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Do two half-truths add up to a complete truth or a complete falsehood?

olivia-twenty-dahl

I swear that the evidence that I shall give, shall be the truth, the whole truth and nothing but the truth

The interwebs are not a court of law, that is for sure. The whole truth. Interesting idea. I have no idea how applicable Godel’s theorems are outside of mathematics, but from a practical point knowledge is always incomplete. There is too much to know and too little time and brain power to acquire perfect knowledge of a topic.

It is why medicine is a challenge. You have to synthesize all the available data, which is often incomplete. You have to decide what is quality information, what is not, and why, and how a given study or fact fits into the overall picture, on the continuous asymptotic journey towards unobtainable total knowledge. But you try for the whole truth, the good, the bad and the ugly.

Half-truths, partial stories, can be hard to challenge. In part because, well, they are half-true. They have an air of truthiness. It is perhaps much easier to counter an out-and-out lie. Well, maybe not. I’m thinking Wakefield here. I suspect that in having to admit that half-truths have some validity, it renders them more believable.

The world of pseudo-medicine, and pseudo-science, is filled with half-truths. I wonder when I read these half-truths whether the author is deliberately avoiding all the information, especially since the rest of the story often results in the weakening the impact of the half-truth. Paul Harvey could have had a field day with the anti-vaccine literature.

One of the greatest challenge facing young people today, is the large scale availability of half truth’s and manipulated facts
– Oche Otorkpa, The Unseen Terrorist

Influenza

Beware of the half-truth. You may have gotten hold of the wrong half.
– Author unknown

Take “Do Not Believe Everything You Read About Flu Deaths” from the October, 2014 Journal of Advanced Practice Nursing. As best I can tell this is a peer reviewed journal. You know, “peer“, as in “to appear partially or dimly.”

I imagine someone squinting over the top of their glasses at the manuscript, muttering, “that ‘peers to be a paper about influenza deaths. Let’s publish it.”
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Posted in: Critical Thinking, Vaccines

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Gut Check

Lactobacillus acidophilus

Some apparently rather useless Lactobacillus acidophilus

I always cringe when I see an acupuncture headline with ‘needle’ or ‘point’ in the title. Can’t the writer avoid the clichéd pun? I had an editor who commented that the titles of my essays are often obtuse. Probably true. In going back over my essays on SBM I often can’t tell from the title what I have written about until I read the article. It is a fine line between (what I think) is a clever title and obscurity. So gut check it is.

Time flies when you are having fun. I wrote about probiotics back in 2009.

My conclusion at the time:

Probiotics are useful for the prevention of antibiotic-associated diarrhea. Probiotics may be helpful in preventing other overgrowth syndromes or diseases associated, and perhaps with perturbations of the gut microbial flora such as IBS and colic.

Probiotics are foreign bacteria that are not a normal part of your GI tract; they do not enhance your immune system and, in normal people do not promote the nebulous bowel health.

If you are a normal human, with a normal diet, save your money. Probiotics have nothing to offer but an increased cost.

Medicine is not static and there have been interesting advances in the understanding of the human microbiome in health and disease since 2009, so for SBM and my own medical understanding, I thought it would be a good opportunity to review the topic. Although with over 12,000 references on the PubMeds, I will only touch on a smattering of the papers. My ID attending in medical school always referred to reading the medical literature as drinking from a fire hose. Indeed. (more…)

Posted in: Herbs & Supplements

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SfSBM at NECSS. Update and More

Screen Shot 2015-01-09 at 1.35.26 PM

A day of Science-Based Medicine, a weekend of science and skepticism

Registration for NECSS, the North-East Conference on Science and Skepticism, is now open. Included in the program will be a day of Science-Based Medicine.

Speakers will be Harriet Hall, Jann Bellamy, David Gorski, Steve Novella and Mark Crislip.

NECSS will be held April 9th–12th, 2015, in New York City at the Fashion Institute of Technology. The SfSBM part of the program will be Friday, April 10 and you can attend one or more of the days. $95 for one day or $195 for the entire conference.

A preliminary program, subject to change

Time Speaker Topic
10:00 Steve and David Introductions and Welcome.
10:10 Steve TBA
10:40 Harriet Chiropractic
11:10 David Integrative Oncology
11:40 Mark Acupuncture
12:10 A buffer because we will run over
12:30 Lunch
1:00 Lunch
2:00 Jann Legislative alchemy
2:30 Panel Topic pending
3:15 Question and answer Questions from the twitter and audience
4:15 Break
4:00 Crislip MC, Jann, David, Jeopardy
Steve and Harriet Compete
5:00 Wrap up
5:15 SfSBM business meeting
5:45 End

For more information and to register, go to NECSS or this registration page.

The Society for Science-Based Medicine is a co-sponsor of NECSS and paid SfSBM members can get a 15% discount using the code SFSBM2015.

This would be a good time to consider joining or renewing a membership in the Society for Science-Based Medicine.

But wait! There’s more.

A self-aggrandizing moment.

You may not know this, but for a year I blogged on my own on the topic of infectious diseases.

I had self-published those early essays in a volume and readers gave it good reviews: 4.5 Stars on Amazon and a 3.89 on Goodreads, but they complained about the lack of copy editing. Go figure.

Screen Shot 2015-01-17 at 8.54.52 AMNo longer. Bitingduck press is my publisher and has collected, edited, and organized the first year’s Rubor, Dolor, Calor, Tumor blog entries, now available on Kindle for a mere $5.99. Other versions, including a paperback, to follow in about 10 days. It should be 99% typo free.

Puswhisperer: A year in the life of an Infectious Disease Doctor.

The perfect gift for the pus lover in your life.

Posted in: Announcements

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SfSBM at NECSS

Screen Shot 2015-01-09 at 1.35.26 PM

A day of Science-Based Medicine, a weekend of science and skepticism

Registration for NECSS, the North-East Conference on Science and Skepticism, is now open. Included in the program will be a day of Science-Based Medicine.

Speakers will be Harriet Hall, Jann Bellamy, David Gorski, Steve Novella and Mark Crislip.

NECSS will be held April 9th–15th, 2015, in New York City at the Fashion Institute of Technology. The SfSBM part of the program will be Friday, April 9 10 (that’s the 10th, not the 9th) and you can attend one or more of the days. $95 for one day or $195 for the entire conference.

The precise program will be announced soon.

For more information and to register, go to NECSS or this registration page.

The Society for Science-Based Medicine is a co-sponsor of NECSS and paid SfSBM members can get a 15% discount using the code SFSBM2015.

Posted in: Announcements

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Mel asks and I do my best to answer.

Several snarks were painfully maimed in the writing of this blog post

Several snarks were painfully maimed in the writing of this blog post

I read a lot of the pseudo-medical websites. The writing is at best pedestrian, often turgid, and, at its worst, incoherent. It is rarely either engaging or clever.

Wit, the clever bon mot, the amusing turn of phrase or retort, is rare at best. So rare I cannot think of an example. It is ironic that those who engage in fantastical treatments are so often lacking in cleverness with language and thought. The closest you get to humor are the painfully-lame cartoons at the Natural News. I am sure that the readers will flood the comments with examples of all the clever writing I have missed in the world of pseudo-medicine just to prove me wrong. Not that the reality-based world is much better. It is the rare author on the internet whose style keeps me coming back for more.

But for some reason I found “Dear Science Based Medicine, Just a Few Questions About Acupuncture” funny and engaging, at odds with most of the purple quasi-paranoid articles I normally read. Just the right amount of chatty snarkiness to be enjoyable, at least for me. So refreshing given the style of the usual pro-acupuncture comments. Your millage may vary. (more…)

Posted in: Acupuncture, Critical Thinking, Energy Medicine, Traditional Chinese Medicine

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Acupuncture Odds and Ends

I’m cheating. No, I’m recycling. ‘Tis the season to have to no time to get anything done. Since I know none of you pay attention to the blog of at the Society for Science-Based Medicine and I have no time with work and the holidays to come up with new material, I am going to collect and expand on the entries on acupuncture I wrote from SfSBM. Anything I write really is worth reading twice. I really need to make my multiple personality disorder work for me, but the Goth cowgirl persona is a luddite at best, so you are stuck with the over -extended ID doctor. Here goes.
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Posted in: Acupuncture, Traditional Chinese Medicine

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Homotoxicology

What you’ve just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.
—James Downey, Billy Madison

Pictured: Toxins coming out.  Or cancer.  Whatever it is, it's your fault.

Pictured: Toxins coming out. Or cancer. Whatever it is, it’s your fault.

My first experience with SCAM was as a first year medical student. I was on the bus to school when the person next to me asked, after looking at my reading material, if I was a medical student. Yes, I am. Why so was he, enrolled at the local naturopathic school. I knew nothing about naturopathy, or medicine for that matter, at the time, so when he told me that warts were not caused by a virus but in fact due to the body walling off toxins and expelling them through the skin, I did not have much to say. I suspected it was nuts, but lacked the education or understanding of disease to know for sure, and who knew, maybe he was on to something.

When we got to cutaneous diseases I learned that warts were indeed caused by the papilloma virus, not toxins, and the best therapy remained swinging a dead cat in a graveyard at midnight. So I filed that curious incident away as a fluke, even though it is part of standard naturopathic teaching, which is often separated from reality.

It should not have surprised me that there is a whole field of pseudo-medicine devoted to the pseudo-treatment of pseudo-toxins that goes by the nom de scam of Homotoxicology. Yet another One True Cause of all disease. Being a splitter, I think Harriet missed this one. All diseases in this particular SCAM are due the toxins and the bodies attempt to remove them. (more…)

Posted in: Homeopathy

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In the Spirit of Choosing Wisely

Oh, loneliness and cheeseburgers are a dangerous mix.
– Comic Book Guy

Same can be said of viral syndromes and Thanksgiving. My brain has been in an interferon-induced haze for the last week that is not lifting anytime soon. Tell me about the rabbits, George. But no excuses. I have been reading the works of Chuck Wendig over at Terrible Minds. (Really, really like the Miriam Black books). Writers write and finish what they start and only posers use excuses for not completing their work.

Recently I attended an excellent Grand Rounds on some of the reasons doctors do what they do. Partly it is habit. We learn to a certain way of practice early in our training and it carries on into practice and it is not always best practice. Patients also learn from us and have expectations on what diagnostics or treatments they should receive, and that too it is not always the best practice.

So to educate physicians and patients, the American Board of Internal Medicine (ABIM) started the Choosing Wisely initiative. (more…)

Posted in: Acupuncture, Chiropractic, Critical Thinking, Energy Medicine, Homeopathy, Science and Medicine

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Why Get A Flu Shot?

Banner_-FLU_Be_Aware_and_Be_Prepared-

Actual discussion:

Parent “I want vaccine for my child”

Doc “There isn’t one, but we have

Parent “We don’t believe in that”

So much of what we are for at Science-Based Medicine is reflected in what we oppose: all the pseudo-medical interventions and SCAMs. It is not always a positive message, forever noting why you should not be participating in a given bit of fantasy-based medicine. We are often the nay-saying curmudgeons of the medical world. Even for medical topics about for which I am in strongly in favor, vaccines, much of my prose is devoted to countering myths and lies about influenza vaccines, from why the Cochrane review is messed up to why health care workers are dumb asses for not being vaccinated.

Well no Debbie Downer or Crotchety Crislip today. Nope. We are going to ride our Rainbow Unicorn to the land of Happiness and Immunity and discuss some of the reasons why you and yours should get the influenza vaccine. (more…)

Posted in: Vaccines

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Infinite Variety?

Age cannot wither her, nor custom stale. Her infinite variety.
– William Shakespeare

This is not a typical post for me, but something I have been meaning to do to satisfy my own curiosity. I have wondered, how many variations of acupuncture are there? I suspected a lot, but I thought I would go looking and make a list. Since acupuncture is not based in reality but is instead a collection of pseudo-knowledge, there is no reason for acupuncture to have fidelity to fundamental concepts. I suspect in the US that in the future acupuncture will become less heterogenous as schools start teaching to the test that allows for acupuncture licensure. For now variation rules.

Acupuncture needling

So this will be a list, with description and commentary. If a missed form of acupuncture is noted by others, and I am sure I have, I will expand the list in an addendum. (more…)

Posted in: Acupuncture

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