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The Gene: An Intimate History

A superb writer, Siddhartha Mukherjee's books are easier to read than his name is to spell

A superb writer, Siddhartha Mukherjee’s books are easier to read than his name is to spell

Six years ago I reviewed Siddhartha Mukherjee’s book The Emperor of All Maladies: A Biography of Cancer. It was hands-down one of the best books I have ever read on a medical topic. Now he’s done it again. His new book is titled The Gene: An Intimate History.

Mukherjee is a superb writer. Much of what I said about his first book applies equally to his second, so I will quote myself:

It is a unique combination of insightful history, cutting edge science reporting, and vivid stories about the individuals involved: the scientists, the activists, the doctors, and the patients. It is also the story of science itself: how the scientific method works…

Beautifully written and informative

Reads like a detective story with an exciting plot.

He links this second book to his first by pointing out that cancer is an ultimate perversion of genetics, and that studying cancer means also studying its obverse: normalcy. He gives the subject a human face by interspersing anecdotes from his own family’s struggles with mental illness and its connection to inherited genes. He sets out to tell the story of the birth, growth, and future of one of the most powerful and dangerous ideas in the history of science: the gene. He says it is one of three destabilizing ideas that have transformed science: the concept that irreducible units underlie matter (the atom), digitized information (the byte or bit), and biological information (the gene). He explains how the consequences of these ideas have transformed our thinking, our language, our culture, politics, and society. (more…)

Posted in: Basic Science, Book & movie reviews, History, Medical devices

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Reviewing Andrew Wakefield’s VAXXED: Antivaccine propaganda at its most pernicious

VAXXED

I’ve finally seen it. I’ve finally seen Andrew Wakefield and Del Bigtree’s “documentary” VAXXED: From Cover-up to Catastrophe, and I didn’t even have to pay to see it! Now, having watched Wakefield and Bigtree’s “masterpiece,” I can quite confidently say that it’s every bit as accurate and balanced a picture of vaccine benefits and risks as Eric Merola’s two movies about the quack Stanislaw Burzynski and his Second Opinion: Laetrile at Sloan-Kettering are about cancer and cancer research, The Beautiful Truth is about the Gerson protocol for cancer, Simply Raw: Reversing Diabetes in 30 Days is about diet and diabetes, Expelled! No Intelligence Allowed is about evolution, and The Greater Good is about…vaccines! Of course, based on what I knew of the story, saw of the VAXXED trailer (which deceptively edited together statements by William Thompson), and have discussed about the efforts of Andrew Wakefield, Del Bigtree, and Polly Tommey to use VAXXED as a tool in a publicity campaign to try to spread fear, uncertainty, and doubt (FUD) about vaccines using the “CDC whistleblowerconspiracy theory (about which a primer can be found here), I shouldn’t have been surprised, but I was actually surprised (slightly) at the manipulative depths to which this film sinks.

On the plus side, its production values are better than those Eric Merola’s films (although I, with no experience, could probably make a film with better production values than Merola), but that just makes it somewhat more effective propaganda. In my review and discussion of the movie and its claims, I will discuss the claims made by Bigtree and Wakefield as well as the movie as a movie. Unfortunately, there is so much misinformation in this 91 minute documentary that I will only be able to hit the “high” points without going far, far beyond even a Gorski level of logorrhea in this post. Worse, there is a considerable amount of dishonest framing, in which actual facts and events are presented in a deceptive manner to tell a distorted narrative. Before that, though, let’s meet the key players.
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Posted in: Book & movie reviews, Politics and Regulation, Science and the Media, Vaccines

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Vegan Betrayal: The Myths vs. the Realities of a Plants-Only Diet

If vegans really followed these guidelines, they could get adequate nutrition; but all to often they don't.

If vegans really followed these guidelines, they could get adequate nutrition; but all too often they don’t.

 

NOTE: The original version of this book review was criticized for not making it clear when I was simply reporting the book’s content and when I was expressing support for one of its arguments. I have revised it to make it more clear. The additions are marked by brackets.

 

Vegetarians come in several flavors. Ovo-vegetarians eat eggs, lacto-vegetarians eat dairy products but not eggs, ovo-lacto-vegetarians eat both eggs and dairy products. Pescatarians eat fish but no other animals. Vegans eat nothing derived from animals. Vegans have claimed that a plants-only diet offers a multitude of health benefits, is better for the environment, and is the only ethical choice. While some of them respect the dietary choices of others, some of them proselytize with religious-like fervor and are working to get their diet adopted by all of humanity. In her new book, Vegan Betrayal: Love, Lies, And Hunger In A Plants-Only World, Mara Kahn questions those beliefs, pointing out that no human population has ever endured on a plants-only diet; that while some studies have shown short-term health benefits, long-term follow-up is missing; that long-term vegans frequently experience “failure to thrive,” go off their diet, and feel better when they return to eating meat; and that veganism might actually harm the environment and might not even save animal lives overall.

The book is really three books interleaved into one:

  • The story of her own experiences as a vegan.
  • An evidence-supported analysis of veganism and vegetarianism
  • Some rather woo-woo ideas about finding a unique diet for each individual

I can highly recommend the first two, but I deplore the third. (more…)

Posted in: Book & movie reviews, Nutrition

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Book Review Lagniappe

bookworm
Lagniappe, a word often heard in New Orleans, refers to a bonus or extra gift, like the thirteenth donut in a baker’s dozen. You may have noticed that I write a lot of book reviews. I read far more books than I review, and I have always loved to read about the experiences of doctors and the interesting patients and intriguing illnesses they have encountered. I thought I would write an extra post this week to share some titles that SBM readers might also enjoy.

I value these books for several reasons. They are entertaining. They prove that doctors are not all evil Big Pharma shills just in it for the money. They let readers vicariously experience what it is like to be a doctor in a particular specialty or setting. They highlight the joys of helping patients, as well as the many frustrations doctors struggle with. They put a human face on the practice of medicine. (more…)

Posted in: Book & movie reviews

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Uncertainty in Medicine

snowball
Medicine is an uncertain business. It is an applied science, applying the results of basic science knowledge and clinical studies to patients who are individuals with differing heredity, environment, and history. It is commonly assumed that modern science-based doctors know what they are doing, but quite often they don’t know for certain. Different doctors interpret the same evidence differently; there is uncertainty about how valid the studies’ conclusions are and there is still considerable uncertainty and disagreement about things like guidelines for screening mammography and statin prescriptions.

Snowball in a Blizzard by Steven Hatch, MD, is a book about uncertainty in medicine. The title refers to the difficulty of interpreting a mammogram, trying to pick out the shadows that signify cancer from a veritable blizzard of similar shadows. (more…)

Posted in: Book & movie reviews, Science and Medicine

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Vaxxed and the Tribeca Film Festival: How Robert De Niro learned the hard way about Andrew Wakefield and the antivaccine movement

Robert De Niro made a massive mistake last week.

Robert De Niro made a massive mistake last week. Fortunately, he started to make up for it.

One of the disadvantages of only doing one blog post a week here at Science-Based Medicine is that sometimes stuff happens at too fast a pace for me. If something happens on Tuesday, by the time Sunday rolls around and it’s time for me to do my weekly post, it’s often old news, too old to bother with. That’s why it’s a good thing that I have my not-so-super-secret other blog, where I can keep up with such events. On the other hand, the advantage of a once-a-week posting schedule is that there are times I can look back at a story that evolved over the last week and, instead of blogging about it in daily chunks, I can put together a post that tells the whole story and puts it in context. Something like that happened last week. The beauty of it is that I played a major role in bringing the story to public consciousness, followed the story as it evolved, and now can provide a fairly complete recounting. Or so I hope.

First, however, let’s take advantage of another good thing about waiting to blog about a story, namely getting to see the reactions of quacks to what happened. No one can do it better than everybody’s favorite all around quack, crank, and all-purpose conspiracy theorist Mike Adams, who greeted me yesterday morning with this headline: VAXXED film pulled from Robert De Niro’s Tribeca Film Festival following totalitarian censorship demands from pharma-linked vaccine pushers and media science trolls. What on earth is Adams talking about, you might wonder? In case you haven’t been following the news, here’s a link to the New York Times story on the same incident: “Robert De Niro Pulls Anti-Vaccine Documentary From Tribeca Film Festival.” Basically, the 2016 Tribeca Film Festival selected an antivaccine documentary directed by Andrew Wakefield for screening and then thought better of it after a major uproar and a whole boatload of bad press.

I’ll deal with Adams’ post a bit later because it’s so hilariously nutty but also because it is basically the propaganda line that antivaccinationists are putting on this PR debacle brought about by Andrew Wakefield and Robert De Niro. (I never thought I’d use those two names in the same sentence.) Let’s go back a week and see what I mean. (more…)

Posted in: Book & movie reviews, Science and the Media, Vaccines

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The Essential Role of Regulation In Human Health and In Ecology: The Serengeti Rules

serengeti

The doubling time for E.coli bacteria is 20 minutes. With uncontrolled growth, it would take a mere two days for the weight of bacteria to equal the weight of the Earth. What rules determine the actual numbers of bacteria? Why is the world green; why don’t insects eat all the leaves? How does the body maintain homeostasis? What determines the uncontrolled growth of cancers? What happens when you remove natural predators from an ecosystem?

You can find the answers in Sean Carroll’s new book The Serengeti Rules: The Quest to Discover How Life Works and Why It Matters.

Everything is regulated: every kind of molecule, cell, and process in the body is maintained in a specific range and governed by a specific substance or set of substances. Diseases are mostly abnormalities of regulation. Too little insulin = diabetes. Uncontrolled cell multiplication = cancer. To intervene in disease, we need to understand the rules of regulation.

Carroll calls them the Serengeti Rules because of the ecological rules that regulate the predator/prey ratios in Africa. But the same rules apply everywhere, at every level of biology. (more…)

Posted in: Basic Science, Book & movie reviews, Cancer

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Persecution of Scientists Whose Findings Are Perceived As Politically Incorrect

galileo
It dates back at least to Galileo. A scientist finds evidence that contradicts a cherished popular belief. Instead of a rational examination of his evidence, he is subjected to vicious personal attacks. Alice Dreger examines the phenomenon in her book Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science. She is eminently qualified to do so. She is a professor of clinical medical humanities and bioethics, a historian, a gifted writer, an activist for patient rights, and an indefatigable investigative journalist who has herself been a victim of the kind of persecution she describes.

The histories she recounts are horrifying. She gives example after example of activists using lies and personal attacks to suppress evidence they don’t like. She reveals dirty linen in the most unexpected places. (more…)

Posted in: Book & movie reviews, Science and the Media

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Cure Is About Caring, Not Curing: Placebos, Alternative Medicine, and Patient Comfort

cure
In a recent post, Dr. Gorski criticized two articles by Jo Marchant on placebos and alternative medicine. He mentioned that she had a book coming out and suggested I might want to review it. The title is Cure: A Journey into the Science of Mind Over Body.

I don’t know of any evidence that the mind has ever cured a disease, so I would have been prejudiced against this book just from its title, and Dr. Gorski’s post prejudiced me even more. But I was willing to give it a fair trial. The publisher sent me a review copy of the book and I read it. I was expecting to hate it, but I was pleasantly surprised. I enjoyed reading it. I found it fascinating. I found myself agreeing with much of what Marchant says, and I was intrigued by some of the recent research she reports that I was not yet aware of. Preliminary studies, to be sure, but thought-provoking. The book challenged me to think more deeply about placebos, alternative medicine, and patient comfort. (more…)

Posted in: Book & movie reviews

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Neurotribes: A Better Understanding of Autism

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What is autism? What causes it? Is it genetic? Is it a consequence of something in our environment or lifestyle? What’s an “idiot savant” or an “autistic savant”? What happens when autistic children become adults? Why are so many of their parents scientists, academics, and engineers? If your grandfather’s Uncle Fred was a socially inept inventor with a lot of strange quirks, do you think he might have been autistic? Is autism really becoming more prevalent, or are we just getting better at diagnosing it? What’s happening with these people and what can be done to give them a better life?

Sorry to burden the list of recommended reading with yet another book, but if you are on the autism spectrum, if you know anyone who is autistic, if you think there is an epidemic of autism, if you think vaccines or environmental toxins cause autism, or if you are just interested in autism and want to understand it better, you will benefit from reading this new book by Steve Silberman: NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. You will walk away from the book with new insights and a new appreciation of the “neurodiverse.” (more…)

Posted in: Book & movie reviews, Neuroscience/Mental Health

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