Saturday, December 11, 2004

Please allow me to introduce myself (yes, I know it's a cliche...)

I first discovered the blogosphere a few months ago during the height of the Presidential election. In a matter of weeks, I went from checking out a few blogs to having dozens of blogs bookmarked. (Thank heaven for tabbed browsing, which allows me to open a couple dozen sites at once, very quickly tab through them, and then read only the ones that interest me.) Over the last few months, I discovered the good, the bad, and the ugly of the blogosphere. After a while, I started thinking I could do this just as well as some people whose blogs I read. The question then became: Should I? After all, given the growth of blogging over the last couple of years, it's rather unlikely that I'd accumulate more than a few readers (besides family and friends), if any, unless something amazing happened AND I kept at it. No matter how fantastic your material is (and it's unknown whether mine will rise to that level), with more and more bloggers out there, it's harder and harder to get noticed. Also, as a surgeon and medical researcher, I had serious doubts that I'd have the time to devote to it to make it worthwhile for others to read. From my own experience, I've found that, unless someone posts to their blog at least once or twice a week, I quickly stop going there and ultimately remove it from my bookmarks. Can I post at least a couple of times a week for an extended period of time? We'll see.

One thing that makes me think I can do this reasonably well is my long experience on Usenet (and this is where I finally begin to tell you a bit about myself--if you haven't already left this page). I've been a regular on some Usenet newsgroups now since around 1997 or 1998. During that time, I've posted prodigiously almost every day, despite my busy schedule. It started back in 1997 or so, when I first discovered alt.revisionism. I had always been a bit of a WWII buff and had had an interest in the history of the Holocaust. When I first encountered that newsgroup, it was a bit of a shock to me to discover that there were people out there who denied that the Holocaust happened and used such denial as a means of rehabilitating fascism. I also discovered that my medical knowledge came in handy in debunking these lies and distortions. For example, there was one Holocaust denier who made ridiculous claims about how one could bring prisoners with diarrhea from dysentery back to health with a few days of milk, and debunking him was my entry into the world of debunking Usenet Holocaust denial. A couple of years later, I became interested in alternative medicine. Which treatments worked and which were quackery? What is the scientific evidence that exists to allow one to assign a particular "alternative" treatment to one category or the other. This lead me to misc.health.alternative, where I have been a regular since around 2001. Other areas of interest on Usenet have included debunking creationism and various paranormal stuff and various music groups.

If there is one overriding theme to my Usenet postings, I would say that it is skepticism. I don't mean that in a negative "debunking" sense (although there is certainly some of that), but in the best sense of the word. I want to see the evidence and weigh it against competing evidence before making up my mind. When an alternative medicine practitioner or advocate makes a claim that some herbal remedy will (for example) cure cancer, I want to see the evidence behind that statement. If they can show me compelling evidence, I will take their claim seriously. Unfortunately, it is almost never the case that they can. On the other hand, I myself have sometimes posted studies that suggest some alternative treatment or other may have some value. I treat the claims of Holocaust deniers and creationists similarly. Taking it to the political realm, I treat the claims of politicians in the same way. Skepticism doesn't mean not having an open mind. It just means having critical thinking skills and a keen bullshit detector. It means remembering that extraordinary claims require extraordinary evidence. All of this probably flows from my work as a cancer surgeon and almost NIH-funded researcher. It also probably contributed to my originally choosing my Usenet 'nym Orac (or here) and my favorites of Orac's many pithy lines: "A statement of fact cannot be insolent" and "I am not interested in trying to compensate for your amazing lack of observation." Because I'm not as nearly as arrogant as Orac, I chose the name Respectful Insolence for my blog because I hope to base my opinions and ramblings on facts, but to remain respectful of other viewpoints. Besides, it sounded kind of cool to me.

As far as my politics go, I suspect it will be hard to classify Respectful Insolence into a "conservative" or "liberal" blog. My tendency is to lean somewhat right of center, but that's not always a definitive description, particularly given what's considered "conservative" seems to have changed over the last few years and that I also have a bit of a libertarian streak. I've wanted to comment on these things, but such discussions on Usenet all too frequently degenerate into flamefests. At least here, I can respond to reasonable comments (if anyone actually wants to take the time to make any) and delete abusive, racist, or insulting comments.

But enough. Here are the topics I'll probably be commenting on most frequently:
  1. Medicine and surgery. Go with what you know, I always say. I know surgery and medicine, and this is a great forum for such discussions. One disclaimer: No one should EVER take my ramblings to represent medical advice except in the most general of terms. You should see your doctor or appropriate specialist for treatment recommendations. I never give specific medical advice without doing a complete history and physical examination. (Besides, how do you know I'm really a doctor?) This disclaimer will be repeated any time I make a comment on a medical issue that might be interpreted as offering advice.
  2. Biosciences. Again, go with what you know. This can also cover the politics of medical research.
  3. WWII history and Holocaust denial. I've been a WWII buff and debunking Holocaust denial for so long, why stop now? Besides, discussions of Holocaust denial segue nicely into discussions of freedom of speech, hate crime laws, and all sorts of other political issues. Check out the Holocaust History Project and Nizkor for a primer.
  4. Alternative medicine. I'll tell you what I think is quackery and what isn't (and why). No doubt my views will piss off a fair number of people, but my real hope is to inform and educate the five people who actually read this.
  5. Creationism and other pseudoscience. No doubt I'll manage to piss off anyone who wasn't pissed off by my comments on alternative medicine when I get to this topic.
  6. Politics. There are a lot of other bloggers who can do this better, but, hey, this is the Internet. Everyone can say what they like. Why should I miss out on the fun?
  7. Science fiction and fantasy. Because I love it. Too bad I don't have enough time to indulge in it much anymore.
  8. Music and movies. Because everyone wants to be a critic, and I'm no exception.
I've gone on with this introduction way longer than I had intended. Hopefully, if you're still reading to this point, you may check me out later to see what I have to say.

11 example(s) of insolence returned:


At 12/14/2004 1:27 AM, Blogger Steve Wolk said...

Dave, where do you get the time for this? It's cool.

 

At 12/14/2004 11:06 PM, Anonymous Anonymous said...

Hey, make it six people who actually read this!

-Ben the mathematician (applied)
(bjkeen {{{AT}}} mac.com)

 

At 12/15/2004 7:56 AM, Blogger Badaunt said...

Just in passing: if you're still bookmarking blogs, stop right now! Your bookmark folder will quickly become an unmanageable mess. Take advantage of the RSS feeds. You don't need to know what this means. (I don't.) Just go to Bloglines (http://www.bloglines.com/) or any of the other, er, blog managers (I don't know what they're called, and only mention Bloglines because that's what I use - I think yahoo have a similar service) and 'subscribe' to blogs instead. That way you can easily keep track without it all being on your computer. It's free, and it saves a lot of time.

 

At 2/13/2005 8:23 PM, Blogger MIchael Geddes said...

Hey Thanks for your posting people do read and now I have another page to help me with Blogging
Mike www.glycomike.info

 

At 4/03/2005 4:01 PM, Anonymous Heine said...

After a while, I started thinking I could do this just as well as some people whose blogs I read. The question then became: Should I?

Yes! Please continue your weblog; it's great reading material.

PS: Don't design for a specific browser. Just adhere to the WWW Consortium recommendations.

 

At 6/29/2005 4:35 PM, Anonymous daen said...

Ah, Blake's 7 ... I heard rumours of a remake a couple of years ago. Did that ever happen, I wonder?

 

At 6/30/2005 9:05 AM, Blogger Orac said...

Not that I'm aware of. I'm just looking for Blakes7 DVDs that are coded for the U.S. and Canada. There are plenty for Europe, but I don't think I can justify purchasing a multiregion DVD player just for them...

 

At 8/04/2005 6:39 PM, Anonymous Anonymous said...

I came across your blog in a happy accident. Now I have your blog-site bookmarked.

Considering that I don't know you and I'm not even related to you, it must really mean something when I say that I enjoyed reading your postings. You are a very engaging blogger. Keep up the good work. I hope you can stand the strain.

Count me a happy #8

calvind98362@msn.com

 

At 9/24/2005 3:05 PM, Anonymous Anonymous said...

Orac, are you a doctor or a pharmaceutical salesman or a parent of an autistic child or a government employee, or maybe you are just an idiot. Yes, the former seems to fit you best.

 

At 9/24/2005 4:50 PM, Blogger Orac said...

You realize, of course, that the "former" would be doctor, don't you? (It is the first thing you mentioned.) And, yes, you're correct. That's what I am, a doctor.

Have a nice day.

 

At 12/07/2005 12:53 PM, Anonymous Anonymous said...

As an anonymous chiropractor, I agree with a lot of what was said in the alt med section. However, using statments, etc. from the likes of Homola, Jarvis and Barrett and their quack watch group puts serious question to one's credibility. Just about everyone who has looked at their points of view, including the New Zealand government and many judges in legal situations, have concluded they (Barrett and Jarvis in particular) are not objective and skew the information to their benefit.

Yes, chiropractic has its faults:
1. Subluxation theory-junk science in my opinion and it's a term I never use unless a medical subluxation exists. I don't use the VSC malarky either.
2. Some of the schools need to get their act together. Unfortunately, they are run by subluxation gurus-mine was not. I hardly ever heard the word subluxation in 4 years.
3. Nervous system claims with regards to the internal organs are definitely hyped by the "subluxation" faction. An osteopathic Ph'd research did a lot of work on viscerosomatic and somatovisceral reflex information. However, claims by the profession on somatovisceral reflexes do not hold up to scientific validation.
4. Weak enforcement systems-we need better policing of what people are saying and doing. In my town, we have the president of the state association making claims on his website that are definite violations of the practice act and others that are purely misleading.

Several issues arise in my mind:
1. Chiropractic needs to continue to embrace scientific research.
2. It needs to abandon the subluxation and subluxation complex.
3. Medical acceptance and cross referral needs to be more prevalent. This is important for DCs like me who use primarily evidence based or best evidence available neuromusculoskeletal treatment and management without the hype. The subluxation guys are the high pressure and high marketing DCs. They do a better job at surviving because people listen to their well rehearsed scrips from practice management gurus. The average DC who doesn't do the hype is hard pressed to make a living.

The only way, however, the chiropractic profession will change is with acceptance by the medical profession of those (not necessarily the group supported by Barrett and Jarvis) DCs embracing conservative orthopedic and neurological management of patients and ultimately squeezing out the others. Podiatrists and Osteopaths have moved in the direction of accepting mainstream treatment protocols.

Another change needed is treatment protocols accepted by the profession. Right now you are likely to get anything from a standard manipulation to someone muscle testing you with substances in a vial (not touching) for the same problems. It confuses the hell out of the public as to what we do. The profession needs to put these techniques and claims on the research testing block and get rid of some of the bs. Such things as surrogate testing with vials not only escapes the rational mind but I am sure patients have to wonder what the hell they are doing.

A clear cut role needs to be cut out. Seveal options could be looked at including:
1. Hiring less foreign doctors and moving DCs into additional training to qualify them to practice within the mainstream medical model.
2. Expanding the DC scope of practice to include the use of limited pharmaceuticals-muscle relaxants, non-narcotic pain relievers, injections, etc. We are already doing this with nurses, pharmacists and physician assistants. This would require additonal training. It would also relieve medical doctors of non-surgical back pain treatment which most don't like doing anyway and expand the patient volume for DCs without all the hype. It may also open the pathway for better interaction between medical specialists and chiropractors treating neuromusculoskeletal problems.
3. Insurance parity for those doctors moving into mainstream medicine and abandoning the subluxation treatment mentality.

These are herectical comments; however, many of my colleagues feel the same way. Improve our tools, improve our acceptance, and squeeze out the fringe elements. Focus on the positive things the profession has to offer and work to get rid of the negative elements. The constant focus of the Barretts and Jarvis of the world is to focus on the fringe elements of every profession and make them look representative of the profession. Although no studies have been done, there are lot more out there that think as I do than one would surmise. Unfortunatley, they often get into the subluxation model just to survive.

 

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