Evolution Intelligent design/creationism Medicine Skepticism/critical thinking Surgery

The Energizer Bunny of antievolution

i-d5565635b918cfa067c599ce43e9024a-BnyBigBunny_img.jpgI need some β-blockers STAT.

I say that not because I’m hypertensive or because I’m having heart palpitations–at least not at the moment. I’m saying it because, after reading the latest brave foray into antievolutionary ignorance by–as much as I hate to admit it–a fellow surgeon named Dr. Michael Egnor, I need to do something for prophylaxis against such problems. Yes, Dr. Egnor is back again, hot on the heels of taking massive and muchdeserved abuse from the science blogosphere (including a heapin’ helpin’ of Respectful Insolence™ from me) over his spreading of misinformation and particularly for his paean to medical student ignorance in which he claimed that “Darwinism” is completely unnecessary and irrelevant to modern medicine. I’ve basically resigned myself to the fact that Dr. Egnor will be enthusiastically letting the “intelligent design” creationists over at the Discovery Institute suck up to him and trot him out as a BRAIN SURGEON (which, as we all know, means he must be qualified to talk about evolution, right?) to spread his particularly annoying statements about evolution and medicine. Indeed, I hadn’t planned on writing about him again for a while, mainly because it causes me agitation and even heart palpitations (hence my request for β-blockers) to contemplate the sheer arrogance that it must take to spout off again and again about a topic that Dr. Egnor clearly does not understand, all the while dazzling his new friends with his credentials as an academic neurosurgeon and his willingness to cheerfully make statements just as brain dead as a Discovery Institute press release.

And then I came across another podcast by Dr. Egnor.

Forgive me, dear readers, if I’ve dwelt on Dr. Egnor too long. It may be that this will be going back to the well one time too many, but his latest escapade has to be the worst of the lot, begging for one final application of Respectful Insolence™ before I can let the topic of the antievolutionist brain surgeon rest for a (hopefully long) while. You may wonder at my sanity for subjecting myself to this insanity and then even going so far as to transcribe parts of it. Think of it as a public service, where I take the hit, so that you don’t have to–although, to get the full vomit-inducing flavor of the interview, you really do have to listen for yourself. Don’t thank me, though for taking one for the team. It’s my duty, albeit not my pleasure.

Once again, as before, Dr. Egnor is being interviewed by chipper Discovery Institute flak Casey Luskin, who can’t resist starting out with some serious brown-nosing to the Great Dr. Egnor:

LUSKIN: Well, I really enjoyed talking to you last time. We learned about some of the reasons that you are a scientific skeptic of evolution. After all, you’re only a Professor of Neurosurgery. So what do you know about this subject?

[Both laugh]

EGNOR: Right.

LUSKIN: But I’d like to know some more about, you know, I think that maybe some of our Darwinist friends, if you don’t have a Ph.D. in evolutionary biology, they complain that you aren’t qualified to talk about the subject. Even if you do have a Ph.D., sometimes they will complain if you don’t have the right views. But in this case, you are clearly an outstanding representative of the medical field, and you are fully qualified, there’s no one can dispute that–you are more than able to talk about…you know, how does the medical field interact with neo-Darwinian theory. And I’d like to find out from you: Does neo-Darwinism play a large role? By the way, I dispute anyone who says you are not qualified to talk about evolution, but I think that no one would argue that you are qualified to talk about the medical field. So, talk to me about the medical field, and does it rely on neo-Darwinism in, you know, everyday practice of medicine?

If anyone doubts that the Discovery Institute is practically orgasmic in its ecstasy over having reeled in a live one (a full Professor of Neurosurgery, yet!) and that the intent behind trotting Dr. Egnor out at every opportunity is to dazzle people with his almost completely irrelevant credentials as an academic neurosurgeon, Luskin’s nauseating sycophancy should put those doubts to rest. My response to Luskin, of course, would be that, while I don’t dispute that Dr. Egnor is qualified to talk about the medical field, he definitely is unqualified to talk about the intersection of evolution with the medical field. Besides the fact that his training is irrelevant to the task (which simply means that he has no formal training but doesn’t necessarily mean–by itself, anyway–he is incorrect), his frequent prior statements provide abundant evidence that he has zero clue about evolution, “Darwinism,” or whatever he wants to call it (usually between clenched teeth or spit out as an epithet). Right on cue, Dr. Egnor marches boldly ahead to provide still more unequivocal evidence of his utter cluelessness about evolution, especially evolution with respect to its intersection with medicine, with a nice heaping dollop of cluelessness about history piled on as well:

EGNOR: It doesn’t rely at all on neo-Darwinism, either in the everyday practice of modern medicine or even in research in modern medicine.

The first part of Dr. Egnor’s statement is mostly true but becoming less true as time goes on, depending upon the medical specialty. It is indeed still possible to practice quite happily in many medical specialties (specialties that don’t include infectious disease or medical oncology, by the way) and rarely, if ever, have to think about evolutionary principles. However, the second part of his statement is utter poppycock. The entire field of genomic medicine rests firmly on a foundation of the neo-Darwinian synthesis of genetics and evolution. Genomic epidemiology has shown us, for example, a mutation in the CCR5 gene first appeared several hundred years ago and became more prevalent in northern European populations because of the bubonic plague and how it now also confers resistance to HIV infection. I could go on, but both Burt Humburg and I, plus many others, have explained in nauseating detail just how wrong-headed Dr. Egnor is on this point. The only way Dr. Egnor can banish “Darwinism” from medicine is by conveniently labeling any pesky contributions of evolutionary theory as “population genetics” or just “genetics” even though it is all but impossible to separate evolutionary theory from population genetics.

There’s also only one other way that Dr. Egnor can fallaciously argue that evolution never contributed to medicine:

EGNOR: It used to rely a lot on Darwinism back in the early 20th century when eugenics was a very important part of the practice of medicine in this country and many other countries. Eugenics was essentially the application of Darwinian ideas about breeding animals to human beings. And, almost immediately, with the publication of The Origin of Species, many of Darwin’s colleagues, including his cousin Francis Galton, began applying these ideas to people. Darwin himself applied these ideas in The Descent of Man, which he published subsequent to Origin of Species.

And eugenics was basically the concept that human beings could be bred as one would breed animals and that there was something morally right about “survival of the fittest,” that it actually extended Darwin’s ideas to the moral realm. Of course, all ideas as shattering as Darwin’s ideas were ultimately get extended to some extent into morality and politics, and eugenics was central to American medicine. 60,000 people were sterilized against their wills in the early 20th century…

To get the full flavor of the conversation, you should know that, as Dr. Egnor pontificates pompously about eugenics and Darwin, Casey Luskin repeats in an awestruck voice “Wow” several times, louder and louder, in a tone that almost cries out, “Oh, Dr. Egnor, you big, bad neurosurgeon, I love it when you say that Darwinism leads to eugenics! I love it when you say that Darwinism contributes nothing of value to medicine. More! More!” Really, you need to listen to the podcast to believe it. But I digress. Back to Dr. Egnor:

EGNOR: …because they were viewed by Darwinian eugenicists as “unfit” and not worthy to have their kind propagated into the future. So medicine has had a large dose of Darwinism in the early 20th century. There has been, however, no contribution of Darwinism to the practice of medicine aside from eugenics. Neither has there been a contribution of Darwinism to medical research.

Yes, Dr. Egnor’s still repeating the same pseudohistory again. I know I’ve addressed this issue before in some detail, but I guess it hasn’t sunk in. So let’s for the moment imagine that Dr. Egnor is completely correct. Let’s imagine for a moment that eugenics was entirely based on the principles of “Darwinism,” and, heck, let’s even imagine that the biggest, baddest eugenicist in history, Adolf Hitler, quoted liberally from Darwin in Mein Kampf as an explicit justification for ridding the volk of the “unfit.” While we’re at it, let’s imagine that he even explicitly said that the T4 euthanasia program, which was a precursor to the Holocaust, was a Darwinian in nature. (In fact there is no record that I’m aware of of Hitler referring to Darwin as a justification for his racial hygiene program, but there are plenty of records of him making explicitly creationist statements; not surprisingly, you won’t hear creationists acknowledging that.) While we’re at it, let’s go all the way and imagine that “Darwinism” was (and is) indeed inarguably directly responsible for eugenics, racism, genocide, abortion, Nazi-ism, Communism, and any other evil that antievolutionists like Dr. Egnor like to ascribe to it. Even if all that were all so, it’s still a logical fallacy known as appeal to consequences. How evolutionary theory is used is utterly irrelevant to the scientific question of whether evolution is a valid theory or not, in just the same way that the use of atomic theory to produce hydrogen bombs does not change the fact that atomic theory is a valid theory. That some eugenicists may have been influenced by Darwin or used a perverted version of his theory to justify forced sterilization and even involuntary “euthanasia” in no way invalidates the scientific merit of the theory of evolution by natural selection. Indeed, one is tempted to point out to Dr. Egnor (a staunch Roman Catholic) that Catholic doctrine was used centuries ago to justify the torture and killing of suspected witches and suspected heretics. Does that consequence of Catholicism (or, as Dr. Egnor would likely characterize it, that perversion of Catholic doctrine) invalidate Catholicism in Dr. Egnor’s eyes? If not, why not, given that he’s making basically the same argument, namely that a perversion of Darwin’s theory (social Darwinism and the eugenics movement) invalidates the whole of the theory of evolution? I would also point out that Hitler, for example, frequently likened Jews to an “infection” of the German volk and German racial hygiene frequently described the disabled and retarded as “parasitic.” Once again, I could point out that Hitler likened himself to Louis Pasteur and Robert Koch (he never likened himself to Darwin, as far as I’m aware). Does that mean we should blame Pasteur for the Holocaust?

It’s also rather amusing to point out that Dr. Egnor actually provides an argument against his own pseudohistorical “revisionism” when he likens eugenics to applying the principles of breeding animals to breeding humans to remove certain unwanted traits and promote wanted traits. That is indeed basically what eugenics is. However, the selective breeding of animals for various desirable traits and to weed out undesirable traits had been practiced by farmers for millennia before Darwin published his theory. Indeed, Darwin devotes the entire first chapter of The Origin of Species to discussing animal breeding; observations of such artificial–not natural–selection were a major influence on Darwin’s ideas about how selection might lead to speciation in nature:

But when we compare the dray-horse and race-horse, the dromedary and camel, the various breeds of sheep fitted either for cultivated land or mountain pasture, with the wool of one breed good for one purpose, and that of another breed for another purpose; when we compare the many breeds of dogs, each good for man in very different ways; when we compare the gamecock, so pertinacious in battle, with other breeds so little quarrelsome, with ‘everlasting layers’ which never desire to sit, and with the bantam so small and elegant; when we compare the host of agricultural, culinary, orchard, and flower-garden races of plants, most useful to man at different seasons and for different purposes, or so beautiful in his eyes, we must, I think, look further than to mere variability. We cannot suppose that all the breeds were suddenly produced as perfect and as useful as we now see them; indeed, in several cases, we know that this has not been their history. The key is man’s power of accumulative selection: nature gives successive variations; man adds them up in certain directions useful to him. In this sense he may be said to make for himself useful breeds.

The great power of this principle of selection is not hypothetical. It is certain that several of our eminent breeders have, even within a single lifetime, modified to a large extent some breeds of cattle and sheep. In order fully to realise what they have done, it is almost necessary to read several of the many treatises devoted to this subject, and to inspect the animals. Breeders habitually speak of an animal’s organisation as something quite plastic, which they can model almost as they please.

Darwin was commenting on what animal breeders and horticulturists had known for many centuries: That accumulated small changes produced by selective breeding could over time and multiple generations produce very large changes in animals and plants. His great insight is that this very process occurred in nature as well, leading to diversity and new species. What it really took for eugenics to take hold among scientists was the burgeoning understanding of genetics that blossomed in the early 20th century. It was a horrific misuse of the new science of genetics combined with a warped version of evolution in which it was used to justify what was in reality artificial, not natural, selection. Dr. Egnor is either unaware of these basic facts or has let his hatred of “Darwinism” and the associated evils that he perceives as accompanying it it to make him stubbornly resistant to reality.

If you think the Dr. Egnor’s statements thus far have been stupid, though, you really ain’t seen nothin’ yet. I’ll have to warn fellow ScienceBlogger Mike the Mad Biologist if he’s reading this: Beware of this next section. You’ll have a stroke. I mean it. You’ve been warned. I won’t be responsible for the consequences if you continue. I’m serious.

Luskin next asks Dr. Egnor about antibiotic resistance and whether the understanding of how such resistance arises is a contribution of the theory of evolution to medicine:

EGNOR: Well, it’s a pretty funny claim on the part of Darwinists. It’s sort of like Al Gore claiming that he invented the Internet, that he was the basis for Love Story. I mean, people who are infatuated with their ideas can claim credit for everything. The reality is that bacteria are killed or not killed by antibiotics because of reasons that have been uncovered by molecular biology, by pharmacology, by all sorts of very important parts of medicine. We don’t need the Darwinists to tell us that bacteria that are killed by antibiotics don’t survive and that bacteria that aren’t killed by antibiotics do survive. We don’t need to read Origin of Species to understand this. Perhaps a Darwinist physician does, but other physicians don’t. The idea that Darwinists can take credit for the simple observation that bacteria that aren’t sensitive to antibiotics aren’t sensitive to antibiotics is astonishing. It’s a ridiculous notion. Darwinism is nothing in our understanding of that.

Mike, I’m there for you with the defibrillator; that is, if I don’t need someone to use it on me first. But, astounding as it may be, Dr. Egnor deludes himself even further responding to a question by Luskin over whether applying the what we’ve learned from evolution about how bacterial resistance to antibiotics evolves can help us prevent the development of “superbugs” resistant to most, or even all, antibiotics:

EGNOR: It contributes nothing to it. Not very little. The point is that, if you have an antibiotic that doesn’t work on a bacterium, it won’t work. Darwinism doesn’t really help you, but the molecular biology part helps you with that, and the pharmacology helps you with that. Bacteriology helps you with that. Darwinism is basically just a tautology, and it’s completely meaningless in reference to bacterial resistance.

Evolution “completely meaningless in reference to bacterial resistance”? Does this man never use antibiotics?

Excuse me for a moment, folks. Mike? Mike? Speak to me. Mike! Damn!

“Clear!” ZAAAP!

“Clear!” ZAAAAP!

There. I think Mike’ll be OK. Oh, and Mark? Please Mark, put away that baseball bat. Thanks.

Dr. Egnor goes on to repeat even more emphatically than in his essay the same incorrect information that medical schools don’t teach evolution and don’t require any prerequisites knowledge of evolution. Burt and Afarensis already demolished that argument totally; so I won’t belabor the point. This brings me to the pièce de résistance of ignorance (yes, it gets even worse). An awestruck Casey Luskin asks Dr. Egnor what he thinks about while operating on a brain and whether he is thinking about the “natural selective forces” that shape it. A jaw-droppingly stupid question. Even I rarely think about evolutionary biology while operating, except for occasionally marveling at comparative anatomy; I think about how best to accomplish the operation. It’s in the development and, more recently, the planning of treatments that evolutionary biology is becoming more and more important. By the time we’re in the O.R., the plan has been set and just needs to be executed, with sufficient flexibility to alter the plan based on findings at the time of surgery. Not surprisingly, in a typical fashion, in marked contrast to his intelligence in other areas of endeavor, Dr. Egnor is more than up to providing an equally jaw-droppingly stupid answer:

EGNOR: Well, Darwinism, in my view, is a significant impediment to intelligently performing surgery or intelligently practicing medicine because again the Darwinian hypothesis is that the human being that you’re working on, in their biology, is the result of random events. These are accidents that have been retained by natural selection. The intelligent practice of surgery and the thoughtful practice of medicine is to look for patterns to look for things that are not chance and not random, so that the assumption of design, the assumption that there’s reason for the disease you’re treating, and you’re trying to unravel that reason and trying to correct it, means explicitly that you ought to keep Darwinism out of your thoughts. It doesn’t help you, it hurts you. The design inference is of great value in medicine. It actually has been an enormous help in scientific research in general and medical research. You’re a much better doctor and a much better surgeon if you assume that organ you’re working on was designed, understandably.

Evolution, of course, says nothing of the sort. Natural selection, as has been pointed out numerous times, is not random; it’s stochastic and probabilistic. In fact, it is evolution, not ID, that really involves looking for patterns, specifically, for patterns of similarities among living things to ascertain evolutionary relationships and functions of genes and the proteins they encode or the comparative anatomy of humans and other animals. Indeed, were this not the case it would not be possible to do, for instance, the yeast two-hybrid screen, isolate a yeast protein that pairs with a human protein, look at the function of that yeast protein, and then conclude something useful about the existence and/or function of an evolutionarily conserved human protein. All ID does is look at gaps in our knowledge and conclude that, just because we do not yet know how a structure or molecule could have evolved, it must have been “designed.” It provides no patterns with predictive power and ascertains no functions of genes or proteins that could be used to design new therapies. Or maybe Dr. Egnor can tell us how it does do these things. Maybe he can tell us how, specifically, the “design inference” has been “of great value” in medicine and “of great help” in scientific research, preferably with some references in pee-reviewed journals in which the design inference was invoked to make a discovery or produce a new treatment. In reality, the design inference has produced nothing but a bunch of P.R. flaks at the Discovery Institute who are very good at P.R. but very bad at science, having published exactly nothing and produced hypotheses that predict exactly nothing that isn’t already consistent with evolution. Dr. Egnor could easily prove me wrong by listing a few of the “contributions” of ID to medical science, but, sadly, as before, I was disappointed. He’s great at talking in generalities about this, but sadly unable or unwilling to go into specifics. I’m sure that, if he ever answers this criticism, he will not be able to name any good examples to back up his generalization.

I’ve had about enough, and I’d bet that you probably have too. Fear not, I don’t plan on debunking every post that Dr. Egnor makes on the DI blog or every masterpiece of misinformation that he provides in DI podcasts.

My heart really couldn’t take it. Now where were those β-blockers again?

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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