Thursday, September 29, 2005

Lightening of the blog

Blogging will be light (and may actually end up being nonexistent--it all depends on whether I get any time and the quality of the Internet access I have) over the next three days. I have to go to a training conference in Chicago and then come back and be on call on Sunday.

Don't worry, though. You-Know-Who (and I don't mean Valdemort) will make his usual monthly appearance no later than Monday--and maybe even sooner if I happen to get the chance. It wouldn't do to disappoint his fans...

Also, stay tuned. There's a study (not medical this time) that came out this week that could use a bit of deconstruction, but unfortunately I didn't have time to do more than barely get started on doing a proper job of it before having to leave. I hope to take it on early next week, unless some other more interesting topic comes along. (That's the problem with blogging; if you wait too long to post about an incident, you're so far behind all the other bloggers that you might as well not bother...)

The Eighteenth Meeting of the Skeptics' Circle is here

The Eighteenth Meeting of the Skeptics' Circle has been posted at Wolverine Tom's. Go forth and be innoculated against the rampant credulity in the blogosphere!

And then join Nurse Kelly as she hosts the Circle on October 13 at Time To Lean. And, as always, I continue to scour the blogosphere for hosts for the Circle. If you're interested, e-mail me at oracknows@gmail.com. This is what it's all about.

Well, this is an interesting development...

Via Majikthise, I've learned that the Louisiana Attourney General and a senior medical examiner are investigating allegations of euthanasia after Hurricane Katrina. Because, I posted a very skeptical examination of the allegations a couple of weeks ago, I'll be very interested in seeing where this goes and whether the charges are substantiated.

Grand Rounds, Vol. 2, No. 1 (or #53)

Grand Rounds has just entered its second year, and with it has advanced to a new volume. This time, Family Medicine Notes is hosting. Go forth and check out the best of the medical blogosphere.

Here's a meme we can all participate in

Via Majikthise and Pharyngula, I've learned of a meme we can all participate in. Yes, as I've mentioned before, this week is Banned Books week, and this meme involves listing how many of the American Library Association's Top 100 Challenged Books you've read. So, even though I haven't yet been invited, I'm crashing the party. Here we go. The one's I've read are in bold and red:
  1. Scary Stories (Series) by Alvin Schwartz
  2. Daddy’s Roommate by Michael Willhoite
  3. I Know Why the Caged Bird Sings by Maya Angelou
  4. The Chocolate War by Robert Cormier
  5. The Adventures of Huckleberry Finn by Mark Twain
  6. Of Mice and Men by John Steinbeck
  7. Harry Potter (Series) by J.K. Rowling
  8. Forever by Judy Blume
  9. Bridge to Terabithia by Katherine Paterson
  10. Alice (Series) by Phyllis Reynolds Naylor
  11. Heather Has Two Mommies by Leslea Newman
  12. My Brother Sam is Dead by James Lincoln Collier and Christopher Collier
  13. The Catcher in the Rye by J.D. Salinger
  14. The Giver by Lois Lowry
  15. It’s Perfectly Normal by Robie Harris
  16. Goosebumps (Series) by R.L. Stine
  17. A Day No Pigs Would Die by Robert Newton Peck
  18. The Color Purple by Alice Walker
  19. Sex by Madonna
  20. Earth’s Children (Series) by Jean M. Auel
  21. The Great Gilly Hopkins by Katherine Paterson
  22. A Wrinkle in Time by Madeleine L’Engle
  23. Go Ask Alice by Anonymous
  24. Fallen Angels by Walter Dean Myers
  25. In the Night Kitchen by Maurice Sendak
  26. The Stupids (Series) by Harry Allard
  27. The Witches by Roald Dahl
  28. The New Joy of Gay Sex by Charles Silverstein
  29. Anastasia Krupnik (Series) by Lois Lowry
  30. The Goats by Brock Cole
  31. Kaffir Boy by Mark Mathabane
  32. Blubber by Judy Blume
  33. Killing Mr. Griffin by Lois Duncan
  34. Halloween ABC by Eve Merriam
  35. We All Fall Down by Robert Cormier
  36. Final Exit by Derek Humphry
  37. The Handmaid’s Tale by Margaret Atwood
  38. Julie of the Wolves by Jean Craighead George
  39. The Bluest Eye by Toni Morrison
  40. What’s Happening to my Body? Book for Girls: A Growing-Up Guide for Parents & Daughters by Lynda Madaras
  41. To Kill a Mockingbird by Harper Lee
  42. Beloved by Toni Morrison
  43. The Outsiders by S.E. Hinton
  44. The Pigman by Paul Zindel
  45. Bumps in the Night by Harry Allard
  46. Deenie by Judy Blume
  47. Flowers for Algernon by Daniel Keyes
  48. Annie on my Mind by Nancy Garden
  49. The Boy Who Lost His Face by Louis Sachar
  50. Cross Your Fingers, Spit in Your Hat by Alvin Schwartz
  51. A Light in the Attic by Shel Silverstein
  52. Brave New World by Aldous Huxley
  53. Sleeping Beauty Trilogy by A.N. Roquelaure (Anne Rice)
  54. Asking About Sex and Growing Up by Joanna Cole
  55. Cujo by Stephen King
  56. James and the Giant Peach by Roald Dahl
  57. The Anarchist Cookbook by William Powell
  58. Boys and Sex by Wardell Pomeroy
  59. Ordinary People by Judith Guest
  60. American Psycho by Bret Easton Ellis
  61. What’s Happening to my Body? Book for Boys: A Growing-Up Guide for Parents & Sons by Lynda Madaras
  62. Are You There, God? It’s Me, Margaret by Judy Blume
  63. Crazy Lady by Jane Conly
  64. Athletic Shorts by Chris Crutcher
  65. Fade by Robert Cormier
  66. Guess What? by Mem Fox
  67. The House of Spirits by Isabel Allende
  68. The Face on the Milk Carton by Caroline Cooney
  69. Slaughterhouse-Five by Kurt Vonnegut
  70. Lord of the Flies by William Golding
  71. Native Son by Richard Wright
  72. Women on Top: How Real Life Has Changed Women’s Fantasies by Nancy Friday
  73. Curses, Hexes and Spells by Daniel Cohen
  74. Jack by A.M. Homes
  75. Bless Me, Ultima by Rudolfo A. Anaya
  76. Where Did I Come From? by Peter Mayle
  77. Carrie by Stephen King
  78. Tiger Eyes by Judy Blume
  79. On My Honor by Marion Dane Bauer
  80. Arizona Kid by Ron Koertge
  81. Family Secrets by Norma Klein
  82. Mommy Laid An Egg by Babette Cole
  83. The Dead Zone by Stephen King
  84. The Adventures of Tom Sawyer by Mark Twain
  85. Song of Solomon by Toni Morrison
  86. Always Running by Luis Rodriguez
  87. Private Parts by Howard Stern
  88. Where’s Waldo? by Martin Hanford
  89. Summer of My German Soldier by Bette Greene
  90. Little Black Sambo by Helen Bannerman
  91. Pillars of the Earth by Ken Follett
  92. Running Loose by Chris Crutcher
  93. Sex Education by Jenny Davis
  94. The Drowning of Stephen Jones by Bette Greene
  95. Girls and Sex by Wardell Pomeroy
  96. How to Eat Fried Worms by Thomas Rockwell
  97. View from the Cherry Tree by Willo Davis Roberts
  98. The Headless Cupid by Zilpha Keatley Snyder
  99. The Terrorist by Caroline Cooney
  100. Jump Ship to Freedom by James Lincoln Collier and Christopher Collier
Hmmm. Only 19. I was hoping for at least 20. I almost counted Madonna's Sex, except honesty demands that I admit that, although I did pick it up in a bookstore and and browse it once, I didn't exactly "read it." I'm sure know what I mean.

Of course, I'll never get to 100, given that I have absolutely no interest in some of these books (like Goosebumps, The New Joy of Gay Sex, or any of the Judy Blume books). Also, some of the books on the list aren't necessarily good. Just because someone has tried to get a book banned doesn't mean it's a good book. On the other hand, I have no idea which of the other books on the list I should check out. So, everyone, you can crash the party too. Which of these books have you read? Which ones should I check out (that is, if I ever manage to get through the pile of unread books that I have lying around)?

Yoda debates Mace Windu over intelligent design

Yoda debates Mace Windu over intelligent design creationism here. A sample of Windu's critique of evolution:

There is no need to look any farther than my beautiful, perfect, shiny head to know that someone intelligent had to have a hand in its design. This kind of cranial prettiness did not come about by accident.

It degenerates from there...

I never realized that the Flying Spaghetti Monster was an activist

Apparently, the Flying Spaghetti Monster is branching out. This time, the Noodly One was spotted at an antiwar rally. The funny thing is that the right wing blogger who posted this to mock anti-war protesters (some of which, I must admit, are pretty flaky and off the wall) seems to be utterly clueless about the significance of His Noodliness. He should feel honored to have encountered a Pastafarian prophet such as this openly proclaiming his message. He even looks as though he might be wearing an FSM T-shirt, but I can't tell for sure, because the sign is covering the image.

One can only hope this prophet heads over to Dover, PA to proclaim the Word at the intelligent design trial there, where fundamentalists are waging a never-ending battle against biology textbooks "laced with Darwinism." The horror.

This sounds just like our dog

This sounds just like our dog, only our dog weighs about 1/3 as much.

She does the same thing with her butt...

Hat tip to my wife for pointing this one out...

Wednesday, September 28, 2005

A little criticism directed Orac's way

I really have to stop checking Technorati searches on my blog and my Sitemeter referral logs. I really do. If I didn't check them a couple of times a week, then I would probably never come across posts mentioning me that raise my blood pressure like this one (unless, of course, readers alert me to them). Or maybe I should just learn to ignore such posts, rather than responding and risking provoking a blog flame fest. Too bad last night that I was in just the right mood to pay attention to one post in particular that mentioned me and feeling just cranky enough to lay down a little Respectful Insolence about it.

For a blogger who says he works in the pharmaceutical industry and doesn't like Kevin Trudeau (although I would disagree with his qualification of his dislike in which he said that there's "a lot to Kevin Trudeau that's admirable"--I consider Trudeau to be a scam artist), a blogger going by the 'nym Random John sure doesn't seem to understand one of my major recurring points. He starts here:
Posts like this simply make my blood boil. Perhaps I should keep my “buttons on the inside” (i.e. not let other people push my buttons), but I get frustrated when doctors get their priorities all out of whack and misinterpret the results of experiments.
That's two of us who should perhaps keep our "buttons on the inside," but I get frustrated when other bloggers make big, fat straw men out of what I say and then angrily (or happily--or both) tear down said straw men. The post of mine to which he was referring is here. In it I pointed out how easy it is for doctors to delude themselves into believing a treatment works on the basis of anecdotal observations when it may not and why evidence-based medicine as exemplified by well-designed clinical trials can help avoid that trap and allow doctors to confirm or reject early anecdotal observations. John took issue:
Statistics measure population tendencies, and are bad at predicting individual results. I ought to make every doctor on the face of this planet write this on a chalkboard until they say it in their dreams. Maybe it should be a semester course in medical school and biostatistics. A three-hour course required for graduation. Three hours a week of writing this on the board, supervised, and a recorder stuck under their mouths at night for verification. To pass the class, they have to be saying this in their sleep.

Orac seems to take the most extreme example of the alternative-medicine-is-good-and-conventional-medicine-is-bad nutcase (and, the person who fits the description he gives on the page is a nutcase, I’ll give him that), and equate people giving testimonials.
Geez, I wonder what I said that set him off so much.

Uh, no, that's not what I said or meant. My piece on the altie to which you refer was humor that was indeed directed at the most extreme example, but it did not say that anecdotes are without value. What it did say that is relevant is this:
If you accept vague and/or poorly documented anecdotes and testimonials as sufficient evidence that an "alternative" therapy "works," you just might be an altie.
How is that unreasonable? And, yes, John, there are a fair number people like that. I've encountered them on misc.health.alternative. They inspired the piece, to which many old regulars of m.h.a. contributed, whether they knew it or not. Another relevant excerpt:
If you dismiss every well-designed randomized clinical study that failed to show a benefit for an alternative medicine or therapy over placebo control as either not proving that the therapy is ineffective or as having been manipulated by nefarious forces (conventional medicine, the pharmaceutical companies, the government, etc.) to produce a negative result, you may well be an altie.
Hmmm. Note the words. "Vague and/or poorly documented anecdotes and testimonials." "Dismiss every well-designed randomized clinical study." (Emphasis mine.) I was making fun of people who buy vague and/or poorly documented testimonials for their favorite cure du jour while at the same time automatically rejecting well-designed studies either because they were done by the hated conventional medical community or because don't show what they want them to show. But John isn't finished:
Let’s look at this argument then: clinical trials good, testimonials bad. Do you see the bias here? No?
Uh, no, John, it's not "bias" to understand that testimonials are inherently less reliable than clinical trials in identifying which treatments work and which do not and then putting them into their correct place in the hierarchy of medical evidence. It's just good science. And, no, John, I did not say that anecdotes are "bad." I merely pointed out that they are far less likely to be widely applicable than the results of clinical trials. I've explained multiple times why most testimonials don't even meet the minimum standard of medical evidence, and why personal observation alone is prone to many more biases, including selective thinking and confirmation bias. Finally, contrary to John's characterization of what I said, I have not entirely dismissed anecdotal evidence. Actually I have said repeatedly, that such evidence, if better documented than just a testimonial, can be useful to guide further research. Consider, first, what I said about the difference between testimonials and anecdotes:
The other problem with testimonials is that they don't rise even to the lowest level of medical evidence, the anecdotal report. Anecdotal reports in medicine require a careful documentation of symptoms, lab tests, diagnoses, exact courses of treatment, and a patient's response to treatment. Testimonials almost never present these elements in sufficient detail to judge whether the treatment actually did anything. There's just no way of telling truth from exaggeration or fiction.
I reiterated the faults of testimonial-based "claims" here:
So what's wrong with testimonials? Well, as I like to say, the plural of "anecdote" is not "data," and testimonials usually don't even rise to the level of anecdotes. Testimonials are often highly subjective, and, of course, practitioners can and do pick which testimonials they present. Even in the case of cancer "cure rates," testimonials often mean little because they are given for diseases that surgery alone "cured." (Also, dead patients don't provide good testimonials.) Worse, testimonial-based practice tends to preclude the detailed observation and long-term followup necessary to identify which patients benefit from treatments and which do not, complication types and rates, or long-term results of the treatment. Anecdotes are really good for only one thing, and that's developing hypotheses to test with basic scientific experimentation and then clinical trials.
Note the last sentence. That's me pointing out the proper weight that should be given to anecdotal evidence, which is not zero but is much less than the weight that should be given to a well-designed clinical trial. I suspect the problem here is that John seems to be equating testimonials and anecdotal data. Given that John works for the pharmaceutical industry, I would have thought that he would know the difference (namely that testimonials are usually poorly documented or not at all and are usually primarily intended to sell a product), but apparently not. In any case, what I said was not all that different from what John himself said, except for my emphasis on distinguishing dubious, highly subjective testimonials from the more objectively observed medical anecdote:
The sparks for ideas that lead into scientific revolutions come from odd, anecdotal observations that are outside of what statistics predicts. Individuals give important information that statistics will miss, and cutting out anecdotal or testimonial information and relying solely on clinical trials for our research is like cutting off our legs because the car gets us there faster.
John's also constructing and attacking another huge straw man here. I never advocated "cutting out" anecdotal information (although I definitely do advocate cutting out testimonials, for the reasons I described in detail here, here, and here). I merely pointed out that anecdotes are usually pretty weak evidence. John did have a point in mentioning that clinical trials may not adequately predict the response of any single individual to treatment. That does not invalidate my point, however, because anecdotes are considerably worse than clinical trials at such prediction. In addition, it isn't more anecdotes that will help us predict more accurately the response of any individual to any given therapy. It will be clinical trials that identify factors that might help us predict which individual patients will respond better to which treatment. Indeed, that's the whole point of genomic medicine and molecularly targeted therapeutics like Herceptin.

Now that I think about it, it's rather tempting to build up a straw man of my very own and take John to task for recommending that we abandon clinical trials as medical evidence in favor of anecdotes and testimonials. (Insert much triumphant ranting and raving about said straw man here.)

If I were to do so, though, I just hope it would be a real straw man and not the truth.

Tuesday, September 27, 2005

Last call for submissions to the Skeptics' Circle

The Eighteenth Meeting of the Skeptics' Circle will convene on Thursday. You still have a day to get your best skeptical blogging to Wolverine Tom. So let's see 'em!

Answering some lurker comments

I was amazed and gratified to the response to my post last Thursday asking for lurkers to delurk temporarily and make a comment, 81 comments thus far and counting, most complimentary. If I'm not careful, I might get a swelled head at the praise. Of course, I realize that, should that ever happen, you (and my fellow bloggers) will be there to slap me down and teach me humility again. There were too many comments for me to answer them all individually, but there were a few that caught my eye.

For example, fasta benj said:
Delurking: medical editor (f, 40) in the UK - read for pieces on critical thinking (alt med, Holocaust denial, ID, ...). So much for the 'medical' part; the 'editor' part suggests that you condense your writing somewhat, And, sorry, but cut the Hitler Zombie.

Blake's 7: first series, or second series?
The "editor" part is correct. I realize that I tend to be more verbose than I should be. Suffice it to say it's probably my biggest weakness, as far as writing goes, and I continue to work on it. As for cutting the Hitler zombie, well, let's just say that, although he has been lying low recently, he may be making an appearance in the near future, having clearly chomped the brain of an old nemesis. Sorry. As for Blakes 7, I'm really not sure which series Orac was in. I thought Orac showed up in the last episode of the first season and stayed until the end.

Next, a reader by the 'nym of Sastra says:
Since you asked: given your expertise, I suppose I'd like to see you post more on "alternative" medicine...Over time, though, I think I've slowly started to develop a bit of a crush on Eneman. This is not good. He seems like a nice, friendly, well-traveled guy with a lot of hobbies and interests, good with kids, happy disposition -- but I have an uncomfortable suspicion that he might be a bit "kinky," so to speak.
Hmmm. I'm not sure how to respond to this one. I wouldn't want to be responsible for such a development. EneMan might be happy and cheerful, but he does have a bit of a creepy edge to him, which is why I find his hanging out with children a bit disconcerting. I'd recommend staying away from EneMan. There are others who are interested in him that way...

Next, we have a comment from "anonymous":
Hi Orac - I read you almost every day. I work for Big Pharma in the NJ/NY/Conn area (where else would big pharma be?) My job responsibility is Market research for Oncology drugs and services. So, while I find all the other stuff riveting, it is your insight into cancer treatment that I find most useful.
Uh-0h. Don't tell the alties that. They already think I'm a pharma shill as it is.

Finally, Kristjan Wager, who has contributed as a guest blogger, comments on something another anonymous poster said regarding my posts on the thimerosal/autism activists:
Someone anonymous asked:

"I've never seen so much sheer anger in a blog dialogue. Does this happen when you mention any other diseases?"

I haven't seen it here at Orac's place , but I have seen quite a lot of anger when someone's favorite alternaitve cancer cure has been debunked. However, with the autism debate, it's often peoples' children we are talking about, which makes the anger more prevalent.
Indeed. I've seen this anger before extensively on misc.health.alternative. It's not just autism, although Kristjan has a point that because it autism affects children it tends to provoke more intense reactions. Oddly enough, I've had tirades almost as intense directed at me for referring to dentists who remove people's fillings for exaggerated fear of mercury as quacks or for pointing out that the evidence does not support the claims of activists that breast implants cause systemic diseases like fibromyalgia or autoimmune diseases. (I can't believe nine months have gone by and I haven't blogged on this topic; I'll put it on the list of future posts.) The problem is magical thinking and desperation, and anything that goes against that thinking is viewed as a threat.

Now, for the moment, I close the mailbag. I liked this whole delurking thing. I hope that some of the lurkers who revealed themselves will comment more often in the future.

This is what I'm talking about

I've mentioned Mothering.com before as a source of antivaccine nuttery and in the context of interviewing Christine Maggiore, the HIV/AIDS denialist whose adherence to altie beliefs appears to have cost the life of her child. Now, via the Final Church of the Nodding Apocalypse, I've found a photo that sums up the altie madness that this magazine was advocating four years ago:


This magazine also fully buys into antivaccine rhetoric, mercury/autism hysteria, and antiamalgam wingnuttery. Remember this whenever an altie cites anything written in this magazine, which appears to be a dubious amalgamation of the worst of altie excesses.

It's a RINO stampede!

The RINOs are stampeding over at Tinkery Tonk. Stay out of the way...

Monday, September 26, 2005

Banned Books Week

I didn't realize it, but I just found out that it's Banned Books Week. Go out and buy or read a book that people have tried to ban!

You can start here.

I still can't believe that the Harry Potter series, Madame L'Engle's A Wrinkle in Time, and Daniel Keyes' Flowers for Algernon (among many other rather hard-to-believe candidates for banning) have kept ending up on this list over the last 15 years.

Maybe I wasn't as on top of this as I had thought

Last week, I wrote about a couple of Letters to Nature in which scientists discussed in a tongue-in-cheek manner what the genetics of inheritance of the wizarding ability might be in the Harry Potter stories. A reader named Sarah has pointed out to me that I (and the authors of both Nature letters) are a bit behind the times. Apparently, this discussion has been going on for at least since 2003, and Sara shared with me some links to prove it. I thought I'd share them with you:


Ah, well. I guess that's what I get for being a relative newcomer to the Harry Potter phenomenon, having only just read all the books since last winter.

Another tragically unnecessary death of a child

A few weeks ago, I commented extensively on the case of Abubakar Tariq Nadama, a five year old autistic child who died of a cardiac arrest while receiving an unproven "alternative" treatment (chelation therapy) for his autism. Now I've been made aware of another case just as tragic, a case also sadly resulting in the preventable and unnecessary death of a young child:
The HIV-positive mother of two laid out matter-of-factly why, even while pregnant, she hadn't taken HIV medications, and why she had never tested her children for the virus.

"Our children have excellent records of health," Maggiore said on the Air America program when asked about 7-year-old Charlie and 3-year-old Eliza Jane Scovill. "They've never had respiratory problems, flus, intractable colds, ear infections, nothing. So, our choices, however radical they may seem, are extremely well-founded."

Seven weeks later, Eliza Jane was dead.

The cause, according to a Sept. 15 report by the Los Angeles County coroner, was AIDS-related pneumonia.

These days, given advances in HIV care, it's highly unusual for any young child to die of AIDS. What makes Eliza Jane's death even more striking is that her mother is a high-profile, charismatic leader in a movement that challenges the basic medical understanding and treatment of acquired immune deficiency syndrome.
Christine Maggiore is a high profile spokesperson for a movement that refuses to accept the now well-established science that concludes that HIV causes AIDS. She is the author of a book entitled What If Everything You Thought You Knew About AIDS Was Wrong?, has appeared on The Ricki Lake Show and 20/20, and has been interviewed for Mothering and Newsweek magazines about her activism for the contention that HIV does not cause AIDS. (Mothering, by the way, is the same magazine where the web discussion forums are filled with anti-vaccination rhetoric.) This phenomenon of HIV/AIDS denialism is disturbing to scientists and mainstream AIDS organizations for good reason:
Mainstream AIDS organizations, medical experts and ethicists, long confounded and distressed by this small but outspoken dissident movement, say Eliza Jane's death crystallizes their fears. The dissenters' message, they say, is not just wrong, it's deadly.

"This was a preventable death," said Dr. James Oleske, a New Jersey physician who never examined Eliza Jane but has treated hundreds of HIV-positive children. "I can tell you without any doubt that, at the outset of her illness, if she was appropriately evaluated, she would have been appropriately treated. She would not have died.

"You can't write a more sad and tragic story," Oleske said.
Well, actually, you can. The story of Abubakar Nadama, for instance. Both stories are as sad and tragic as can be imagined, and in similar ways.

I've encountered HIV/AIDS denialists before, not surprisingly, on misc.health.alternative. They tend to be influenced by the opinions scientists such as Peter Duesberg and Harvey Bialy, both of whom are proof positive of the way in which even f0rmerly reputable scientists can fall under the sway of pseudoscience. Based on their writings and those of others, HIV denialists claim that it is drugs like AZT used to treat AIDS that destroy the immune system, not HIV. Of course, when it is pointed out to them that AIDS was identified as a syndrome in the early 1980's and AZT wasn't widely used until 1987, they wave their hands and blame AIDS on "lifestyle" and "recreational drugs" (exacerbated by anti-HIV drugs, of course), which to me sound a lot like the unnamed "toxins" to which alties like to attribute many diseases. HIV denialists also ask questions like: Why do the in vivo and in vitro virus neutralizing antibodies that are present in easily assayable amounts in the blood of HIV infected people not protect against AIDS if HIV is the culprit? (Even I, a surgeon, can answer that one without having to look up any references: There are lots of diseases that provoke a neutralizing antibody response that doesn't fully protect against disease. Hepatitis B, for example. If the antibody response protected against disease, then the organism wouldn't be pathogenic.) They also like to claim that we don't know very much about how HIV does all the things to the immune system that it does, when in fact we know quite a bit about how HIV accomplishes its devastation of the immune system. In any case, the evidence that HIV causes AIDS is overwhelming, and the success of antiretroviral cocktails in decreasing death rates from AIDS and producing many actual long term survivors of a disease (AIDS) that used to be 100% fatal within a relatively short period of time flows from the scientific validity of the HIV/AIDS hypothesis.

The HIV/AIDS denialists, like alternative medicine cranks in many other diseases, cherry pick studies and ignore the vast quantity of evidence that doesn't support their point of view. They magnify anything we don't understand about HIV or any inconsistency in existing data and conveniently forget about the enormous amount that we do know about how HIV causes AIDS. They absolve themselves from having to come up with a compelling alternate hypothesis and the evidence to support it. And, of course, they postulate dark conspiracies of pharmaceutical companies wanting to "suppress" alternative "cures" and sell high-priced drugs. They also tend to be to be antivaccine, as many mercury/autism activists are and Ms. Maggliore was:
What set Maggiore apart became clear only when she talked about her views on medicine.

She didn't vaccinate either child, believing the shots did more harm than good. She rejected AZT and other anti-AIDS medications as toxic. "I see no evidence that compels me that I should have exposed a developing fetus to drugs that would harm them," she said.

Maggiore hired a midwife and gave birth to her children at home; Charlie was born in an inflatable pool on her living room floor. She wanted to avoid being tested for HIV or pressured to use AZT in a hospital, although technically neither is required by California law.

She breast-fed both children, although research indicates that it increases the risk of transmission by up to 15%.
AZT and other anti-retrovirus drugs can decrease the risk of maternal-child transmission to very low levels and is responsible for the plummeting rate of cases of AIDS among children; for an HIV-positive mother to refuse to use it is tantamount to child abuse (no matter how well-meaning she is or how much she loves her child) and exposes the deficiencies in the child welfare system. And right in the thick of this story is an old friend, with whom Orac has tussled before over his posts to the Huffington Post: Dr. Jay Gordon, who apparently was one of the doctors who treated Eliza Jane:
Dr. Jay Gordon, a Santa Monica pediatrician who had treated Eliza Jane since she was a year old, said he should have demanded that she be tested for human immunodeficiency virus when, 11 days before she died, Maggiore brought her in with an apparent ear infection.

"It's possible that the whole situation could have been changed if one of the doctors involved — one of the three doctors involved — had intervened," said Gordon, who himself acknowledges that HIV causes AIDS. "It's hindsight, Monday-morning quarterbacking, whatever you want to call it. Do I think I'm blameless in this? No, I'm not blameless."
No, Dr. Gordon is not blameless. Although I believe that Dr. Gordon probably means well and probably does more or less accept that HIV causes AIDS, I hope he'll excuse me if I can't help but thinking that he sounds a bit like he is covering his behind. It is some of the stuff I've found on his own website that leads me to wonder about whether he truly accepts the science behind the HIV/AIDS hypothesis. For example, look at Dr. Gordon's preamble to a bunch of recommendations for unproven "remedies" to alleviate HIV/AIDS symptoms, such as echinacea to "strengthen the immune system" and milk thistle to "cleanse" the liver:
The conventionally and most widely held approach say that AIDS is caused by the HIV (Human Immunodeficiency Virus) which is a very difficult virus to kill or control.

There is a second school of thought not terribly popular with physicians: HIV causes AIDS with, because of, or assisted by the medication used to prevent AIDS. The usual anti-HIV medication is quite potent and works in ways beyond the scope of this article. Suffice it to say that the medications have huge side effects and that the latest research published in late-April makes it quite clear that our hope that the antiviral compounds actually cure AIDS is probably incorrect and the virus is very capable of surviving this chemical onslaught and "hiding" for many decades in the human body. Please do not misunderstand, as far as I can tell, many lives have been prolonged, changed for the better and even saved by advances in AIDS chemotherapeutics. I just think it's also very reasonable and prudent to investigate other ways of keeping this virus in check by strengthening the immune system's ability to deal with it and by increasing the overall health of the person who is carrying HIV.
Is it just me, or does it sound as though Dr. Gordon is rather sympathetic to the AIDS denialist position and somewhat grudging in his acceptance of the HIV/AIDS hypothesis? If, as Dr. Gordon says, he accepts the current science that HIV causes AIDS, then why does he present the the view that HIV causes AIDS "with, because of, or assisted by the medication used to prevent AIDS" on his website in such a context that leads the reader to believe that he considers the denialist view as almost equally plausible to what he terms the "conventionally" held view that HIV causes AIDs. Why is his disclaimer so weak? Why, also, did he not seem to consider the possibility that the "ear infection" that he suspected in Eliza Jane might be something more serious, given that he knew that she was the child of an HIV-positive mother who had flouted every medical guideline for preventing HIV transmission to her children, even having breast fed them? Why did he not insist on an HIV test? Even I would have known to suspect AIDS, and I'm just a dumb surgeon. No doubt Ms. Maggliore would have refused, but at least he would have started to do the right thing.

I am quite sure that Mrs. Maggliore is suffering enormous emotional pain because her daughter died. I also have no doubt that she loved her daughter as only a mother can, despite her rationalizations about the cause of her daughter's death. However, we must not allow our sympathy for her grief to lead us to forget that her daughter is dead because she enthusiastically bought into a bogus, pseudoscientific line of altie nonsense--or that she still buys the line and is aggressively selling it on the radio and elsewhere. It is indeed unfortunate that this horrific experience didn't lead her to wonder if maybe--just maybe--conventional science is right about HIV causing AIDS after all.

Unfortunately, all too many others buy into HIV/AIDS denialism too, which guarantees that Eliza Jane will not be the last child to be infected with unnecessarily with HIV via maternal transmission or to die from that infection.

ADDENDUM: Mossback Culture has more on this here and here,particularly on the role of prominent bloggers in facilitating HIV/AIDS denialism. (And, boy, is he pissed, so much so that he does something I wish he hadn't done and takes a cheap shot at his intended target in the last paragraph of this post.) His main target is one blogger in particular that I rather used to like--until I was made aware of his decidedly unskeptical (or, as I like to call such crankery, "pseudoskeptical") HIV/AIDS denialist opinions last spring (opinions that I would have been aware of sooner had I read his blog more often).

More can also be found, ironically enough, at the Huffington Post, where Trey Ellis comments. Other medical bloggers Red State Moron and Gordon's Notes have also commented.

Saturday, September 24, 2005

Thirty three years too late...

Given that Bowie is probably my favorite performer of all time, I find this reassuring...


david bowie
You're David Bowie...and every guy wants to be you, every girls wants to be in your pants. Or vice versa, or both! You are innovative, always weird, and aesthetically pleasing. Your lyrics are literate, and your music is unlike any other. You are always unique, no matter what situation you are in. Everyone tries to bite off your style, but no one can be you because you are funky fresh. Be careful to keep your mental health in check, because you have a tendency to flip out. But hey, being borderline crazy makes you even more alluring! You are skilled at manipulating everyone: the press, your fans, and even your closest friends. You are beautiful and strange, and you allow yourself to change and grow.


Because I have a soft spot for glam (among my other musical proclivities, both odd and mainstream), I thought this would be a good jumping off point for me to list a few of my favorite 1970's glam rock albums:
  1. David Bowie, The Rise and Fall of Ziggy Stardust and the Spiders from Mars
  2. David Bowie, Hunky Dory
  3. Mott the Hoople, All the Young Dudes
  4. David Bowie, Aladdin Sane
  5. T. Rex, Electric Warrior
  6. Queen, A Night at the Opera
  7. Alice Cooper, Billion Dollar Babies (Alice was glam, albeit its darker side.)
  8. Sweet, Desolation Boulevard
  9. Elton John, Goodbye Yellow Brick Road (Oh, yes, Elton was glam in his 1971-1976 heyday. Believe it.)
  10. Various Artists, Velvet Goldmine: Music from the Original Motion Picture (OK, I know this isn't 1970's glam, but it's the best recreation of 1970's glam I've ever heard.)
Hmmm. What should be next sometime? My top ten favorite metal albums? My top ten favorite punk albums? Folk? New wave? Or maybe even my top five favorite Sinatra albums?

Stay tuned...

In the meantime I'll probably write something to post either tomorrow or Monday addressing some of the comments from lurkers who were kind enough to delurk since my request a couple of days ago.

Friday, September 23, 2005

Another reason to love the Harry Potter books

Wow. I'm totally surprised at the response I got from my Lurker Day post. I expected maybe one third the response. I'm also flattered at some of the comments. In fact, I think I may address a few of them sometime over the weekend if I get time. In the meantime, if you're a lurker and haven't de-lurked, please go here and let me know you're reading.

On to other topics...

Via Stupid Evil Bastard, I've found another reason to love the Harry Potter books. British geneticists Jeffrey M. Craig, Renee Dow, and Mary Ann Aitken examined the chromosomal basis of being a wizard or a muggle, suggesting that wizarding ability is inherited in a Mendelian fashion as a recessive. Last month, they even got their idea published as a Letter to Nature. They speculated:
Wizards or witches can be of any race, and may be the offspring of a wizard and a witch, the offspring of two muggles ('muggle-born'), or of mixed ancestry ('half-blood').

This suggests that wizarding ability is inherited in a mendelian fashion, with the wizard allele (W) being recessive to the muggle allele (M). According to this hypothesis, all wizards and witches therefore have two copies of the wizard allele (WW). Harry's friends Ron Weasley and Neville Longbottom and his arch-enemy Draco Malfoy are 'pure-blood' wizards: WW with WW ancestors for generations back. Harry's friend Hermione is a powerful muggle-born witch (WW with WM parents). Their classmate Seamus is a half-blood wizard, the son of a witch and a muggle (WW with one WW and one WM parent). Harry (WW with WW parents) is not considered a pure-blood, as his mother was muggle-born.

There may even be examples of incomplete penetrance (Neville has poor wizarding skills) and possible mutations or questionable paternity: Filch, the caretaker, is a 'squib', someone born into a wizarding family but with no wizarding powers of their own.

We believe that, with the use of these examples, the concepts of mendelian genetics can be introduced to children as young as five, and then built on by gradually introducing specific terms such as 'gene' and 'allele', and relating these to chromosomes and DNA. At every stage, the children's familiarity with the Harry Potter characters can be used as a hook to engage them in discussing concepts of heredity and genetics.
I like it. Too bad I missed the original letter, which Panda's Thumb pointed out when it was originally published. (I think the reason I missed this one is because it came out while I was on vacation and I never quite caught up on the journals that piled up in my absence, ending up just filing many of them away mostly unread.) In any case, although I know a lot about genetics, I'm not a geneticist. Even so, I realize that this proposed explanation is probably too simplistic. Fortunately for my ability to blog on this without seeming a month and a half out of date, another group of scientists, not to be outdone, agree. They fired off a retort that was published in Nature last week:
Following Craig and colleagues' analogy, Hermione, as a muggle-born witch, must have WM parents. However, as Rowling fans could point out, Hermione's parents were muggle dentists who lack any family history of wizarding. It's true, of course, that chance may not have thrown up a witch or wizard for many generations, or that any who did have magical powers may have kept them secret to avoid a witch hunt.

What about Neville's apparently poor wizarding skills? These cannot be explained by incomplete penetrance, as Craig and colleagues suggest. In incomplete penetrance, individuals either display the trait or not: they do not display an intermediate degree of the trait. Poor wizarding skills might be indicative of variable expressivity of an allele. However, both variable expressivity and incomplete penetrance are associated with dominant alleles. If the wizarding allele were dominant, rather than recessive as suggested, wizarding children such as Hermione could not be born to non-wizarding parents.

Neville's clumsiness may, perhaps, be an individual characteristic unrelated to his potential powers. However, it is not possible, from the evidence presented so far, to conclude that wizarding is a heritable trait.
Hmmmm. They have a point there. However, if wizarding abilities are not somehow heritable, then what determines who is a wizard and a muggle? Or should I just realize that it's only fiction and stop contemplating the question?

Of course not! What fun would that be? In any case, the discussion in the comment section after the original Panda's Thumb article has some entertaining speculation:
Wizardy is clearly a quantitative, multigenic trait with variable expressivity and incomplete penetrance. I wouldn’t discount a role for epigenetic effects either.
Or:
Possibly the magic ability is only partly inherited. One explanation for squibs and muggle-born wizards/witches would be that the allele(s) for magic are fairly common in the population, but that they are expressed only when they are triggered by some external factor. This factor would have to act sometime in the early years (wizards and witches develop their abilities slowly up to around age eleven, and there is no mention in the books of someone gaining magical powers as an adult.) This factor could simply be exposure to magic, or to some microorganism that is endemic to the wizarding community. Muggle-born wizards/witches could come from accidental exposure to either of these. If it is a microorganism, squibs could be explained by immunity from an earlier infection by a related organism. It would be an exciting topic for a research project!
Personally, I favor the latter explanation, but it could be simply because I understand that explanation better than the former. (My memories of my genetics classes are getting hazier, the further out from graduate school I get.) Regardless of the obviously tongue-in-cheek nature of this little exchange, I like the concept of using Harry Potter to teach young children some very basic concepts of genetics and inheritence described in the first letter. Given the sorry state of biology education in this country, any reasonable gimmick should help. Heck, it might even work. Yes, the concept of wizarding skills doesn't quite fall into a concept based on Mendelian inheritance, but it's close enough to provide a "teachable moment." Besides, the second group of scientists were probably just expressing sour grapes because they didn't think of the idea first. I do note, however, that they cleverly managed to get their names on a Letter to Nature, just like the first group of scientists. Having any publication in Nature, even just a letter, is a an addition to one's CV that many scientists would kill for. I know I'd have to think about it if someone told me that all I'd have to do is to kill someone to get a first author paper in Nature. Just kidding.

Barely.

Of course, there is yet another upside to this idea, if it ever caught on. Teaching genetics also implies implies the acceptance of evolution and could even provide an "in" to introducing basic concepts of evolution. As SEB and Clive both point out, that's another reason for the Christian right to hate Harry Potter. Not only would they accuse J. K. Rowling of indoctrinating children into witchcraft, but they could accuse her of something many of them probably view as even worse: introducing them to concepts of evolution.

Is pre-emptive homicide justified?

Normally, I would say no, but this has made me wonder if I should change my mind.

It's clear that Ice-T has lost his mind. "Hassel the Hoff"?

The Mad House Madman tells it like it is

Medical students! You want to know how to write a scintillatingly brilliant personal statement for your residency applications?

Listen to the Mad House Madman! He'll tell you how. The Madman gives ready, bite-sized prose to sneak into your personal statement to guarantee that you get noticed by the residency admissions committee. Actually, his suggestion for medicine residency applications sums up perfectly why I went into surgery instead:
I really love treating chronic disease. I particularly enjoy diabetes. It always fascinated me how blood glucose can go up and then down and then up, and then down. I find it particularly interesting how certain medications will help and then stop helping, and then I add another medication, and then that will help, and eventually it will stop helping. Sweet! (I mean that ironically)"

Thursday, September 22, 2005

One week until the Skeptics' Circle

The Eighteenth Meeting of the Skeptics' Circle will occur one week from today at Wolverine Tom's. Get your best skeptical blogging to Tom at wolverinetwh513@gmail.com and put the words "Skeptics' Circle" in the Subject header. Guidelines are here and here.

And, as always, I'm still looking for hosts. I'm happy that we have hosts lined up into early February (and the one year anniversary of the Skeptics' Circle), but I'm looking for hosts to get the second year off to a great start, including prior hosts who might be interested in hosting again. If you're interested, drop me a line at oracknows@gmail.com.

Blog lurker day

Alright, I know I've been following the blog crowd a bit this week (for example, doing this academic blogger meme). Well, what the heck; sometimes I just feel like going with the flow. That time is coming to an end soon, but there's still one more thing going around the blogosphere that I became aware of. It interests me; so I'll do it. Yesterday, Creek Running North declared Lurker Day, and was joined in rapid succession by Feministe, Pharyngula, afarensis, Cosmic Variance, and Science and Politics. Of course, in order to be slightly contrarian or just "different" (or just because I'm lazy), I'll do it a day late.

The idea is that, every so often, a blogger gets curious about who's reading. In my case, I've always realized that it's a relatively small subset of my readers who comment regularly. This has to be the case, given that this blog's visit count has climbed to an average of around 1,000 visitors a day but only rarely do I attract more than 10 comments or so a day. (The exceptions, of course, are some of my posts about the mercury-autism controversy--or even ones that were not primarily about mercury and autism but were somehow perceived to be. These posts drew so many comments of a rather intense--vitriolic, actually--nature that it was almost scary. PZ Myers may be used to getting over 100 comments after many of his posts, but I sure ain't.)

In any case, today, I'm humbly asking those of you out there who read what I like to write down on a regular basis but have either never commented (or only very rarely commented) to take a moment to delurk and leave a comment to say hi. Tell me who you are and where you're visiting from. (No names necessary unless you want to tell, obviously.) Let me know what you like about Respectful Insolence or fire off some constructive criticism. What do you want to see? More medblogging like this? (I realize I've drifted somewhat away from that compared to the early days of the blog.) More science? More Hitler Zombie (who is always--pardon the term--lurking in the background himself)?

And, of course, spread the word.

More evidence that many Holocaust "revisionists" are Nazi sympathizers

I've occasionally been criticized for equating Holocaust deniers with neo-Nazis. Via Flavor Country, I've found a link that lends a little tactical air support to what I've been saying all along. Check out what they're saying about the death of Simon Wiesenthal over at "The Revisionist Forum," which is the web forum of the so-called "Committee for Open Debate on the Holocaust" (CODOH) and vho.org, both prominent denier organizations.

Some representative quotes from the discussion that broke out after the news of Wiesenthal's passing was posted:
  • At the foot of the BBC's gushing obituary it says - "Six million Jews were murdered in the Nazi death camps of World War II, along with thousands of Gypsies, homosexuals, disabled people and political dissidents." They're still using 6 million, what figure do the lobby currently use?
  • It may be in bad taste, but can we break out the Schnapps yet?
  • To anyone reading who thinks that Simon 'Jewish soap' Wiesenthal was a man of integrity, ethics, and truth, they should read the threads here which demolish this evil, hatemongering piece of human garbage. Good riddance.
  • How does one survive FIVE 'death camps'? Answer: They weren't 'death camps'.
  • A disgrace to the Jewish people and a spreader of malicious hate & lies against the German peoples. Yeah, what a man he was.
  • A shot of Cuervo Gold for me. Ole' amigos, the slimeball is dead.
  • The man was a criminal liar, a scumbag. The world is a better place without him.
Why did these so-called Holocaust "revisionists" (who claim that they are simply interested in "objective" historical research) hate Wiesenthal so? Easy, he was effective in bringing Nazis to justice, even decades after the war. He was the most effective Nazi hunter of all, and he was Jewish. That's why revisionists hated him, and that's why they are rejoicing at his death.

Still don't believe me? Delve deeper into the CODOH discussion forums and see. Read some more "revisionist" literature. But be sure to bring a barf bag.

The hatred of these scumbags is the greatest posthumous tribute to Wiesenthal's life and work I can think of. It is a testament to his effectiveness in fighting them. Let them rant.

Wednesday, September 21, 2005

The AAS tells it like it is

The American Astronomical Society has come out in favor of teaching evolution in public schools and against teaching intelligent design as science. This in and of itself is not surprising. However, the AAS statement gives one of the most succinct descriptions of what a scientific theory is and why ID is not a scientific theory:
Evolution is a valid scientific theory for the origin of species that has been repeatedly tested and verified through observation, formulation of testable statements to explain those observations, and controlled experiments or additional observations to find out whether these ideas are right or wrong. A scientific theory is not speculation or a guess -- scientific theories are unifying concepts that explain the physical universe.
And:
In recent years, advocates of “Intelligent Design,” have proposed teaching “Intelligent Design” as a valid alternative theory for the history of life. Although scientists have vigorous discussions on interpretations for some aspects of evolution, there is widespread agreement on the power of natural selection to shape the emergence of new species. Even if there were no such agreement, “Intelligent Design” fails to meet the basic definition of a scientific idea: its proponents do not present testable hypotheses and do not provide evidence for their views that can be verified or duplicated by subsequent researchers.
I'm just too longwinded. I wish I could have boiled it down to its essence so nicely.

Tangled Bank XXXVII

Tangled Bank XXXVII has been posted at milkriverblog. Time for some great science blogging!

The Wedgie Document and the creationist challenge

Creationists have the Wedge Document. Now, thanks to The Commissar, one of my favorite conservative bloggers, a man after my own heart who leans right (albeit a bit farther right than I do) but doesn't buy into the fundamentalism of the Christian right that has infested the Republican Party, we now have the Wedgie Document, a guide to arguing with creationists on the Internet.

One phenomenon The Commissar mentions that hit close to home is the "not a creationist" creationist, a phenomenon, I would point out, that is not limited to just one variety of crank. Back in my days on alt.revisionism, we had to deal with a similar sort of person, the "not a denier" Holocaust denier. We regulars could spot them right away. Usually, it would start with a newbie entering the newsgroup. They would then express innocent-sounding "doubts" about some aspect of the Holocaust or other. A little questioning would usually be all that it would take to reveal their true agenda and that their "doubts" came straight from the standard list of denier canards. I usually tried to give them the benefit of the doubt, at least initially, in case they were just someone ignorant about history who had stumbled onto neo-Nazi or Holocaust denier websites. I soon learned I was wasting my time and became a lot faster to realize that, when it walks like a duck and quacks like a duck, it's probably a duck.

I can well understand why Holocaust deniers would want to try to hide their true agendas or beliefs. Most people consider Holocaust deniers to be despicable--and rightly so--because it is virtually always anti-Semitism that drives their Holocaust denial. As I have said before, although I leave open the possibility that there is a Holocaust denier out there who isn't either a neo-Nazi, an anti-Semite, or both, I have yet to encounter one. (Indeed, every Holocaust denier that I've ever encountered will, with a little questioning, reveal anti-Semitic and/or neo-Nazi sympathies.) On the other hand, I have a harder time understanding why creationists would go so far to deny that they are creationists. There is no real perjorative implication to being labeled a creationist in large swaths of the country, certainly nothing as bad as being labeled a Holocaust denier. Creationists tend to confuse religion with science, and they really only become a problem when they try to pressure gullible school boards to put the imprimatur of the state behind their beliefs and require their teaching in public schools. I suspect that their reluctance to reveal themselves is because, for some reason, creationists seem to crave the mantle and authority of science. They're desperate to be taken seriously outside of the context of their religion, which is odd, given the contempt many of them seem to have for science. Such a desire will drive "intelligent design" creationist "luminaries" like William Dembski to say with a straight face during a CNN debate with Michael Shermer that "intelligent design" doesn't require the "designer" to be God (and could even be aliens or some sort of Gaia-like intelligence). Of course, he will then turn around and say in essence to evangelical audiences that of course the "designer" must be God. Because they either know they are peddling religion or are too ignorant of science to realize that ID is not science, creationists can't admit that ID is religion-based in secular settings. They realize that doing so would endanger their strategy to get ID taught in public school classrooms as an "alternative" to evolution by explicitly running afoul of the Establishment Clause.

So, if I may be so bold, I'd like to suggest to the Commissar another variety of ID creationist: the "my religious beliefs have nothing to do with my support of ID" variety, a variant of the "not a creationist" creationist. And, in The Commissar's spirit of going on the attack, I'd like to adapt an earlier challenge to a different variety of crank. The next time you see an ID apologist claiming that religion or God has nothing to do with ID, lay this challenge on them:
Where are all the "intelligent design" advocates who are atheists (or even just agnostics)?

It's a fair question. After all, how can ID advocates hope to be taken seriously if they all have such apparent biases, agendas and axes to grind? If, as its advocates claim, "intelligent design" is strictly about science, evidence, and experimentation and has nothing to do with a belief in God, then it is not unreasonable to expect that there should be some atheists out there who accept ID as science.

In a particularly telling contrast, there are plenty of "evolutionists" out there who believe in God, refuting the oft-voiced claim by some creationists that "evolution=atheism." There is clearly no inherent conflict between belief in God and acceptance of the science of evolution. So, if ID is science, as its adherents claim, then why shouldn't we also expect there to be some atheists out there who, without a belief in God (or any religious beliefs at all) have come to accept "intelligent design"?

So, then, if "intelligent design" is an intellectually honest scientific endeavor, where are the ID advocates who are atheists (or even agnostics)? You'd think that after many months of my looking for one, at least one ID advocate who is an atheist or agnostic would have come forward and said "Here I am!"

But, no. It appears that there just aren't any such ID advocates around.
I plan on posting this challenge every so often. I encourage readers to do the same. Unfortunately, even though it should be, simply emphasizing and explaining the mountain of evidence for evolution and contrasting it with the zero credible scientific evidence for ID creationism isn't enough. We have to frame the debate in its true terms: adherents of ID trying to have their religious views taught as science. And it's not just any religion or even Christianity in general, but a small fundamentalist subset of Christians and other religions, including Muslims and Jews. Most mainstream religions accept evolution as settled science and as being in no conflict with their beliefs. That point needs to be hammered home again and again and again, and my little challenge is just one way of doing it. Coming from a Roman Catholic background, I have no problem with religion or a belief in God, as long as it is not forced upon children in state-run schools. Unfortunately, that's exactly what teaching creationism, whether of the ID variety or otherwise, in public schools would be.

Tuesday, September 20, 2005

Simon Wiesenthal has died

Simon Wiesenthal, 96, the controversial Nazi hunter who pursued hundreds of war criminals after World War II and was central to preserving the memory of the Holocaust for more than half a century, died today in Vienna, Austria, his base of operations. (Link)

Rest in peace. Your work will not be forgotten.

Grand Rounds LII

Grand Rounds LII has been posted at SoundPractice.net. Go forth and check out the best of the medical blogosphere.

A meme strikes

Yesterday was clinic day. Clinic always wipes me out, and yesterday was no exception. Thankfully, via Pharyngula, I found this meme, the answers to which my readers might find informative and which didn't require much effort to answer, thus providing precious material on a day when I didn't much feel like blogging and didn't have anything in reserve. So, without further ado:

Academic Blog Survey

Overview:

The following survey is for bloggers who are actual or aspiring academics (thus including students). It takes the form of a go-meme to provide bloggers a strong incentive to join in: the 'Link List' means that you will receive links from all those who pick up the survey 'downstream' from you. The aim is to create open-source data about academic blogs that is publicly available for further analysis. Analysts can find the data by searching for the tracking identifier-code: "acb109m3m3". Further details, and eventual updates with results, can be found on the original posting:

http://pixnaps.blogspot.com/2005/09/academic-blog-survey.html

Instructions:

Simply copy and paste this post to your own blog, replacing my survey answers with your own, as appropriate, and adding your blog to the Link List.

Important (1) Your post must include the four sections: Overview, Instructions, Link List, and Survey. (2) Remember to link to every blog in the Link List. (3) For tracking purposes, your post must include the following code: acb109m3m3

Link List (or 'extended hat-tip'):
1. Philosophy, et cetera
2. Pharyngula
3. Respectful Insolence
4. Add a link to your blog here

Survey:

Demographics
Age - early 40's
Gender - Male
Location - Mid-Atlantic
Religion - Roman Catholic
Began blogging - December 2004
Academic field - Surgical Oncology
Academic position [tenured?] - Assistant Professor [not yet]

Approximate blog stats

Rate of posting - Daily, with occasional days off
Average no. hits - Excluding Instapundit-generated visits to my hosting of the History Carnival, just under 1,000/day (folks, let's get the average over 1,000!)
Average no. comments - 5-10/day
Blog content - 30% medicine, 25% science; 30% skepticism; 10% political, 5% personal.

Other Questions

1) Do you blog under your real name? Why / why not?
- No. I use a pseudonym. I've explained why here. Basically, I do not want my blog to be the first link that comes up when patients Google my name. However, as I've pointed out before, it's not particularly difficult to find out who I really am. Indeed, recently, I was "outed" on a mailing list. The woman who did it listed a bunch of links, and seemed to be implying that I was sympathetic to or somehow connected to Jeff Rense, who, in case you haven't heard of him, is a conspiracy-mongering racist who routinely posts or links to tripe like this. She was clearly too blinded by her own dislike of my message for evidence-based medicine and against quackery to realize that the reason my name sometimes pops up alongside anti-Semitic twits like Rense is because I have spent a lot of time arguing against such hatemongering. Either that, or she didn't care.

2) Do colleagues or others in your department know that you blog? If so, has anyone reacted positively or negatively?
- Yes. My Department Chair and Division Chief know. Neither of them has given feedback negative or positive, and, as far as I can tell, neither of them read it regularly. I'm not sure if either of them read it at all. When informed of its existence, both have told me they don't care about it as long as it's done outside of work and doesn't interfere with my duties.

3) Are you on the job market?
- No, not now. I don't have any plans to go anywhere anytime soon. (Of course, if I actually were thinking of moving on, do you think I'd mention it here? Didn't I just tell you that my Division Chief and Department Chair know about my blog? That's one reason this question in the meme is a little bit silly for any but students and postdocs.)

4) Do you mention your blog on your CV or other job application material?
- Are you out of your mind? I doubt potential employers would understand or appreciate EneMan or the Hitler Zombie (although one who did would certainly go up several notches in my estimatinon.) I would never lie if asked about it by anyone, but I see no reason to be the first to bring it up. Certainly, I see no reason to put it on my CV, as it is irrelevant to my qualifications.

5) Has your blog been mentioned at all in interviews, tenure reviews, etc.? If so, provide details.
- I have no way of knowing right now. When I finally go up for promotion to Associate Professor, I may find out, but I highly doubt it will matter one way or the other.

6) Why do you blog?
- I've been active online on and off since the early 1990's and continuously since 1997. Mostly I was on Usenet and other forums combatting Holocaust denial. After starting to blog on a whim, I rapidly discovered is much more fun and satisfying than Usenet and online forums, because I can write about what I want to write about when I want to write about it and when I have time, rather than primarily reacting to what other people post, which is the usual case on Usenet. I also have managed to amass a much larger readership than I probably ever did on Usenet. Finally, scientific writing (which is what I have to do a lot of at work) is very formalized and staid. Blogging allows me to indulge my creative side. As a side benefit of blogging, I've even noticed that I encounter writer's block while working on grants and papers noticeably less frequently than I used to.

Any academics reading this, feel free to participate...

RINO Sightings XI: The Hornitarian Jihad

RINO Sightings XI has been posted at evolution. As j.d. likes to say:
The rhinoceros is a good mascot for the Raging RINOs. Rhinos are mostly docile; they like to sleep, lie in the cool mud, have sex, eat, play with the kids, things we all like to do. We Hornitarians like to keep our horns sharp, however, for when the elephants and donkeys come stampeding through with their bags of money and TV cameras.
Go get 'em.

Monday, September 19, 2005

What makes a crank a crank?

The other day, I was amused to read PZ Myer's highly entertaining slapdown of Timothy Birdnow, who posted to the mis-named website The American Thinker an appallingly ignorant article entitled, The Case Against Darwin. PZ was brutal as he usually is with such confidently asserted ignorance about evolution, but no more brutal than the material, a listing of the usual creationist "critiques" of Darwin served up with some truly egregious errors in basic biology--such as not getting the number of phyla even close to correct (Birdnow claimed there are 5 when there are 30) and the claim that DNA molecules are "composed of the even simpler RNA molecule"-- deserved. Predictably, Birdnow whined in his blog that he was being abused and then laughably removed his response and created a new Blogspot blog entitled Darwin's Inquisition, where he re-posted his original laughable response, entitled Darwinist Declare Jihad on Birdblog. (No, that's not my typo.) He even ran to William Dembski's blog begging for help, claiming that he's being "assaulted by PZ Myers and his Panda's Middle Finger minions at my website," while directing poetry back at PZ that, ironically, he doesn't seem to realize applies to him far more than his critics.

It is not my intent to pile on and add another point-by-poing blog slapdown of Mr. Birdnow to those of PZ. There's really no need, as Mr. Birdnow has dug himself into a deep hole and made an utter fool of himself flaunting his amazing ignorance of biology and then, when all his errors were pointed out to him, claiming that his errors didn't make his arguments less valid. (Besides, I can't come close to PZ when it comes to giving creationists like Birdnow the blog slapdowns they beg for.) When faced with legitimate (albeit somewhat rough) criticisms of the blatant errors in his presentation and his arrogance in refusing to recognize how much he does not know, Birdnow went running to Dembski, making him hardly worth bothering with as much as I have. Rather, what caught my eye was an interesting exchange in the comments of his post that summed up quite well what makes creationists cranks. Indeed, it summed up a characteristic of cranks in general, which is why I wanted to make it my launching point.

A commenter going by the 'nym of StaticNoise said:
Without the complete taxonomic relationship of organisms we can't possibly guess at ancestral relationships and declare evolutionary theory completely settled. There has been a persistent campaign by evolutionists to bully the lay public, as evidenced in this thread, into accepting that the debate is over.
Another commenter called Dr. G. Hurd, recognizing this as an argument from ignorance, retorted:
Can you tell me the exact trajectory of every round of every rifle fired in the Second world War? Can you tell me the names of every person, civilian or military, who died on Nov. 17th, 1943 as a result, direct or indirect, of the Second World War?

Obviously, your failure to do so "proves" that the "theory of the Second World War" is a total fabrication used by historians to "bully the lay public, as evidenced in this thread, into accepting that the Second World War is over."
Hurd nailed it right on the head! And succinctly, too! In fact, I wondered as I read his comment whether he had had some experience dealing with Holocaust deniers. Why? Because one of the key claims of some Holocaust deniers is that there could not have been nearly as many Jews killed in the Holocaust because, as they like to demand, "Where are the bodies and ashes?" Or, alternatively, they like to ask they like to make the fallacious claim that there is no forensic evidence that victims were gassed. As creationists do about mainstream scientists, they make claims that "mainstream" historians try to "bully" the public that the "debate is over" while implying that, if historians can't come up with a Holocaust death toll that accounts for every single Jew, Gypsy, Slav, and others who died at the hands of the Nazis, this somehow casts grave doubt on the very historicity of the entire Holocaust. (Oddly enough, they never ask the same questions or raise the same doubts about the Dresden firestorm or the Hamburg bombing, instead accepting without question even the most obviously inflated death tolls--a point I and others often throw back in their face, asking the same question, "Where are all the bodies?") In any case, in their their zeal to deny the Holocaust, Holocaust "revisionists" magnify uncertainties in estimates of the death toll or minor controversies over various aspects of the Holocaust, selectively disregarding the massive quantities of other documentary, physical, and forensic evidence supporting the contention that the Nazis intentionally developed a campaign of mass murder designed to eliminate European Jewry and any others that they saw as inferior or potential enemies of the state.

[DISCLAIMER: I do not mean to imply that creationists are anti-Semitic, as virtually all Holocaust deniers are, or Nazi apologists, as some Holocaust deniers are. I doubt that you would find a larger percentage of anti-Semites or neo-Nazis among creationists than you would in the general population. As I have pointed out before, I use this example to illustrate similarities in the fallacious reasoning the two groups use. I realize that such comparisons need to be used with care, hence this disclaimer.]

This sort of selectivity in attacking flaws in a theory or history is not limited to pseudohistorians like Holocaust "revisionists," of course, as "Dr. G. Hurd" pointed out by using his obviously absurd example. Creationists, including those of the "intelligent design" variety, like to pull a similar fast one, implying that, because we do not understand everything about how evolution occurred, because there are gaps in the taxonomy, because we do not entirely understand every step, because we haven't found each and every transitional fossil, this must imply that evolutionary theory is somehow fatally flawed and untrue. They ignore how much we do understand about evolution (which is a lot) and focus on every "flaw" in evolutionary theory, real or perceived, and every area where our understanding is incomplete, trying to magnify them in order to cast doubt on the theory of evolution. (Of course, they are also happy to overlook the fact that there is zero scientific evidence for "intelligent design.") The second implication, if you buy their claims that evolutionary theory is fatally flawed, is that their pet idea of "intelligent design" must be correct (or at least better). They seem to think that, by attacking evolution by hook or by crook, they "prove" that "intelligent design" is a reasonable alternative, all, conveniently enough, without having to produce any actual positive evidence for their alternative idea. (I won't dignify it by calling it a "theory.")

Indeed, this sort of behavior is almost a sine qua non of every variety of crank and pseudoscientist, be they "intelligent design" creationist or altie. Cranks tend to crave certainty, and, usually unintentionally, they often misinterpret weaknesses in current theory as fatal flaws that completely negate the theory. To them, if every hole isn't filled in, if every doubt isn't addressed, if every detail isn't understood, then theory must be invalidated, and, by implication, theirs must be a reasonable alternative. Science doesn't work that way, though, nor does history. For such disciplines, there will always be areas we do not understand in as much detail as we would like, and there will always be areas that current understanding doesn't adequately explain. However, these areas must be examined in light of what we do understand. For example, for evolution we understand a lot. There is an enormous amount of observational and experimental evidence from many disciplines that support current theory.

Unfortunately, science will always be susceptible to this sort of attack, at least in the eyes of nonscientists, because it is the very nature of science that no theory is ever final. Although to become elevated to the level of a "theory," a set of scientific postulates must have an enormouse amount of evidence supporting them, making them the best current understanding of a natural phenomenon that we have, no theory is ever considered to be the final word; every theory is subject to revision (most common) or replacement with a better theory (much less common) when new evidence and experimental results warrant it. To me and most scientists, science would be a boring and unrewarding field indeed if it were otherwise, because we would have very little to study. Much of the excitement of doing science comes from the possibility of discovering something new and unexpected that adds to our understanding of nature. Indeed, contrary to what cranks seem to think, the greatest glory in science is not confirming current theory but modifying it or even overturning it for something new. Unlike scientists, however, cranks don't understand that only pointing out and exaggerating the flaws in current theory is enough. They conveniently forget the part about having to produce strong evidence that supports their ideas, evidence strong enough to convince the vast majority of scientists.