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The “pharma shill” gambit

Editor’s note: Since I happen to be on vacation (sort of–in reality I plan on spending most of next week holed up in my Sanctum Sanctorum at home writing a grant that’s due in February) and because readership tends to be down during the week between Christmas and New Years’ Day, I thought I’d resurrect something from well over three years ago and revise it to fit this particular blog. In doing so, I hope to provide you with something amusing to read, as well as something to link to time and time again whenever you want to refer to a particular gambit beloved by promoters of quackery and pseudoscience. I present here….The “Pharma Shill” Gambit! Enjoy!

I’ve mentioned before on this blog at least once that I cut my skeptical teeth, so to speak, on Usenet, that vast untamed and largely unmoderated territory full of tens of thousands of discussion newsgroups which used to be a lot more active before the rise of the World Wide Web and then later blogs. These days, few ISPs even offer much in the way of Usenet access; it’s become pretty much irrelevant since Google archived Usenet in the form of Google Groups. My forays into skepticism started out with combatting Holocaust denial on a newsgroup known as alt.revisionism (as good an excuse as any to remind you that nearly all Holocaust “revisionism” isn’t historical revisionism but is actually denial) and then branched out into more general skepticism, particularly about the claims of creationists and, of course, promoters of “alternative” medicine, the latter of which ultimately led me to being the editor of this wild and woolly thing we call the Science-Based Medicine blog. After I began to participate in the debates in the main newsgroup where alternative medicine is discussed, misc.health.alternative, it didn’t take me long to encounter a favorite tactic of promoters of alt-med who were not happy with one who insists on evidence-based medicine and who therefore questions claims that are obviously not based in valid science: The “Pharma Shill” Gambit. This is a technique of ad hominem attack in which a defender of “alternative” medicine, offended by your questioning of, for instance, his/her favorite herb, colon or liver flush technique, zapper, or cancer “cure,” tries to “poison the well” by implying or outright stating you must be in the pay of a pharmaceutical company, hired for nefarious purposes.

Since I entered the blogosphere several years ago under another guise, I’ve only occasionally checked back at my old stomping ground, mainly because blogging is so much less constraining than posting to Usenet, where mostly I used to respond to the posts of others, rather than writing about what I wanted to write about. A while back, though, out of curiosity I checked back and found this interesting little tidbit from a poster calling himself PeterB that demonstrated such a perfect example of the “pharma shill” gambit that I thought it might serve as a perfect example of the sort of thing I’ve had to put up with ever since I started speaking out against quackery:

To : All participants and readers of misc.health.alternative + other health-related newsgroups

Please be aware that many comments and responses posted to this forum are not those of casual posters interested in an honest exchange. A number of individuals with ties to industry are engaging an effort to shape public sentiment about the risks of mainstream medicine while denigrating the benefits and validity of natural medicine. I refer to these individuals broadly as “Pharma Bloggers”(*). Pharma Bloggers on usenet don’t promote a specific company or product, as might be the case with standard “blogging” on a weblog. Most of these people are likely to have an association with a PR campaign whose “blogging” efforts are underwritten by the media and marketing groups of industry. They are not difficult to identify due to specific patterns of behaviour in posting.

Here are a few points to remember while participating in usenet newsgroups:

  1. Pharma Bloggers on usenet use intimidation, mockery, and insults to silence those who express belief or interest in natural medicine.
  2. Pharma Bloggers on usenet attack those who question the effectiveness of mainstream medicine and defend disease-management “healthcare” as the only viable form of medicine.
  3. Pharma Bloggers on usenet post the majority of their responses simply to bury the comments of others; they also strive obsessively to have the last word.
  4. Pharma Bloggers on usenet are much faster at posting than casual participants; they almost always respond first to a new thread, question, or observation.
  5. Pharma Bloggers on usenet use multiple “bloggers” in a swap-&-relay fashion to create an aura of the “consensus view” in an effort to isolate posters who question the value of mainstream medicine. You will see this tactic used more often than any other.

Tip: If you find yourself reading a response that is unusually dramatic in tone, or inexplicably vicious toward other posters, and if that response is a defense of mainstream medicine, you can be sure you have stumbled upon a “Pharma Blogger.” Unfortunately, there are more of these individuals posting to usenet on a daily basis than virtually anyone else, which is why I am posting this alert. If you find it odd that so few people on health-related usenet newsgroups are expressing an interest in natural medicine, it isn’t because they aren’t there, it’s because they have been intimidated into silence. The Pharma Bloggers have over-run the various newsgroups with their industrial brand of dogma, mockery, and ridicule. Many casual posters are simply frightened away. That’s one of the goals of Pharma Blogging.

(*) Pharma Blogger: An individual who uses the Internet to: 1) promote and defend maintstream medicine while denigrating natural medicine approaches; 2) attack others who express a preference for natural medicine, or who question the value of mainstream medicine; and 3) cite a variety of “junk medical science” funded by industry for the purpose of establishing markets for marginally effective, and often dangerous, medical products and devices.

PeterB

See what I had to deal with? First, let me just mention that I realize that astroturf campaigns do exist, but, quite frankly, die-hard defenders of alt-med on Usenet like PeterB tend to be interested in such Internet PR efforts only as a means of smearing those who criticize them for their claims or who have the temerity to ask them to provide scientific studies to back up their assertions. To them, everyone who questions them is probably part of an astroturf campaign. It goes with the conspiracy-mongering proclivities so common among cranks.

This sort of obvious pre-emptive ad hominem attack (again, a.k.a. the logical fallacy of poisoning the well) would be utterly laughable if it were not so common. I sometimes get the impression that PeterB and his compatriots must think that there are hordes of “pharma shills” sitting behind banks of computers (remember the claim “more of these individuals posting to Usenet than anyone else”), waiting to pounce the instant anyone like PeterB starts posting critiques of big pharma or praising herbal “cures.” (Yes, that they seem to think they are worth that sort of effort implies PeterB and others like them do seem to have an inflated view of their own importance.) My usual first response to such gambits tends to be facetious and runs along the lines of asking, “Where do I sign up to become a pharma shill? How do I get me a piece of that action? After all, why should I waste my time seeing patients and working like a dog to do science, publish papers, and write grants and then only having a couple of hours in the evenings to blog, when I could make big bucks ruthlessly mocking online dissent against big pharma full time while sitting back in my pajamas and sipping a big hot mug of coffee? Count me in!” (Expect to see my words posted somewhere out of context to make it seem as though I was being serious about this.)

However, facetiousness usually just infuriates people like PeterB to new heights of “pharma shill” accusations. At that point, it’s time to try to be rational, hard as it may be in the face of such provocation, but I try. First, a lot of this smear tends to be a case of projection, of the pot calling the kettle black. For example, #1, #2, and #3 are more typical of supporters of alt-med than of anyone who questions alt-med claims. Indeed, the denizens of misc.health.alternative who are most pro-alternative medicine tend to react quite defensively to questioning of their assertions. They are often like a group of Cyber Sisters (except that they are comprised of both men and women) ruthlessly descending upon anyone who questions the dogma of their favorite alternative medicine, criticizes their behavior, or suggests that maybe, just maybe, conventional medicine might have value. (No, those on “our side” are not entirely innocent, but in my experience the certain promoters of alt-med tend to be quicker with the ad hominem.) One reason for this, I suspect, is that many of them are also active on moderated groups such as CureZone.com, where anyone questioning the alt-med treatment du jour too long or too vigorously will be banned from the discussion groups, thus providing a nice, safe, cuddly environment, where never is heard a discouraging word towards quackery. #4 and #5 are clearly designed to imply that the so-called “Pharma Bloggers” either don’t have a regular job (why else would they have so much time?) or that they are working for big pharma. Of course, they never provide any evidence to support their accusations. In fact, they almost never provide even any reasoning to support their accusations more substantive than variations on “he’s criticizing alternative medicine a lot so he must be a pharma shill.”

The “pharma shill” gambit, like other varieties of ad hominem or well-poisoning rhetoric, conveniently frees defenders of “alternative” medicine from having to argue for their favorite remedies on the science and clinical studies supporting them (which in most cases tend to be badly designed or nonexistent). It’s a technique that’s not just limited to them, either. Anti-vaccination cranks and mercury/autism conspiracy theorists like it too, and, indeed, I have been the subject of some particularly vicious attacks over the years at the hands of the anti-vaccine movement1,2, Generation Rescue and its founder J. B. Handley in particular3,4,5, all of whom appear to be trying very hard to poison my Google reputation. (Indeed, another such attack rolled in just today, courtesy of AoA hanger-on Harold Doherty.) Moreover, J.B. Handley, in particular, has also attacked our very own Steve Novella. More recently, the late Hulda Clark’s former attack Chihuahua Tim Bolen appears to have decided for some reason that I have been named the heir apparent to Dr. Stephen Barrett. While I’m flattered that he somehow seems to think this, I’ll have to be at this for many more years and become much more effective even to approach Barrett’s legacy. Be that as it may, you have to have a tough skin if you’re going to try to combat the infiltration of pseudoscience into medicine.

Skeptico pointed out, even if a newsgroup denizen were a pharma shill, that wouldn’t necessarily invalidate his argument. Yes, in the case of a true “shill” who does not reveal that he works for a pharmaceutical company and pretends to be “objective,” it would be entirely appropriate to “out” that person with extreme prejudice, so that his bias could be taken into account. That being said, I’ll take this opportunity to point out that I have never over the last decade observed such a person in action, which tells me that they are probably a lot less common than people like PeterB like to claim. Even in the case of a real shill, however, this sort of “outing” is not a refutation of that person’s arguments; it merely serves to increase appropriately the level of skepticism about what that person is saying. Such an “outing” still leaves the task of actually using evidence, logic, and sound arguments to refute what that person is saying, something boosters of alt-med rarely even attempt to do. It’s far easier to fling the accusation of “pharma shill” about and see if they can get it to stick, as PeterB and his ilk do.

No doubt, may of our readers here at SBM have heard of Godwin’s Law, which states:

As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1.

Over the years, an assumed corollary to Godwin’s Law has become commonly accepted that in essence states that once such an “argumentum ad Nazium” is made, the discussion thread is over, and whoever brought up the Hitler or Nazi analogy first automatically loses the debate. Recently, this corollary was the basis of Scopie’s Law, which is more relevant to the topics covered on this blog and states:

In any discussion involving science or medicine, citing Whale.to as a credible source loses you the argument immediately …and gets you laughed out of the room.

Over time, I and others have suggested that, although Whale.to is clearly The One Quack Site To Rule Them All, there are at least a few other sites whose promotion of pseudoscience lead them to deserve to be included in Scopie’s Law, such as NaturalNews.com, Mercola.com, and the anti-vaccine crank blog Age of Autism. However, I think that there’s another law, a law similar to the original formulation of Godwin’s Law, that applies to virtually any online discussion of anything resembling alternative medicine. Perhaps we could dub it “Gorski’s Law,” and this is what I propose it to say:

As an online discussion of health, in particular vaccines or alternative medicine, grows longer, the probability of the invocation of the ‘pharma shill gambit’ approaches one.

If there’s an exception to this law, other than in moderated forums and (usually but not always) here at SBM, I haven’t found it yet.

Posted in: Humor, Science and Medicine, Science and the Media, Vaccines

Leave a Comment (114) ↓

114 thoughts on “The “pharma shill” gambit

  1. windriven says:

    And so goes life on the battlefield. If it wasn’t for the freaks, cranks, wootitioners and their ilk, you’d just be preaching to the choir.

    This is a battle for minds and it is no surprise that, deprived of arguments based on reason and scientific evidence, the alt.nuts resort to the Pharma Shill Gambit, accusations of Nazism and so forth.

    One suspects that they are, by and large, true believers in the magical powers of woo. But faced with compelling proof that they are among the few who really do need a good colon cleansing, how and why do they labor on?

    Fear and superstition die hard.

  2. Zoe237 says:

    Huh, by those definitions anybody who disagrees with you is a pharma shill… how convenient for them!

    I’m more concerned about industry funded research than individual commenters. Yes, if it’s good research, it doesn’t matter who does the funding, but I tend to look at it much more skeptically.

  3. Sastra says:

    They don’t seem to think there would be a problem on the other side, do they? People who earn their living selling alternative medicine coming into forums where patients support each other, in order to provide glowing testimonials about what “worked for me.” If it does happen, then they’re just spreading the Good News. They’re sharing.

    The lack of consistency here does surprise me. My altie friends are pretty uniformly disparaging of Big Pharma, corporations, capitalism, and people trying to make a buck — until they enter the world of Alt Med, where all of a sudden studies which are done by people who sell the remedies are just fine, without replication. They go to see naturopaths who diagnose them with problems no one else can diagnose, and then sell them solutions that no one else can sell them — and they fail to smell a rat.

    One friend is now touting the benefits of something called “prolotherapy.” She showed us the website, played a video, and handed out pamphlets. Now, I know little to nothing about this particular remedy, but just looking at the website sets off my skeptical alarm bells. They’re claiming a very high success rate for multiple common problems — but insurance won’t pay for it. It’s been around for something like 50 years, and from what I can tell looks very testable — but it’s still classified as ‘alt med’ and only available in a few places. It’s supported by the impressive-sounding American Association of Orthopaedic Medicine — but this was apparently formed by prolotherapy practitioners, specifically in order to promote prolotherapy. It’s light on the supporting studies — and heavy on the glowing testimonials. Though I can’t say it’s not legit, there are odd little clues here and there that they’re trying to appeal to alties — and it’s very expensive indeed.

    But when I point out that it all sounds like a commercial, and that these people are selling something — they roll their eyes.

    There are no Big Altie Shills — only brave mavericks struggling against Big Pharma.

  4. Old Coyote says:

    So by this gambit you automaticaly paint anyone who disagrees with you as dishonest and/or nefarious by definition… Hmmm… sounds like something Nazis would do.

    AWWW DAMMIT!

  5. David Gorski says:

    You do realize that the “intentional Godwin” doesn’t work, don’t you? :-)

  6. provaxmom says:

    Can you show me how to be a pharma shill? Is there a secret handshake or something? Because I’ve been dealing with pharmaceutical companies for years, and all I have to show for it is quite an impressive collection of pens and sticky-note pads. I’d really prefer the cash.

  7. Versus says:

    An example from today’s news:

    http://www.courant.com/news/connecticut/hc-chiropractors-green-1229dec29-col,0,6549282.column

    Look how quickly “big pharma” came up in the comments to this column on chiropractic and neck manipulation. While there is no mention of anyone’s being a shill (yet) the implication is there.

    Also, excellent example of another sCAM gambit: the “doctors kill more people than [insert CAM practice]” argument.

  8. backer says:

    i would like to know why any of you have a reason to trust big pharma?

    Just take the berni madoff scandal as an example, this financial giant was “trusted” with these people money. His credentials were impeccable, no one had any reason to question him. Big Pharma can’t even claim that, so what reason do you have to trust them?

  9. David Gorski says:

    Nice straw man ya got there, backer.

    No one here has said that we should necessarily trust big pharma, now has he? The point of this post was to show how alt-med promoters often try to poison the well by accusing those defending science of being “pharma shills.” Part of the reason it’s poisoning the well is due to the rather low opinion many people have of pharmaceutical companies. The other part of the reason is that it’s easier to dismiss someone if you can convince yourself if that person isn’t sincere, that he’s being paid to defend the opinion he’s defending. Never mind that such smears have no bearing on the actual scientific and evidentiary merit (or lack thereof) of, for example, my arguments. When you don’t have the evidence, it’s easier to try to paint your opponent as a shill for a special interest than it is to try to refute what he is saying based on science.

  10. backer says:

    david-

    are you kidding this site oozes with implied trust for big pharma. what am i to draw from this article? that you are skeptical of big pharma? yeah right dave. pharma companies do a wonderful job of discrediting themselves, so why would i trust any amount of “evidentiary merit” when they produce it for every new wonder drug they create, only later to recall the wonder drug that produced the “evidentiary merit”

  11. pmoran says:

    Backer: “i would like to know why any of you have a reason to trust big pharma?”

    There are many reasons for being cautious concerning the results of some types of scientific study and an association with the marketing needs of drug companies is merely one that happens to have intruded onto public consciousness recently.

    A better question would be “do we trust the overall system?”

    I guess we do, because it does detect and corrects errors of judgment over time, and there is no obviously better way at present.

    You can argue that some settings of the system should be tighter, or others looser, but any change you make will introduce added costs to medicine and likely have unintended consequences.

  12. backer says:

    pmoran-

    my question is a little more fundamental than this. the article mentions whale.to. (let me preface this with i am by no means a proponent of whale.to) but why should i distrust the stories describing vaccine deaths on that site? why should i distrust the statistics they put forth? (e.g. 99.4 decline in measles prior to vaccines?) Also please show me what product they are trying to sell me? by putting forth these claims. I am always more likely to trust someone without an agenda than someone with an agenda.

  13. qetzal says:

    Is it ironic, or merely to be expected that the pharma shill gambit has been invoked in the comments of a post decrying the pharma shill gambit?

  14. David Gorski says:

    Yes, I had noticed that. backer is on the verge of doing it; he’s just stopped short of accusing me of being in the pay of big pharma.

    Come on, backer! Let it all out! You know you want to. :-)

  15. David Gorski says:

    are you kidding this site oozes with implied trust for big pharma. what am i to draw from this article? that you are skeptical of big pharma? yeah right dave. pharma companies do a wonderful job of discrediting themselves, so why would i trust any amount of “evidentiary merit” when they produce it for every new wonder drug they create, only later to recall the wonder drug that produced the “evidentiary merit”

    You clearly haven’t been reading very long, have you?

    Read these and then get back to me about how much I trust big pharma:

    http://www.sciencebasedmedicine.org/?p=192
    http://www.sciencebasedmedicine.org/?p=665
    http://www.sciencebasedmedicine.org/?p=215
    http://www.sciencebasedmedicine.org/?p=2466
    http://www.sciencebasedmedicine.org/?p=408
    http://www.sciencebasedmedicine.org/?p=56

    Yep, those articles about big pharma and scientific fraud sure do show me to be totally trusting of pharma.

  16. David Gorski says:

    why should i distrust the statistics they put forth? (e.g. 99.4 decline in measles prior to vaccines?)

    Here’s one reason:

    http://scienceblogs.com/insolence/2008/06/the_nuttiness_that_is_whaleto.php

    If Whale.to is as reliable on vaccines as it is on virtually everything else, if it said that the sun rises in the east on Whale.to, I’d make sure to wake up before sunrise the next morning to check its assertion.

    But, hey. Post the link to the specific article claiming a 94.5% decrease in measles before vaccination. I think I know what’s going on here with that claim, and I want to see if I’m correct.

  17. backer says:

    david-

    you are on the payroll for big pharma! :)

  18. Chris says:

    More about that infamous chart on measles showing a mystical drop before vaccines:
    http://www.iayork.com/MysteryRays/2009/09/02/measles-deaths-pre-vaccine/

  19. David Gorski says:

    That’s a useful link to keep in mind the next time that particular anti-vax lie comes up.

  20. backer says:

    Read these and then get back to me about how much I trust big pharma:

    fair enough, maybe you should point these things out to some of the people on this site. I suggested a conflict of interest in one study that was done by a pharma company and the response i received in return…”i don’t see how it would be a conflict”

    if Whale.to is as reliable on vaccines as it is on virtually everything else, if it said that the sun rises in the east on Whale.to, I’d make sure to wake up before sunrise the next morning to check its assertion.

    cmon dave didnt you get the connection the “Well-Hidden Soldiers Of Satan” is just a distraction for big pharma. ;) (kidding in case people think i am serious)

    But, hey. Post the link to the specific article claiming a 94.5% decrease in measles before vaccination. I think I know what’s going on here with that claim, and I want to see if I’m correct.

    again not saying i believe these things, but just pointing out that i really have no reason to distrust things such as this…

    http://www.healthsentinel.com/joomla/index.php?option=com_content&view=article&id=2662:historic-data-shows-vaccines-not-key-in-declines-in-death-from-disease&catid=5:original&Itemid=24

    especially when no one is trying to sell me anything, and it “appears” to jive with real data.

  21. Chris says:

    It has been explained to you what was wrong with the plot before. But to review:

    1) To compare how effective a vaccine is you have to look at incidence, not deaths. The only thing that affects incidence are vaccines. Rates of death can be affected by other factors, like increased health due to better nutrition and sanitation, advances in medical care, and even better access to medical care due an improved economy (compare the Great Depression with the USA after World War II).

    2) The incredibly inflated timeline, starting in the mid-19th century will obscures the actual drop of measles incidence. Do you think that there might be some differences between 1860 and 1960?

    3) That website admits a real bias, and none of the authors have any real biology or medical background. Indeed, I even quoted from that website where one author says “I decided I was not going to subject either of my children to getting vaccinated.”

    Do you think we forget previous encounters with your arguments? Do you think they are going to disappear from this website? Do you have a type of memory loss disorder?

  22. David Gorski says:

    Yep, it’s exactly what I thought it was: A classic antivax bit of antivax distortion of history in which the argument is made that, because death rates were falling before the measles vaccine was introduced, then the vaccine wasn’t important. However, this decrease in death rates beginning before the licensing of the vaccine were more due to better supportive medical care. The actual incidence of measles didn’t start to fall until after the introduction of the vaccine, and it declined dramatically. See:

    http://www.iayork.com/MysteryRays/2009/09/02/measles-deaths-pre-vaccine/

    Apparently you didn’t bother to look at that link.

    Finally, here’ my favorite link refuting this nonsense, short and sweet:

    http://www.cdc.gov/vaccines/vac-gen/6mishome.htm#Diseaseshadalready

  23. Chris says:

    David Gorski:

    Apparently you didn’t bother to look at that link.

    Dr. Gorski, I posted the table that one of the plots came from in response to backer at least twice (I think it was three times), and yet he still wants to perpetuate the lie. He even posted that plot even after he was told by me and others why it was misleading and not reliable.

  24. pmoran says:

    .”Backer: “my question is a little more fundamental than this. the article mentions whale.to. (let me preface this with i am by no means a proponent of whale.to) but why should i distrust the stories describing vaccine deaths on that site? why should i distrust the statistics they put forth? (e.g. 99.4 decline in measles prior to vaccines?) Also please show me what product they are trying to sell me? by putting forth these claims. I am always more likely to trust someone without an agenda than someone with an agenda. ”

    How interesting! You have been bombarded with evidence and close reasoning, but still don’t know what to believe. You probably won’t any time soon.

    I have previously suggested here that we skeptics misunderstand the mechanisms that sustain dubious medical beliefs. We assume that the problem is poor comprehension of science and that it can be countered with sound data and careful reasoning.

    You demonstrate how no amount of these can persuade. The key matter may be is how people decide to apportion their trust, and it is clear that our profession has some work to do in that regard.

  25. David Gorski says:

    We assume that the problem is poor comprehension of science and that it can be countered with sound data and careful reasoning.

    I used to assume that, but I learned fairly quickly that there are certain people whom no amount of data, reasoning, and explanation can persuade; for instance, J.B. Handley of Generation Rescue, who is anti-vaccine to the core. Once I come to that conclusion about someone, I no longer try to persuade them; rather, I work more to counter their message. I no longer work to try to get them to see reason but rather to try to keep them from misleading others. For such people, if they ever come around to see reason, I’m humble enough to know that it’s not likely to be me or anyone else who will persuade them.

    The problem is not to be too quick to relegate someone into the category of those whom no amount of science or reason can persuade. That judgment may not be tricky for the J.B. Handleys of the world, but it can be a difficult matter for others, requiring a lot of frustrating attempts to persuade before giving up.

  26. backer says:

    chris, david-

    I am not here to debate these old tired MMR arguments. trust me there isnt enough evidence available to prove your case to me. Chris and i have tirelessly gone over this. That is not what i am getting at. I am simply showing you how i have no reason to distrust either the link i presented, nor the one Chris presented. They both “appear” to have merit. if the data on the health sentinal website is true. (I can’t verify because the data is on a CD ROM) then they truly can make the claim that death rate dropped by 99% before vaccines were introduced.

    however i did find something interesting maybe you can form a theory as to why vaccination seems to have ZERO effect in scotland in association with measles vaccination. death rate was 20 by 1955

    http://www.gro-scotland.gov.uk/files1/stats/scotlands-population-2005-the-register-generals-annual-review-151stedition/j9085e05.htm

  27. backer says:

    virtually all “vaccine eradicated” diseases seem to have disappeared in scotland by 1955. huh, interesting. Maybe scotland has a thing or 2 to teach us.

  28. Zoe237 says:

    “You demonstrate how no amount of these can persuade. The key matter may be is how people decide to apportion their trust, and it is clear that our profession has some work to do in that regard.”

    Yes. It’s the same thing in politics. People often vote because of who seems more likeable, who they feel like they can “have a beer with.” It’s incredibly annoying that everything is a popularity contest. Scientists and doctors utterly fail in that regard much of the time. The us. vs them, scientists as the guardians of knowledge and ultimate truthseekers and laypeople as idiots doesn’t help much either (in general, not necessarily SBM).

    I read a quote from Nancy Snyderman’s (NBC chief medical correspondent) medical myths book the other day at B & N. I don’t remember the exact quote, but it was basically that the truth was that doctors like integrative medicine and that it’s the way of the future. (I also read Gorski’s blog about how it’s because doctors are being lied to about what integrative means).

    Alternative health advocates, sorry, just seem a heck of a lot more likeable to me. People fall for the feel good crap. Enter Oprah and Dr. Oz and Psychology Today and Weilman and Deepak… JB Handley hardly seems likeable to me though.

    I don’t really understane how people can look at HIB vaccine in 1992 or varicella vaccine in 1997 or the yo-yoing of measles rates in direct proportion to vax rates and claim that it was sanitation solely. But then, I don’t get how people fall for Noah’s ark, UFOs, homeopathy, astrology, creationism etc either. Sometimes the opposition does seem pointless, but I don’t think it is, at least to lurkers. As long as it’s done respectfully.

  29. Chris says:

    backer:

    however i did find something interesting maybe you can form a theory as to why vaccination seems to have ZERO effect in scotland in association with measles vaccination. death rate was 20 by 1955

    Yes, we know that better health standards and medical care in 1955 versus 1905 made sure that fewer kids died of measles. That has been explained to you multiple times.

    Did you notice that the next number over was “0″? That means if no kids get measles, then they don’t die of measles.

    Again, to see the effect of vaccines you must look at total incidence, which is only affected by vaccines. Your obsession with using only deaths is a way to muddy the waters, because that is a number that can be affected by factors other than vaccines.

  30. Chris says:

    Showing that backer did not fully read the website he posted to, bolding added:

    Several of the charts, notably those for measles and whooping cough, display continued high levels of mortality well into the twentieth century. Indeed it was not until the second half of the twentieth century, and widespread childhood immunisation, that steady low levels were attained.

  31. backer says:

    Did you notice that the next number over was “0″? That means if no kids get measles, then they don’t die of measles.

    yeah guess what the number was in 1960? “2″

    Yes, we know that better health standards and medical care in 1955 versus 1905 made sure that fewer kids died of measles. That has been explained to you multiple times.

    sorry but in 1940 there were 262 deaths by the end of the 40′s down to 22 that’s a reduction of 90% in 10 years WITHOUT A VACCINE! health standards/medical can’t have progressed that much in 10 years. Then 1950 to 1960 down to 2, 10 more years
    and another 90% reduction.

    Again, to see the effect of vaccines you must look at total incidence, which is only affected by vaccines. Your obsession with using only deaths is a way to muddy the waters, because that is a number that can be affected by factors other than vaccines.

    in the 1950′s an average of 8500 cases were reported each year, vax introduced in 1968.
    total reported cases in…
    1983-6193 vaccine uptake 60%
    1994-6192 vaccine uptake 94%
    2004-257 vaccine uptake 88%
    2008-219 vaccine uptake 93%

    doesnt look too muddy to me, it continued to decline even when vaccine uptake declined. and it increase when uptake increased!

  32. Chris says:

    Um, no. From the file you posted, it listed deaths from measles for the following years:
    1855……. 1905…… 1955…… 2005 … with these numbers:
    1,180…… 1,662……… 20 ….. 0

    Here is more information you were leaving out:
    http://www.documents.hps.scot.nhs.uk/immunisation/measles/measles-notifications-vaccine-uptake-1968-2008.pdf

    Now you are using a different website, and your statement “doesnt look too muddy to me, it continued to decline even when vaccine uptake declined. and it increase when uptake increased!” shows that you are still ignoring several important things:

    Like there is not an instant change due to vaccine levels, there is a lag of cause and effect.

  33. Newcoaster says:

    Thanks for the repost as I hadn’t seen it before. As it is I’m a few weeks behind on SBM blogs anyway.

    It is interesting to see the tactics haven’t changed that much. I do my small part of skeptical foot-soldier work the Alternative Health room on Yahoo Answers, and the Pharm-shill ploy is still being used, in exactly the same way, almost word for word.

    It will be great to have this to link to….not that those guilty of the logical fallacies will actually read it.

    And congratulations, SBM blog has achieved the same level of vitriolic hatred as QuackWatcher has. Must be hitting a nerve.

  34. backer says:

    chris please show me where i mentioned…

    “1855……. 1905…… 1955…… 2005 … with these numbers:
    1,180…… 1,662……… 20 ….. 0″

    in my previous post?

    and please explain this…

    Like there is not an instant change due to vaccine levels, there is a lag of cause and effect.

    2004-257 vaccine uptake 88%
    2008-219 vaccine uptake 93%

    this is 4 years, an increase in uptake and a 38 case decrease. I guess the vaccine they use must royally suck becasue it doesnt have much effect.

    then there is this…

    in 1982 there were 10324 cases and 0 count em’ 0deaths. (this makes the 1-2 out of 1000 number look like a HUGE lie)

    tah tis 14 years, so how long does it exactly take for the vaccine to kick in?

    according to your link here…

    http://www.iayork.com/MysteryRays/2009/09/02/measles-deaths-pre-vaccine/

    it takes about 5 years.

  35. cloudskimmer says:

    While I agree with the post, I’d prefer that doctors refuse the pens, notepads, “free” samples, and “educational” seminars offered by the pharmaceutical companies. Sure, the posters look pretty on the exam room walls, but it influences the physician and costs the patient. And while we’re at it, it would be great if drug advertising were proscribed; whenever I see the full-page ads in popular magazines, and the seniors romping through grassy fields on TV, it reminds me that elderly people on limited incomes are paying for that very expensive advertising every time they take a pill. If it really is something small, why not refuse it and avoid the appearance of impropriety? It wouldn’t cost much to buy a few pictures for the office, and invest in an anatomy book to illustrate discussions with your patients. To the extent that Doctors accept these bribes–oops, I mean “gifts”–they are in the pocket of big pharma, and it’s shameful. It’s really sad that professionals sell themselves so cheaply.

    It’s just as bad when someone who worked hard to get an M.D. added to their name goes off the deep end and adds acupuncture, homeopathy, or some other loopy alt-med subject, to their practice. In both cases, it’s an abandonment of science-based medicine, and doesn’t serve patients or the profession.

  36. weing says:

    “I am always more likely to trust someone without an agenda than someone with an agenda.”

    Sorry. No such beast. Everyone has an agenda. Just because you can’t see it, doesn’t mean it isn’t there.

  37. Chris says:

    backer:

    chris please show me where i mentioned…

    Dude, I cut and paste from the website you posted at:

    # backer on 29 Dec 2009 at 9:38 pm

    ….snip…
    however i did find something interesting maybe you can form a theory as to why vaccination seems to have ZERO effect in scotland in association with measles vaccination. death rate was 20 by 1955

    http://www.gro-scotland.gov.uk/files1/stats/scotlands-population-2005-the-register-generals-annual-review-151stedition/j9085e05.htm

    Copy and paste from the table from that website (I will need to edit it!):

    1855

    1905

    1955

    2005

    Total deaths

    …. snip…

    Measles

    1,180

    1,662

    20

    0

    (note the “0″ that I was referring to)

    What!? You cannot remember the website you posted? Nor can you remember what was on it? Really, check with someone (preferably a real neurologist) about that memory problem.

    Interesting how you took a blog posting on measles and decided to comment on “Silver Sol” while complaining there were too many posts on vaccines. Then, now, on a post about the “Pharma Shill” gambit you decided to turn it into a post about measles. You seem to be consistent with your inconsistency.

    Seriously, dude, you have some memory problems. Not only do you repost graphs that were discussed earlier, forget previous explanations… you cannot even remember what you posted earlier!

    (By the way, dude, the UK had a better record with measles and mortality than the USA, NEWSFLASH: Scotland is part of the UK… the one or two deaths out of a thousand was only for the USA. The reason is that the UK has a national health system, the USA does not. The one or two deaths per a thousand is based on the 1987-1992 measles outbreak in the USA only. But what is still true that there is a one out of a thousand chance of something bad happening. These are things like deafness, blindness, mental retardation, etc. If you look you will notice I usually say a “one in a thousand chance of neurological damage”, not death.)

  38. Chris says:

    AAAAGH… HTML fail… the blockquote ends after the URL link!

  39. Newcoaster says:

    Has Dr Gorski or any of the other done a piece on the “Doctors/Drugs kill more people than disease” gambit yet?

    If so, send link.
    If not…..there’s a topic for you.

  40. tahoe69 says:

    the “pharma shill”….i read this on Bloomberg: 10 million prescriptions about 15% of all drug sales in the U.S. are for unapproved uses without adequate evidence the medications work according to a study by Randall Stafford, a medical professor at Stanford University. this article also provided info. regarding the False Claim Act. the top 20 False Claims Act cases in terms of money recovered 12 included settlements/judgements against drug companies. most recent cases were against Pfizer and Eli Lilly& Co. Since 2004 the two companies mentioned along with 5 other companies have paid a total of $7 billion in fines and penalties. Here’s a quote from New York Attorney General Andrew Cuomo regarding a case with a pharma co.: “drugs should be prescribed to patients on the basis of needs and safety, not on a corporate giants promise of an all-expense paid vacation.”

  41. Mark P says:

    “i would like to know why any of you have a reason to trust big pharma?”

    Because the rules of the game keep them, more or less, honest. Those rules include:

    1) Say one company finds what they think is the best beta-blocker on the market. The company with competing products will do everything to make sure that claim is checked as valid. In the real pharma world, companies compete. And even if the US firms were to collude, what makes the Chinese go along, other than actual evidence?

    2) Law suits. A very obvious manner in which dangerous claims are held in check.

    3) The pharma companies hire real scientists. Who sometimes leave the firm and go to competitors. When they leave they have every reason to blow the whistle on false claims. But examples are strikingly rare.

    4) evidence based on open claims made in public journals, with anecdote not acceptable as evidence.

    And this is what alt-med put up instead:

    1) Never bag another alt-meddie. No matter that they believe something entirely contradictory.

    2) Make sure that that no really accurate trials are run, such as finding what is in your “herbs”, because that could lead to big trouble lawsuits.

    3) ignore any alt-med who leaves alt-me. People like that who blow the whistle have an impaired mental state, shown by leaving alt-med.

    4) use anecdote as much as possible. Ignore all those irritating trials that keep showing no effect.

    In general the rules keeping big pharma honest are pretty much the same as those that keep supermarkets from selling you poison: competition, legal constraints, honest workers and testing of products. Or do you test every item of food you buy, just in case big supa are trying to poison you?

  42. Deetee says:

    backer, yet again (3 other people have tried to tell you) a “decline” in measles or any other infection can only be assessed by looking at the incidence of the disease, and not the deaths from the disease. Incidence means the number of cases of the disease that are occurring.

    A useful analogy might be leukemia. The mortality from this has declined significantly. That does not mean leukemia has “declined” (in fact its incidence may have even gone up for all I know).

    No-one here has ever claimed vaccines are solely responsible for the decline in mortality. The antivax web sites like to conflate the 2 different epidemiological indices (incidence and mortality) in a deliberate attempt to fool people. Judging by your posts here, they have been very succesful in confusing you.

    You will realise that the incidence of some diseases is quite unaffected by sanitation/nutrition. These are mainly the childhood infections sprtead by the inhalation route – eg measles. You will notice that “everyone” got measles, even if they were rich and healthy. Until vaccinations were introduced, that is. Then the incidence declined dramatically.

    Please tell us you understand this, then we can move the discussion on.

  43. David Gorski says:

    Chris, you amaze me. You have far more patience to try to repeat the same thing over and over again to backer, who clearly has no interest in being educated. In my eyes, he’s rapidly drifting to that latter category I mentioned of people who are uneducable. I haven’t followed his antics on other threads much, but I gather that you have. Either that, or he’s just your garden variety troll.

  44. David Gorski says:

    @Newcoaster

    Harriet beat me to it. :-)

  45. woofighter says:

    I think Backer enjoys being a distraction, wasting everyone’s time and energy, and changing the subject. I suggest he be ignored.

  46. Joe says:

    @backer on 29 Dec 2009 at 5:26 pm “… I am always more likely to trust someone without an agenda than someone with an agenda.”

    Yogi Berra once said “If you don’t think too good, don’t think too much.” If the agenda is to get a patient the best therapy, that is a good thing.

  47. backer says:

    Deetee-

    maybe you missed this so i will repost…

    1950′s-8500 incidence

    vax introduced in 1968.

    total reported incidence in…

    1983-6193 incidence vaccine uptake 60%

    (sarcastic tone) wow! that was a HUGE decline in 14 yrs

    1994-6192 incidence vaccine uptake 94%
    2004-257 incidence vaccine uptake 88%
    2008-219 incidence vaccine uptake 93%

  48. backer says:

    joe-

    my hairy uncle once said. “Never trust a guy named joe, because joe is another name for coffee and coffee will give you the runs”

  49. backer says:

    david-

    Chris, you amaze me. You have far more patience to try to repeat the same thing over and over again to backer, who clearly has no interest in being educated. In my eyes, he’s rapidly drifting to that latter category I mentioned of people who are uneducable. I haven’t followed his antics on other threads much, but I gather that you have. Either that, or he’s just your garden variety troll.

    this is complete BS, i noticed how you avoided my evidence which you attest…”I used to assume that, but I learned fairly quickly that there are certain people whom no amount of data, reasoning, and explanation can persuade;” well tell me dave, why the sound data i presented to isnt enough to persuade YOU? You wont even humor me with a theory.

    For all of you people out there that think i an just trying to distract, i did all of this to illustrate my initial point. In light of evidence, such as the evidence that i presented, why should i trust big pharma? OBVIOUSLY their vaccines had minimal effect AT BEST in scotland yet they still push their drugs. To further this point i believe there is shred of truth coming from big pharma as well as alt. med. unfortunately most of you “smart guys” have your heads so far up your bu…..stethoscopes you fail to realize the potential of the opponent.

  50. Deetee says:

    @backer -
    No I didn’t miss your post about the number of cases.
    It was the same post in which you said:

    “sorry but in 1940 there were 262 deaths by the end of the 40’s down to 22 that’s a reduction of 90% in 10 years WITHOUT A VACCINE! health standards/medical can’t have progressed that much in 10 years. Then 1950 to 1960 down to 2, 10 more years and another 90% reduction.

    indicating you are still fixated upon trying to show vaccines did nothing to reduce mortality. Will you accept none of us are saying vaccines are the only thing to lower mortality? If you do accept this, then why bang on about the mortality rates?

    Another source that shows what happened in the USA with the introduction of vaccination can be found here:
    http://ajph.aphapublications.org/cgi/reprint/70/11/1166.pdf

    Look at Figure 1.

  51. backer says:

    deetee-

    indicating you are still fixated upon trying to show vaccines did nothing to reduce mortality. Will you accept none of us are saying vaccines are the only thing to lower mortality? If you do accept this, then why bang on about the mortality rates?

    i DO accept this, i have said it in many other posts. what i DON’T accept is that without vaccines it wouldnt have continued to decline.

    oh and BTW fig. 1 proves my point quite nicely, notice how the cases are in DIRECT relation to deaths. which indicated that death is a great indicator for determining case prevalence.

  52. weing says:

    If you have a population that’s unvaccinated and all is quiet, then fine. Wait a number of years, throw in a case of real live measles at a social gathering and the law of averages catches up with you.

  53. Deetee says:

    backer:

    “i DO accept this, i have said it in many other posts. what i DON’T accept is that without vaccines it wouldnt have continued to decline.

    oh and BTW fig. 1 proves my point quite nicely, notice how the cases are in DIRECT relation to deaths. which indicated that death is a great indicator for determining case prevalence.

    No it doesn’t.
    Fig 1 shows that cases remained pretty constant, until vaccination kicks in.

    Of course there will be a relationship between cases and deaths, but you will find that the case to fatality ratio has altered through the last century because the number of cases is not the only determinant of the number of deaths (if it were, there would be an even clearer demonstration of the highly beneficial impact of vaccines). Deaths are not “a great indicator” of the number of cases. Did you not appreciate the simple leukemia analogy I gave above?

    Oh, and please try not to use terms like “case prevalence” will you, since you clearly have no understanding as to what it means.

  54. Deetee says:

    Case-fatality ratios for USA:

    Measles may be nasty and will certainly kill some of the people who get it. So the case-fatality rate should be constant, no??? Well no, it actually appears that measles killed as many as 1 in 37 who got it back in 1912, but only around 1 in 1000 who got it in 1960.

    Now why would this be? Only possible suggestions are:

    1. The virus was mutating to become less lethal.
    No. All evidence suggests measles virulence has not altered.

    2. Humans were becoming better able to cope with the effects of the virus.
    Yes – nutritional status and other health/comorbidity determines outcome of measles, as a look at any developing country will tell you, and this certainly improved through the first half of last century in the US.

    3. Medical care has improved so that children who would previously have died now live.
    Yes, indubitably. Most deaths would be from secondary bacterial infections and pneumonia which are treatable with antibiotics. Use of these has dramatically helped prevent measles deaths. (However some deaths will be from direct measles encephalitis and pneumonitis, which are pretty untreatable even with modern facilities and drugs).

    Now that is out of the way, let’s think about what might have happened after 1960, in the absence of a vaccine. The cases would have continued unabated, and there may have been a sllght further fall in death rate (some further medical care advances), but this inevitably would have plateaued out. Why? Because whatever you do, however good your drugs are, there is no specific treatment for measles pneumonitis/encephalitis and this would continue to kill a fairly fixed proportion of anyone who catches measles.

    So mortality could not and would not have dropped to zero all on its own.

    Now let’s see what actually happened after measles vaccine came in in the early 60s.

    Since this can only prevent cases of measles, not its complications, so we expect that the mortality rate associated with measles would remain as it would have done without vaccine being available – in other words a plateau, possibly with a slight further initial fall. We would however see a further significant fall in the number of deaths after this time, as the number of overall cases declined rapidly.

    And this is exactly what we saw.

    Using the data described on the Figure 1 here (http://ajph.aphapublications.org/cgi/reprint/70/11/1166.pdf)
    I have compiled the following case-fatality series:

    1912: 37 to 1
    1920: 55 to 1
    1930: 133 to 1
    1940: 370 to 1
    1950: 628 to 1
    1960: 1000 to 1
    1970: 950 to 1

  55. gaiainc says:

    From backer:

    that’s a reduction of 90% in 10 years WITHOUT A VACCINE! health standards/medical can’t have progressed that much in 10 years.

    Yes, they can. The biggest change that happened in the 1940′s was the development and distribution of penicillin which was huge. Absolutely, totally, immensely, and completely huge. Prior to the 1940′s, there were maybe the sulfa drugs for use as antibiotics, but really medicine had little to battle bacterial infections. After 1940, we got penicillin then all the antibiotics derived from it and so on.

    A more recent example would be the introduction of the H influenza type b vaccine. This first came out in 1992. Incidence of invasice Hib infection was about 1:200 at that time (if I am wrong, I am more than willing to be corrected). I started medical school in 1995. I take care of kids on a very regular basis. I have never seen (and hope to the powers that be that I never will see) a case of invasive Hib infection, all thanks to a vaccine. I trained at two major medical centers in the Northeast and now work at an academic medical center in the PNW that has a specialty children’s hospital.

    So, yeah, medicine can dramatically change in 10 years. And if I push vaccines it’s because I know they do my patients far more good than harm. Period. Full stop.

  56. Chris says:

    Thank you for the kind words, Dr. Gorski.

    I see backer still refuses to acknowledge the concept of confounding variables that are inherent in using death versus incidence when determining the effectiveness of vaccines.

    I also should have noticed sooner that he was playing “let’s change the topic” game again, and should have only answered him on Dr. Crislip’s latest post on Measles (by the way, his “Measles” Quackcast is a hoot! … and isn’t it convenient I have to drive by a Waldorf School each time I go to our family doctor, I shall remember to hold my breath, though the stop light at that corner can be kind of long).

    I shall now ignore the off-topic ignorant troll.

    (I just finished reading Dr. Ben Goldacre’s book, Bad Science, where he explains the use of confounding variables used by those who attempt to downplay the role of vaccines, the tactics inexpertly employed by backer)

  57. backer says:

    deetee-

    Deaths are not “a great indicator” of the number of cases. Did you not appreciate the simple leukemia analogy I gave above?

    leukemia is not an infectious disease, your are comparing apples to oranges

  58. backer says:

    chris-

    if you notice i was trying to get back ON topic, however you people seem more interested in picking apart any argument that doesnt fit your mold.

    Now tell me why do i have a reason to distrust the information i presented you?

  59. weing says:

    Sounds like you are getting fooled by randomness. That’s enough reason to mistrust it.

  60. windriven says:

    @backer

    “you people seem more interested in picking apart any argument that doesnt fit your mold”

    The problem is that most of your ‘arguments’ do not rise above the level of idle speculation. You are to serious discourse as Mickey Mouse is to acting.

    Why don’t you pick one subject – hopefully on topic but hey, we aren’t picky here – and write a coherent argument supported by facts (with citations) and avoiding straw men, ad hominems and logical fallacies. You will find no paucity of willing interlocutors.

  61. David Gorski says:

    The problem is that most of your ‘arguments’ do not rise above the level of idle speculation. You are to serious discourse as Mickey Mouse is to acting.

    Hey! Don’t diss Mickey! He, at least, means to be amusing.

  62. backer says:

    windriven-

    I am not even presenting an argument! I have been forced to defend a position, and not even one i necessarily agree with. I even asked on MANY occasion for people to give me a plausible explanation/theory for why disease seemingly disappears in scotland pre vaccine era. I made no case all i did is present COLD HARD FACTS for you to determine.

    As i have said before i have tried to stay on topic here i will show you. notice my opening statement here…

    http://www.sciencebasedmedicine.org/?p=3212&cpage=1#comment-38174

    now notice the CHRIS takes it off topic by trying put forth the same tired nit picky arguments about me being obsessed with deaths, etc etc etc.

    Once again i am forced to defend a position. All you people have to do is admit that it is plausible (and IMO likely) that eventually disease will peter out and go way on it’s own. I have presented data that seems to shows how this was occurring. When the deaths are down in the 10-and 20′s per year and incidence still steadily declining it seems plausible to me.

    then again…

    http://www.sciencebasedmedicine.org/?p=3212&cpage=1#comment-38213

    i tried to get back to the topic, and what did everyone else continue to comment on?

    not the topic, but some side bar that i tried TWICE to steer back in the proper direction. so you can take your straw man and shove it where the logical fallacy don’t shine :)

  63. cloudskimmer says:

    Mickey’s acting improved greatly when he was given pupils in “Fantasia.” He gave a great performance as the Sorcerer’s Apprentice; even a skeptic should be able to appreciate the magic!

    The discussion got way off topic. I was hoping for a response to my comment about how Doctors sometimes become shills for big pharma by accepting gifts, samples and “educational” seminars paid for by major pharmaceutical companies, who in turn pass on the expense for this and all the slick magazine and TV ads to customers who end up paying high prices for brand-name drugs. And many of those customers are elderly people who often can’t afford them. And if it’s just a minor matter, why not refuse these bribes and lose the appearance of impropriety?

  64. Deetee says:

    backer: “I even asked on MANY occasion for people to give me a plausible explanation/theory for why disease seemingly disappears in scotland pre vaccine era.”

    You are at it yet again!! You have had this explained to you 4 or 5 times already. “Disease”represents cases, not deaths.

    I cannot believe your pigheaded inability to acknowledge this fact. Either you are totally ineducable or plain dumb. Which is it?

    The Scotland data you quote show a decline in mortality from measles, and NOT a disappearance of disease. In the prevaccine era the “disease” of measles was as common in 1950 as it was in 1900, not just in Scotland but everywhere.

    Now I have given a quite detailed explanation of why mortality from measles has declined in the prevaccine era. It’s at 1.53pm above.

    I suggest you read it, and then explain why it is not “plausible” in your estimation.

  65. pmoran says:

    Backer: “Now tell me why do i have a reason to distrust the information i presented you?”

    I agree that material cannot be dismissed simply because it is on the unspeakable “whaleto” site. Is this an equally unsound obverse of “argument from authority”?

    Yet I don’t think anyone has challenged the basic data you referred to. Any untrustworthiness arises out of a vast amount of data NOT considered, the straw men (no one argues that vaccines are entirely safe or 100% effective or are the only possible reason for declining measles death rates), and an overly simplistic and one-eyed interpretation of the data.

    I fear you are out of your depth, and that you would be well advised to invest your trust where the probabilities lie. You have admitted that vaccines “probably work”, I think. Is that not enough?

  66. Chris says:

    See, Deetee, you can try to educate backer, but his skull is welded shut. No actual information can actually get through.

    cloudskimmer, I know my family doctor has taken the free samples of drugs and just used them to tide me over before a prescription can be filled. He told me what it was, how he got it, and then would prescribe a generic.

    My family doctor is frugal to the point of being miserly. He does not like waste, so he is unlikely to toss away freebies. But he does not feel any obligation to buy the stuff.

    Kind of like me and the address labels the alumni association sends every year or so. I use them, but I don’t exactly donate (I actually send my donations to the organization that provided my son with over three years of intensive speech therapy for free).

  67. Chris says:

    Oh, and reminder cloudskinner… it is about Eneman! There is a pharma mascot that is described here:
    http://improbable.com/2009/01/01/up-up-and-away-with-eneman/

    Oh, and the website it quotes has moved, which was conveniently the third google hit. Even the second google hit quoted http://scienceblogs.com/insolence/medicine/eneman/ .

    Enjoy!

  68. windriven says:

    @backer

    “Big Pharma can’t even claim that, so what reason do you have to trust them?”

    Vancomycin to name one.

    I could recite any number of reasons – of drugs, actually – that have improved the human condition. There is plenty to dislike about Big Pharma. But Big Pharma has also made the world a better place.

  69. windriven says:

    @Deetee

    “I cannot believe your pigheaded inability to acknowledge this fact. Either you are totally ineducable or plain dumb. Which is it?”

    Could you quantify the IQ differential between ineducable and plain dumb? ;-)

    Personally, I’ve always preferred the ‘are you drunk or stupid’ metaphor.

    That said, I don’t believe backer is dumb but his ignorance is clearly unassailable. I have seen it attacked by you and others of estimable intellectual prowess. But when the smoke clears the edifice of ignorance stands unmarred. Must be a teflon deposition on a titanium substrate. You must admit, it’s awesome.

  70. backer says:

    pmoran-

    thanks for your levelheadedness.

    I agree that material cannot be dismissed simply because it is on the unspeakable “whaleto” site. Is this an equally unsound obverse of “argument from authority”?

    Unfortunately this doesnt reflect the view of most people. i don’t know how many times i have heard things like…

    “oh i am supposed to trust info on whale.to”

    and…

    “this is an inferior journal, therefore the data can be discounted”

    would Em=c2 be any less true if it were in an inferior journal? No.

    My point is people rarely analyze data without preconceptions, they approach the data “in light of the journal” many times. Sorry this is plain wrong.

    (no one argues that vaccines are entirely safe or 100% effective or are the only possible reason for declining measles death rates)

    Exactly my point, when i say i do not want to go over the same tired debate. I REALLY mean it. I want people to open their minds to new possibilities beyond vaccines and interface about possibilities. I guess you people have never heard of brainstorming?

    I fear you are out of your depth, and that you would be well advised to invest your trust where the probabilities lie.

    while you may think this is true, as a side note, the reason i commented on the subject to begin with is because years ago completed a 4yr contract with Bristol Myers Squibb, so i know a little about the subject. You might have even seen my work.

  71. backer says:

    That said, I don’t believe backer is dumb but his ignorance is clearly unassailable. I have seen it attacked by you and others of estimable intellectual prowess. But when the smoke clears the edifice of ignorance stands unmarred. Must be a teflon deposition on a titanium substrate. You must admit, it’s awesome.

    Let’s just say i don’t like to show my hand.

    However i must tell you that i DO take into consideration good arguments. In the course of these argument it has lead me to do further research, which has lead me to make the decision to get the DT shot for my family. This one i can see merit for.

    so if it is any consolation i would like to thank…

    Chris-for being an a**hole,
    weing-for dropping unsolicited random comments
    pmoran-for being the grandfatherly voice of reason
    windriven-for his overuse of $10 words
    harriet-i think she is a sweet lady and pretty smart to boot

    see, i can change my mind as long as it is merited, that is a HELL of alot more than i can say for the rest of you!

  72. pmoran says:

    Backer:” I want people to open their minds to new possibilities beyond vaccines and interface about possibilities.”

    Is that so? Yet you also don’t want to “show your hand”, a very odd position in a supposedly scientific environment.

    Is that why you rarely state precisely what proposition you are testing out? . You seem to snipe away with isolated fragments of data, hoping that you are hitting some target or other. We are left to guessing what is going on your mind, apparently mostly wrongly.

    No wonder discussions meander on forever.

  73. David Gorski says:

    I agree that material cannot be dismissed simply because it is on the unspeakable “whaleto” site. Is this an equally unsound obverse of “argument from authority”?

    Not really. An argument from authority is not necessarily a logical fallacy if that authority is a legitimate authority. Similarly, expressing extreme doubt about material on a site that is “renowned” worldwide for its extreme crankitude is not necessarily the mirror image of an “argument from authority.” Given the history of Whale.to, it is not unreasonable to assume that any “science” presented on that site is false until proven otherwise. True, on occasion it’s possible that there may be accurate information there, but when that happens it’s almost certainly by coincidence only and not design. I mean, really. Whale.to is a repository of an unbelievable amount of misinformation.

    No, when a source has proven itself to be so wrong for so long, it is not unreasonable to reject it out of hand unless there is other corroborating evidence to argue why it should not be dismissed.

    I mean, have you ever actually perused Whale.to?

  74. wales says:

    Late to the pary, but some may find this information interesting.
    Much has been written about the dramatic decline of infectious disease mortality often referred to by demographers as the “Great Mortality Transition” that occurred in the US and other developed nations between the late 19th and early 20th centuries, prior to the widespread use of antibiotics and vaccines. For those interested here are some informative papers.

    http://pediatrics.aappublications.org/cgi/content/abstract/106/6/1307

    Regarding the spectacular decline in 20th century childhood morality rates this paper states “ Nearly 85% of this decline took place before World War II, a period when few antibiotics or modern vaccines and medications were available. “

    also see http://jama.ama-assn.org/cgi/content/full/281/1/61

    and “The Urban Mortality Transition in the United States 1800-1940” M. Haines

    http://ideas.repec.org/p/nbr/nberhi/0134.html Haines frames the high infectious disease mortality rates of the 19th century as a “mortality crisis” caused by the dramatic impact of the industrial revolution on society via population surges in cities and the accompanying lack of sanitation and hygiene in overcrowded tenement housing.

    and “The Elusive Role of Scientific Medicine in Mortality Decline: Diphtheria in 19th and Early 20th Century Philadelphia” G. Condran

    http://jhmas.oxfordjournals.org/cgi/content/abstract/jrn039

  75. pmoran says:

    David:

    Given the history of Whale.to, it is not unreasonable to assume that any “science” presented on that site is false until proven otherwise.

    If Scudamore said it was raining I would go outside and look.

    The thing is that very little of the material on his site is his. It is nearly all borrowed from innumerable other authors, and copied from books, newspapers, web sites etc.

    Scudamore’s mindset is such that you are not likely to find much sound, balanced opinion there, but I don’t think we can go so far as to say that any data described there is automatically untrustworthy, This is what Backer was on about.

    So far as logical principles are concerned, I pretend to no expertise. I agree that we can reasonably claim an “appeal to authority” of sorts with vaccinations when nearly every doctor, scientist , public health official throughout the world thinks that vaccinations are a good thing. But the force of this consensus comes from something else. It comes from the vast amount of data and experience we have concerning vaccines — far too much for the average lay person to easily assimilate.

    It is true that expert opinion can be wrong, but usually only in detail, and invariably with less mature areas of science.

  76. backer says:

    pmoran-

    Is that why you rarely state precisely what proposition you are testing out? . You seem to snipe away with isolated fragments of data, hoping that you are hitting some target or other. We are left to guessing what is going on your mind, apparently mostly wrongly.

    i really wish i could be more specific, but that would compromise the integrity of my endeavor.

  77. zed says:

    backer –

    You’d have to have some integrity before it could be compromised.

  78. David Gorski says:

    i really wish i could be more specific, but that would compromise the integrity of my endeavor.

    Now that’s the most hilariously lame excuse I’ve seen in a very long time for not getting specific!

  79. David Gorski says:

    Scudamore’s mindset is such that you are not likely to find much sound, balanced opinion there, but I don’t think we can go so far as to say that any data described there is automatically untrustworthy,

    That’s not exactly what I said, although I would go almost that far. My point about Whale.to is that it is so unreliable, so full of crazy, that anything published there can reasonably be assumed to be a load of bollocks until proven otherwise. You in essence admitted pretty close to the same thing yourself when you said that if Scudamore said it was raining you’d take a look outside to make sure. After all, Scudamore picks everything that he hosts on Whale.to and writes some of it.

  80. edgar says:

    When I see dramatic drops in data like that I think two things:
    1. An intervention that is working.
    2. A change in surveillence.

    Just a hypothesis, but what what happened to our (their) public health surveillence during a pesky thing called WWII?

  81. Scott says:

    i really wish i could be more specific, but that would compromise the integrity of my endeavor.

    This reads to me like a fairly direct admission that he’s a pure troll. After all, it’s a direct statement that his “endeavor” is NOT related to actual discussion of issues.

  82. windriven says:

    Oh, I don’t know Scott – you may be giving backer more credit than he deserves. It seems to me that he opens his mouth and words drool out that don’t necessarily have any meaningful connection to reality. “Endeavor” suggests a goal and an effort made in pursuit of that goal. If backer has a goal it is to waste other people’s time. He sputters and whines but avoids being pinned down like a blob of mercury.

    @ backer –
    Just for you I’ve tried to avoid any words that you mightn’t have learned by the eighth grade. And just so you know, I’m offended that Chris earned an a**hole rating from you and I just got (paraphrasing here) obnoxiously articulate.

  83. Scott says:

    I guess I’m just an eternal optimist; I find it hard to believe anyone’s actually THAT terminally uneducable. Without having already earned a Darwin Award, anyway.

  84. backer says:

    windriven-

    fine then you are an a**hole too :)

  85. David Gorski says:

    Please, enough with the profanity, people. That goes for everyone. We try to run a PG blog here–at worst PG-13–as far as language goes.

  86. weing says:

    “In the course of these argument it has lead me to do further research, which has lead me to make the decision to get the DT shot for my family. This one i can see merit for.”

    That may be fine and dandy and work great as long as everyone else continues to vaccinate themselves and their families. You take advantage of herd immunity at no cost to you, the payoff must seem good. But we live in a complex system. The landscape is not rugged but dancing. What happens if others, seeing the same advantage for themselves, stop vaccinating also? Herd immunity wanes. All of a sudden, you and your family are no longer on top and at risk of the diseases and their sequelae. Doctors make money treating the acute illness and complications. Big pharma makes money selling drugs for the same. Big vaccine continues to make vaccines, as the diseases that have the potential to be eliminated, persist. If such stupidity persists, how many people will die from these diseases and how many will suffer from the complications over the next 1 or 2 thousand years?

  87. Chris says:

    windriven:

    I’m offended that Chris earned an a**hole rating from you and I just got (paraphrasing here) obnoxiously articulate.

    I’ll have you know there is even a bigger honor. Search for the names of Gorski, Novella and Moran on whale.to, and you will see they all have tribute pages there!

  88. backer says:

    windriven

    Vancomycin to name one.

    yeah, if you wanna become deaf

  89. Chris says:

    So backer, what are the real chances of becoming deaf with Vancomycin versus a bacterial infection? Show us the evidence that it would be better to fight off a bacterial invection than to get the evil Vancomycin.

  90. Chris says:

    backer:

    Chris-for being an a**hole,

    Hey, thanks! Glad I can be an irritant in your troll plans!

  91. windriven says:

    ” Vancomycin to name one.

    yeah, if you wanna become deaf”

    Oh for Pete’s sake, how moronic can your comments get, backer? Hearing loss is a rare side effect of a drug that can literally make the difference between life and death. Have you heard of MRSA? What are you going to treat that with? Elderberry juice?

  92. Deetee says:

    Pneumococcal meningitis.
    Risk of deafness = 20%
    http://brain.oxfordjournals.org/cgi/content/full/126/5/1015

    Vancomycin.
    Used to cure pneumoccoal meningitis.
    Risk of deafness with recommended dosing and monitoring of drug levels = 0%

  93. backer says:

    windriven-

    Oh for Pete’s sake, how moronic can your comments get, backer? Hearing loss is a rare side effect of a drug that can literally make the difference between life and death. Have you heard of MRSA? What are you going to treat that with? Elderberry juice?

    nope honey…havent we been over this?

    http://www.ncbi.nlm.nih.gov/pubmed/19559969?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

  94. Chris says:

    windriven:

    What are you going to treat that with? Elderberry juice?

    Perhaps backer does wear army boots and smells of elderberries. Perhaps even elderberry wine.

  95. backer says:

    windriven-

    for some reason my post didnt show so here it is again.

    Have you heard of MRSA? What are you going to treat that with? Elderberry juice?

    no honey…

    http://www.ncbi.nlm.nih.gov/pubmed/19559969?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

  96. backer says:

    windriven-

    “Endeavor” suggests a goal and an effort made in pursuit of that goal. If backer has a goal it is to waste other people’s time. He sputters and whines but avoids being pinned down like a blob of mercury.

    this is not my goal. I am truly surprised that you “smart” people can have so much oversight. I really figured eventually someone would stop trying to defend their stagnant positions and engage in ideas that could have the possibility for progress. I realize this is a rare quality, as people feel more comfortable accepting the status quo, however this is the quality i seek. Maybe my name will give you an clue as to my endeavor.

  97. windriven says:

    @ backer

    You would treat systemic MRSA with honey? Where exactly would you apply it?

    “Maybe my name will give you an (sic) clue as to my endeavor.”

    I would speculate but Dr. Gorski has cautioned us to keep this PG.

    @Chris

    “Perhaps even elderberry wine.”

    Now there’s an idea I can get behind. My grandfather made wine during Prohibition. When I was in my early twenties he gave me what he believed was the last bottle. It was cherry wine but was dry and delicious. Many years later and long after his death I discovered another bottle in the basement. My father, aunt, wife and I enjoyed it. The wine was almost 60 years old by then as was still fabulous.

  98. weing says:

    Methinks that, to backer, all MRSA are skin infections that can be treated topically.

  99. backer says:

    windriven-

    I would speculate but Dr. Gorski has cautioned us to keep this PG.

    this would have been much funnier with a winky at the end ;)

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