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How not to win friends and influence people

BLOGGER’S NOTE: The incident described in this post is true, although somewhat embellished to protect the names and identities of the innocent, if you know what I mean. This conversation occurred a few years ago at a large national cancer meeting.

The question caught me by surprise.

While attending a large national cancer meeting, I was having brunch with a friend, a colleague with whom I used to work when I was doing laboratory research, someone whom I hadn’t seen in a long time. She and her husband had brought along two of their oldest and dearest friends, whom they had known for decades, as well as another of my former coworkers from my old lab. We were idly chatting away and eating, when one of the occupational hazards of being a doctor presented itself. Tthe conversation drifted to medical topics. And then it came.

“What do you think of Dr. Gonzalez?”

Ah, hell.

Blindsided again! Why hadn’t I seen that one coming? As a doctor, I find that these sorts of questions hit me when I least expect them. I was half-tempted to play dumb and pretend that I didn’t know who Dr. Gonzalez is, but decided against that approach. It doesn’t work anyway. I knew feigning ignorance would only result in her telling me who Dr. Gonzalez is in excruciating detail. Instead, I asked a single question to make sure we were both on the same page and talking about the same Dr. Gonzalez, “Do you mean the Dr. Gonzalez in New York City, the one who uses ‘detoxification,’ diet, and enemas to treat cancer?”

“Yes, that’s him,” she replied.

No escape there. For those of you who aren’t aware of who he is, Dr. Nicholas Gonzalez is a physician in New York City who claims to be able to treat incurable cancers with a regimen that includes dietary manipulations, “detoxification” with coffee enemas, and the ingestion of pancreatic enzymes. I’ve discussed him before in the context of a patient who followed his regimen and paid a price and, indeed, who might even have been treated by Dr. Gonzalez himself back in the mid-1990s. My co-blogger Dr. Atwood has produced a series of blog posts (1, 2, 3, 4, 5, 6) that will tell you in exquisite and painful detail. Dr. Gonzalez’s methods are based on a regimen popularized by William Donald Kelley, D.D.S., whose regimen resembled that of Dr. Max Gerson (whom I’ve written about). Using this regimen, Dr. Gonzalez claims that he can produce long-term survival in patients with inoperable pancreatic cancer, for whom the median survival is usually less than six months. Never mind that his study only had 11 patients who could complete the regimen, had no control group, and, given the rigor of the regimen required, had the potential for serious selection bias (Gonzalez’s regimen can sometimes require as many as 150 pills per day). Based on this tiny uncontrolled study, somehow NCCAM saw fit to fund a $1.4 million clinical trial, for which my co-blogger Dr. Atwood has produced compelling evidence that the Gonzalez regimen did not work and, indeed, may have even produced worse results than conventional therapy. As I’ve said before, if I were to submit a grant proposal to the NIH with so little preliminary data, the study section would have a good laugh at my expense before filing my application in the cylindrical file. In fairness, I will give Dr. Gonzalez a modicum (but just that!) of credit for at least making an attempt to use science to look at his therapy, however dubious the supporting data. Too bad he apparently wasn’t intellectually honest enough to report the results when they almost certainly didn’t go his way.

I wasn’t in the mood, though. I had just wanted to hang out with some old friends and talk about science, old times, and other topics. Also, I knew that a debunking session would probably not be appreciated (they almost never are, particularly in what was supposed to be a light social situation), and I didn’t want to risk offending my friends by being too strident with their old friend. So I tried to discourage her. “You probably don’t want to know what I think,” I replied, with what I hoped was a self-deprecating smile and chuckle.

“No, I do,” she said.

Damn, she’s going to be persistent, I thought. Not in the mood for a confrontation, I became more insistent. “No, I really don’t think you do.”

“Please.” She leaned forward, expectantly.

“You’re probably not going to like it,” I gently warned her, feeling like Deep Thought preparing to reveal after seven million years of working on the problem that the answer to the Great Question of Life, the Universe, and Everything is 42. If she didn’t know what I was going to say now, I would no longer be responsible for what came next.

“Come on.”

OK, I warned you. “He’s a quack,” I blurted out, wincing inwardly at how it must have sounded coming out. “I see no evidence that his ‘therapies’ do anything for cancer patients.” Did you have to use the q-word? Why couldn’t you be more diplomatic? I rebuked myself. You know what you normally do in these cases. You normally say that the treatment is unproven, that there is no evidence that it does anything whatsoever to increase long-term survival in cancer patients, but that you doubt it does any harm. (Even if you don’t necessarily believe that inside for this particular therapy.) That’s how you defuse the situation, avoid unpleasantness, and even possibly educate the people asking about the questionable therapy. You don’t use the q-word!At least, you don’t use the q-word with well-intentioned people who just don’t know any better. Hard-core alt-med mavens, on the other hand, are another matter entirely.

She was silent for a moment. Silverware clinked, but no one spoke. Everyone, my friend included, was looking at me expectantly.

I began a discussion of why I held the opinion I did about Dr. Gonzalez. I was starting to explain that Gonzalez’s methods were based on out-dated, faulty, turn-of-the-century concepts of how cancer developed, how his concept that cancer is due to a deficiency in pancreatic enzymes is not only implausible but not supported by scientific evidence, how there was (at the time) no good randomized clinical study that shows his methods do anything for cancer patients, and how the only reason his methods hadn’t gone the way of Laetrile was because of aforementioned tiny study, which led to the NCCAM study, when my friend’s friend interrupted. “You know, my husband and I know one of Dr. Gonzalez’s patients.”

“Oh, really,” I said. So that was why she was so interested.

“Yes, he had melanoma. His doctors told him he should just go into hospice or go home to die. But he went to Dr. Gonzalez, and he’s been fine. That was 12 years ago.”

Ah, geez. The dreaded “the doctors sent me home to die” cliché of so many alternative medicine cancer cure testimonials–even worse, the testimonial told second-hand to a friend. You can’t effectively fight that one without risking serious unpleasantness, and I didn’t want things to get too unpleasant, in deference to my friends. I realized that there was no way I was going to convince these people that Gonzalez was using unproven–even harmful–methods with no evidence of efficacy. They believed he had saved their friend’s life when no other doctor could. I also realized that questioning them to see if I could figure out whether their friend really did have metastatic melanoma was probably pointless. I guessed that most likely their friend probably didn’t have stage IV melanoma and that surgery probably took care of the disease, as it does for the vast majority of melanoma patients who survive the cancer. (Lay people and even some physicians not familiar with melanoma frequently confuse “stage IV,” which does mean metastatic and, with few exceptions, incurable with Clark “level IV,” which does not, unless the melanoma is accompanied by distant metastases.) But people won’t believe that or hear it when you say that. Indeed, in my experience, lay people rarely have enough information to let an oncologist or cancer surgeon assess the true severity of their friend’s or relative’s illness.

So I did the only thing that was left to me. I explained that a single anecdote does not constitute evidence for general efficacy, using one of my favorite sayings, “The plural of ‘anecdote’ is not ‘data.’” I also explained that spontaneous remissions, although very rare, do occasionally occur for melanoma and that it was impossible to assess whether the Gonzalez treatment really worked or whether conventional surgery had taken care of the melanoma. (Remember, when patients undergo surgery and then decide to opt for alternative medicine for the remainder of their treatment, they almost always attribute their “cure” to the alternative medicine, and not to the surgery.) Finally, I pointed out that my skepticism was rooted in both the lack of evidence that Gonzalez’s therapy does any good and the flawed “model” of cancer upon which the Gonzalez therapy is based. I told them that it was being studied in a clinical trial but that I sincerely doubted that it would be shown to have much, if any, benefit. I also explained the concept of selection bias, and how the healthiest patients were the ones who could manage to go through Gonzalez’s rather rigorous regimen, which could include as many as 150 pills a day.

“Oh,” she said. “You know, I heard of another person that Dr. Gonzalez had turned down because he had had so much chemotherapy and other treatments before.”

“That doesn’t surprise me and only makes me think selection bias even more,” I replied.

Perhaps I had gotten through after all–maybe just a little. It also helped that everyone at the table except them were scientists involved in medical research. I got a little tactical air support from them.

The conversation moved on to other topics. I did see everyone again a couple of more times while in Anaheim, and, to my relief, the topic of Dr. Gonzalez never came up again.

But this encounter reminded me of a few things. First, credulity will hit you when you least expect it. Most people who believe in these things aren’t hardcore alt-med aficionados. They are regular people who just don’t have the background in science and critical thinking to assess claims of “unconventional” practitioners properly. Second, many of these people can be educated, but not by stridency or overly strong attacks on their favored practitioner. That’s why I winced when I let it blurt out that I thought Dr. Gonzalez was a quack, even though I do, in fact, believe that he is. That could have turned them off so completely that anything else I said would have been ignored. (Fortunately, it didn’t, but it could have.) It also reminded me when, out of the blue, a couple of my close relatives expressed to me the belief that Sylvia Browne could really communicate with the dead. Suffice it to say that I did not cover myself with glory in terms of communicating skepticism and critical thinking, even to my family. Indeed, I recall yelling and the liberal use of terms like “bullshit,” “con artist,” and “scammer,” among others. True, Sylvia Browne is all of those things and her claims to be able to speak with the dead are, in fact, bullshit, but using those terms probably did not change any minds.

Blogging is one thing; being blunt is often appropriate here because the modalities that we are talking about are often not just useless but actually harmful. Moreover, to engage the reader, we have to be at least somewhat entertaining to read, and it is entertaining to read a sarcastic deconstruction of quackery. Also, reading a blog post or an article is not the same as having someone call quackery to your face. Face-to-face encounters usually require a different, more diplomatic approach, which is, believe it or not, possible without compromising. I also believe that the same (usually) holds true for radio and television, where it is very easy for believers to paint the skeptic as angry and intolerant, just as creationists have been doing to defenders of evolution for years whenever one is tempted to accept invitations to debate creationists. Finally, if you’re a skeptic and a doctor, you have to be prepared at any moment to do your part for science- and evidence-based medicine and against quackery. And remember, don’t resort to bluntness until you’ve exhausted more diplomatic means of getting your message across–unless you’re dealing with a hardcore believer, of course, in which case diplomacy is probably pointless unless there are others around whom you don’t want to turn off. The old saying may point out that there is more than one way to skin a cat, but you have to know when to pick one way over another; i.e., diplomacy over all out war or vice versa.

Posted in: Cancer, Health Fraud, Science and the Media

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30 thoughts on “How not to win friends and influence people

  1. Joe says:

    Penn & Teller have a show called Bullshit, it declined in quality after the first season, and the fifth was quite bad. In the first episode, Penn explained that he was going to be quite profane because, if you call someone a quack you can spend the rest of your life in court defending yourself. However, you can call someone an asshole with impunity.

  2. storkdok says:

    I am put in this position all the time. I have to be very careful, because almost no one with a child under the age of about 12 years with autism hasn’t been subjected to the biomedical treatments in my area. I have spoken with a lot of parents who have teenagers and older with autism, and they almost never have used biomedical treatments, so those are the ones I tend to talk to more.

    I was almost physically attacked about 4 years ago at a support meeting at the special preschool my son attended. Someone asked me to report on the conference I had just attended, Margaret Baumann with LADDERS puts on a yearly update conference on autism, and when I was discussing the genetics, one of the mothers flipped out, got up and got in my face, while I was holding my newborn son, screaming at the top of her lungs that it was mercury poisoning. Needless to say, I no longer attempt to go to support groups.

    I used to get blindsided in my practice by questions about Christianne Northrup and her alternative practices. The flip side was I and my partners also got a lot of the patients who came to their senses and desired a real OB/GYN with evidence based practices.

    My father, a gyn oncologist (first one trained at Sloane Kettering Memorial!) in SoCal battled a lot of quackery. I grew up hearing about the quackery industry in Tiajuana and my father testifying in Sacramento on cases involving quackery. He used to have friends dipping their toes into alternative practices, and was put in the position of delicately explaining why it doesn’t work without ending their friendship.

  3. marilynmann says:

    So this friend you were talking to was an oncologist? That part surprises me.

  4. Michelle B says:

    Thanks for stating the obvious (and you stated it excellently) differences/needs between snarky blogging and a more toned-down version of confronting wonky medical claims when face to face with people.

    It is heartening to see the blogging here used for doctors to help other doctors in being prepared for such situations. Kudos to all.

  5. David Gorski says:

    My friend is not an oncologist. She is a Ph.D. basic scientist in the lab I spent nearly three years working in.

  6. Peter Lipson says:

    I had a similar experience over Thanksgiving…always interesting.

  7. ama says:

    Oh, well… I had a subscription for situations like that.. :-(

    I always put a foot in… No escape…

    The point here is:
    Why are WE responsible?
    Why should WE apologize?
    Why should WE be careful?

    It is always us: WE are offensive. People cannot take the truth, and so WE are bashed becaused we tell the truth.

    After a number of years I
    a) got accustomed to he situation and
    b) got angry because WHY should *WE* always give in!?

    The real offense is to accuse us. Only, the way of HOW the accusation is made, is driving us backwards against the wall. And this with no real facts…

    Just the accusation in itself is the accusation. There are no real arguments.

    So I decided to say:
    “YES, these are PLAIN FACTS, AND I AM RIGHT!
    If you can’t stand them, it is YOUR fault!”

    If these people would say ” 2 x 2 = 5″, we would call them stupid.

    If they say “coffee enemas are good”, we duck out.

    WHY? it is the same bullshit. And it is THEIR bullshit and THEY are too stupid to understand facts.

    No whining, no compliments, no apologies, just straight forward.

  8. tarran says:

    I frequently find myself in this position when discussing politics with family members (I am a radical anarchist, and most of my relatives work in the financial industry and are mercantilist republicans or democrats ie people who benefit from big-government).

    I have found the approach you took to rarely work since it strikes people as passive aggressive (although I have no information as to the emotional atmosphere present at the table – without that one can’t make any definitive comments).

    I have found that the best approach is to demonstrate no emotion other than humor – humor that must be slightly self-deprecating. My experience is that these things where 1 person is challenging the strongly held beliefs of a few that are widely but not strongly agreed with by the rest of a group can easily trigger behavior seen in other primates, where the strong believers lead the rest of the group on an attack on the threat to the social heirarchy. Among humans, there is usually nothing more than shouting (certainly I have never seen any feces throwing), but it does not get you anywhere in convincing other members of the group.

    My aims in political discussions are probably the same as yours in discussing medicine – to trigger critical thinking in my listener. That can be a delicate thing: people are very good at rejecting that which makes them uncomfortable. Thus – self deprecating humor is practically required. It also helps when you ask them questions as well – people are willing to listen to you if you are wiloing to listen to them respectfully – even when the opinions expressed are mired in absolute blinkered ignorance. Generally, once people conclude that you are not a loon who is not going to ruin the tenor of the discussion, you can really educate people.

    I probably haven’t convinced anybody to become an anarchist in a face to face conversation. However, I have observed that the people who work with me have become far less credulous when listening to politicians whom they want to agree with.

    Of course, I have the benefit of repeated contact with the same group over and over again, and have benefitted by the predictable behavior of politicians in the past few months which has allowed me to seem prescient to my coworkers and family members.

    Incidentally, the prediction you made about the clinical trials and the follow on conversation was absolutely perfect. Way to sow the seeds of doubt!

  9. maus says:

    “# Joeon 08 Dec 2008 at 5:27 am
    Penn & Teller have a show called Bullshit, it declined in quality after the first season, and the fifth was quite bad. In the first episode, Penn explained that he was going to be quite profane because, if you call someone a quack you can spend the rest of your life in court defending yourself. However, you can call someone an asshole with impunity.”

    I have to say, I love P&T’s magic show. I try to be skeptical about a lot of “conventional wisdom”. I enjoyed the first few Bullshit seasons as well. Heck, when I was in Miami I attended a number of Randi’s monthly meetings and enjoyed them greatly.

    After the Bullshit cranked on, but mostly after I read what Penn had to say about Libertarianism and free-market “common sense” I really soured on his intentions and the cato institute tainted anything he had to say on well, anything.

    Yes, I’m for removing anti-science figures from public health and education. Yes, I appreciate that he is pro-science and anti-CAM. No, I do not agree that a pro-big corporate narrative should replace the existing dumb narratives.

  10. maus says:

    “# tarranon 08 Dec 2008 at 12:21 pm

    I have found the approach you took to rarely work since it strikes people as passive aggressive (although I have no information as to the emotional atmosphere present at the table – without that one can’t make any definitive comments).”

    Politeness isn’t passive-aggressive. The expectation that all positions are equally deserving of respect and adoration is passive-aggressive. Directly confronting a societal problem/obstacle may be perceived as aggressive, but it’s by no means pussyfooting around. If someone has false expectations that their anectodes are worthful, you’re by no means obliged to coddle them further.

    Does it solve anything? Not really. They don’t know HOW to think, no matter how much data one could throw at them. At best you could convince them temporarily, but it’d only seep out their brain when some other aspect of reality confuses them.

    So yes, other than an increased focus on logic and “trust” games in early education, I have no suggestions on how to fix this issue :)

  11. overshoot says:

    When someone tries to take a pleasant get-together into Holy War territory, I try to just say, “We’re having a very pleasant conversation and I’d like to keep it that way.”

  12. David Gorski says:

    After the Bullshit cranked on, but mostly after I read what Penn had to say about Libertarianism and free-market “common sense” I really soured on his intentions and the cato institute tainted anything he had to say on well, anything.

    True, alas. I used to consider Penn to be a model skeptic, but I see he believes in his own form of radical Libertarian woo. In particular, until very recently he didn’t accept the data that secondhand smoke was harmful, and I’ve heard him in the past express “skepticism” right out of the denialists’ playbook about the science behind anthropogenic global warming.

    You know, if there’s one thing I’ve noticed about skeptics and “freethinkers,” it’s that instead of religion, the paranormal, or quackery, they tend to be prone to this sort of über-Libertarian sort of woo, often coupled to a super pro-free market belief system, sometimes to the point where they are almost as unscientific and irrational about it as believers in the paranormal. I really do think that such beliefs sometimes substitute for religion for them.

    {Dons asbestos jacket}

  13. James Fox says:

    I’ve had a number of similar incidents and have also tried to not use the word quack or con…, mostly without success. There are times when I know my wife has the phrase “why do you have to be so strident” on her tongue after an all to similar discussion with friends or acquaintances. Well dear, its because I care and people should know who the cons and quacks are!!

    The whole politics and skepticism issue is certainly problematic. The issue is that much of politics involves ideals and philosophical notions which are not effectively measured through the scientific method. Even saying one is a pragmatist will get you called a quisling fence sitter.

  14. Joe says:

    @maus and David,

    I am unfamiliar with the libertarian component, I’ll take your word for it. I always thought a major problem P&T have is there staff of researchers. They take on a diverse range of topics and they cannot be qualified to evaluate most of them.

    To get back to the subject at hand. I live near four, top colleges (Smith, Amherst, Hampshire and Mt. Holyoke) and the flagship U of Massachusetts at Amherst. As a result of all the highly-educated faculty here, there is a great demand for, and supply of, woo of every type.

    Six years ago, K. Atwood estimated there were 34 naturopaths in MA who wanted licensure (they don’t have it); today, two of them live within walking distance of my home. I try to avoid confrontation with my neighbors (the herbalists, astrologers, acupuncturists, etc.), they are nice people. I don’t know what I will do if push comes to shove.

  15. Calli Arcale says:

    I ran into a situation like this recently with a coworker convinced that the “autism epidemic” was real. I wish I’d been more diplomatic; she was pretty icy to me for a while. When I brought up studies, she finally said, “Well, you can believe what you like. I just know what I’ve seen.” It was then I realized that although I was the one with data on my side, she was the one being diplomatic. She was trying to avoid biting *my* head off about something very important to her, and I was being all holier-than-thou, don’t-dare-correct-me-when-I’m-right.

    I try to be diplomatic and respectful, but I need a wakeup call every now and then. Also happened some years ago with a friend from church who had bought into the Apollo hoax nonsense.

  16. maus says:

    “You know, if there’s one thing I’ve noticed about skeptics and “freethinkers,” it’s that instead of religion, the paranormal, or quackery, they tend to be prone to this sort of über-Libertarian sort of woo, often coupled to a super pro-free market belief system, sometimes to the point where they are almost as unscientific and irrational about it as believers in the paranormal. I really do think that such beliefs sometimes substitute for religion for them.”

    I’m often disappointed when entertainers stop being insightful and start being grouches to appease their audiences. Maybe it’s that they’ve gone as far as they feel that they can go, and then feel obliged instead to pander what they feel their target demographic expects.

    The whole “complaining about political correctness” schtick can lead to valid, specific complaints, but the people who try to apply it to society as a whole willfully discount all the immense progress we’ve made over the last fifty years in race relations and gender equality.

    But yes, they’re just symptoms of our culture model, the quality of “infotainment” always seems to burn out until the subject is no longer useful as any source for knowledge and facts.

  17. Prometheus says:

    In one of the Penn and Teller “Bullshit” episodes, Penn commented that “Everybody has a gris-gris.”, meaning that everybody has some irrational belief that they’re not willing (or at least not ready) to let go of.

    I’ve found that even otherwise rational, skeptical people can seem very “irrational” when the topic at hand is politics. I think that much of this apparent “irrationality” has to do with conflicting political views held by the listener. After all, to a person of the opposing political viewpoint, any political viewpoint can seem “irrational”. Conversely, when you speak with someone who holds similar political views, they seem more rational and wise.

    To me, all politics is inherently unscientific because the policies and programs proposed have never been tested under the same conditions as they are being put forward to address. Even policies that have been tried – and succeeded – in other times or other places have no guarantee of working in this time and in this place. I find some political ideologies – I must confess – less rational than others, but only insofar as they ignore or contradict what is known about physical reality.

    As a result, I generally give a “bye” to otherwise sane, rational and skeptical people when political topics arise. There is generally no “right” or “wrong”, only differences of opinion.

    However, in the matter that Orac describes – the “treatment” of cancer (or any disease or non-disease) by means that are not only bizarre but have no basis in physiology (e.g. putting coffee into the “exit” end of the alimentary tract) – is not a matter of opinion, since there are (or can be) data that either support or refute these claims.

    Like some of the commenters, I find it frustrating to be “on the defensive” when I am presenting the known data – “the facts”, if you will – to counter fantasy and fabrications. The people claiming that “diet has a significant effect on cancer” should be the ones trying to find a way to not offend me with their nonsensical and unsupported claims. Yet, we see such nonsense put forth constantly as if it were fact and not fantasy.

    It may yet turn out that “diet” or some other simple intervention will be the “cure for all cancers” (or other ills that afflict us), but nobody has data to support that claim. On the other side of the table, there is a lot of data that support the opposite conclusion – that diet (apart from making sure that caloric and nutrient needs are met) has little impact on the progress of cancer; that cramming your stomach full of “supplements” and your colon full of coffee will not alter the outcome of pancreatic cancer; that having a support group will not alter the outcome of breast cancer. I could go on.

    I’m ready to stop being defensive and go over to the offense.

    Who’s with me?!

    Prometheus

  18. khan says:

    I recently contacted (email) my sister for the first time in 6 years. I mentioned that I had inherited the ‘family curse’ (arthritis/carpal tunnel syndrome/ulnar nerve entrapment); the response was interesting:

    >>I believe all of mother’s ancestors had those problems due to bad diets white sugar, white flour and white salt. … The pharmaceutical companies and the big food and dairy companies run this country and they want every one sick so they can make a profit.

    I am a member of the Weston Price Foundation… I just had all of my mercury amalgam fillings removed…<<

    I was reminded why I hadn’t contacted anyone for 6 years.

  19. David Gorski says:

    As a result, I generally give a “bye” to otherwise sane, rational and skeptical people when political topics arise. There is generally no “right” or “wrong”, only differences of opinion.

    Not when politics leads one to take positions that science has shown to be demonstrably false, such as that secondhand smoke isn’t harmful or that anthropogenic global climate change is not happening.

  20. I believe Penn has recanted his position on secondhand smoke (she says, not at all remembering the reference to cite). I think it was in an interview about Bullshit, wherein the question was something like “Have you changed your mind about any of the topics?” and he replied that he had later been shown evidence that changed his mind about the secondhand smoke conclusion their show presented.

  21. James Fox says:

    “Not when politics leads one to take positions that science has shown to be demonstrably false,…”

    It has always been interesting to me that science often seems to be viewed differently through ones own political prism especially with regard to particular issues. Sometimes it appears that those who tend toward more conservative views tend to reject obvious scientific evidence (The two examples you mention and evolution). Whereas those with more liberal views will tend to accept woo claims without critical analysis. The state I live in is generally quite liberal and we appear to have much more than our share of quack/woo/loony CAM practitioners and their devotees. ID and creationism would never be tolerated in a public school classroom here. However, if anything critical of cultural/tribal non scientific healing practices was part of the science curriculum it would get squashed under an avalanche of multi ethnic culturally sensitive hubris.

  22. Fifi says:

    Joe – I recommend using voodoo or ritual performances of woo on your neighbors if metaphysical push comes to literal shove. You may not believe in it but if they do…..

  23. David Gorski says:

    I believe Penn has recanted his position on secondhand smoke (she says, not at all remembering the reference to cite). I think it was in an interview about Bullshit, wherein the question was something like “Have you changed your mind about any of the topics?” and he replied that he had later been shown evidence that changed his mind about the secondhand smoke conclusion their show presented.

    The problem was, the evidence was pretty damned conclusive before that episode aired; the whole episode bordered on denialism, as I recall. (It’s been a long time since I saw it.) So, yes it’s good that Penn did ultimately sort of “recant” (I’ve seen the video), but it’s bad that he let his free market ideology and/or his need to be contrary to lead him to reject pretty compelling evidence even then.

  24. megancatgirl says:

    I have to say that I really admire your approach in discussing these topics, after reading this post and several others. In general, getting mean or upset in a disagreement tends to make the other person become defensive and refuse to listen you simply to “win” the argument. I also think it’s great that you don’t just insult the people who disagree with you (calling the doctor a ‘quack’ is pretty minor). You explained your beliefs based on evidence and reason, and didn’t just say that the whole thing is silly or ridiculous. All too often, I see skeptics resorting to ad hominem attacks or appeals to emotion, and we simply don’t need to do that because the evidence speaks for itself. Insulting other people or ideas, even if those ideas are not supported by evidence, doesn’t help our side in any way. It’s very refreshing to see someone who relies on explanation of evidence. Even if you didn’t change those people’s minds immediately, I’m fairly confident that it at least made them more willing to think about from a different point-of-view.

  25. Winfield J. Abbe says:

    Frankly it is most of the medical orthdoxy engaged in the only approved cancer “treatments”, if you can call them that, who are engaged in the most non scientific medical fraud of the century. It is they in the NCI, NIH and FDA who have fraudulently not properly scientifically studied many alternative cancer treatments and that is why they have so many “references” claiming it is fraud and quackery when it is they themselves engaged in such unscientific conduct. They do this in a variety of ways, mainly lying with statistics no one can disprove, or cherry picking references, they routinely accuse their ememies of doing. After all, these government “scientists” have all the public money and power and time to seek to deceive a gullible and unwitting public. Wouldn’t you think that the squandering of multi billions of public and private dollars by now would have solved the cancer problem? Yet most of them cannot even tell you what causes cancer, let alone cure it once it exists as a clinical disease in the human body. Here are a few references you never see them mention, and if they do , they will usually seek to divert attention from the issues by claiming they are from “unreliable sources” or other unscientific comments to divert attention from the basic issues of fraud by the medical orthdoxy, rather than talking about the issues themselves. Here are a few:
    “The Truth About Hydrazine Sulfate-DR. Gold Speaks” by Joseph Gold, M.D., http://www.hydrazinesulfate.org. This article is about 20 pages with 77 references and is basically a criminal indictment of the NCI, NIH and FDA. Dr. Gold is a distinguished medical doctor who did post graduate work at UC Berkeley. He has spent a large part of his career seeking to have this substance approved for cancer treatment, only to have the prejudiced non scientists of the orthdoxy seek to kill it, not because it is not or has not been proved effective as a cancer treatment for advanced cancer patients with scientific evidence as he clearly documents in this article, but due to prejudice against it by the non scientists of the medical orthodoxy. There is no mention of this article on the misleading quackwatch site these authors like to quote. This article disputes every claim falsely made there about this substance. The government agencies even still lie about it on government websites as documented in this article.
    “American Cancer Society America’s Wealthiest ‘Non-Profit’ Institution” by Samuel S. Epstein, M.D., International Journal of Health Services about 1999 also available at http://www.preventcancer.com. Dr. Epstein is a distinguished medical doctor and emeritus professor at the University of Illinois, Chicago and has published about a dozen books and almost 300 scientific articles. Do you ever observe this article references on this website? No. This article demonstrates the many unethical, improper and likely illegal sordid activities of the American Cancer Society over roughly 30 years or more.
    “The Cancer Industry” by Ralph W. Moss, Ph.D., Equinox Press, N. Y., 1996, first published as “The CAncer Syndrome” about 1980. Dr. Moss has a Ph.D. in classics from Stanford University in California and has written many books and hundreds of articles about cancer. He was fired from the position of assistant director of public affairs from Memorial Sloan Kettering Cancer Center in New York in the 1970′s for refusing to lie about research there on Laetrile. This is documented in the 1989 edition of the above book. This book is documented with about 500 references and discusses, among numerous other sordid episodes of fraud and scientific misconduct by the orthodox cancer “scientists”, the “Summerlin Painted Mouse Affair” where a cancer “scientist” a Memorial Sloan Kettering Cancer Center in New YOrk painted spots on the backs of laboratory animals in order to fool others about cancer research. Virtually nothing happened to him for this scientific fraud either. Do you ever see this book referenced on this site?
    The medical orthodoxy is very powerful. Even if any of the above M.D.’s believed and sought to use alternative cancer treatments, they could have their medical licenses revoked if they did as others have in the past. They are basically part of the failed medical orthodoxy which has failed now for almost a half century to deal with the cancer problem where about one person dies every miinute either from cancer, treatment or both. All approved medical treatments by the medical orthodoxy are life threatening, so when one dies while under treatement for cancer, one never knows for sure if they died of the cancer, the treatment or both. Fortunately for the medical “doctors” involved, a true and objecdtive autopsy, to prove the true and objective cause of death, is rarely, if ever performed. It is quite obvious the cancer generals not only do not know what they are doing, but do not want to know what they are doing either.
    In fact, not only should and must they be fired, they must be charged with scientific misconduct, medical quackery, fraud and crimes against humanity.
    The late Hardin Jones, Ph.D., former professor of medical physics and physiology at UC Berkeley, and an expert im medical statistics, proved long ago, that those who did not receive any treatment for cancer, lived up to 4 times longer than those who accepted the failed orthodox treatments of chemotherapy, radiation and surgery. Little has changed today.

    Winfield J. Abbe
    A.B., Physics, UC Berkeley, 1961
    Ph.D., Physics, UC Riverside, 1966
    150 Raintree Ct.
    Athens, GA

  26. David Gorski says:

    For the first part of your rant, see my response on this thread:

    http://www.sciencebasedmedicine.org/?p=496#comment-20113

    Now on to the rest of Abbe’s rant:

    The medical orthodoxy is very powerful. Even if any of the above M.D.’s believed and sought to use alternative cancer treatments, they could have their medical licenses revoked if they did as others have in the past. They are basically part of the failed medical orthodoxy which has failed now for almost a half century to deal with the cancer problem where about one person dies every miinute either from cancer, treatment or both. All approved medical treatments by the medical orthodoxy are life threatening, so when one dies while under treatement for cancer, one never knows for sure if they died of the cancer, the treatment or both. Fortunately for the medical “doctors” involved, a true and objecdtive autopsy, to prove the true and objective cause of death, is rarely, if ever performed. It is quite obvious the cancer generals not only do not know what they are doing, but do not want to know what they are doing either.

    In fact, not only should and must they be fired, they must be charged with scientific misconduct, medical quackery, fraud and crimes against humanity.

    The late Hardin Jones, Ph.D., former professor of medical physics and physiology at UC Berkeley, and an expert im medical statistics, proved long ago, that those who did not receive any treatment for cancer, lived up to 4 times longer than those who accepted the failed orthodox treatments of chemotherapy, radiation and surgery. Little has changed today.

    Actually, I answered a lot of these claims in my comment, too. I merely wanted to point out that you’ve become much more “over the top,” so to speak. “Crimes against humanity”? Really?

    As for Hardin Jones, our regular commenter, resident gadfly who keeps us honest, and good friend of the SBM blog, retired surgeon Peter Moran, discussed Hardin Jones’ claims in great detail:

    http://www.users.on.net/~pmoran/cancer/hardin_jones_and_cancer.htm

    It turns out that Hardin Jones never said anything of the sort and that his nihilism with regards to cancer therapy was very much a product of his times, mainly because in the 1950s there really wasn’t much doctors could offer patients who had failed surgery or for whom surgery was not possible.

  27. @Winfield Abbe:

    Dr. Gorski has covered much of what your comment demands, so I’ll add only a couple of points. First:

    “Wouldn’t you think that the squandering of multi billions of public and private dollars by now would have solved the cancer problem?”

    This is a surprising suggestion, coming from someone ostensibly trained in science. Money is not a sufficient basis for solving complex biomedical problems or anything else about nature. The science must be ready for such solutions. The solving of ‘cancer’ (not one disease but many, as Dr. G pointed out) is an ongoing project that began well before Watson and Crick elucidated the molecular basis of the gene, which is fundamental to its understanding. An enormous amount has been learned during that time—some of it having resulted in effective treatments and even cures for some cancers and also for other diseases whose fundamental causes involve molecular genetics, such as AIDS—but much more needs to be done.

    Cancer will be solved in the forseeable future, but only a naif would yet attempt to predict the time frame within a range of years or even decades. For a more general critique of impatience regarding biomedical breakthroughs, look here:

    http://www.sciencebasedmedicine.org/?p=157

    Next, regarding hydrazine sulfate and Joseph Gold:

    “There is no mention of this article on the misleading quackwatch site these authors like to quote.”

    Your link to Dr. Gold’s article is broken at the moment, but no matter. On QW, the late Saul Green posted a comprehensive critique of hydrazine sulfate as a treatment for cancer, covering most of its ‘literature’, including that by Dr. Gold:

    http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/hydrazine.html

    The claim is clearly bogus, as are Laetrile, ‘antineoplastons,’ the Gonzalez Regimen, Krebiozen, and numerous other fantastic cancer ‘cures’ championed by the ‘unreliable sources’ that you seem to recommend. To the extent that some of these are competing for money and attention at the NIH, not because of scientific promise but because of arm-twisting by powerful but ignorant politicians such as Burton and Harkin, they delay real progress and distract a scientifically-naive public. Money is not a sufficient basis for progress in science, but it is a necessary one.

  28. Wallace Sampson says:

    I want to add comment from two other angles. One is from a basic science, molecular basis, the mechanism of cancer formation and likely routes to cures; the other from an analogous situation in Dr. Abbe’s own field, physics.

    Complementing Dave Gorski and taking cues from Kim Atwood’s comment, a single “cure for cancer” will not exist. Unless one considers surgery or radiation as “single” methods, which they are not – there are many variations applied differently. But for cancers not curable by surgery or radiation, there will be no single treatment for all; no magic bullet, no single hydrazine, no single laetrile, and no empirical method or herbal-supplement combination such as those of Hoxsey or Gonzales, no chemical like Burzynski’s anti-neoplaston or even a single immunological product.
    Today’s cures (Lymphomas, Hodgkin’s, acute leukemias, testis, etc.) are somewhat empirical discoveries, made through differing routes. Some through observations of toxic effects (alkylating agents from mustard gas,) anti-metabolites (through biochemical discoveries – methotrexate, 6MP) – hormones through unrelated other biological discoveries.
    As empirical as they are, today’s cures had to be developed and refined after the basic science was developed and refined. Then further developed and refined through trials, each taking years to carry out and to observe results…and are all different – different drug combinations, different drug scheduling, etc.
    That complexity exists not because of a human failing or some systematic conspiracy. It exists because each cancer tissue type is biologically unique. In addition, each particular patient’s specific cancer has even more unique characteristics from the patient with the same cancer next door. On top of that, each person’s cancer cells are themselves heterogeneous – genetically differing from one another in small yet important ways. This is more than one reason anti-cancer drugs have to be given in combinations and in series, and the reason why some cancers are still incurable.

    The variations among cancers of similar tissue origin exist because at discovery, each cancer has undergone at least 30 cell divisions to reach a volume of one cubic centimeter, which contains + – 10/\9th cells. With each set of cell divisions, there is a chance for a multiplicity of gene translocations, inversions, unbalanced duplications and over expression, deletions (of repressors and inhibitors.) For each of these abnormalities, there exists a different over-expressed or missing protein – integral to tumor replication, migration, and other controls, for which a unique or separate set of specific inhibitory molecules or antibodies have to be designed. So for cures for each cancer type, several specific approaches will be required. That is now called tailored or “targeted” therapy.

    For each person’s specific cancer cell population there will likely be more than one different molecular DNA change plus an as yet unknown number of meta-genetic changes that may contribute to cell growth through extra-DNA, cytoplasmic locations. For the specific approaches above, tests have to be invented for biochemical and biological definition of the precise genetic aberrations. Then, methods have to be discovered for administration and transportation of the specific molecules to their respective tumor locations. Some locations will be in known sanctuaries – locations not supplied with adequate blood or that lack diffusible entry membranes for large molecules (testis, central nervous system.)

    A chemist or physicist should be able to comprehend the enormity of this problem. And, appreciate that the advance of cures is dependent on the advance in the basic sciences of biology, biochemistry, physiology, pharmacology, and on…. This advance is now occurring throughout the world – as scientists and clinicians from every continent work together and share knowledge. The advances depend on discoveries that unmask the secrets to the origins and evolution of life. Some job.

    Against this amazing problem and effort are critics who feel the thing is simpler. Some mundane explanation and material must be lounging in the claims of an unrecognized outsider and held secret by a malevolent government/doctor-AMA/pharmaceutical conspiracy. Or maybe the inertia of academic hierarchies. (This latter is even plausible.) But one never hears about the number of conspiracies that must exist in all those foreign countries, and how the various elements hold the thing together. Hmmm. Now that we‘re thinking about it, let’s look into it…

    Now, I happen to feel the same problems exist – but in physics and engineering. I read today of the opening of the National Ignition Center Lab at Lawrence Livermore Labs. The power of the stars it was headlined. Bull. All they have to do is create the same conditions for hydrogen and its endless supply in the oceans to be converted to helium, with resultant energy release far in excess of input. We have had a hydrogen bomb since 1950sumpthin”. There was something about using lasers to produce a temperature of 120 million degrees – celsius or Fahrenheit, I don’t recall – in a B-B size glass bulb. What’s holding things up?
    Pons and Fleischman showed 20 years ago that table-top cold fusion happened on their kitchen counter. The doubters couldn’t believe it. The Establishment physics community spent years and wrote books debunking these honest and devoted workers. They had to leave Utah and work in France, sponsored by the Japanese for heaven’s sake. A treatment only Paul Robeson and Linus Pauling could appreciate.
    And how about zero point energy? I read that ia home device can produce more energy than consumed, e http://ww.zeropointpower.net and runs perpetually.
    Then there is the solved problem of generating energy from the earth’s magnetic field – it’s just standing there being wasted through the ignorance of the physics establishment and the greed of special interests of dam builders and coal and gas industries.
    Then there’s the nuclear waste problem. The nuclear interests want to poison us for generations with deformed children and an epidemic of cancer.
    As for the hiding of the technology for running cars on water, well, need I say more?

  29. Wallace Sampson says:

    In the comment immediately above I avoided countering the many errors in Dr. Abbe’s comment. One of them was that Summerlin went unpunished for his painting black spots on the backs of mice (showing the genetic trait to be passed through genrations.) Dr. Summerlin lost his research job, was banned from receiving more NIH grants for a period, and was last known to be practicing medicine in Alabama.
    There is no fine or imprisonment punishment for scientific fraud. It is not a crime. This is recorded in th book, The Patchwork Mouse.
    Ralph Moss got everything backwards in his reporting of the Laetrile research at Sloan Kettering. The research observations claimed to show effects on cancer were wrong, and could not be replicated. Moss was fired from SKI – sort of like Summerlin’s fate. He went on to be a booster for Laetrile – a fraud =- and other anomalous cancer treatments. He still runs a cancer consultation web site and bulletin.

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