medicine
oracknows | July 20, 2015And now for something completely different...but depressingly the same in some ways.
Longtime readers—and I do mean longtime—might remember from several years ago a certain case adjudicated before the Vaccine Court. I'm referring, of course, to the Autism Omnibus. In Autism Omnibus, some 4,800 claimants were bringing action seeking compensation for "vaccine injury" characterized by autism. Basically, it was a large number of parents who thought vaccines had caused their children's autism seeking compensation from the Vaccine Court, and they implicated the MMR and thimerosal-containing…
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 17, 2015Three weeks ago, I did a post about how prone the antivaccine movement is to conspiracy theories. At that time, one example that I used was the then-very recent death of an autism quack and antivaccinationist (but I repeat myself) who's been big in the "autism biomed" movement for a long time and a regular fixture at autism quackfests like Autism ONE for many years. I'm referring, of course, to Jeff Bradstreet, whose body was found in a river on June 19, dead from a gunshot wound to the chest that appeared to have been self-inflicted. It didn't take long (less than a week) for the antivaccine…
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 14, 2015Homeopathy is quackery.
There, I've said it for the hundredth or even thousandth time, but I don't care if it's repetitive because it can't be emphasized enough times that homeopathy is The One Quackery To Rule Them All, with the possible exception of reiki and other "energy therapies." I also find it useful to make it clear right where I'm coming from right off the bat. If you're a homeopath and are offended, quite frankly, I don't care. Any "medicine" whose very precepts break multiple laws of physics and chemistry, laws that wouuld have to be proven not just wrong but spectacularly wrong…
oracknows | July 14, 2015Ever since SB 277 became law, I didn't think I'd be writing about it much anymore. Actually, I probably won't be writing about it much any more, because it's now a done deal. It's the law of the land in California. Beginning in 2016, non-medical exemptions (i.e., religious exemptions and personal belief exemptions) to school vaccine mandates will go away. Only medical exemptions will be permitted, which is as it should be. Sure, implementation will be a big deal, and I'll probably have something to say about it as news of how it will happen filters out. However, right now, not much is going…
oracknows | July 13, 2015I sometimes catch flak for repeating this, but there was a time when I thought there might be something to acupuncture. I don't care, because, as a blogger, when I write a post I assume that a significant fraction of people reading it have never seen this blog before and therefore aren't even the least bit familiar with what I've written before on the subject. That makes them a blank slate, as far as this blog is concerned, and obliges me to explain everything. That time was about nine or ten years ago, and my rationale was, not surprisingly, that, unlike many other alternative medicine…
oracknows | July 10, 2015Naturopathy is a cornucopia of quackery with a patina of plausibility applied in the form of some seemingly reasonable recommendations about diet and exercise. Under the patina, however, lies virtually every form of quackery known to humankind. Be it homeopathy, traditional Chinese medicine, applied kinesiology, iridology, bogus diagnostic testing, reflexology, craniosacral therapy, or even organ repositioning (nonsurgical, I hasten to point out), no form of pseudoscientific medicine is rejected by naturopaths based on science. This is not surprising, given that naturopathy is based on…
oracknows | July 9, 2015As much as I write about the foibles, pseudoscience, and misadventures of cranks and quacks that endanger patients. However, never let it be said that I don't also pay attention to the foibles and misadventures of real doctors that endanger patients. Sometimes that occurs due to incompetence. Sometimes it's due to the persistent use of invasive modalities that have been shown not to work far longer than they should have been abandoned (e.g., vertebroplasty). Sometimes it's poor judgment. Of course, because I'm a surgeon, I tend to gravitate towards discussions of surgery when I leave my usual…
oracknows | July 7, 2015One of my favorite quotes from classic literature comes from Lewis Carroll's Through the Looking Glass, when Alice encounters a rather strange character named Humpty Dumpty. Humpty Dumpty, as you will likely recall, was a giant egg with whom Alice got into an argument about the meaning of words:
And only ONE for birthday presents, you know. There's glory for you!'
'I don't know what you mean by "glory,"' Alice said.
Humpty Dumpty smiled contemptuously. 'Of course you don't—till I tell you. I meant "there's a nice knock-down argument for you!"'
'But "glory" doesn't mean "a nice knock-down…
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, 2015Dammit.
I had planned on posting something else tomorrow that, because it had been posted elsewhere, would be minimal work. The reason, of course, is because it's the 4th of July weekend and today is a federal holiday. Unfortunately, sometimes things happen that I cannot ignore, even though all sorts of other bloggers are writing about the same thing, because, well, it's something that goes to the very core of what this blog stands for. As you know, one of the most frequently addressed topics (certainly in the top three, if not number one) is the antivaccine movement, its pseudoscience, and…
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 | July 2, 2015Sometimes, I think advocates of "integrative" medicine are trolling me. Of course, unlike antivaccine advocates, I realize it (usually) isn't about me at all and they're just writing what they believe and have (usually in the vast majority of cases) never encountered me and (usually in the vast majority of cases) aren't considering me at all. Even so, it's hard, when coming across an article like The Power of Integrative Medicine When All Else Fails by Emma M. Seppälä over on Psychology Today, not to think that I'm being trolled, so blatant are the alternative medicine propaganda and apologia…
oracknows | July 1, 2015My original intention was to write about something entirely different today, but, really, how could I, given that SB277 has become law in California and non-medical exemptions to school vaccine mandates are a thing of the past? The topic I had in mind for today can easily keep for a day or two anyway. Besides, what I want to contemplate now is how SB277 will work in practice. Sure, it's fun to watch the antivaccine fringe completely lose it as SB 277 got closer and closer to passing. Indeed, if you want to experience a combination of amusement and revulsion, just peruse the comments of this…
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 29, 2015The overarching goal that proponents of so-called "complementary and alternative medicine" (CAM) or, as is becoming the preferred term, "integrative" medicine is the mainstreaming of the "unconventional" treatments that fall under the rubric of these two terms. Indeed, that's the very reason why they so insisted on the shift from calling it CAM to calling it "integrative medicine." Not being content with the subsidiary status as not quite "real" medicine" that the words "complementary" and "alternative" imply, they want their woo to be seen as full co-equals with scientific medicine, hence…
oracknows | June 25, 2015About a year and a half ago, I began an intermittent series that I called How "They" View "Us." There are several posts in the series now. Basically, given the amount of nastiness directed at those of us who refute pseudoscience, in particular quackery and antivaccine pseudoscience, by those who believe in it, I tried to envision, quite literally, how "they" view "us." I even did a talk on the topic at the Science-Based Medicine workshop at The Amazing Meeting last year. Basically, I pointed out that we might think of ourselves on the side of right (and, let's face it, we are), the believers…
oracknows | June 24, 2015My opinion about medical marijuana has been fairly consistent. First, the claims made by its advocates for it far exceed the evidence for its benefit, which is why I've referred to it as the "new herbalism." Of course, it's not really very new, but it is herbalism in that medical marijuana advocates make grandiose claims for using their favorite "drug" in its plant form rather than doing the standard thing that modern medicine does with natural products and try to isolate the active compounds, in this case a class of molecules known as cannabinoids. Second, although medical marijuana might…