The Panic Virus

When Seth Mnookin and his wife found out they were expecting their first child they got all sorts of unsolicited advice form friends and family about vaccines and their safety. He decided to investigate for his personal reasons and in the process felt it would be an intriguing topic for a book. In an interview he stated that his original intent was to just present the controversy. However, after finding that all of the evidence was on one side he turned the book into an expose’ on those that preach fear at the expense of logic, evidence and children’s safety. The Panic Virus is that book.

The anti-vaccination groups out there are really good at getting you to ignore the logic and the lack of evidence. They focus on a few heart breaking stories of kids who were diagnosed with autism at roughly the same time they were vaccinated and then try to get use to connect the dots and link the two. The stories are truly heart-breaking but no matter how sad they are that doesn’t prove that the vaccines caused these kids’ conditions. What makes Mnookin’s book stand out over the many others out there is that he fights fire with fire. Rather than just focus on the statistical and epidemiological evidence that shows absolutely no casual link with vaccines, Thimerosal or mercury; Mnookin bests the antivaxers at their own game. He tells much more emotional stories of children being crippled or dying of Polio, Pertussis and Measles because they were not vaccinated. Jenny McCarthy has stated that she is just fine with this kind of collateral damage.

The Panic Virus is a brilliant and timely history about the manufactured controversy about vaccine safety. From the initial Lancet report all the way to Dr. Wakefield’s complete and thorough discreditation, Mnookin shows that vaccines are safe and effective and do not cause autism.

My only criticism of the book is the same that I’ve had with others too. I have become so familiar with this topic that I was waiting for him to tell me something new. I‘ve grown used to reading articles daily on autism and vaccines. I have news aggregators send me any story with the word Andrew Wakefield in the body. But I had to take a step back and look at the book from the perspective of somebody not as familiar as I was. It is a great resource.

I encourage anybody who has an questions at all about the safety of vaccines to please read this before you hesitate to vaccinate your children. You should be convinced by the evidence that getting vaccinated is much safer than not vaccinated. And if that’s not enough the evidence of fraud, shoddy research, dishonesty, conflict of interest and foul play by the anti-vaccination community should sway you the rest of the way. And if there is still any doubt left in your mind the heart-breaking stories of children dying from easily preventable illness should completely tip the scales.

Fear of Science Will Kill Us

Not again...

Take a second to read this article. It's good to see someone finaly give a skeptical report of facilitated comunication. FC is a cruel farce that just will not go away. In test after test after test it has been shown that the patient cannot answer simple questions when the facilitator does not know the answers. Show a patient a card with a word and a picture on it and even spell out the word for them and they can re-type the word with the facilitator’s assistance. Then take the facilitator out of the room, when another card is shown and the word spelled. Bring the facilitator back in and the patient cannot spell the word. The only reasonable conclusion here is the most obvious one, the facilitator is just using the patient’s hand like a Ouija board pointer and typing the word herself, not the patient. Since she didn’t see or hear the word she can’t answer the question.

This is a particular thorn in my side because as I’ve said before, my brother-in-law is severely autistic and primarily non-verbal. No single medical breakthrough would trill me more than the ability to sit down with him and have a meaningful conversation. Unfortunately, FC is not that breakthrough. I believe that most facilitators are self-deceived, but some of them know full well it is a scam and are selling parent’s false hope in order to make a buck. It really chaps my hide to see once again some idiot reporter give a totally credulous report of a non-medical breakthrough. An eight year old can look at what is going on here and see right past it, but somehow reporters at MSNBC who call themselves "Dr" are completely taken in.

Why We Make Mistakes

For years I've been fascinated with the concept of human decision making. I've enjoyed reading books that explore this concept. I'm also intrigued about the strategies that people use to justify their mistakes and the cognitive dissonance required to make your actual decisions jive with what you know is right.
Why We Make Mistakes: How We Look Without Seeing, Forget Things in Seconds, and Are All Pretty Sure We Are Way Above Average by Joseph Hallinan is my latest read on this subject. In the opening chapter of the book Hallinan describes a commercial airliner simply flying into the ground because they got too hung up on a small light that was burned out ans ignored the fact that the plane was slowly loosing altitude. I felt that this one simple metaphor described the rest of the book. We do lose focus of the things that are truly important. And all too frequently our focus was shifted by relatively trivial details.
Hallinan skillfully points out how uncommon common sense really is. But rather than just blame the decision maker he talks about how we can put ourselves into positions that will help to make better decisions. sometimes it takes a design difference so that, for instance, clockwise is off on all the knobs. Things like always putting the hot on the left and the cold on the right, etc. Sure it sounds like a simple design issue but he gave some frightening mortality statistic from an anesthesia machine that was clockwise for off on on drug and counter-clockwise for another.
Hallinan compared the airline industry to operating room. In the past few decades accident rates in the airline industry have dramatically dropped and there has been an increase in the operating rooms. Hallinan points to the main cause of this as the changes that have been made to the authority system in on and not in the other.
In the airline industry anybody the cockpit is virtually free of authority struggles. Many decisions are not based on rank or position. A 20 year old air traffic controller tells the pilot where to land and the pilot obeys and doesn't pretend that he knows better just because she's been doing flying since the controller was a kid. In the cockpit as well the co-pilot and even attendants are valuable resources and their input is encouraged.
Conversely, this authority system seems to be trending the other direction in the operating room. Doctors all too frequently are seen as unquestionable. Even in situations where nurses have spoken up to prevent the error Hallinan sights instances of flipped x-rays and the wrong limb being removed.
A few years ago my youngest daughter had to have a tooth pulled. We went to see the specialist with the x-ray from our dentist. She'd taken a fall on the driveway and one of her teeth was a starting to go gray. The x-ray seemed to confirm that the root on the graying tooth was dying. When we went to get her tooth pulled the nurse questioned the x-rays. She thought we we looking at it backwards. The dentist did not question her and called to have another x-ray taken just to be sure. She was absolutely right. In spite of the fact that one tooth was starting to turn gray it was the tooth on the other side that had the dead root. The dentist went ahead and pulled the dying tooth and the gray tooth eventually regained its color. Had that nurse not spoken up and, more importantly, had the dentist not accepted her advice Eve would have had to go back and have the correct tooth pulled later and they'd have had a very upset father on their hands. I'm very grateful to have had a dentist who was willing to admit that he could make mistakes and ultimate prevent them.
I enjoyed this book and would recommend it to anybody who is aware that they can make mistakes. I also think it should be force feed to anybody who thinks that they can't.

Trick or Treatment cont.

I’ve just finished reading Trick or Treatment. Since I’ve made it a little bit of a hobby to stay informed about the science or lack thereof behind many alternative treatments, I can’t really say that much of the information in the book surprised me. However, the thorough history of these treatments’ origins gave me a better understanding of why so many people choose to believe in these treatments even after the foundations that they are built on have shown to have no basis in fact or evidence.

Their evaluation was primarily limited to acupuncture, homeopathy, chiropractic and herbal medicines. Each was given a very good historical overview. Then they started looking into the actual trails to test each treatment. With most of them the treatments were found to have little to no effect beyond that of placebo. In evidence-based science research if you find an anomalous effect and to try to isolate that effect to test it the effect gets stronger as you increase your protocols and the test can be duplicated by other researchers. In nearly all of the tests of acupuncture, homeopathy and chiropractic the results were indistinguishable from placebo and any anomalous effects disappeared once the proper controls were in place. So clearly if these treatments are working at all they are not working because the water had a memory of the arsenic it used to contain, the innate intelligence can travel up and down the spine, or the chi’i can flow better along the meridians.

The one treatment they authors did find more effective than placebo was the herbal treatments. This was not, however, an endorsement. Unlike the other three treatments discussed in the book herbal treatments actually have active ingredients. Those active ingredients may indeed have positive effects. They also have side-effects. (I always get a kick out of the infomercials for homeopathic remedies that brag about having no side effects. Of course they don’t have any side effects. They have no effects at all.) The inconsistent dosages and lack of controls that would be put on these products otherwise make herbal treatments the most dangerous of the ones reviewed.

My personal concern is not that any of these treatments themselves would be harmful. The real danger comes from the fact that while the patient is busy trying these alternative treatments they are forgoing the evidence-based treatments that could really help them.

Rather than just seeming like a couple of guys who had an axe to grind the authors genuinely come across as open-minded seekers of evidence. In fact one of the authors used to be a practicing homeopath. He became disillusioned with his trade after he tried to recreate Hahnemann’s original experiment that was supposed to have cured malaria. After numerous trials he was forced to conclude that there must have been some mistake in Hahnemann's original work. Since that experiment was the foundational experiment in the whole “like cures like” philosophy of homeopathy, the author was forced to question the entire field. His research not only convinced him that homeopathy is just a placebo, it was a very expensive one to boot.

In the last chapters the book calls for stricter government control and labeling of all treatments that may take the place of traditional medicines. My libertarian views normally restrict me from endorsing big government solutions. However, these treatments clearly represent a danger to the taxpayers when they are taken in place of more tested, evidence-based treatments. I wouldn’t want the government to restrict them entirely, but I see no problem with stricter labeling laws.

Several years ago a guy I know was diagnosed with leukemia. He is an alternative medicine practitioner. He has gone to India to study several different forms of treatment. He is even a believer that the Earth has acupuncture meridians and that we can fix the climate problems by simply placing large needles in the Earth at exactly the right point. (I wish that last sentence was a joke, but it isn’t). As detached as his beliefs were I really though that he wouldn’t be around much longer once he was diagnosed with leukemia. The last time I spoke with him his leukemia was in full remission and it wasn’t because of any alternative treatment. It was because he took his doctor’s recommendation and had a very aggressive, mainstream treatment that included radiation treatment and chemotherapy. I am so thankful that he did not risk his own life with alternative treatments.

Note:
There are different ways to Romanize the pronunciation of the Chinese word 気. I’ve seen it spelled ki, qi, chi, and chi’i. for these posts I simply used chi’i because that was the one the authors chose. Technically it is pronounced 気.

Trick or Treatment

It's been a while since I've reviewed a book on my blog. Primarily, because I really haven't read much in the last couple months. I have been reading, but most of the books have been on how to play the guitar and not really good subject of book reviews. Victoria checked out a few book that she thought I'd like. Wanting a little break from the guitar, I started reading the first one yesterday.
Trick or Treatment is a very thorough study of several of the more popular trends in alternative medicine. The first chapter is a history of the scientific method and a lesson on how we discover what works and what doesn't. The authors focus on what they refer to as evidence-based medicine. All the anecdotes and sales pitches mean nothing if the treatments don't stand up to rigorous scientific testing. Lets put the superstition, snake oil and wishful thinking aside and focus strictly on the facts.
The remaining chapters of the book deal with the top four of alternative therapies; acupuncture, homeopathy, chiropractic and herbal remedies. So far I've only read the chapter on acupuncture. But if they handle the other chapters as thoroughly as they did acupuncture I know I will enjoy them.
I was very pleased that the authors did not start out with an agenda. Their only loyalty is to the evidence. Honestly, I was a little surprised that they had anything positive to say about acupuncture at all. After finding no evidence of the alleged mechanism of acupuncture, chi'i, I expected them to just conclude that the entire practice was based on a flawed understanding of human physiology. While they admitted there is no evidence of chi'i and that the very nature of acupuncture negates a true double-blind test they did say that in certain cases it does promote pain relief. Until somebody figures out a way to truly double-blind test acupuncture it may be impossible to tell weather this is a real effect of the treatment or if it is placebo.
I'll give a complete review after I finish the book. In a day and age when Jenny McCarthy is telling us to just trust her "mommy instinct" and not vaccinate our kids it is refreshing to read a book that bases its conclusions on evidence and not just emotion, anecdotal evidence and superstition.