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The Huffington Post‘s War on Medical Science: A Brief History

I realize that our fearless leader Steve Novella has already written about this topic twice. He has, as usual, done a bang-up job of describing how Arianna Huffington’s political news blog has become a haven for quackery, even going so far as to entitle his followup post The Huffington Post’s War on Science. And he’s absolutely right. The Huffington Post has waged a war on science, at least a war on science-based medicine, ever since its inception, a mere two weeks after which it was first noticed that anti-vaccine lunacy ruled the roost there. Because I’ve had experience with this topic since 2005, I thought I’d try to put some perspective on the issue, in order to show you just how pervasive pseudoscience has been (and for how long) at the blog whose name is often abbreviated as “HuffPo.”

ANTI-VACCINE LUNACY AT THE HUFFINGTON POST

My disdain for The Huffington Post’s treatment of medical science goes way, way back–all the way back to its very beginnings. As I mentioned before, a mere two or three weeks after Arianna Huffington’s little vanity project hit the blogosphere, I noticed a very disturbing trend in its content. That trend was a strong undercurrent of antivaccination blogging. At the time, a “friend” of mine pointed out how Santa Monica pediatrician to the stars and “vaccine skeptic” Dr. Jay Gordon (whom both Steve and I have discussed) had found a home there, along with David Kirby, author of the mercury militia Bible Evidence of Harm (and who has been a regular punching bag of mine for at least four years, and deservedly so), and Janet Grilo.

This was right from the beginning.

These anti-vaccine “luminaries” were soon joined by Robert F. Kennedy, Jr (whose anti-vaccine activism I have discussed before) and more recently by Deirdre Imus, the driving force ramping up the antivaccinationist mercury militia proclivities of her husband, aging shock jock Don Imus. (Indeed, if Jenny McCarthy didn’t exist, Deirdre Imus would get my vote for the antvaccine zealot who routinely says the most astoundingly ignorant things about science.) Although we don’t hear much from Grilo or Gordon anymore, other than an occasional specious analogy between tobacco companies and the pro-vaccine stance of the CDC and AAP or nonsense about Tamiflu, unfortunately we do hear from Kirby, Imus, and Kennedy on a fairly regular basis, all on The Huffington Post, with one of the few voices of reason when it comes to vaccines being Arthur Allen, author of Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver. Unfortunately, Allen has not posted to HuffPo in a long time. Given this history, it’s not for naught that on occasion I’ve referred to The Huffington Post “Arianna’s Home for Happy Antivaccinationists” and noted that it’s been seriously questioned whether it could ever do a real science section.

Meanwhile, while anti-vaccine “luminaries” such as David Kirby and RFK, Jr. regularly delivered the anti-vaccine propaganda on HuffPo, former Media & Special Projects Editor of The Huffington Post, Rachel Sklar was quite impressed with McCarthy’s antics on CNN back in April 2008, when McCarthy shouted down pediatricians and scientists who tried to refute her scientific ignorance. Since then, she has e-mailed me to argue that she is not “anti-vaccine,” and I will take her at her word, but she sure could have fooled me with her breathless praise of Jenny McCarthy’s boorishness last April on Larry King Live. Soon after, Alison Rose Levy joined her. In recent days, I’ve learned that Levy also happens to be a booster of other forms of unscientific medicine and was recently very impressed with the testimony of Dean Ornish, Andrew Weil, Mehmet Oz, and Mark Hyman, at the Institute of Medicine that I discussed earlier this year, arguing that their talks were nothing more than the same old pseudoscientific justifications for “integrating” pseudoscience and faith-based medicine with science-based medicine. Indeed, of late, HuffPo even invited a managing editor of the antivaccine propaganda blog Age of Autism, namely Kim Stagliano, to blog for it. It doesn’t get more anti-vaccine than that–one of the “editors” of the most prominent anti-vaccine blog promoting the scientifically discredited idea that vaccines somehow cause autism.

Finally, just a little more than a week ago, surprising me, given that I had been waiting for Jenny McCarthy to make an appearance as a blogger on HuffPo, her much more famous boyfriend, Jim Carrey, started blogging for HuffPo with an incredibly inane bit of anti-vaccine propaganda entitled The Judgment on Vaccines Is In??? In it, Carrey regurgitated all manner of anti-vaccine talking points, including the “toxins” gambit (apparently Dr. Jay never warned Carrey just how much it reveals Carrey’s ignorance to use the “formaldehyde” or “antifreeze” in vaccines gambit); parroted the intellectually dishonest Generation Rescue “study” that tries to correlate the vaccine schedules of various nations with their autism prevalences (which I discussed here) and its equally intellectually dishonest “Fourteen Studies” website (discussed by Steve, leading to an all-out personal attack on him by J.B. Handley; Mark; and, of course, me). Suffice it to say, the intellectual incompetence on display by Carrey was very reminiscent of at least one of characters he used to play on In Living Color back in the 1990s. The post even had a similar structure to one of his old sketches.

There is little doubt that the blogging culture of HuffPo is steeped in anti-vaccine pseudoscience. If that were all that’s wrong with HuffPo, it would be bad enough. But it’s not. This year, HuffPo blogging has taken a turn for the worse. For HuffPo, this year is the year of the quack.

2009: THE EMERGENCE OF RANK QUACKERY IN THE HUFFINGTON POST

HuffPo has been home to more than just anti-vaccine propaganda over the years. Perhaps the most famous example is the regular appearance of that maven of “quantum” healing pseudoscience, Deepak Chopra (whose IntentBlog often crossposts the same nonsense), who of late has become a point man in the battle to coopt President Obama’s plans for health care reform in order to insert unscientific ‘alternative medicine” under the guise of “wellness” and “prevention.” On the HuffPo, he has laid down all sorts of nonsense about dualism, “intelligent design” creationism, universal consciousness, and “quantum” healing. All of this is standard fare for Chopra, and, for the most part, that’s as far as HuffPo went into dubious medical science outside of vaccines. Indeed, before 2009 advocacy of rank quackery not related to vaccines in the HuffPo has been relatively slight.

In 2009, that changed. Big time. Enter licensed acupuncturist, certified clinical nutritionist, and a homeopath (not to mention HuffPo’s new “Wellness Editor”). Here is how she is described in her bio:

She has a Master’s Degree in Traditional Chinese Medicine and a Doctorate in Homeopathic Medicine. She is the founder and Medical Director of the Santa Monica Wellness Center and the author of the best-selling, award-winning The Detox Solution: The Missing Link to Radiant Health, Abundant Energy, Ideal Weight, and Peace of Mind. You can learn more at TheDetoxSolution.com.

On HuffPo, Patricia Fitzgerald has recommended a “spring cleaning” for your liver for “detox” and praised Jenny McCarthy and her promotion of “biomedical” quackery for autism. I can’t help but speculate that in this case, the correlation between Fitzgerald’s arrival and the major uptick in the number of posts touting unproven and pseudoscientific medical practices on HuffPo may well equal causation, even though Fitzgerald appears to be relatively careful not to go too far off the deep end in terms of the health care practices she advocates on HuffPo. She, at least, is apparently smart enough to qualify them and stick mostly with diet and exercise as her cure-all.

Ramping up the woo a bit more into Deepak Chopra territory is Srinivasan Pillay, “certified master coach, psychiatrist, brain imaging researcher and speaker,” whatever that means (other than psychiatrist). As Peter Lipson has pointed out, his “brain imaging” publications in PubMed are pretty darned sparse, mostly functional MRI studies, which are very difficult to do correctly in order to obtain any correlations or useful data. If his HuffPo presence is any indication, I hate to think what he’s doing with that fMRI machine. His first major “contribution” was an article entitled The Science of Distant Healing, in which he purports to present the “scientific evidence” for distant healing. Distant healing, for those who may not be aware, is the magical belief that just by sending one’s “intent” or wishes to a distant person one can actually heal that person or send one’s “intent” to him or her. I say “magical” belief because there really isn’t any other word to describe it. There’s no scientific or physical mechanism by which it can occur, at least none that scientists have yet been able to find. His followup post, with Pillay seemingly irked at all the criticism he received for his distant healing article, was aptly entitled Why Rational Thinking Is Not All It’s Cracked Up to Be. In it, he concludes that, because humans are irrational, science can never be rational, never realizing that the scientific method itself is a system designed to minimize the effects of human cognitive biases and shortcomings on the observation of nature. Steve Novella had some real fun with the nonsense in this post, and I can’t say that I blame him.

Still, like Fitzgerald, Dr. Pillay is relatively careful to stay in the rather mystical quantum world of Deepak Chopra and not to directly advocate anything clearly dangerous. The same cannot be said of other bloggers, as not long after Fitzgerald’s arrival a new quackery apologist lit up HuffPo with some of the most outrageously dangerous quackery I’ve seen in a long time.

I’m referring to Kim Evans, “author of Cleaning Up! and the creator of The Cleaning Up! Cleanse, a powerful body cleanse that addresses deep levels of toxicity throughout the body and a common fungal problem, candida overgrowth.” She goes on to describe herself in her bio:

Kim believes that toxicity in the body is at the root of most all disease and impacts us in ways spiritually that perhaps defies current spiritual understanding. She also believes that most disease can be permanently removed from the body with deep body cleansing, upgrading your on-going diet and consciously avoiding common toxicity sources.

Kim has spent thousands of hours researching, studying, cleansing and experimenting with different cleansing techniques and has eliminated more than a dozen problems in her own body – including several problems that medical doctors had no solutions for. She’s given people information that when they applied it, eliminated their health problems and had medical doctors adding years to their life expectancy – in addition to asking what they were doing so they could pass the information along to their patients because they had “never seen anything like it.”

Regular readers of this blog can predict the sorts of nonsense that Ms. Evans has been laying down about “detox” and colon and liver “cleanses.” And lay it down she has, claiming that “detox” can get rid of fungal infections which, she claims that 90% of us have. Of course, 90% of us do have candida albicans growing on or in our body somewhere, but in the presence of a competent immune system, it doesn’t cause any problems. That’s not what Kim Evans is saying. She’s claiming that 90% of us have “overgrowth” or are infected with candida.

Steve has already discussed Kim Evans’ quackery advocacy twice, pointing out that her claim that antibiotics cause cancer and that fungus is cancer is rank quackery and that her defensiveness over the criticism that she is promoting pseudoscience is, in fact, an excellent example of how pseudoscientists think, rife with logical fallacies, postmodernist nonsense and tu quoque, as did a certain “friend” of mine. However, because I’m a surgical oncologist, I can’t help but briefly discuss one aspect of Kim Evan’s world view that disturbs me greatly. Specifically, it’s her belief that Dr. Tullio Simoncini is correct about cancer.

DANGEROUS CANCER QUACKERY

So who is Dr. Simoncini? He’s an Italian physician who claims to be an oncologist, whose claim to fame is the invention of the quackery–yes, quackery–that claims that cancer is in reality a fungus and that all cancer can be treated and cured with sodium bicarbonate. Here is a video in which Simoncini describes how he came to this conclusion as he hawkshis book Cancer Is A Fungus, makes the argument that fungus is the One True Cause of Cancer and that the medical establishment is Too Deluded or Too Blind to realize it:

Worse, Simoncini proposes a treatment that, even if cancer were a fungus, is completely implausible and wouldn’t work. Indeed, we don’t treat fungal infections that way even when we are treating a clearly diagnosed fungal infection. You can get an idea of just how quacktastic this video is by listening to Dr. Simoncini opine in the first couple of minutes of the vide that whenever he sees a cancerous tumor in the body, the lumps are “always white.” He emphasizes this amazing observation several times, so apparently important is it. Yes, that was the observation that supposedly led him to his idea (I refuse to dignify it with the term “hypothesis”) that tumors are in fact due to fungus. In response, the host gushes about how brilliant that is and how obvious it is. Just crush up a mushroom! Of course, it would be a major blow to Dr. Simoncini’s idea, would it not, if not all mushrooms are white. Truly, Dr. Simonici has demonstrated the the ultimate in taking a flawed observation and running with it straight off the cliff, as this description of his book shows:

The book “Cancer is a fungus” describes how a fungous infection always forms the basis of every neoplastic formation, and this formation tries to spread within the whole organism without stopping.

I also have to wonder what kind of oncologist Simoncini is if that’s all he’s seen. From my experience as a surgeon, it’s trivial for me to tell you that not all tumors are white. Many are, but a lot of them are brownish-colored, tan, or even greenish-colored. (Uh-oh, better not let Dr. Simoncini know that; that’s fungus color we’re talking!) And what about leukemias and other blood cancers? Dr. Simoncini then shows a bronchoscopy and thoracoscopy demonstrating white tumors. I’m supposed to be impressed by this? He also argues that in reality cancer is due to “excess acidity” that allows the fungus free rein.

So what is the answer, according to Dr. Simoncini? Baking soda. Yes, baking soda, a.k.a. sodium bicarbonate. Dr. Simoncini injects sodium bicarbonate into tumors and claims to be able to cure any cancer using these injections. One thought that immediately comes to mind whenever I see a claim like this is: If Dr. Simoncini can actually do what he claims he can do, where are his publications? Where is his Nobel Prize? To be able to cure cancer by something as simple as injections of sodium bicarbonate directly into tumors would be such an incredible breakthrough that there’s no way it could be kept quiet. Yet somehow only Dr. Simoncini knows this remedy, which is not only physiologically incredibly implausible and isn’t even used to treat real, biopsy- or culture-proven fungal infections but has no evidence to support it. There’s a whole culture of acid-base quackery that I’ve been meaning to write about in more detail, and Dr. Simoncini would be right up there among its chief “practitioners.”

Not surprisingly, Dr. Simoncini has been a focus of attention for the Italian health authorities.All I could find was this thread on the JREF forums. According to various commenters, not only was Dr. Simoncini expelled from the Italian Medical Order (Ordine dei Medici e Chirurghi) but he was condemned in the first degree by an Italian court for cheating and homicide. Here’s one report from a woman by the ‘nym of JennyJo:

I live in the Netherlands.

Last year, tullio simoncini was giving his treatments with sodium bicarbonate in a private clinic for alternative ‘medicine’ in Bilthoven in the Netherlands.

October 2007, a woman with curable breast cancer, who was afraid of operation and chemo therapy, came into contact with simoncini and was treated by him. He injected large doses of baking soda into her breast.

On the fourth day of the therapy, the woman became very ill and was transported to a university hospital in Amsterdam, where she died the following day.

The matter is since under investigation by the Dutch Justice Department. Simoncini denies he ever treated the woman, although various staff members have seen him administering injections. The clinic maintains the woman died of dehydration (sic).

More application of science to Dr. Simoncini’s quackery can be found at Cancer Is Not A Fungus and, of course, the Quackwatch affiliate Cancer Treatment Watch. There’s just so much wrong with Simoncini’s ideas that at some point I may well jump into the ring myself with a more detailed explanation of just what is so wrong and why. Suffice it to say Dr. Simoncini is without a doubt the very picture of a quack. Also suffice it to say that Kim Evans believes in Simoncini’s quackery and views him as “persecuted,” as this comment by her reveals:

Tullio Simoncini, yes, he had his license revoked, and there are reasons for that. In modern medicine today, medical doctors must practice standard accepted procedures, and if not, their license is in jeopardy. Let’s be clear, Dr. Simoncini was not going the standard and accepted chemo and radiation route. He found something far more effective and posed no harm to the patient. But because it was outside standard practice, he had his license revoked. Unfortunately, vitamin and herbal therapies also fall outside standard accepted practice, and are not often taught in medical school, as this community seems to think that only drugs are effective and little else plays a role in the body.

There are plenty of videos on the net if you care to watch Dr. Simoncini pour an alkaline solution of baking soda and water as close to a tumor as possible, and have the tumor disappear, often in a matter of days. While I grant that it is possible that Dr. Simoncini could be wrong about the cause of the tumor (I don’t believe he is, but for arguments sake, I’ll allow that possibility), I find it hard to believe that after graduating from oncology school he doesn’t know what a tumor looks like. Or that the videos showing the tumors being eliminated were somehow not eliminated or not tumors to begin with. So, even if the cause was incorrect, the fact that these tumors are being quickly eliminated seems pretty straight forward.

To Evans, Simoncini is a persecuted martyr for the One True Cause of Cancer who’s being attacked because he’s supposedly better at curing cancer than “”outside of standard practice.” Never mind that it has zero physiological plausibility, relies on a model of cancer causation that is trivial to demonstrate to be utterly incorrect, and has zero evidence other than the lowest quality testimonials to support it. Never mind that it’s never been convincingly demonstrated that injecting anything into a large, established tumor will cure it, much less solutions of baking soda. Never mind that Simoncini has been directly linked to the deaths of patients from his quackery. Again, if Simoncini could really do what he claims and demonstrate it to accepted scientific standards, the Nobel Prize is his. I suspect, however, that the Nobel committee won’t be considering him any time soon.

This is the sort of irresponsible promotion of outright quackery that HuffPo permits within its pages, but it doesn’t end even there.

SWINE FLU QUACKERY AT HUFFPO

Given the recent scare over the likelihood of a swine flu pandemic, the quackery level has ramped up even more at HuffPo, led by (who else?) Kim Evans, who penned a post called Swine Flu: Protect Yourself and Loved Ones. In this post, Evans is more than willing to recommend her detox quackery to protect against swine flu:

Cleansing involves changing your internal environment and specifically, removing a bunch of the stored waste that most people have trapped in their bodies. Most estimates are that the average person has ten or more pounds of stored waste just in their colon, and I’d argue far more throughout their body. In any case, many people have found that disease disappears when this waste is gone, and that when the body is clean it’s much more difficult for new problems, like viruses, to take hold in the first place. And it’s my understanding that many people who took regular enemas instead of vaccines during the 1918 pandemic made it out on the other side as well.

That’s right. Evans is recommending enemas and “detox” quackery to protect yourself against the swine flu. I can tell you one thing; this woman is utterly ignorant of history.There was no vaccine against influenza during the 1918 influenza pandemic. In fact, influenza vaccines were only developed widely available during World War II, where they were used to protect our soldiers. After the war, development of the vaccine continued. Moreover, there are not–I repeat, not–ten or twenty pounds of “stored waste” in the colon that are making people sick, and it especially isn’t feces in your colon that gives you the flu. Any surgeon who’s ever operated on the colon regularly (as I used to do until I subspecialized) or gastroenterologist who does endoscopy knows this to by a myth, but it’s the basis of so much enema quackery, as is the belief that the liver needs “help” dealing with these unnamed “toxins” through purging and enemas. Indeed, this obsession with “toxins” and poo caking the inside of the colon is nothing more than the alt-med version of the religious belief that one is “unclean” and desperately needs “purification” in order to achieve righteousness but all the enemas in the world won’t purify believers in this woo. They always think they are “toxic.”

Next up is Matthew Stein, who wrote a post entitled When a Superbug Strikes Close to Home, How Will You Deal With it? (also published in a patently unreadable form on Stein’s own website). After a whole lot of fear-mongering over “superbugs” and swine flu, Stein presents his answer:

The good news is that there are many alternative medicines, herbs, and treatments that can be quite effective in the fight against a wide variety of viruses and antibiotic-resistant bacteria, to which mainstream high-tech Western medicine has little or nothing to offer. The bad news is that 99 percent of the doctors in our hospitals are not trained in these alternatives, and don’t have a clue about what to do when their pharmaceutical high-tech medicines fail to heal. If you wait until a pandemic starts, you will have only a slim chance for locating an available health practitioner familiar with alternative herbs, medicines, and methods. In the words of Robert Saum, PhD, the typical attitude amongst most of his medical colleagues in this country is, “If I didn’t learn it in medical school, it can’t be true.”

That’s right, according to Matthew Stein, there are all of those “natural cures ‘they’ don’t want you to know about” for all those nasty, horrible, resistant bacteria. And, of course, those nasty, close-minded “allopathic” physicians are too clueless or prejudiced against them to learn about them or offer them to you. Even better, they will heal when the products of big pharma fail. So says Stein, who even claims that homeopathy could be an answer, citing an article Could Homeopathy Prevent a Pandemic?:

Do we have alternatives? During Spanish flu pandemic of 1918, which killed up to 50 million people worldwide, homeopathic physicians in the U.S. reported very low mortality rates among their patients, while flu patients treated by conventional physicians faced mortality rates of around 30 percent. W.A. Dewey, MD, gathered data from homeopathic physicians treating flu patients around the country in 1918 and published his findings in the Journal of the American Institute of Homeopathy in 1920. Homeopathic physicians in Philadelphia, for example, reported a mortality rate of just over one percent for the more than 26,000 flu patients they treated during the pandemic.

Today, a number of homeopathic remedies for the flu are available, including oscillo, or oscillococcinum, which has been shown to shorten the duration of symptoms when taken within 48 hours of onset. Homeopaths have been given this remedy since 1925. Interestingly, it’s made from the heart and liver of ducks, which carry flu viruses in their digestive tracts.

“Based on clinical studies, homeopathy produces some of the fastest results in relieving flu symptoms,” says Dana Ullman, MPH, the author of nine books on homeopathic medicine.

Anyone who’s been a regular here for a while probably remembers Dana Ullman, the homeopath who seems to have a lot of time on his hands to Google himself for new mentions on blogs and then infest blogs that criticize him and homeopathy. I have little doubt that he will show up here. If you want the best deconstruction of Ullman’s nonsense, check out the new Internet law that my coblogger Kimball Atwood laid down about him:

In any discussion involving science or medicine, being Dana Ullman loses you the argument immediately…and gets you laughed out of the room.

How true. Moreover, Stein’s falling for the same old claims by homeopaths that somehow patients treated with homeopathy only suffered a 1% mortality compared to conventional physicians, whose patients supposedly suffered a 30% mortality. As co-blogger David Kroll pointed out a couple of years back, these are the same sorts of nonsense claims that were trotted out during the avian flu scare. Of course there’s a big problem here. No doubt homeopaths reported low mortality, but was there any objective evidence that they actually observed such low mortality in their patients? What about selection bias, where the less severely ill patients chose real medicine instead of homeopathy? How do we know that patients who got sicker under the homeopaths’ care didn’t go to real physicians or die without being followed up? Do we know that the homeopaths’ patients were comparable to the patients treated by “conventional” medicine? We don’t. Finally, if the peer review of the Journal of the American Institute of Homeopathy is anything like the peer review of homeopathy journals in 2009, I don’t have high hopes that Dewey’s article was subjected to anything resembling rigorous peer review. That hasn’t stopped it from being trotted out in the intervening 90 years since the Spanish flu pandemic by homeopaths every time a flu pandemic or flu scare comes up. Truly, it is a zombie study that just won’t die, and a HuffPo blogger is promoting it.

But that’s not all Stein is promoting. He’s also promoting something called the Beck protocol, which consists of:

  1. Blood electrification
  2. Colloidal silver
  3. Magnetic pulsing
  4. Ozonated water

The Beck protocol could take up an entire post on its own, and perhaps someday I will write one. In fact, each of the four elements of the Beck protocol could be the topic of its very own post, and perhaps I should do a four-parter. However, in the meantime, regular readers should recognize that each of these four elements is quackery. But even that level of quackery isn’t enough for Stein. He finishes with a list of a veritable panoply of herbalism, supplements, and other dubious remedies to “protect yourself” against the swine flu.

Most recently, another HuffPo blogger, Lisa Sharkey, opined in a post entitled What Most Doctors Won’t Tell You About Preparing for the Swine Flu:

What can I do to keep my family safe? How can I boost our immune systems now and what complementary medicines can I begin taking immediately, regardless if I ever come in contact with the dreaded Swine Flu?

You know what sort of answers are coming, I bet. That’s right: Supplements, herbalism, homeopathy, reflexology, tapping, this post is a veritable cornucopia of quackery for swine flu, with Sharkey touting it all as “immune-boosting.”

She even prefaced her post with the typical “dodge the FDA” disclaimer:

Author’s note: This swine flu story on alternative and complementary medicine is not meant to replace anything you hear from you doctor, the WHO or the CDC, but is meant to show you some natural ways to enhance your overall wellness in addition to any medication you may need either to prevent or treat the flu.

Very appropriate, I would say. Too bad the rest of HuffPo’s health bloggers don’t add the same disclaimer to their posts.

WHY IS HEALTH PSEUDOSCIENCE SO INGRAINED AT THE HUFFINGTON POST?

Seeing the pervasiveness of anti-vaccine views, New Age mysticism and pseudoscience à la Deepak Chopra, and, most recently, outright quackery at HuffPo, one is left to ask: Why? Why is health pseudoscience and even outright quackery so pervasive at HuffPo? Why is it that (as I have been told) so many commenters who try to counter this nonsense find that their comments are “moderated” (a.k.a. censored), as I myself have experienced when trying to counter anti-vaccine posts I’ve seen on HuffPo. Why is it that a woman who so profusely praised President Barack Obama in an editorial about his first 100 days for reversing the Bush Administration stand on embryonic stem cell research, runs such a site so full of quackery? Huffington in particular praised Obama’s statement that it is “about ensuring that scientific data is never distorted or concealed to serve a political agenda, and that we make scientific decisions based on facts, not ideology.” I agree. It’s a fine sentiment, long overdue after the Bush administration. Too bad Arianna Huffington doesn’t apply President Obama’s sentiment to her own blog and kick out the quacks and pseudoscientists.

But then the question is, once again, why? Why doesn’t Huffington kick out the quacks? Part of the answer, at least, is suggested in an article in The New Yorker that appeared about her last fall entitled The Oracle: The Many Lives of Arianna Huffington, in particular these excerpts:

During a student-group fair, Huffington toured the chambers of the university’s debating society. Since girlhood, she had possessed a spiritual impulse, studying Hinduism and fasting on the name day of the Virgin Mary.

Huffington’s business and spiritual pursuits merge in her interest in human-potential movements, the sorts of popular groundswell that, as she once wrote, will provide us, in “a new age that is being born,” with “an opening for great possibilities of new being, for a breakthrough in our evolution.”

Over the years, Huffington has been touchier about her relationship with John-Roger, the baby-faced spiritual leader of M.S.I.A., who was born Roger Delano Hinkins in Rains, Utah, in 1934, and, in 1963, rechristened himself upon his emergence from a nine-day coma induced by kidney-stone surgery. In an investigation published in the Los Angeles Times in 1988, the reporters Bob Sipchen and David Johnston linked John-Roger—whose students believe that he has unique access to a power called Mystical Traveler Consciousness—to financial and sexual improprieties. (John-Roger stated, through a spokesman, that the allegations “remain as untrue today as when they were first published.”) His views on the body are certainly unusual: In “Sex, Spirit & You,” he writes, “When a woman has a history of blocking her creative flow and shutting off this area of expression by pushing the energy back down into the creative center, she may develop many problems related to her menstrual flow.”

The couple eventually embarked on a period of metaphysical inquiry that alienated some of their friends and colleagues as much as it entertained the press. Christopher Hitchens wrote, “Let the record show that in October 1979. . . Bernard Levin achieved the total state of self-absorption towards which he had been moving for so long. The venue was the Café Royal: amid incense and vaguely Oriental music, flanked by his companion, Levin rose and told a large invited audience how they could be ‘changed,’ by investing £150 in a 50-hour ‘Insight training.’ ” (Insight was founded by the spiritual leader John-Roger, with whom Huffington has remained affiliated. Huffington denies that incense and Oriental music played a role in the event.) When Levin died, in 2004, his obituary in the Times noted that Huffington’s “interest in mystic cults . . . was to lead him into one of the more embarrassing episodes of his journalism—his hyperbolic praise through a number of columns of the self-promoting guru, Bhagwan Shree Rajneesh.”

Christopher Hitchens, even when I don’t agree with him (which is fairly frequently on political topics), always has a way with words. And, most impressively, there is this descriptoin of Arianna Huffington:

Through all her incarnations, Huffington’s interest in mass movements, human potential, and the improvability of man has been as consistent as her suspicion of pharmacology, utilitarianism, and Skinner boxes. Her own life may be her greatest project.

In five decades of self-improvement, she has tried fire-walking, list-making, journal-keeping, mercury detoxification, homeopathy, chiropractic, infrared saunas, microdermabrasion, est, and—she writes in her 2006 book, “On Becoming Fearless”—“the Beverly Hills diet, the all-brown-rice diet, the grapefruit diet, the cabbage soup diet, the no carbs, no fat, indeed no calories diet.” Her daily regimen includes yoga, meditation, and prayer.

In other words, in this article, at least, Arianna Huffington comes across as a credulous New Age believer, flitting from one woo to the next, one quackery to the next, with no apparent understanding of why they are woo and quackery. Anyone who can embrace homeopathy uncritically is not someone who runs her life from a science-based perspective, all of her praise of President Obama’s sentiments about science and all of her claims not to be a relativist described in the New Yorker article notwithstanding. It is thus not surprising that her political blog would reflect this. However, until recently HuffPo’s bad medical science was primarily limited to its support of anti-vaccine bloggers such as David Kirby, Kim Stagliano, Robert F. Kennedy, Jr., and, most recently, Jim Carrey. Recently, however, HuffPo’s promotion of pseudoscience has accelerated.

WHAT TO DO?

In the wake of the recent surge in quackery promotion on HuffPo, there has been a debate in the blogsophere over what, if anything, can be done. My co-blogger Peter Lipson has described the promotion of quackery on HuffPo as a “dangerous assault on medicine” and suggested a “Vendetta!” of sorts, in reality a letter-writing campaign in which writers are urged to present “specific examples of their malfeasance, and asking them to consider altering their editorial policy on health issues, for the sake of morality, health, and humanity.”

Although I understand the sentiment, sadly, I don’t think that it will do that much good, unless it somehow impacts HuffPo’s bottom line in terms of the page views that determine advertising rates. The antivaccine nonsense, for example, has been very deeply ingrained in HuffPo blogging culture from the very beginning. I highly doubt, for instance, that Arianna would ever kick Robert F. Kennedy, Jr. off of HuffPo or allow any of her editors to do so. He’s just too high profile a liberal voice. Similarly, given how the influx of outright quackery has coincided with the tenure of the new “wellness editor,” I highly doubt that, short of removing her, any level of complaints will dislodge the quacks. I’d love to be wrong, but I fear I’m not, which is why I don’t think it’s a bad idea at least to try to deluge the editors with complaints about the recent spike in quackery blogging on HuffPo, the most irresponsible and utterly opportunistic of which are the claims by various charlatans that homeopathy or “detox” regimens can somehow protect you from the swine flu or that “cancer is a fungus” and sodium bicarbonate can cure it.

Janet Stemwedel, who blogs at Adventures in Ethics and Science, echoes a question I’ve been asking myself for a while now, namely whether to engage with The Huffington Post:

Should scientists and physicians try to do something about this?

Sure, blogular dissections of problematic HuffPo posts count as responses, and I know a great deal of work goes into countering flaky reasoning with logic while preventing one’s own head from exploding. But it’s not clear how many of the responses to HuffPo posts arguing that enemas and prayers will be sufficient to protect us from swine flu are getting to the large HuffPo audience.

Hypothetically, if HuffPo invited a scientist or physician to write an article, would it be a good idea or a bad idea to accept the offer? Would it help the HuffPo readers? Would it hurt the scientist or physician?

I don’t know the answer to that one. On the one hand, any respectable physician or medical scientists who blogs about health on HuffPo runs the risk of taint by association, along with a deluge of HuffPo CAM aficianados shouting “pharma shill” in the comments. Moreover, such a person risks being coopted by HuffPo’s editors as “evidence” that HuffPo does provide an outlet for science-based blogging about health. On the other hand, HuffPo has a very large readership, far larger than even the most popular of science bloggers. Granted, it’s the front page political blogs that drive most of the traffic, and it’s unclear how much traffic that the many dozens, if not hundreds, of other blogs on HuffPo actually garner. Still, there’s no doubt that, if it continues on its current path, HuffPo may someday rival Whale.to, Mercola.com, and NaturalNews.com. Should medical scientists try to stop that by “joining up,” so to speak? And what would be the price? More importantly, would joining up be more effective in muting the cheerleading for quackery on HuffPo than remaining outside and ruthlessly criticizing and mocking examples of it? Should we try to “fight from the inside” or “attack from the rear”?

Again, I don’t know the answer to this question. However, this question is somewhat more than hypothetical, which is why I need to contemplate it further. In either case, something needs to be done to counter HuffPo’s war on medical science.

Posted in: Cancer, Health Fraud, Herbs & Supplements, Homeopathy, Politics and Regulation, Science and the Media, Vaccines

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40 thoughts on “The Huffington Post‘s War on Medical Science: A Brief History

  1. SD says:

    Govorit’ Cde. Gorski:

    “What is to be done?”

    Well, here’s an idea:

    Why don’t you establish a directory of this shit, like snopes.com? Build a reputation. Give people one place that they can reasonably trust to find information. Rate it, on some simple numerical scale boiled down to a known composite, say on a scale from 0 to 10. “The Gorsk-O-Meter gives this treatment a 3.3 (Not Recommended).”

    TELL THEM WHY YOU RATE IT THE WAY YOU DO. e.g.

    “This treatment was evaluated and received a score of 0.3 for the following reasons:

    (*) No studies showing it to be useful [-1]
    (*) Two studies showing it to be harmful: (cite studies) [-1 each]
    (*) Reputation of the doctor pushing this treatment is questionable (cite reasons) [-1]
    (*) Analysis of the doctor’s patient survival past five years shows him to have a poor success rate [-1]”

    &c.

    Make the calculation unweaselable, and update it. If flaws are identified, update the rating. Make it knowable, in advance; a man sitting in Timbuktu with a thirty-year-old Soviet-make electronic calculator should be able to produce the same rating that you do, given a printout of your criteria. Your criteria should fit on an 8.5×11″ piece of paper.

    Allow patients to post their anecdotes. Perform basic screening. Flag these as “anecdotes”, along with a boilerplate warning: “Anecdotal evidence can be compelling! Everybody knows of one person who won the lottery. Not everybody wins the lottery, though. Do a lot of reading about a treatment – both in support of a treatment, and against it – before you commit to a decision that can damage your health. Ask lots of questions. Use the library. Use your brain. Use a lot of other people’s brains, too.” Solicit negative anecdotes, too. Anecdotes may not be data of the type that you would prefer to have, but they *are* data of a sort, and they *are* compelling. Produce a composite metric of these anecdotes to see how popular the treatments are. If the metric isn’t a number you like, then find out why it’s so damned popular. Maybe you missed something.

    If you don’t think a CAM treatment will hurt, say so, even if it won’t do any good either. “I doubt that a diet of apricot mush will accomplish anything, even though it’s probably a mighty tasty way to eat healthy. I doubt that coffee enemas will accomplish anything, either, although it’s great for constipation and very conveniently lets you load up on caffeine without interfering with your ability to talk on the phone.”

    Let people read the actual studies, without excerpting or “interpretation”. Encourage open access to that information, “free” as in both beer and speech. Help people to find it. Enable commentary on it.

    Be fair. Be SCRUPULOUSLY fair. Fry a medical treatment once in awhile, and do it visibly. (SBM the blog does this, but I’m just reinforcing the point.) “Why are doctors doing this? The Gorsk-O-Meter gives beta-blocker therapy for Condition X a 1.2 (EPIC FAIL).” Or whatever. Take the heat for it. Be proud. Show neither fear nor favor.

    Give people lots of exit points. Make it “easy” to defect from CAM. Do a few thoughtexperiments about “What if someone did CAM for one year for Condition X and decided to abandon it – what could we do then? Could we make any useful blanket recommendations about what to do to enable them to not cut off their retreat from CAM by accident? Could we suggest self-evaluation timeframes that would catch the worst negative effects and still permit people to ‘try it’ before they move to useful treatments?”

    Have automated questionnaires and tests. Make it fun to participate.

    Acknowledge the absolute right of the patient to get (and pay for) the treatment they want, even if you don’t think it’s a good idea. Do not, by word or deed, interfere with that right. People are entitled to be stupid, up to and including to the cost of their own lives, without interference. Acknowledge the fact that we live in the digital era, in the age of the Internet, and that you no longer have any control over information. Acknowledge that we live in an age where people want free, and want custom, and want *what they want*, *when they want it*, and see absolutely no reason at all why they shouldn’t be able to get it. Acknowledge that this is a completely reasonable way to act and think. Act accordingly.

    Acknowledge that you are going to lose some, through no fault of your own, and this is part of the price of freedom. Mourn, and move on.

    Help people. Can the smarmy attitude; nobody likes a smartassed servant, and *that is what you are*. You *serve* your customers; you are not their lord and master; you are not the arbiter of their menu of choices. When you decide that you are, or act even a tiny little bit like it, you are on the short road to oblivion. You are entitled to your opinion – and it is a valuable opinion – but its utility is not infinite, and you should cease seeking a position of privilege for it. Do this the hard way, the *right* way, and you will triumph, because *you* *are* *right*. Seek to take the shortcut and you will fail, because when you take the shortcut it doesn’t matter if you’re right or not.

    Be a capitalist. Tell your customers why you deserve their money more. If you fail, ask yourself why.

    CAM is not a disease. It is a symptom. The disease is that your business model does not fit the realities of the world today. If you want to fix this, then fix your business model. Otherwise, prepare for (more) failure.

    “say you want a revolution?”
    -SD

  2. tommyhj says:

    SD: Seems to me that you’re describing a neon-infused cochrane.org.

    I do like the Gorsk-O-meter though, but scientifically we like power of evidence better and number needed to treat/harm etc. Even so, i am yet to discover a book that mentions the actual evidence for all treatments it recommends.

    As for the general advice on using the thinking-organ: Wouldn’t the world be nice if people were actually able to follow such an advice in all aspects of life? :)

    But you are correct. We do need a huge marketing of sciene based medicine. If only we had the money…

  3. markentel says:

    One thing we can all do is contact our Representatives and Senators when healthcare legislation is on the table that we DO NOT want our tax dollars spent on CAM; or, as Doctor Novella would have it, medicine that does not work. Medicine that does work is a much better investment.

    From posts here I have learned that there are defenders of CAM in Congress, and it is worrisome (I believe Sen. Harkin was the subject of a particularly dissappointing one re: NIH research into “alternative” treatments). At the very least elected officials should hear that plenty of people are more than happy to leave wishful thinking to the private sector.

  4. pec says:

    You have divided the world into pro-science vs anti-science,. You are fighting for what you perceive as the side that is good, intelligent and scientific, against the forces of ignorance, idiocy and deception. You fight primarily by attacking your opponents’ intelligence and credibility, rather than offering logic and scientific evidence. Unemotional, objective rationality is scarce in your arguments — which is ironic since you claim to speak for science and reason.

    I am not saying there are no quacks, or that every alternative medicine idea makes sense. But the world is not divided the way you think it is.

    The American public is losing its faith in medical authoritarianism and that’s what you are really fighting. You want the public to remain sheeplike and trusting, to stop questioning and exploring alternatives.

    As for quantum “nonsense,” it isn’t just Deepok Chopra who takes it seriously:
    http://discovermagazine.com/2009/may/01-the-biocentric-universe-life-creates-time-space-cosmos

  5. daedalus2u says:

    Wasn’t there once a treatment for cancer that involved infecting the tumor with some type of bacteria? Could that be the mechanism behind his “successful” anecdotes (if there actually are any)? Using non-sterile sodium bicarbonate to “stimulate” the immune system with live pathogens?

    Sudden death sounds more like sepsis and anaphylaxis than dehydration. Easy to have happen when non-injectable grade materials are injected. Just a little bit too much “stimulation”.

  6. happyhumanist says:

    Yesterday, Johann Hari posted a review of a new book exposing the ridiculousness of conspiracy theories:

    http://www.huffingtonpost.com/johann-hari/conspiracy-theories-drain_b_195348.html

    The book is: ‘Voodoo Histories: The Role of the Conspiracy Theory in Shaping Modern History’ by David Aaronovitch. Hari’s review is comprehensive, I believe. It offers both praise and criticism of the conspiracies Aaronovitch chooses to tackle. Yet it is uncompromising–nothing nefarious happened on 9/11, JFK and RFK were killed by lone gunmen, and poor Princess Diana died in a car crash.

    But look at the comments–full of the same stuff and nonsense that is promoted in the blogs listed above. A few people (myself included–same user name, BTW) try to inject some sanity, but it is like swimming upstream. The Kim Evans “de-tox” blog got covered by skeptical comments–overriding the nonsense. Perhaps those reading this can also offer poor Mr. Hari a hand?

  7. Karl Withakay says:

    daedalus2u,

    You might be thinking of an engineered form of the herpes virus.

    http://www.sciencedaily.com/releases/2007/10/071016093219.htm

  8. daedalus2u says:

    No, what I was thinking about was something from ~110 years ago.

    http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17860660

    Using a “natural” way of producing healing by stimulating the immune system that modern surgeons have abandoned.

  9. TsuDhoNimh says:

    Gee, fungus is white. Cancer is a fungus because it is white. My dog is white, so I suppose my dog is either cancer or a fungus.

    Yes, reading the HuffPoo is hazardous to your health.

  10. SGNeill says:

    Holy cow, I’m digging what SD wrote. I had thought of something similar, except in my mind the skeptic/SBM community could work on a “rebuttal bank” in which we could construct concise, accurate responses to the main lines of quackery present on the internet. That way, instead of painstakingly deconstructing every sham idea and product that appears, we would have a ready-made response that folks such as myself could basically cut-and-paste to spread across the blogosphere.

    These rebuttals would have to be made in a palatable fashion, because as much as I enjoy reading mockery of the foolish… people don’t like to be called fools. And though we won’t “convince” the con artists and charlatans heading up the pseudoscience movement, we do want to persuade those who might endorse and follow them. I think we can combine humility with dogged rebuke.

    The other part of defeating the pseudoscience movement is to clean up our own act. I think people seek out the snake oil guys because by and large they aren’t being served well by the medical community. Is it because of poor science education, so people just don’t know what they’re getting from medicine? Or is it a factor of doctors not being able to spend much time with patients? Insurance issues? I wonder.

    Think about it: nutjobs probably have much more time to spend with their patients, and it is incumbent upon the nutjob to be able to clearly explain what he is doing and why (in a layperson’s terms). He has to because he doesn’t have the luxury of operating with the weight of the medical establishment (or truth) behind him. There are no insurance concerns in seeing a quack because no insurance would pay for it anyway. It’s probably pretty nice, except for the fact that the central item on the bill is ineffective.

  11. Prometheus says:

    SD concludes:

    CAM is not a disease. It is a symptom. The disease is that your business model does not fit the realities of the world today. If you want to fix this, then fix your business model. Otherwise, prepare for (more) failure.

    In a way, I agree with SD. CAM is a symptom of a medical system that has so consistently delivered on its promises that people are aghast when it comes up against something it can’t immediately cure.

    CAM is a symptom of people wanting an “easier” way to treat diseases that used to be 100% fatal.

    CAM is a symptom of people who aren’t willing to accept the fact that not everybody can feel great all the time for their entire life.

    CAM is a symptom of aging “Baby Boomers” who refuse to face the fact that they are getting old and are going to die.

    What about disease that real medicine can’t cure? Like cancer? Well, despite the fact that many types of cancer are “curable” with real medicine, there are still many types (and stages) of cancer that are not (yet). In addition, the current treatments for cancer – even those cancers that are “curable” – are often unpleasant. Nobody likes the side effects of chemotherapy, radiation or surgery. That, however, does not mean that they don’t work.

    Enter CAM, with its promises to “cure cancer” with simple, mild and sometimes even “natural” treatments. To someone facing death from an “incurable” cancer, this looks a lot more appealing than the real medicine alternatives. The only problem is that CAM doesn’t work – not against “incurable” cancer and – tragically – not against cancers that are treatable or even “curable”. It is a tragedy when someone who could have been “cured” or given years of disease-free life goes down the “CAM” route and pays the ultimate price, but is that a failure of real medicine or a failure of CAM? I submit that it is CAM that has failed in this example.

    SD thinks that CAM’s success means that real physicians need to change their “business model” to be more attractive to patients. I disagree.

    CAM appeals to people because it promises things it can never deliver. CAM appeals to people because it never tells them the unpleasant truths. CAM appeals to people because it never, ever contradicts them – even when they are wrong.

    As for physicians needing to “prepare for (more) failure” – what hubris! What utter arrogance! Physicians I know are upset about CAM because it is hurting people. That’s right – not because their “bottom line” is being hurt, but because people are being hurt!

    Why physicians should care is beyond me – these people made their choices and should pay the consequences. And from a strictly “business model” point of view, more use of CAM is a good thing for the practitioners of real medicine. After all, my doctor gets paid more to treat me when I’m ill than to check my blood pressure and give me some sage advice about my weight.

    Ask your own doctors and they’ll tell you – they get a lot more money for treating someone with out-of-control diabetes and infected feet than they do for writing a prescription for medications. They make more money treating advanced breast cancer than for doing a simple lumpectomy. And they could get much more money for treating measles than they could ever hope to get by giving a vaccination.

    So, what sort of “business model” does SD suggest for physicians?

    Acknowledge the absolute right of the patient to get (and pay for) the treatment they want, even if you don’t think it’s a good idea. Do not, by word or deed, interfere with that right.

    I wasn’t aware that this was different from what we have right now. If someone wants to treat their hypertension with chiropractic or their cancer with homeopathy, they are free to do so. Or is SD suggesting that physicians give a patient treatment (i.e. medications, surgery) that the physician thinks is not a “good idea”?

    Acknowledge that we live in an age where people want free, and want custom, and want *what they want*, *when they want it*, and see absolutely no reason at all why they shouldn’t be able to get it. Acknowledge that this is a completely reasonable way to act and think. Act accordingly.

    Is “I want what I want when I want it!” a “reasonable way to act and think”? I don’t think so. To me, this seems like the worst of the Baby Boomer failure-to-mature attitude. How about “You can’t always get what you want. But if you try, sometimes, you get what you need“?

    SD seems to have a chip on his shoulder about physicians – especially the fact that they hold the keys to the drug box. He should try going to a naturopath or chiropractor, since many states have given them the right to prescribe controlled medications. Maybe they would be willing to give him “what he wants, when he wants it”.

    I don’t see real physicians going out of business because of CAM. I suspect that they will always be around to treat sensible people and to pick up the pieces from CAM’s failures. I am reminded of the closing line from an auto-repair ad I saw years ago:

    You can see me now…or you can see me later.

    I just hope that the real physicians don’t all decide to practice CAM because they think it is such a good “business model”.

    Prometheus

  12. beatis says:

    @ David Gorski,

    Thank you so much for bringing attention to the dealings of mr. Tullio Simoncini, who btw is now busy setting up business in the USA.

    On this blog, we collect information on Tullio Simoncini: http://anaximperator.wordpress.com/category/tullio-simoncini/

    We have help from an Italian MD who also started blogging:
    http://medbunker.blogspot.com/ The story of Aysha and Simoncini was originally posted on the Italian blog and we translated it into English. We are also supported by the pathologist of http://www.123hjemmeside.dk/cancer_is_not_a_fungus/

    We know that Tullio Simoncini is currently treating an American woman with breast cancer, because she blogs about it, on her blog “Dancing with the Daffodils”: http://journeytowardhealth.blogspot.com/

    We tried to talk some sense into her, but to no avail.

    Tullio Simoncini had his licence revoked because he sold useless treatments for money and making people believe they would work. In other words: for selling bogus treatments. He was sentenced to 4 years in prison for involuntary manslaughter, because a patient of his died while receiving infusions with baking soda in the bowel. Thanks to a general amnesty, he did not have to serve time, but the conviction still stands.

  13. Khym Chanur says:

    Gee, fungus is white. Cancer is a fungus because it is white. My dog is white, so I suppose my dog is either cancer or a fungus.

    Your dog is a Fungi from Yuggoth! Guard you brain!!

  14. David Gorski says:

    Prometheus gets it right here:

    SD thinks that CAM’s success means that real physicians need to change their “business model” to be more attractive to patients. I disagree.

    CAM appeals to people because it promises things it can never deliver. CAM appeals to people because it never tells them the unpleasant truths. CAM appeals to people because it never, ever contradicts them – even when they are wrong.

    Exactly.

    Another reason to shut down quacks like Tullio Simoncini is the same reason we write laws to shut down frauds like Bernie Madoff. Indeed, one wonders if SD thinks there should be laws against Ponzi schemes and other fraud or if he thinks that Bernie Madoff should be in prison for his financial chicanery. After all, Madoff gave the people what they wanted, and, hey, if they were too dumb to see that he was scamming them then they’re adults. They should take the consequences of their actions. Let the buyer beware! Information is free, and they had access to the Internet and all that, didn’t they?

    At least, that seems to be SD’s attitude towards CAM. Total deregulation, and let the buyer beware!

    I realize that there are areas that are more “gray,” where the fraud is less intense or the practitioner believes in what he is selling. However, SD doesn’t appear to make any distinction, if his little screed is to be believed, between a patient having the “absolute right” to total fraud like that of Dr. Simoncini or to go to the acupuncturist down the block.

    In any case, the one thing SD mentions that is not a bad idea is a scoring system. Of course, such scoring systems already exist, such as the Cochrane Database and various evidence-based medicine scoring systems. That may be a worthwhile endeavor, but we are too few and all have day jobs, making this at best a long term project. Indeed, our very complaint about existing scales is that they do not take into account prior probability based on longstanding, well-supported scientific theory.

  15. David Gorski says:

    Thank you so much for bringing attention to the dealings of mr. Tullio Simoncini, who btw is now busy setting up business in the USA.

    Oh, geez. We have enough quacks of our own. We don’t need to import them from Italy.

    That patient blog is horrifying.

  16. beatis says:

    I know. I’m losing sleep over this woman.

  17. Versus says:

    Kim Evans says: “I find it hard to believe that after graduating from oncology school he doesn’t know what a tumor looks like.”
    Oncology school? It’s interesting that someone who discredits medicine so easily doesn’t even know the basics of medical education. Apparently Kim thinks to be an oncologist one goes to “oncology school.”

  18. pec says:

    “AM is a symptom of a medical system that has so consistently delivered on its promises that people are aghast when it comes up against something it can’t immediately cure.”

    Oh yes, CAM is becoming popular because mainstream medicine is so wonderful. The public is so idiotic it will always choose the most worthless alternative.

  19. Prometheus says:

    David,

    I think SD is laboring under the mistaken idea that physicians like yourself are only concerned about CAM because they are afraid of losing business. That’s the only way I can reconcile his laughable suggestions that physicians change their “business model” and give patients “what they want, when they want it”.

    I doubt that it has crossed his mind that physicians might be (“are“, in my experience) primarily concerned that CAM is hurting people who turn to it. I realize that altruism and caring about what happens to people who aren’t family (or “customers”) may not be considered a good “business model”, but it’s what I’ve come to expect from physicians.

    Besides, the physicians I know are not suffering monetarily from CAM “competition” – in fact, their CAM-using patients are often some of their more regular visitors. Not to mention the “business” they get from people who foolishly use CAM to treat real illness.

    SD appears to be angry at physicians, perhaps because he feels that he is smart enough to be one and resents the fact that they are in a position of authority (and he is not). He wants to drive the bus without going to bus-driver school – and we know how that one usually ends.

    As a “business model”, CAM shares more with Bernia Madoff than it does with any legitimate enterprise. Are deception and wishful thinking really good “business models”? Maybe SD thinks so, but I don’t.

    Prometheus

  20. Prometheus says:

    Pec arrives:

    Oh yes, CAM is becoming popular because mainstream medicine is so wonderful.

    If popularity were any guide to reality, life would look a lot more like popular films. The “appeal to popularity” didn’t work with my mother (“All the other kids are getting high coloncs – why can’t I???”) and it shouldn’t work with other adults.

    And there’s even some doubt about how popular CAM really is. The surveys that claim to show CAM’s overwhelming popularity routinely include such modalities as “exercise”, “relaxation”, “prayer” and “meditation” as “CAM” therapies. I’d like to see how many people really think that CAM is superior to real medicine and how many “CAM users” are just “hedging their bets” (using CAM and real medicine simultaneously).

    The public is so idiotic it will always choose the most worthless alternative.

    “The public” has shown over and over again that it prefers a pleasant lie to an unpleasant truth. CAM appeals to that aspect of human nature that shrinks from necessary unpleasantness and seeks out a palatable – if unreal – “alternative”. In some circles, this is called “denial”.

    Also, see above about “the public” and its true dedication to CAM.

    Prometheus

  21. hyperlalia says:

    @Daedalus2u

    I think you are referring to several attempts over the years using various bacterial extracts to induce immune responses to attack the tumor cells, the most well known of which being “Coley’s Toxin” http://en.wikipedia.org/wiki/Coley%27s_Toxins

    Coley WB. Annals of Surgery 1891;14:199-200

    We discussed it briefly in my introductory immunology class in the context of the function Tumor Necrosis Factor and its synthesis in response to infection. I remember the professor saying that Coley’s Toxin had been abandoned because it was more likely to cause lethal sepsis than it was to actually cure the cancer, but some research had been done into mimicking some of the immune response characteristics of such an infection inside tumors, but trials of TNF alone had been a wash. I’m pretty sure it’s a subject still being studied in the context of combination therapies and many different immune modulators.

    http://www.ncbi.nlm.nih.gov/pubmed/17714025

  22. qetzal says:

    @hyperlalia,

    I, too, have heard of old research that attempted to treat cancer with live bacteria. There have even been some recent attempts to resurrect/update this idea, such as this.

  23. deancameron says:

    “There are two sides to every issue: The right side and the wrong side…”

  24. SD says:

    Ah, Cde. Gorski.

    “Another reason to shut down quacks like Tullio Simoncini is the same reason we write laws to shut down frauds like Bernie Madoff.”

    Point of order: you are assuming that you need to “write laws” to shut down fraudsters, as opposed to simply using the basic concept of fraud. What portion of Bernie Madoff’s activities – or Tullio Simoncini’s, for that matter – are not encompassed under the standard definition of “fraud”? Okay, so why write a new law? Why define new classes of criminal activity (“activity likely to be fraudulent”, “activity that may lead to fraud”, &c.) instead of simply punishing fraud when it is proven?

    “Indeed, one wonders if SD thinks there should be laws against Ponzi schemes and other fraud or if he thinks that Bernie Madoff should be in prison for his financial chicanery. After all, Madoff gave the people what they wanted, and, hey, if they were too dumb to see that he was scamming them then they’re adults. They should take the consequences of their actions. Let the buyer beware! Information is free, and they had access to the Internet and all that, didn’t they?”

    Discussing this is fascinating, because it illuminates the internal thought-processes of this crowd. The mental yoga required to avoid confessing the fundamental ethical contradictions in one’s cherished shibboleths is all kinds of fun to watch. Most of the responses remind me of the Roman plebe’s scoff: “How shall we eat, then, if Caesar does not give us bread?”

    No, Cde. Gorski, Bernie Madoff should hang, because he made a material misrepresentation of fact, as the money to pay off his old investors came not from the sources he claimed but solely from his new investors; yes, his investors were adults; yes, they should have known better, the kinds of returns he was offering should have been a clue that something wasn’t right; no, they did not deserve what happened to them; no, they are not hugely sympathetic victims; no, that doesn’t matter; yes, they should take the consequences of their actions, and in fact don’t have much of a choice; yes, the existence of cheap access to information (including the Internet) is important and changes things to a certain extent, although that extent is arguable; no, “special” laws against Ponzi schemes are not necessary; yes, the concept of “fraud” is sufficiently definable that Ponzi schemes are covered; no, if I tell the truth to my investors, that their returns depend on my ability to find new investors, I am not committing fraud, even though I am perpetrating a Ponzi scheme; yes, anybody who invests in that scheme after I tell them so deserves what they get and has no just recourse.

    [SD takes a deep breath.]

    But what *differential* fraud, i.e. material misrepresentation of fact, is present in CAM vs. SBM?

    CAM treatments may not work in a given instance. Most CAM practitioners will acknowledge that.

    SBM treatments may not work in a given instance. Most SBM practitioners will acknowledge that.

    Is a lottery fraudulent because only one person wins? Is a lottery with only one winner in a million “more fraudulent” than a lottery with ten winners in a million?

    Answer: No, and no. Lotteries are not a good idea (negative expected return), but they are *not* fraudulent. Correspondingly, there is no fraud in selling someone a treatment which may not work *so long as they are aware of that fact*. Material misrepresentation or omission of reasonably-knowable and relevant fact is the important test. This rule is subject to some interpretation; if I sell a man cyanide salts on the theory that it will cure his cancer by killing the tumor – arguably true, in the same way that VX gas is great way to fix that potato-bug infestation in your home garden – there is something wrong there. This is for a jury to decide. Standard concepts of fraud cover this quite well, and the argument is straightforward for any competent attorney; there is no requirement for “special” legislation to cover this case, such legislation being a prime evil of our age.

    If I tell someone that they might be able to cure their cancer by having their chakras manipulated, on the other hand, who the hell knows? Have you ever *seen* a chakra? (Me neither, but maybe I’m just not wearing the right glasses.) Anybody can point to studies that suggest that maybe a strict chemo regimen affords a better shot at survival – assuming proper methodology for the studies, of course – but is there sufficient scientific evidence, sufficient understanding of the mechanisms of disease, to say that that treatment *will* work in that instance, that the cancer (assuming proper diagnosis in the first place) *will* be gone at the end of the treatment? Of course not. It’s a crap-shoot. So’s the other one. The magnitude of the probability in each crap-shoot is orthogonal to the question of fraud.

    I therefore cavil against the “special” legislation attendant to the practice of medicine in these days, which legislation has a multitude of evil effects, besides being rooted in morally dubious philosophy about the proper purposes and roles of the State to begin with. If CAM is fraud in se because it may not work, or may not work for the reasons hypothesized, whether or not the practitioner informs the patient of that beforehand, then SBM is precisely as fraudulent; the difference is one of degree, not one of kind. This is because medicine is yet *art* and not *science*. You cannot – in fact, *do* not – guarantee the outcome of *any* treatment. When we get to that stage – when we know enough to say with certainty equal to that of observed physical law that in *this* given case, with *this* given disease, that *this* treatment will fix the problem, without fail – then, we have reached a stage where we can begin defining fraud in terms of a given standard of care. We ain’t there yet. Funny thing: when we *do* get there, the need for such a definition disappears anyway, since people tend not to bet against sure things. “Laetrile? Are you fucking kidding me? Why the hell would I not just go to the Onc-O-Center and have it nuked? I can’t remember the last time I heard of someone’s cancer not being cured there. Are you out of your mind?”

    Prediction: There will be a great deal of noise about this assertion – particularly from the fanbois – and exactly zero evidence that anybody has grasped these basic concepts. I especially look forward to Wang’s contribution, presumably a malapropism or non-sequitur.

    “At least, that seems to be SD’s attitude towards CAM. Total deregulation, and let the buyer beware!”

    The buyer needs to ‘beware’-ing anyway, Cde. Gorski. Do you suggest that he not? Do you think that flogging the idea of Nerf Medicine (“no thought required, safety guaranteed, jus’ listen to the doctor”) is a good idea? What are you willing to give up in order to provide the illusion of Nerf Medicine to the world? Do you believe that constraining individual decision in this process by removing all “wrong” choices by fiat leads to a good result? Are you accepting total responsibility for those decisions moved from the buyer’s discretion to your own? In that case, do we get to execute you in the parking lot if you screw up and cost the buyer his life? Or maybe we could just ruin you utterly instead, reducing you to penury and hard labor in the sulfur mines to work off your debt to your patient’s next-of-kin? These are “just” punishments for someone who takes responsibility for another man’s life and who fails that responsibility in any meaningful fashion. Are you prepared for that level of responsibility? Or would you prefer to let the emptor caveat, instead?

    “I realize that there are areas that are more “gray,” where the fraud is less intense or the practitioner believes in what he is selling. However, SD doesn’t appear to make any distinction, if his little screed is to be believed, between a patient having the “absolute right” to total fraud like that of Dr. Simoncini or to go to the acupuncturist down the block.”

    Oh, I don’t think we disagree, there, and I do make a distinction; a greasy quack selling cyanide capsules from the back of a pickup truck with the engine running differs somewhat from an attractive hippie chick in tie-dyed sari manipulating chakras to lower blood pressure. I focus mostly on the gray areas, though, because the areas that are black-and-white are well-covered under standard theories of fraud, negligence, and so forth. Moreover, they always have been. There is no need for “specialness” in these cases; the addition of “special treatment” either has no effect at all, making it a waste of money and effort, or has unintended consequences that ineluctably outweigh the benefits gained.

    The key observation is that while I don’t have to *like* CAM, and while I don’t have to think that it’s a good idea, there aren’t any just ways to interfere with it by means of legislation or regulatory fiat, unless it’s being practiced by someone who is not committing clearly-definable fraud. (And no, SBM does not get to define “fraud” yet; see above.) I also note that the regulatory apparatus has other side effects, such as limiting the penetration and availability of SBM by increasing its cost and reducing the available supply of it, which push such interventions further into the “bad idea” category. And finally, I note that allowing the camel’s nose of regulatory intervention into the tent of medicine leads to the result we see now, where that same camel is being hijacked to provide support and cover for CAM. This is a sort of Trifecta of Fail. You need not believe me, of course. I make testable predictions about continuing down the political path you’re on – further failure, problems in this system magnifying, further political interventions, poorer quality of care, spiraling costs, poorer standard of living. All you have to do is keep it up and see if I’m right.

    Predictions: This portion will be ignored – particularly by the fanbois – and there will remain exactly zero evidence that anybody has grasped the core of these concepts. Where not ignored, there will be attempts to “explain” the status quo to me, too – possibly in the belief that I am some form of mental defective, or fell off the turnip truck fifteen seconds ago, and therefore have no grasp (from long observation) of the arguments *in favor* of the status quo – relating how the current regulatory structure is a good idea and really for the best, along with the typical tropes used in support of it, ignoring the fact that the underpinnings of those tropes have already basically been destroyed by both argument and evidence. There will be several attacks on straw-versions of my theses, as well as attacks reductio ad absurdum, as well as at least one special pleading.

    “how do you think Caesar gets the goddamned bread in the first place?”
    -SD

  25. daedalus2u says:

    My suggestion was a little bit tongue in cheek. Nothing “stimulates” the immune system like an infusion of live bacteria, and “stimulating” the immune system is one of the generic mechanisms of CAM products. Any material if suitably contaminated with bacteria will serve as a very powerful immune system stimulant and MIGHT CURE CANCER!!!.

    Revere over at effect measure has a post up on cytokine storms in the context of flu infection.

  26. daedalus2u says:

    I just remembered I have a long post on fever therapy. I only talk about the neuroinflammation aspects and how it was the standard of care for neurosyphilis for decades. The physician who developed it won the Nobel Prize. It involved deliberate inoculation with malaria, letting it go through ~10 cycles of fever before curing it with quinine. It had remarkable effects on people suffering from disorders characterized by neuroinflammation. I blogged about it in the context of the effect of fevers on autism behaviors.

    Using something like that on tumors is much more complicated.

  27. Karl Withakay says:

    SD

    “This is because medicine is yet *art* and not *science*”

    Medicine is an applied science, not an art.

    “You cannot – in fact, *do* not – guarantee the outcome of *any* treatment.”

    Sometimes science is not about guarantees; it is about probabilities. That doesn’t make it no longer science.
    I can’t guarantee when an individual neutron will decay, but I can give you a probability curve; that’s still science.

  28. The Blind Watchmaker says:

    Homeopathy may have a role in preventing the H1N1 virus. However, instead of drinking the magic water, people should use it to wash their damn hands. At least that would provide some plausible benefit :)

  29. SD says:

    Karl:

    ‘Medicine is an applied science, not an art.”

    “You cannot – in fact, *do* not – guarantee the outcome of *any* treatment.”

    Sometimes science is not about guarantees; it is about probabilities. That doesn’t make it no longer science.
    I can’t guarantee when an individual neutron will decay, but I can give you a probability curve; that’s still science.’

    Really. Yeah, I remember the last study I read of differences in neutron decay between neutron populations from the ages of 18-29 and 60-75. I also remember reading this fascinating paper on neutron decay as a result of poor neutron care in low-GDP nations, as opposed to the outcomes of neutron care in developed nations. And there was this one really awesome study about how neutrons of African descent are more prone to early neutron decay than Asian or European neutrons.

    Anyway. Yeah, uh, neutrons are subatomic particles, described by quantum mechanics. Neutrons are indistinguishable from one another and are adequately described by quantum theory; humans are mostly special individual snowflakes, and quantum theories applied to humans and human problems are best described charitably as “fraught with problems”. (Are you gonna get your Deepak on, Karl?) Sad, shattering truth: medicine is most certainly not a “science” on a par with physics or chemistry, not even close, in part because its subject material is not as endearingly homogeneous as neutrons or atoms, in part because medical experiments cannot be repeated in any meaningful fashion, and in part because medical goals (“restoration to health” – what the hell is ‘health’?) are inchoately defined. (If we dilute the concept of “science” to include things like “sociology”, then I suppose we can define medicine as a “science”, but I submit that you might not want to labor in such company.) No, medicine may *use* scientific methods to arrive at some of its conclusions, and may employ scientific results in some its treatments, but such use is *not* “science” any more than engineering is “science”. To claim that it is a science is pompous, self-serving, ill-advised, and just flat incorrect, the end.

    Question: What the hell is wrong with medicine being an art? Is there some ego-investment in having this field of endeavor thought of as a science?

    The statistics used in physical and chemical modeling (“real” statistics, as opposed to “bullshit” statistics, the sort used for epidemiology and other social studies) are rigorous, yes, and well-verified by experiment. Further, those statistics lead to “guaranteeable” macro-scale phenomena; while I don’t know which mole of water molecules in a solution will wind up moving to the other side of a semipermeable membrane into a hypertonic solution, I *do* know that there will be one mole of them there at any given time at equilibrium. If I set that experiment up identically, I will get the same result each time I do it. So yeah, for physical phenomena on scales above the subatomic, you’re damn skippy you can offer guarantees about what’s gonna happen, or at least feel confident in making a bet that you will not lose barring force majeure or divine intervention.

    You, on the other hand, cannot guarantee that one cohort of a hundred patients given a treatment will respond identically to a second cohort of a hundred patients given the same treatment; you can’t even guarantee that the same cohort will respond the same way twice. That’s because, in the majority of cases with few exceptions, you do not know fully why the treatments work, or why they fail. (THIS IS NOT AN ATTACK – YOU CANNOT ETHICALLY GET THAT INFORMATION, BECAUSE YOU CANNOT EXPERIMENT ON LIVING HUMANS IN THE WAY NECESSARY TO GET SUCH DATA EXCEPT IN EXTREMELY LIMITED CIRCUMSTANCES, AND IT IS GOOD THAT YOU CANNOT DO SO.) But it’s the way things are; you can get rough numbers that are sort-of useful for purposes of triage, to predict roughly how many and what kind of medicines and how many body-bags you need to keep stocked, and to offer prognoses that have the best reasonable chances of being correct. That’s *it*.

    Hell, the “flip-flop” of medical studies is well-documented. Conclusions change based on cohort size, composition, day of the week, funding agency… Meta-analyses yield different answers than their composite studies. Diversity in the human population – genetic, environmental, hell, even anatomical – leads to differing answers each time a study is done on a particular topic. To claim that this process produces knowledge of the same certainty as, say, the Boltzmann distribution of particle energies, is disingenuous. (And by “disingenuous”, I mean “total bullshit”.)

    “doin’ the neutron dance”
    -SD

  30. El-D says:

    @ SD: “You, on the other hand, cannot guarantee that one cohort of a hundred patients given a treatment will respond identically to a second cohort of a hundred patients given the same treatment…”

    Um, I’m pretty sure that you can. Perhaps “a hundred” patients would be too-small of a sample for some interventions, perhaps not. But your point regarding repeatable results in macro-scale phenomena is exactly right — and seems to undermine your whole point.

    I’d be willing to bet that there exists some reasonable n for which if you gave aspirin to n people with headaches, you could observe a positive response in a very predictable fraction. I’m also pretty sure n << 1mol :)

    The fact that there are flip-flops in the outcomes of medical studies probably says more about the fact that we’re usually not talking about the low-hanging fruit. (Selection bias in studies of meta-studies, yay!) There aren’t flip-flops in the question of “setting vs. not-setting broken bones”, because we usually try to avoid spending time answering stupid questions. Really, it would be terrible if studies were NEVER overturned, since it would imply that we’re not asking the difficult questions.

    “To claim that this process produces knowledge of the same certainty as, say, the Boltzmann distribution of particle energies, is disingenuous. ”

    No one could reasonably expect medicine or biology to generate knowledge at the same level of certainty as comparatively simple physical systems (my background was in condensed-matter physics). In fact, I’m sort of with you on the medical art-v-science idea. But you seem to suggest that medical “science” can’t offer perfect or guaranteed knowledge and therefore is no more or less helpful than any other approach to health.

    Do you really consider it an equal fraud to say “aspirin cures headaches” as it is to say “baking soda cures cancer”?

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