Evolution Intelligent design/creationism Medicine Science Skepticism/critical thinking Surgery

Dr. Michael Egnor: The gift that keeps on giving


I say: Agh! Again.

Remember how it was just a mere three days ago that I administered some Respectful Insolence™ to Dr. Michael Egnor, the Energizer Bunny of jaw-droppingly, appallingly ignorant anti-evolution posturing based on his apparently nonexistent understanding of what the theory of evolution actually says? Remember how I said how much I sincerely hoped that I could ignore him for a while? I really did mean it at the time.

Really, I did.

And then Afarensis and Mike Dunford had to and let me know that Dr. Egnor’s at it yet again.

Dr. Egnor just won’t stop, and as a fellow surgeon, I can’t help but feel obligated to be there for him with another intervention when he starts disgracing the field again. Once again, I’m forced to wonder how someone can be so competent and smart in an area as complex and demanding–and, let’s face it, downright studly–as neurosurgery and so appallingly dumb in another area (evolution). And, worse, he seems proud of his ignorance, flaunting it to the world, utterly impervious to the multiple corrections of the misinformation and misunderstanding of evolution that he so flagrantly displays.

Dear readers, once again Orac tried to ignore Dr. Egnor. He really did. Even at a surgical meeting in Washington, DC, he can’t egnor–I mean “ignore”–Dr. Egnor, particularly since the weather was crappy as hell last night, complete with snow and sleet, leaving Orac time to sit in the hotel room and marvel at the egnorance–I mean ignorance. No, actually, I mean both. But sometimes a Tarial Cell computer that is the most sophisticated artificial intelligence in the universe‘s gotta do what a a Tarial Cell computer that is the most sophisticated artificial intelligence in the universe’s gotta do, and this time around it’s gotta deliver some Respectful Insolence™, even if it is the weekend, when tradition around here is to post mostly fluff, if anything at all is posted.

It would appear that traditions are made to be broken, especially when Orac is sitting alone, bored, in a hotel room in a distant city and thus needs something to do.

When last we left Dr. Egnor, in rapid succession he had posted an objection to the Alliance for Science’s essay contest for high school students in which the subject was Why would I want my doctor to have studied evolution?, drawing my ire, and then followed up with a mind-numbingly brain dead podcast, in which that ever-chipper P.R. flak with zero sense of shame, Casey Luskin, gave a fawning interview where Dr. Egnor denied that evolution had anything whatsoever of use to tell us about anything in medicine, and, his most astoundingly brain dead statement in a whole boatload of brain dead statements, that evolution has done nothing at all–zero, nada–zip, to help physicians understand antibiotic resistance develops in bacteria.

Poor Mike the Mad Biologist is going to have a stroke at this rate, and Dr. Egnor’s misunderstanding of what the word “tautology” means is likely to drive blogchild Mark to drink.

This latest dustup occurred when Dr. Egnor noticed Dr. Burt Humburg’sevisceration of his rationale for not liking the Alliance for Science’s essay contest and tried to write a rebuttal, which Dr. Humburg duly shredded. The ball in his court, Dr. Egnor tried to respond again, and, in doing so, made more horribly incorrect statements of ignorance while, not surprisingly, focusing on only a strawman version of one argument that Burt made and ignoring all the other valid points that Burt made. This time around, I’m going to focus like a laser on the last part of Dr. Egnor’s post because (1) Afarensis and Mark have already taken on most of the other willful ignorance that makes up Dr. Egnor’s post (particularly the part about how the evolutionary biologists teach only comparative anatomy and genetics in medical school, as if comparative anatomy wasn’t the very stuff of evolutionary study and as if understanding medical genetics didn’t require a grasp of basic evolutionary principles, given that the entire field of genomic medicine rests on a foundation of the neo-Darwinian synthesis of evolutionary biology and genetics); and (2) he’s repeated an assertion yet again without providing one shred of evidence for it, and this assertion is of interest to me. (Oh, and there’s one final reason: My head might explode if I do yet another line-by-line deconstruction of such Egnorance so soon after my last two feats of self-abuse.)

After denying yet again that evolutionary theory has made any contribution to medicine whatsoever and claiming that evolutionary biologists in medical schools do not teach any evolution to medical students, Dr. Egnor once again bravely asserts:

The central assertion of Darwinism–that all biological complexity arises by random heritable variation and natural selection–is of interest to evolutionary biologists (and to those of us who disagree with it), but the assertion that randomness is the raw material for all biological complexity plays no role in medical education or research. Darwin’s assertion of randomness is irrelevant not only to medicine, but to much of biological science. Darwinism is, in Phillip Skell’s apt phrase, a narrative gloss applied to biology and highly superfluous. Teaching medical students about the anatomy of the brain or the molecular structure of DNA is very important. Teaching students about Darwinian speculations about the random origins of the brain or of DNA adds nothing to students’ knowledge of medicine.

In fact, most research and education in medicine involves the implicit assumption of design. The best medical research is the search for patterns recognizable as design, and the best teachers teach their students, implicitly or explicitly, to search for design and purpose in human biology. Evolutionary biologists who teach anatomy, and physiology, and microbiology, and molecular biology in medical schools contribute much to modern medicine by teaching those important subjects. Evolutionary biology itself, however, is superfluous to medicine.

As Ronald Reagan would say, “Michael, there you go again!” (Sorry, I just like that line.)

Again, I want to zero in like a laser on Dr. Egnor’s assertion that most research and education in medicine involve the implicit assumption of design. There’s only one word for that assertion:

Poppycock! (Well, actually there are many words, but these days I’m trying to keep the blog PG-13 rated.)

No assumption of “design” is made in teaching anatomy, for example, at least not in any anatomy class that I’ve ever taken. Indeed, comparative anatomy and the use of evolutionary relationships between creatures can make the usual tedious and difficult rote memorization of anatomic structures easier by putting some context behind them. Similarly, no assumption of “design” was made in histology, microbiology, physiology, biochemistry, or any other basic science course that I took in the first two years of medical school, nor is, as far as I can tell, any such assumption made now at the medical school that I’m at. Indeed, I defy Dr. Egnor to provide concrete, verifiable examples in which assuming that the human body was “designed” improves teaching. As for the “best teachers” teaching their students to look for “design and purpose” in human biology (or any biology), I have to wonder if Dr. Egnor’s just making way too much about a common figure of speech that’s used in medical school, where we will sometimes say things like “the liver is designed to eliminate toxins,” “the kidneys are designed” to filter the plasma and produce urine to eliminate waste,” or “the neuron is designed to transmit an electrochemical message to another neuron.”

Yeah, I bet that’s it. Heck, even I sometimes use the same figure of speech and say that this organ or that is “designed” to do this or that. Really, Dr. Egnor, it’s just a figure of speech, not an assumption of “design,” except, perhaps, when being used by creationists like you, who are rather rare in the basic science departments of medical schools, fortunately.

Similarly, it’s utter balderdash that the best medical research proceeds from looking for patterns that are evidence of “design” (remember, Orac is from an old British TV show). In fact, the areas that provide the most promise in medicine at the moment are genomic/proteomic medicine and systems biology. Genomic medicine is based on whole genome expression profiling, where the levels of messenger RNAs for every gene in the genome can be assayed simultaneously on a single chip, and on tracking changes in alleles in different populations, the frequencies of which cannot be understood without an understanding of evolutionary biology. I’ve discussed this all before; so I don’t want to be too repetitious. It also just so happens that today I attended an excellent talk on systems biology by Dr. Leroy Hood (a truly amazing and brilliant man), a talk that I will probably blog early next week. The area of systems biology promises to allow the molecular diagnosis of hundreds of diseases from a single drop of blood. Understanding the interacting systems and subsystems of molecular networks at the level of genes, proteins, cells, and organisms requires evolutionary biology, which informs us of how these systems came to be and allows us to infer predictions about systems for which some of the nodes are not yet known. Indeed, the study of evolution at all levels, molecular, cellular, organismal, and population are integrated in order to understand the molecular networks in humans and how disease perturbs them, allowing early diagnosis and possibly the design of drugs to reverse the perturbation that causes the disease. As Dr. Hood states:

The challenges of biology are focused around three central features of life: evolution, development, and physiology. These features operate across very different time dimensions: roughly millions of years, the lifetime of the organism, and seconds to weeks, respectively. Our laboratory is focused on a series of deep biological questions relating to these features.

  • How do gene families evolve?
  • How do gene regulatory networks change in evolutionary terms and operate across the developmental and physiological time dimensions to control biomodules? Biomodules are groups of proteins that execute a particular function (e.g., cell cycle or sugar utilization).
  • How do innate and adaptive immune systems develop and function?


Halobacterium and yeast are wonderful model organisms in which to develop the approaches to systems biology so that they can be applied to higher organisms. In these organisms, we are studying the relationships between gene regulatory networks and their control of biomodules.

Dr. Egnor can answer me and others when we cite reproducible evidence of similarities evolutionarily conserved proteins in many disparate organisms by saying that “God did it” all he likes and follow that up by using the explanation that God used similar mechanisms in designing all living creatures to account for all these observations, but saying a “designer” designed life in similar ways contributes nothing–zero, nada, zip– to our understanding of human biology or disease. Studying simpler organisms and how gene networks evolved as these simpler organisms developed into more complex organisms and ultimately humans, as Dr. Hood and many other scientists do, does allow us to make predictions and define how human biology functions in a way that would not be possible without understanding evolution. (I’ll probably have more to say about systems biology next week.) Dr. Egnor is correct that looking for patterns in biology is very important, but these patterns are derived by evolution. Without evolution, the reasons for the patterns that we observe in all biological organisms are all but impossible to understand.

I’ll leave everyone with one final thought. Dr. Egnor has said on at least two occasions now that the design inference or the assumption of design results in the best medical research and is “of great value” in medicine. Indeed, he has even said that thinking about evolution hurts you as a surgeon and physician. (It hasn’t hurt me any, as far as I can tell.) However, Dr. Egnor has yet to provide even a single concrete example of how the design inference or assuming design has helped medical research. Not a single one. You’d think if the design inference were so useful to medicine and medical research that Dr. Egnor would be brimming with examples to show us the wondrous discoveries that were facilitated by “intelligent design.” Instead, he keeps making the same assertion as fact without a single piece of evidence to back it up, and then actually describes the evolution of resistance to antibiotics rather well but refuses to acknowledge that the very process he is describing is evolution! In any case, I challenge Dr. Egnor: I’ve already discussed several examples of how an understanding of evolutionary biology contributes to medical research. It’s now your turn. Show me examples of medical research in which the design inference has made a difference, in which it led to or significantly contributed to new medical knowledge or a new treatment for disease. Please include references to the peer-reviewed literature, so that I can look them up.

One final thing: Dr. Egnor whines that “most of the Darwinists’ comments on my posts have been personal attacks on me, rather than carefully reasoned arguments.” In my case, as heated as my language gets sometimes (people like Dr. Egnor, who repeat the same irritating canards over and over, tend to have that effect on me), this is not true. I have simply pointed out erroneous and downright stupid statements that Dr. Egnor has repeated made and criticized the content of his online writing and podcasts, which to me demonstrates a disturbing blind spot and an unwillingness even to consider data that contradicts his belief that evolution is not a valid theory and that it contributes nothing to medicine. I do this while acknowledging that Dr. Egnor appears to be an outstanding neurosurgeon otherwise. It has always puzzled me how someone like Dr. Egnor can be so very competent in one area and so very clueless about another area without even being willing to concede that he might be clueless. Be that as it may, it is not an ad hominem attack to point out that Dr. Egnor continues to repeat the same misinformation and attack his same straw man versions of the theory of evolution; to fail to back up his statements with scientific studies or evidence; to tout (or allows the Discovery Institute to tout) his credentials as a Professor of Neurosurgery and renowned neurosurgeon as though they had anything to say about his knowledge of evolutionary biology (they don’t), and to remain stubbornly and intentionally oblivious to all the evidence that contradicts his position, because all of this has been amply documented by me and many of my fellow ScienceBloggers. Dr. Egnor can continue to whine about how he is the poor victim of “personal attacks” by “the Darwinists” and continue not to be taken seriously (and deservedly so), or he can put his money where his mouth is and present, instead of his usual evidence-free assertions brimming with unjustified confidence, some actual evidence to support his claims. Inquiring minds want to know: Will Dr. Egnor show us some of these wonderful insights into human biology and disease provided or facilitated by the design inference or will he simply keep repeating the same misinformation? You never know. Maybe he’ll surprise us all.

I wouldn’t bet on it, though.

Orac’s debunkings of Dr. Egnor thus far (the list of which, sadly, seems to grow every week):

Slinking away in shame over my profession yet again (another surgeon behaving badly over evolution)

Medicine and Evolution, part 8: Two major medical misconceptions about evolution parroted by a Professor of Neurosurgery

Train wreck, thy name is Egnor!

The Energizer Bunny of antievolution

Dr. Michael Egnor: The gift that keeps on giving

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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