Mar 12 2010
Just the Facts
Get your facts first, and then you can distort them as much as you please.
—Mark Twain
There is an educational approach to becoming a doctor. It involves learning massive amounts of basic science, followed by massive amounts of pathophysiology, which barely prepares you for the clinical years of the last half of medical school and subsequent residency, with the massive knowledge dump you will have to absorb. Much of the information is given by experts in the field, usually MDs or PhDs (or both), who lecture formally and informally. Being considered an expert in infectious disease (ID) at a teaching hospital, I now spend hours a day yammering on about infections to anyone who will listen, students in all the medical fields who rotate through our hospitals. I value the facts I have learned in my field and respect those who have worked to provide me with the information. I greatly value facts and the people who provide them.
Most of the information I get in medicine is from those in the field. It is rare for people to write about aspects of medicine that I will take seriously. Yes, there are a lot of people who write on the web about medicine, but given what it takes to achieve even a solid knowledge in medicine, much less develop expertise, I usually can’t take them too seriously. Call me arrogant, but if you want to be a legitimate source of information there are dues that have to be paid.
The world of anti-vaccination discourse is small. There are few physicians who take an interest in the topic. Most doctors are too busy to care and it is like worrying about defending fresh water and clean air. I would wager that to most physicians outside the world of pediatrics, the benefit of vaccines is rarely given a thought.
The anti-vaccinationists are an equally small group of people, at last the ones that bother to write on the topic. Sometimes they seem inordinately loud, but that is only because they end up on Oprah.
I often feel that the two sides inhabit different worlds with different approaches to reality. I live in a world dominated by facts derived from the sciences. The facts always change, or better words may be evolve or refined, with time. But facts matter to me. There is a world of facts derived from observation of the natural world and in the end my opinion on a topic medicine does not matter. It is what the facts indicate that should determine my opinions, not the other way around. Facts can be tricky things, especially in medicine, with nuance and subtlety that makes the facts less clear cut than one would like, especially compared to a hard science like physics or chemistry.
Facts often do not seem to matter to anti-vaccine proponents and other CAM practitioners to the same degree that they do to me. For example, given the preponderance of information about the worthlessness of homeopathy I cannot see how anyone would ‘practice’ homeopathy. Or acupuncture. Or chiropractic. Or virtually any CAM discussed on this blog.
I have spent half of my life accumulating facts to understand the best way to practice medicine and, as best I can tell these facts, do not matter much to the CAM practitioners or anti-vaccinationists.
And I don’t get it. Why do the CAM practitioners and anti-vaccine proponents not pay attention to the facts. It is, as I have said, like we live in two separate cultures. I have spent some time in other countries whose customs are different from mine: Japan, France, Minnesota. Before visiting those foreign lands I would read texts by anthropologists and historians on what to expect and how their culture differed from mine. I would never have survived my three years in Minneapolis if not for “Lake Woebegon.” But who better to understand a foreign culture than an anthropologist. What I need is anthropologist to help understand why the facts do not matter.
Ask and you will receive. I serendipitously came across two articles. The first is by Leonard Pitts in my local paper.The other is “A Post-modern Pandora’s box: Anti-vaccination misinformation on the internet” by Anna Kata, an anthropologist from Canada. There are other studies on the beliefs of the anti-vaccinationists, but they are from the perspective of doctors and have underlying belief that if you get the right information to people they will make the right decision. Doctors believe, in the end, in rational discourse.Others do not.
The Internet plays a large role in disseminating anti-vaccination information. This paper builds upon previous research by analyzing the arguments proffered on anti-vaccination websites, determining the extent of misinformation present, and examining discourses used to support vaccine objections. Arguments around the themes of safety and effectiveness, alternative medicine, civil liberties, conspiracy theories, and morality were found on the majority of websites analyzed; misinformation was also prevalent. The most commonly proposed method of combating this misinformation is through better education, although this has proven ineffective. Education does not consider the discourses supporting vaccine rejection, such as those involving alternative explanatory models of health, interpretation strikes me that this argument is for a freedom without responsibility for the consequences of parental responsibility, and distrust of expertise. Anti-vaccination protestors make post-modern arguments that reject biomedical and scientific “facts” in favour of their own interpretations. Pro-vaccination advocates who focus on correcting misinformation reduce the controversy to merely an “educational” problem; rather, these post-modern discourses must be acknowledged in order to begin a dialogue.
Note she puts facts in quotes.
What the author did was Google for websites that opposed childhood vaccinations for any reason and she ended up with 9 sites, including the whale, vran.org, vaclib.org, and vaccinationnews.com. Why so few? Evidently those seeking health information on the net rarely look past the first 10 search results, so she tried to mirror the results of the average internet user searching for information. She then analyzed the sites for content relating to Safety and Effectiveness, Alternative Medicine, Civil Liberties and Conspiracy Theories/Search for Truth as well as design attributes of the web sites, emotive appeals and content. Interestingly, a search using the terms “immunization OR immunization” failed to find any anti-vaccine sites; anti-vaccinationists do not use the term as “they tend not to believe that vaccine confer immunity.”
The findings will be no surprise to those who frequent anti-vaccine sites, or alt med sites in general.
What 100% of the sites had in common was the assertion that vaccines are dangerous because they contain poisons or cause a variety of illnesses. It was noted that on the sites “pertinent information was not elaborated upon” and gave examples of the amount of ‘toxins’ being too small to cause disease and that the ether in vaccine is the chemical not the anesthetic not being mentioned on the anti-vaccination sites.
Also common were statements concerning the lack of vaccine immunogenicity, the lack of vaccine efficacy in decreasing childhood diseases (credited to diet, hygiene, etc) and a trivialization of vaccine preventable diseases, failing to mention the past and present morbidity and mortality of the diseases.
What these sitesdemonstrateis a disregard for facts, which at one time were considered the final arbitrator of reality. If facts do not matter, and can be ignored arbitrarily, then the conversation between the reality based approach to medicine and the alt med practitioners is impossible.
She notes that most sites endorsed the use of alternative medicines and often argued against germ theory.
Anti-vaccination website tended to reject scientific, clinical and epidemiologic studies demonstrating the safety and efficacy of vaccines. Pro-vaccinations studies were criticized as unreliable, conducted by those with vested interests in vaccination.
Again. Facts ignored or dismissed.
Three quarters of the sites cited the infringement of civil liberties by requiring vaccination. It strikes me that this argument is for a freedom without responsibility for the consequences. It is an argument for which I have some sympathy, but only as long as those who wish to exercise their freedom not be vaccinated are always at least 30 miles away for me and mine or agree to take all the financial responsibilities for the medical care of anyone they inadvertently infect. My problem with the civil liberty approach comes from having to take care of for free and my hospital treat for free people in the trauma ICU who preferred the freedom of not wearing seat belts and helmets in defiance of the man and ended up with multiple, very expensive, traumas. But we are all biased by our experience.
“The conspiracy theory theme was present on every website analyzed”. Someone, usually doctors or big pharma, is covering up of the TRUTH they don’t want us to know (but is somehow widely available) about the sordid truth that vaccination production and promotion is being motivated by solely profit.
Those who speak out against vaccination were considered martyrs to the cause, such as Dr Andrew Wakefield. I cannot wrap my head around the fact that after all the information that has been released about the conduct in his Lancet paper that people would resort to insisting that the man is out to get him rather than the fact that his study was unethical and the data falsified. I hate to risk invoking Godwins law, but I am reading the Fall of Berlin at the moment, and one of the many striking aspects of the madness of the Eastern front is how, as the Soviet’s were shelling Berlin and the Soviet troops were entering the city, there were still those who still thought and acted like a German victory was possible. I have also seen patients who deny remarkable pathology and present with advanced cancer or AIDS. The ability for people to deny even the most compelling evidence is beyond my feeble intellect to comprehend. I can only shake my head in wonder.
Religious ideology was the least represented reason against vaccination on the sites, although the morality of growing vaccines in aborted fetus or experimenting on children was mentioned, it was only mentioned in about a third of sites.
Not unsurprisingly, misinformation and falsehoods were found on every site. “88% made claims unsupported by evidence” and personal testimonials of the harm alleged to caused by vaccines were also common.
Only the Wikipedia was free of taint.
The open nature (of the Wikipedia) appears to have acted as form of peer-review, keeping the page current, unbiased and properly referenced. There appears to be no self-criticism within the anti-vaccination community; this was demonstrated by most of the analyzed website.
Free and open debate is least practiced by those who rage against the oppression of the man. That should have been an Alanis lyric; she would have had less criticism for a lack of understanding of ironic. Again the pattern: a disinterest in facts as well as no interest in having factual errors corrected. The attitude evidently being ‘if I want your opinion, I’ll give it to you.’
Interestingly, 25% identified themselves as non-partisan, non-profit or a public education group, giving the impression impartiality, but all linked to other anti-vaccination sites while only half linked to pro-vaccination sites.
If you spend time in the anti-vaccination world, or alt-med world, none of the above will come as any surprise. To my mind what was an interesting conclusion of the author.
A proponent of vaccination would likely wish to counter with “correct” information; indeed, the most commonly proposed intervention to combat vaccine misinformation is education…With acknowledging falsehoods is important, the assumptions behind educational methods must be examined. Assuming additional information will influence vaccination decisions reduces the issue to one in which the two sides are separated only by a gap in information.
She further points out that educational attempts only anger those who are corrected (AoA anyone?) and that historically education has not altered the opinion of those who have been against vaccination, whose essential messages have changed little since the 18th century, despite the massive increase in biomedical information to correct vaccine misinformation.
It is not the facts that inform the rejection of vaccines (or, more broadly, modern medicine) but “belief in alternative models of health, promotion of parental authority and responsibility and suspicions of expertise.”
It is not the facts that guide opinion, but opinion that determines the facts. She uses the relationship opinion = evidence + values, and as the former approaches zero, the latter predominates.
She also points out how the trend in medicine to patient autonomy and informed choice has had the inadvertent effect of medical consumers extending that autonomy to public health issues and rejecting the premise of vaccines for the overall societal good, noting that “parents may reject epidemiological and population-level risk arguments for vaccinations, for such statistics do not take into account specific experiences, ideologies, and health histories.”
It is both the triumph of medicine that so much benefit can be gained by ignoring specific experiences, ideologies, and health histories, and is medicines current bane. I know that the data suggests the more we treat all patients the same, the better the outcomes, but no one wants to be another cog in the medical industrial complex.
I am motivated by the facts, and have a trust in the long term validity of the results of medical research. Ideas wax and wane, but most people in the field are doing good work and are not dishonest. They are good people trying to do good work. Dr. Wakefield is an aberration. However, to the anti-vaccination crowd, not only is Dr. Wakefield a source of truth, the rest of the results of biomedical research are suspect. It is the post-modern questioning of the legitimacy of authority and science, and neither is valued nor trusted. In my world, both are valued and trusted.
So where does that leave science based medicine? I am not certain. I value facts, medical and scientific authority, always with the understanding of its somewhat fluid nature. The ‘other side’ does not value facts or the weight of expert opinion, especially when it contradicts their opinion. Those who promote anti-vaccination or homeopathy or the numerous non-reality based therapies live in a different world than I, and we do not share a common common view.
What is the proper dialog or is such a dialog even possible? I suppose the best I can do is plant a seed of doubt here or serve as a source of information for someone who is not committed to the ideas of scams. Maybe Fordor’s needs to have a new guide.
187 Responses to “Just the Facts”
Isn’t it ironic. My wife bought me a car recently and loaded the six stack sterio with CDs. On of them was Alanis Morissett’s “Little Jagged Pill” which contains the song “Ironic”. There was also her album “Under Rug Swept”. I had ever paid much attention to Alanis Morissett before, in fact I didn’t even know she existed for a long time, but after listening to her over the past few weeks I have become a devoted fan. Isn’t it ironic.
Also I have known a girl called Alana Morris for about 20 years.
Isn’t THAT ironic?
Anyway, back on topic….
“She further points out that educational attempts only anger those who are corrected (AoA anyone?)”
Anger, yes, and then censorship.
That was my experience recently at AoA trying to courteously explain the problems with “personal experience” as a legitimate form of evidence.
” Being considered expert in ID…”
Dr. Crislip,
Reading this during my morning coffee my half-awake mind thought you meant “Intelligent Design” for 10 or 20 milliseconds. But eventually I clued in.
Thanks for a fun Friday morning WTF? and a great article.
Mastering real knowledge in the real sciences is hard work. That is part of the appeal of the other ways of knowing concept. These folks have never taken the time to master enough knowledge to reach a threshold where one can actually start to think for oneself. It is far easier to make things up as you go along. They truly live in a different world but they do not know enough to appreciate that fact.
“Religious ideology was the least represented reason against vaccination on the sites, although the morality of growing vaccines in aborted fetus or experimenting on children was mentioned, it was only mentioned in about a third of sites.”
This made me laugh out loud, not because of any intrinsic humor, but because in my estimation religious nonsense lies at the root of why, for instance, facts don’t seem to matter. We are taught from an early age to believe the unbelievable, the unverifiable, in some cases the patently ridiculous.
Mix that taught-from-the-crib willing suspension of disbelief with a good measure of clenched-jaw paranoia (medico-industrial complex, corporatist, cover-up! BIG HARMA!!!), shake, bake (but only halfway) and you have an antivaccinationist (or some other flavor of moron).
There have always been humans living on the realistic end of the continuum and others on the fantasy end with the majority dwelling someplace in between.
Evidence changes. As it does, so do conclusions based on “presently available evidence”. Realists base conclusions on independently verifiable evidence. commonly referred to as “facts”. Others, many of whom find the real world just too unpleasant to dwell in or who were born with vivid imaginations, prefer to create and live in their own fantasy worlds. The Internet enables large numbers of both groups to find and reinforce each others views.
This will never change. However, what we are seeing now is something people of our generations haven’t seen before, large numbers of very vocal fantasizers (sp?) who are very articulate and who strongly influence public opinion.
My guess is that the pendulum will swing back the other way again, but I have no idea when. Till it does, I think that by arguing and debating with those who live in fantasy worlds will be counter productive especially for doctors and scientists since it reinforces the stereotypical doctor alts rally against. IMO, realists have to aim their educational efforts at the general public, not those on the extremes, and accept the fact that there will always be people who reject objective evidence.
I think that the reason the number of people living in Fantasy Land has increased so dramatically within the last few generations is that people not only no longer have personal experience with unscientific medicine, the days when there were rabid dogs running loose and everyone suffered from childhood diseases, but they haven’t even heard the stories or seen movies about those times.
I also think that educating the general public should include stories about such things and, if possible, movies and videos, media which get through to many more people than words on a computer screen or in print.
@rosemary
“I think that the reason the number of people living in Fantasy Land has increased so dramatically within the last few generations…”
Why do you believe this number has grown? Fear and superstition are powerful forces and they have been around forever (Heraclitus: dogs bark at what they don’t see). Could it be that the number, the percentage actually, hasn’t changed so much but that the accumulation of knowledge casts them in sharper relief?
windriven “my estimation religious nonsense lies at the root of why, for instance, facts don’t seem to matter. We are taught from an early age to believe the unbelievable, the unverifiable, in some cases the patently ridiculous.”
Yet the vast majority of the people I know have some spiritual belief. Still, they get their children vaccinated, use conventional medicine exclusively, work in technologically advanced fields that require an in depth understanding of science. Statistically, the number of people who have a religious belief in the U.S. is high, but the number of people who refuse vaccination is far, far, far, lower.
Do you see any statistical correlation between countries that have a higher secular population and lower vaccination refusal rates? I have not seen any data on that.
“What is the proper dialog or is such a dialog even possible? I suppose the best I can do is plant a seed of doubt here or serve as a source of information for someone who is not committed to the ideas of scams.”
Yes, and that is important, because a whole lot of parents are NOT committed to the anti-vaccination movement. They are just looking for good information. It’s important it be available.
Great Mark Twain quote, by the way.
Windrive, you are correct. I may be wrong. The number may not have grown. However, although I haven’t investigated, I believe that the number of people who reject scientific medicine, the kind of medicine that is based on objective evidence, and embrace the unscientific kind, has dramatically increased and that that can be seen by the large numbers of what were previously scientific institutions which now promote the unscientific kind, the kind based on subjective experience as opposed to objective evidence. It can also be seen by the numbers of health care practitioners who practice nonsense like TT, the number of media reports that promote crazy “medical” practices, the fact that “dietary supplements” and homeo “remedies” are sold in pharmacies next to OTCs, the number of parents refusing to vaccinate their children, the ads aimed at mainstream consumers telling them what non-experts like “doctor mom” think of their products, government policies, etc. I believe that ads and government policies in particular reflect what the majority either believes or at least is not offended by.
In my experience until very recently, scientific medicine and its practitioners were highly regarded by western societies. Their opinions were, for the most part, valued and trusted because people assumed that they were based on objectively verifiable evidence. But that has all changed within the last two decades and we now live in a populist age where everyone with a computer is an expert in whatever suits his fancy.
While I am not religious, I do not believe that religious beliefs by and of themselves indicate that people are irrational simply because I have known far to many religious people, including doctors and scientists, who were very rational. For the most part, they kept their religious beliefs and their medical opinions separate believing that religious beliefs cannot be objectively demonstrated as true or false and that they must be accepted or rejected “on faith” while at the same time believing that science and medicine can and must arrive at conclusions based on objective evidence. Those were basically a cultural views shared by most of society whereas the view that someone detecting energy emitting from a human body that no one else can detect, waving their hands over the person and redirecting the energy to cure them of disease would simply have been considered crazy by most of society in the recent past. (As it probably still is although not to the extent that prevents large numbers of nurses from practicing it.)
I’m sure someone can state this better than I can, but psychologists maintain that holding an irrational belief that is believed by the society or group in which one lives is a cultural thing. Whereas holding an irrational belief different from that of those around one is a delusion. What I’ve never been able to find out is at what point such an idea is considered to move from a delusional idea to a cultural one.
‘Why do the CAM practitioners and anti-vaccine proponents not pay attention to the facts.’
I think that, essentially, humans are not consistently logical or ‘fact based’, and that most people are a combination of ‘irrational’ nonlinear, and the ‘rational’ linear, and that some people are mostly intuitive in their approach to understanding the world about them, e.g. I once took an art course and I found this out very quickly! Medical types are not good at this type of brain processing.
Our schooling process as medical professionals in the western world (taught to us by similar thinking professors, by the way) has created an emphasis on one type of brain processing that is rational, and understands the world in this way. It’s a very useful and practical way…. but to say that it’s the only way to get at reality misses the point about how the mind works in the average person, perhaps.
I know it has been mentioned before in previous comments, but Mistakes Were Made (but not by me) (C. Tavris & E. Aronson) really can’t be recommended highly enough. It actually addresses Wakefield specifically, along with a lot of other interesting stuff.
Tavris & Aronson would give a very simple answer to why antivaxers resist evidence. Once anyone makes an initial decision, irrespective of the reason or evidence, it becomes an act of willpower to admit an error, review new evidence, and resolve the cognitive dissonance. In this case, the dissonance between “I am a smart person who educates themselves about their risks to their children” with “there’s no good evidence to believe that the vaccines I have denied my child are harmful”. Instead of carefully evaluating the new and disconfirming evidence to arrive at a new conclusion, their energies go towards “how I can I dismiss this new evidence and thus continue to support my self-perception that I’m a smart, caring parent”. That means pulling out all the conspiracy theories, belittling people who believe, and shutting down all actual critical thinking in favour of mindless criticism.
Kata is correct that it is a mistake to attempt to address this through education. Tavris & Aronson would probably suggest solutions that emphasize and support the belief that the parent is a good parent, that skepticism is warranted, that drug companies can be dicks, but resolve the dissonance in another way – perhaps an appeal to openmindedness.
Or my approach – sell their fellow anti-vaxers down the river, throw ‘em under a bus, and make them look smarter for rejecting it. Emphasize that by changing their mind in response to new evidence, they’re actually smarter than their former peers, who are too bloody-minded-stubborn to change their minds. It’s like coaxing someone off the ledge – you do it by appealing to their sense of self.
Anyway, good book and its implications are immediately apparent for the antivax crowd.
Very good observations, grasshopper.
I agree with youy generally that it is very odd how the anti-vacc crowd will fight and carry on in the face of contrary evidence. I don’t think imunizations cause autism, and my children have been immunized per schedule.
However, along with your medical knowledge, it seems like you are on a good path to figure out how “facts” might be different from “knowledge,” and how “knowledge” might be different from “wisdom.”
One recent real-world issue is the idea of vaccination for rotavirus.
Before Rotashield, did you know a “fact” that rotavirus was a serious health threat? Were there ID discussions of the unaddressed specter of rotavirus? Or, was there just a “fact” that it happens, and we should monitor for dehydration?
After Rotashield was approved, and was heavily promoted, the medical community had a new “fact:” rotavirus is a serious, life threatening disease and we need to do something about it. Here, take this shot.
It is probably a fact that Rotashield protected infants generally from rotavirus, and for a small portion, gave them intussusception.
Were you “for” Rotashield when the “facts” seemed to say the benefits outweighed the risks? Before the intussusception facts emerged?
What was the process like for you to hear the emerging information that Rotashield was causing more U.S. deaths than it was saving? Was there a transition period, where you were first skeptical of the dangers of Rotashield, then suspicious, then fairly concerned, then convinced in the other direction?
Adjusting to emerging “facts” is a good thing, generally. But a point is that the picture painted by “facts” changes as more “facts” emerge.
Maybe that gets at the idea of “knowledge.”
When Rotateq was approved, were you on-board immediately, after reading the couple of studies concerning safety as well as efficacy? Or were you hesitant, having been burned once? Being hesitant might be getting at what I am trying to say with the word “wisdom.”
Currently, is it a “fact” that Rotateq is safe?
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5610a3.htm
Is there actually a fact that sounds like this: “Rotateq is safe.”
If there is, then why have post-approval surveillance?
Or is that “fact” a qualified “fact”? “As far as we know, from post-approval surveillance, Rotateq is safe.”
That is sounding less like a fact, and more like “a summary of current evidence-based opinion.”
Here is one “fact” concerning Rotateq that is puzzling to me: the CDC link above notes that rates of intussusception are not higher WITH wide use of Rotateq, compared to no Rotateq use.
Each incidence would be a fact; the two facts together add up to “safe.” The CDC says intussusception incidence with Rotateq “was not elevated above the age-adjusted background rates.”
However, the puzzle is this: how is Rotateq making intussusception incidence dramatically lower?
This CDC reports a drastically reduced 20-day-post-rotateq-vaccination incidence of intussusception. RR = .3:
If this data were framed as a prevention-of-intussusception study, Rotateq would be wildly successful in reducing incidence of intussusception.
But it is not.
What does the CDC make of this “fact?”
My take is that the difference is accounted for by differing surveillance measurement used for the base rate incidence and for monitoring rotateq-related incidence.
I am moved to believe that it is a fact that we do not have adequate intussusception incidence “facts.” Either one incidence measurement or the other is dramatically off to give a RR of .3 when we should expect a RR of 1.0. Either one estimate/measurement or the other is pretty far out of range of being a “fact.”
If we don’t have good incidence measurements, then how factual is our “fact” that Rotateq is safe?
And if my local pediatrician cannot answer these questions decently, then why should I trust him regarding the next round of vaccinations?
Even more scary:
If my local pediatrician has not even thought of these questions, which seem reasonable to me, why should I trust him with the next round of vaccinations?
Dr. Crislip, first I would like to thank you for this post and for your work on this blog. I too am a science minded, fact-based person and find a wealth of information here. Nothing gets my blood boiling more than the anti-vaccination movement and I’m always happy to have more talking points.
Second, could you explain or direct me toward another post of yours that explains why you believe Minneapolis/Minnesota to be a “foreign county?” I have lived here for 3 1/2 years and have mostly encountered rational, sensible people. Of course, I work mostly with scientists and science-friendly folks, so I may not encounter those you speak of.
Thank you.
@micheleinmichingan
“Statistically, the number of people who have a religious belief in the U.S. is high, but the number of people who refuse vaccination is far, far, far, lower.”
I did not mean to suggest that everyone exposed to religious teachings becomes an anti-vaxer. My point is that we teach conflicting values. When we teach children that inchoate belief is (at least in some confessionals) more powerful than scientific evidence, we prepare the fields in which the weeds of magical thinking can flourish.
It’s always interesting to me when someone insists on believing something which is contrary to all observable facts; somehow that just don’t see the facts. And can’t be made to see the facts. This does seem to happen in everything, not just medical knowledge.
“Interesting” isn’t always “non-harmful,” although I do think in a lot of cases irrational beliefs are harmless…too bad there are those exceptions.
On a tangential note–and one that will be of limited help, what with that willful ignorance I mention above–I saw a lovely graph a while ago and can not find it again. It was a graph of individual disease incidences (deaths or just diagnoses? I don’t know) over time, with a marking for when the vaccine for each disease was introduced. It was a fascinating and compelling graph, but I didn’t look into it any more at the time, and I can not recall where I saw it. Can anyone point me to the source?
@rosemary
We do not, in large part, disagree. But there are many factors at work here. Doctors may well have been held in higher esteem a couple of generations ago. But a couple of generations ago the relationship between doctor and patient was far different: patients generally paid for their care themselves; doctors made house calls; medicine was less commercial than it is now.
And I think that much of the alt.med nonsense was around a couple of generations ago – just different nonsense, often under the name of home remedies.
“psychologists maintain that holding an irrational belief that is believed by the society or group in which one lives is a cultural thing.”
I maintain that holding an irrational belief is irrational. A commonly held irrational belief might be construed by some as culture, by others as mass delusion. The Heaven’s Gate people all shared the same irrational belief. Is the fantasy of Heaven’s Gate really different in kind from the Roman Catholic dogma that condom usage is sinful?
“My point is that we teach conflicting values.”
But I often wonder if that is a bad thing or a good thing. Kids and adults all need to learn to distinguish between conflicting values. We do it all the time. I can see that dogmatism can lead to a lack of differentiation but dogmatism can happen with or without religion.
But then I tolerate a certain number of weeds in my garden. That is my ‘choose your battles’ philosophy at work.
My main complaint with the religious right is evolution in schools and reproductive choice . That is the equivalent of Campanula L. Bellflower (terribly invasive things) in my garden. But, I will note that most religious people I know agree with me on those two things.
rosemary-”What I’ve never been able to find out is at what point such an idea is considered to move from a delusional idea to a cultural one.”
Thats an interesting question. An incorrect idea could understandably be held by a person who is ignorant of the facts, and not be considered irrational. The irrationality comes into play when the person is taught, and understands why a belief is wrong, but still continues to believe it despite the evidence. But that is also tricky to pin down, because cultural beliefs that contradict evidence, that are well ingrained in a person are hard to overcome with facts. Does that make the person irrational? Or does it just mean that cultural beliefs are more important, or that the individual really does not understand the idea of what constitutes good evidence? I think the latter, along with confirmation bias, and the avoidance of cognitive dissonance, are what are driving the anti-vax believers.
And then we get into psychological distinctions between “normally irrational” and “abnormally irrational.”
Human beings are not that rational. A very rational, dedicated-to-rationality human being is usually one who has a particular talent for rationality and has then been rigourously educated in the discipline.
People normally live their lives using a lot of irrational shortcuts. One common one is, “Distrust enemies.” Rather than dispassionately dissecting everything said by someone who is acting against my interests, I simply discount it.
If I am your enemy and you know it, I can’t reasonably expect you to listen to anything I say.
Ways you can know if I am your enemy and acting against your interests:
— My actions and/or values and/or persona are viscerally repellent to you.
— I get richer while you get poorer.
— I try to constrain your private actions.
— I tell other people not to listen to you.
The fact that most people accept public health measures like vaccination is a testimony to the great effectiveness of education in overcoming these non-rational (but powerful and not necessarily wrong) shortcuts.
This whole discussion reminds me of the challenge of countering climate change deniers, Tea-Partiers, and any number of other angry, distrustful groups. It seems like a good first step to recognize that rejecting vaccines is an expression of belonging to a certain subculture. This movement, like the others, derives from an underpinning of shared beliefs, such as mistrust of authority, fear of losing autonomy, frustration with complexities of modern life, etc.
I’m not claiming that these shared beliefs are the same across or within the movements, or that any of these categories are the ones that motivate the cohesion of a particular movement. But perhaps a global attempt (like the one taken by the anthropologist) to place behaviors that we skeptics find baffling, such as vaccine rejection, within a particular worldview may be helpful in developing counter strategies. Refusing vaccines makes sense to the antivaxxers – if we want to influence their behavior, we might do well to try harder to understand why that is.
Alison – “Human beings are not that rational. A very rational, dedicated-to-rationality human being is usually one who has a particular talent for rationality and has then been rigourously educated in the discipline.”
No kidding that we’re generally not that rational! Though even the most outwardly irrational act usually has an internal rationalization or rationale that can be understood even if it’s entirely faulty in objective terms. It’s been my (subjective) observation that some people have a “talent” for a certain kind of rational or linear thinking, while others have a talent for more intuitive or associative kinds of thinking – but that both can be learned to a certain degree. They can actually be quite complimentary and some of the most creative scientists seem to be able to harness both speculative/creative and rational/logical ways of thinking. However, these two different ends of the spectrum often end up in opposition (as do people who express one end of the spectrum or the other) and can lead to great misunderstandings and conflict between people.
Oh, and the very human tendency is to believe that the way we (meaning ourselves and our tribe) are wired or think is far superior to the way those other people are wired or think. Even when we try to place ourselves in another’s shoes, so to speak, we tend to imagine what it would like to be ourselves inside their mind (or undoubtedly ill-fitting shoes). One of the many functions of art – or at least some art – is to try to express and share this subjective and experiential aspect of being human.
Possible typo: “immunization OR immunization”. They’re both the same word… should one of the Zs be an S?
In a Futurama episode, the following dialogue occurs:
Since everyone uses the terms “fact” and “factual” to describe their beliefs, perhaps a better word is “empiricism”. Lots of people who are empirically wrong are quite willing to admit that they might be — but, well, there’s more to life than cold, heartless, empirical facts, right? Maybe vaccines are empirically safe — but in a warm, fuzzy, spiritual way, they’re evil and toxic. (The inverse for homeopathy.)
MedvsTherapy: Your argument seems to come down to suspicion because Rotateq was made safer with regards to intussusception. Huh.
You say:
Do you… will you… ever understand why scientists don’t hold out for 100% certainty? No vaccine will ever be either “100% safe” or “100% effective”. No human activity is either of those things (have you driven a car lately?). The point is that Rotateq (especially since it has been made even safer) is a very good idea.
But because of what happened in 1999, you are permanently suspicious of rotavirus vaccines (for you “Rotateq” is “Rotateq”), and would rather risk the intangible, don’t-have-to-feel-guilty-that-my-kids-got-sick-cause-it-was-just-Mother-Nature disease. That’s like refusing a polio vaccine because its 1950 version had a small likelihood of causing the disease, even though the likelihood is even tinier or nonexistent today.
I actually went to the trouble to register for this site so that I could point you to this article from Nature:
http://www.nature.com/nature/journal/v463/n7279/full/463296a.html
It discusses how our identification with a community can color how we interpret facts, even to the point of disregarding them.
I have been thinking about the vaccine issue with this article in mind, because it explains why I occasionally get emails from people telling me that I’ve convinced them to get their kids vaccinated after I leave a comment on someone’s blog post about it. My initial reaction to this is “WTF??? Why would you trust some random stranger on the internet, who won’t even disclose her real name more than you trust your pediatrician???” But now I get it- it is because I am a part of their community. My comments were left on blogs that I comment on frequently. I am known there as a mother with vaguely attachment parent leanings, not as a scientist (which I also am).
Anyway, it is interesting to think about how we might better conduct the argument, because I think convincing more people to vaccinate their kids is worth the effort it takes us to have the argument in the most effective way possible.
An amazing book. Actually, it was fascinating to note how “normal” life was in much of Berlin right up until the Soviets had advanced within shelling range.
Lol @ Minnesota? You betcha!
Dr Gorski – “Normal” for those who were left! We’re talking about a society that was already in deep denial about what was going on inside itself and heavily invested in conforming to the “normal” narrative lest they themselves get shipped off for being subversive. Acting “normal” and believing in the narrative of superiority and victory would have been pretty much required to get by I’d suspect.
Dr. Crislip:
Very nice article. There’s a lot more to Minnesota than Garrison Keillor, dontcha know! Perhaps you should return to this frosty land for another visit
Scientists, for the most part, subscribe (whether they realize it or not) to a particular school of philosophy called “logical positivism” (or logical empiricism, if you like), codified pretty well by AJ Ayer’s “Language, Truth & Logic”. This way of thinking has never, as a matter of fact, been very popular in the wide world. The notion that the only two ways of knowing anything are either (a) to deduce it from that which is already known or (b) to observe it as carefully as possible in the material universe, is considered by most people to be self-evidently false, because they see ghosts and Jesi all the time. Most people would prefer to believe in the supernatural and the subjectively arbitrary. Around the 1960s, French writers began to pick up on this and became postmodernist philosophers, and they see their duty today as convincing the world that, essentially, the universe is only really there when your eyes are open, and even then just barely. Since this is the sort of thing that most people are told when they’re children, it seems they’ve just been waiting to be given permission to go back to believing it, and totally abandon the reality of big people.
Wikipedia is not free of taint; it is merely free of unpopular, implausible taint. More subtle taints grow freely on Wikipedia, because, after all, anyone can edit it at any time for any reason, and everyone has equal potential to contribute, whether expert or imbecile. Thus, the balance of information on Wikipedia is defined by what more than half of active contributors consider to be correct. It’s been described as a “quantum encyclopedia”, in a sort of superposition of accurate and inaccurate, depending on the exact moment you consult it.
In fairness, the point of education isn’t to change the messages of the ignorant; it’s to reduce the number of ignorant. A better statistic would be what proportion of the population in the 18th century rejected vaccination compared to the proportion today. That’s your yardstick of success.
Good points Medsvstherapy. I know it probably puts me in the evil anti-vax camp, but I will wait a year or two before giving my kids, future or otherwise, the rotateq vaccine. Not because of the unknown, probably miniscule risk, but mostly because there is almost no tangible benefit to avoiding rotavirus in a first world country. But after an initial post licensure surveillance, I’m fine with it. Same thing with gardasil.
Other than that, I’ll have to agree: people are not by nature rational. They tend to be even less rational when the rational ones treat them like idiots (whether they are or not).
Lots of interesting comments here. A few thoughts:
For me, the way I counter the postmodern concept of viewing all opinions as equal is by this argument:
1. There is an objective reality independent from subjective thought.
2. Empiricism has a proven record of being superior to non-empirical methods when it comes to interpreting the objective reality.
3. Hence: opinions based on empiric facts are superior to opinions not as they will come closer to reality in the long run.
At least as long as you actually care about what works from a practical standpoint.
Now, there are obviously exceptions. Interpreting a painting empirically correct is not superior to doing it intuitively as a painting is per definition subjective, not objective. Similarly, when one only considers the existential aspects of faith atheism is not superior to religion even though it is more empirical as existentialist questions are internal and subjective.
Vaccines do not qualify here. Vaccines are objective and have a mission in an objective world: to make children healthier. Hence, when discussing vaccines, empirical opinions are superior as they are better at reaching the mission goal.
Of course, we all know this here on SBM but its still interesting to dissect the philosophical underpinnings. At least I think so.
———————————————————————————-
No for something completely different: the conundrum of reason and faith. As been said, there are tons of people who are have both. This is actually quite amazing seeing how the two are utterly juxtaposed. On the one hand, faith ordains belief in spite of proof, anecdotes before evidence and suspension of disbelief. Not to mention claims running counter to all known science. Reason requires only two things: empirical evidence and logic. Faith lacks both.
So how can people still combine them? As I see it, through compartmentalization. They simply never allow the two to meet. Instead the two operate within their own theaters and are seamlessly switched between at will.
Take a Christian doctor: when he enters the hospital he takes on the persona of a person of reason and science along with his white coat. If he is a good doctor that is, I’m not getting into the failure that is an M.D. subscribing alt-med for anything but as placebos. His belief in his work stems from proof through science, not personal belief – although the latter can strengthen his resolve.
Yet when he is not a doctor he is free to be faithful. Free to go to church, take communion and pray devotedly even though the same person he was earlier would rightfully yell to him that there is no proof for any of it.
This double-think works because it is a highly effective way to establish parallel strategies for different situations even when their justicative stories counter each others.
Unfortunately this does not mean faith is reasonable. And some people will continue to choose faith over reason if they find reason too tasking precisely because both are revered equally, if differently.
This is the problem with religious society. It offers an alternative reality which, frankly, is not as well in sync with objective reality as is empiricism and science.
@ Zoe237
If that is your choice your free to do so. You don’t become evil anti-vax until you go on a crusade to convince others to do the same and use lies and deceptions to do it. We’re cool.
My view of vaccines has always been “the more the merrier”, especially for myself. I sort of consider it an immunobooster (fully knowing this is not really the case) but, nonetheless, the truth is that after having taken a vaccine, there’s one more disease out there that can’t get to me.
Kinda empowering. And yes – I can’t wait for the first neuroimplants to hit the markets. I view things sort of different from the CAM-people I guess
Naturalistic fallacy indeed, I take cerebral nanomechanics over fruit any day.
While slightly off-topic, the special Vaccine Court has issued a ruling in three separate test cases that the mercury-containing preservative thimerosal does not cause autism.
http://www.latimes.com/news/nation-and-world/la-sci-autism13-2010mar13,0,5900639.story?track=rss
@Zoe237
The Rotateq vaccine is only offered up to 32 weeks of age. if you opt out in that time, I’m pretty sure you won’t be able to get it as a “catch-up” vaccination.
Stroh,
“the truth is that after having taken a vaccine, there’s one more disease out there that can’t get to me.”
It just did. Actually, you have acquired the disease antigens so that makes you no longer naive to the disease.
@JohnW,
Interesting article.
I noticed that Trine Tsouderos (!) was a contributor.
“It just did. Actually, you have acquired the disease antigens so that makes you no longer naive to the disease.”
That’s the point of the vaccine. Even my 2 year old nephew understands that.
weing,
“That’s the point of the vaccine. Even my 2 year old nephew understands that.”
Right. Hence, vaccines do not protect the people from the disease antigens but rather introduce the disease antigens to their naive immune system. In short, vaccination is a disease-promoting process.
Obvious troll is obvious.
“Right. Hence, vaccines do not protect the people from the disease antigens but rather introduce the disease antigens to their naive immune system. In short, vaccination is a disease-promoting process.”
I asked my 2 year old nephew and even he knows it’s a disease mimicking process.
I’m torn between the possibilities that Th1Th2 is a jackass, just for the sake of being a jackass (is that you pec?), or he/she/it really believes in the dribble he/she/it is posting.
come on…France, Japan, MINNESOTA??
It wasn’t that bad, donchaknow.
General Surgery 1982-88
Hennepin County Medical Center (The Mother Hen)
Mpls, Mn
@Zoe237
“The Rotateq vaccine is only offered up to 32 weeks of age. if you opt out in that time, I’m pretty sure you won’t be able to get it as a “catch-up” vaccination.”
Right, same thing with HIB. Rotavirus is really only dangerous to young infants. It would only apply to future infants for me, and I’m past the post surveillance period that I’m comfortable with, so I’d be fine w/ them getting the vax, even though I think the benefits are minimal for my individual child, the risks are even less so.
I don’t know, rotavirus is pretty common. Some of the nastier gastrointestinal bouts that adults get can be rotavirus.
When I had it, I could not be more than a few feet from the bathroom. I even borrowed some diapers, and still could not contain the outflow. It was horrible.
In comparison, the prep prior to my colonoscopy was a cakewalk.
I’d hate to imagine the same happening to a baby or toddler, especially since they often become dehydrated.
My son had it when he was three (about ten years ago) and it was horrible, although he didn’t get dehydrated or go to hospital. Still, I’d rather buy the vaccine for an infant (hypothetically speaking) in a third world country, who can die from rotavirus.
Small points:
I agree with Coyote. I saw ID and thought “Intelligent Design”. Admittedly, only for a few moments, because the rest of the sentence made it clear, but a bit distracting nonetheless.
Berlin:
There’s no need use that example and risk having Godwin’s law applied to you. Just remember Saddam Hussein’s information spokesman, nicknamed “Comical Ali” by the media, who happily gave live interviews just prior to the fall of Baghdad, earnestly claiming that Saddam was winning, and the enemy would never touch Baghdad – while in shot, behind him, you could see and hear the city falling apart under artillery bombardment.
[ Afterwards, when Saddam's henchmen were being rounded up, Ali voluntary surrendered himself at the American HQ. He was told to go away, they were busy. Talk about humiliating! ]
@Draal
“I’m torn between the possibilities that Th1Th2 is a jackass, just for the sake of being a jackass (is that you pec?), or he/she/it really believes in the dribble he/she/it is posting.”
You have to look at the posts … no understanding of the topic, self-contradictory, intended to create arguments … yes, it’s pretty clear to me. He/she really believes it. Trolls usually take the trouble to say something at least slightly worth arguing about.
I didn’t read all of the comments, so I don’t know if this has been mentioned yet, but this article is in desperate need of an editor. One would think that in all of those classes that the author had to take there would have been an English class or two.
Edit this article. Seriously. It reads like it was written by someone in a remedial English class. I can’t take it seriously, or recommend anyone else read it solely for this reason.
“S/he/it really believes it.”
Believes what?
You mean this…
“vaccines do not protect the people from the disease antigens but rather introduce the disease antigens to their naive immune system. In short, vaccination is a disease-promoting process.”
But what is there to believe?
You can’t even make any sense of it.
pumpkinpie24
“Second, could you explain or direct me toward another post of yours that explains why you believe Minneapolis/Minnesota to be a “foreign county?” I have lived here for 3 1/2 years and have mostly encountered rational, sensible people.”
In Australia, it’s Queensland. Quaint sprt of place.
Stroh.
” the truth is that after having taken a vaccine, there’s one more disease out there that can’t get to me.”
The truth is that your risk is lowered
Zoe,
“psychologists maintain that holding an irrational belief that is believed by the society or group in which one lives is a cultural thing. Whereas holding an irrational belief different from that of those around one is a delusion. What I’ve never been able to find out is at what point such an idea is considered to move from a delusional idea to a cultural one.”
I think if you call it “delusional idea” and “cultural delusion” it sort of solves the problem.
I work in both Cambodia and Australia. I invite all comers to join me on ward rounds in both countries in order that they may see the effect of vaccination. I will offer no commentary, although the patients and their families may.
# BillyJoeon 13 Mar 2010 at 5:51 am
“S/he/it really believes it.”
Believes what?
You mean this…
“vaccines do not protect the people from the disease antigens but rather introduce the disease antigens to their naive immune system. In short, vaccination is a disease-promoting process.”
I also feel torn. I feel he/she could just be stirring the bees nest for fun. He/She could be in the grip of some group propaganda or pet theory that He/She feels the need to proselytize about or they could be in a more delusional phase of a mental disorder. The quoted phrase sounds a bit like a highly organized “word salad”. But I am not expert, the last may only be a remote possibility.
Of course the other possibility is that he/she is just lonely and this is the main way they know how to reach out to people.
Gosh, I could go on for awhile. I guess, I’ll never know. Unfortunately, it does seem necessary for someone to vigilantly post science based facts in response. I am happy that there are people here capable of doing that.
Sanofi has just produced a pro pertussis vax commercial with JLo. Fight fire with fire I suppose. To me, it will be interesting to see how the anti-vaxers respond. Seeing as one of our major criticisms is that JM is nothing more than a actress and pinup…..to which we always hear “But she’s a mommy. Mommies know.” So I will be interested to hear if they fling the “JLo is not a doctor” retort at her.
BillyJoe: Come on, of course I know that! I’m just being optimistic here: take the Hep B vaccine I got at medschool for example. It provides almost complete immunity and lasts well over 25 years, if not indefinitely – to me that means I won’t have to worry about getting Hep B any time soon. If ever. Even though there might be an itty bitty risk left.
Of course there are other vaccines that are not as effective. But its not those I’m thinking about.
And as for Th1Th2… sure I got exposed to the disease. But most people, me including, does not think it counts until we actually get sick. Hence: protection; not infection.
“So I will be interested to hear if they fling the “JLo is not a doctor” retort at her”
If it’s a betting pool, I’d place my money on a ‘She’s just doing it for the money’ with the implication that she’s a bad mommy gambit.
The monkeys are tribal.
Crislip, you identify with the science-minded tribe. It’s who you are. Others identify with different groups that value other stuff.
Solution: make respect for basic rules of evidence something that’s important to all the cool kids, be they mods, rockers, Jesus freaks, or geeks. Make facts as American as free speech, baseball, and apple pie.
Civics textbooks should include stories of brave American heroes sacrificing safety and sometimes their very lives in the fight against tyranny and for the preservation our precious right to know the scientific consensus.
In the teleplay of this thread, the part of Th1Th2 shall be played by an obese middle-aged pedophile with bad skin.
Wow, my psychology is so weird. When I read Th1Th2 and the replies, it’s like there’s a tiny anti-vaxer in my head going “Yes! Yes! Speak truth to power!” I dunno. Even though nearly all anti-vaxers are in theory supportive of the vaccination principle, I think there’s a subtext of what Th1Th2 is saying to everything they say — that vaccination is doo-doo at every level, and polio was just “renamed” (the standard conspiracy theory on the subject).
It’s like the way intelligent-design folks talk about common descent. “Oh, of course all organisms are related, except I’m really suspicious about that and Darwinist scientists tell nothing but lies and more lies, but really, it’s true, but it isn’t.”
I think the problem is that when conventional medicine admits the limits of its knowledge such as when we say we can’t cure the common cold or we don’t know what causes autism the alternative side steps in with easy answers. Frustrated patients want easy answers. Patients become easily frustrated by doctors who don’t offer solutions. It comes across in poor bed side manner or just dismissiveness “it’s just a cold, you’ll get over it”. Alternative medicine on the other hand often rather eloquently says things like “take this 20C preparation of bullshitium it cures all”. They swipe your credit card and you miraculously get better. Another anecdote is born.
When you exercise you damage muscle. The body heals the muscle and it is stronger. When you breathe oxygen, oxygen does some damage to the tissue, but the body heals and has a source of energy. That is life. Medicine is mostly about helping the body heal itself, it’s not about the absence of disease.
Sorry, my comment didn’t make much sense from the order it appeared in. I was addressing the comment that vaccination is a disease promoting process. A little challenge to the immune system strengthens the immune system.
@Sir Eccles
“Alternative medicine on the other hand often rather eloquently says things like “take this 20C preparation of bullshitium it cures all”. They swipe your credit card and you miraculously get better.”
Back when explicit placebo use was acceptable to medical practitioners, there were ethical guidelines taught for its use. They could only charge a nominal fee (such as the cost of the sugar pill), for the placebo. I wonder what the fees are now for various CAM treatments.
stroh,
“BillyJoe: Come on, of course I know that! I’m just being optimistic here: take the Hep B vaccine I got at medschool for example. It provides almost complete immunity and lasts well over 25 years, if not indefinitely – to me that means I won’t have to worry about getting Hep B any time soon. If ever. Even though there might be an itty bitty risk left.
Of course there are other vaccines that are not as effective. But its not those I’m thinking about. ”
Oh, come on, I was just inviting you to be a bit more accurate (smily and all
)
Andrewcon, “I work in both Cambodia and Australia. I invite all comers to join me on ward rounds in both countries in order that they may see the effect of vaccination.”
That is exactly the kind of education that people need. If they can’t observe in person, then they should be taught with videos or at least stories told in print. Aside from the small core of true believers, the majority of people who are presently deceived by them, would, I believe, learn if they experienced the facts, the human facts.
As an animal lover, I have friends who swallow most of alt. “med.” hook, line and sinker. They go to alt practitioners and have never met a supplement they didn’t love. But that all stops when they hear anyone preach the “dangers” of vaccinating because they remember what the bad old days were like, before all the animal vaccinations we have now, and how diseases spread rapidly through kennels and catteries. They experienced the sufferings and deaths for themselves and experienced the changes brought about by vaccinations.
Like it or not, we all learn by experience. The trick is that we must also learn that experience alone is not sufficient to draw accurate conclusions, but usually it is the place where most leaning processes begin.
Now if someone could prepare and post video lessons showing what life is like in areas where scientific medicine is unavailable as well as in areas where it is, I think it would have a major impact on making the majority of people believers in evidence based medicine.
@ BillyJoe
Sorry about the grumpiness, no hard feelings intended
‘Guess I woke on the wrong side this morning.
OFC you’re right about me being slightly inaccurate. But I still like vaccines. A bit too much possibly.
Spot-on article; thanks for putting these thoughts together in one place.
Although, I have to ask- you state
“the data suggests the more we treat all patients the same, the better the outcomes”
Can you share some papers that state this conclusion? I thought individualized care led to better outcomes? Thanks!
Great article. Does anyone out there seriously believe we’re going to get through to the hard-core anti-vaxxers? I think we all know it isn’t going to happen, even as we struggle to understand how they can think that way.
What we can do is counter their misinformation and their philosophies for the uncommitted. So in that sense education is vitally important. And a way this view of anti-vaxxers can help is that part of that education needs to be showing parents what the basis of their objections are – that they have nothing to do with health and everything to do with worldview. This is one of the reasons we have Stop the AVN in Australia – we know we can’t change the minds of the AVN, but we can destroy (or realistically, delay) their ability to get to parents.
On my blog and parenting fora I’ve been using a simple tactic that seems to work quite well whenever conspiracy theories come up. I point out, with a lot more detail, that it’s an accusation of mass murder and they’d better have some darn good evidence to back it up. It very quickly stops them. I don’t know if they stop because they think I’ll be mean to them or because they actually reflect on what they’re saying, but the information is out there for moderates to see.
Oh and it’s not Queensland – it’s the NT. Admit it, you forgot all about us, didn’t you
Good read for students
This is why we need willing combat epistemologists to point out that regardless of their values, everyone holds the same worldview when it comes to finding things out about stuff we can check. Because denialists *do* actually value facts; if they didn’t, they couldn’t find their car keys.
They don’t find their car keys using the sort of sophistry they use to defend their adoption of alt-med; they use observation, induction, and deduction. Science simply does this more carefully. None of them are radical skeptics when it comes to locating the doorways they walk through, or expecting that their car will not turn into a penguin.
Epistemologists are handy for quickly delineating knowledge as something arguably near to “true justified belief” and talking about how one might check whether beliefs like “this vaccine will protect my child from measles” are true or justified, and what might count as a way of doing that. We need more of them knocking around the medical field generally.
Thanks for the excellent blog post, Dr. Crislip! When it comes to vaccines, I defer to the experts in mainstream medical science. While I support vaccination, I mostly keep quiet because I am not an expert on the subject, (see earlier comment on vaccines).
I have one minor criticism that has nothing to do with vaccines. You wrote,
Yes, there are definitely dues that have to be paid to be a legitimate source of information. Certainly, posing as a Playboy model or being Hollywood star does not give one any authority to speak on vaccines or medicine. Being an expert requires years of hard work and sleepless nights as well as extensive immersion in facts and information. I couldn’t agree with you more on this point.
However, it is unfair to say that if someone does not have a degree in medicine or biology, there’s not much of a chance you’d take their writings on medicine seriously. By following the same line of reasoning, a statistician or computer scientist[1] could dismiss an MD who writes about medicine from a statistical perspective. After all, most doctors have not spent 80+ hour work weeks for years proving theorems to make mathematical guarantees for statistical estimation algorithms. Many of them probably have never written a proof longer than two pages, never mind ten pages or longer. When a doctor is asked to take gigabytes of raw sequence data and perform alignments, most wouldn’t even know where to start. Even if a doctor learns how to program, knowing how to prove an algorithm is correct (i.e. show it gives the best result mathematically possible) requires significant experience, which usually isn’t acquired during medical residency. A doctor might be able to recite formulas from memory but this is not the same as fully understanding the body of lemmas to derive the formula. A doctor might be very savvy on how to use excel/S-plus to perform plotting and analysis, but this is as superficial as a typical statistician’s knowledge of the immune system. Speaking with authority in medicine requires dues to be paid. However, doctors should not outright dismiss scientific experts from other fields who write about non-biological aspects of medicine, especially when the expert is very careful not to assert authority on matters beyond the scope of their expertise.
As technology advances, the field of medicine is moving from data-starved to data-drowned. In order for discovery of novel medical science to keep pace with technology, doctors will need to invoke expertise from fields outside biology, chemistry, and medicine such as statistics, computer science, engineering, and physics. Medical science and biology are both going through growing pains. As medicine increasingly uses knowledge and tools from other fields to make advances, it will need experts from those fields to ensure such knowledge and tools are applied appropriately and correctly[2]. This will ensure new discoveries meet high standards of validity in all the sciences.
——-
[1] There is a blur between stats and CS. Some statisticians are more like computer scientists, focusing their work on the development of sophisticated algorithms for performing computationally intensive statistical analyses. Some computer scientists do very little programming and applied research, and focus their research on theoretical and mathematical problems. Sometimes this heavily involves statistics.
[2] I’ve been monitoring CS postdoctoral jobs for some time. I’m pleased to see postings for computer scientist postdocs at medical schools.
Mark Crislip: “the data suggests the more we treat all patients the same, the better the outcomes”
lkregula responded: “Can you share some papers that state this conclusion? I thought individualized care led to better outcomes? Thanks!”
Mark doesn’t usually respond to comments, I think, because lack of time, so I hope you don’t mind if I respond.
I’m pretty sure Mark was referring to the *individualisation* practised by alternative medical practicioners.
Alternative medical practitioners use *individualised* treatment as an excuse for ignoring clinical trials which show that what they do doesn’t actually work.
(Of course, it is untrue that individualised treatments cannot be subjected to a clinical trials)
On the other hand, what you are referring, I think, is the idea that science-based medical practitioners should apply the results of clincal trials to their individual patient. In other words, they consider whether, and to what extent, the results of the referenced clinical trials apply to the particular patient in front of them.
( As an example, a patient in his 90s who is found to have high cholesterol may not necessarily benefit from cholesterol lowering drugs especially since the trials generally have not included patients in this age group.)
I think you have an excellent point. The interplay biology, chemistry, statistics, computer science, engineering, and physics are important in medicine. On a pragmatic and anecdotal level, as someone who worked in web development (as a art director, not IT or computer engineering) I was frustrated for years watching doctors, practitioners and medical offices dealing with incredibility outdated, inefficient medical records systems.
After many years, our hospital system finally implemented long overdue good computerized record keeping system (Hallelujah!) and to me the benefits to both the doctors and the patients are clear.
I would point out that the esthetics are lacking,
but I do not want to let the perfect be the enemy of the good.
Whoops, my above comments were response to DREads comments…
regarding “However, it is unfair to say that if someone does not have a degree in medicine or biology, there’s not much of a chance you’d take their writings on medicine seriously. By following the same line of reasoning, a statistician or computer scientist[1] could dismiss an MD who writes about medicine from a statistical perspective.” etc.
I am a slow writer and by the time I formulate a response, the conversation has moved far past any response I would make.
Currently there are numerous guidelines to treatment of diseases. In the world of ID, the better the adherence to the guidelines, the better the outcome in terms of length of stay and mortality.
What is curious is that in the world of ID the guidelines often concern initial antibiotics, before the bacterial cultures return and you have a specific dx and treatment plan.
So for emperic therapy for, as an example, community acquired pneumonia, it is better to treat everyone the same than to individualize the therapy.
A recent review:
Semin Respir Crit Care Med. 2009 Apr;30(2):172-8. Epub 2009 Mar 18.
Impact of guidelines on outcome: the evidence.
Martínez R, Reyes S, Lorenzo MJ, Menéndez R.
Servicio de Neumología, Hospital Universitario La Fe, Valencia, Valencia, Spain.
Pneumonia continues to be the main cause of death due to infection in the world, and it produces a high consumption of healthcare resources. The guidelines established by the scientific societies improve the care of patients with pneumonia. One way of evaluating the effect of the guidelines is to analyze their impact on the prognosis of the infection. To evaluate this effect, cohort studies have been performed using before-after, observational, cost-effectiveness, and, to a lesser degree, randomized designs. The most recent studies show that the implementation of the guidelines is accompanied by an increase in the process of care percentage and a lower inpatient hospital mortality rate- including the first 48 hours and after 30 days. These findings are consistent across various studies, and they have been confirmed in patients admitted to the intensive care unit. Clinical stability is also reached earlier in patients hospitalized for community-acquired pneumonia (CAP) when the antibiotic treatment is begun early and complies with the recommendations. Finally, the choice of antibiotics that adhere to the guidelines is cost-effective in CAP requiring hospitalization, which is responsible for 80% of the total cost of this disease.
PMID: 19296417
===
Those are good examples of people outside of medicine I would pay attention to, depending on the topic. They are examples I had not considered in preparing the entry.
When dealing with parents about vaccines, most parents are confused by the misinformation that they hear from the media, family and other places. Education works well with them.
For some, the emotional fear invoked by the anti-vaccinationists is so hard to overcome, even if they can logically acknowledge the facts and understand relative risks and benefits, education simply creates cognitive dissonance. Most of these scared parents already are carrying a lot of guilt baggage and attempts at education simply increase this. For them, they have to arrive at good decisions themselves. Fortunately, if one gives such parents good sources of information and some space and time to think, they usually end up making good decisions.
For the parents that are die-hard antivaccinationists, all attempts at education fail and just end up in conflict. This ruins everyone’s day. However, many of these folks don’t come to scientific doctors anyway.
Dash, “What we can do is counter their misinformation and their philosophies for the uncommitted. So in that sense education is vitally important.”
But how do we educate? I get the impression that most scientists and intellectuals believe that means stringing words together – either talking or typing them one after the other, and quite frankly I suspect that the general public, the target audience, pretty much ignores that.
I don’t have the answers, but I suspect someone does.
Communication is a science too though certainly not as black and white as the “hard” sciences or even the medical sciences, but I would guess that anyone who has studied communication scientifically would say that stringing words together to educate people is relatively ineffective especially if it is done in a dry, abstract, unemotional fashion, exactly the way most scientists have been trained to communicate with colleagues when writing professionally.
My guess is that anyone who has studied the science of communicating would conclude that people learn with all their senses and that the best way to educate is with experiments, stories illustrating points and/or videos of such things. If you think about it, even scientists learn a great deal this way. They don’t just read journals. They have labs. They experiment. Doctors see patients, lab specimens and perform or observe surgery. They don’t simply learn anatomy from a book. They dissect bodies so that even their basic education includes learning through all of their senses, not just through words strung together sequentially.
TIME had an article saying that Jenny McCarthy can’t be ignored. As most of us know, she has reached a major part of the public even if the majority doesn’t yet completely believe her. She has their attention because she speaks their language.
http://www.time.com/time/nation/article/0,8599,1967796,00.html
One quote, “…in McCarthy’s world, there is scientific truth and there is emotional truth. There is the fact of a mother looking into her son’s eyes and knowing something has gone very wrong and the fact of about two dozen studies showing no link between vaccines and autism. There is the truth of the parents and the truth of the doctors.”
My guess is that it isn’t really about scientific vs. emotional truth, but about ineffective vs. effective communication. I think that to be effective one has to adapt one’s style to one’s target audience and that the failure of large numbers of people to do that is one of several reasons why those with crazy ideas about medicine have successfully convinced the majority of the public as well as lawmakers that those crazy ideas are either correct or have some validity and should be promoted, or at the very least permitted.
@AState
“Edit this article. Seriously. It reads like it was written by someone in a remedial English class. I can’t take it seriously, or recommend anyone else read it solely for this reason.”
Gee, there are a goodly number of people who would disagree with you about Dr. Crislip’s language skills, which are not I might add, the subject of this blog. So why don’t you remove your right index finger from whichever nostril it is in and click on down the road.
regarding windriven’s response to @AState.
Gosh, I was kinda enjoying the retro feel of someone who thought they could easily dismiss a writer by correcting their spelling. I haven’t seen that since I was in an alt.goth newsgroup in the ’90s.
Kinda makes me feel young again.
rosemary,
It’s hard to educate the masses since most people don’t have the attention span or motivation to understand the mechanisms of vaccines and their complexity. Scientists are careful with their words when communicating because science is complex, and diluting or simplifying the discourse can easily result in inaccuracies, which can do more harm than good. There is an effort on part of mainstream medicine to educate the public with simple terms (see the CDC for a good example). If people are unsatisfied with the simplicity of information they find from trusted sources, their doctor, or pamphlets in their doctor’s waiting room, then they will need to read and study information from scholarly sources. However, as Dr. Crislip points out, it is hard for lay people to digest this information without years of training in medicine, biology, or other fields. Cherry-picking knowledge from textbooks and various scholarly sources at the public library without having the wealth of knowledge acquired in graduate education/medical residency can give an incomplete and wrong picture of the science.
Productive scientific dialogue from two opposing groups can only result when they both adhere to the highest standards of evidence-based scientific discourse. No productive debate can be expected by engaging people like Jenny McCarthy because they are not scientifically-minded individuals. It’s true she can’t be ignored but it does not mean that scientists should spend their time engaging her. A more productive approach is to educate the public about the serious consequences of not vaccinating, and let them judge Jenny McCarthy for themselves.
At some point, it’s irrelevant. No matter how much effort scientists and doctors put into educating the public in honest, scientifically-supported, and honorable terms, there will also be laypeople who believe what they want to believe. There will always be people who always deem information coming from the mainstream medical establishment as suspect. There will always be people who believe in conspiracies despite either scant evidence or implausibility. What’s left? Rational people. Even then, fear and misinformation can completely disrupt a rational person’s belief system.
Damian
I hadn’t noticed AState’s comment before, but I agree that good writing is very important and I have voiced this in the past. Interestingly, I have specifically held up Mark Crislip as an example of a good writer. The cardinal quality of poor writing is that it betrays sloppy thinking. Mark Crislip’s writing is not polished, but it reveals both sharp thinking and and an engaging persona. I can’t ask for more from a blogging volunteer, and I don’t.
@ DREads
“If people are unsatisfied with the simplicity of information they find from trusted sources, their doctor, or pamphlets in their doctor’s waiting room, then they will need to read and study information from scholarly sources. However, as Dr. Crislip points out, it is hard for lay people to digest this information without years of training in medicine, biology, or other fields.”
WTF is that supposed to mean? The choices are only “vaccines are heap big powerful medicine” or a medical degree? That is USDA Grade A bullcrap. By your, ahem, logic, non-specialists would be unable to comprehend the fundamentals of string theory, anthropogenic global warming, or the differences between Austrians and Keynesians.
Lucky for the rest of us, science writers including the bloggers on this site go to some length to bridge the gap between pablum and professional understanding of research esoterica. It has been said that Aristotle was the last man to know everything that was knowable in his time. Think through the implications of your reasoning reductio as absurdum. Is that the society you’d like to live in?
# DREads
It’s hard to educate the masses since most people don’t have the attention span or motivation to understand the mechanisms of vaccines and their complexity.”
I do agree that it is hard to educate the public (the masses, really? as in unwashed…:) I think that it has been shown that you can change public opinion regarding activities even when complex scientific processes are involved.
For instance, I know that cigarettes are bad for me and lead to lung cancer and emphysema. Yet, I have no idea of the actual mechanism that is causing the cancer or the emphysema. The same goes for seat belts, lead, mercury, etc. I think it is a mistake to think that you need to convince each person scientifically. Yes, the science should be there as support, but it is not the whole conversation.
That said, you are not going to convince everyone. There are always going to be people who do dangerous ill advised activities and find ways to rationalize their decisions. Ditto, conspiracy theorists. The goal is to keep those individuals from endangering others.
Stroh,
“And as for Th1Th2… sure I got exposed to the disease. But most people, me including, does not think it counts until we actually get sick. Hence: protection; not infection.”
And so are people who don’t get sick amid exposure to natural infection. The only difference though is that you certainly have the injected disease antigens in your system, courtesy of vaccines of course, whereas the unvaccinated has the capability to fend them off from invading the body. Thus, anyone who thinks that by being a carrier of disease antigens is a kind of protection is seriously in a gross state of delusion—and they need immediate help.
[Wikipedia] been described as a “quantum encyclopedia”, in a sort of superposition of accurate and inaccurate, depending on the exact moment you consult it.
That makes it a perfectly normal encyclopedia.
I don’t understand why Wikipedia has to be exactly right all the time when no other encyclopedia can possibly meet this challenge.
Unless you can show me an encyclopedia free of any taint, error or out-dated information.
Actually, rosemary, I have a Master of Education (which I think is different in Australia), so I do think about the science of communication and education a lot!
On the internet I use words because that is what is available to me – I belong to parenting fora and have developed long term relationships and authority, especially on vaccines. So it’s not about dry words, it’s about conversations and relationships. I also have a reputation as the devil’s advocate, or at least the one who is willing to buck the general agreement on all sorts of issues, so people are primed to listen to me because they know I will have an interesting, thought-provoking reply – again, it’s about relationships. I’m well known as an extended breastfeeding, cloth nappying, co-sleeping Mumma who is passionate about science and vaccination.
And I use social media, because that is where so many parents hang out. Stop the AVN uses satire, information, and legal means against the AVN.
For my more creative contribution, I run a blog promoting science for babies, toddlers and kids, with the explicit aim of showing parents how easy, natural and fun science is and giving them activities to play with. I state upfront that learning to love science and think critically is vital for future informed citizens and occasionally throw in a vax piece. I’m also in early stages of talking to the local education department about their primary science.
When I say we need to educate parents on where anti-vaxxers are coming from, I mean opening it up. Most things I’ve seen over the years from pro-vax people are facts and ridicule. For a parent who’s looking for information ridicule is often a bad tactic. They don’t have the expertise to understand why it is justified and it just sounds mean. I agree it’s sometimes justified and effective, but we need more. I’ve never seen anyone else actually say “Do you realise this is based on a conspiracy theory?” and then logically work out what must be involved and the consequences. Which isn’t to say it doesn’t happen all the time – I live in my little corner of the internet!
@ rosemary – re: delusions/culturally-sanctioned beliefs etc.
As a psychiatrist, this is exactly why I don’t like content-based definitions of phenomenology, preferring definitions based in form – as described beautifully many years ago by Karl Jaspers. A delusion then is defined by how the belief arises, rather than by what the belief is; so a delusion can potentially be true, and a false belief not delusionary.
Relevance? The ideas – even of the rabid antivaxxers – are unlikely to be delusionary, as they don’t arise de novo/out of the blue, as something “just known” to be true (although they do achieve that level of faith).
I would however characterise them as (in Jaspers’ terminology*) “overvalued ideas”: a non-bizarre** idea that develops over time, and grows to overwhelm the person’s thinking and behaviour. Sound like anyone we know of?
*More recent definitions of overvalued ideas are kind of “delusion-lite”, and I would argue they’re pretty much useless.
**”bizarre” in this context means things like the blue aliens put a chip in my tooth to spy on me because the government are making deals with the greys …. To me, the antivaxxers’ beliefs are – in a lay, rather than a phenomenological sense – bizarre indeed.
[/tangentiality]
The more you present facts, the more you get this “rational” appeal to fear and the toxin gambit… at least that is what I am finding when I go to parenting sites and encounter gems like this one:
“DOSE MAKES THE POISON
Perhaps in a general laboratory setting. Each individual will have his or her own tolerance level to toxins. There’s not really a good way to predict who will react badly to which toxins at which point. Also, many toxic ingredients can be cumulative in the body. Exposure to a small amount of a toxic ingredient might be fine…if it were just one time…but exposing a tiny developing body to not one but several toxic ingredients many times throughout infancy is just lunacy.
Sure we can get toxins other ways besides vaccines, and there’s nothing wrong with trying to avoid them if at all possible. [We avoid aluminum as much as possible (nope, we don't do antiperspirants or tin cans.) There's no good reason for it.]
Toxins = crap.
Injecting crap into the body without a direct obvious need and justification is asking for trouble.”
@michelleinmichigan
“For instance, I know that cigarettes are bad for me and lead to lung cancer and emphysema. Yet, I have no idea of the actual mechanism that is causing the cancer or the emphysema.”
Sometimes the science gives you answers to more than one question that you didn’t know were related. Did you know there is as much radiation exposure in one cigarette as one single view chest xray? So smoking 4 cigarettes will give you about as much radiation as a mammogram (although, you would probably have to adjust that to a full pack, if you are only interested in the breast tissue exposure). Radiation exposure from smoking is just one of the factors in causing cancers. It isn’t considered a major factor in emphysema.
Oops, made another mistake. The risk of smoking one cigarette is equal to the risk of 1 chest xray, not the radiation exposure. It takes about 5 packs of cigarettes to equal the radiation exposure of a chest xray, or 2 cartons to equal the exposure of a mammogram.
You betcha Minnesota is a different culture, but I don’t know what would be more difficult: moving to Minnesota or leaving there after growing up there. Sometimes I felt like I lived some episodes of Lake Wobegon; Keillor is uncannily accurate. My dad often told a legend of a reclusive northern Minnesotan lumberjack who, before antibiotics, ate moldy bread and “never got sick”. I reckon he may have got cancer from the aflatoxins in the mold
I spent one year in Minnesota. That was enough.
Dr. Crislip, if you want more suffering… you should try a year in Texas or (shudder) western Missouri.
I am an Army brat. I have lived in many varied spots in this country. Some good, and some bad. The worst bits have one thing in common: they are near I-35.
I think you are missing my point. When it comes to deciding whether you or your child should be vaccinated or not, it is much safer to rely on expert advice from trusted sources. “Comprehend[ing] fundamentals” is very different from being an expert in a subject. Laypeople are much less likely to understand the full complexities of vaccination and immunology and more likely to believe ideas circulated outside medical mainstream that may seem, on the surface, scientifically plausible and supported with some evidence. When making decisions about my health, I’d prefer to take the advice from those arrogant pricks (j/k) who’ve dedicated their career to medical science over a lay blogger or some conspiratorial medical narrative book at Borders. Taking information at face value without weighing the authoritativeness of each source is only potentially dangerous if it influences your health decisions or someone else’s.
As for string theory, again, I don’t think a non-specialist can be an expert. One of my good friends and colleagues got his Ph.D. in Theoretical Physics, studying theoretical general relativity and string theory. He spent five years working 100+/hours a week working out a single open problem. He read several hundred non-trivial math books to eventually acquire the mathematical background to make headway on his problem. Could a non-specialist have had a shot at making a similar impact in string theory? I highly doubt it. Could they have written an interesting blog on string theory that’s inspirational, colorful, and thought-provoking? Sure.
I spent over a year of my PhD delving into computational complexity and computability. It’s a fascinating subject. Go to the popular science section of any major bookstore, and you’ll find books on Alan Turing, Kurt Godel, Turing Machines, etc. Some of these books will certainly give you a grasp of some of the basics of decidability. Would reading them make you an expert? Hardly. Popular books and blogs are written to captivate the lay reader, which is why most pages are sparred of mathematical detail. In order to know enough to make headway on an open problem in the field, I had to spend many 100 hour work weeks reading a significant number mathematically dense original sources to understand the body of theorems supporting the current state of knowledge of the field. Sometimes, I would focus 2-3 days trying to understand a single page of math. In the end, I learned an extraordinarily massive amount of information but it was enough to prove a single open problem. Retrospectively, do I find popular blogs and books on Turing Machines and the like worth reading? Not anymore. They tend to be too simplistic and usually gloss over important details. I cringe when people gloss over details I know too well. But do these books have their usefulness? Certainly. They create an awareness, fascination, and appreciation of the subject to a more general audience. This is a good thing. If someone considers themselves an expert because they spent a few days reading such books, well, that’s their business but I’d rather consult my colleagues on the subject.
The bloggers on this science-based medicine site are doctors, not non-specialist, laypeople. What’s your point?
I certainly sympathize with doctors who defend vaccine science in the face of a flood of misinformation perpetuated by non-experts.
You mean reductio ad absurdum? This is a useful proof technique but the word “absurdum” makes it sound like it might be a bad thing.
What kind of society do I want to live in? A society where the key players in science are experts because they have the best shot in advancing the body of scientific knowledge.
Damian
rosemary
“…stringing words together to educate people is relatively ineffective especially if it is done in a dry, abstract, unemotional fashion, exactly the way most scientists have been trained to communicate with colleagues when writing professionally…”
Simon Singh tried to buck that trend and speak directly to the layman in layman’s language. For his efforts, he has spent the last two years of his life defending himself in court.
Sometimes you can’t win.
windriven
“WTF is that supposed to mean? The choices are only “vaccines are heap big powerful medicine” or a medical degree? That is USDA Grade A bullcrap. By your, ahem, logic, non-specialists would be unable to comprehend the fundamentals of string theory, anthropogenic global warming, or the differences between Austrians and Keynesians. ”
It’s not a dichotomy, it’s a spectrum.
On the one extreme is the person who doesn’t know and doesn’t care and, according to their inclination, blindly follows either the expert advice or the contrary/conspiratorial view. At the other extreme, there is the expert with his 100-plus-hours-per-week-for-six-years knowledge and experience. In the middle there is the person who understands the basics but not the detail and who has faith (because he has no option – he cannot spare 100 hours per week) that the peer-reviewed details that underlie the basics that he understands is solid.
dash.
“I’m well known as an extended breastfeeding, cloth nappying, co-sleeping Mumma who is passionate about science and vaccination.”
I hope it’s not a straightjacket they’ve placed you in – worse still, one you’ve placed yourself in.
Th1Th2: That’s so far off from reality it’s not even wrong.
Here is how it really works: when you inject yourself with a vaccine, your body receives a cocktail of dead or half-dead infectious agents. These agents are too weak to put up a fight against your immune system and make you sick.
What your immune system does is completely destroy the agents and harvest them for immunological markers, antigens, which are then used to create pin-point targeted antibodies from B-cells and Memory Cells for future immunity. Note one important point: the agents and their antigens are eliminated. Those vaccinated do not carry antigens but antibodies, which are wholly beneficial and are fully a part of ourselves.
The exact same thing happens when you contract a disease, but with one key difference: in these cases the agents are still viable. They can, and will, put up a fight and if they win it they might proceed to kill you. If you win you will eliminate the agents, harvest them for antigens and procure immunity through antibodies and Memory Cells.
Now, what would you prefer? An easy fight with a guaranteed win or an all out struggle for your life? That is the primary difference between immunity through vaccination as compared to immunity through infection.
thimple1thimple2
“And so are people who don’t get sick amid exposure to natural infection. The only difference though is that you certainly have the injected disease antigens in your system, courtesy of vaccines of course, whereas the unvaccinated has the capability to fend them off from invading the body. Thus, anyone who thinks that by being a carrier of disease antigens is a kind of protection is seriously in a gross state of delusion—and they need immediate help.”
You have to smile, don’t you.
…well, a sad sort of smile.
michelleinmichigan,
Yes, good point. In my posting, I was going to mention condom advocacy programs as an example but it slipped my mind. We don’t need to teach kids the likelihood about contracting different diseases or their pathophysiologies for them to get a good sense that wearing a condom is a good idea.
Damian
Who’s michelleinmichigan?
She is my evil twin. It’s amazing how much mail I get addressed to her. On the other hand considering that the pronunciation of my full (undisclosed) name is regularly slaughtered, I do not mind an occasional spelling confusion.
# Tsuken – I think the distinction between a delusion and a over-valued idea is great.
My experience is that one can seldom make much headway arguing against a delusion. With an over-valued idea, we can sometime be convincing if we reframe the idea, such as Dash does when putting the anti-vax idea into a conspiracy theory framework.
We can also put the over-valued idea into a greater context. For someone who is afraid to fly we might acknowledge the risk, but put them into the context of driving or other daily activities. We might also encourage discussion on the negative consequences of not flying (more time driving, loss of income, increased stress, etc) which may encourage the person to seek to overcome their fear.
Dash – “When I say we need to educate parents on where anti-vaxxers are coming from, I mean opening it up. Most things I’ve seen over the years from pro-vax people are facts and ridicule. For a parent who’s looking for information ridicule is often a bad tactic. They don’t have the expertise to understand why it is justified and it just sounds mean.”
Yes, I agree. I think sometime people forget that all sorts of people happen upon these science/medicine blogs. The often do not have any context for the vigor of this debate. For me it’s like walking into the middle of a couple bickering. Regardless of who is right or wrong. my natural tendency is to side with the person that seems to be the one being picked on and dislike the person who is attacking.
Also, I’m always looking for science projects. I’d like to check out your blog if you’re interested in posting a link.
Dash – “I’m well known as an extended breastfeeding, cloth nappying, co-sleeping Mumma who is passionate about science and vaccination.”
BillyJoe – I hope it’s not a straightjacket they’ve placed you in – worse still, one you’ve placed yourself in.
BillyJoe – didn’t they tell you the straightjacket comes with the child? You need if for when the beloved child asks you “why are bananas called bananas” for the 2000ed time within the one minute that you have to talk to computer tech support for whom you have been waiting on-hold one hour.*
Compared to that, I’m assuming extended breast feeding, cloth diapers and co-sleeping are nada.
*gripping about parenting is one of my hobbies, just to undermine the “it’s ALL joy and bliss” myth.
I have been a casual observer on this site for a few months now. I first came here after reading Amy Wallace’s article on vaccines in Wired magazine. I am a parent of a toddler, and I had to go through the whole “should we or shouldn’t we vaccinate” debate myself before my son was born (sorry to tell you this, but it has become almost a rite of passage for today’s parents). I decided to move forward with vaccinations, although at the time, I didn’t have a lot of good reasons. It just felt like the best choice for my family. Eventually, I stumbled across enough information that made me realize that the anti-vaccination movement is misguided at best, and that the risks of not vaccinating my son are far greater for him and for my community than the limited risks of vaccinating him.
I am writing in the hopes of providing a little insight into the mind of a layperson. So often on this site, your articles and the comments that follow devolve into a rhetoric that is wholly pompous, detached, aggressive, and self-aggrandizing. You think that you and yours have all the answers because “science told you so” and that anyone who thinks differently is an idiot. Many of you seem to me to live in a world of black and white, “us vs. them”. You think that those you criticize do not believe in science, and that anyone who questions the status quo is a quack and a moron.
Let me first just tell you, there is a LOT of information out there. Most of it is shit, and even worse, most of it is designed to scare the shit out of you. But as a pregnant woman, I felt it was my responsibility to my child to weed through some of it so I could give him the very best start in life. And what I found is that there is a lot to be afraid of: BPA in baby bottles, phthalates in crib mattresses, thimerosal and aluminum in vaccines, toxic chemicals in the home, perchlorate in our water… the list went on and on and on and on. I am not a scientist. I am not a doctor. I had to try hard to find the right information without killing myself with overload (or fear!) in the process. But the right information is not readily available. Somehow I managed to get through it OK. I got BPA-free bottles for my baby, I got a phthalate-free mattress, I found out that thimerosal is no longer found in most vaccines and I spread out his shots by one week to minimize the amount of aluminum he receives in one visit, I try to use only eco-friendly cleaning products in my home, I use filtered water to drink, etc. But it was a huge battle getting even to this point.
I was overwhelmed with information, and not all of it was good. But where is a parent supposed to turn? Pediatricians aren’t necessarily doing a bang-up job of delivering the goods. In my experience, I got a lukewarm reaction when I started asking questions about vaccines. I don’t even recall what the answers were at the moment, but there was certainly no passion in the delivery, and definitely not a lot of information. Amongst my circle of friends (and there are about 30 of us that have reproduced over the last 2 years), none have received a good, strong opinion on the topic. There are lots of voices out there and, right or wrong, in many cases the voices with the worst information are also the loudest. Not everyone has the patience or the resources to keep digging until they reach the real information (or like me, decide to err on the side of caution/science until they are sure). You can’t always fault people for being drawn to the loudest voices. YOUR voices need to be the loudest voices out there. Why aren’t they? (But PLEASE, it will never work if you don’t tone down the condescending attitude!).
And if you really think about it, can you blame people for being unsure of scientific evidence? Do you remember when eggs were going to kill us all, but now eggs are OK? What about butter being the root of all evil, but wait, now science tells us that margarine is even more evil than butter? Oh, and now lard is better than Crisco? How about hormone replacement therapy – remember when that was supposed to keep women from getting cancer or heart disease? Oh, OOPS! But science told us that hormone replacement would prevent these things! And science is never wrong! BULLSHIT. Stop being so damned pompous. You may have the best method for coming to a conclusion, but you don’t have all the answers. Stop pretending that you do and stop criticizing people for not having access to good information. Your bad attitude is only serving to widen the divide.
Sorry, this came off much more negatively than I intended. If I ever post again, I will try to be nicer. My comments aren’t directed to anyone here, as I have not had time to read through any of the comments, but after reading the article my feathers were a little ruffled. Again, I apologize for venting. Carry on.
kleenhed – (at the risk of sounding overzealous) – Amen! In general I think the SBM commentors are more even keel than on some science blogs, but sometimes they (we?) do go over the top.
It’s always good to be knocked down a peg or two (or three, etc.)*
*this has been a presentation of mixed metaphors inc.
“You think that you and yours have all the answers because “science told you so” and that anyone who thinks differently is an idiot.”
We have the answers that science gives us. Anything else is guesses or pot luck. We do not have all the answers. Even the things you say about HRT is an oversimplification and the story there is not settled yet either. Our knowledge is evolving and so will our practice. Are you sure you aren’t looking for some unchanging truths? If so, this is not the place.
kleenhed -“You think that you and yours have all the answers because “science told you so” and that anyone who thinks differently is an idiot.”
weing “Are you sure you aren’t looking for some unchanging truths? If so, this is not the place.”
I would read it as she’s looking for some respect (or as Aretha would say, r-e-s-p-e-c-t) and the acknowledgment that not trusting the scientists or doctors 100% of the time doesn’t make someone an idiot.
IMO that is.
BillyJoe
“Who’s michelleinmichigan?”
micheleinmichigan
“She is my evil twin.”
—–
After thinking about it, I have to admit, she is probably my good twin.
“I would read it as she’s looking for some respect (or as Aretha would say, r-e-s-p-e-c-t) and the acknowledgment that not trusting the scientists or doctors 100% of the time doesn’t make someone an idiot.”
I’m sorry, my bad. I thought she was looking for information.
weing: “We have the answers that science gives us. Anything else is guesses or pot luck. We do not have all the answers. Even the things you say about HRT is an oversimplification and the story there is not settled yet either. Our knowledge is evolving and so will our practice.”
My point is that if your knowledge is evolving, and facts are changing all the time, then (a) how can anyone feel that they have all the facts (including you guys, but especially us common folk – we don’t even know how to weed THROUGH all the facts! poor us, ha!) and (b) how do you know your answers are right even though you know the answer might be different when more facts come to light years down the road?
To be clear, my comments are not specific to vaccines, anti-vaxers, etc. I am also following some comments re: CAM as well.
Might as well put it all on the table while I’m here. I have alopecia totalis. Medical science tells me that if the few sanctioned treatments don’t work for me (they didn’t) then there’s no hope. So what is left for someone like me? Where do I turn? I have been living with this for 9 years, and have learned to just accept that I am a bald woman with no hair, eyebrows or eyelashes. And after 9 years, I just might decide that acupuncture could offer me something. Or maybe herbs or vitamins might offer me something. They might not, but I am almost 40 and I feel like I have to try something! Those “alternative” options that most of you seem so quick to dismiss as “folk magic” are the only options someone like me has left.
I am not looking for approval from any of you good folks… I merely mention it to remind you that there are individual, human stories out there and it is unfair and closed minded to be categorically dismissive of those who seek alternative therapies when left with no other options. Make fun all you want, but some folks have no choice.
You all seem quite smart and I know you know what I am telling you – just know that you have a wider audience here than you may realize.
And I apologize for the tone in my last post.
But at the end of the day, maybe weing is right. Maybe this site isn’t for me after all…
Wait … what? You talk about not discussing things in a condescending manner then come at people like that?
I’m not sure where you got the idea that “science” has all the answers, because a scientist should never give anyone that impression unless a mountain of evidence is available (see Evolution). Because there are things that are hard facts. I can give you one thing though, those in science will (usually) admit being wrong about something and change their information to suit new evidence. No other line of thinking does this. Our knowledge base is ever expanding and our understanding of our surroundings is bound to change as new evidence comes in. Would you rather we just kept the status quo?
And I do. Not many people out there will take the time the read things in the manner that kleenhed did. It’s great that she employed critical thinking, logic and reason (as well as trust) in many of these things. And there is such a thing as “bad science” out there performed by the likes of “Dr.” Buttar, etc. Being skeptical about everything, even studies in science, nature, etc. is a part of being a good critically minded individual. However, saying that “science has been wrong before” is not a reason to cast it’s practice to the wind. Because as she said in her post, it’s the best problem solving skill in our possession. Nothing else has the explanatory power that comes from applying a scientific mindset to a problem.
weing: “I’m sorry, my bad. I thought she was looking for information.”
Where did you get that idea? She said she was writing to “provide insight,” in part, into her own feelings about already being over-inundated with less than fully trustworthy information. This comment makes it sound like you think a layperson’s mode of interaction with you ought to be a one-way flow of information, where we sit at your feet and listen respectfully while you tell us not to worry about those studies showing HRT causes cancer.
“it is unfair and closed minded to be categorically dismissive of those who seek alternative therapies when left with no other options.”
If I ever wrote anything that could be considered to mean I was categorically dismissive of those people, I apologize for the misunderstanding. But I don’t think any of us fits that description. I think you are reading something into this blog that was never there.
As I mentioned, I am following other articles on this site. I have come & gone a few times over several months.
If given the time, I will go back through and reference some of the comments that led me to make my own comment moments ago, just for reference. I wasn’t specifically referring to any of the comments related to this particular article. I am sorry for the confusion – it was probably a bad idea to refer to months’ worth of observations in this one string of comments. It’s bad form.
I will either return with more information to continue the discourse or move my comments to where they make more sense.
Thanks to all who have replied.
I disagree. As i said in my last post, you have all the makings of a good critically-minded individual. You are skeptical, but I think at this point you’ve misunderstood what science is about, replacing it with something that comes from media hype. Society assumes, and the media purveys, that since an experiment shows a correlation, it must be true. When in all reality many experiments are later proven false in some way by further experimentation. However, when a large amount of evidence piles up in favor of an idea, you have to know when to fold the cards, admit that you were wrong, and swallow your pride and admit you were wrong. Things like creationism, homeopathy, realigning Ki, etc. are good examples of mountains of evidence not supporting the claims these ideals preach. When people start utilizing these ideals to capitalize on others misfortune, I believe we are right to get worked up and angry at those people, especially when large amounts of evidence exist refuting their claims!
The one thing to keep in mind is that science is all about discussion and peer-review. It’s one of the ways of working through these problems. So while it may seem intense at times, it’s just part of the process.
kleenhed,
If you can stick around and tolerate the bickering-couple vibe that sometimes develops here it can be quite enlightening. The bloggers and many of the commenters are doctors, and while they never agree with eachother on everything eventually you get to see the shape of how they think. What kinds of things they think are important, how they think about them, how they communicate with their patients. How they try to work with a patient they cannot cure.
The concerns you raise are very familiar to doctors. Sometimes someone will respond understandingly; other times you will be ignored or get a snotty response. Often the snotty responses come from doctors who care but who are tired of justifying themselves to people who assume they are unfeeling. Other times they come from people who are angry about the harm they have seen CAM do. (In addition, of course, some of them come from people who just enjoy making snotty responses. The internet is great for that.)
This is a good place to have intelligent discussions, but they will be geeky, meaning when people (doctors, interested laypeople) tell you that you are wrong they aren’t always going to be nice about it. There will also be people who share your point of view and will say so.
In my experience we “champions of science” (heh) are never that dismissive about those seeking alternative cures and desperately wading through conflicting claims but rather those providing bogus treatment and arrogantly dismissive decades of hard work on a whim.
Think about it. Tens of thousands of man-hours have been spent by highly qualified experts, devoting great parts of their lives, disproving links between autism and vaccines and we still have these B-rate actors and ex-playboy models denying everything for a whim. Have can we be expected not to get angry and upset?
And don’t get me started on the CAM-prophets. They’re exploiting people for heavens sake! They’re KILLING people! Sure, most seeking care are not seriously ill but some are – and when quacks are treating cancer patients with herbs rather than referring them to real doctors I say we OUGHT to be angry and upset!
kleenhed – The problem will be that all the commenters who conscientiously try to be respectful will feel like you are talking to them. All those who actually have treated someone like an idiot will think you are talking about someone else.*
But I think you should come back. In my book, the more sensible patient advocates commenting on SBM the better.
(I have no idea were I stand. Probably the later group, but that becomes paradoxical.)
micheleinmichigan – “The problem will be that all the commenters who conscientiously try to be respectful will feel like you are talking to them. All those who actually have treated someone like an idiot will think you are talking about someone else.”
Could not have chuckled harder.
OK, I will stick around and will also bear in mind that many of you have witnessed things that rightfully should make you angry (killed by CAM, why yes, that should make anyone angry).
Thanks to all for welcoming me here.
@ kleenhed
You are ever so welcome, of course. The more the merrier.
In my personal experience the only ones that are not are those whose only aim seem to be evangelizing their own pet faith – be it religion (faith healing), new age CAM (“I have anecdotes proving energy healing and homeopathy really works!”) or those smooth-mouthed denialists in the anti-vaccination league.
And that’s not that we are scared of being criticized, it’s more the case of having to hear the same arguments for the 500th time from people not interested in either debate nor dialogue.
Clearly you are not one of said people. So once more, please stay as long as you please.
“Where did you get that idea? She said she was writing to “provide insight,” in part, into her own feelings about already being over-inundated with less than fully trustworthy information. This comment makes it sound like you think a layperson’s mode of interaction with you ought to be a one-way flow of information, where we sit at your feet and listen respectfully while you tell us not to worry about those studies showing HRT causes cancer.”
I was not referring to her reason for writing. The rest of you comment sounds like a straw man.
kleenhed, I can kind of relate.
I had to quit work due to several medical issues with my newborn, and got acquainted with daytime television. I thought they would be helpful for a new parents. (this was before the internet, the pediatrician of the day was Dr. Sears’ dad — who my doctor actually told was a bit nutty!)
I was so very wrong.
It seems the more sensational stories hold sway on folks like Oprah, and who ever else was on the boob tube during working hours. Everything was dangerous! From apples (remember alar?) to the way grandmothers hold babies. I just had to swear off of those shows. I have not watched an entire Oprah episode for twenty years!
Though I did temper some of the information with the fact that I did have a subscription to Skeptical Inquirer at the time, plus I was taking the baby to some kind of medical appointment at least once a month or so. This is why I have bought one and only one copy of Mothering Magazine (it was the chiropractors claiming to cure ear infections that disgusted me).
Fortunately I do live very close to a good resource: our local Children’s Hospital. They have many parenting classes and seminars, and I attended many. I also used their library to check out books on child development (one way to figure out how to tell if the behavior is normal for a child that age, or part of the disability).
Of course, part of it was that my child was actually in the hospital about half a dozen times before he turned three years old (in addition to getting weekly neurodevelopmental therapy). One time he was transported there by ambulance due to seizures from what is now a vaccine preventable disease.
By the time we got onto the interwebs, I already knew most of the stuff was dreck. Especially after venturing onto Usenet over a decade ago and encountering John Scudamore of whale.to fame!
Dash, my impression is that your definition of educating, or the method you use to educate, is different than that of most people here. I hope you have a way to evaluate the effectiveness of your endeavor and that if you find it is more effective than the usual string of words most others use that you can either teach others how to use it or set up a service doing that for those who are trying to educate the general public but who don’t have the time or resources to learn and use your method.
Tsuken, “**’bizarre’ in this context means things like the blue aliens put a chip in my tooth to spy on me because the government are making deals with the greys …. To me, the antivaxxers’ beliefs are – in a lay, rather than a phenomenological sense – bizarre indeed.”
I haven’t followed antivaxxers. However, I have extensive dealings with silver supplement promoters and I am convinced that many suffer from serious mental illnesses that make them delusional. One, very well known and influential in silver circles who disappeared from cyberspace a few years ago, has written that my website is a front for a secret US military organization engaged in psychological warfare and that federal agents follow him around recording what he says, among other equally bizarre things, and he is not alone. Yet he has influenced many people because he can sound very rational to anyone who doesn’t know the topic or hasn’t looked closely at all his sites, now down. He used to cut and paste hundreds of citations to articles in scientific journals. Most laypeople assumed from that that his conclusions were scientific. I know the literature quite well and know that the articles did not support his conclusions.
DREads, “as Dr. Crislip points out, it is hard for lay people to digest this information without years of training in medicine, biology, or other fields.”
We are talking about different information. When I learned that silver was being sold as a “dietary supplement” and wanted to write a webpage warning the public about the danger and uselessness of ingesting the stuff, I tried to hire someone because writing is very difficult for me and I’m not good at it. Scientists would not do it. Journalists were afraid of the science. I said, “What science?” If someone claims that silver is an antibiotic, then you ask for verification, cases that can be independently verified demonstrating that many people had infections, took the stuff and nothing else and were cured. If they provide such independently verifiable evidence, it doesn’t show that silver is an antibiotic, it shows that more studies are required to determine that. However, if they can’t even come up with one such case, it is at best baloney and at worst fraud and that is something that the general public can understand. I wound up writing my own webpage which has convinced a lot of the general public and scientists that silver is a fraud.
Rosemary on public education:
“When I learned that silver was being sold as a “dietary supplement” and wanted to write a webpage warning the public about the danger and uselessness of ingesting the stuff, I tried to hire someone because writing is very difficult for me and I’m not good at it. … I wound up writing my own webpage which has convinced a lot of the general public and scientists that silver is a fraud.”
Well, I’m glad you did.
Kjeenhed, “And after 9 years, I just might decide that acupuncture could offer me something. Or maybe herbs or vitamins might offer me something. They might not, but I am almost 40 and I feel like I have to try something! Those ‘alternative’ options that most of you seem so quick to dismiss as ‘folk magic’ are the only options someone like me has left.”
I cannot speak for anyone but myself. But I can tell you that I get furious with alt. promoters, not their customers, when I read statements like yours. Why? Because they are trying to sell desperate people cures when all the objectively verifiable evidence indicates that they don’t have any to sell. I am not talking about your case directly since I don’t know anything about your condition or whether or not there are alts who claim that they can cure it. I am talking from my own personal experience with a great many alts in which I know the diseases well that they claim to cure and have investigated the “remedies” they sell to cure them with, remedies which I know cannot possibly help anyone and that some of them can actually harm or even kill people.
You have had alopecia totalis for 9 years. I have had argyria, gray skin, for over 50. Argyria is caused by ingesting silver. I got the condition from a drug prescribed by an MD who never would have prescribed it if he had read med. journals instead of fraudulent ads from drug companies in an era when they weren’t strictly regulated. Today silver is sold as a “dietary supplement” and “natural antibiotic” even though silver supplements don’t even kill common bacteria in test tubes. As I predicted 15 years ago when I learned that silver was being sold as a supplement, there are now many cases of argyria caused by them, including cases of children and teenagers.
A furious young man once wrote to me saying that his mother had Lyme disease and asking what could be worse than that. I said, Having LD and being gray. I now know of two cases of people who took silver for LD and are now gray.
While many alt “remedies”, may not cause bodily harm, they cost money. Most people who decide that they have to “try something” keep right on trying one useless thing after another, things for which there is no evidence to even suspect that they might help. That adds up to a lot of money that could be better spent somewhere else.
kleenhed:
Thanks for surfacing and welcome to SBM (and other science-based blogs like Neurologica and The Bad Astronomer and Respectful Insolence, just to mention a few of my favorites).
And, especially thanks for taking the time to respond to and discuss our comments. Ultimately, any good blog and comment thread is about diverse people trying to participate in an at least semi-informed discussion. If you read the article and comments, think about what people are saying (or at least trying to say) and offer your own honest response and/or thoughtful questions, you can get a lot out of following the site and a lot of people will be willing to help you on your intellectual journey and point you to good resources.
Here are a few of my favorite thoughts on science:
1. Science is not about final, absolute, perfect answers. Rather, it is an ongoing process of trying to reduce the uncertainty in those answers. In other words, science tries to make those answers more accurate and reliable.
2. Scientific research, and especially medical research, is about sorting out the wheat from the chaff and trying, as Richard Feynman pointed out, to avoid fooling yourself.
3. Even if science or medicine doesn’t have a good answer for you today, there is still hope for a good or at least better answer in the future. I did a quick search on medline and found a list of 14 studies on alopecia.
http://clinicaltrials.gov/search/open/condition=%22Alopecia%22
7 of the studies are now recruiting. The rest are not yet recruiting.
This won’t help you much right now, but it shows there are people still trying to look for a better answer.
I apologize for some comments that may seem pompous, aggressive or dismissive. I know when you have been trying to explain the same ideas to someone 2 or 3 times on 5 or 10 different blog-comment threads it eventually gets frustrating and you don’t always have the time or energy to go over it all again thoroughly, carefully, and “once more with feeling”.
Still, we mostly manage at least to respond “in kind”.
Good luck on your journey.
Dash, BillyJoe, Michelleinmichigan, DReads, et al:
One resource I recently re-listened to and think offers some good advice on communicating with others is Brian Dunning’s Skeptoid episode:
http://skeptoid.com/episodes/4116
I have a couple of friends who are very enamoured of homeopathy and natural/herbal/nutritional supplements, etc. I have tried to follow his suggestions to be honest about what you think, but let the other person bring up the question, etc. Their friendship and our long-term good relations are more important to me (at least at the moment) than winning a debating point.
I can’t say that I have any great results to point to as yet, but I am still hopeful.
kleenhed and rosemary,
One more comment I forgot to include in my little tome.
For people who have a condition for which there is no good or satisfactory treatment at present, I offer this advice.
First, do no harm. Stay away from treatments, supplements, alternatives such as chelation or silver supplements for which there are know, demonstrable, negative side-effects.
Two, don’t spend more than you can easily afford.
And, when someone tells you about product X that works great and has no side effects, keep in mind Wesley’s comment from The Princess Bride:
“Life is pain. Anyone who tells you otherwise is selling something.”
kleenhed,
A drowning person will grasp at a razor. People during 9/11 jumped out of the windows of the Twin Towers to avoid the flames. None of these actions save them. Your desperation is understandable.
Stroh,
“Now, what would you prefer? An easy fight with a guaranteed win or an all out struggle for your life? That is the primary difference between immunity through vaccination as compared to immunity through infection.”
Literally, that is just rubbish. The immune system does not differentiate between an infection from vaccine antigens and an infection from natural exposure. Hence, you don’t choose what kind of crap you are going to expose/inject yourself to. Either way is an act of barbarism and unhealthiness that corrupts the very essence of immunity.
I am glad you did this as well. If less people used silver as a supplement because of your webpage, then this is a good thing. It would take me time to write about how I weigh the authoritativeness of different kinds of sources. I am not saying people who aren’t medical doctors should keep not write about medicine. Nor am I saying people should only read medical information from experts. Rather, people should develop good sense on how to judge information they read, where it comes from, and the consequences of acting on it. In the absence of such sense, people should only read expert advice. When it comes to making important health decisions (e.g. treating X cancer with therapy Y), it’s best to corroborate non-expert information with legitimate sources written by experts.
Unfortunately, for every accurate web page on health information, there are many inaccurate web pages. I do not know the best strategy to counter this. It would be great if companies like Google develop a technological solution such as a special search engine for ranking pages on authoritativeness rather than PageRank. Another strategy is to encourage non-experts to write about fraud and scams such as your webpage on silver supplements. I do not know enough about the dynamics of health education to draw a conclusion on the best way to proceed.
Stroh,
This idiot still hasn’t learned what an infection is. Don’t waste your time.
The funny this is, he says:
But then still goes on to believe that vaccination is “… an act of barbarism and unhealthiness that corrupts the very essence of immunity.” So it’s the same … but different.
Sorry, that first part is supposed to read “The funny thing is …”
Although it was a diversion from the topics in discussion, I feel I should still correct my previous statement. I oversimplified the calculation of radiation exposure to the breasts from cigarette smoking. So please don’t quote it. The radiation exposure from cigarette smoking to the lungs is much easier to measure than the radiation exposure to the breasts. It is more reliable to compare the risk of dying from cigarette smoking versus mammography, than to come of with estimates of radiation to the breasts from cigarette smoking.
For anybody following these articles and threads for medical information that might be used to make a decision about healthcare, I would like to make a point that is more than just a legal disclaimer. It is important to be informed (and this site is good for information, but the discussions can be caustic) when you have to make a decision. Be aware that making decisions from that information is usually not that straightforward, when you are dealing with the information from medical science. Medical science tends to deal with groups of patients that are characterized by the group’s average. Patients are individuals. We have medical students spending most of their time learning what the information is about the average patient and average disease, the textbook cases. In residency, doctors learn how to use that information to practice medicine (translating the science into art). In both medical school and residency the students are taught how to analyze the information from textbooks and the body of medical scientific literature (which is SBM).
So being versed on the latest information from medical science is not a guarantee that you can come up with the right decision. It is always important to listen to the recommendations of someone who is practiced at making decisions from the information, a doctor that knows you, and how you may or may not be like the average of those groups. The doctor can help you understand the importance of different factors in the decision. The doctor can also make sure that you have considered all that may be factors. The decision is ultimately yours, but guidance is still helpful.
Kleenhed,
“after 9 years, I just might decide that acupuncture could offer me something. Or maybe herbs or vitamins might offer me something.”
I don’t understand this. You just decide that acupuncture could offer you something? Why would you do that? Or herbs or vitamins. Why those as opposed to a hundred and one different unproven remedies?
“They might not, but I am almost 40 and I feel like I have to try something! Those “alternative” options that most of you seem so quick to dismiss as “folk magic” are the only options someone like me has left.”
Why do you call them options? After nine years, why do you suddenly want to parachute into the unknown? If there is no plausible mechanism and no evidence for effectiveness, why are we not justified in calling it “folk magic”?
regards,
BillyJoe
Thimple1Thimple2,
“Literally, that is just rubbish. The immune system does not differentiate between an infection from vaccine antigens and an infection from natural exposure. Hence, you don’t choose what kind of crap you are going to expose/inject yourself to. Either way is an act of barbarism and unhealthiness that corrupts the very essence of immunity.”
Thimple take home methage:
Both vaccines and pathogenic organisms induce immune reactions and can cause disease.
But here’s the BIG difference:
Pathogenic organisms cause disease a whole lot more frequently than vaccines, in many cases 100,000 to 1,000,000 times more frequently.
Now pith off.
BillyJoe wrote: “Why do you call them options? After nine years, why do you suddenly want to parachute into the unknown? If there is no plausible mechanism and no evidence for effectiveness, why are we not justified in calling it “folk magic”?”
With both pregnancies, I approached and surpassed 41 weeks gestation, with nary a contraction. Now, all the women on here will probably commiserate with me, in that at 41+ weeks, you want that baby out…….NOW!
So I scoured the internet, and found myself eating pineapple, spicy food, walking so much the dogs hid when I got out their leashes, red raspberry leaf tea and a few other “folk magic” remedies to induce labor.
None worked and both times I found myself medically induced (with no regrets btw).
But my point is, I don’t have a problem with parents or individuals trying otherwise harmless remedies. Note that I did not list castor oil as one of my folk remedies–as it can induce labor but also serious health problems.
I was recently in an argument with a parent who insists her autistic son’s GI issues were finally resolved when he started sleeping on a magnetic mattress. Eh–who has the time, right? Sleeping on a magnetic mattress is harmless, imo. Chelation is not. GF/CF is not. As are many of the other therapies we frequently discuss on here.
My autistic son does “Listening Therapy.” It’s supposed to train his brain how to listen properly. Ok, not proven to work. Otoh, listening to classical music for 30 mins a day is not harmful and he seems to enjoy it.
So yes, there are options. Unproven, sure. But if they are harmless and I want to throw away my money, so be it.
Billyjoe – I’m not sure what you mean by a strait jacket, we do what works for our children, our circumstances, and ourselves, and that has been different for each child and at different times. We also follow what research there is available, which is abysmally little for something as important as parenting!
I don’t breastfeed and didn’t use cloth nappies or co-sleep because they were cool and trendy or fit in with my friends. Cloth won hands down on cost, convenience and reliability. Co-sleeping (both bed-sharing and in arm’s reach at different times) was about sanity with a baby who was, and remains, a truly appalling sleeper, she now co-sleeps with her sister. And breastfeeding is a no-brainer when it’s easy with the WHO recommendation of feeding to 2 years and beyond.
rosemary – I always find it interesting reading science blogs, as a professional educator I seem to view some things very differently to other writers and commentators. You’ve put your finger on the hard bit – seeing if it makes a difference. I’m in the strange position of only knowing how I’m doing through testimonials, while knowing that anecdotes prove nothing! That’s one of the reasons I’m talking to the education department – I want to actually be able to collect some data and see if it makes a difference. My link is in my name, I’d love you to have a look.
provaxmom said “My autistic son does “Listening Therapy.” It’s supposed to train his brain how to listen properly. Ok, not proven to work. Otoh, listening to classical music for 30 mins a day is not harmful and he seems to enjoy it.”
Provaxmom, you probably you already know this, but I thought maybe it could be helpful for another reader.
There is a technique called auditory training used in children with hearing loss and auditory processing disorder. It is often performed by either Audiologists or TOD (Teacher of the Deaf) to train children (and their brains) to use residual hearing and/or amplification.
Although it is outside my experience, I think this technique is also used in ASD (maybe that is what you are referring to).
For instance, at my son’s school the HI and ASD classes meet together for their “music and movement” class, which they use partly as auditory training and partly to motivate vocalization and also to have fun and get their wiggles out.
This would be one of the least formal forms of auditory training. The TOD also performs more formal forms and I believe Audiologists perform training using auditory stimulation in the sound booth, etc.
So I’m guess what I’m saying is that it is plausible that Auditory Training could be helpful to a child with a sensory issue of some kind. IM not medically trained O. And as long as it is harmless, what the hey!*
*Not that you needed my approval
Just sharing my thought process.
Th1Th: You clearly aren’t listening to a word I’m saying so a serious discussion is evidently pointless. Stick around if you will but everything you write will henceforth be met with ridicule:
Everything you write is wrong, you know nothing of immunology and you are too ignorant to listen to people who do. You are stupid, stupid, stupid!
Regarding patients seeking alternatives for untreatable or difficult to treat diagnoses.
Speaking from personal (anecdotal) experience as a patient and parent of a patient, I think it’s helpful for the patient to know and the medical professional to remember that any significant health change in a patient often entails a grieving process for the patient and/or the patients parents.
The stages of grief are often stated as such: Denial, Anger, Bargaining, Depression, Acceptance. It’s often pointed out that they may not present in that order, they may not all present and that people may return to previous stages experienced when sparked by a life event. It think it’s also important to point out that even a relatively minor loss may need a grieving process. Although, probably not something so minor as my lost keys
I think it can be helpful for a patient or patient’s family members to contemplate where they are within those stages when dealing with treatment decisions of any kind.
I think it is also helpful when medical professionals (or even friends or family) remember these stages. For instance, when they talk with a patient that is looking for the easy answer to a rather complicated disease, that patient may be experiencing the stage of denial. Maybe the patient will have moved on to another stage in a few months or maybe they need some help or support to move on, etc.
It’s just good to remember that experiencing this stage of denial is rather predictable and natural for the patient, it does not mean that the patient is inherently irrational or pigheaded.
I know a tangential thought, but it was sparked by a couple of previous comments.
Stroh on 16 Mar 2010 at 10:21 am
“Th1Th: You clearly aren’t listening to a word I’m saying so a serious discussion is evidently pointless. Stick around if you will but everything you write will henceforth be met with ridicule:
Everything you write is wrong, you know nothing of immunology and you are too ignorant to listen to people who do. You are stupid, stupid, stupid!”
Stroh – whoa there! – once again, the name calling probably doesn’t help (although it may feel good.) I mean, if you are actually dealing with someone with inferior cognitive skills, is it productive or sporting to call them stupid? Or if they are not lacking in cognitive skills, why call them stupid?
Doesn’t it just make you look out-of-control and a bully to the audience that you are actually trying to convince? (not TH1TH2 one might wonder if they will ever be convinced without medication.)
Or, if you insist on insulting someone, could you be a bit more creative? You know the judge from Switzerland scores almost entirely on artistic content.
BillyJoe:
“I don’t understand this. You just decide that acupuncture could offer you something? Why would you do that?…”
I have had acupuncture sessions in the past for other reasons. During a few of my later sessions, my acupuncturist and I decided to focus on my scalp, just to see what would happen. We probably had about three sessions that included scalp treatment. I definitely did notice some hairs growing around the sites where she placed her needles. This could have been coincidence, this could have been placebo effect (if so, though, who cares? I don’t care if my mind does it or if the treatment does it, I just would like my hair back now, please already). The only reason I stopped going to acupuncture is that she wanted me to increase my sessions to 4-6 times a month. I did not have the time or money then to continue treatments. At that point I turned my energies toward just dealing with acceptance of the fact that I was now a bald, eyebrowless, eyelashless, alien-looking creature. But damn it all, I wasn’t going to let it ruin my life, either.
“…Or herbs or vitamins. Why those as opposed to a hundred and one different unproven remedies?”
Why those as opposed to a hundred and one different unproven remedies? Well, for starters I have to begin somewhere. And I can’t do them all at the same time. My mother (a nurse) works with a woman who claims she cured her alopecia by taking B vitamins and zinc. Is that true? I have no idea. But like so many others have stated before me, if it isn’t going to hurt me, why not? I may not have anything to gain, but what have I got to lose by taking some B vitamins and zinc, if I take them in safe quantities? What have I got to lose besides a few extra dollars a month? I am also trying – just attempting – something that I KNOW you will all refer to as “snake oil”. I have read some good user reviews of a cream called Calasol. I am trying one tube of it on my eyebrows (the tube should last me six months). This will definitely not sit well with any of you, I am sure (it has never gone to clinical trial), but… the ingredients list doesn’t seem too frightening, and the cost was do-able, and the results for some seemed to make it worth the risk to me to try it. (Feeling sheepish now for even admitting this to you guys, but again, it isn’t gonna kill me and seemed worth the risk to try it.)
“Why do you call them options? After nine years, why do you suddenly want to parachute into the unknown?”
Because, after 9 years, I am tired of it. I have spent the last 9 years just trying to accept it. Then one day (at the start of this year) I said to myself, why should I have to “accept” it? What if there is something I can do to change it? Alopecia is a strange “disease”, indeed. Some treatments work for some people, and not others. Some treatments may not be “condoned” by the medical community because they haven’t been proven to work in enough people? How would I know that? I do know this: my grandfather had alopecia, but he died with a full head of hair. My mother told me that my grandmother rubbed some sort of special ointment on his head every night & eventually his hair came back. Why did it do that? Was it the ointment? Was it the act of rubbing itself, which perhaps increased blood flow & stimulated the hair follicles? Can we ever know for sure? There isn’t a lot of knowledge yet on how alopecia works, what triggers it to start, what triggers it to end, etc. And since there aren’t a lot of treatment options, I can either (a) continue to just “live with it” as I have done for 9 years or (b) venture out of my comfort zone and at least give a few of these options a try. As long as I am not hurting myself, why not? Oh, and for the record, several of the medically-condoned treatments for alopecia ARE known to be potentially hurtful to the body. The most common treatment is steroid injections into the scalp. I did this for three months and it took me a full year to be “normal” again (whatever that is). I lost 12 pounds in three weeks because I was disgusted by food. I thought everyone was out to get me. I was aggressive and angry, and in general not myself. Another sanctioned treatment (which I have not tried) is PUVA (Psoralen combined with UVA treatment). I will not try this treatment because the side effects are unacceptable to me (up to and including an increased risk of squamous cell carcinoma, basal cell carcinoma and malignant melanoma). With sanctioned treatments like these, who needs enemies? But I jest.
At the end of the day, I know now that you all are much more upset about CAM treatments that actually harm people than you are about how someone like me might be interested in trying acupuncture, vitamins, or (gasp) “snake oil” treatments. I am enjoying the debate nonetheless and welcome your points of view and your expertise (even if they don’t convince me completely).
Chris
“I had to quit work due to several medical issues with my newborn”
I hope your child is OK.
“It seems the more sensational stories hold sway on folks like Oprah”
This is so true (specific to vaccines, I think I came across every sensational story out there but had to DIG for good info), although it makes no sense. Something is definitely wrong with our culture when sensationalism drowns out truth at every turn.
rosemary
“You have had alopecia totalis for 9 years. I have had argyria, gray skin, for over 50. Argyria is caused by ingesting silver. I got the condition from a drug prescribed by an MD who never would have prescribed it if he had read med. journals instead of fraudulent ads from drug companies in an era when they weren’t strictly regulated.”
I have heard of argyria, I’m sorry you have had to deal with this. I am sure after 50 years you have learned a wealth of coping mechanisms to get you through it. Still sucks, though.
squireelelite
Thank you for your comments and your link to various studies and clinical trials on alopecia. I am already participating in the first one, and the rest either don’t apply to me (different type of alopecia or cancer-related) or are trials that I would be uncomfortable participating in (i.e., the Botox one). But I do appreciate the link! And your comments, too (especially the PB reference – I love that movie).
weing
“A drowning person will grasp at a razor.”
Yup.
@ micheleinmichigan:
It’s infantile and trollish on purpose
I got curious to see how a troll would respond to being trolled at. It will probably backfire now though.
If my previous responses to Th1Th2 didn’t sway the audience in the favor of reason nothing probably will.
That, and I have an odd sense of humor.
Stroh, oh. very well then. carry-on.
But, as a sometimes card carrying member of the UFSP (Union for Stupid People), I must protest that we don’t want TH1TH2 associated with our organization.
kleenhed:
No, he is permanently disabled. You can see why I have very little patience with the likes of Th1/Th2.
“The stages of grief are often stated as such: Denial, Anger, Bargaining, Depression, Acceptance. ”
Interesting that you mention this. I recently heard a podcast with George Bonanno on the Berkley Groks talking about this. You might want to take a listen. I think it’s the Feb 3 podcast.
Thanks weing, I will.
While the stages of grief are widely accepted, the idea that everyone passes through all of them in the same order is one of the “50 Great Myths of Popular Psychology” in the book of that title.
@ Harriet Hall
Yep, they are. It never really made much sense to me even before I heard that – its too convenient and doesn’t even apply to everything.
Denial and anger, sure. But bargaining? With whom is a terminal cancer patient expected to bargain with? God?
Acceptance is another debatable one, a lot of people I’ve met never made it past anger or depression. Some others simply backtracked to denial and stayed there.
actually, here is that grief article. – http://ia341343.us.archive.org/1/items/groks413/groks020310_vbr.mp3
Some very interesting observations on grief from a clinical and anthropological perspective. Firstly the speaker talks about the flaws in the 5 stage model I mentioned above. I can always count on someone here to point something like that out to me.
One interesting thing he mentions is that when feeling sad, people become deeply contemplative and realistic. This helps them cope by giving them the focus needed to adjust their thoughts and life style to accommodate their loss.
Stroh on the stages of grief:
“With whom is a terminal cancer patient expected to bargain with? God?”
Yes. Literally. I have a friend with cancer. He’s 36. He’s had it for a couple of years now. He’s probably going to die before the end of the year. He had a religious ephiphany recently in which he decided he would become a better person (less Angry) and God would lead him to a new treatment which would work.
I thought Hmm… bargaining, huh. Stages of grief. Had no idea they were so literal.
(I think he moved on within a couple of weeks and he’s now more or less in the Acceptance phase.)
If you read her comment, Michele was very clear that she didn’t think the Five Stages were absolute and sequential. If you rephrase it as “five aspects” it can be a useful model allow you to contextualize odd moods and peculiar reasoning as different ways that people wrestle with loss.
Harriet Hall
“While the stages of grief are widely accepted, the idea that everyone passes through all of them in the same order is one of the “50 Great Myths of Popular Psychology” in the book of that title.”
The podcast addresses this also.
Stroh – I remember when my four year old hamster was dying when I was eight I did some serious bargaining with God to save that hamster. Needless to say, it didn’t work.
Actually one of my personal experience sort of demonstrate how I think grief can work within a medical situation.
Years ago my husband and I tried to start a family. It became apparent things were not happening and we were referred to a Reproductive Endocrinologist. After a good number months of diagnostics and attempts at reproductive hormone therapy which were not helpful, it became clear that our only medical option was a form of IVF.
At that time I read an article about Mind/Body connections and how depression and other negative emotions had a negative impact on fertility. Since I was feeling pretty upset and really stressed, I decided to see a therapist who could fix me, (joking).
At the end of maybe the third session the therapist offhandedly said something about how it’s appropriate to grieve when we have to deal with a loss or change in our expectations.
I almost slapped for forehead and shouted “Oh shit, I forgot to grieve.”* I had been so focused on the diagnostic process and all the details and research of what medical process was going to fix everything, that I had forgotten to just sit for a few moments now and then and be sad that things hadn’t worked out how I had planned. Once I did that, it was much easier to look at the big picture, see all our options and chose the one that worked best for us. **
Really, I don’t know how typical that is, but whenever I see someone who is sort stuck in that “fixing” mode that I was, I always think of that. It’s not very scientific though.
*Yes, I’m not the most emotionally introspective person sometimes.
**For us, that was adoption.
@ Alison Cummins
Huh. Look at that – could be a cultural thing. Over here in Sweden religion is not as big a thing as it is in the US, and none of the terminal patients I’ve had contact with ever entered the bargaining state. Possibly because none was very religious. Some where religious to an extent but somehow they never figured bargaining with God would actually work.
Oh, and I never intended it to be criticism of Michele. It was more of a general blow aimed at the oversimplification of pop-psychology.
micheleinmichigan (one L) wrote:
“There is a technique called auditory training used in children with hearing loss and auditory processing disorder. It is often performed by either Audiologists or TOD (Teacher of the Deaf) to train children (and their brains) to use residual hearing and/or amplification.
Although it is outside my experience, I think this technique is also used in ASD (maybe that is what you are referring to).
”
Similar. It was started by his OT, and we purchased the CDs and equipment ($300) to continue on our own. We figure it can’t hurt, he has CVI so we know his brain doesn’t process visual signals properly, not sure how well his receptive listening is, trying this.
I know there are studies supporting this, but my core belief is that it’s not going to make him any less autistic, kwim? If it encourages him to speak sooner and better great–but we’ll never really know if it works. It’s not like a “hey we started this program and 2 weeks later he was talking!” kind of thing.
@ Michele
That is a very good point, grief is very important. Being stuck in denialism is very bad for anyone as it prevents you from facing reality and making good decision.
The problem I mainly have with “The Five Stages Of Grief” is how some people seem to believe that they are some sort of requirement. They fully expect that unless you go through them all in the right order you will never recover.
In other words, they will urgue you to get angry when acting as if in denial, then bargain and then to “face your sorrow”. It easily leads to a form of intolerance towards those who do not grieve according to this template.
Supporting someone after an emotional trauma is about listening to the needs of the individual – something you provided an excellent example of when you mention people as being in a “fixing mode”. Thats the right way to go about it. Not, like some other people, to treat them like stereotypes.
kleenhed, “I may not have anything to gain, but what have I got to lose by taking some B vitamins and zinc, if I take them in safe quantities? What have I got to lose besides a few extra dollars a month? I am also trying – just attempting – something that I KNOW you will all refer to as ‘snake oil’.”
I will not call something”snake oil” unless it is being promoted to treat a disease when there is no evidence that it does or when there is evidence demonstrating that it is ineffective. I don’t believe there is anything wrong with experimenting as long as there is information available to give you a good idea of the risk involved in the experiment and you are comfortable with that degree of risk. That applies to any treatment, evidence-based or pulled from a hat.
I suspect that most people reading these blogs are very aware of the fact that approved drugs are not perfect and that they can cause serious harm, even death. I also suspect that like myself they believe that one must weigh the benefits against the risks when deciding whether or not to use them. However, the difference between scientific medicine and the unscientific kind is that the former is studied in depth so that there is usually a great deal of reliable information to base a decision on whereas the latter has usually never been adequately studied so that often taking an alt remedy is like playing Russian roulette.
What I personally do when I am told of an amazing cure is try to verify the story independently to determine first of all if the story itself is true, but I can understand why someone wouldn’t want to bother doing that with things like vitamin B and zinc.
From what you say about your grandfather and the lady who claims that she cured herself with vitamin B and zinc, I would guess that your condition sometimes resolves itself for yet unknown reasons which is actually true with a lot of diseases and conditions and which is why drugs must be tested in large numbers of people to determine if they are effective. That kind of resolution or cure is part of what comes under the umbrella of the term “placebo”. Our bodies are like chemical factories in which many different unknown reactions continually take place, but few people who haven’t had experience with the development of drugs usually ever think of that. The more likely a disease is to go away on its own, the greater the number of test subjects that are needed to accurately evaluate a drug used to treat it and the more likely it is to be targeted by people selling alt remedies which they think cure it.
Supporting someone after an emotional trauma is about listening to the needs of the individual – something you provided an excellent example of when you mention people as being in a “fixing mode”. Thats the right way to go about it. Not, like some other people, to treat them like stereotypes.
Yes, we are on the same page then.
“Denial and anger, sure. But bargaining? With whom is a terminal cancer patient expected to bargain with? God?”
Not to overemphasis the bargaining thing, but I just wanted to mention that when I was search out those 5, controversial
phases.
Two examples were on Diabetes and Chronic Kidney Disease sites. I believe they both used diet as bargaining examples. Meaning that people went through phases where they believed if they tried a new diet or were really, really perfect with their diet that their disease should improve, which is not always the case. Is that a form of bargaining or too much a stretch? I don’t know.
I think the whole stages thing is only useful IF it gives you some insight into what you or someone else might be experiencing. I don’t think it is a good manual for how grief “should” be.
God (or quantum physics) save us all from people who think they know how we SHOULD feel.
michelleinmichigan and Stroh,
I suppose you could try playing chess with the devil, but I don’t think there are any RCT’s on the results:
http://en.wikipedia.org/wiki/The_Seventh_Seal
…and squirrelelite throws it in all the way from left field.
Good one.
BillyJoe,
“Both vaccines and pathogenic organisms induce immune reactions and can cause disease.”
Well said. I just hope that other vaccine apologists will listen to you. Just a reminder though, they don’t want to hear about vaccine-induced diseases. It’s blasphemy. The sacrament of vaccination is sacred to them and its content is pure (yeah, pure crap).
That is why we no longer use the OPV, and switched to the IPV.
The chances of getting a disease from a vaccine is much much much much much smaller than from the actual virus or bacteria.
Stroh,
“Everything you write is wrong, you know nothing of immunology and you are too ignorant to listen to people who do. You are stupid, stupid, stupid!”
I believe this guy though when he said:
“Both vaccines and pathogenic organisms induce immune reactions and can cause disease.” —BillyJoe
Maybe, just maybe, you can shift your interest to pathophysiology and pathogenesis.
Chris,
“The chances of getting a disease from a vaccine is much much much much much smaller than from the actual virus or bacteria.”
Choosing the lesser evil or should I say crap is not even a healthy option, kwim? How about the chance of not getting any diseases at all? Let’s say a toddler who remained naive (unvaccinated) to polio, hepB, rotavirus, diptheria, pertussis, measles, mumps etc. Would you consider him being unhealthy thus susceptible?
Inactivated vaccines only limit the spread of infection producing less and benign symptoms of the disease.
We managed to get through the whole discussion of psychology without noting the role of instinct in some of our reactions. We have a built in xenophobia that tends to extend across all aspects of the strange as opposed to what we have accepted as the normal. What that means is that we have a great barrier to overcome when we challenge what people have accepted as the normal. Words from those who are not of our tribe are to be treated with distrust, no matter how reasonable sounding. That level of doubt is found in all of us, no matter how educated. We must work to overcome it on a daily basis, and we must be educated to the need to overcome it, for we do not naturally see that need. It is not hard to understand how such instincts evolved over the long term, because the needs of larger society have only really been in place for this tiny bit of our existence.
The group of people with autistic children have accepted each other as their tribe, and they find no working answers to their questions and problems in the rest of society or in science. They are left to whatever anecdotal information that they can glean and the tortuous paths marked by accidental or spontaneous cure found in almost every illness. Add to that the fact that few people are educated in a deep understanding of the scientific process, and you have an almost irretrievable combination. These same people will respond almost instantaneously if a high percentage cure is found, and they may or may not show much interest in a scientific explanation of the causation of autism, should that be found, unless it offers some cure or treatment. I believe that is the long and short of it.
Kleenhed, I’ve thought similar about the site as well. I’ve come more to the conclusion that it’s a few of the commenters rather than the bloggers. Particularly when people respond to a “troll” really nastily, but when you haven’t been here awhile, you don’t know that poster is a troll. (So, just fyi, responding to th1th2 or whoever like a jacka$$ damages the cause, although personally, I just skip to the next comment). Dr. Gorski in particular seems very fair. Squirelelite, pmoran, calliarcale, jmb, windriven, Rosemary are a few of the commenters who are really knowledgeable, AND pay some attention to how they phrase their points. I won’t name the alternatives.
The other thing that still gives me that impression is the still near constant attention given to alt-med and anti-vax, although “science based medicine” to me should look at all aspects of medicine, especially conventional (which is what I use, and is NOT all science based. I mean, cmon, how’s about a post on the amount of money wasted on conventional cold remedies?). Yes, I know there have been a few.
Oh, and ita with windriven about religion.
Michelleinmichigan and zoe237,
Two kudos in one night!!!
I am honored. Thank you.
Actually, second base was about my range. I didn’t have enough arm for an outfielder.
As someone “who remained naive (unvaccinated) to polio, hepB, rotavirus, diphtheria, pertussis, measles, mumps etc.” when I was growing up, I got pertussis, measles, mumps and a few other illnesses. They were no fun! Fortunately, I didn’t have any serious side effects and managed to retain my fertility.
Also, fortunately, I managed to avoid polio, hepatitis and diphtheria and rubella(I may have had a diphtheria vaccination. They were available.) until effective vaccines were available. But we worried about them, especially polio and rubella, and I was very happy to get the first oral polio vaccine.
Having grown up in a family of five kids who all got those diseases and raised four kids who all got their vaccines, I much prefer the results with vaccination. But, that is mere anecdote.
Having followed these blogs for a couple of years and occasionally done a little research to inform myself before scribbling up a comment, I have noticed that the annual statistical data show a major drop in both incidence of the disease itself (such as measles) and major side effects like death following the introduction of effective vaccines.
For that reason, I continue to vote with my feet and got my seasonal flu shot last fall, got the H1N1 shot at a clinic at the school where I work and got (probably) the Tdap booster a few months ago.
Kleenhed,
Sorry I missed your comment earlier. I was a little busy.
Good luck in your study.
I agree with you about botox for alopecia. That even sounds weird. I wonder what plausible mechanism they are investigating for that to help!?!?
Coincidentally, I wasn’t on-line earlier because I was watching NCIS:LA, who did a show a few weeks ago called “LD50″ about a possible botox terror weapon. That is nasty stuff! It’s even worse than the polonium I did a little work with many years ago. (Fortunately, I wasn’t using the most dangerous isotope.)
Anyway, hang in there.
Dash
“Billyjoe – I’m not sure what you mean by a strait jacket…”
Just that if you “are known” for having certain opinions, and you have been set up as an opinion leader or have set yourself up as an opinion leader within a group of like-minded individulas, you may continue to hold onto those opnions when they are long past their use by date (though I don’t mean to imply that the use by date has come for your opinions)
kleenhed,
“At that point I turned my energies toward just dealing with acceptance of the fact that I was now a bald, eyebrowless, eyelashless, alien-looking creature. But damn it all, I wasn’t going to let it ruin my life, either.”
I love you already
)
(Actually, I happen to know someone with alpecia totalis and, I have to say, I’m strangely attracted to her . Unfortunately she has a very attentive husband
“Why those as opposed to a hundred and one different unproven remedies? Well, for starters I have to begin somewhere.”
I suppose I would have to be in your situation to understand that. I can’t ever see myself trying unproven treatments. (Hell, I won’t even get my prostate test – even though my father died of prostate cancer – because the test is of unproven value). But I’ve read too much about them and seen too many come and go to pay any heed to alternative medical treatments.
“My mother (a nurse) works with a woman who claims she cured her alopecia by taking B vitamins and zinc. Is that true? I have no idea.”
Have you seen any evidence that it does?
“especially the PB reference – I love that movie”
PB? I think you meant BP. But, yes, great movie. Though, in my opinion, EN heaped it over BP (but, then, I am not a woman).
regards,
BillyJoe
BillyJoe said: “Both vaccines and pathogenic organisms induce immune reactions and can cause disease.”
DoubleThimple said: “Well said. I just hope that other vaccine apologists will listen to you. Just a reminder though, they don’t want to hear about vaccine-induced diseases. It’s blasphemy. The sacrament of vaccination is sacred to them and its content is pure (yeah, pure crap).”
Typical of you to cherry pick your quote.
You forgot this bit:
“But here’s the BIG difference:
Pathogenic organisms cause disease a whole lot more frequently than vaccines, in many cases 100,000 to 1,000,000 times more frequently.”
OH, yes, and this bit:
“Now pith off.”
Zoe,
Dr. Gorski in particular seems very fair. Squirelelite, pmoran, calliarcale, jmb, windriven, Rosemary are a few of the commenters who are really knowledgeable, AND pay some attention to how they phrase their points. I won’t name the alternatives.
Oh, come on, why should I miss out?
Zoe,
No way! I don’t even watch Dr. House.
kleenhed,
I have had several patients with alopecia totalis but, fortunately, they were elderly men and didn’t consider it a problem. I am sure you have looked into where there is ongoing research on this. I wonder about the acupuncture caused response. There is evidence of hair follicle regeneration induced by abrasions via the Wnt signaling pathway. Just a thought about the possible mechanism for your experience.
BillyJoe – apparently it’s going to make me crazy. EN?
Well, BillyJoe, you’re certainly on my list of people whose comments are usually informative and make sense. But, any informal quick list like that is bound to be incomplete.
By the way, PB is The Princess Bride. I’m not sure about BP. Is that blood pressure or British Petroleum or something else?
I’m still waking up and my mind is about half speed this morning.
micheleinmichigan: “BillyJoe – apparently it’s going to make me crazy. EN?”
squirrelelite: “By the way, PB is The Princess Bride. I’m not sure about BP. Is that blood pressure or British Petroleum or something else? I’m still waking up and my mind is about half speed this morning.”
Sorry for the confusion. It must be me who’s half asleep. I was certain there was a reference to Tyler Durden back there somewhere. Tyler Durden was, of course, a character in the movie “Fight Club” played by Brad Pitt. So, when you said you love PB, I thought you got the letters reversed and meant BP for Brad Pitt.
EN is, of course Edward Norton who was second billed after Brad Pitt but played the lead character and narrator in the movie.
—————–
squirrelelite: “Well, BillyJoe, you’re certainly on my list of people whose comments are usually informative and make sense.”
Thanks, but I’m not certain that I deserve it. I am amazed by some of the posts I read here. I just try to contribute a little in return. But I was actually referring to this bit:
Zoe: “I won’t name the alternatives.
”
She was referring to “people who respond to a troll really nastily” for example those who respond “to th1th2 or whoever like a jacka$$”. That would be me and weing.
Th1Th2 is one of those individuals who doesn’t know what he is talking about and doesn’t know that he doesn’t know and therefore carries on like everyone else is an idiot. You cannot get through to them whatever you try and if you ignore them they feel they have a victory – I silenced the critics! Fun and games is the order of the day in my opinion.
Ahhhh, That was my Tyler Durden reference (in another article) and strangely when I saw EN I thought. Edward Norton? He’s not in the Princess Bride.
I got an EN preference too, and I’m chick.
At least you guys are funny when you do it… just sayin’ though, if you haven’t read here before. Th1th2 has posted only 4 comments on this thread, none particularly trollish (just wrong). Yet about five people called him an idiot. So I can see why people might get that impression about this site in general, and I’ll say that we two certainly aren’t the only ones.
Also add that his/her comments provided a really good opportunity for education (for lurkers). A heck of a lot of parents think they are injecting their kid with a disease. It just doesn’t feel right, if you don’t understand the science, to give your kid a shot of polio of whatever, especially when you have no personal experience with the disease. And then you have these facts versus these facts, people don’t know who to believe… and it seems to them that “sciencey” people are a lot snottier/holier than thou.
Believe me, I’ve reflected on this with regard to my absolute disdain of religion. Not that I don’t appreciate some snark sometimes still.
Hey! I actually answered with something that somewhat agreed with him! (The OPV did cause polio, which is why developed countries now use IPV)
I did not call him an idiot here.
I have called him a liar on another thread where he posted within a few hours that he actually administered vaccines and then claimed that they went directly into the bloodstream! Um, yeah. There seems to be a disconnect of reality in those two statements.
Chris,
There is no hope for you. It is a shame that not even one medical expert in this so-called “opinion-based” board can even support to defend your stance.
Thimple1Thimple2
I’m going to let you have the last word.
No, really.
If you post below this space, no matter what you say, I promise not to respond.
In fact, I promise not even to read it.