]

Limbaugh is whining that the scientifically illiterate will be deprived of their ability to throw anti-science tantrums on this science site.

People with more spare time than sense are being told that their ignorance is not as good as a scientist’s education. The horror. The horror.

Am I exaggerating?
 

Let me tell you: This is Popular Science cutting off comments because of a “politically motivated, decades-long war on expertise.”[2]

 

Don’t have your vehicle fixed by an expert (mechanic), since expertise is bad.

Don’t have your illness treated by an expert (physician), since expertise is bad.

Should Jenny McCarthy and her University of Google followers be treated as if they know what they are doing?
 

[youtube]uDYba0m6ztE[/youtube]
 

When it comes to science, is Jenny McCarthy any different from Rush Limbaugh?

Climate change denialists (people who pretend that reality is not real) have been insisting that the planet is not warming because the yearly temperature does not move in a straight line and they seem to think in the most simple terms.
 


 

The data (green) are the average of the NASA GISS, NOAA NCDC, and HadCRUT4 monthly global surface temperature anomaly datasets from January 1970 through November 2012, with linear trends for the short time periods Jan 1970 to Oct 1977, Apr 1977 to Dec 1986, Sep 1987 to Nov 1996, Jun 1997 to Dec 2002, and Nov 2002 to Nov 2012 (blue), and also showing the far more reliable linear trend for the full time period (red).[3]

 

If we were treating a septic patient, should we rejoice that his peripheral temperature (skin, arms, legs) is coming down?

Should we assume that the patient is getting better by cherry picking data that appears to support what we want to happen?

An expert (physician) should ignore the predictable anomaly and realize that the core temperature is what matters.

Should the septic patient be treated according to science, or should we make treatment about politics?
 

cranks tend not to mind the crankery of others, since they see themselves as opposed to a scientific orthodoxy. Consistency be damned, they just want to see science with egg on its face so they can prove that they are being persecuted.[4]

 

Rush Limbaugh, Michael Moore, Jenny McCarthy, . . . are cranks. They do not understand science and cannot tell the difference between nonsense and science.

Climate change is not politics. Ways of dealing with climate change will involve politics.

Persuading people that climate change is politics is one way of avoiding science and claiming that any ignorant criticism is as valid as understanding science.

Climate change is science.

Science is not politics.

Science denialism is politics.

Footnotes:

[1] Why We’re Shutting Off Our Comments – Starting today, PopularScience.com will no longer accept comments on new articles. Here’s why.
Popular Science
By Suzanne LaBarre
Posted 09.24.2013 at 8:15 am
Article

[2] Popular Science Ends Reader Comments Because Too Many People Disagree with Them
The Rush Limbaugh Show
Quick Hits Page
Link to Quick Hits Page – there does not appear to be any link to the actual article by Limbaugh.

[3] The Escalator
Skeptical Science
Article

[4] Crank Magnetism
Denialism Blog
Posted by Mark Hoofnagle
June 28, 2007
Article

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Informed Consent and Vaccines

 

Oregon is changing its policy for vaccine exemptions, but only by requiring parents to be informed about the risks they are dealing with.

Vaccines are not 100% effective and doctors do not pretend that vaccines are 100% effective, but anti-vaccine propagandists claim that nobody is endangered when they do not vaccinate their children.

That claim is a lie.

There will always be some people for whom the vaccine is not effective. These children are endangered by unvaccinated children transmitting vaccine-preventable diseases.

There will always be people who cannot get vaccinated for medical reasons. Cancer patients are just one example of a large group of people endangered by unvaccinated children transmitting vaccine-preventable diseases.
 

Proponents point to the current 6.4 percent of Oregon kindergartners whose parents exempted them on religious grounds from at least one vaccination this year — the highest rate in the nation and one that has increased steadily over the past decade.[1]

 
 

Image credit. Click on images to make them larger.
 


 

This is measles, but the same is true of other vaccine-preventable diseases. They have been increasing since Andrew Wakefield tried to discredit the MMR vaccine in order to sell his own competing vaccine.

Vaccine-preventable diseases are not good for children.

Opponents of the bill claim that this is discrimination against religious people because the exemption waiver states that the child is not vaccinating for religious reasons.

This is also a lie.

While the waiver does state that it is for religious reasons, the anti-vaccine propagandists have encouraged their followers to claim that they have religious objections. This does nothing to prevent parents with religious reasons for refusing vaccination for their children from continuing to refuse vaccination for their children.

There is no current requirement that parents know anything about vaccines before preventing their children from being vaccinated. this bill would require that they receive accurate information from an online video or receive information from a doctor before preventing their children from being vaccinated.

Parents will still have the option of receiving inaccurate information about vaccines from the few anti-vaccine doctors out there, like Dr. Jay Gordon,[2] an anti-vaccine propagandist. They will still be able to have their biases reinforced by an anti-vaccine doctor. Yes, the terms anti-vaccine and doctor do indicate a lack of understanding of medicine.
 

Sen. Doug Whitsett of Klamath Falls said he personally believes vaccination is “the right thing to do.”

But “who are we to tell the parents of children that they must vaccinate … their children? Where do we get that right?” he asked.[1]

 

That is suggesting that the bill would force vaccination, which is not true, but why should we expect truth from politicians?

Informed consent is the standard of care and this bill is attempting to present parents with accurate information, rather than the misinformation that anti-vaccine groups use to try to scare parents.

Parents are only trying to do what is best for their children.

We should be helping them to make good decisions based on information that is true.
 

A similar law implemented in Washington state in 2011 reduced by 25 percent the rate of kindergartners with at least one religious exemption from immunization, officials said.[1]

 

We are faced with a return of diseases that killed children at the beginning of the last century, but were almost completely eliminated near the end of the century. These diseases are coming back and killing children again, due to the actions of anti-vaccine propagandists.

This is a simple action to help parents protect their children from vaccine-preventable diseases.

Footnotes:

[1] Vaccine opt-out change advances – Senators vote to require parents who don’t want a child vaccinated to get a science lesson first
By Saul Hubbard
The Register-Guard
Published: 12:00 A.M., June 7
Article

[2] Dr. Jay Gordon’s profound misunderstanding of science
Respectful Insolence
Posted by Orac on February 18, 2011
Respectful Insolence
Article

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We cater to the most stupid people out of fear of . . . whatever

 

What do I mean by stupid?

This is an excellent example of stupid.
 

Florida country radio morning-show hosts Val St. John and Scott Fish are currently serving indefinite suspensions and possibly worse over a successful April Fools’ Day prank. They told their listeners that “dihydrogen monoxide” was coming out of the taps throughout the Fort Myers area.[1]

 

dihydrogen monoxide?
 

Terrifying.

di = Two
hydrogen = H
mono = One
oxide = O

Two Hs and One O.

We can rearrange these into the familiar chemical expression of H2O.

Danger! There is H2 in the drinking water!

I hope so. Water is not water, if there is no H2O.

So, some people were worried and called the water company. The water company should have stated –

Dihydrogen monoxide is just water.

Today is April Fools’ Day.

You have been fooled.

Have a laugh at yourself and get on with your day.

But no.

That would have been too reasonable.

This was the response – and threats of felony charges.
 


Click on images to make them larger.
 

Don’t tell people that there is dihydrogen monoxide in the water! Tell them that the reported problem is just a prank, but do not use the opportunity to educate people about what you sell them.

Feed their ignorance.
 

the two hosts could face felony charges for, again, reporting that the scientific name of water was coming out of the pipes. “My understanding is it is a felony to call in a false water quality issue,” Diane Holm, a public information officer for Lee County, told WTSP, while Renda stood firm about his deejays: “They will have to deal with the circumstances.”[1]

 

There is water in the water. – That is not a false water quality issue unless you are an idiot.

There are idiots making threatening to bring felony charges to try to deflect attention from the stupidity of the idiots. – That is a real water quality issue.
 

 
This is dihydrogen monoxide –
 


 

 

 

 
This is water –
 


 

 

 
Do you understand the difference?

What we call it has nothing to do with what it is.

Water is dihydrogen monoxide is H2O.

Water has also probably had every deadly disease in it for as long as there has been water. People, and other animals defecate in that water. The water company cleans the water that they provide to us.

The result is that tap water is almost always much cleaner than the bottled water you buy in a store.

We also fluoridate water in many places. fluoride protects teeth. The result is that the water is healthier with fluoride than without fluoride.

Some people make the mistake of thinking that a complicated name means that something is dangerous.

Or they think that a chemical is more dangerous than something that is natural.

Or they think that something man made is more dangerous than something that is natural.

That is not just wrong, it is Jenny McCarthy wrong, it is Creationist wrong, it is climate change denialist wrong, it is homeopathy wrong, it is just plain stupid, but too many of us are afraid to tell stupid people to stop spreading their stupidity, because we think that is not nice.

By that niceness, we lower ourselves to their level of stupidity.
 

How many scientists support Jenny McCarthy’s anti-vaccine conspiracy theories? Only a handful – and they seem to make money off of it.

How many scientists support Creationism’s anti-evolution conspiracy theories? Only a handful – and they seem to make money off of it.

How many scientists support climate change denialists’ conspiracy theories? Only a handful – and they seem to make money off of it.

How many scientists support homeopathy’s anti-medicine conspiracy theories? Only a handful – and they seem to make money off of it.
 

We give these con men equal time out of some distorted sense of balance between reality and their even more distorted misunderstanding of reality. Maybe these nuts should go hug a unicorn and leave sensible people alone.

Stupidity is not a virtue.

The cure is education, not denialism.

 


 

I do not know the origin of the Deadly Facts About Water poster. If you know, please send me the link and I will give credit. This poster is great.

Footnotes:

[1] Florida DJs May Face Felony for April Fools’ Water Joke Worse Than Rubio’s
By Alexander Abad-Santos
April 2, 2013
The Atlantic Wire
Article
 

Update, Wednesday: St. John and Fish were back on the air Wednesday, and officials with the local health department tell The Atlantic Wire that felony charges are not expected.

 

Maybe somebody did point out that criminal charges would be stupid and open them up to ridicule, but I had already written this when that update was posted.

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