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An open letter to Dr. J. Douglas Bremner

Peter Lipson wrote a post last week entitled Before You Trust That Blog…, which was a criticism of Dr. J. Douglas Bremner’s blog Before You Take That Pill. Dr. Bremner was not pleased, and posted a rebuttal entitled Response to Peter Lipson MD of “Science” Based Blogs, My Blog Does Not Suck, Yours Does. Given the kerfuffle and my role as managing editor of SBM, I felt the need to put my two cents in, which is why I’m posting this open letter to Dr. Bremner. This letter started as a much briefer response that I was going to e-mail to Dr. Bremner, but as I wrote it grew and grew to the point where I decided that, given the public nature of the disagreement between Dr. Lipson and Dr. Bremner, I might as well make my commentary public too. Consider it a bonus post from me. I still plan a post for my usual slot on Monday. In the meantime, here’s my open letter:

Dear Dr. Bremner:

I read your harsh rebuttal (Response to Peter Lipson MD of “Science” Based Blogs, My Blog Does Not Suck, Yours Does) to a post by one of our bloggers (Before You Trust That Blog…) that criticized some of your stands on flu vaccines, angioplasty, and mammographic screening for breast cancer. After rereading Peter’s post and reading yours, quite frankly I actually do see Peter’s point and find your rebuttal unconvincing, or, as you so charmingly put, it “lame-O.”

Let me describe to you the genesis of Dr. Lipson’s post. A reader sent in your flu vaccine post (Flu Shots Are [Still] For Idiots), asking me what I thought about it. I was appalled. So I circulated it among our bloggers to see if anyone wanted to comment on it, and Peter stepped up to the plate. As a blogger who regularly combats the lies of the anti-vaccine movement in general, especially the myth that vaccines cause autism, and the outrageous quackery that results from the lie that vaccines cause autism, I have in the past found your posts on vaccines (and now especially the one Peter took issue with) to be bordering on being anti-vaccine themselves and at the very least to reveal anti-vaccine sympathies in both content and tone. Really, saying that the flu vaccine is for idiots and telling people they shouldn’t get it, as you did? That I cannot countenance or leave unanswered, and, quite frankly, you richly deserved a blog beat down for it. Indeed, I had been contemplating doing a rebuttal or two to some of your more–shall we say?–hyperbolic posts myself, but Peter beat me to it. If he is too “blunt” for you, check out these posts by other SBM bloggers, which directly and indirectly demolish your points:

Try to dismiss them as not being “science-based,” if you can.

If that’s not enough, peruse the posts on the flu, the swine flu, and the flu vaccine by an acquaintance of mine “revere” at Effect Measure, a senior and well-respected epidemiologist:

For example:

Start by reading these posts, especially Influenza Deaths and How do we know how many people die from flu each year?, and you’ll see (I hope) that your complaint that the 30,000/year flu death figure is an exaggeration is, well, an exaggeration. You take a complex issue and simplify it beyond recognition, concluding:

Politicians that fell asleep in science class in high school are getting a lot of money from vaccine manufacturers. Through a combination of greasing the wheels and the fact that they are too stupid to know better, they actually think that they are helping us out by using government resources to try and ‘educate’ us that we need to get a flu shot that actually will do nothing for us.

And you object to Peter referring to you as “stupid”? Do you really think flu vaccines are “for idiots”?

Also, as a breast cancer surgeon, I find a couple of the posts I’ve seen on your blog about cancer (readers have actually forwarded them to me) and in particular on breast cancer so painfully simplistic and distorted that my teeth would grind reading them. I’ve even shown up at least once in your comments to take you to task for at least one grossly incorrect statement I’ve seen you make regarding cancer. (I did it under my other, pseudonymous persona, though; so don’t go looking for Gorski anywhere. Guess for yourself.)

Before you dismiss me as a pharma shill or a physician hopelessly in the thrall of the Dark Lords of Pharma, peruse my posts on SBM. Any fair reading of my output will show I am no such thing. Quite frankly, although Peter may have been a bit more–shall we say?–vociferous in how he expressed himself than I might have been (at least on SBM; on my other blog is a different story), I tend to agree with most, if not all, of what he wrote. From my reading, you appear to have lost all perspective. To you, if it’s pharma, it can’t be right; flu vaccines are useless; mammography is useless; chemotherapy is pointless and doesn’t save lives; and it’s all a plot by the medical-industrial-pharma-government complex to milk the sheeple of their hard-earned cash. Certainly that’s the impression I leave your blog with, as well as the question of what, if anything, from modern scientific medicine you actually do consider worthwhile and not a huge pharma-enriching scam.

That’s why I think Peter nailed it. You have devolved from reasonable skepticism to cynicism and beyond to conspiracy mongering. Worse, you overgeneralize and oversimplify complex medical and scientific issues to support that cynicism and conspiracy mongering. Moreover, you are hardly one to take affront at harsh language, when a recent perusal of your blog reveals posts entitled, Pimps, Whores, and the European Society of Cardiology Meeting, Should I Take Aspirin or Put a Gun To My Head?, Response to Peter Lipson MD of “Science” Based Blogs, My Blog Does Not Suck, Yours Does, and, of course, your post that started it all, ” “Flu Shots are [Still] For Idiots.” A lovely example comes to mind from a post to which you linked in trying to rebut Dr. Lipson, in which you criticized those who argue that PTSD may be overdiagnosed:

They write:

PTSD, as presently diagnosed, described, and treated, has failed to improve on what had been standard teaching. It has redefined and overextended the reach of a long-recognized natural human reaction of fear, anxiety, and conditioned emotional reactions to shocks and traumas.

In other words, nothing like the old days, when guys killed Japs and enjoyed it, and gals got raped and if they didn’t stop sniveling you could just give them a good wack to help them get over it.

Nice.

I suppose that your “flu shots are for idiots” post means you must think I’m an idiot, as I plan on getting my flu shots this year, be it one, two, or three. Be that as it may, it’s very easy to dismiss criticisms because they are harsh. It’s a lot harder to look a bit more closely and ask yourself if there’s anything to them.

Think about it for a moment. Try. Try real hard. Not every criticism of you is because the minions of big pharma are ganging up on you or because the person criticizing you or with whom you disagree is hopelessly deluded, biased, or stupid. You can be wrong, and in several cases that I’ve seen just from perusing your blog over the last couple of days, you are.

There is a fine line between severe criticism and conspiracy-mongering or taking complex issues and simplistically (and in a knee-jerk fashion) taking the side that most fits with your biases, the latter two of which are what you appear to do more often than I am comfortable with. I can’t speak for my co-bloggers, but I will be with you when you are correct and against you when I think you are wrong, as in here. You may have thought that doing a post saying that flu vaccines are still “for idiots,” complete with photos of of a pidgeon reading a book about pooping on people and a tasteless photo of “cretins” proclaiming, “Even these guys think your an idiot” was funny. I do not. I think it’s extremely irresponsible. The issue of flu vaccines and the the potential swine flu pandemic deserve better than your sophomoric attempt at humor.

But, hey, what do I know? I’m just one of those “stupid” people you dismiss who has concluded, on the basis of the scientific evidence, that flu vaccines are worthwhile, chemotherapy can save lives, and that mammography, when properly used as a screening tool, benefits women.

Sincerely

David Gorski, MD, PhD

P.S. Perhaps while you’re at it, you could answer me one question: Do you think that vaccines cause autism?

Posted in: Medical Academia, Pharmaceuticals, Public Health, Science and the Media, Vaccines

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