The Carnival of Bad History

Speaking of blog carnivals, the Carnival of Bad History has been posted at Science and Politics. It's a lot like the Skeptics' Circle, only it concentrates on history and how people distort, mangle, and misuse it.

Grand Rounds XXXVI

Grand Rounds XXXVI has been posted at Dr. Sanity. Time again to check out the best of the medical blogosphere, complete with art from the great Leonardo da Vinci.

A blog possessed: How vaccine blogging has taken over

Blogging is odd and fascinating. Sometimes it leads you in directions you never anticipated or intended--and, when it does, it can do so with astonishing speed, sometimes taking you by total surprise. One day, you're blogging about one set of topics, and then a day later you suddenly find your blog dominated by a topic that you neither intended nor foresaw. For example, about one week ago, a reader sent me a link to a post on the Huffington Post that was pushing the usual anti-vaccination rhetoric I hear from activists. That e-mail led me to investigate further and find at least five posts with anti-vaccination rhetoric in the short history of the Huffington Post. Because the Ninth Skeptics' Circle was coming up and I wanted to provide my blog buddy St. Nate (the founder of the Skeptics' Circle) with some good material, I decided to write a rather lengthy post rebutting most of the fallacies in those five articles. I barely finished it in time to submit to the Circle, but finish it I did. I posted it last Wednesday and submitted it to the Skeptics' Circle just under the wire for the deadline.

And, suddenly, I'm an autism blogger.

Since then, I've ended up on an e-mail list from Neurodiversity.com, because of a link I posted to an online petition of theirs. (I don't mind; that's partially what this post is going to be about.) I've also ended up writing more about this issue, being cited by Skeptico and having my posts referenced and posted in the comments section of another anti-vaccination piece on the Huffington Post (something I should have done, but I hadn't realized that this particular article allowed comments, unlike previous ones).

We'll see what happens, but I never intended for this subject to take over Respectful Insolence the way it did. I just thought it would be an interesting piece to submit to the Skeptics' Circle on a subject I knew a bit about. I don't plan on making it a major theme of this blog, when someone like Autism Diva can do it better, but I can't resist one last entry into the fray.

One thing that came up during all this was the question: What's wrong with anti-vaccination activists pushing a link between thimerosal and autism? After all, thimerosal has been removed from all early childhood vaccines other than the flu vaccine (which is not a standard vaccine that is given to all children). If the anti-vaxers were right, we'll soon see the epidemiological link over the next few years, right? Ditto if they're wrong. And it is true, as I pointed out. Indeed, Dr. Gordon and I agree on this; we just don't agree on what the following 5-10 years are likely to show with regard to the epidemiology of such a link. In the meantime, is it such a bad thing to get the mercury out of vaccines?

There's nothing wrong per se (although it probably increased the cost of vaccination for in essence no benefit and left a nice fat juicy opening for the trial lawyers to imply that the fact that the government and vaccine manufacturers have succumbed to activist pressure to remove thimerosal from vaccines proves a link), but there's a price for this removal of thimerosal that anti-vaxers don't like to acknowledge. First, postulating the link when the evidence supporting it was very weak to nonexistent frightened parents, making them unjustifiably suspicious of vaccination and therefore less likely to have their children vaccinated (or, at the very least more resistant to it). Second, suggesting such a link on very weak evidence inflamed the guilt of existing parents, who were told in effect that it was at least partially their fault for their children's autism because they vaccinated their children as advised. Third, the postulating of a probably nonexistent link between mercury and autism opened the doors to the chelation therapy quacks, who use the ineffective treatment of chelation therapy to "remove the mercury" and supposedly "cure" the child of autism, a therapy that is unfortunately spoken of approvingly by some elements of the mainstream media, such as Paul Harvey last Thursday (and that formed the basis of many of the abstracts at the Autism One quackfest in Chicago this weekend). Even if mercury is found to be a major contributor to autism as the epidemiologic evidence comes in over the next five to ten years, it is already known that chelation therapy does not improve autism.

However, there is one more consequence, as pointed out in this open letter to David Kirby, the author of the recent book favorably reporting on those postulating a link between mercury and autism, Evidence of Harm. I got this open letter from the Neurodiversity.com mailing list, and its contents shocked me. The letter tells of a coarsening of the debate through anti-vaccination zealotry, as demonstrated by the advertising campaign for Mr. Kirby's book and the dialog on the message boards on Mr. Kirby's website. An excerpt from the open letter:

I have read many online newsgroup posts (including posts to the EOH list) written by parents of autistic children who do not describe witnessing any specific reaction at the time that shots were administered to their children, but who have become convinced of the vaccine hypothesis due to the publicity efforts of vaccine litigants. These parents are now consumed with guilt that their good-faith decision to vaccinate their children might have had damaging consequences, and rage at those individuals whom they presume misled them and inflicted damage upon their children, whether that guilt and rage are warranted or not.

It is also a legal strategy undertaken with little regard for the potential long-term, stigma-perpetuating impact upon those autistic people and their family members who are not inclined to believe that all autistics are poisoned. I have observed numerous instances in which vocal proponents of the autism=poisoning hypothesis have displayed outright contempt for anyone who might have come to their own conclusions about their and their family members' lives, and I will cite many of these instances in this letter.

For example, here is a comment by Lujene Clark, responding to Kevin Leitch, a British father of an autistic child; she and other EOH list members descended en masse upon Mr. Leitch after a blog entry he had written was mentioned on the list (http://www.kevinleitch.co.uk/wp/?p=146, EOH message 1014):

"...if you remain in denial you don't have to extend yourself or take responsibility to heal your child because it is so much easier to blame 'bad genes' and accept your child's fate. Or worse, try to get your child to accept his "genetic" fate. That is a COP-OUT. Your child deserves better. Get off your lazy bum and start to heal the biomedical problems of your child!!"

When Mr. Leitch stated that he recognized autistic traits in members of his extended family, Mrs. Clark replied,

"it seems apparent from reading your reply there is a history of serious psychiatric illness in your family. My apologies, I would not have attempted to engage in rational discussion had I known you were affected."

Now, this is quite a toxic attitude to have towards disability, towards evidence of the genetic transmission of devalued characteristics, and towards parents who think for themselves.

Indeed it is, and sadly there are several other examples in the letter of nastiness engendered by Mr. Kirby's book and other sources loudly touting a mercury-autism link. It is likely that Mr. Kirby does not support such viciousness, but we don't know for sure because he does not appear to have condemned it. He may not even know of it. Hopefully, this open letter will inform him of what is going on based on his book and provide an impetus for him to condemn such attacks. In any case, this toxic rhetoric towards parents who have the burden of caring for an autistic child reminds me of some of the rhetoric that another bunch of zealots, animal rights activists, sometimes heap upon people who have benefited from animal research. Such a stigmatizing attitude would be bad enough to subject the parents of autistic children to even if the science justified a link between thimerosal and autism. It is utterly inexcusable when the science does not support such a link. Most anti-vaccination activists don't behave this way, but the hysteria engendered by them emboldens the minority who do. When one is utterly certain that one has The Answer, it then starts to make a sort of sense to conclude that parents who do not subscribe to that "answer" and therefore do not treat their children accordingly are either deluded, careless, or even bad parents doing harm to their children and that they therefore deserve contempt. Parents with autistic children have enough problems; they don't need this one added on top of the difficulties they have to deal with every day raising their children.

Takin' care of business

Over the Memorial Day weekend, I tried to do a little spring cleaning on my sidebar. I found some dead links and either removed them or fixed them. I also added a few new blogs and websites, and removed several others that I no longer regularly browsed, as well as a few blogs that hadn't been updated in a long time. The "Essential Orac" section was reorganized, with some posts added and a few others removed. Finally, some new Chicklets were added to the sidebar make subscribing feeds of Respectful Insolence in My Yahoo!, My MSN, and Newsgator easier. Overall, the sidebar should be somewhat shorter, more concise, and (hopefully) better organized.

Over the summer I'll continue fiddling with it until I get it to where I want it to be--at least until I finally decide whether to ditch Blogger for something else or not.

Memorial Day

Today is Memorial Day. It is the day set aside to remember those who have died fighting for our nation in its wars. I was debating about what to post today, when I remembered that, two and a half weeks ago, I happened to be in Bethesda for a conference sponsored by the NIH. Because of my interest in World War II history and because I had a few hours hadn't seen the new World War II Memorial before (which had been dedicated on Memorial Day weekend last year), I decided to take the Metro into Washington and check it out before heading home. As regular readers of this blog know, sometimes I succumb to the temptation to engage in some photoblogging. Today it seems appropriate to post some of the pictures I took of the monument.

From accounts in the press and opposition to the choice of a location for the monument, I had had my doubts about the design, but I have to say that seeing it up close and personal, in the context of all the other monuments in the area and with the nearby Reflecting Pool, I was impressed and moved. Fears that critics voiced that the monument would ruin the sight lines between the Lincoln Memorial and the Washington Monument were unfounded. Lining paths leading to the fountains in the center are a number of bas-relief panels by sculptor Ray Kaskey, and the overall effect was serene. My one disappointment was that some of the pools without fountains appeared rather stagnant, with algae. You'd think they could take better care of the monument, which is only a year old.

The photos (click for larger versions, and go here for more):

Overall, this seemed to me a fitting memorial to the hundreds of thousands who died in World War II. On this Memorial Day, between the trips to the beach and the barbecues, let us remember the soldiers who have fought and died in all of our wars.

For more, go here.

A sign of the times

In Britain, a cell phone ringtone--"Crazy Frog Axel F," a ring tone based on the sound of a revving Swedish mo-ped--has become a #1 hit, outselling the new single by Coldplay by a four-to-one ratio. Coldplay is reportedly bummed, having hoped to go straight to #1 with their single, "Speed of Sound."

Expect to see more of this, although not among us old farts.

This is so wrong

Apparently, someone thinks it's a good idea to sell a thong for your cellphone...

I'm sorry, but I just don't understand. I can understand the utility of some device or other to hang a phone from, but why on earth make it look like a thong?

(Via Gizmodo)

More antivaccination puffery on The Huffington Post

A few days ago, I posted a long piece about how antivaccination fallacies are being given wide distribution on the new group celebrity blog, The Huffington Post. I then posted an addendum mentioning for the sake of fairness that at least The Huffington Post allowed one expert to post a rebuttal. Well, as expected, it didn't take long for Dr. Jay Gordon to post his response to the rebuttal. As with his other pieces, it's a relatively content-free post, in which once again Dr. Gordon makes dire insinuations that those who don't believe that the objective evidence supports the contention that mercury in vaccines causes autism are shills for the pharmaceutical industry:

The American Academy of Pediatrics (of which I have been a member for a quarter century) has a very cozy relationship with the vaccine industry. Most authors and speakers in the vaccine controversy have been paid consultants to the vaccine industry. Most of these researchers still accept funds while commenting on the issues.

OK, Dr. Gordon, so you think that the American Academy of Pediatrics is biased because of a "cozy" relationship with the vaccine industry? If that's so, then why has the AAP come out for removing thimerosal from vaccines--as you yourself pointed out, "adamantly" for it. (I'd have to guess that it's mainly it's because of activists like you, not because of the experimental evidence for a link, which has always been very weak at best and is becoming weaker and weaker with each new study. Apparently, the AAP's "cozy" relationship with the pharmaceutical industry didn't stop it from recommending this.) I'd also turn Dr. Gordon's insinuation around and ask him if he's ever accepted funds from any groups advocating that thimerosal in vaccines is a major cause of autism. If he has, then perhaps he would explain to me why his "accepting funds while commenting on the issues" himself" is any different from other doctors doing the same.

But what about researchers on the "other" side of the issue. In Dr. Gordon's view, apparently it's not good for one's objectivity to have a financial interest in one side of the issue. Fair enough; most people would probably agree that a researcher shouldn't have a strong financial interest in one side of a question. (Leave aside for the moment that most scientists who don't have a financial interest in vaccines also have concluded that there is no link between thimerosal in vaccines and autism and not just in this country.) Given that, why, then, does it not seem to bother Dr. Gordon in the least that David Geier and Dr. Mark Geier, whose research he once again singles out to cite approvingly and both of whom make a significant part of their livings providing legal counsel and consulting and expert witness services to parents pursuing legal action for alleged "injuries" due to vaccination? Doesn't that count as a financial conflict of interest? Yet Dr. Gordon thinks their research is "excellent." Or why doesn't it bother him that their work has been criticized for sloppiness and methodological flaws and they've been rebuked for risking patient confidentiality while mining the CDC's database.

Oh, wait. I get it. The Geiers are not in the pockets of the pharmaceutical industry (pharmceutical industry: always bad). They're in the pockets of trial lawyers and antivaccination activists (antivaccination activists: always good). They're on the "right" side; so Dr. Gordon appears willing to overlook their blatant conflict of interest, while at the same time making vague insinuations of a conflict of interest against by claiming that most researchers in the field accept funding from pharmaceutical companies that manufacture vaccines.

It looks as though Dr. Gordon is going to be a regular at The Huffington Post. Unfortunately, that means he'll have a huge platform for pushing his antivaccination misinformation. That means he'll also probably be occasionally providing me with ideas for this blog for some time to come. But I'd give up all that material in an instant if he's stop making exaggerated claims for a link between thimerosal and autism that almost certainly doesn't exist.

I echo the Mad House Madman

A few days ago, the Mad House Madman asked what ever happened to CodeBlueBlog, creator of CSI:Medblogs. I had been wondering the same thing myself, as the blog hadn't been updated since April 20. It used to be one of my favorites and was one of the first I encountered shortly after discovering the medical blogosphere. True, CodeBlue would wander into a bit of conspiracy-mongering from time to time (his posts on Bill Clinton's recent surgery, for example), but CodeBlueBlog was always a good read. (Indeed, I had been meaning to comment on his posts on Mammographic Serfdom for some time now, but somehow never got around to it.) Of course, looking at CodeBlueBlog now, the depressing thing is that, even though the blog hasn't been updated in five or six weeks, he's still averaging only slightly fewer than the same number of hits per day than I do, down from around six times my average in March. Talk about deflating my ego! CodeBlue can leave his blog alone and it takes six weeks for its hit count to fall below mine, which is updated nearly every day, sometimes even three or four times a day.

Oh, well.

However, CodeBlue's mysterious extended absence did get me to thinking about what, if any, obligation a blogger may have to his or her audience if he or she has to discontinue the blog or go on extended hiatus. Consequently, I've come up with a few policies for my blog:

1. I will post an announcement if I plan on not posting for more than a few days, whether due to vacation, obligations of work (usually impending grant deadlines), or whatever. (Of course, on vacations, if I have Internet access, I will still probably post intermittently every few days. I just can't help myself.)
   
2. I will also include in such announcements the date (or an estimate of the date) that regular posting will resume.
3. If, for whatever reason, I ever decide to discontinue this blog or to go on an extended hiatus (longer than a couple of weeks, which is about the longest I'm ever off for a vacation or would ever need for grant crunchtime), I will announce it and provide an explanation.
   
4. If I go more than a week without posting and don't post an announcement, either bad things have happened to my computer or bad things have happened to me.

I wonder if Dr. Charles ever found out what happened to CodeBlue. Perhaps I'll e-mail him myself...

Needlestick

Alan, a.k.a. Gruntdoc, my favorite ER doc blogger, has an interesting post today regarding getting a needlestick injury. As he points out, it's an occupational hazard of being a doctor, although some specialties (emergency medicine and procedure-oriented specialties like surgery) have a much higher risk than others (psychiatry, radiation oncology, non-interventionalist radiologists, for example). I can totally sympathize with his first thoughts:

The first thought that flew into my mind: "Crap! I'm better than that." Really, I was terrifically disappointed in myself, and angry I'd made the rookie mistake of not watching the needle in my hand. I handle needles for a living, and they never get me, they get the patient, as intended. That's how it's Supposed To Be.

Indeed.

Needlesticks are almost inevitable if you're a surgeon. All you can do is to try to take every precaution and keep them to a minimum. However, sooner or later, it will happen. Gruntdoc's post took me back to the worst blood exposure incident I ever suffered, one that still haunts me to this day. Fortunately, given that it was 11 years ago and I've had multiple negative hepatitis B and HIV tests since then, I know I'm no worse for it. I was the senior resident on the trauma service, and a man had come in after a fall from a balcony of about 25-30 feet. He had multiple broken ribs, severe head trauma, and a fractured pelvis. It's unclear what he was doing there or what led to the fall, but he did reek of alcohol. In any case, we had done a diagnostic peritoneal lavage to rule out intraabdominal bleeding (these days, we would have done a quick ultrasound or even spiral CT), and we were working on him, getting ready to take him for a head CT. Over about five minutes, his blood pressure fell to zero and we were unable to get a pulse. It was clear that he was going down. It was decided by the trauma attending that we would do a bedside thoracotomy. Now, for blunt trauma (as opposed to penetrating trauma like gunshot wounds or stabbings), the success rate for bedside/ER thoracotomies is very close to zero, which is why we generally don't do them anymore for blunt trauma. When a patient with extensive blunt trauma loses his vital signs, that's usually all she wrote. It's rare to be able to bring him back, no matter what you do. In retrospect, therefore, it probably wasn't the correct thing to do, as it had such an incredibly small chance of making any difference in this man's outcome. But the attending was new and wanted to "do everything." An older, more experienced attending almost certainly would have simply coded the patient for a while and, if there were no immediate response to our interventions, called the code.

So, I got ready to do the procedure with the intern, and the intern asked if he could do the incision. Fool that I was (this was not one of our more stellar interns, to say the least) or in the heat of the moment, I said yes. And so it began.

The intern made the skin incision, and then, while I was repositioning a retractor, telling him to hold on a second to let me get better exposure, he ignored me and carried the incision deeper--right across the side of my index finger.

I was stunned. I stared at the slice in my glove, the cleanly severed latex edges flapping to reveal the cleanly severed skin beneath. Blood was pooling within the finger of the glove, darkening my finger and slowly leaking out of the gash to mingle with the patient's blood already there. After a couple of seconds, I regained my composure enough to utter a few choice profanities at the clueless intern and throwing him out of the procedure. (Crap! I'm better than that. I should have kept a better eye on the intern--especially this intern. Or I never should have let him do this in the first place!) I quickly regained my composure and continued the futile procedure. When the attending saw what happened, he gloved and gowned up to take over, allowing me to run off to wash out the incision. It was pretty deep, but fortunately, as far as I could tell, not deep enough to damage any nerves or tendons. Sensation distal to the injury was intact, and there were no deficits in my ability to move my finger that might indicate an injury to a tendon. While I was doing that, our attending finally bowed before reality and called the code.

I was royally pissed at the intern, who in his hurry hadn't listened. (Lest you think I was being unduly hard on him, the main reason this intern was not one of our more stellar interns was his recurrent and obnoxious inability or refusal to listen and follow instructions.) I was also really furious at myself, as I should have known better than to let this clown near a knife in an emergency situation. But I was scared too. Even though the odds of getting infected from a single blood exposure incident are very small, I still couldn't help but see visions of my young life being snuffed out prematurely and in a most unpleasant fashion, all because of a stupid mistake. Making the fear level higher, the patient didn't look like the most reputable character in the world, and we later found out that he had a history of polysubstance abuse. I ended up getting a shot of gamma globulin, and sweating it out. Fortunately, much to my relief, his HIV and hepatitis B tests turned out negative (and I found out that I still had a strong antibody titer for hepatitis B from my previous vaccine, anyway). Six months later, my repeat HIV test remained negative, and, in the 11 years since then, I haven't developed hepatitis (there were no tests for hepatitis C back then).

Since then, I've had a couple of more needlestick incidents, despite my best efforts. One of them happened while I was, of all things, aspirating a breast cyst in a nice little old lady. Ironically, in my opinion, the "safety" needles that are used in our hospital now are so cumbersome that I honestly believe they make it more likely I will accidentally stick myself. Ditto the "safety scalpels" (which I've dubbed "Playskool knives"), but that may be a topic for another post. Fortunately, it's been around four or five years since I last had a needlestick incident, and I hope to extend that streak to the rest of my career.

I was going to come up with a pithy ending to the description of this incident, but Gruntdoc summed it up better than what I can come up with right now:

Mortality sucks. Mortality through stupidity would be unforgivable, for me, and I resolve to not make any more stupid mistakes.

I couldn't have said it better myself. If I could, I would have.

The Cult of Apple revisited

Heh. But at least our cult is a force for good...

Oh my...

It's stupid stuff like this that gives me migraines:

It boggles the mind. Repeat after me, people: "Evolution is not incompatible with Christianity." Fortunately, the way I learned of this was through Right Thoughts, yet more evidence that not all conservatives buy into the rejection of science that all too many fundamentalists and "intelligent design" creationism apologists are pushing. Unfortunately, it is the fundamentalists who have taken over the Republican Party, and it doesn't look as though they're going to be ousted any time soon. Their anti-science viewpoint is one of the reasons I no longer identify myself as a Republican.

The Carnival of Comedy #5

The Carnival of Comedy #5 has been posted at IMAO. It's a nice bit of light-hearted reading to get you in the mood for the long weekend.

Nice resource on the scientific evaluation of alternative medicine

Professor Thomas J. Wheeler, of the Department of Biochemistry and Molecular Biology at the University of Louisville School of Medicine, has made the classroom handouts and reading lists for his course, A Scientific Look at Alternative Medicine, available online. It's a nice resource for anyone interested in a critical look at alt-med claims, and I can only give Paul at Confessions of a Quackbuster his well-deserved props for having found it.

I wish more medical schools and universities would offer courses like this, and hopefully Professor Wheeler will expand on this resource in the future.

The introduction to his course gives a nice summary of the characteristics of alt-med claims (some of which I've annotated with my own comments in parentheses):

SOME CHARACTERISTICS OF PSEUDOSCIENTIFIC HEALTH CLAIMS

• Nonfalsifiable or irrefutable hypotheses. (This is almost essential to not just quackery but pseudoscience in general, like "intelligent design" creationism.)
• Attribute failure to reproduce results to: (1) Failure to perform procedures properly; (2) bias; (3) incorrect attitude. (This is one that I hear again and again in misc.health.alternative. Alties will claim that scientists are biased, that they approach the idea with a "skeptical" attitude--which in my book is entirely appropriate. Scientists should approach such claims with a skeptical attitude.)
• Unwilling to examine the phenomena closely with carefully controlled experiments. (This one is common in all pseudoscience as well. It's particularly common for paranormal phenomenon, but devotees of several altie techniques, like "psychic surgery" or many of the traditional Chinese medicine techniques that rely on Qi, which is basically an vaguely defined "life force" also fall under this rubric, as do quacks like Hulda Clark. How on earth does one measure quantitatively Qi, by the way?)
• Reliance on anecdotal evidence, or on data from flawed studies (poor controls, insufficient sample size, etc.). (This is a big one. Alties will use testimonials to sell their product or berry pick very small studies that seem to show an effect and ignore all the others that do not, as chelationists frequently do.)
• Anecdotal evidence can be very persuasive - especially if it concerns yourself. (True, although in most cases, even the anecdotes are questionable, based on insufficient diagnostic testing, insufficient followup, and neglecting the contribution of previous conventional medical treatments. Often the reason the anecdotes seem convincing because most people do not understand the disease for which the testimonial is being given.)
• Argument from authority rather than evidence - endorsements by doctors, panels, etc. (There's not necessarily anything inherently wrong with arguing from authority if the authority is truly an authority and if the evidence supports it. However, the "authorities" these guys argue from are usually highly questionable at best.)
• Selection of only supportive data, or deletion or changing of unfavorable data. (A favorite. However, in fairness, I will point out that, unfortunately, scientists aren't always above selection of only supportive data to make their case. Other scientists will usually call them on it, though. However, unlike the case with alties, scientists who are caught deleting or changing unfavorable data will suffer severe consequences in their career, their ability to be published, and their ability to obtain funding to support their research. Not so with alties.)
  
• Confuses correlation with causality. (Chapters of books have been written on this. Repeat after me, everyone, "Correlation does not necessarily mean causality. The antivaccination zealots who claim mercury in vaccines causes autism are prime examples of this pseudoscientific fallacy.)
• "Special pleading" - less stringent rules of evidence should be applied to its claims. (I've seen this one before. Typical is the claim by some alties that there are "different ways of understanding" or "different ways of knowing" other than science. Of course, these "different ways" are almost always less stringent and biased in favor of the "alternative" treatment being discussed. It makes me want to barf when I hear this one.)
• Claim to be too busy healing patients to pursue verification through research. (A great excuse if you can get away with it. I wish I could use this one four years from now, the next time I have to renew my grant. Oh, I'm sorry, Dr. Study Section Director, I was too busy taking care of patients to pursue the research. Somehow I doubt they'd be very sympathetic. This excuse is a cop-out used by alties who are clearly not interested in proving or disproving their claims using empiric evidence.)
• Lack of acceptable confirmation of diagnosis before treatment and/or proper followup to confirm healing. (Another big one. When you see "hair analysis" or "live blood cell analysis" used to diagnose cancer or other medical conditions and then to "monitor" response to treatment and "prove" that it's been cured by altie treatments, you're definitely dealing with a quack." Another example is Hulda Clark's "Syncrometer," which purports to diagnose the presence of toxic compounds by changes in skin resistance.)
• Subjective evaluations or measurements. (See above.)
• Use of pseudomedical jargon: "detoxify," "rejuvenate," "energy," etc. - entities which cannot be measured. (Another favorite pseudomedical piece of jargon among alties is "strengthens the immune system." How many times have you heard the claim that some altie therapy or other "strengthens the immune system"? More times than you can count? Me too. Too bad it's a meaningless claim, as they never get specific. For example, does the therapy improve T-cell function? What is the evidence that it does? Does it improve antibody response? You'll never get a specific answer with evidence to back it up.)
• Proposes a single underlying cause for diverse diseases or conditions. (Hulda Clark is guilty of this in her Cure for All Diseases claims, in which she attributes all cancer to an intestinal fluke. Another example is the Gerson therapy, which attributes all cancer to a deficiency in pancreatic enzymes.)
• Supported through myth and legend: if idea has been around so long, must contain some truth. (Traditional Chinese medicine is a prime example of this. Yes, a few of the herbs they use have medicinal value, but that does not mean the whole package is correct. As for the claim that the fact that an idea has been around a long time must mean it contains some truth, consider this: For thousands of years, people thought that the earth was flat and then, after scientists realized that it wasn't, for hundreds of years after that people believed that the sun revolved around the earth. Just because an idea has been accepted a long time does not necessarily mean it is true.)
• Charge opponents with being close-minded. (See The Galileo Gambit, by yours truly.)
• Charge persecution of unorthodox and revolutionary ideas: "They laughed at..." (See The Galileo Gambit again, by yours truly.)
• Appeals to vanity of patients: "think for yourself." (Indeed. What's the matter with you? Are you going to let doctors and so-called "experts" tell you how to think? Well, are you?... That's sarcasm, by the way.)
• Exaggerated or false advertising claims. (Just listen to infomercials and many radio commercials to see this one.)
• Bogus credentials of practitioners (e.g., degrees from unaccredited institutions). (There are too many examples of this to list.)
• Use of secret formulas. (If they won't tell you what's in it, be very suspicious about putting it into your body.)
  

The above are a very good primer on the warning signs of pseudoscientific quackery. I'm going to download all his course notes and check them over. I recommend that you do too.

It never ends

After all this autism/mercury/chelation blogging, what do I hear on the radio five minutes ago as I was typing away on grant reports in my office? Paul Harvey giving a credulous glowing report from parents who claim that chelation therapy "cures" autism!

Arrrrrggghhhhh!

Sorry. I had to take two minutes to vent. Back to work...

(You know, it occurs to me that I probably just revealed what an old fart I'm becoming that I regularly listen to a radio station that broadcasts Paul Harvey's reports...)

Give me that old time skepticism!

After seven editions away, the Skeptics' Circle has come home to its founder's blog, and St. Nate has brought it back to its roots, which, in this case, is a good thing. Consequently, the Ninth Edition of the Skeptics' Circle is filled with great skeptical blogging that would do the Amazing Randi proud. Check it out.

And look for the next edition to appear at Skeptico two weeks from now. Be sure to show Richard some love and send him examples of your best skeptical blogging to rrockley AT pacbell DOT net.

More vaccine blogging

As you can see by scrolling down this page, I posted a rather lengthy article yesterday about anti-vaccination "skepticism" on The Huffington Post. Coincidentally, Skeptico also posted a nice article on the very same day about Mercury in vaccines and chelation therapy. Through this article, I found a rather interesting blog, Autism Diva. It's a lovely counterpoint to most of the stuff on the Internet about autism in that it approaches the subject from a skeptical viewpoint and doesn't push all sorts of unproven altie therapies for autism. There's one post on the blog that gives an idea how much pseudoscientific quackery like chelation therapy for autism can cost the unfortunate parents of autistic children and another nice withering piece about the uselessness of chelation therapy for autism:

Autism Diva believes the whole chelation "cult" appears to be in some kind of trance wherein everyone agrees that chelation cures the kids, any improvement they make is always attributed to chelation. If it is a cultlike atmosphere, ones who don't see improvement will be afraid or too ashamed to speak up and say it isn't working for fear of being marked as apostates. Everyone in the "cult" sees the emperor fully clothed.

Amen.

She also has a nicely snarky piece on the Autism One conference in Chicago (which starts today), which features talks claiming that fermented foods can cure autism and that you can use "vibrational medicine" to treat autism, among other claims. The fact that David Kirby, author of Evidence of Harm, is the keynote speaker probably should tell you all you need to know about this conference. If that's not enough, Mark and David Geier are featured speakers, as is Dr. Andrew Wakefield, the investigator whose study claiming to find a link between MMR and autism was renounced by 10 its other co-authors as not showing any such link. If that doesn't convince you, then look at the list of abstracts. There are a couple of abstracts that look as though they might be legitimate science, but the vast majority do not. There's a whole lot of abstracts on mercury causing autism, treating autism with zinc, lowering your "toxic load" (a favorite altie term), etc.

I'm going to add the Autism Diva to my blogroll this weekend when I do a little spring cleaning of the list this holiday weekend.

Forgot about this one yesterday

Reported in the New York Times, eighty years ago today.

John T. Scopes, young Dayton (Tenn.) high school teacher, tonight stands indicted for having taught the theory of evolution to students attending his science classes in violation of a law passed by the Tennessee Legislature and signed by the Governor on March 21, 1925.

The indictment was issued on May 25, 1925. (Via RPM at Evolgen.) Note that the Scopes Monkey Trial did not begin until July 10. Expect the science blogosphere to erupt around the time the 80th anniversary of the trial this summer. Certainly, I plan on commenting on it.

You'd think that eighty years later this wouldn't still be an issue, but you'd be wrong, unfortunately. Look around at how Kansas or Georgia debate the teaching of evolution, and you'd hardly know that eighty years have passed.

Rubinstein keeps digging, apparently

Via my Sitemeter logs, I've discovered a blogger named Jody, who has carried out an e-mail correspondence with Professor William D Rubinstein, the history professor who wrote a really badly argued article criticizing evolution, chock full of "intelligent design" creationism canards. He's the same Professor Rubinstein that I lambasted, resulting in an invitation to comment by a blogger named J. Bowen, who had written in essence, a defense of Professor Rubinstein and other evolution "skeptics," which was similarly full of intelligent design canards (although Mr. Bowen does deny being a creationist). Mr. Bowen feels I was unfair with him and that I had used a straw man when calling him a creationist. All I can say in reply is: If Mr. Bowen is truly "not a creationist," as he claims, then I hope that readers knowledgeable about ID fallacies will forgive me for my thinking he is, given that he used some classic ID apologist techniques to "debunk" evolution. If he's not a creationist, he certainly knows how to imitate one almost flawlessly.

But I digress. All I really wanted to say in this post was that Jody's account of his e-mail exchange with Rubinstein gave me a chuckle, and I think it will give you one too.

Antivaccination rhetoric running rampant on the Huffington Post

A couple of weeks ago, Arianna Huffington introduced into the blogosphere with great fanfare a new group blog, The Huffington Post, which was going to be populated by various pundits and celebrities who would blog. To me so far it looks like just a standard political punditry website with a bunch of periodic articles by different people. (Heck, the website doesn't seem to allow comments or Trackbacks.)

So far, I'm not impressed.

Indeed, during its 16 days of existence, Huffington's group blog appears to have already become a repository for anti-vaccination propaganda based on the usual pseudoscientific and fallacious arguments that most antivaccination zealots use. (Tip o' the hat to "chaperonin60," who pointed this out to me.) I've already counted at least five posts "questioning" the efficacy of vaccination or postulating a (probably nonexistent) link between thimerosal in vaccines and autism. They come from three writers. First, there is an article by Janet Grilo, an autism advocate on the Cure Autism Now advocacy group. It's hard to criticize this article that much, because Ms. Grilo is the mother of a child with autism. However, her article blames her son's condition on thimerosal-containing vaccines and mentions "studies" that supposedly prove a link (without actually directly citing any of the studies). As much as I sympathize with parents of autistic children, I also realize that their desperation to do anything to help their child can make them prone to believe all sorts of questionable science and quackery that offer them a cause for their child's plight and a hope that the child might get better. Indeed, autism is one of the most common diseases that quacks prey on, mainly because it has no effective treatment and is so devastating to the child and family. Quacks will offer all sorts of ineffective treatments, particularly chelation therapy (and here), bilking the parents for sometimes as much as hundreds of thousands of dollars. The Institute of Medicine has examined the evidence and affirmed the safety of vaccinations twice, in 2001 and 2004, but that doesn't deter the quacks pushing chelation therapy for autism. Indeed, it feeds their conspiracy mongering, allowing them to claim that the government is prematurely trying to "dismiss" or "suppress" the "real story," and that is to the harm of children with autism and their parents.

Next up in the queue are two articles (and here) by David Kirby, the author of Evidence of Harm. The first one is brief and more or less a plug for a movie, plus a bunch of "questions." The second one is a rant against the CDC, which Kirby accuses of withholding data. He also makes dark unsubstantiated accusations that the CDC covered up data showing a link, approvingly referring to a study by Dr. Mark Geier and David Geier that purports to have found a link between thimerosal and autism using the CDC's own data set. I'm not sure which study he is referring to, but I'm guessing that it is a 2003 study that was rife with methodological errors and inadequate description of statistical methods. Kirby also neglects to mention that Dr. Geier has been a consultant and expert witness in many cases presented to the National Vaccine Injury Compensation Program and that he has also been deemed unqualified to be an expert witness in several cases. David A. Geier, his son, is president of MedCon, a medical–legal consulting firm that helps vaccine injury claimants to obtain money from both the National Vaccine Injury Compensation Program and through civil litigation. Kirby also neglects to mention that, in their zeal to find a link between thimerosal and autism, the Geiers have engaged in data collection irregularities, drawing a rebuke from the CDC and suspension of Dr. Geier's IRB approval from Kaiser-Permanente. Odd that Kirby didn't mention this. Perhaps he thinks this is all part of a nefarious plot by the CDC to discredit the Geiers. Or perhaps he doesn't see anything the least bit questionable about the Geiers' data collection irregularities or their clear conflict of interest in making their livings consulting for and representing parents bringing litigation against the NVICP and thus sees no reason to mention it. Who knows? Of course, anti-vaxers frequently dismiss studies that fail to find a link between mercury in vaccines and autism by pointing out when the investigators have ties to industry. In contrast, they seem blithely unconcerned when two of the leading advocates of a link happen to make their living off of parents trying to get compensation from the NVICP, which is the only reason I mention the Geiers' activities in the legal realm. What's good for the goose is good for the gander.

Personally, though, I'd prefer to get back to the data. Consequently, I'd ask Kirby a few questions of my own, based on known evidence: First, if thimerosal is indeed the cause of the increase in the incidence of autism observed over the last 25 years, as he clearly seems to believe, then why is it that autism rates are still rising, even though thimerosal has been removed from virtually all early childhood vaccines, as shown by a Danish study (also here)? Remember, this is years after thimerosal was ordered removed from childhood vaccines in Denmark in 1992 (vaccines were completely free of thimerosal in that country by 1995)? Similar observations have been reported in California (and here), although there are those who point out that earlier diagnosis of and expanded diagnosis criteria for autism accounts for the majority of the increase. In this country, thimerosal was removed from most vaccines in 2000 and none of the required early childhood vaccines have had thimerosal in them since 2002-2003. Few children under four have received a thimerosal-containing vaccine, and even those that did have received far less thimerosal than older children. However, even correcting for better diagnosis and the broadening of diagnostic criteria (which have definitely contributed the lion's share to increase in the apparent number of new cases of autism), autism rates are probably still rising, just not nearly at the rate that the anti-vaxers claim. In any case, if mercury in vaccines really does act as some sort of environmental "trigger" for autism, wouldn't we expect rates to have started to fall precipitously by now (particularly in Denmark, where it's been 10 years since there was thimerosal in any of its vaccines) or at least leveled off, given the usual age range children show the first symptoms? Second, I'd ask him if, as he seems to believe, a major part of the pathogenesis of autism is mercury from vaccines, then why is it that autistic children do not demonstrate the known symptoms of mercury toxicity, which include visual disturbances, unsteady gait, slurred speech, and numbness in the digits? Third, why is it that no increase in the blood level of mercury to above safe levels is observed in infants who have received thimerosal-containing vaccines and that much of the mercury is rapidly eliminated in the feces? Finally, why is it that there is no correlation between the dose of mercury received and the incidence and/or severity of autism observed? All of these are pretty significant pieces of data casting doubt on a mercury-autism link.

Unfortunately, the most disappointing two articles of the bunch come from a physician, Dr. Jay Gordon, who posted the first anti-vaccination article a week ago under the title Parents' Right to Choose and then followed it up with another piece entitled Vaccines and Autism: Answers. Although he is clearly not a full-fledged anti-vaxer, Dr. Gordon's website suggests that he is bordering on being altie and maybe even an HIV/AIDS denialist, given that he seems to buy at least partially into the idea that anti-HIV drugs contribute to AIDS and lists a number of "alternative" methods to "strengthen the immune system" (a favorite altie all-purpose "treatment strategy") of AIDS patients. I'll give him some credit that at least he does give his patients most of the recommended vaccines, but in many places in his website he expresses "skepticism" over the safety of vaccines and emphasizes again and again how few cases of the diseases being vaccinated against there are (forgetting, perhaps, the concept of herd immunity and how mobile people throughout the world have become). Unfortunately, though, even though he claims to "rebut" antivaccination activists, he seems to buy at least partially into a standard anti-vaccination line that the mercury in the thimerosal preservative of some vaccines causes autism:

Very few experts agree with the only partially proven hypothesis that vaccines have contributed to the huge increase in autism and related disorders. Vaccines remain a public health triumph but still worry many parents. They worry me, too.

The "only partially proven hypothesis that vaccines have contributed to the huge increase in autism and related disorders"? How about the unproven hypothesis that vaccines have contributed to the huge increase in autism? That would have been more accurate. I'd have given Dr. Gordon the benefit of the doubt based on the contents of his website, which, while a bit on the altie side, is not totally off the wall, if he hadn't hit me with this statement in his other article in the Huffington Post:

The “triggers” to this huge increase (from 1 case/5000 in 1980 to 1/166 in 2005) undoubtedly include mercury. Mercury from vaccines is a very likely culprit and the most recent studies support this. Conflicting analyses do exist. Most of the doctors and researchers involved in denying that vaccines cause autism are recipients of large sums -— millions of dollars in some cases -— from the vaccine industry.

Oh, my.

Dr. Gordon, I had hoped you wouldn't invoke the usual conspiracy theory mongering that anti-vaxers love. I really had, as your website, flaky as some of its contents are, is fairly unremarkable in its medical advice about other areas and downright reasonable in comparison to many of the loony anti-vaxer websites I have had the misfortune of encountering. However, when I see someone so quick to intimate that those who disagree with their beliefs are, in essence, shills for some corporation or other, I know I'm reading someone who is probably well along the path to the Dark Side, even if he has not yet arrived there. To such people, anyone who questions their assertions regarding vaccines must be in the pocket of the pharmaceutical industry. There can be no other explanation. Surely they couldn't have come to their conclusions through science and their own research, at least not according to alties. Other than well-documented examples like the Geiers, I don't automatically assume that researchers who believe there is a link between thimerosal and autism have a financial interest in finding out that there is such a link, and I try hard to evaluate each study on its own merits. (I may or may not succeed, but I try.)

Worse, through the link in his article, Dr. Gordon invokes Professor Boyd Haley, Chairman of the Department of Chemistry at the University of Kentucky, who has become the darling of the anti-vaccination movement and has even gone so far as to refer to autism and ADHD as "mad child disease." This insensitive remark provoked a petition demanding an apology, which Dr. Haley has refused to do, claiming he had said "M.A.D. child" disease (for Mercury-Acquired Disease of children--an extremely insensitive and tasteless acronym even if you take Dr. Boyd at his word that the acronym was the meaning that he had originally intended when he made the statement). He is also an advocate for dental amalgam removal, a favorite altie stalking horse for practically every chronic disease humans suffer from, particularly fibromyalgia and autoimmune diseases. Indeed, he is Chair of the Advisory Committee for Toxic Teeth, an anti-amalgam group. Even worse, an educated layperson has been able to show many of the fallacies of Dr. Haley's claims, particularly the oft-repeated anti-vax claim that vaccines contain 50-100 times the FDA safe dose of mercury. Well, that's not exactly true; older vaccines contained 50-100 times the FDA safe dose for one day (originally developed as a guideline for eating fish, which may contain mercury). As the study I mentioned above shows, even that dose of mercury in vaccines does not raise blood levels above levels considered safe.

The bottom line is that the evidence purporting to show a link between thimerosal and is weak at best to nonexistent at worst. Does that mean a link definitely doesn't exist? No. However, the observation that autism rates are still rising despite the reduction and elimination of thimerosal as a preservative in childhood vaccination is pretty strong epidemiological evidence that there is probably no link or, if such a link exists, it is probably very, very weak. In fact, the only thing I agree with Dr. Gordon on is that in the next few years, as more and more of the present generation of preschoolers who have never received thimerosal-containing vaccinations reach and pass the age range where autism is most frequently diagnosed, doctors and scientists will "break" this case. However, based on the experience in Denmark, I consider it highly unlikely that they will come to the conclusions that Dr. Gordon apparently thinks they will. (In a way, though, I sometimes actually think it would be great if such a neat link were discovered, because then we could anticipate that the rate of diagnosis of new cases of autism will fall precipitously over the next few years. Given the devastation that autism causes to children and their parents and the cost of taking care of these children, who wouldn't want that?)

In reality, though, even if autism rates do continue to rise and further research does continue to fail to demonstrate an epidemiological or biological link between the thimerosal in vaccines and autism, that still probably won't stop anti-vaxers from continuing to blame vaccines for autism. Like Ahab, they've identified their whale and will pursue it to the end, no matter what. Most likely, their explanation for a supposed link between vaccines and autism will simply shift to another area. For example, they still blame MMR vaccines for autism, even though MMR does not and never has contained thimerosal and there is no link other than a discredited study which the majority of authors have now renounced. I'm guessing they'll find other creative ways to blame vaccines for autism. No doubt we'll see articles on the Huffington Post about that, too, when it happens.

ADDENDUM: Earlier today, the Huffington Post printed a rebuttal to David Kirby's and Dr. Jay Gordon's earlier posts by Dr. Marc Strasburg, an adjunct Professor of Epidemiology at UCLA. It's about time. Let's see, five anti-vax posts, and one short rebuttal. Oh well, at least they let someone post something. Now just wait for a flurry of posts attacking Dr. Strasburg's article. Just wait. I hope I'm wrong, but I predict it's coming.

ADDENDUM #2: Apparently more recent posts on the Huffington Post now allow comments.

The Commissar gets it right

Not all conservatives drink the "intelligent design" Kool Aid. For example, the Commissar takes the "argument" of "let the students decide" what should be taught to its "logical" conclusion! Sadly, I've seen some course lists that sort of look like the one he describes.

Quoth the Commissar: "The best part is... if this curriculum is all wrong... the kids can figure it out for themselves!! Put it all out there and let the students decide."

Sadly, that's what ID adherents are in essence saying when they say, "Let the students decide."

The Commissar also gets it right when he lambastes pseudoscientists for whining rather than doing what real scientists do (looking for evidence) when their ideas are not immediately accepted, and he gives the examples of several real scientists whose ideas were rejected at first--until the weight of evidence forced scientists to revise their opinions. I've said more or less the same thing in the past:

...no real scientist claims that the "Theory du Jour" is the "final word." Such thinking is anathema to scientists. Real scientists consider every theory as merely provisionally accepted as the best presently existing explanation for a natural phenomenon. All theories, including evolution, are subject to revision or replacement if new evidence mandates it. Indeed, the greatest joy a scientist can achieve is not to confirm current theory (although that can be satisifying) but rather to challenge and go beyond current theory, filling in its flaws or even overturning it altogether in favor of something new that leads to new understanding and new areas of inquiry. But achieving that is not easy. It takes evidence so compelling and in such quantities that the bulk of scientists are finally forced to admit that present theory can't stand against it, something ID proponents don't seem to understand. If they think ID is a superior explanation for evolution than present day theory, they need to produce the goods to prove it, just as every scientist who has successfully challenged current theory has done before. It is not up to the skeptics to prove ID is not the best explanation for the diversity of life; it is up to its adherents to prove that it is.

Grand Rounds XXXV

Grand Rounds XXXV has been posted at Iatremia: The Chaplin.News, but only after a demand by Dr. Chaplin on Saturday to "submit to me," and then introducing each entry with appropriate quotes, some altered to fit the material. It would appear that many have submitted to Dr. Chaplin, and the result is one of the larger and more varied Grand Rounds I can recall.

Enjoy.

Invitation accepted

Yesterday morning, I was quickly looking through my e-mail before heading off to clinic, when I noticed a message with a Subject header reading "Invitation to comment." The message was from a "J Bowen," someone of whom I had never heard before.

I should have known better. I really should have. I knew no good could come of it, just as no good can come of clicking on a piece of spam. But I did it anyway. I foolishly clicked on the link to the article about which Mr. Bowen apparently wanted me to comment. I instantly regretted it. Contained in the article was more "intelligent design" apologia, this time in response to Dr. Richard Hoppe's critique of the same mind-numbingly bad "criticism" of evolution written by historian Professor William D. Rubinstein that I myself had critiqued, both in the comments of Professor Rubinstein's original article and right here on Respectful Insolence.

Humble guy that I am, I immediately realized that I was probably not being singled out for the "honor" of being asked to comment on Mr. Bowen's article because he was genuinely interested in my opinion about it. Rather, I'm guessing that I was probably "invited" to comment on his piece because (1) I had commented on Professor Rubinstein's article in similarly unflattering terms as Dr. Hoppe had and (2) because Bowen probably thought (mistakenly, I hope) that I would be an easier mark than either PZ Myers, who had also eviscerated Professor Rubinstein's article twice or Dr. Hoppe, who had posted the original article to Panda's Thumb that had gotten Mr. Bowen all worked up. Although I'm a physician with extensive training in molecular biologist, I'm not an evolutionary biologist. Given the shoddy quality of the "rebuttal" Mr. Bowen posted, I'm not surprised that he would naturally seek out whom he perceived to be the weakest target, rather than simply forwarding his permalink to Dr. Hoppe for comment. However he miscalculated. I'm more than sufficient to take care of ID apologia as poorly constructed as that by Mr. Bowen. And I also called him on it by forwarding his request for comment to the target of his wrath (I had to get to clinic and didn't have time to start to address his post until last night).

So what did I see when I made the mistake of clicking on the link provided? Well, this sure wasn't auspicious:

If you should ever see a jackass wearing a mortarboard exiting a biology department, it might well answer to the name "Hoppe." From a post attacking someone who dares to dissent from evolutionary dogma, quoth Richard Hoppe:

Oh, boy.

Whenever I read or hear anything along the lines of "dissent from evolutionary dogma," I know I'm probably dealing with a hard-core creationist of the "intelligent design" variety. Mr. Bowen is a prime example of the "pot calling the kettle black." He's oh-so-self-righteously upset that anyone would use less than perfect decorum criticising an author who publicly posted something so risible that he utterly deserves being called "pig-ignorant" but then sees no problem calling Dr. Hoppe a "jackass wearing a mortarboard." Mr. Bowen then proceeded to use a time-honored ID technique for attacking evolution: quote-mining. In this case, he carefully selected a few paragraphs from the Talk Origins speciation FAQ that put the topic in context and pointed out a few shortcomings with the presently existing reports of speciation, with the clear intent to make it appear that this FAQ "admits" that there are few examples of speciation. Of course, Mr. Bowen neither linked directly to the FAQ, nor did he bother to mention that the FAQ to which he referred lists at least a couple of dozen more examples of observed instances of speciation. He did mention another FAQ from Talk Origins that lists a few more examples, but then dismissed them blithely as having "their flaws" (without, of course, actually listing what any of those flaws are or why he considers them flaws--surprise, surprise), finally concluding with another fine example of a "pot-kettle-black" attack on Dr. Hoppe:

Spend your time researching instead of defending your faith with content-free invective like Hoppe.

No, Mr. Bowen, I suggest that you spend some time learning some basic evolutionary biology, rather than defending your faith with content-free invective. Good places to start are here, and, for information regarding what you incorrectly label as "missing" fossils, here. I could go on more about Bowen's obvious selective quoting, but why bother? PZ, as usual, has beaten me to it, dismantling Bowen's post in more detail and with more gusto. I don't want to belabor the obvious about this ID apologist and the utter speciousness of his "arguments," other than to point out that he invited me to comment on his article. All I can say now is:

Invitation accepted.

Aren't you glad you invited me? No, no, don' t thank me for my trouble.

It was my pleasure.

ADDENDUM 05/24/2005 11:30 PM: Someone told me that the link to Mr. Bowen's article was broken. I tried to access the article and Mr. Bowen's blog to verify whether or not this was true, and, as of this writing, Mr. Bowen's blog is indeed unavailable, at least from here. I keep getting an error message. Blogger bug? Who knows? Anyway, hopefully his article will be up again soon. Articles like that should be read widely to demonstrate the utter speciousness of the usual "criticisms" of evolution made by self-proclaimed "skeptics," most of whom are ID apologists. Also, whatever nastiness has passed between us, I can't help but feel sympathy for a fellow blogger whose blog may have been sabotaged by Blogger's shortcomings. I've been there myself.

Credit where credit is due

Yes, it appears that I'm not the only one ruminating about the strange behaviors cell phones will lead people to. Dr. Charles beat me to it last week and did it without descending into bathroom humor. I did remember seeing his post and being amused; I probably should have mentioned it. Oh, well, better late than never.

An odd place for a telephone booth

I was sitting in my office, working on a yearly summary report for a grant. In such reports, it is customary to report on what you have done the previous year and, most importantly, to paint a glowing picture to the granting agency (in this case, the Army) of how much fantastic progress has been made on the funded project and how well-spent its money had been, so that they continue to fund the remaining years of the project. While I was typing away and cutting and pasting various figures into the document, I felt the call of nature. It's not surprising, given that the verbiage that I was introducing into the report was not unlike one of the end products of answering said call (which is probably why such tasks seem to stimulate certain biological functions in me). I tried to ignore the need for a while, wanting to finish the section I had been working on first, but the urge became steadily more insistent. Biology can only be denied for so long before it has a way of forcing its will to be done.

I headed towards the bathroom nearest my office, thankful that the urge hadn't hit me while I was in the operating room.

Entering the nearest stall, I prepared to do what my colon was demanding of me when, eminating from the stall next to me, I heard it. No, it wasn't the rude noises common to such facilities, nor was it the flush of a toilet. It was this (paraphrased from memory, of course; I don't carry tape recorders into the john with me, at least not routinely):

"Well, I realize that that regimen will really knock him for a loop. He'll be neutropenic for quite a while, and he might even need to be admitted. On the other hand, he's failed first-line therapy, and this is probably your best next option."

I recognized the voice. It was one of our medical oncologists (whom I'll call "Dr. X"). In fact, it was a senior oncologist, one of the best we have in our facility, one whose abilities and compassion I respect enormously. Apparently Dr. X had felt same call that I had. But apparently the call of nature wasn't the only call he had felt the need to answer.

"Of course I'd be happy to accept him here, if that's what you'd like. However, if you'd prefer to give him the chemo yourself, you could always transfer him if he got into trouble." A pause, during which I could hear a quiet buzzing that must have been the person he was talking to coming through on his phone. "Yes, I'd say the odds of inducing a remission are probably less than 50%, but he'll progress rapidly if you don't do anything, and even if you don't get a complete remission you could get a strong partial response."

Holy crap! (An appropriate exclamation, given the situation.) Dr. X was having a long and involved conversation on a cell phone about a patient with another physician while sitting on the throne! As I sat there, I could not help but become engrossed (another seemingly appropriate word) in the conversation. He was going into great details about this patient's course of treatment, the likelihood of success, the potential side effects, and how those side effects could be managed. I was getting a serious education in the second-line therapy for non-Hodgkin's lymphoma right there on the commode! At first I thought to myself that this had to be some sort of HIPAA privacy violation, but on second consideration, I realized that no patient-identifiable information was being discussed at this end. (Hopefully the doctor on the other end of the conversation was in his or her office or someplace suitably private.) The conversation was perfectly legal! So engrossed was I that I temporarily forgot my purpose in entering that stall. No problem, though. My colon wouldn't let me forget for long my original purpose.

I completed the task for which I had entered the stall.

Sweet relief, but I was now faced with a dilemma. Dr. X was still continuing his conversation next door, but my task was actually not yet quite complete. One thing remained. The problem is, I realized, that that "one thing" might cause a problem. So, there I stood, having finished wiping, and pondered the question for several seconds: Should I or shouldn't I flush? On the one hand, flushing would very likely be heard by the person on the other end of the line, revealing that Dr. X was in the bathroom while carrying out this conversation. I didn't want to embarrass him if I could help it. On the other hand, the end result of my visit to the commode was rather large and stinky, my having had a pretty big and greasy meal the night before. It really wasn't fair to future users to leave it there unflushed to pollute the rest of the public restroom. Dr. X had decided to have his conversation in the sanctum sanctorum. I couldn't be responsible. However, I could be responsible if I left the disgusting product of my colon behind, unflushed, to gross someone else out and to require them to do what I should have done in the first place. My course was clear. I knew what I had to do.

I hesitated a moment, my hand over the handle, and then flushed.

The sound filled the restroom, loud and reverberating off the walls. It was an unmistakable sound, an emphatic declaration that my business there had concluded. There was no way that Dr. X's conversation partner wouldn't have heard, as the phone couldn't have been more than five or six feet from the sound, separated only by a partition. The sound of rushing water seemed to go on forever. It's fortunate that it did go on so loudly and luxuriantly.

The flush covered my escape.

I darted out of the stall, went right past the sinks, left the restroom, and headed for my lab, where I could wash my hands without the chance of Dr. X seeing me on his way out, although I think he was still otherwise indisposed.

Gentle reader, you might wonder why I behaved in the manner that I did. I ask myself the same question. Why couldn't I have thought of another solution? For instance, I could have refrained from flushing and then simply checked back in a few minutes, after Dr. X had finished both parts of his business, the primary and secondary (I don't know which he would consider primary and which secondary). My office wasn't far away, nor was my laboratory. Such a solution would have worked quite well.

The answer, I think, comes down to annoyance, plus a little embarrassment at having listened in on a private conversation about a patient. Yes, I realize that the embarrassment was irrational, given that I had little choice but to hear the conversation (unless I wished to go to the public restroom one floor down, not a great idea given the urgency of my need), but the annoyance was not. It used to be that, even in a public restroom, one could expect a modicum of privacy to go about one's business with regard to the purpose for which the stall was intended. Little in the way of conversation usually happened there (the exception being large restrooms at stadiums, where people waiting in line will frequently talk), and even there usually not in the stalls. But I think the annoyance was more generalized than that. The younger readers of this blog may not understand this, but I was annoyed at the intrusion. I was annoyed that technology has reached the point such that no place is considered off-limits for conducting business or doing work, a point driven home by this incident.

No place, that is, except the rare locale that doesn't have a signal.

Don't get me wrong. Cell phones are wonderful devices, something so phenomenally and incredibly useful that I no longer see how I could go through life without one. I'm a complete gadget freak in many ways. However, back when I started my residency, pagers were used only by doctors and drug dealers. A few years later, anyone could afford them. A few years after that, cell phones proliferated. I got my first cell phone in 1997, and it was a brick and too expensive to use all that often. Now cell phones are tiny, and you can get plans with huge buckets of nationwide minutes at relatively cheap prices. No wonder almost everyone has one. No wonder Dr. X uses one to take care of business while he's taking care of business, so to speak, given how much he has to do in a day. However, thinking of being so busy that I would feel the need to occupy every minute with productive activity, including my time on the throne, would give me pause.

The great benefit of these devices is that they allow us to be connected almost anywhere, an attribute that is particularly useful in emergencies and especially useful for doctors who take care of a lot of sick patients. Unfortunately, that same interconnectedness is also their curse. For many, there is now no escape from work, no place that can be considered private, no excuse for not answering. For others, there is now no place that is safe from being subjected to the interconnectedness of others. Being subjected to a detailed conversation about a paitent while I was trying to take care of business that, until recently, had been considered private reminded me of that. Twenty years ago, no one would have conceived of having telephone conversations of great import while sitting on the can. Now, no one thinks anything of it. It's bad enough when someone as busy as Dr. X feels so harried that he won't even allow himself a moment's peace, but what about less important uses. I've seen guys walk into the restroom, phone plastered to their ear jabbering away, walk up to the urinal, whip it out, do their business, flush, and put it back in their pants, all without even slowing down their conversation.

Are all these conversations really so important that they can't wait a few minutes? To some extent I can understand why Dr. X, being so unrelentingly busy taking care of his patients, might consider it entirely rational to take advantage of a cell phone's ability to let him to do two things at once even in the strangest of places, but that doesn't mean I have to like it. Technology exists to serve, but unfortunately it's all too easy to let it rule us. All this wonderful technology that wires us and binds us through radio waves to each other can, at times, seem a smothering electronic cocoon that destroys the precious little personal space we have left.

Yoda's wisdom for the ages

An example of Yoda's wisdom:

Saying, "A disturbance in the Force, I sense" after someone farts, only funny once, it is.

Indeed.

There's more where that came from...

Ease the pain

Apparently, yesterday was morphine's 200th birthday (something I didn't know), and articles on celebrating the occasion pain are here. On the same blog (written by a nurse), there's also a rather amusing post about where her demented patients wanted to go during the night shift and where she suggests they should go.

Movie recommendations

Hmmm. I hadn't expected this result when I took this test, although having SF/Fantasy come in so high is consistent. I would have expected it to come in first, though.

You scored as Mindfuck. Congratulations, you scored Mindfuck. You've probably seen a lot of movies, and have grown to hate mainstream shit. You're looking for the movie that will leave you breathless, and with 21 questions to think about. Check out: Donnie Darko, Being John Malkovich, Pulp Fiction, Memento. Mindfuck 75% Sci-Fi/Fantasy 70% Artistic 65% Drama/Suspense 60% Sadistic Humour 50% Mindless Action Flick 50% Romantic Comedy 30% Movie Recommendation. created with QuizFarm.com

I do like mindfuck movies like Donnie Darko (great movie), Pulp Fiction, Brazil, Dark City (another cool one), and 12 Monkeys. However, I didn't much like Jacob's Ladder (too manipulative and predictable). I haven't seen Being John Malkovich or Memento. Perhaps I should rent them....

Professor Rubinstein digs himself in deeper

I normally post either lighter fare (or nothing at all) here on weekends, but last night I became aware of something that led me to make an exception yet again.

Last weekend, during a Sunday random link roundup, I mentioned a jaw-droppingly, mind-numbingly bad piece of anti-evolution writing by a British historian, Professor William D. Rubinstein, that I had found via PZ Myer's evisceration of the sillier assertions and "doubts" about evolution in the article. This article was a fantastic example of how highly educated people who have presumably been well trained in the evaluation of evidence in one field can stumble very badly when they start commenting on another field that is outside their area of expertise. What was truly amazing about the article was that Professor Rubinstein uncritically parrotted a variety of long-debunked anti-evolution canards usually spread by "intelligent design" creationist advocates to the point that it demonstrated such a lack of understanding of basic biology and even the very fundamentals of basic evolutionary theory that I found it hard to believe that it was written by an academic.

Professor Rubinstein's article provoked a firestorm of criticism (to use a cliché) and many responses, which seemed to surprise him. Well, yesterday, Professor Rubinstein decided to respond to all the criticism with a comment of his own (scroll to the comments for May 20 to find it). He was surprised at the number and intensity of the responses and seemed hurt--yes, hurt!--that anyone might conclude from his piece that he might be a creationist. Observe Professor Rubinstein's response, with my comments added:

None of my previous articles for the Social Affairs Unit have attracted more than ten responses, most have only attracted a few responses. When I, for example, advocted abolishing the income tax-- www.socialaffairsunit.org.uk/blog/archives/000214.php--it only received two responses. When I posted my article on evolution I did not expect it to attract a single response, not on a site unrelated to science or biology, let alone more than seventy.

That's nice, but what did you expect? You attracted the attention of quite a few scientists who couldn't believe the number of fallacies you included in it. Your article richly deserved the scorn that was heaped upon it. Besides, arguing about tax policy is different in that there are good arguments to be made for abolishing income taxes as well as for keeping them. There are no good scientific arguments for creationism.

I wish to make only two points in reply. First, to reiterate what I said in the article, I am not a “creationist,” and would not allow any of what I wrote to be cited by fundamentalists, although there are a wide range of non-“creationist” critics of evolutionary theory.

If you are, as you claim, "not a creationist," then why did you ignorantly parrot long-discredited and fallacious creationist "criticisms" of evolution? Sorry, Professor Rubinstein, but through your article you walked like a (creationist) duck and quacked like a (creationist) duck. You shouldn't be surprised when so many people concluded that you are a (creationist) duck, and I don't buy your denial. Also, you seem to be laboring under the delusion that you have control over what fundamentalists will cite. They will cite your work whether you approve of their doing so or not. You've put it out there on a public website. Unless you remove the article, anyone can cite it simply by linking to it and quoting from it. Even if you do take it down, they can quote from it.

Finally, to which "non-creationist" critics of evolutionary theory are you referring? Whom, specifically, and what is their critique? If there is indeed such a "wide range" of these critics, then why didn't you mention an example or two? Here, you seem to be playing another game many creationists play by equating controversies among evolutionary biologists over the mechanisms driving evolution with "criticism" of evolutionary theory. Let's get one thing straight here. Modern evolutionary theory is one of the most successful and well-supported scientific theories there is. There is indeed controversy about the specific mechanisms that drive evolution, but the fact that evolution occurs and the broad outlines of the mechanisms by which it occurs are not in dispute among biologists. See here for more.

You could always prove me wrong by getting specific regarding these "noncreationist" critics of evolution, but somehow I doubt that you will.

Secondly, I would be happy to donate say one hundred dollars or fifty pounds to charity if, by the end of ten years from now (May 2015) anyone can produce an example of evolution in the animal world which has occurred during that time span - that is, the appearance of a new species of animal, which does not exist today, but which is descended from an existing species. (Of course this must occur in the natural world - laboratory experiments are excluded). I readily admit that ten years is a ridiculously short period, but there are more than one million species of animal life and new species should be appearing all the time, surely. I would stipulate a much longer time frame - fifty or five hundred years - but won’t be around to monitor the results.

(Professor) William D. Rubinstein

I honestly find it hard to believe that you would repeat yet again the "speciation has never been observed" canard, which is what you are clearly doing here with "offer." Heck, you even admit that 10 years is a "ridiculously short" period, thus implicitly acknowledging the speciousness of your challenge. Indeed, I would point out that the "ridiculously small" amount of your proposed prize should someone point out an example of new speciation by 2015 strongly suggests that your challenge is more for show than any sort of substance and you know it. In any case, speciation has been observed, and once again Talkorigins.org has many examples (and here as well). I suggest you check those examples out and be educated.

I had thought that perhaps PZ and I were too hard on Professor Rubinstein. Now that I see his non-response to the criticisms of his article, in which he failed to address directly any of the substantive concerns raised by PZ, me, or any of the commenters on his article, I realize that perhaps I was too easy on him. Professor Rubinstein is Exhibit A for why expertise in one area does not necessarily translate to expertise in another area. Indeed, it boggles my mind that a man trained to wade through detailed primary historical evidence could make such basic mistakes. I suspect that the reason it is possible for him to make such egregious errors is that he doesn't have the scientific background to properly evaluate the sources he has looked at and lacks the humility to recognize what he doesn't know. (He doesn't even seem to know the definition of the word "theory" when used to refer to scientific theories.) Consequently he gives more credence to fallacious "criticisms" of evolution than they deserve, most likely because they appeal to his pre-existing beliefs. When I write about history on this blog, I do so with a distinct appreciation for the limitations of my understanding of history. Indeed, always in the back of my mind is the fear that I may be making a fool of myself commenting on a field outside the area of my expertise (something I've probably managed to do at one time or another, despite my best efforts). Unfortunately, Dr. Rubinstein doesn't appear to have that same appreciation for the limitations of his understanding. If he had, he would have shown a little more humility and probably would have tried to learn some basic biology before forging ahead with an article that could only sully his reputation and make him appear a fool.

Some light weekend reading

Usually, the weekend is the time for lighter material (for the most part) on this blog. So it's entirely appropriate that I point out that the latest Carnival of Comedy has been posted at IMAO. I'm not sure I'm entirely down with the ratings system that the host decided to use (which informs the reader if there's any profanity or sexual content), but I suppose it's not an entirely bad idea.

What kind of blogger am I?

How perceptive this test is...

You Are a Pundit Blogger!

Your blog is smart, insightful, and always a quality read. Truly appreciated by many, surpassed by only a few.

What kind of blogger are you?

I only seldom wear turtlenecks, though, and I'm not left-handed. I'd also like to know how the guy in the picture blogs without a keyboard. I'm tempted to see what other types of bloggers would result if I changed some of my answers.

Calling all skeptics!

The Skeptics Circle IX will be posted on Thursday, May 26, and it has come full circle. Its founder, St. Nate, will be hosting it for the first time since he hosted the inaugural edition back in February. Since its humble beginnings (to which I added my humble contribution), the Skeptics' Circle has grown, such that the latest version (hosted at Pharyngula) was the biggest and most varied edition yet. So, if you're a blogger and you're tired of seeing all the credulity echoing back and forth throughout the blogosphere from "intelligent design" advocates, alties, believers in the paranormal, and anyone else pushing pseudoscientific or irrational ideas and you've posted something recently to combat such silliness, send your post to St. Nate.

And if you're really good and skeptical, you might even want to consider hosting an edition of the Skeptics' Circle yourself. Again, just drop St. Nate a line, and he'll work you into the schedule.

Finally, I don't want to tread on the Founder's perogative unduly by making pronouncements about the Skeptics Circle, which is why I will preface this with a disclaimer that the following represents my opinion only and that I only say it because the Skeptics' Circle is my favorite carnival. I was on board from the very beginning and I want it to continue to maintain the high standards it has managed to attain in the past. Unfortunately the last Skeptics' Circle had a couple of questionable entries submitted. PZ characteristically handled the commentary about them more bluntly than I probably would have done had I been hosting, but I have to admit that PZ's point was not unreasonable. Unfortunately, the article happened to have been submitted by a pretty high traffic blogger--more than ten times the traffic that I usually get--who was also an early booster of the Circle, and he was pissed off (here too) about PZ's commentary. It does, however, seem to be a trend that more overtly political or ideological posts and posts based on questionable science or data are being submitted to the Skeptics' Circle. Unfortunately, it's a problem not limited to the Skeptics' Circle. Indeed, yesterday, PZ himself lamented that even his own baby, Tangled Bank, is starting to see posts that are primarily political rants or, worse, based on pseudoscience. Given that background, I just want to say that the Skeptics' Circle was never intended to be a political soapbox. Indeed, recall what St. Nate himself said:

I'll also like to keep this free from political interests. I'm all for factchecking propaganda, but in the blogosphere it's too hard to do that without it being hijacked by one side's agenda. I'd only be interested in proven hoaxes from the media, pseudoscience, quackery, historical revision, phenomenon that seem paranormal but aren't, etc.

Unfortunately, I also foresaw politicization of the Skeptics' Circle as potential problem before the first edition, even if St. Nate did want to try to keep politics out of it. I was also somewhat--shall we say?--skeptical that it would even be possible to keep politics from slowly creeping into the Circle, given that certain areas skeptics routinely deal with (evolution and global warming, for example) are so ideologically, religously, and/or politically charged:

Let me just take the opportunity to enthusiastically back this idea and make a couple of suggestions. St. Nate did not want political or ideological biases to come into it. I'm not sure how that will be possible, unless the topics are restricted to science and pseudoscience, and I'm not sure such a carnival should be so narrowly restricted. On the other hand, leaving things too wide open could potentially put each host of such a carnival in the uncomfortable position position of having to evaluate the arguments themselves, which might be too much work. Also, not all hosts would have the same capabilities in the same areas.

Fortunately, so far I've been pleasantly surprised that the Circle has gone on for four months with very few problems in this regard, from either hosts or contributors. Hopefully, a little fine-tuning and refocusing on the fundamentals of what the Skeptics' Circle was intended to be will help to pre-empt most such problems in the future, something St. Nate has already done by reemphasizing what the Circle is about. My view on the matter is that, because skepticism and some scientific issues cannot be entirely separated from politics, only posts that are clearly primarily political in nature should be excluded (and I think that the Dean Esmay piece that PZ criticized and the piece that provoked Dean's article both probably fall into that category). There are plenty of other blog carnivals for such polemics. Obviously, the line gets blurry when it comes to social sciences and public policy (a situation unlike that for "intelligent design" creationism versus evolution, where the science makes it clear that ID is nothing more than an attempt to introduce religion into science classes). However, each host should do his or her best.

The next time I host the Skeptics' Circle (whenever that happens to be), I will not hesitate to point out submissions that I deem questionable on the basis of the science (or lack thereof) or the reasoning (again, or lack thereof) or that I just plain disagree with. If they are really questionable I won't use them, although I will consult with St. Nate and perhaps one or two others in cases I'm not sure of. (I know that the Amazing Randi reads the Circle from time to time, and I don't want to be embarrassed.) I hope other future hosts will exercise their best judgment and do the same. I realize that it's a fine line between encouraging as wide a variety of posts with unfettered skepticism about any topic and maintaining some standards, but some judgment is necessary. We don't want to discourage contributors, but we don't want to post examples of the very credulity or obvious twisting of data, science, or history to serve political, religious, or other ideological agendas. After all, that, in addition to the permeation of society with urban legends, paranormal beliefs, and pseudoscience, is one of the things that the Skeptics' Circle was originally intended to combat!

More Star Wars geekiness

I can't resist, you know. I promise to try to restrain myself after this.

First off, I've become aware that, not only do Darth Vader and Yoda have blogs, but so does....Boba Fett! At least I found out how he escaped from the Sarlac. Chewbacca also has a blog, but it seems to be a one-joke affair, and it's not particularly amusing.

Lastly, I have to wonder how far some people will go to indulge their obsession with all things Star Wars to the point of inflicting it on their pets:

Hmmm. Our dog might actually look kind of cool as Darth Vader, don't you think? The costume is only $14.99, after all. Just look below. Our dog is black, for one thing, which goes well with the costume:

Nahhh. First off, she's just too mellow and sweet-natured to be Darth Vader (except, unfortunately, when it comes to random small critters like rabbits, chipmunks, or squirrels that find their way into our backyard, in which case she can be Death Incarnate). Second, even I'm not that geeky. Third, our dog would never tolerate it. Finally (and quite importantly), my wife would absolutely kill me.

OK, that's enough Star Wars stuff for a while. Every so often I have to let my geek flag fly. Thanks for indulging me...

Friday morning random 10 (on Friday for a change)

I was in the O.R. late yesterday and didn't have time to finish the main piece I had planed. Fortunately, I had a couple of short things previously written. Also, I haven't done this in a while; so I figured, what the heck? Basically, take iTunes (or your MP3 player of choice), set it to random or shuffle play, and then list the first 10 songs from your music library that it plays. This week's list was rather odd, at least as far as the different types of music mixed together.

1. Arlo Guthrie, Last Night I Had the Strangest Dream
2. AC/DC, Love Hungry Man
3. The Clash, Look Here
4. The Saints, (I'm) Stranded
5. Yeah Yeah Yeahs, Man
6. Simon & Garfunkel, Homeward Bound
7. Red Hot Chili Peppers, Blood Sugar Sex Magik
8. Paul Simon, Old
9. Elton John, Too Many Tears
10. The Who, Shakin' All Over
    

Hmmm. The transition between the Arlo Guthrie song and AC/DC was rather jarring. Otherwise, it seems rather heavy with older stuff. The Paul Simon song is appropriate though, given that I'm feeling a bit old right now...

I like this bumper sticker

I may have to buy one. I won't put it on my car (I could never understand why people mess up their bumpers with all sorts of stickers); but I'm sure I can find a place in the lab to put it...

A blast from the past (other than Star Wars)

I realize I've said in the past that this blog is not meant to be primarily about me or my personal life (although I have on occasion gotten somewhat more personal than my usual broadsides against irrationality). However, with the confluence of one blast from the past opening in theaters everywhere today and another blast from the past that hit me a couple of days ago, I'm in a mood to change course for one post. What the heck? I could use the change of pace to refresh my skeptical bullshit detector in preparation for (hopefully) reaching new heights in medicine, science, and skepticism blogging. A little wafer to cleanse the palate, so to speak, and perhaps to reveal my geekiness for all to see--an appropriate topic for the day when a new Star Wars movie is released.

A couple of nights ago, I was perusing my e-mail, as I often do in the evenings, when I came across a Subject header that almost looked like it might be spam:

Hiya Orac

(OK, it didn't say exactly that, but you get the idea.)

I was almost going to delete the message. At first glance, I thought it was some sort of spam that had somehow managed to evade Apple Mail's Bayesian spam filter and the rather extensive set of additional custom filters that I had developed and fine-tuned over many years of being forced to dodge offers for "low, low interest rate mortgages"; supplements or herbs guaranteed to "make her want me again and again" (I hope it's my wife they're referring to); "herbal Viagra"; various devices and herbal "extracts" that promise to enlarge my penis to the point of turning me into a freak of nature that women won't be able to resist; miscellaneous pyramid scams (sorry, I mean "multilevel marketing opportunities"); online "pharmacies" offering Viagra, Cialis, and Vicodin, all without the pesky need for a doctor's prescription; cable "decoder" boxes; offers for VISA and MasterCards, no matter how bad my credit rating may be; remedies that promise to reverse baldness (something I don't need; if anything I have too thick a head of hair); and, of course, the usual assortment of porno spams promising "barely legal" girls who will "do anything," "hardcore action," and college girls promising to "get wild" for me in front of their "very first" webcam. And, of course, there are the profoundly insulting "phishing" e-mails designed to try to fool me into giving up credit card numbers and other personal information.

Then I looked at the From: header and saw the name. It was familiar--and unexpected. It was an old friend, whom I'll simply refer to as Paul. I hadn't seen him in at least six years and had only had sporadic contact with him since then. Two or three years ago, all contact ceased. I had e-mailed him, but it bounced. I had toyed with the idea of trying to call him. (I should have, but I never did.) Even more unexpected were the contents. The e-mail told of his recent divorce and how he had found someone else whom he had wanted to marry. It sounded as though his divorce was pretty ugly, which saddened me because I knew there were children involved. The e-mail said that he wanted to get in touch again, concluding:

I don't think either of us has changed that drastically, even in twenty years.

Is that really true? I wondered.

Flashback to 1979. (If this were a movie, you'd hear something off of Tom Petty & the Heartbreakers Damn the Torpedoes, Cheap Trick's Dream Police or At Budokan, The Cars' Candy-O, or maybe Supertramp's Breakfast in America, none of which you could possibly escape in Detroit in 1979. Then you'd see the scene dissolve to a high school in Anywhere, U.S.A, with a lot of bad hair in evidence.)

Paul and I had been pretty good friends in high school. He and I were part of a group of five buddies who used to hang out at school and get together at each other's houses fairly frequently to play Dungeons & Dragons. This was back in the late 1970's, before role-playing games had become more accepted, and back then those of us who played them and enjoyed them were viewed as profoundly weird. (No snarky comments about how Orac is still profoundly weird, even 25 years later. Orac realizes that he is, but at least his weirdness is now mostly channeled into blogging. Indeed, if he weren't profoundly weird, do you think he would have taken the 'nym of a cranky computer from a 20 year old British SF show?) This was right about the time of the famous case of a 16-year-old child prodigy named James Dallas Egbert III, who in August 1979 disappeared from his dormitory at Michigan State University. The investigation turned up that he was a D&D player, and the media focused on his disappearance as the result of a "live action Dungeons & Dragons game" in the steam tunnels of MSU having gone horribly wrong. In actuality, Egbert was just a messed-up kid under a lot of parental pressure to succeed who had also become confused about his sexuality and gotten into drugs. It turns out he had run away to commit suicide in the tunnels with sleeping pills, but only slept a day. He ended up staying with friends for nearly a month. Ultimately he was found, but he committed suicide a year later. Unfortunately his story inspired a really bad made-for-TV movie and hilariously over-the-top tracts by the fundamentalist and rabidly anti-Catholic cartoonist Jack Chick. These formed the view most people had of D&D 25 years ago and, to some extent, even today.

In the light of that sort of recent story and the anti-D&D hysteria it engendered, you would think that the priests at my Catholic high school would have stopped us when we played D&D at lunch breaks, but, oddly enough, they never did. I still sometimes wonder if my parents thought secretly that this game was a sure path to Satanism and hell (particularly given that my characters included a high level cleric who worshiped Heimdall, as well as thieves, and warriors), but they said little. In any case, although we had been acquaintances and friends before we discovered D&D, after we started playing, our little crew formed a pretty strong bond, particularly in our senior year. After graduation, some of us went to the University of Michigan. Others stayed with parents and went to a local university. Paul also stayed behind but went to community college, hoping to get into a university to study art later. He was a very talented artist. His drawings used to blow me away. He also had a great imagination and was the best and most diligent dungeon master of any of us. When I (or anyone else, for that matter) tried to be dungeon master, somehow the results just never came out as entertaining. We kept getting together after high school, to hang out, to play D&D, and occasionally to go to concerts. The non-U. of M. part of our group liked to come up to the dorms because there were frequently parties going on and there were usually lots of girls. We'd often play D&D until late in the night and then go out for a while. Sometimes, the game would peter out early, and we'd just sit around the dorm room or one of the lounges, drinking beers and shooting the bull (as hard as it probably is for present-day college students raised in an era of zero tolerance, to believe, back then universities were pretty lax about enforcement against alcohol on premises, or even drinking it in public, in the dorms was pretty lax--our RA would sometimes even join us).

(If this were a movie, we'd now cue to some early 1980's new wave music or something from Michael Jackson's Thriller, some scenes of college life and hanging out at the dorm, and some shorter hair and baggier pants.)

During that time, Paul decided to move to Florida briefly, where he met his wife. I never really thought their marriage would worke out (I didn't like his wife much), but as far as I can tell they seemed to be happy, and the marriage lasted quite a while. During his Florida sojourn, we actually kept in touch by old-fashioned letter (this being the early 1980's, with long distance too expensive to use that often and e-mail available only to serious tech-heads at universities). Paul ended up giving up on his dreams to study art. He ultimately moved back to Michigan and took a job in the family business doing heating and cooling work. He made a good living at it and had some children. When I went to medical school, I found a couple of other medical students who were into D&D, introduced them to Paul and one of my old crew, and another bunch of buddies formed, two of the original bunch having lost interest (or "matured," as some might put it).

(Movie cue: Some good mid-1980's music, such as The Smiths, Depeche Mode, Pet Shop Boys, R.E.M., The Cult, or The Cure, perhaps with shots of us looking older, me having to dress in a tie--thin, of course, this being the mid-1980's--and earnest-looking medical students staring in rapt attention at an instructor fading to brutalized, haggard interns stumbling through their days.)

We had a grand old time throughout medical school. We'd get together on the occasional weekend when we could, play D&D, drink beer, and sometimes play some low stakes poker. Over time, though, as the demands of family life became greater and my medical school rotations ate up more and more of my time, these sessions grew less and less frequent. Finally, I graduated and had to move to Cleveland to do my residency. Amazingly, even in the face of a surgery residency in a city that was a three hour drive away, we got together a few times over the next year. But all good things must come to an end, and my medical school all buddies graduated and scattered to do their residencies in other states. The "fellowship" (such as it was) was broken.

But I still kept in touch with Paul and a couple of other of my old buddies from high school and college. It wasn't so hard; he still lived in Detroit, and I liked to get back to visit my parents and other family whenever I could. Sometimes I'd manage to see him. We also called each other from time to time. Then I got married, and trips home became more complicated, with two sets of relatives separated by 90 miles to make the rounds on. As the 1990's progressed and my wife and I moved to Chicago for me to do my fellowship, we still exchanged e-mails fairly regularly and phoned each other on rare occasions, although, almost imperceptibly, the phone calls and e-mails became progressively less frequent. This continued right up until two or three years ago, although the last time I saw him was at least six years ago. Then I moved to the East Coast. Suddenly, I was making it back to Detroit only twice a year on average, and there was rarely time to visit any but family and the closest friends on these trips.

And then, two or three years ago, silence.

I haven't responded right away. It's not because I don't want to but rather because I'm not sure what to say. (Yes, even the blogorrheic Orac can sometimes be at a loss for words, hard as readers of this blog may find that to believe.) In fact, writing this piece sort of gave me some ideas of what to write. But foremost in my mind right now is the question all middle-aged men wonder about sometimes, the one that Paul answered for himself:

Have I changed that drastically in 20 years?

How could I not have? I've been through medical school, graduate school, and residency. I've dealt with life and death. I've seen people in tragic circumstances that I could never have imagined myself dealing with when I was 20. I now run a lab and have four people working for me. I've even had a couple of really bad things happen to me that have changed me forever.

Of course I've changed. And no doubt so has Paul. It can't be otherwise. But is the core the same? I don't know. Maybe, though, for all the changes we've undergone in 20 years, we can be friends again.

There's only one way to find out.

Well that's reassuring...

With the release of Star Wars III: Revenge of the Sith today, I couldn't resist following the hordes of other bloggers who have already taken Liquid Generation's Ultimate Star Wars Personality Test.

Hmmm. I always thought Luke was a bit of a whiner (at least in the original Star Wars movie). On the other hand, he did turn out pretty decent in the end. On the other hand, it could have been worse. I could have come up Jar-Jar Binks...

Off to see Revenge of the Sith either this weekend or next weekend. Too bad I have to operate both today and tomorrow, otherwise, you might see me in this situation:

Everybody's blogging

It would appear that way, particularly with the release of Star Wars III: Revenge of the Sith. First, I found Darth Vader's Blog (which appears to be rapidly careening towards its end), and now I've found Yoda's Blog. He seems most unhappy at being compared to a certain other short, pointy-eared character, although he does appreciate the many faces of Windu.

Tangled Bank XXVIII

Tangled Bank XXVIII has been posted by the Mad House Madman, and it's another fine sampling of the best of the science blogosphere. And, damn if he didn't come up with a format that I should have thought of, that of alties:

We wanted so badly to be original that we decided to highlight, for the first time in Tangled Bank history, some of the more questionable practices of medicine. We therefore reached out ot the homeopaths and the herbalists for submissions. Quickly, we learned how to swindle people's hard earned money ourselves and developed our own Mad House line of products. If you would like to purchase any please email me at I’m_a_sucker@Madhouse.com.

Hey, wait a minute! Debunking quacks and dubious alt-med is my territory! (OK, it's also the territory of Peter, Anne, Paul, Skeptico, and others, and I know I've gotten derailed a bit dealing with "intelligent design" pseudoscientists during the last couple of weeks. Don't worry, though, the alt-med stuff is coming again next week.) And, worse, the Mad House Madman is funny about it. Now I remember why I stole his idea for an interesting and unusal format to do Grand Rounds when I hosted my first blog carnival way back in February. Damn. If I had known the Madman's intent, I would have submitted this article instead of the article about the risks and benefits of phase I oncology trials that I did submit.

As was the case with the Canadian Cynic's take on one of ID's sillier arguments (also in Tangled Bank), I can only stand back in envy, wishing I had thought of it first.

But it's all OK. Madhouse Madman is a fellow medblogger (although, now that I think of it, I'm probably actually some sort of bizarre hybrid of a medblogger and science blogger crossed with a history blogger and skeptical blogger--in other words, Frankenblogger!). So please, show the Madman some love and head on over to Chronicles of a Medical Mad House to check it out.

Also, don't forget, in two weeks, Tangled Bank XXIX will be hosted by Organic Matter.

Cool new feature in PubMed

Perhaps they were inspired by HubMed, but it appears that the National Library of Medicine is finally developing an RSS 2.0 feed for PubMed searches. Those in the biomedical sciences know that PubMed is the web interface for searching the MEDLINE database of the peer-reviewed scientific literature. It contains millions upon millions of citations going back to 1965, and it is the means by which most physicians and scientists search the biomedical literature. It's a cool feature that allows you to set up an RSS feed to monitor authors, keywords, and other searches You just set up a search, choose the "Send to RSS feed" in a pulldown menu, and set some options and limits on the feed, after which it will generate an XML link. RSS searches monitored this way will be updated using the same "What's new?" strategies used by My NCBI for updating saved searches and will be updated once a day.

It's about time. Now that I've discovered the joy of perusing blogs using RSS feeds, I can't imagine any other way to monitor searches of the literature like this if you're a frequent user of PubMed. If you're a less frequent user, PubMed still offers e-mail updates. Unfortunately, it doesn't appear to be working yet; the "Send to RSS feed" option isn't showing up on the pulldown menu that it's supposed to. Here's hoping that they have it up and working soon.

My world view

Hmmm. My world view would appear to be "materialist," although by switching a couple of answers my view seemed to move towards "postmodernist." Hmmm. Given that Tangled Bank will be posted today at Chronicles of a Medical Mad House, perhaps this is appropriate...

You scored as Materialist. Materialism stresses the essence of fundamental particles. Everything that exists is purely physical matter and there is no special force that holds life together. You believe that anything can be explained by breaking it up into its pieces. i.e. the big picture can be understood by its smaller elements. Materialist 69% Existentialist 56% Cultural Creative 50% Postmodernist 50% Modernist 44% Idealist 44% Romanticist 25% Fundamentalist 19% What is Your World View? (corrected...hopefully) created with QuizFarm.com

Brian McNicoll responds to Orac

Unfortunately, it appears that Skeptico has sapped Brian McNicoll's energy to the point that the best reply to my last e-mail he feels like mustering is:

Thanks for reading and responding. I'm glad you enjoyed the piece.

Do I sense a bit of sarcasm there?

Naaahhh. Must be my imagination.

Oh, I did enjoy Mr. McNicoll's piece, just not in the way Mr. McNicoll had intended it to be enjoyed. If you "enjoyed" it too, please feel free to tell him yourself how much you also enjoyed his massive collection of bad reasoning, bad science, and straw men in the service of attacking evolution.

Grand Rounds XXXIV

Grand Rounds XXXIV has been posted at Galen's Log. Once again, it's time to check out the best the medical blogosphere has had to offer over the last week. One of these days, Nick should try to arrange so that we can get CME credit from it.

However, I'm not sure why Galen thought I might be trying to jab anybody in the eyesocket with anything, much less a polio vaccine. I'm a nice guy. Really, I am...

Read this now

Every so often, I come across a post by another blogger that's just so perfect that I can only stand by in envy, wishing I had thought of the argument first. So it is with this article by Canadian Cynic on why one particular creationist canard, the demand for "direct observation," may not be as smart a gambit as they think it is. Better yet, it's labeled as "Part 1 in the serial adventures of John Q. Creation." Please, go and read it. I can't wait for part 2.

I tried not to discuss "intelligent design" again, but...

I hadn't intended on mentioning the "intelligent design" (ID)/evolution "debate" again for a few days (I try not to harp on any one topic for too many days in a row), but something came up and it's still topical as long as the Kansas evolution "trial" is still fresh news. You may recall that I congratulated Skeptico on his nice dismantling of an article by Brian McNicoll that appeared on Townhall.com last week. In the article, Mr. McNicoll trotted out every creationist/"intelligent design" (ID) canard and straw man in the book, while demanding a "little humility" from scientists. I e-mailed a brief rebuttal to him, along with a link to Skeptico's piece adding that Skeptico rebutted him better and in more detail than I had time to do. Mr. McNicoll's reaction? He sent me a brief e-mail speculating that Skeptico's piece was a "schoolhouse prank"! Given his grave invocation of Galileo and other scientists that have been proven to be wrong over the centuries, I couldn't resist a response.

My response to Mr. McNicoll, edited to clean it up and make it better:

Funny, but I almost thought that it was the Townhall.com article that wasn't serious. Almost. It's just too chock full of bad science and creationist canards that have been thoroughly debunked so many times that some of us who've dealt with them don't always have the patience to debunk them yet again. However, I will point out that your appeal to Galileo in the article conveniently neglected to mention that it was the Church, not scientists, who persecuted Galileo for his "heresy." In fact, the appeal to Galileo (or to past examples of experts or scientists being wrong) is so frequently used by defenders of pseudoscience such as "intelligent design" creationism that we even have a name for it, the Galileo gambit.

Now that I think of it, your use of the example of Galileo may be more apt than you thought, just not in the way you intended, Galileo's correct science was actually assailed by dogmatic religious people who could not accept Galileo's scientific conclusions because they did not agree with what their religious beliefs told them, not by scientists. So it is with evolution and intelligent design creationists. The difference is that (so far) religion hasn't trumped science as far as evolution goes--but sadly it's not for lack of trying by ID adherents. Oddly enough, in all this, one of the most conservative religions in the world, the Catholic Church, is not the religious force demanding that ID be taught in schools, as it was the force that persecuted Galileo; Pope John Paul II reconciled the Church with evolution nine years ago, reinforcing Pope Pius XII's statement that evolution was not incompatible with Catholicism, made 50 years ago. Apparently the Catholic Church has learned. Why can't the fundamentalists who push ID creationism?

No, "Skeptico" was serious and effective in dismantling the "arguments" (such as they were) in the article. I'm surprised he had the patience to slog through all the straw men, particularly the one where you claim that scientists are boycotting the Kansas proceedings because such forums are "beneath them" because they believe that "all issues regarding the origin of life are settled." I didn't have the patience, which is why I referenced Skeptico's article.

Sincerely,

Orac

I'll let everyone know if I get a reply.

Don't know much about history...until now

The History Carnival #8 has been posted at St. Nate's Blog. Check it out. As a physician with an interest in history myself, my attention was first drawn to this piece on physicians making diagnoses on historical figures, which somehow I had missed. There's also plenty of blogging on the anniversary of V-E Day and our President's comments about the Baltics.

Risks and benefits of phase I oncology trials

After having spent much of last week blogging about the 60th anniversary of V-E Day (and here), Pat Buchanan's idiotic comments about World War II, the intelligent design creationism craziness going on in Kansas (and here), and slapping down ID apologists, the start of a new week would seem to be a good time to get back to more medical topics, specifically the science of clinical trials.

A couple of months ago, I read an article in the New England Journal of Medicine about the risks and benefits of phase I oncology trials, and I thought it might be a good opportunity to clear up some misconceptions that many people have about phase I clinical trials. Normally, drug development follows a rather rigidly defined pathway. Compounds that serve the basis of drugs are usually discovered either through screening natural compounds or synthesizing new compounds based upon either compounds that have known activity or based on molecular knowledge of the intended drug target, known as "intelligent" or "rational" drug design (not the same thing as "intelligent design"). Promising new compounds, however they are found or synthesized, are then generally tested in cell culture systems for in vitro activity. Those that show promise there can then go on to animal testing. Finally, those that show an ability to shrink experimental tumors in animals without unacceptable toxicity to those animals are chosen for human studies.

The very first study a new drug will go through in humans is known as a phase I trial. Phase I trials are different from phase II and Phase III trials in that the primary purpose of a phase I trial is not to determine if the drug has any efficacy. The primary purposes of a phase I trial are to determine the optimal dose and identify toxicities. They are not the only purposes of such trials, but the determination of whether there is an objective tumor response to a new drug is definitely a secondary consideration in phase I trials. Drugs that are shown not to have excessive toxicity are then evaluated in phase II and phase III trials to compare them against existing therapies for efficacy. This is one reason that the ethics of phase I trials have been questioned, because, in the mind of some ethicists, phase I trials imply the promise of a benefit that is unlikely to be there. Although patients generally take part in clinical trials out of altruism, they also do hope for some benefit for themselves. That's why great care needs to be taken to make sure that potential patients understand that the chances of their personally benefitting from the trial are very small. Patients are hoping for a complete response (complete disappearance of their tumor) or a partial response (defined as a greater than 50% shrinkage of their tumor), but the odds of that are small.

Given this background, this article is of interest because it examines critically what exactly the risks and potential benefits of phase I oncology trials are. The authors evaluated all nonpediatric phase I trials sponsored by the National Cancer Institute between 1991 and 2002 for rate of response to treatment, toxicity, and treatment-related deaths. These trials included single agents, combinations of investigational agents, combinations of FDA-approved agents with investigational agents, antiangiogenesis agents, signal transduction blockers, and vaccines. Complete response rates ranged from 0% to 8%; partial response rates ranged from 0% to 20.4%. The overall response rate (partial and complete responses) was 10.6%. In addition, in 34.1% of participants, either stable disease (no growth) or less-than-partial responses were observed, for an estimate of 44.7% of patients who have a chance of benefiting. In contrast, deaths from toxic events ranged from 0% to 2.02%, with an overall treatment-related death rate of 0.49%. Finally, 14.3% of patients had at least one grade 4 toxic event.

So what does this all mean? First, the response rates observed are higher than previously reported response rates of 4% to 6%, although the mortality rate is roughly the same. Second, it implies that the risk-benefit ratio of such trials is suprisingly favorable, given that these are usually trials representing the first use of a new experimental agent or combination of experimental and/or previously approved agents. The risk of death is at most 0.5%, which in my mind is surprisingly low, given the patient population, which consists of patients with advanced cancer who are likely to be physiologically fragile to begin with. Given that the chance of a partial or complete response is approximately 10.6%, that makes the odds of potential benefit (I say "potential" because complete and partial responses may not actually improve survival) versus the risk of death from the experimental agent approximately 22:1. True, the risk-benefit ratio becomes less favorable when you factor in severe complications, such as grade 4 toxicities, falling to 3:4, but it becomes more favorable if we add in stable disease and lesser responses, with a ratio of stable disease/response to severe complication/death of 3:1. Also, the observation that as many as 44.7% of patients may have stable disease or better in phase I trials becomes more important in light of the increasing appreciation that stable disease or minimal tumor shrinkage can be of clinical benefit, with the recent introduction of less toxic agents that do not kill tumors but rather prevent their growth, such as antiangiogenic agents. Moreover, another important result of this study is that phase I studies are more heterogeneous than most clinicians assume, with a wide variety of classes of agents, all with different chances of efficacy and toxicities. For classes of drugs for which the toxicities are lower, the risk benefit ratio of phase I trials may therefore be even more favorable.

Phase I trials are critical for the development of new cancer therapies. Also, even though the primary purpose of such trials is not to determine efficacy against specific tumors, but rather to determine dosage and toxicities of investigational agents, indications of a potential response observed in phase I trials often serve as both a major impetus for phase II studies and as a guide for which tumors should be studied. Of course, overall risks and benefits cannot be generalized to individual trials from the results of this study, and it's impossible to predict them for any single trial. However, this study suggests that the risks of these trials are not as high as some have suggested, nor are the chances of benefit as low as feared. The bottom line is that it would appear that more patients probably benefit from phase I trials than are harmed by them. Consequently, previous objections on ethical grounds appear less compelling than they perhaps once were, and, given the new generation of targeted therapies, enrollment of patients in phase I trials has the potential to benefit more patients at lower risk than ever.

Skeptico vs. Brian McNicoll

As much as I thoroughly enjoyed PZ Myer's evisceration of a piece of intelligent design idiocy written by a historian who should have known well enough to stick to his area of expertise, I enjoyed Skeptico's point-by-point demolition of this even more idiotic piece of ID advocacy by Brian McNicoll at Townhall.com even more. My favorite line? "Oh no, I can smell straw." (As in "straw man.") I'll have to remember that line so that I can steal it and use it someday.

Check it out to see how it's done.

Random Sunday links

Store Wars. I realize this is propaganda for the organic food industry, but it's just funny enough that I think it's worth looking at, particularly with a new Star Wars movie only four days away. If Darth Tater and Cuke Skywalker don't give you a chuckle, then you're just not geeky enough. (Via Ubergeek Chic.)


Restaurant badness. Fat Eye for the Skinny Guy points out the incredibly annoying things people do when eating out Here's one: The "how about we all order different things and pass them around the table" group. I agree. To me, this practice is only acceptable in a Chinese restaurant. Quote from Fat Eye:

Group ordering, to a fat dude, is like playing a warped game of Russian Roulette. It all comes down to plate placement and plate passing. In any group ordering situation, there will usually be about 1 to 2 dishes you really want to tackle. Now, it's up to Jesus and the waiter as to where those dishes are going to be placed upon arrival.

At last, a day off from crushing tracheas (well, not quite). If you've ever wondered what a Dark Lord of the Sith does on his day off, go here and be enlightened.

Intelligent design is neither intelligent nor design. Finally, given that much of last week was devoted to the refutation of some of the more silly "intelligent design" apologists, it's only fitting to finish this Sunday roundup with that theme. To start with Jesus' General takes the time to praise Dr. G. Thomas Sharpe of the Creation Truth Foundation for his work teaching children about God's gospel lizards. In the meantime, Tinfoil Hat Pundit suggests a rather disgusting experiment "intelligent design" creationists might set up to disprove Darwin.

Finally, check out the "science" (and I use the term very loosely) that creationists are encouraging school children to pursue as "evidence" against Darwin. I'm still not sure if this is a parody or not, given some of the "experiments" presented. For example: "Using Prayer To Microevolve Latent Antibiotic Resistance In Bacteria." Please, someone, tell me this whole thing is a joke, along the lines of the reDiscovery Institute! They can't be serious, can they?

Why historians should stick to history. Via Pharyngula, I've become aware of a truly awful piece by an historian "questioning" evolution, entitled, The Theory of Evolution: Just a Theory? Ugh. The title alone tells me all I need to know about the author's knowledge. Naturally, reading PZ's evisceration of this piece was enormously entertaining, as this article is full of some of the most idiotic creationist drivel I've seen in many weeks. It even includes hoary old creationist/intelligent design canards such as the "evolution appears plainly impossible," "no one has ever observed an example of speciation," and "new traits or organs must appear fully formed, rather than in stages, to be useful" variety. Get this man to Talkorigins.org, STAT! This is the very reason I don't stray too far out of my area of expertise. When I blog about history, it's generally only about history that I personally have studied and always with some trepidation that an actual historian will tell me that I'm an idiot. Clearly Professor William Rubinstein, the author of this travesty, has not studied enough biology to avoid making a fool of himself. I tried to leave a comment, but it appears that the "staff" has not permitted it; so I'm leaving a TrackBack.

Orac the tortured artist

Who'd have thought it possible? Certainly not me. On the other hand, others are too simple-minded to appreciate the nuances of my work...

You are a Tortured Conceptual Artist. Your fellow
postmodernists call you an anachronism, but
you've never cared much about the opinions of
others. After all, most of them are far too
simple-minded to appreciate the nuances of your
work. They talk, while you are part of a lived
tradition.

What kind of postmodernist are you!?
brought to you by Quizilla

(Via ahistoricality.)

First baseball post of the season

I had mentioned a while ago that pretty much the only professional sport that I follow regularly is baseball. Although we're six or seven weeks into the season, I've yet to comment. (Too bad I missed my opportunity to express my schadenfreude over the Yankees' travails last week; now they seem to be on a hot streak. Oh, well...)

As a warm-up for future MLB blogging, however, check out the MLB's All-Porn Mustache Team.

Speaking of applying "intelligent design concepts" to other sciences

This is just way too good to remain buried in the comments of a post from yesterday.

If you've ever wondered what might happen if the principles of "intelligent design" were applied to chemistry, wonder no more! Check out the reDiscovery Institute. An example, which looks suspiciously similar from a parody that appeared on the back page of the The Skeptical Inquirer last month (which makes me wonder if the Committee for the Scientific Investigation of Claims of the Paranormal had anything to do with this) is:

Its stated mission:

The reDiscovery Institute is non-profit, non-partisan, public-policy think-tank located in Tacoma, Washington, with branches in Atlanta, Georgia and Fort Worth, Texas. The reDiscovery Institute fosters integration of science education with traditional Judeo-Christian principles of free market, limited government, morality, faith, property, obedience and anti-intellectualism.

Our primary focus is to extend and promote Design Theories, which have been so successful in Biology, to the fields of Chemistry, Astronomy, Physics and Geology. Our goals are to Teach the Controversies, each and every one of them. The reDiscovery Institute produces articles and studies on how to better educate children at all levels, and on how to re-educate certain adults (you know who you are). The reDiscovery Institute supports Fellows, which gullible and lazy journalists present to the public as credible scientists. The efforts of reDiscovery Institute Fellows are crucially abetted by the Institute's members, board and an ultra-conservative, ultra-rich, California savings and loan heir who believes that the American democracy should be replaced with biblical theocracy.

The reDiscovery Institute publishes books, reports and articles, and participates in conferences and debates. We provide material and support to school boards, museums, and theaters across America, to help establish best practices in science education. We are consultants to Fox News Network. The reDiscovery Institute urges adherence to John Phillipson's "Ice pick Gambit", which states that "one does not mention the Book of Genesis in the design debate because one does not want to sound like blithering idiot."

Even better, it looks like there's more to come. The reDiscovery Institute plans on applying "design" principles to astronomy and germ theory in the future, if its website is any indication! I'm definitely adding it to my sidebar under "Humor."

Unfortunately, the person who turned me on to this commented anonymously; so I don't know whom to thank. If you want proper credit from me, you'll have to 'fess up!

I knew Chicago was for me!

I can't argue with the results, although I would have thought the score for Chicago would be even higher and that L.A. and San Diego wouldn't have even registered at all.

American Cities That Best Fit You:

75% Chicago

65% New York City

60% Philadelphia

55% Los Angeles

50% San Diego

Which American Cities Best Fit You?

Pat Buchanan on World War II

I know that I said a few days ago that there'd probably be no more World War II or Holocaust blogging for a while, now that the 60th anniversary of V-E Day has come and gone. I felt that I'd been doing a lot of writing on the topic and that it was probably time for a change in pace for a while. Indeed, I'd had in mind for today a post about a rather amusing little incident that I'd observed that says a lot about the effect cell phones have on people. After all, if there's one thing I've learned in my five months of blogging, it's that my hit count will almost always fall drastically beginning Friday, hitting a low point on Sunday, before rebounding to its usual weekday levels on Monday or Tuesday, regardless of what I post. (It makes me realize just how much productivity is probably lost during the week because of people surfing the 'net and perusing blogs at work.) Consequently, I tend save my more substantive posts for weekdays (even if I actually wrote them over the weekend) and post lighter fare on Fridays and the weekend. (Last week was an exception because of the 60th anniversary of V-E Day on Sunday.)

But then Pat Buchanan had to go and write this, screwing up my plan. I guess the amusing anecdote will have to wait until the weekend or sometime next week. Sorry. But, as the medicine/science/Holocaust/World War II blogger, I have to comment briefly. Buchanan commented about President' Bush's speech, in which Bush pointed out that America bore some culpability for the domination of Eastern Europe for nearly a half century. Instead of simply partially agreeing while finding Bush's history a bit simplistic, as I did here and here, he took the issue much farther:

Other questions arise. If Britain endured six years of war and hundreds of thousands of dead in a war she declared to defend Polish freedom, and Polish freedom was lost to communism, how can we say Britain won the war?

If the West went to war to stop Hitler from dominating Eastern and Central Europe, and Eastern and Central Europe ended up under a tyranny even more odious, as Bush implies, did Western Civilization win the war?

In 1938, Churchill wanted Britain to fight for Czechoslovakia. Chamberlain refused. In 1939, Churchill wanted Britain to fight for Poland. Chamberlain agreed. At the end of the war Churchill wanted and got, Czechoslovakia and Poland were in Stalin's empire.

How, then, can men proclaim Churchill "Man of the Century"?

True, U.S. and British troops liberated France, Holland and Belgium from Nazi occupation. But before Britain declared war on Germany, France, Holland and Belgium did not need to be liberated. They were free. They were only invaded and occupied after Britain and France declared war on Germany – on behalf of Poland.

When one considers the losses suffered by Britain and France – hundreds of thousands dead, destitution, bankruptcy, the end of the empires – was World War II worth it, considering that Poland and all the other nations east of the Elbe were lost anyway?

If the objective of the West was the destruction of Nazi Germany, it was a "smashing" success. But why destroy Hitler? If to liberate Germans, it was not worth it. After all, the Germans voted Hitler in.

Ugh. Notice that nowhere is there a mention of the Holocaust. True, the Holocaust was not the original reason Britain and later the U.S. went to war with Germany. (Indeed, the Holocaust did not turn mainly exterminationist until after the 1941 invasion of the Soviet Union, and most of the six million were killed between 1941 and 1945.) But isn't Buchanan's failure even to mention it rather telling? Apparently to him, stopping the Holocaust was not a sufficiently good outcome of the war even to be worth mention in passing. You'd think he might have at least mentioned it, but apparently it is not sufficiently important a historical event for him.

Next, note how Buchanan puts the blame on Britain for "wanting to fight for Poland," rather than on Hitler for invading Poland in the first place! Never mind that Hitler had been pursuing an aggressively expansionist agenda and that Neville Chamberlain had been burned at Munich and labeled an "appeaser" for his agreement with Hitler, which he had proudly trumpeted to his people as "peace in our time." He was in no mood to trust Hitler again, and he was right not to. Apparently, in Buchanan's world view, Britain and France had no business making alliances with Poland to try to check German power and that Western Europe wouldn't have needed to be liberated by the United States if only Britain and France had left well enough alone and not bothered to declare war on Germany after the invasion of Poland.

Finally, note that Buchanan apparently doesn't blame the Stalin for going back on his agreement at Yalta to allow free elections in the territories occupied by the Soviet Union, even though it was his desire to dominate Eastern Europe that led to the occupation of Poland and the rest of Eastern Europe. Our alliance with the Soviet Union was one born of necessity. The U.S. and Britain had little choice but to ally themselves with Stalin, as odious as he was, after Hitler invaded the Soviet Union. If the Soviet Union had fallen, then Hitler would have become almost unbeatable, dominating all of Europe from the Urals to the English Channel. The U.S. may have made mistakes, which, if they had not been made, could have decreased the territory that fell under Soviet control or decreased that control, as Professor Bainbridge has argued, but it is unlikely that anything the U.S. could have done would have prevented Soviet domination of Eastern Europe. And we should remember that the real person responsible for the Soviet domination of Eastern Europe was Hitler. After invading Poland and partitioning it between him and Stalin, he then opened the door to the Soviets by invading the Soviet Union, brutalizing its population and thereby feeding a frenzy for revenge, and then losing the war. After Stalin, Hitler was the primary author of the misery that Eastern Europe endured, because he made it possible for Stalin to take over that territory.

Creationism in Kansas--again

I don't understand Kansas. Having once before given itself a black eye in 1999 by proposing eliminating the teaching of evolution in 1999, why on earth was it up for a second round? And this evolution trial is such a farce that it's hard to understand why even intelligent design (ID) advocates would have thought it was a good idea.

There's a nice summary of the trial and how ID advocates have been trying to use evolution as a "wedge" to get religion taught as science at Salon.com. An example of ID advocate strategy:

A principal aim of the creationists is to scrub the definition of "science" from Kansas classrooms -- now described as "human activity of systematically seeking natural explanations" for phenomena -- and to replace it with a more general definition lacking the words "natural explanations." If that sounds like an innocuous change -- well, that's the aim. By removing the notion of "natural explanations" as part of science, the creationists aim to give religion a foothold in the classroom, in the name of scientific balance.

Indeed. If we're not going to insist on natural explanations in science, then why not apply "intelligence" as an explanation behind every phenomenon in science. But there is one tactic that may work against ID advocates:

"The mainstream religious community, the business world, the scientific community, they haven't always taken this as a serious threat, but they're starting to," says Krebs. "We're seeing a much greater level of concern than we had in 1999." After all, the notion that bad science education can lead to fewer jobs in the future is an argument almost everyone can follow -- even if they don't want to read a bunch of technical stuff about science.

I've thought that all along. Argue it as an economic and competitiveness issue. As the cartoon I linked to pointed out, the Chinese and Indians love it when we teach our childrens probably like it when we teach our children bad science. They want their future jobs.

Oh, wait. Maybe that's the idea.

Exactly!

This cartoon gets it right...

The Skeptics' Circle VIII

The Eighth Edition of the Skeptics' Circle has been posted at Pharyngula. As I had hoped, it is a veritable feast of skeptical blogging, a great antidote to the credulity that permeates the blogosphere. Heck, it's more than a feast, it's a multi-course gourmet banquet, the biggest and most extensive edition yet. PZ even includes a couple of entries the arguments in which he himself is--shall we say?--skeptical about. However, in the spirit of unflinching skepticism, he presents them anyway, confident that the reader will be able to evaluate for him or herself whether they meet adequate standards of skepticism and reason.

Go and learn why intelligent design is neither intelligent nor design and why irrational beliefs are leading to a resurgence of previously eradicated diseases, among other things....

It's probably going to take me through the weekend to check out all the great skeptical blogging there.

Calling all history bloggers

St. Nate is hunting down history posts, as he's scheduled to host the next edition of the History Carnival on Sunday, May 15. You have three days to send him any good blog posts you've done involving history or how history affects current events. You don't have to be an historian to contribute, just a blogger with an interest in history and the desire to blog about it. I've always been quite impressed at the high level of erudition posts featured at the History Carnival have demonstrated in the past, so much so that I'm amazed that History Carnival hosts occasionally actually accept some of my humble efforts with regard to Holocaust and World War II history.

More uses for a light saber

With the release of Star Wars Episode III: Revenge of the Sith only one week away, I have to admit I'm starting to get a little bit excited about it. As a big fan of the original three movies (I saw the first showing of The Empire Strikes Back and Return of the Jedi the days they were released in 1980 and 1983), I was quite disappointed in the prequels. The last two movies were mediocre (worse, parts of Episode II were actually kind of dull--a mortal sin for any Star Wars movie); but, geek that I am, I have to confess that the trailer for Episode III looks very promising, as does the description of the movie in the latest Time Magazine. Do I dare hope that George Lucas, after two misfires, has finally delivered the goods and produced a worthy successor to the original movies? (If only he hadn't bothered with Episodes I and II. And if only he could have left well enough alone and not tinkered with the original three movies to turn them into "special editions.")

So, given my Star Wars geekiness (although, thankfully, I'm nowhere near as bad as these geeks), it's only natural that, via Keat's Telescope, I would be amused by these additional uses for a light saber (and more here). I could think of yet a few more (lighting charcoal grills, for instance), but this will do for now.

And don't forget to check out how Darth Vader reacted to Luke's escape at the end of Episode V: The Empire Strikes Back or how he likes to deal with labor unrest among the contractors building the second Death Star. I wonder how much longer Darth Vader's blog can continue, given that he's now entering into Episode VI territory.

Last call for skeptics!

Tomorrow, the Skeptics' Circle will be hosted at Pharyngula. You have until tonight to get your best skeptical blogging to PZ. Instructions to submit a piece this week are here. Guidelines for the Skeptics' Circle are here.

I've already submitted my article, time to submit yours and help to make this one yet another success.

"Intelligent design" apologia: Pot. Kettle. Black.

While idly perusing my Sitemeter referral log over the weekend, I noticed a spike in traffic directed here from one site. Curious, I read the piece that had mentioned me and saw that I had managed to get an "intelligent design" (ID) apologist named Susanna rather annoyed with my deconstruction of Scrappleface's so-called "satire" about the debate over the teaching of ID in Kansas. I debated whether it was worth the bother to respond to the "rebuttals" and ad hominems in her post, and, after three days, my snark factor won out, as it did a couple of months ago for an altie troll calling himself the Herbinator. Given that the Skeptics' Circle is due to appear at Pharyngula tomorrow, I thought: What the heck? What better way to whet my palate (and hopefully yours as well) for the skeptical feast that Pharyngula will hopefully provide tomorrow than to have a little fun at the expense of an ID apologist?

Does that mean that it's time for some of that Respectful Insolence Orac likes so much? Of course it does!

I'm an old Usenet hand, having been active on and off in various newsgroups since the early 1990's. Indeed, before I discovered blogging, my primary outlet for non-technical writing was on Usenet, particularly in the newsgroups alt.revisionism and misc.health.alternative (and, occasionally even on talk.origins, the newsgroup dedicated to the discussion of evolution and creationism). In Usenet, we had a number of shorthand sayings, one of which was "Pot. Kettle. Black." This particular saying was used, as you might guess, to point out when another person was guilty of being the "pot calling the kettle black," as the old saying goes. Normally, I ignore most attacks like the one Susanna launched, having learned from a recent encounter with Vox Day and his sycophants that it is usually not worth the trouble to engage in debate with certain people, at least not if you don't want to risk having such exchanges take over your blog. But this comment from Susanna just amused me far too much for me to let it pass unanswered:

When you feel a need to debunk satire, you may want to consider professional help.

Heh. If that's the case, then I would ask Susanna: If I need "professional help" because I felt the need to "debunk satire," then what does it say about you when you felt the need to debunk my debunking of satire? I think I'll let Susanna's comment about me guide me in my answer and just say:

Pot. Kettle. Black.

Of course, Susanna denied she was in fact "debunking the debunker," with a rather transparent excuse: "I would debunk his debunking, but I don't want to descend further into parody over satire." Don't worry about it, Susanna. You already descended into parody with your rather lengthy defense of ID; so you might as well have gone the rest of the way and tried to "debunk" me while you were at it. You could hardly have done worse than you already did. This comment of yours, for example, could have come straight from a Discovery Institute press release:

There's an interesting debate going on in Kansas - some want schools to be able to discuss the fact that there is controversy about the theory of evolution. That seems a reasonable request, since there is controversy within the scientific community itself about what permutations of the theory are most correct. But the evolutionists are Horrified, Horrified that someone would question them, and the possibility that a Much Debunked Idea (we don't want to say "intelligent design", that will just bring them here in hordes, again, to debunk me) may slip in some classes as a result of this door opening.

Yawn. A typical ID straw man, and not even an imaginative presentation.

No, it's not that evolutionists are somehow "afraid" of ID or somehow want "special treatment" for evolution. Nor is it that evolutionists want evolution to be immune from criticism, as one blog that Susanna has quoted claims. In actuality, it is the advocates of ID who want "special treatment" for their idea in schools because intelligent design as a concept (I won't dignify it by calling it a "theory" or even an "hypothesis") has failed utterly thus far to be taken seriously as science. Indeed, that is the key observation that served as the basis for my criticism of Scrappleface's attempt at satire. The reason, of course, is that ID is not science. There is no observational or experimental evidence to support it. It makes no predictions and explains no great mass of data, other than by resorting to attributing the diversity of life to an "intelligence" that must have done it all. (Gee, I wonder just who ID advocates think this "intelligence" might be? God? Well, they claim no, not necessarily. Maybe they think it's Giant lizards, perhaps?)

The bottom line is that ID has utterly failed to gain a foothold in biology as serious science the way that every accepted scientific theory ultimately becomes accepted: through the preponderance of evidence and through the theory's ability to unify, explain, and to some extent predict natural phenomenon. Nor is it about evolutionists not wanting to teach the various permutations of evolutionary theory. Scientists do not object to teaching the remaining questions that evolutionary theory has not yet explained or controversies among scientists about the mechanisms of evolution. Teaching real scientific controversies in evolution is not what ID advocates want, anyway, their claims otherwise notwithstanding. No, ID advocates want one specific concept taught, a concept that has failed scientific validation at every turn and whose advocates spend far more money and effort on PR and legal fights that misguided school boards get into on their behalf than on doing actual scientific research. If ID advocates really want to get their concepts introduced into the classroom as science, then the best way to do it is to divert some of that massive money and effort used to bulldoze various initiatives forcing the teaching of ID as "science" in high schools and use it to produce the goods. Do the research. Show scientists the evidence. Publish the research and evidence in peer-reviewed journals. Present it at national meetings of biologists. Show how ID explains the diversity of life better than (or at least as well as) evolutionary theory does.

That's how real scientists, rather than pseudoscientists, would work to get ID taught as a science in high school, college, and graduate school!

Susanna should have quit while she was just guilty of no more than a strawman argument, but she couldn't resist descending into bad science as well:

One of the arguments of evolutionists against intelligent design is that it is not amenable to scientific exploration, and that if you believe in intelligent design, you basically have no foundation from which to launch scientific inquiry. Intelligent design as an explanation of origin is as robust as the Big Bang Theory (or whatever the Theory Du Jour is, since it changes all the time, despite the scientific claims that whatever the Theory Du Jour is is finally the final word), which doesn't explain to anyone's satisfaction a) where the original matter or energy came from or b) how their origin theory presupposes a type of behavior of matter that their own science has found to be absent from current behavior of matter - that is, everything now is degrading, not improving. I don't know how they get by with such bad science, flying in their own faces.

First off, no, ID is not an explanation of origin as "robust" as the Big Bang Theory. The Big Bang Theory has enormous quantities of scientific evidence gathered over many decades from many disciplines to support it. No such thing can be said for ID. Second, I can't believe Susanna actually had the temerity to mention the hoary creationist canard that evolution somehow violates the Second Law of Thermodynamics. Now that's some really bad science, so much so that I don't need to "debunk" it. It's been debunked quite well before here and specifically here (which includes some of the detailed nitty-gritty, complete with formulas). Finally, I don't know which scientists Susanna is referring to, but no real scientist claims that the "Theory du Jour" is the "final word." Such thinking is anathema to scientists. Real scientists consider every theory as merely provisionally accepted as the best presently existing explanation for a natural phenomenon. All theories, including evolution, are subject to revision or replacement if new evidence mandates it. Indeed, the greatest joy a scientist can achieve is not to confirm current theory (although that can be satisifying) but rather to challenge and go beyond current theory, filling in its flaws or even overturning it altogether in favor of something new that leads to new understanding and new areas of inquiry. But achieving that is not easy. It takes evidence so compelling and in such quantities that the bulk of scientists are finally forced to admit that present theory can't stand against it, something ID proponents don't seem to understand. If they think ID is a superior explanation for evolution than present day theory, they need to produce the goods to prove it, just as every scientist who has successfully challenged current theory has done before. It is not up to the skeptics to prove ID is not the best explanation for the diversity of life; it is up to its adherents to prove that it is.

Then she concludes with the biggest straw man of all:

Quite frankly, I think dismissing intelligent design out of hand as an option is unscientific on its face too. I'm not saying they have to like it, or agree with it, or even use it. But to say categorically that it is not true when they have no solid evidence to reject it is to close the door on a whole range of possible answers.

Oh, please. Give me a break. That is not why scientists are doing, nor is it why they are saying that ID should not be taught as science in the classroom. Scientists are not saying that intelligent design is not true; scientists are saying that there is no credible or convincing scientific evidence that ID is true, nor is there any sort evidence that could ever prove that it isn't true. In other words, there is no good evidence for ID, nor is ID falsifiable, as scientific theories must be, including evolution. (As an aside, the types of data that could falsify evolution and common descent, were they to be found, are listed exhaustively here). Personally, I have no problem with Susanna or anyone else believing that God or whatever intelligence is behind the evolution of all living creatures. However, barring God revealing Himself for all to see, such an idea is not a testable hypothesis and not a valid basis for a scientific theory, which deals only with phenomena that can be proven or disproven on the basis of physical observation and experimentation. Such an idea is religion or philosophy, not science.

Unfortunately, Susanna does not appear to allow comments on her blog. Otherwise, I might have simply posted a much briefer version of this piece in her comments section and seen what she had to say. (Hmmm. Now that I think about it, I wonder what her lack of a comment section says about her desire to engage in debate, especially after her claim that evolutionists don't want to have their views challenged. Should I say "Pot. Kettle. Black." again? Sure, why not?) However, I have little doubt that she'll eventually become aware of my article, if you all click on the right links. When that happens, I cordially invite her to feel free to tell me exactly what the specific scientific evidence for ID is that she finds so compelling that ID should be taught as an "alternative theory" to evolution. My comment section, unlike hers, is open for business. I'll even forget that she said publicly that she thinks I need professional help.

Oh, and Fat Steve, my cordial welcome applies to you as well, if you would like, given that you apparently felt the need to lend some rather ineffectual but unintentionally amusing--to me, at least--tactical air support to Susanna (your self-proclaimed "sterling intellectual qualities" notwithstanding). I'll even forget that you called me a putz and said that I should "get a clue."

I'm just that kind of a forgiving guy, you know, now that I've had a chance to vent.

And, please, both of you, visit the Skeptics' Circle tomorrow at Pharyngula. It'd definitely do you both some good. Heck, why don't you both send PZ your pieces as entries to the Skeptics' Circle, examples of your "skepticism" over evolution? On second thought, never mind. I confess that my suggestion was a bit of a trap. (I was just feeling snarky again.) PZ isn't nearly as tolerant as I am of ID apologists like you. I doubt he'd be as patient with you as I've just been.

Grand Rounds XXXIII

Grand Rounds XXXIII has been posted at Azygos, and a fine edition it is. Check it out.

Is this for real?

I'm afraid it is:

I definitely won't be buying one. Even if I were still a Bush supporter, I'd find it incredibly tacky.

And a bit scary, as well.

V-E Day anniversary roundup

I couldn't resist one last post on the 60th anniversary of V-E Day, which I blogged about a couple of days ago. Others have been commenting in the blogosphere as well, and some of these pieces are worth reading too. (Those of you getting tired of this topic: Don't worry, this will probably be the last post on this topic for a while.)

First off, Kevin at LeanLeft apparently agrees with me that Bush's regrets for the abandonment of the Baltic Republics, Poland, and Eastern Europe to Soviet Domination after WWII was simplistic, although he said it more strongly than I did:

Unsurprisingly, Bush is being a historical idiot here. The Red Army was massive, battle tested, possessing the best armor in the world at the time, and Stalin had no intention of leaving. The life of a permanent revolutionary and the brutal nature of intra-Communist politics had exacerbated Stalin’s natural paranoia. He did not trust the West – he remembered both the attempt of the West to restore the Russian monarchy after WWI and the delays in opening the Western front while his troops were bleeding in the East. The Nazi near success convinced him that he needed a buffer. He had it in Eastern Europe, he had the Army to defend it, and he would not willingly give it up. The United States would have had to have removed the Soviets by force.

That war would have been a bloody, horrible mess. Patton – darling of the right wing of the day – suggested rearming the Germans and using them to fight the Russians. Such a decision would have meant no Nuremberg and thus no reckoning for Auschwitz. And perhaps no public acknowledgment of the depths of the Nazi horrors. After all, the American and British publics would not have liked the fact that US soldiers where fighting along side people who were at least partially responsible for the Holocaust. And even that morally grotesque suggestion would not have been enough. At some point, nuclear weapons would almost certainly have had to have been used. And we haven’t even discussed what effect such a war would have had on the Pacific Theater. If it started before the surrender of Japan, does anyone think that the Soviets and the Japaenese would not have made common cause? And if it happened shortly after the surrender, it is entirely possible that the Japanese Army would have seen an opportunity to reverse its fortunes.

He has a point (particularly about the likelihood that a war with the Soviet Union jeopardizing our defeat of Japan and potentially preventing the perpetrators of the Holocaust from being brought to justice). However, it rather bothers me that Kevin seems to be so blithely dismissive of the domination of Eastern Europe by the Soviet Union for 45 years as "the best option available" to Franklin D. Roosevelt, before using President Bush's comments as an excuse to launch into an attack on Bush and the right wing. It would have been nice if he had more fully acknowledged just how horrible that "best option" was for those people who were unfortunate enough to be caught on the wrong side of the Iron Curtain in 1945. It is not necessary to be just "parroting the visceral hatred of FDR that the plutocrats of the day wallowed in and imparted to the far right of the Republican Party" to acknowledge that, even if all out war was probably not a viable option to stop this injustice, the U. S. did basically abandon Eastern Europe when Stalin broke the agreement at Yalta to allow free and fair elections and new democratic governments in Poland and its occupied territories.

In another vein, Professor Bainbridge ruminates about whether World War II could be truly considered a "just war," commenting on this article. Specifically, the making of common cause with Stalin against Hitler bothers him, as does the strategic bombing campaign (which I've discussed before in both the European and Pacific theaters). The latter bothers me more than the former (after all, after the German invasion of the Soviet Union, how could the Allies not have joined cause with Stalin, as distasteful as he was?). However, one also has to remember that bombing technology was so primitive and inaccurate that even "precision bombing" rarely hit its target with bombs in sufficient number to destroy it, and that, in 1942 and 1943, strategic bombing was the only real way that the Allies could do anything to prosecute the war other than at the fringes (North Africa, for example). Stalin was demanding that something be done, accusing Churchill and Roosevelt of letting the Russians do the fighting and dying while they sat back.

The bombing campaign probably did help end the war faster, although not by destroying German industry, as intended:

But bombing Germany did divert air cover away from the Eastern Front. In the spring of 1943, 70% of German fighters were in the western European theater, leaving German ground forces in the east increasingly vulnerable to Soviet air attacks. Lack of air cover was one of the reasons the German tanks were beaten at Kursk.

Strategic bombing also greatly hampered Albert Speer's considerable efforts to mobilize the Nazi economy for total war. In January 1945, Speer and his colleagues calculated the damage done in terms of what they couldn't produce: 35% fewer tanks than planned, 31% fewer aircraft and 42% fewer trucks. The impact of bombing on the Japanese economy was even more devastating.

But, as the Professor reminds us, that the logic of total war overtook us as well, at a moral cost.

More evidence that not all conservatives buy into intelligent design

It comes again from Balloon Juice:

I find it a grave insult to the English language that something as stupid as ID should incorporate the word 'intelligent' in its title.

Indeed.

More evidence that not all conservatives buy into the ID line comes from our comrade Stephen at The Politburo Diktat.

Mothers' Day wishes from....Darth Vader?

It's true. Even the Dark Lord of the Sith has a soft spot for his mother.

What is a surgical oncologist?

Although I've mentioned before that I am a surgical oncologist, but I recently noticed that, in nearly five months of blogging, I've yet to explain exactly what that is or what it means. I've written about all sorts of things, ranging from alternative medicine, to the evolution-creationism conflict, to the Holocaust, to even trying my hand at reviewing music.

True, I've discussed a fair number of anecdotes based on patient stories. Certainly those stories can give a feel for what I do in the clinical part of my duties, but they don't really explain what my specialty is. I've also spoken about the difficulties of combining a research career with a clinical career, but the emphasis was usually on the research and not so much on the actual clinical work that I do. I've never actually talked about what my specialty is. I find that somewhat odd. It just never occurred to me. Perhaps I just assumed that everyone knows, even though I know better than that.

In my experience, there is a fair amount of confusion among lay people about what exactly a surgical oncologist is. Basically, a surgical oncologist is a surgeon who specializes in the surgical treatment of cancer and malignant diseases. The reason that there is confusion over what a surgical oncologist does is because there is considerable overlap between what we do and what general surgeons do. Indeed, I am a general surgeon, because most surgical oncologists do a general surgery residency first and then a surgical oncology fellowship. It's a long haul, because a general surgical residency is at least five years. If one opts to do research during residency (more or less mandatory to get accepted by a good fellowship program), then the general surgery is more like six or seven years. Then, the surgical oncology fellowship is three more years.

The fellowships for surgical oncology are quite competitive to get into, as there are only 14 training programs in the U.S. approved by the Society of Surgical Oncology, with around 30 slots per year. What does this addtional training provide? First, it educates the surgeon in the state-of-the-art care of common malignancies that can be treated surgically, such as breast, lung, and colon as well as providing extensive exposure to complex and unusual cancer problems. Second, the training includes considerable experience in management of complex disease involving endocrine pancreas and in surgery for benign and malignant tumors of the thyroid, parathyroid, adrenal, and ovary. However, perhaps the most important additional skills and knowledge provided by a surgical oncology fellowship are the understanding of the multidisciplinary management of the major cancers that are primarily treated with surgery, such as breast cancer, colorectal cancer, melanoma, stomach cancer, pancreatic cancer, and liver cancer. The surgical oncologist takes rotations in medical oncology, radiation oncology, and pathology. In addition, the surgical oncologist is expected to complete a research project on malignant disease during the fellowship. This additional experience prepares the surgical oncologist to take the lead where appropriate in the multidisciplinary management of solid tumors and to develop either a clinical or translational research program into his cancer of interest.

A surgical oncologist is different from a medical oncologist or a radiation oncologist, with whom we are sometimes confused. Medical oncologists do not so surgery; they treat cancer by administering chemotherapy. This makes them the primary doctors who treat hematologic malignancies, such as lymphoma and leukemia, for which surgery is not helpful, other than for the occasional diagnostic lymph node biopsy. They also administer adjuvant chemotherapy, which is chemotherapy given after surgery with curative intent that is designed to decrease the rate of recurrence. Cancers for which adjuvant chemotherapy has been shown to improve survival and disease-free survival include breast cancer, colorectal cancer, and several others. They also have the very difficult and emotionally draining job of treating patients with metastatic solid tumors, for whom cure is not possible. Radiation oncologists, on the other hand, are more like surgical oncologists in that they treat local disease, this time using radiation, rather than surgery. Radiation oncologists sometimes are the primary treatment for some cancers with or without chemotherapy (Hodgkin's lymphoma, anal cancer, for example), but most of the time they give adjuvant therapy after surgery, as in breast cancer and rectal cancer.

We should get one thing straight here. Most cancer surgery for the common abdominal malignancies (excluding prostate or gynecological malignancies) is still done by general surgeons and is likely to continue to be done by general surgeons for the forseeable future. Breast cancer and colon cancer, for instance, the two most common cancers surgical oncologists deal with, are primarily dealt with by general surgeons, particularly when they are uncomplicated cases. There are a fair number general surgeons even do advanced cancer operations, like the Whipple pancreaticoduodenectomy or liver resections. Surgical oncologists are more highly trained, but a lot of what a surgical oncologist learns and brings to the table can be learned outside of a fellowship through experience taking care of cancer patients, and many general surgeons have done so. However, these days, as for many specialties, fellowship training is becoming more important, and among younger surgeons who want to take care of cancer patients not completing a surgical oncology fellowship is becoming less of an option. There will probably never be enough surgical oncologists to take care of all of the cancer in this country, and general surgeons will probably still take care of the bulk of the common cancers that surgery can cure, like breast or colorectal cancer. However, for cancers that require a complex operation to remove, such as pancreatic cancer requiring a Whipple pancreaticoduodenectomy or liver tumors requiring large liver resections, you are probably better off with the specialist. (Of course, this can be confusing to patients as well, because colorectal surgeons do a fine job of taking care of colorectal cancer, and there are many liver surgeons or liver transplant surgeons who do liver resections for cancer, mainly because, except of very busy transplant programs, there are not enough liver transplants at most hospitals that do them to keep a liver transplant surgeon busy.)

As a career, surgical oncology has many advantages. One of the great joys of surgical oncology is that you can actually cure your patient. If most of your practice is breast cancer, as is mine, you can actually "cure" your patients a fairly high percentage of the time (one of the key reasons that altie testimonials for "breast cancer cures" from patients who eschew chemotherapy and radiation therapy proliferate). For such patients, chemotherapy and radiation therapy are the "icing on the cake" that decreases the rate of recurrence, but surgery was the primary therapy. That is not to say that some patients with tumors that should have been curable don't sometimes relapse, but most of the time they do not. Another great advantage of surgical oncology as a specialty is that it tends to lend itself better than many surgical specialties (trauma, for instance) to basic and translational research, which is the path I have taken. If, as a surgical oncologist, you work at an academic cancer center (as I do), the opportunities for collaboration and research that makes a difference in the lives of cancer patients is great. And depending upon the diseases you take care of, the lifestyle can be not so bad, as much of the time you don't have to take trauma or general surgery call. Of course, one disadvantage of being a surgical oncologist is that you become the general surgeon for the medical oncology service. That means that, whenever patients with cancer get general surgical problems (cholecystitis, appendicities, bowel obstructions), the medical oncologists usually call you, not the general surgeon. Bowel obstructions are seldom the easy kind where you operate and cut a couple of bands to fix the problem. No, the bowel obstructions we see are usually in patients with carcinomatosis, for whom our best efforts are unlikely to relieve their obstruction for long. We don't see straightforward cases of appendicitis or cholecystitis; the patients we see with these diseases usually have very low white blood cell counts (meaning they're immunosuppressed) and/or low platelet counts (meaning that operating on them has a much higher risk of causing bleeding).

Overall, surgical oncology as a specialty is evolving and becoming more defined. There are now subspecialties of even surgical oncology. The most common one is breast surgery, and there are now a number of breast fellowships for surgeons who want to specialize in breast surgery. I only see this trend proliferating, as it has in so much of medicine. Nonetheless, for common cancers, both surgical oncologists and general surgeons with a strong background in treating these cancers can provide excellent, state-of-the-art care. For more uncommon or complicated cancer problems, however, a surgical oncologist is usually the better bet.

Happy Mothers' Day

Today is Mothers' Day, and I just want to take this opportunity to wish my mother and my wife's mother a happy day.

Unfortunately, there is a tinge of sadness to this day, because it's the first Mothers' Day since my grandmother died last fall; Mothers' Days just won't be the same.

60th Anniversary of V-E Day

60 years ago today, on May 8, 1945, the unconditional surrender of the German armed forces (Wehrmacht) was signed by Field Marshal Wilhelm Keitel, ending World War II for Germany. Although more than three months of bloody fighting in the Pacific against Japan remained, the war in Europe was finally over.

The war, which lasted nearly six years for the European combatants and three and a half years for the U.S., changed the world forever. Killing on a scale not before seen in history became the norm. The horror of the Blitzkrieg and the Battle of Britain unleashed by Hitler were repaid by the Americans and British with the massive bombing of German cities. The horror of operation Barbarossa (the German invasion of the Soviet Union) and the crimes of the Einsatzgruppen mobile killing units that followed the Wehrmacht into Russia were repaid by the Soviet Union with the brutal conquest of the eastern half of Germany, with mass rapes and the subjugation of half of Germany under Soviet domination for nearly half a century. On the Eastern front, nations caught in the middle of this titanic conflict, such as Poland and the Baltic nations, suffered first under one tyranny and then under another. The Jews in Europe paid an even higher price, given their status as the primary target of Hitler's hatred, but Hitler's murder was by no means limited to the Jews. Although appoximately six million Jews died by various methods, including shooting, hanging, intentional starvation and overwork, and gas chambers, in Hitler's Holocaust, five or six million non-Jews met the same fate, particularly in Poland, the Ukraine, and western Russia. When the war was over, the division of Europe into two spheres of influence set the stage for the Cold War that dominated geopolitics for half a century.

As we celebrate the victory over fascism and Nazi-ism that took place sixty years ago, I'm actually struck by how relatively little discussion of this great anniversary there is here in the U.S., given its importance. The discussion that I do hear either tends to come from European sources or to dwell on the appropriateness of President George W. Bush's attending the celebration in Moscow, particularly the military parade that he will see with Russian President Vladimir Putin. Anne Applebaum, for example, puts it this way:

Try, if you can, to picture the scene. A vast crowd in Red Square: Lenin's tomb and Stalin's memorial in the background. Soldiers march in goose step behind rolling tanks, and the air echoes with martial music, occasionally drowned out by the whine of fighter jets. On the reviewing stand, statesmen are gathered: Kim Jong Il, the dictator of North Korea, Alexander Lukashenko, the dictator of Belarus, Gen. Wojciech Jaruzelski, the former dictator of Poland -- and President George W. Bush.

That description may sound fanciful or improbable. It is neither. On the contrary, that is more or less what will appear on your television screen May 9, when the 60th anniversary of the end of World War II is celebrated in Moscow. I have exaggerated only one detail: Although Kim Jong Il has been invited, his attendance has not yet been confirmed. But Jaruzelski is definitely coming, as are Lukashenko, Bush and several dozen other heads of state. President Vladimir Putin of Russia will preside.

Indeed, it is correct to be concerned that this celebration may be perceived as an endorsement of the Soviet Domination of Eastern Europe, particularly since Putin seems to want to make it into exactly that. Not surprisingly, the Baltic states are less than thrilled with the manner in which this anniversary is being celebrated, particular given that President Putin is still claiming that the Baltic complaints were being aired to mask a "discriminatory, reprehensible policy" against the Russian-speaking minorities in their countries. While it is indeed true that the Soviet Union bore the brunt of the European war, losing approximately 27 million people during four years of brutal combat, a contribution that has been downplayed in Western accounts of the war, it is equally true that Stalin had made a deal with Germany to carve up Poland and then took advantage of its victory to occupy the Baltic states, Poland, and half of Germany.

Fortunately, President Bush seems to understand the appearance problem, and has visited the Baltic nations before proceeding to the Soviet Union. Indeed, he has gone farther than any previous President in accepting blame for the U.S. in making this deal with Stalin at Yalta, saying:

As we mark a victory of six days ago -- six decades ago, we are mindful of a paradox. For much of Germany, defeat led to freedom. For much of Eastern and Central Europe, victory brought the iron rule of another empire. V-E Day marked the end of fascism, but it did not end oppression. The agreement at Yalta followed in the unjust tradition of Munich and the Molotov-Ribbentrop Pact. Once again, when powerful governments negotiated, the freedom of small nations was somehow expendable. Yet this attempt to sacrifice freedom for the sake of stability left a continent divided and unstable. The captivity of millions in Central and Eastern Europe will be remembered as one of the greatest wrongs of history.

Although many have criticized the Yalta agreement in just these sorts of terms, it is quite remarkable to hear a sitting President of the United States do so, likening the Yalta agreement to the Nazi-Soviet pact that carved up Poland in 1939. In one way, I find it heartening to hear an acknowledgment that the U.S. itself was partially responsible for the Communist domination of Eastern Europe. There is no doubt that the U.S. partially was responsible, but let us also not forget that it was Hitler's deal with Stalin, then Hitler's invasion of the Soviet Union, and then finally Stalin's territorial designs that were primarily to blame. Also, it still makes me uneasy because it is, as many of President Bush's proclamations are, a bit simplistic. From the safe distance in time of 60 years, it is very easy to label Roosevelt's decision to accept the carving up of Europe into spheres of influence as cynical, unjust, or a vestige of colonialism (which is why Churchill was thought to be less disturbed by the agreement than Roosevelt), and it probably was to some extent all three. On the other hand, it is easier to understand taken in the context of the time. The Allies were weary of war, and Japan had yet to be defeated. In May 1945 it was widely believed that defeating Japan would require a large-scale invasion of the Japanese islands. (The atomic bomb had not yet even been tested.) Challenging the the Soviet Union too aggressively, which, in response to Hitler's invasion, had built itself up into a military colossus unrivaled in the world in order to defeat Germany, would have meant being willing, if necessary, to go to war with an enemy that had become even more powerful than Hitler ever was while still needing to defeat another foe who was weakened but still dangerous. Although General George Patton might have wanted to attack the Russians right away, politically it was probably not politically or militarily feasible in 1945. Before you conclude that the U.S. sold out Eastern Europe in 1945, try to put yourself in the place of Americans and British in 1945 and then ask yourself: What could we have done? Stalin would have been unlikely to back down without a credible threat of war. Would you have supported plunging into a potentially even more bloody war with the Soviet Union, having just completed one such war?

Does this excuse our abandonment of Poland, the Baltics, and Eastern Europe to Soviet domination? No. But it does explain why it may have seemed acceptable at the time.

It's a hugely difficult question, but I think it illustrates exactly what Allied leaders had to ask themselves as they confronted the colossus that the Soviet Union had become. They had to ask themselves if they were willing to enter into another war. I don't know how I would have answered that question. However, one of the most useful things about studying history is that it forces you to think about such questions and apply the answers to events that occur in your own lifetime.


Other V-E Day articles and commentary:

V-E Day Slideshow
V-E Day Audio Slideshow
The full text of President Bush's speech in Riga
Bush flies into celebration, controversy in Russia
60th Anniversary of V-E Day
Bush criticizes deal dividing Europe after WWII
The Party to End All Parties
V-E Day in New York
Russians observe 60th anniversary of V-E Day
A peace tainted by horror

Happy Birthday Dear Sister!

Today is my sister's birthday. It's also one of those milestone birthdays that many dread and some embrace, one that I myself passed a couple of years ago. I know that my sister reads this blog (although I don't know if she reads it every day or not). All I can say is: It's really not that bad; so have a good time today!

Happy Birthday!

Polio returns, thanks to anti-vaccination zealots

If ever you want evidence of the harm that fundamentalist and altie beliefs can do, look no further than Africa and Asia, where polio has returned with a vengeance, thanks to the efforts of anti-vaccination zealots and fundamentalist Islamic preachers. Skeptico and Universal Acid have already ably commented about the resurgence of polio in the Third World, and, of course, Peter Bowditch has been constantly refuting the distortions of anti-vaccine kooks for years, but I feel the need to chime in once again. I agree that we shouldn't feel too superior here in the West. As Skeptico puts it:

We shouldn’t feel too smug though: the West has its own anti-vaxers who also rely on ignorance to oppose such proven solutions. These range from quacks such as Naturopaths to celebrity idiots like Bill Maher. Whatever its source, it results in unnecessary suffering. Polio is a horrible crippling disease that has been eliminated in the Western world.

Indeed.

But whether polio will remain eliminated is now open to question. I had thought that anti-vaccination zealotry was a byproduct of wealth and so many years of vaccination success that have virtually eliminated once dreaded diseases like polio and smallpox. People no longer fear these diseases enough to vaccinate their children or believe that their children are vulnerable to them, even without vaccination. In this sort of background, reports that exaggerate the very small risks of vaccination, such as alties who push a non-existent vaccine-autism link, lead people who don't understand the concept of herd immunity and have never seen anyone they know come down with the disease to be vaccinated against conclude that even the tiny risks of vaccination are too high to protect against what they believe to be a (now) nonexistent disease. (Of course, recent studies have utterly failed to find any such link between thimerosal-containing vaccines and autism, but that never stopped the alties.) However, it's clear that, even in poor countries, where preventable diseases cause considerable suffering and death, where the populace has the most to gain from aggressive vaccination programs, anti-vaccination hysteria can take root. Also, given the increasing mobility of even populations from the Third World, we can't just sit back in the U.S. and consider ourselves safe. Vaccination (or lack thereof) anywhere in the world where there are people who wish to come to the U. S. should be of concern to us, as travel between nations could allow polio or other previously "eradicated" diseases to gain a foothold here if we let our vaccination rates fall too low.

In poor countries in Africa and Asia, it is not so much "New Age" or naturopathic beliefs that fuel pseudoscientific alarmism against vaccines as they do in much of the Western world, but rather paranoid conspiracy theories postulating that vaccination is part of a U.S. plot against Muslims, usually taught by fundamentalist preachers One such myth claims that the vaccines are intentionally contaminated with anti-fertility chemicals that would leave their children sterile or (in another version) infect them with AIDS, all as a part of a plot to depopulate the developing world. But these sorts conspiracy myths are not unique to Muslims; various Christians push them as well, although the ends of the plots are usually more concerned with privacy issues. Sometimes, they claim that the Bible itself states that vaccination is against God's will, even likening it to witchcraft. One particularly disturbing example by Dr. Leonard Horowitz seems to be arguing that, because vaccinations prevent the weakest from from dying from disease, it is somehow interfering with "natural evolution" and God's will and thereby weakening the population and contributing to epidemics of disease. Remove the word "God" from the sentence and replace it with "nature," and you have an argument that is starting to get uncomfortably close to the Nazi justification for euthanizing those whom they termed "worthless eaters" or "life unworthy of life" (the mentally retarded, the schizophrenic, etc.). The only major difference is that Dr. Horowitz is not proposing actively killing those who can't hack it as far as the "survival of the fittest" goes, although he certainly does appear to be advocating not even trying to protect them from diseases that could kill them. (That hardly seems consistent with a concept of Christians showing compassion to the sick, as Jesus did.)

If, according to Dr. Horowitz, vaccination is wrong because it interfere's with God's will and His plan for natural evolution, then I have to ask him: How can he justify any aggressive treatment of the sick? After all, according to him, it is God's will that they got sick in the first place, isn't it? If they get a disease, it must be God's will. Presumably they will then either live or die, depending upon God's will. Horowitz's rationale seems to be that preventing disease allows the "unfit" to escape God's "natural selection," but if God is all-powerful (as I'm sure Horowitz would consider Him), then nothing man could do could thwart His will, could it? None of the "unfit" could escape, no matter how clever humans were at creating vaccines, could they? Horowitz seems to be saying that man can thwart God's will with vaccines; but making that argument seems to presuppose that God is not all-powerful, that His will can be thwarted by man. His handwaving that "epidemics" and resistant organisms are a smokescreen. If God is omnipotent, He shouldn't have need of such indirect actions; He could simply prevent the vaccines or antibiotics from ever working, so that His will is never thwarted. If even one "unfit" person were, through vaccination, to escape God's will that he or she contract a disease and die, then that would mean either that God failed to prevent humans from thwarting His will in this one case or that it is His will that the person saved by vaccination should not get the disease vaccinated against. Dr. Horowitz can't have it both ways, although I'm sure the inconsistency does not trouble him.

That logical inconsistency aside, how could preventing disease be against God's will for evolution and treating disease not be against God's will? We are not given much guidance about how to decide, other than that "natural cures" (whatever "natural" means) seem to be acceptable treatments, whereas drugs are not:

The drug industry, however, wants you to know that the people who heed the advice of alternative medical gurus are simply misguided, dead wrong, or placing themselves at great grave risk. If there is a God, pharmaceutical advocates claim, He must have made a mistake. Forget what science teaches about evolution of the species and survival of the fittest under God's natural laws of selection! The petrochemical-pharmaceutical cartel derived vaccination movement proposes that we also forget that the whole person, body, mind and spirit, is greater than the sum of its parts, a truism that underlies the concept of wholistic health and effective alternative therapies such as acupuncture and homeopathic medicines. Forget, too, what is taught in every religion about God's supreme omnipotence in guiding destinies and even miraculous healings. Rather than Divine intervention, natural selection, or alternatively empowered immunity, public health vaccine evangelists (from the Centers for Disease Control and Prevention, the CDC, mostly) and medical deities (M.D.s) have become our surrogate saviors.

Scary, isn't it? Personally, couldn't one use Christian belief to counter that God gave humans the reasoning ability to produce medicines that prevent and treat disease? If He gave us these abilities, then why on earth would He not want humans to use them to relieve suffering?

In some cases, fundamentalist opposition to vaccination is rooted in their disapproval of the behavior that leads to the disease being vaccinated against, as with their opposition to the recently developed human papilloma virus (HPV) vaccine. Apparently, as is the case with condoms, these fundamentalists believe that prudent prevention efforts against the spread of sexually-transmitted diseases other than their favored (and largely ineffective) abstinence-only programs will only encourage promiscuity and should thus be discouraged. (Perhaps they think that AIDS and cervical cancer are just punishments for promiscuity, although few will actually come out and say so explicitly.) These conspiracy myths can be eerily similar to some alties' conspiracy theories suggesting that vaccination is a plot by pharmaceutical companies or a plot by the government to track people and invade their privacy, and they may cost thousands their lives. Indeed, with the exception of objections on the basis of removing a negative consequence of what is seen as an immoral behavior, at the heart of anti-vaccination madness are very frequently conspiracy theories, whether religion-based or based in an extreme mistrust of the government, pharmaceutical companies, or "conventional" medicine.

All of this seems to be part of a rising tide of anti-science sentiment that only appears to be growing, particularly in the U.S. Unfortunately, it's not just fundamentalists who spread these distortions about vaccination; even self-proclaimed "skeptics" and atheists sometimes fall prey to this pseudoscience as well, making anti-vaccination mania the irrational belief that ultraconservative Christians and Muslims and even avowed atheists can embrace, albeit for different reasons. Bill Maher is a perfect example of one such outspoken atheist who expresses contempt for religion and "irrationality" but has nonetheless apparently found a way to drink deeply of the anti-vaccination Kool Aid. He demonstrated his anti-vaccination credentials recently on his show by his repeating of the myth of Pasteur's "deathbed conversion" on his show as if it were fact, stating bluntly, "I don't believe in vaccination," and adding to the mix some vague mutterings about "aggregate toxicity" and pharmaceutical companies (all standard altie conspiracy theory fare) for good measure. If we in the U. S. and the developed world let these pseudoscience-pushing alarmists influence policy and persuade people to stop vaccinating their children, the fate of Nigeria and Indonesia and their resurgence of polio may be ours a few years from now. We already see evidence that this future is not as unlikely as we'd like to admit. In very wealthy, progressive towns in Colorado, pertussis has returned, thanks to anti-vaccine propaganda. Don't think it can't happen all over the U.S.

It can.

Best quote of the day on the Kansas evolution controversy

The best quote of the day on the Kansas "evolution trial" going on right now comes from an article in the Washington Post:

"It's clear from the beginning that this is not a real science discussion. This is a showcase for intelligent design," said Jack Krebs, vice president of Kansas Citizens for Science, which is boycotting the four days of hearings. "They have created a straw man. They are trying to make science stand for atheism so they can fight atheism."

Exactly right.

At least some conservatives don't drink creationist Kool Aid

I especially like the slogan in the picture of intelligent design advocates included with this broadside. The slogan:

I don't accept the fundamental tenets of science, and I vote.

Heh heh. That about sums up ID advocates.

ADDENDUM: Oops. I made a little mistake. The picture that Balloon Juice used came from an article in The Onion.

I should have guessed!

Happy Nurses' Day

In the U.S., May 6 is Nurses' Day. Doctors, show the nurses you work with how much you appreciate their care and help. (I know my clinical workload would be far less manageable without my nurse; I might not even be able to handle it and my laboratory research at the same time.)

Patients, show how much you appreciate their caring work.

First impressions of Mac OS X v10.4 ("Tiger")

Mac geek that I am, I naturally got copies of the latest update to the Mac OS, OS X 10.4 "Tiger" for my lab, office, and home computers. Over the weekend, I installed Tiger on three of our computers. Now that I've had a chance to play with it for a week, I thought that I'd give my impression. Never mind that St. Nate beat me to it a few days ago (along with scores of other bloggers, no doubt); given that I've been a Mac user for at least 16 years, I can't refrain from putting my two cents in.

First, Tiger is evolutionary, not revolutionary, at least as far as the interface is concerned. OS X 10.3 ("Panther"--and, no, I don't know why Apple names its operating system releases after big cats) was a far bigger change compared to 10.2 than 10.4 is compared to 10.3. Tiger's interface is more or less the same as before. The graphics seem a bit cleaner, with the windows and fonts looking sharper, but all the same elements are there, including the sidebar. The System Preferences window is quite similar to that of OS X 10.3, but more logically arranged into groups, with a nice "browser-like" interface. I haven't seen objective testing yet, but one much appreciated change is that the OS "feels" snappier and more responsive. Even on my four-year-old original Titanium PowerBook (which, unfortunately, I'm presently forced to use as my main axe until my regular computer gets back from the shop) feels less sluggish. Indeed, it feels usable now, whereas before it was annoyingly sluggish for even basic operations. I don't know if this is just my perception or wishful thinking, but it is noticeable--and appreciated. Far too often software developers concentrate so much on new features that they don't bother to optimize the system so that it runs fast and is responsive. Apple has not done this, at least not for Tiger. The first version of OS X was almost unusably slow, but with each iteration Apple has tweaked things and made the OS more responsive. But with Tiger, most of the improvements seem to be under the hood.

So, on to individual features.

Installation. Tiger is the first Mac OS update that is contained entirely on a single DVD-ROM, rather than on multiple CD-ROMs. This is fine for most computers less than a couple of years old, but if you have an older Macintosh that otherwise meets the minimum system requirements to run Tiger but doesn't have a DVD drive, you have a problem. If you want to install Tiger on such a machine, you have to utilize Apple's exchange program, in which you pay $9.99, send back in your system DVD, after which Apple sends you the system installers on CD-ROMs. Very annoying, particularly since I happen to have one computer that can run Tiger but does not have a DVD drive. I can understand why Apple did this, given that nearly all of its computers made more recently than about three years ago have DVD drives or DVD-R drives, but many Macs older than that could run Tiger (and would benefit from its peppier speed). As with the last release, there are three installation options: update (which updates the old system); archive and install (which archives the old system and installs a clean copy, with or without maintaining all the user settings, depending on what you choose); and format and install (formats the hard drive and installs). As usually, everything worked smoothly.

Spotlight. This is the feature everyone's talking about. Spotlight is a system-wide search engine that looks not just at the names of files but what's inside files. It indexes everything on your computer in the background and allows it all to be searched. You can type a search term, and Spotlight will retrieve every file, e-mail message, contact, music or video file, image, URL, PDF file, application, etc. that matches the search term, all arranged neatly by type. Better yet, it's lightning fast. This feature could well change the way people use computers, because it will become much less important where a file is located when it can be found very rapidly by Spotlight. This feature will probably mean less to people like me, who are anal-retentitive when it comes to arranging files in well-organized nested folders and who know pretty much where every file they want to use is anyway. However, most people don't organize their files and folders like that. One really useful feature that comes from Spotlight is "smart folders." These are in essence saved searches that are stored in a different kind of folder. They update automatically and can serve as a convenient means of accessing documents meeting certain search criteria.

Dashboard. Dashboard is a way to have a number of small "one-trick pony" applications (called "Widgets") that can be accessed in an instant on your desktop to do various useful things, like check the time and weather, function as a calculator, track flights, look up people in various directories, among others. Widgets zoom in from the sides to sit in front of your desktop at the touch of F12 and zoom out again. Hitting an icon in the corner brings up a line of icons for all the available Widgets. Clicking on a Widget activates it, with a really spiffy "rock in a pond" kind of effect. This is way some cool eye candy. However, eye candy is useless without function, and fortunately the number of features you can have as Widgets will likely increase as developers write more and more of them. All in all, Widgets remind me of a really sexed-up version of Desk Accessories from back in the days of System 6 and before. (I know, I'm dating myself, given that System 6 was supplanted by System 7 in 1991.) All in all, Dashboard is a nice feature, but nothing earthshattering. I'm not sure I find this feature all that compelling.

Automator. Applescript is an incredibly useful scripting language, but it's in essence a programming language (albeit a simple one). Most people can't access its power (or won't take the time to learn it). Automator provides a simple graphical user interface to build one's own workflows. I haven't had much of a chance to use it yet, but in my limited testing it seems to work well. I suspect this one will grow on me over time as I discover its features and design custom workflows for my needs.

Safari. Apple updated its standard web browser with a really nice feature. Safari 2.0 now handles RSS newsfeeds with aplomb. If a web page has a newsfeed link on it, a little "RSS" emblem will appear in the navigation toolbar. Click on it, and the feed is added to your bookmarks. It's simple, elegant, and functional. Another nice feature is that you can open the RSS feeds in a folder all at the same time in tabs or you can choose "View all RSS articles." Safari's RSS reader doesn't have a lot of bells and whistles, but I don't need a lot of bells and whistles. Best of all, I can keep my newsfeeds and bookmarkes to websites all in the same places; there's no need for a separate application. I'm now going through all the links to blogs and news sources and saving them as RSS feeds. One other feature containing Apple's patented eye candy is RSS Visualizer, which is a screensaver that scrolls headlines from RSS newsfeeds. Of course, just doing that is not enough for Apple. Oh, no. Apple has to have the headlines swoop in and swirl around a central line, like a DNA helix or a spiral staircase, with blue and green, vaguely cloud-like patterns swirling in the background. Oddly enough, I like it. I've set my screensaver to show New York Times RSS newsfeeds.

Mail. Pesonally, since OS X debuted, I've had a love-hate relationship with Mail. Its trainable Bayesian spam filter was my favorite feature. It's far better than Microsoft Entourage's anemic spam filter, but Mail's interface had a number of irritating quirks to it, not the least of which was the irritating "drawer" that popped in and out on the side. Also, it lacked a lot of features that I took for granted with Entourage, especially the rather elegant way Entourage can handle mailing lists. Apple still hasn't added a feature equivalent to Entourage's ability to handle mailing lists, but it has improved its interface greatly and eliminated most of my pet peeves. One cool new feature is the "smart mailbox," which is basically like the smart folders in the Finder or smart playlists in iTunes, only for mail. Best of all, if you have a .Mac account, you can now sync all of your mail, filters, accounts, and mailboxes across as many computers as you like, just as you could sync all your bookmarks, iCal schedules, and contacts. That's the feature I'll be using once I get my main computer back and set up Mail on it the way I like it.

There's a lot of other stuff there, too, but those are the major features. Besides, I'm guessing that all the Windows afficianados have either stopped reading long before this or are bored to tears. That's OK. When you live in a world where the percentage of computer users using Macs numbers in the single digits (as I do), you're used to being ignored by the bulk of the computer world; so I have little sympathy for Windows users who complain about all the hype surrounding Tiger, the iMac, the iTunes Music Store, or the iPod, or whatever. I'm sure that, whenever Longhorn makes its appearance in 12-18 months, the hype will be nonstop, probably enough to drown out any hype over what no doubt will be Mac OS X 10.5 coming out around the same time. (Sorry, couldn't resist the dig.)

In any case, I like this upgrade. It adds a fair number useful features and boosts performance. That's a rare combination for an operating system update, regardless of platform.

Holocaust Remembrance Day

Holocaust Martyrs' and Heroes' Remembrance Day 2005 began at sunset last night and will continue until sunset tonight. Regular readers know of my interest in Holocaust history and my efforts (paltry as they are compared to those of others) to combat Holocaust denial. However, newer readers may not be aware, which gave me the idea for what to post today. In commemoration of Holocaust Remembrance Day, I will simply provide links to everything I can find that I've written about the Holocaust since starting this weblog:

Musings on the 60th Anniversary of the Liberation of Auschwitz: How I discovered Holocaust denial

45% of Britons have no idea what Auschwitz was

60 years ago today: The evacuation of Auschwitz and start of the death march

Political misuses of the Holocaust

A survivor's story

Our Vice President at Auschwitz

Sunday afternoon history lesson

60 years ago today: The liberation of Buchenwald

60 years ago today: The liberation of Bergen-Belsen

60 years ago today: The liberation of Dachau

60 years ago today: The end of the Führer

And, in remembrance of the victims, take the time to do a little reading and learning a little more about the Holocaust and how Holocaust deniers try to minimize or deny what happened, almost always out of anti-Semitism and/or fascist beliefs. Good places to start are the Holocaust History Project and Nizkor, the two premiere sites dedicated to fighting Holocaust denial. Other sites dedicated to education about the history of the Holocaust worth checking out include (in alphabetical order):

Aktion Reihnard Camps

The Auschwitz Museum (Note: the server is often very slow or down, in my experience)

Ressources documentaires sur le génocide nazi et sa negation: Documentary Resources on the Nazi Genocide and its Denial (in both English and French)

The Einsatzgruppen Archives

The Forgotten Camps

The Holocaust Chronicle

Holocaust Denial on Trial (about the David Irving trial)

The Mazal Library

The Simon Wiesenthal Center

United States Holocaust Memorial Museum

Yad Vashem

That ought to do it for now. Please take a moment to contemplate the enormity of Hitler's crime and vow, "Never again!"

How David Irving became a Holocaust denier

Holocaust Remembrance Day has gotten me to thinking about Holocaust denial again, specifically Holocaust deniers, particularly as it coincides with a recent E-Skeptic article discussing David Irving

I've never understood David Irving. Clearly a highly intelligent man who can be quite engaging, he is nonetheless a Holocaust denier. Although not a historian, early in his entry into writing books about World War II history Irving demonstrated a talent and diligence for research, as well as for writing, such that even an historian like Hugh Trevor-Roper recognized these talents. Even Judge Charles Gray, who presided over his lawsuit against Deborah Lipstadt wrote of him:

As a military historian Irving has much to commend him. For his works of military history Irving has undertaken thorough and painstaking research into the archives. He has discovered and disclosed to historians and others many documents which, but for his efforts, might have remained unnoticed for years. It was plain from the way in which he conducted his case and dealt with a sustained and penetrating cross-examination that his knowledge of World War Two is unparalleled. His mastery of the detail of the historical documents is remarkable.

Yet this same judge found Irving to have misrepresented historical evidence and to be a "Holocaust denier," just as Professor Lipstadt had represented him in her book, Denying History, which had triggered Irving's lawsuit. This same judge ruled against him, finding for the defendant. There is no doubt that Irving knows a hell of a lot about World War II and the Holocaust. Given that, how can he have been quoted saying things like “more women died in the back seat of Edward Kennedy’s car at Chappaquiddick than ever died in a gas chamber at Auschwitz”? How can he have gone from a potentially promising new voice in World War II history to Holocaust denier and laughingstock, one who has been known to repeat this doggerel on occasion:

I am a Baby Aryan
Not Jewish or Sectarian;
I have no plans to marry an
Ape or Rastafarian.

Irving didn't emerge full blown as a Holocaust denier. His descent began when, back in the 1970's, he issued a challenge to produce the written order from Hitler ordering the extermination of the Jews. At the time he didn't deny that the Nazi regime killed millions of Jews, only that Hitler directly ordered it. As a self-proclaimed expert in all things Third Reich, he should have known that that's not the way Hitler ran things. Hitler would make his wishes known, sometimes obliquely sometimes directly, and let his underlings figure out the rest. Indeed, Ian Kershaw has termed his method of operation of getting his underlings to "work towards the Führer." He would make his wishes known to multiple underlings, who would then compete with each other "work towards the Führer" and obtain his favor by coming up with the most radical solution to whatever problem they were trying to solve. Hitler's orders were rarely written down. Indeed, one time when Hitler did commit a signed order to paper authorizing the T4 euthanasia program in 1939 (which served as a precursor to the Holocaust, because it was in this program that medicalized killing and gas chambers were first developed), it later came back to haunt him. As unexpected and mysterious death notices filtered out into the German populace, it led to protests by churches and families of those with mental illnesses or retardatino and an increasing mistrust of state medical facilities, all of which was laid at Hitler's door, not that of his underlings or his ministries. Hitler decided to rescind the order. (The involuntary "euthanasia" program did not stop for long; it was soon resurrected without a formal order.) After his experience with T4, Hitler was loathe to commit orders in matters involving ordering the killing of Jews and enemies of the state to writing. That way, he could have plausible deniability for unpopular policies, thus maintaining the astounding myth that unpopular policies of the regime were being carried out without knowledge of the beloved Führer. Indeed, this paucity of written orders by Hitler regarding the Holocaust is a frequently used denier canard used to "prove" that Hitler supposedly didn't know that millions of Jews were being murdered in his name or that there was a systematic plan to exterminate European Jewry.

Later, after reading Fred Leuchter's pseudoscientific Leuchter Report, which denied the existence of homicidal gas chambers, Irving began to deny the Holocaust altogether and start to speak to Holocaust denial groups, like the Institute for Historical Review. As Michael Shermer pointed out, thus began a Faustian bargain. The more he downplayed or denied Nazi atrocities, the more in demand by neo-Nazi and Holocaust denying fringe groups he is for speaking engagements and the more books he sells. Because mainstream historians have rejected him for intentionally distorting history (which he definitely has done (and here), he accepted the embrace of these groups. As Irving himself it:

I find it odious to be in the same company as these people. There is no question that there are certain organizations that propagate these theories which are cracked antisemites.

But that is the bargain he has made, his pact with the devil. In one way, it makes me have some sympathy for him. He is a brilliant man who perceives himself as having been forced to throw his lot in with people that he abhors because he has been "rejected" by mainstream historians, all the while still craving their acceptance and acclaim, which he was once briefly able to obtain 30 years ago. But the key word is "perceive." That may be the way he perceives himself, but just because that is his perception doesn't make it so. Indeed, in another, more primal way, Irving's choice to make a Faustian bargain with the worst anti-Semites and racists only deepens my disgust at seeing a clearly brilliant intellect devoted to distorting history to deny Hitler's crimes.

I think I've been in bathrooms like these before

Although I've never been in any of the restaurants described in this article, I have encountered similar situations regarding excessively trendy or confusing bathrooms. Picture this poor elderly man described in the article:

Of the many sad things I have witnessed in this city's restaurants, few had the particular pathos of a recent scene at the Modern, where an elderly man who had heard nature's call could not figure out how - or, more precisely, where - to heed it.

He had entered what he correctly surmised to be the restroom, only to find women mingling with men between a row of shared sinks and a series of mysterious doors, the hieroglyphics on which left him utterly clueless about whose commodes were whose.

"It's unisex," said a younger woman with him, referring to the general situation.

He glanced around, frozen in place.

"Unisex!" she said, raising her voice.

More glancing. Still frozen.

She sighed. "He's 85," she said. "He doesn't understand."

It takes a lot of effort to screw up a bathroom enough so that people have a hard time figuring out how to use it, but it appears that some trendy restaurants have managed to do it.

Tangled Bank XXVII is here

Tangled Bank XXVII has been posted. Once again the best of the science blogosphere from the last couple of weeks is on display for all to enjoy. So join Buridan over at Buridan's Ass as he gets the second year of Tangled Bank off to a fine start!

I guess this is what passes for creationist "humor"

Geez, it's been an annoying week on the creationism front this week. First we have an article on Michael Ruse, in which he blames scientists for antagonizing the religious through too-vigorous defenses of evolution against intelligent design, skewered by me, PZ, with the best debunking done by Ophelia Benson. Then we have CBS News posting unedited parroting of Discovery Institute propaganda, as reported by PZ (and here).

Then this.

Scrappleface, which is kind of funny from a conservative point of view (albeit more conservative than my point of view) often enough that I still check it out now and then, appears to have drunk deeply from the creationist Kool-Aid. The evidence? It's this supposedly satirical look at the evolution-creation controversy in Kansas by Scott Ott, entitled "Natural Selection Shrinks Herd of Kansas Darwinists." In it, "Darwinists" are represented as unable to handle "Darwinian" selection/competition from "skeptics" and, because of that inability to compete, as having to be protected in "reservations."

Lame, lame, lame.

Look, I understand this is supposed to be satire, but good satire has to have a kernel of truth at its core, as most articles in The Onion do, regardless of whether its writers are skewering liberals or conservatives. There is none in the Scrappleface article, just "ain't I so clever?" references to "scrappy skeptics" who "contended for equal space in the Darwinists' natural habitat." You can almost hear Scott slapping himself on the back for being so "clever" as to use "Darwinian selection" as the basis of a joke making fun of biologists defending evolution.

Actually, come to think of it, the analogy could have some use. Using Scrappleface's analogy, it is creationism and "intelligent design" that are unable to compete in--shall we say?--Darwinian terms, notevolution. Intelligent design has already been selected against in science. It has lost the battle of ideas because it is not science, cannot produce scientific evidence for its ideas, and is, the denials of its advocates notwithstanding, inherently religious. Consequently, intelligent design advocates, having totally failed to get a foothold in the "natural habitat" of evolutionary biologists, are now reduced to using ignorant legislators to force reluctant teachers to misrepresent the pseudoscience that is ID/creationism as a scientific "alternative" to evolution in a desperate attempt at self-propagation. Their ideas can't compete in the scientific arena on the rather "Darwinian" basis that scientific hypotheses normally compete, on supporting observational and experimental data, predictive usefulness, and ability to explain natural phenomenon. So intelligent design advocates are reduced to exploiting the ignorance of most school board members and legislators about science in order to trick them into forcing teachers to teach their ideas to impressionable teenagers, whom they hope will then become the next generation of intelligent design advocates.

Truly in this case, Scrappleface has descended into the realm of hack.

Bets on when it will level off? (Site notes)

When I first started this blog on a whim back on a cold and dull Saturday in December, I was skeptical that anyone would ever be interested enough to read my ramblings on a regular basis. Nonetheless I plunged in, driven by the enormity of my own ego and a desire to apply my more informal writing skills (as opposed to my technical writing skills) honed during my years on Usenet to a different challenge. Oddly enough, it seems that there are actually some folks out there who like to read what I like to lay down. I was checking out my Sitemeter readings on Sunday, and to my continuing amazement the figures are continuing on an upward trend, with no sign yet of leveling off. Thanks to some good initial buzz from some older more established bloggers like PZ and Ophelia, among others, plus (I hope) my own inimitable style and a more than a little dash of utterly shameless self-promotion, this blog continues to grow. Don't believe me? Check it out:

I don't show these to toot my own horn. (OK, maybe just a little, but cut me some slack. The last time I did this--in December, less than a couple of weeks after I started this blog--the figures were nowhere near what they are now.) I do it simply because I remain utterly amazed that, even almost five months later, the hit count keeps going up, with no sign (yet) of leveling off. No doubt it will level off, but when and at what level? (I'm guessing it's probably nearing the point at which it will level off, but we'll see.)

All I can say is thanks to those of you out there who read my craziness and fuel this blog's continued growth and to those other bloggers who boosted Respectful Insolence early on. I hope to continue to improve upon the experience that is Orac's Respectful Insolence. Of course, there's a long way to go. PZ, for instance, has shown the way, recently having registered his 1,000,000th hit. If my hit count levels off soon, as I think that it probably will, I estimate it will take me around seven years of blogging for me to reach that milestone; compared to many bloggers, even specialized ones, I'm still just strictly small fry. However, as far as I can tell, I am the only M.D./Ph.D. surgeon-scientist with NIH funding in the blogosphere, and maybe that counts for something. (Now watch, someone else will pop up in the comments and tell me I'm wrong! Heck, I'd even be happy if someone would. It's lonely being the only one in a niche in the blogosphere.) Some ask where I get the time. Funny they should ask. I'll save that topic for a day when I can't think of anything else to blog about (although I will say that it helps a lot not to have any other hobbies at the moment other than reading).

I'll get back to the science and medicine blogging by Monday at the latest. It's been two weeks since I got back from the AACR Meeting, and I still haven't gotten around to most of the topics from the meeting that I had planned to write about. (After last week, I kind of needed a change of pace, and doing the science pieces takes a bit more effort and thought than some other topics.) It's high time to do some science blogging and some skeptical debunking of quackery and pseudoscience!

In any case, all of the above having been said, this looks like as good a place as any to solicit a little reader feedback, something I don't recall ever having done before other than leaving most of my posts open for comments. What is it about this weblog that you like? That you don't like? How could it be improved? (No, a brain or personality transplant for Orac is not an option. Sorry.) And, let's not forget the ever-popular question that I've been contemplating (and periodically annoying my readers by vacillating about) for many weeks now: Should I dump Blogger and move to TypePad or some other more robust blogging platform?

Ever wonder what Darth Vader's blog would look like if he had one?

Well, wonder no more!

Hysterical, particularly this rant about the incompetence of his underlings...

Grand Rounds XXXII

Grand Rounds XXXII has been posted at Tales of an MD/PhD Student. Damn if she hasn't gone and tried to one-up me in creative Grand Rounds formats by presenting them as a Day in the Life of a Medical Student.

Nice job!

Belated May Day acknowledgment

As regular readers of this weblog know, besides my interest in skepticism, the debunking of quackery, surgery, and cancer research (all of which I regularly blog about), I have a deep interest in the Holocaust and an unrelenting contempt for Nazis and fascism in all its forms, both of which lead me to write fairly frequently about these topics and which drive my desire to debunk Holocaust deniers.

However, with May Day having come and gone, let us not forget the death toll of the other major totalitarian belief system of the last century, Communism. A round-up of articles on the victims of Communist and Stalinism was posted on Catallarchy on May Day (which I unfortunately only just noticed last night). Although a few of the articles are hit-or-miss as far as quality goes, most are quite good. Of particular interest to me was this article by Rudolph J Rummel, Ph.D., Professor Emeritus of Political Science at the University of Hawaii and a finalist for the Nobel Peace Prize in 1996, who has made his life's work the study of what he terms "democide," which he defines as "the murder of any person or people by a government, including genocide, politicide, and mass murder." He has concluded that approximately 170 million people were victims of democide during the 20th century. He even classifies the regimes who did these murders into what he terms "mega-murderers" (regimes that killed more than 1,000,000 people) and "deka-mega-murderers" (regimes that killed more than 10,000,000 people, which include the Soviet Union, Communist China, the Nazi regime, and the nationalist Chinese regime between 1926-1945). His main theme is that power kills, and from that follows one of his other themes, namely that democracies, although not immune from violence, tend to be far less likely to be capable of such large scale murder because they have checks on the government power that is necessary for such murder to become possible. Although this view has been criticized as idealistic and overly dismissive of other potential explanations for the observations presented, Professor Rummel marshals a great deal of evidence to support his thesis, and he has his defenders.

Unfortunately, not unexpectedly, certain white supremacist neo-Nazi white supremacists have tried to use Professor Rummel's attack on Communist democide in a "they were worse" justification (one typical--and disgusting--comment regarding Rummel's estimate of Stalin's democide: "43 million? Why, it puts their [the Nazis'] paltry, imaginary 6 million [Jews] to shame"). They seem to think that the simple observation that Communists killed more people over their much longer history somehow excuses the mass murder by their favorite fascist regime, the Nazis. Lest any neo-Nazis think that by his emphasis on the sheer scale of Communist killing during the 20th century Professor Rummel is somehow deemphasizing Nazi atrocities or implying that the Nazis were not as bad, such is not the case, as is shown in another of his writings:

Moreover, even though the Nazis hardly matched the democide of the Soviets and Communist Chinese as shown in Table 1.3, they proportionally killed more. Figure 1.2 illustrates this. The annual odds of being killed by the Nazis during their occupation were almost two-and-a-half times that of Soviet citizens being slain by their government since 1917; over nine times that for Chinese living in Communist China after 1949. In competition for who can murder proportionally the most human beings, the Japanese militarists come closest. The annual odds of being killed by the Japanese during their occupation of China, Korea, Indonesia, Burma, Indochina, and elsewhere in Asia was one in 101. Given the years and population available to this gang of megamurderers, the Nazis have been the most lethal murderers; and Japanese militarists next deadliest.

In other words, the Nazis killed a considerably larger proportion per year of the people who were unfortunate enough to fall under their dominion than did the Soviet regime. Bottom line: Both were totalitarian regimes that killed large numbers of their own subjects.

I highly recommend that you check out Professor Rummel's website (which I've used as a resource for years) and blog (which I only just discovered last night) and peruse the statistics on his website, many of which were taken from his books, Power Kills and Death by Government. It should be mandatory reading (as well as a great resource for statistics on government-sanctioned murder) for anyone who opposes totalitarianism, whether it originates from the left or the right.

Possessed by Al Swearingen

I love the HBO TV series Deadwood, although I have to admit that the dialogue in the show is a language all its own, liberally laced with massive (and I do mean massive) quantities of profanity (particularly the F-word), yet at the same time lyrical, highly intelligent, and complex. Although I find it hard to believe that people really spoke that way (using language so complex and lyrical, that is; I have little problem believing that people routinely cussed like crazy in mining towns in the Dakotas in the 1870's), it's hard not to fall under the spell of Deadwood's language. I do have to admit, though, that the dialogue is sometimes so rapid-fire and complex (not to mention so outrageously peppered with gratuitous use of the F-word) that it's easy to lose track of what's going on or to let the profanity distract you from the intelligence behind the show if you don't pay fairly close attention.

Apparently Salon.com's TV critic Heather Havrilesky agrees with me. She's fallen under Deadwood's spell as well and may even have been hilariously possessed by the spirit of Al Swearingen himself (or perhaps that of Cy Tolliver or E. B. Farnum, both of whom are almost as prone to similar profanity-laced monologues, albeit not as poetic as Al's), so much that she composed this week's I Like to Watch column in Deadwood-speak. Particularly amusing is her eerily accurate use of Swearingen-speak in her analysis of 24 ("Terrorist cocksuckers and the like," as she says about one of my favorite shows) or her take on the Fox family comedy American Dad--or , best of all, her deconstruction of Deadwood itself.

Too bad there are only three episodes of Deadwood left.

Computers for everyone are great, but not if you can't teach the basics

Although, total Mac-head that I am, I'm happy that Cobb County has decided to get spiffy new Apple iBook G4's for every high school student and teacher in the district, I'd be far happier if it would spend as much effort and money teaching biology and other sciences properly, rather than trying to sneak the pseudoscience that is intelligent design into the classroom as "science," mandating deceptive anti-evolution stickers on biology textbooks, and wasting its taxpayers' money on costly legal battles to defend those ridiculous stickers in court--and losing.

At least the kids in Cobb County will get to have über-cool computers. But if the creationists trying to hijack Cobb County's science education get their way, one thing they won't get is a good education in biology.

Ophelia beat me to it

I was going to comment more extensively on this article about Michael Ruse's new book The Evolution-Creation Struggle, but Ophelia Benson got there first and did it better than I probably could. While I can see Ruse's point, I can't really agree with his contention that, boiled down to its essence, is that it is scientists' own fault that evolution is so fiercely resisted by highly religious people. Particularly misguided is this:

Ruse argues that evolutionism has often constituted a ''religion'' itself by offering ''a world picture, a story of origins, and a special place for humans,'' while its proponents have been ''trying deliberately to do better than Christianity.''

He's falling right into the creationists' trap, giving them ammunition when they make the fallacious claim that evolution is "just a theory" or, even worse, just another "religion." For someone who claims to understand science, how can he say that? What are we supposed to do, not call creationist pseudoscience for what it is when we see it? (As I've said before, I don't have a problem so much with the concept of intelligent design, but rather the attempt of fundamentalists to have it taught as "science," when it is in fact not science. If they wanted to teach it as philosophy or religion, they'd get no argument from me.) And what's wrong with trying to explain the origins of life "better than Christianity"? Any religion that rejects out of hand new knowledge that science produces isn't worth following. Even the Catholic Church, one of the most conservative and slow-to-change institutions in existence, has managed to reconcile itself with evolution. If Pius XII and John Paul II could, do it, then why can't ID advocates?

End of rant.

The History Carnival VII...plus Orac's advice to blog carnival hosts

The Seventh Edition of the History Carnival has been posted at Studi Galileiani. Once again, there are some fascinating posts on a variety of aspects of history. Hugo host did a fine job collecting history posts from the blogosphere.

However, one thing that Hugo mentioned near the end caught my attention.

I now want to close this Carnival by sounding a note of caution. I received nominations from only two people and had to find most of the entries myself. As I understand it, this is standard practice. I have no complaints against putting in the necessary work but it seems difficult to sustain the notion that the Carnival is a summary of the best blogging on historical subjects when it actually only represents a collection of posts that I happened to read and judge worthy of recognition. I could provide a fortnightly service like this myself (and many bloggers do, with “noteworthy” entries on a regular basis) but calling it a Carnival seems to be moving a long way from what was originally intended.

This may merely be an anomaly, of course, but perhaps readers are becoming overburdened with Carnivals? Whatever the reason, the principle at work seems to be that lots of people reading lots of blogs should provide the host with a range of work - beyond what he or she would discover unaided. Although inclusion inevitably retains an element of personal opinion, the result should in some sense reflect what the community of readers have found valuable in the world of history blogs. With few recommendations and no hint of why posts should be selected, however, I hesitate to call this a genuine Carnival. Nevertheless, I commend the content to your attention.

If I may be so bold as to comment here, I've successfully hosted three blog carnivals thus far (if I do say so myself), the Second Skeptics' Circle, Grand Rounds XXV, and Tangled Bank XXV. Consequently, I couldn't resist commenting further, as I've experienced many of the difficulties Hugo mentions. For example, the Second Skeptics' Circle was particularly difficult because it was a brand new carnival and I really wanted to build on the fine job St. Nate started. Not wanting to drop the ball after such a good start by Nate, I really hustled to get good quality submissions and publicity. I even tried to contact the Amazing Randi (whom Nate had contacted before) and Michael Shermer of the Skeptics' Society. Between Nate and my hectoring, it eventually paid off, but later. Randi has now twice plugged the Skeptics' Circle in his columns, and those of us involved in the Skeptics' Circle hope he will continue to do so periodically. However, even Tangled Bank was a bit difficult because of an initial paucity of submissions that had me rather worried the weekend before the deadline. (Fortunately, there was an avalanche of submissions between then and the deadline, but I was really sweating it for a couple of days--and searching all the science blogs I knew of for material.) The manner in which I made these blog carnivals successful started with absolutely relentless--even obnoxious--promotion, with multiple reminders on my blog, multiple solicitations to the bigger bloggers in the field for reminders for entries, and, as Hugo did so well, a liberal search on relevant blogs for good material that I could appropriate if the number of posts came up short in the end. I also used what I thought to be creative presentations of the posts (not everyone agreed; but most did), but that is not strictly necessary. It is merely a byproduct of my personality.

So, now that I'm a "seasoned" blog carnival host (after less than five months of blogging, no less!), I think I'm as qualified as anyone to offer advice to prospective hosts of any blog carnival. Hugo may be correct in that there could be some blog carnival "burnout," but that just means the hosts of these carnivals have to work harder if they want to be a success. One thing that I've observed is that some carnival hosts seem to just expect posts to roll in and therefore solicit entries only once--or even not at all. With the exception of long-established carnivals like Carnival of the Vanities (which, unfortunately, has grown so huge and unwieldy that I don't think I'll ever volunteer to host it), Tangled Bank, or Grand Rounds, that just won't work. It almost certainly won't guarantee an adequate number of good quality entries. Even in the case of long-established carnivals it's good to publicize to try to get new blood in, as blog carnivals tend to get a bit inbred over time. A host needs to start soliciting entries from the very moment the preceeding host posts his or her edition of the blog carnival and keep soliciting until he thinks he has enough high quality posts. It helps to e-mail other bloggers to see if they will post notices for submissions. These solicitations should be specific and include an e-mail address to send permalinks to, as well as a concrete deadline. Near the deadline, if I see posts that I want to include but that were not submitted I'll pick them and send the blogger who wrote them a courtesy e-mail telling him/her that I plan on linking to their work. Next, try to put the carnival together in an interesting or at least functional fashion. You don't have to go off the deep end with bizarre concepts, as some think I've done on occasion, but at least try to be entertaining and make the reader want to click on the links. (If you don't seem excited about the material, then why on earth should the reader get excited about it?) It helps to put your favorite or a highly topical post first, preferably a short one, and lead up to the longer posts. Featuring a "host's pick" is also a good idea. Finally, be sure to post the carnival on time. Few things are more annoying to regular readers of a blog carnival than its being posted late. The best time to do it is to post it right after midnight on the day it's supposed to appear (or post it a bit earlier and timestamp it after midnight). Either that, or post it very early in the morning, like 6 AM. (Of course, time zone considerations can come into play here.)

After you've put the carnival together, publicity is key. Remember, one of the purposes of these carnivals is to get more people to read good posts by bloggers whose posts might not normally get that wide a circulation. I routinely e-mail the permalink to the carnival to every contributor right after I post the carnival, with a plea for some publicity. It doesn't hurt to send the permalink to the big bloggers who might be interested in the carnival's topic, with humble requests to publicize your carnival. For example, one mention from Instapundit (who routinely plugs Grand Rounds and occasionally Tangled Bank) can result in hundreds of hits. (Unfortunately, no host of the Skeptics' Circle has yet managed to get him to plug it, but we'll keep trying.) None of this is rocket science, and a lot of it has been echoed by Hedwig, but it's essential.

Lastly, have fun. If you enjoy putting the carnival together, it will show in the results and in your enthusiasm in presenting the posts, whether they number 5 or 30. The people submitting articles will be happy, and there will be more readers. If you don't think you'll have fun hosting, then you shouldn't volunteer to do it.

In that vein, I conclude by noting that St. Nate will be hosting the Eighth History Carnival on May 15. So, any bloggers who've written about history, I urge you to send him your best stuff by May 14.

Hmmm. One of these days I have to remember to volunteer to host the History Carnival, as I said I would a while back. But I need a break from blog carnivals for a few months. To do them right is a lot of work!

I rather suspected as much

I am: 50% Republican.

"Congratulations, you're a swing voter. When they say 'Nascar Dad', they mean you. Every Republican ad on the TV set was made just for your viewing pleasure. Don't you feel special?"

Are You A Republican?

At least it's consistent with my conclusion that I'm center-right. My only question is whether the other 50% of me is Democrat or something else...

(Via Pharyngula)

And now for something completely different...EneMan!

I've been on a bit of a blogging tear over the last week, sometimes with multiple posts in a day. Due to a confluence betweents of World War II and the Holocaust (one of my other interests), lot of what I've been writing has been a bit of a downer. There were multiple posts about a brain dead teenager named Teron Francis, a post the liberation of Dachau, and finally some musings on Hitler's suicide and the devastation of Berlin. True, I did post a satirical piece about poster presentations at scientific meetings, an anecdote about dealing with unexpected discussions of alternative medicine from its adherents, and an offhand rant about a Christian horror writer's novel attacking evolution, but, looking back on my output this week, to me (and no doubt to some of you) this blog was a bit of a downer. (Holy crap! I now think in retrospect. Why did I burn through so much good material in such a short period of time? Blogging is a marathon, not a sprint. Pace yourself!) To some extent I was bound by the calendar, given that I had planned to write about the 60th anniversary of liberation of Dachau and of Hitler's suicide (as well as all the other World War II topics I've covered) as far back as January, but the Teron Francis case popped up unexpectedly and, because it was about a topic I'm interested in, in essence took over the blog for a few days, muscling out previously planned science and medicine posts inspired by topics discussed at the AACR meeting I attended a week and a half ago.

Fortunately, there is an antidote, although I have to risk that, after all the seriousness that preceded it, it might be somewhat jarring. The first of the month has rolled around yet again, and regular readers of this weblog know what that means. For those of you who don't, then here's your chance to experience it for yourself and wonder just what the hell kind of a twisted plastic box of blinking lights Orac is anyway. On the other hand, readers seem to love it, and I bet I'd get complaints if I were late with my usual 1st of the month feature.

Yes, it's time once again for the author of this weblog to indulge his strange fascination with that champion of colon health, that Fleet Pharmaceuticals mascot, that guy with the unfortunately shaped hat whose true function you really don't want to contemplate in too much detail.

Yes, it's EneMan time again! Once again, Orac now features photos taken from May of the EneMan calendars from 2002, 2004, and 2005. You may run away screaming, vowing never to click on Orac's URL again. Or, like Orac, you may become a devotee yourself. The choice is yours...

May 2002

May 2004

May 2005

Not content with this, I'll even add in convenient links to every appearance EneMan has ever made on this blog:

April 2005
March 2005
February 2005
January 2005
EneMan's first appearance on this weblog (December 2004)

How's that for service?