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Harassment: The price of defending science-based medicine

Harassment by cranks and antivaxxers is all too often the price of defending science-based medicine. Is it worth it? How can we stop it?

There are perils involved in communicating science and medicine, in particular in standing up to pseudoscience, quackery, and the antivaccine movement. I’ve discussed some of them before, most recently when I was targeted with an abusive Michigan Freedom of Information Act request by Gary Null’s lawyer Neal Greenfield a few months ago. (I’ll update that story later in this post.) Before that, there was the time that a “Lyme-literate” doctor sued Jann Bellamy and most of the other editors of this blog for a post he didn’t like. Fortunately, it was dismissed, but not before causing considerable trouble. Then there was the time that Mike Adams published something like 40 libelous posts about me over the course of a few months and claimed to have submitted “complaints” about me to the local FBI office. Before that there was the time antivaxxers, led by a particularly nasty piece of work named Jake Crosby launched a campaign of harassment against me. They flooded my university’s board of governors, my medical school dean, my department chair, and my cancer center director with complaints about a nonexistent “conflict of interest”. Those are just some “highlights”. There are many more examples.

The reason I’m “reminiscing” (if you will) about some of these incidents is because over the weekend, I came across an article on the perils and price of standing up for science by Anna McKie entitled “Is standing up for expertise a fool’s errand?” It turns out, unsurprisingly, that it’s not just those of us who defend vaccines against antivaxxers and medicine against quackery or scientists like Michael Mann, who defends climate science against its deniers, who routinely come under this sort of harassment. It’s any scientist who tries to communicate science to the public that gores the oxen of powerful interests or is the subject of denialist campaigns against it, as vaccine science and climate science are. Harassment is frequently the price we pay for defending science.

McKie starts out with the example of Oliver Bernard, a pharmacist who runs the blog The Pharmafist. He came under attack, oddly enough, for pointing out (as I have on multiple occasions) that high dose vitamin C treatments are not effective.

McKie begins:

“When you want to defend science publicly, you don’t get a lot of support,” concedes the pharmacist and science communicator Olivier Bernard. “Even my colleagues were telling me ‘you are so courageous’ – and I thought: ‘Thank you, but can you do something? That would be more helpful.'”

Bernard had provoked a ferocious backlash from supporters of alternative medicine after he spoke out on his blog against their lobbying of the Quebec government to introduce vitamin C injections as a cancer treatment. His explanation of where popular perceptions about vitamin C differ from what has been scientifically demonstrated – interspersed with humorous cartoons – prompted activists to lobby for him to be fired from his pharmacy job and removed from the professional register. They also tried to get his TV show cancelled and urged supporters not to buy his wife’s book (on an unrelated topic). They even resorted to sending death threats to Bernard and his family.

“When you are passionate about what you do, you try to do good work,” he tells Times Higher Education. “But when you come home and people are threatening you, you do begin to wonder if it’s all worth it.”

Sound familiar? It sure does to me. I don’t have a TV show, but I’ve experienced all of the above sorts of harassment except for someone trying to cancel my TV show or attacks on my wife’s book, mainly because I don’t have a TV show and my wife hasn’t written a book. This part sounds familiar as well, but less so:

A posting on Facebook about the hate campaign he was facing also provoked a big reaction – but this time it came from the science community in his support. The petition to introduce the vitamin C treatment was rejected and the Quebec government has created a task force to protect scientists who speak on sensitive topics, as well as an inter-professional advisory committee to support healthcare professionals who speak publicly.

That’s what was missing, Bernard believes. Referring to the initial silence from colleagues, he says: “I’m not trying to shame them; I understand why they would not want to do it. But having support is key.”

It’s true. Even now, in the age of social media where finally tech companies, the government, scientists, and physicians are waking up to how easily disinformation is weaponized on Facebook, Twitter, Instagram, and now Tik Tok, science communication to the public is nowhere near as valued relative to its importance to society. The number of doctors and scientists who do it is a far too small percentage of doctors and scientists, and the percentage of those doctors and scientists who specifically speak out about misinformation and disinformation is a relatively small. The reason is likely because of what happens to people like Bernard when they do. If you’re effective speaking out against pseudoscience, denial of science, and quackery, you will be targeted, and this is nothing new. What is new is how easily you can be mobbed and driven from the discussion, thanks to social media. What’s newer is that scientists, physicians, and lay advocates for good science and medicine are finally starting to push back as a group, and my perception is that there are more of them than ever active on social media. Unfortunately, we still remain hugely outnumbered, outfinanced, and outgunned.

The first instance of harassment

The following is a story I recount every few years when relevant; so if you’ve heard it before and aren’t interested in hearing it again, feel free to skip this section, although I will mention aspects of this story that I’ve never recounted before. The date was April 2, 2005. Less than five months earlier, I had started my first blog under a pseudonym that many of you know well, a pseudonym that I still use but that is now among the worst-kept secrets in the medical blogosphere or Twitterverse. That day, I received this email from a man named William O’Neill (and, yes, I have kept his emails all these years):


You are the owner of the website Within the website you make reference to my clincal [sic] practice and myself in a manner that is unfactual, libelous and defamatory.

In the event all materials concerning myself, William P. O’Neill, and my clinical practice, the Canadian Cancer Research Group are not removed by the end of business on Monday April 04, 2005, I will initiate action.

Further note, this is a private correspondence. As such distribution, copy or reproduction is by permission only.

Govern yourself accordingly:

William P. O’Neill
CEO Canadian Cancer Research Group
Suite 22
Ottawa, Ontario
K1S 5K4
[email protected]
[email protected]

c.c. Mr. Joel Taller, LLB Gowlings Ottawa, Ontario.

The weird thing is that this threat was based on a single post in which I linked to a post by Australian skeptic Peter Bowditch, who had frequently criticized the CCRG for promoting cancer quackery. Indeed, Bowditch keeps pages on his website, The GAL Chronicles and The CCRG Correspondence File, dedicated to mocking O’Neill for his email attacks. Let me tell you, perusing these webpages as I wrote this post was a real blast from the past. In brief, Mr. O’Neill formed CCRG in 1998 after he and his wife claimed to have cured their then 12-year-old son Liam of a malignant brain tumor and a recurrence using nonstandard treatments. However, doctors who treated Liam said that the tumor was removed by surgery and the boy received radiation and chemotherapy that cured a subsequent recurrence in the boy’s spine. As Dr. Stephen Barrett (who also received legal threats similar to the one I did) recounted:

In 2001, CCRG’s services cost CN$150/hour for assessment and evaluation (typically $750), $1,500 for “development of therapeutic plan, $10,000 ($5,000 in advance and $500/month for 10 months) for “orthomolecular diagnostic and assays,” and $4,000 per “treatment cycle” for “immunotherapy” (maximum 4 cycles per year). Purchasers were asked to sign a “consent” form agreeing “to not hold liable Canadian Cancer Research Group for act or activity as it relates to the treatment of my cancer.” [5].

For several years, CCRG’s online “interview” form asked whether the prospective client had “general interest” in chemotherapy, radiotherapy, surgery, immunotherapy, vaccine therapy and/or homeopathy and/or “specific interest” in antineoplaston therapy, Livingston therapy, Evers therapy, 714x, Issels’ whole body therapy, Hoxsey therapy, hydrazine sulfate, Revici therapy, tumour vaccines, shark cartilage, Di Bella therapy, Kelly therapy, Laetrile, Gerson therapy, Essiac, Immuno-Augmentative Therapy (IAT), American Biologics therapy, Iscador, Macrobiotics, oxygen therapy, hyperthermia, chelation therapy, DMSO therapy, live-cell therapy, Aboriginal therapies, vitamin therapy, laser resonance, bio-electric therapies, herbal therapy, and Nieper therapy. No method in the “specific interest” list has been proven effective.

Previous versions of CCRG’s Web site have claimed that CCRG “has developed the world’s largest cancer knowledge base, Cancer Canada Net™, fielding over 50,000 inquiries a year, and with an active case load of more than 5,000 international patients.” [1] I seriously doubt that CCRG could have assembled “the largest cancer knowledge base.” Even if O’Neill had managed to compile citations from the major cancer-related databases, the information would not be very useful without interpretation by a qualified cancer specialist. Moreover, these databases can be accessed free-of-charge on the Internet.

In 2006, Canadian Television’s W-FIVE team aired a four-part investigative report that amply demonstrated O’Neill’s dishonesty. One woman, Teresa Bagyan, whose husband Frank had visited CCRG in 2003 after being diagnosed with a brain tumor with a dismal prognosis, told the team that “O’Neill “looked Frank straight in the eye and said ‘I’ve never lost a patient yet.'” She also told the team that O’Neill had also looked at a “before and after” set of MRIs and claimed that the immune system was attacking the tumor and “breaking it up”. After Frank’s death, a radiologist looked at the same MRIs and said that the tumor was still there at the time, with no sign of shrinkage. (That sounds a lot like Dr. Stanislaw Burzynski’s grift.) As part of the investigation, two producers, one of whom was pretending to have stage III lung cancer, visited CCRG with a hidden camera and recorded O’Neill claiming that CCRG’s cure rates were over 80% for lung cancer and 100% for lymphoma, leukemia, and prostate cancer. O’Neill later refused more than half a dozen requests for documentation supporting those claims.

You get the idea.

Ultimately, CCRG was renamed Immune System Management (ISM), a rebranding that was occurring around the time Mr. O’Neill threatened me. Mr. O’Neill ultimately died in 2013, but his son Liam appears to be running ISM now.

In retrospect, I do love the part about not distributing or reproducing O’Neill’s email without permission. Back then, I was so green that I didn’t know that that line is almost always pure unenforceable BS. These days, when I receive emails with legal threats like the one above, I’m fairly likely to post them to Twitter, Facebook, or one of my blogs. But back then, I freaked out, especially since O’Neill CC’ed my department chair, my cancer center director, and my division chief at The Cancer Institute of New Jersey and UMDNJ-Robert Wood Johnson Medical School (since renamed The Rutgers Cancer Institute of New Jersey and the Rutgers Robert Wood Johnson Medical School). I had started the blog under a pseudonym because, if anything, writing a medical blog back then, specifically a blog dedicated to combatting pseudoscience in medicine, was looked on a lot less favorably then than it is now, and, as you’ll see, there is still a sizable segment of medical academia that doesn’t look very favorably on it even now. After receiving the email, I sent late night panicked emails to my bosses explaining what was going on.

Fortunately (I guess), the responses ranged from puzzled to supportive to indifferent. Dr. Stephen Lowry, who was my department chair at the time, was supportive. (Sadly, Dr. Lowry died suddenly of an aortic dissection in 2011, three years after I had moved on from the department. He was an amazing surgeon-scientist and man.) Indeed, at a department meeting later that month he told me that people like O’Neill were bullies, which is true, although when I mentioned that I wanted to hit back by writing about him more he advised me against it. So, even though he was supportive, he wasn’t that supportive. In retrospect, he was probably correct, as Bowditch let me know that O’Neill was all bluster. Hilariously, he even cc’ed me on an email to Mr. Taller asking if he was actually representing O’Neill. Apparently, O’Neill was just adding Mr. Taller’s name to make it appear that he had legal representation.

I laugh at this early attempt at intimidation now, but at the time I was not laughing, and I can see how a newbie trying to get started now at what I was getting started at then might, facing such threats plus online harassment, decide that it’s just not worth it. Since then, as I mentioned above, I’ve received much worse. It seems that, every several months to a couple of years, something happens, most often antivaxxers or cranks trying to harass me at work by complaining to my bosses about imagined misdeeds. Most recently, antivaxxers threatened to come down in their full cosplay gear with their misinformation-packed signs to “protest” against me at my cancer center (see the comments of this Facebook post). No one’s shown up yet, but administration was concerned enough to have me make a report to hospital security. I suspect they won’t show up because even antivaxxers know that disrupting activities at a cancer center and potentially disturbing or interfering with the treatment of cancer patients is not a good look, but who knows? I also note that my cancer center director was totally supportive. He’s come a long way, having gone from being puzzled and (to my perception at the time, at least) seemingly annoyed by such complaints when he first took over ten years ago to being very supportive. He even jokes with me at times, saying that he hasn’t gotten any complaints about me recently, to which I usually joke back with a response something like, “I must be falling down on the job then. I promise do better.”

The harassment climate gets worse

McKie’s article goes on to recount a list of scientists targeted for harassment, including:

  • Climate scientists whose emails were hacked at the University of East Anglia. The hackers used the emails to paint a false picture that climate science had been manipulated and that scientists had tried to silence critics.
  • Naomi Oreskes, professor of history of science and affiliated professor of Earth and planetary sciences at Harvard University and co-author of Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming. She recently recounted how since 2004 she’s been attacked for defending the scientific consensus regarding climate change.
  • Hero Saharjo, professor of forest protection at IPB University in Indonesia. He is an expert on the forest fires that regularly sweep through Indonesia, started by palm oil companies that want to clear land cheaply and quickly. He noted that during four months in 2015, such fires released more carbon dioxide than the entire European Union, and through his studies, has “traced those who started those fires and has testified in hundreds of cases against the companies responsible”. He and his family have faced intimidation and he’s had little support among his colleagues, many of whom are funded by the palm oil companies.
  • Simon Wessely, professor of psychological medicine at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London. An expert in chronic fatigue syndrome who’s shown that two approaches, graded exercise therapy and cognitive behaviour therapy, can help CFS patients manage their symptoms, he’s been falsely attacked by patient groups for not treating CFS as a serious illness. In one instance, a conference slide of his was altered to reverse the meaning.
  • Sameer Jauhar, a senior research fellow in the department of psychological medicine at King’s College London. According to McKie: “After speaking on BBC Radio 4 about the dangers of overstating the withdrawal symptoms from antidepressant drugs, ‘people on Twitter accused me of not caring about patients, saying I was frying people’s brains’, he says.”
  • Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter. We’ve long admired Prof. Ernst for his work against alternative medicine pseudoscience, and for standing up to the many attacks, including attacks by the powerful, such as Prince Charles.
  • Riko Muranaka, a Japanese scientist at Kyoto University. She was “She was threatened, sued and accused of being in the pay of the pharmaceutical industry after she wrote an article claiming that a mouse study revealing a link between the [HPV] vaccine and brain damage was fabricated.”
  • David Nutt, Edmond J. Safra professor of neuropsychopharmacology at Imperial College London. He was fired as chair of the UK Home Office’s Advisory Council on the Misuse of Drugs for saying that “alcohol and tobacco were more harmful than LSD, ecstasy or cannabis.”
  • Linda Bauld, the Bruce and John Usher professor of public health at the University of Edinburgh. She’s been hounded by Big Tobacco for her work exposing the dangers of tobacco and more recently accused of being in the pocket of Big Tobacco for her work suggesting that e-cigarettes are less harmful than cigarettes. She’s suffered online trolling and anonymous threatening phone calls, while activists are “digging into Bauld’s life and work, she says: ‘They find meetings I’ve attended to see if someone from the tobacco industry was there so they can say I am biased’.”

Reading McKie’s article, I see some things getting worse. For instance, the online harassment is definitely getting worse, from my perspective. I suspect the reason is that it’s so much easier to harass someone on social media now, and denialists are so much better organized than they were back in 2005, when I suffered my first brush with such tactics. Think about it. Back then, Twitter (founded in 2006) and Instagram (founded in 2010) didn’t yet exist; Facebook was still limited to college students at Ivy League universities and nearly a year and a half away from being made available to everybody. The only venues for online harassment and the organization of campaigns of online harassment were, essentially, email, blogs, and Usenet, and Usenet was fast dying, thanks to the rise of web-based discussion groups. Twitter, in particular, can be a real cesspit, particularly if you’re a woman or person of color, so that the online attacks you face can have misogyny, threats of sexual violence, and racism added to posts like this:

Typical harassment on Twitter: Death threats.

You might recognize that name. He’s commented here and on my other blog in the past.

Similarly, the rise of social media has made it much easier for denialists to organize harassment campaigns. There are secret Facebook groups (and ones that aren’t secret) where members plot things like protesting at my cancer center. Back in 2010, when my university was the target of campaign by antivaccine activists, I knew that the campaign had largely been organized by email. Today, it would have been organized on Facebook, in one of the many antivaccine groups that still exist even after Facebook’s crackdown on antivaccine misinformation, where thousands more people could be reached.

Moreover, if you work for a private company, do you think your bosses will be supportive if the online mob targets you for harassment at work? I’m fortunate in that I work in academia. The culture here is very much more resistant to online mobs like this than private industry. If you work for a private company and are targeted, there’s a high likelihood that your bosses will tell you to shut up or be fired, not because they aren’t sympathetic but because they don’t want to be bothered, they don’t want the company’s reputation to suffer, and they don’t want controversy involving the company. There’s even a little of that in academia, but freedom of academic expression is so strongly ingrained in the culture of universities that it usually wins out, bringing at least grudging support from administration and in my case (usually) enthusiastic support.

There is, of course, one drawback if you work for a public university. It’s one I’ve discovered before, namely that you might be subject to Public Record Act/Freedom of Information Act (FOIA) requests. It’s a tactic antivaxxers are using increasingly. I’ve been targeted by Gary Null, and Dorit Reiss has been targeted by Del Bigtree. In fact, I’ll launch a preemptive strike here against Null and tell you what was sent to him. Amusingly, Null will get a couple of crank emails sent to Steve Novella and me at our university addresses. (That’s what he gets for asking for any emails mentioning Steve Novella.) He’ll also get an email chain among several provaccine activists discussing the proposed Connecticut law to eliminate religious exemptions to school vaccine mandates. My prediction is that one email in particular will be publicized by Gary Null, in which I wrote:

This is why I find religious exemptions for vaccine mandates so problematic. They unjustifiably privilege one form of personal belief over another just because…religion. There is no meaningful distinction between religion and other personal beliefs, any of which can easily be rendered bulletproof for purposes of these laws by claiming a religious basis.

A couple of those on the email exchange agreed. Of course, what I meant was that exemptions based on religion only are inherently unfair because they discriminate against nonbelievers and unfairly privilege religious belief over other deeply held ideological/spiritual beliefs, which is why I’ve always believed that if you’re going to allow religious exemptions you have to allow personal belief exemptions and that if you’re going to get rid of personal belief exemptions to be fair you have to get rid of religious exemptions as well. It’s both or neither. Of course, I also believe that it’s also much better to get rid of both religious and personal belief exemptions when politically feasible and allow only medical exemptions. Gary Null is very much into labeling anyone who questions his quackery as “atheists” (as if being an atheist were a bad thing!); so I fully expect he’ll try to make a stink about my statement, proclaiming it as evidence that I’m an evil atheist targeting “deeply held religious beliefs”. If you see him do that, feel free to refer him to this post.

The harassment climate improves

It’s not all bad news. In many ways, as McKie recounts, physicians, scientists, and academics are more supportive now when colleagues come under attack. There’s even a prize, the John Maddox Prize, awarded by Nature and Sense About Science every year to individuals who promote science and evidence in the face of hostility. Bambang Hero Saharjo is the recipient of this year’s award. Several others mentioned above have also won the award, including Edzard Ernst, Riko Muranaka, and Olivier Bernard, who won this year’s early career Maddox Prize. I’ll let you in on a secret. I’ve been nominated on at least a couple of occasions. (Thanks to those who nominated me.) Looking at the winners, I realize that I probably haven’t faced the level of high-power hostility that those who actually won have. Personally, I like to think that campaigns against me over the years have led several of my bosses to appreciate the importance of standing up for science as academics, leading to more enthusiastic support. (It also doesn’t hurt that the online cranks who launch these campaigns are often so…cranky. They make it obvious what they’re about.)

Other areas in which the climate has improved include efforts by Google and social media giants like Facebook to rein in the spread of misinformation about medicine, at least. Doctors and those who support science-based medicine have finally woken up and started to organize to help those who are targeted by quacks and antivaccine cranks. The most prominent example is Shots Heard, which exists mainly to counter the swarms of antivaccine activists who will infest the Facebook pages of doctors who promote vaccination and publish fake negative reviews about them on Yelp! and Such efforts are still fairly embryonic and small, however. Supporters of SBM remain outnumbered, outgunned, and outfunded, but things are getting better.

Except for one thing.

The final challenge to science communication

There is one last major impediment to the growth of science communication to the point where the battle against pseudoscience doesn’t seem so hopeless. There remains a prevalent attitude out there among some academics, at least one of them quite prominent, that countering quacks and antivaxxers is so easy that it’s not worth our time as physicians. One major example with whom I tussled on Twitter is someone whom I like to call a Very Eminent Rising Star in Oncology (VERSO)—mainly, because he is just that—Vinay Prasad, MD, MPH.

Back in October, he started Tweeting about how criticizing Goop’s selling of jade eggs and other pseudoscience was like “dunking on a 7′ hoop” and how skeptics should put the hoop back up to 10′ by—of course—joining him in taking on clinical trial shenanigans by big pharma. He even went so far as to suggest that I give up my usual topics for six months and spend those six months doing what he does because what he does is so much harder and more worthwhile. He appears to have since deleted many of the most obnoxious of the Tweets in which he made fun of skeptics who spend time deconstructing quackery and pseudoscience, implying that such activity is so easy as to be unworthy of our efforts and that what he does, analyze clinical trials, is so much more difficult. Of course, there’s considerable overlap in skillsets, given that we frequently have to go deep into the weeds of clinical trials of, say, acupuncture or homeopathy to demonstrate why they do not show what advocates think. When this was pointed out to him, even more obnoxiously, he took it as confirmation that we think that what he does is of more value because we were arguing that we do do the same sorts of analyses of clinical trials that he does. Be that as it may, I tried to search Twitter for the most offensive posts, and it seems that he’s deleted many, perhaps all, of them.

Here’s a remaining example someone took a screenshot of:

In context, he was clearly referring to me (the “fellowship trained” bit). The “soft targets” bit is a claim that he repeated several times. It’s one I’ve dealt with before elsewhere.

Basically, Dr. Prasad raised criticisms of our efforts as though he were the first to think of them and was very dismissive, thinking his efforts far more difficult and worthy than ours. In any event, I don’t want to go into detail about the whole kerfuffle. I’m merely using it as an example of how dismissive some physicians, particularly academic physicians, are of science communication efforts targeted at quackery. I liked Mark Hoofnagle’s comments, though:

That was basically my attitude, too. Maybe I should go back and analyze Dr. Prasad’s podcast on the issue, but I fear it might raise my blood pressure too much. The point is simply how dismissive some doctors are of science communication efforts targeting pseudoscience, even as they “dunk” on a clinical trial based on…a treatment from alternative medicine:

Is that the eminent Dr. Prasad addressing a claim based on an alternative medicine therapy?[/caption]

The point is that, yes, things have gotten better in that many more physicians and scientists are communicating science and pushing back against pseudoscience than there were when I really got started 15 years ago. Also, it should be a big tent, with room for doctors like Dr. Prasad and their critiques against pharma and doctors like us at SBM. We should be natural allies, as is the case with Ben Goldacre, who takes on both pharma and alternative medicine. To me, that’s the hardest nut to crack. Until we manage it, until we can persuade doctors like Dr. Prasad that we’re natural allies and that combatting pseudoscience is not only difficult but a worthwhile activity for an academic, we’re going to be held back in what we can do. Doctors like him don’t have to do the dirty work of pushing back against quackery themselves if they don’t want to. Division of labor is a good thing. All I ask is that they stop making our job harder.

As for everyone else, doctors, scientists, and interested lay people, we welcome you. I just wanted you to know what you could be in for if you join is, so that you go in eyes open. Only you can decide if helping to educate the public and counter disinformation is worth it to you.

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]

116 replies on “Harassment: The price of defending science-based medicine”

I’d say some advances in what used to be called ‘reputation management’ are sorely needed for online discussion. For one thing, the ability of absolutely anyone to post a ‘review’ or ‘rating’ of a service with no verification of actual customer experience renders all reputation and rating systems worthless, with sometimes significant impact to a professional’s livelihood. This is a longstanding problem that the Internet community is still unable to fix.

That will have no impact on purely social/layman discussions, of course. But it does point toward a broader need for a hierarchy of ‘trusted’ sources vs. random opinions, even online. We used to have legitimate news sources that were held to standards of professionalism–ones that could even be held accountable for skewing their reports or lying to the public. We still have professional journals and a few new agencies that maintain such standards, but there’s now a vast gulf between them and random opinion–a muddled playing field full of ‘infotainment’ and blogs and agenda-driven pseudo-reporting that makes it hard to distinguish reliable information from back-fence gossip.

Just sitting back and letting the free exchange of ideas sort itself out, with the best sources rising to the top automatically–sort of a laissez-faire approach to online journalism–has NOT been a resounding success. Instead, we’ve seen enclaves of extremism form–each isolated, each wildly incorrect, and each heavily self-reinforcing. As much as the Internet culture abhors any mention of regulation or standards, I’m afraid that’s exactly what we need to restore a common starting point of objectivity for reality-based discussion and analysis.

Thank you. I want to also mention, with permission, C.I.C.A.D.A, a Facebook group that parallels Shots Heard for non-doctors (antivaccine activists already know of it). That’s another resource.

I really like the idea of verifying customers before allowing reviews. I see some practical challenges in doing it without allowing especially small business to veto negative reviews, but there has to be a way.

If you do that, a business in providing fake verifications will immediately spring up. Or even real verifications: “Here, we’ll sell you this widget cheap if you’ll provide a positive/negative review.” It’s true that number-of-stars ratings are worthless because they are mechanically aggregated, but years and years of reading actual reviews on line have (I think) given me a reasonable sense of which ones are credible.

This is really interesting, and very similar to how the first generation of search engines addressed the problem (relative to the then-status quo) and suggests that a second generation is needed. The academic literature counts citations as a key metric to determine relevance and impact. To wit, the first iteration of Google had the brilliant idea of improving this by weighing ‘citations’ better (by taking the number of links going into a link into account), to form a better idea of relevance. What we need now is relevance based on reputation, as you highlight. Very interesting to see how this will all work itself out. (I’m not talented enough to build a search engine based on this premise myself, even if that would be a potentially good start: The amount of pseudo-science that comes up as results to some search queries on google these days is startling.)

Domain authority is part of the Google Algorithm. But they are fairly lenient on this front, as they should be when so much of the content on the internet is naked editorializing by people who have no idea what they are talking about.

Dealing with outright conspiratorial frauds without taking very intrusive steps that would devastate the rankings of pages that operate in murkier waters will always be a challenge.

Science and medicine should be treated differently but even these issues quickly to bleed over into politics. And unfortunately, not everyone in a position of authority is acting in good faith.

Take the vaping lung disease outbreak, when the Michigan Department of Health and Human Services failed to mention the link to THC cartridges long after preliminary indications were this was the cause.

Whatever their motivations, an axe to grind with Juul, the Governor protecting her pro-cannabis donors, it is importsnt to keep in mind that punishing carney websites necessarily elevates others in the rankings.

There are precious few organizations that have proven themselves worthy of being the great arbiter of truth. And those that aren’t generating point of view content and reporting just the facts simply aren’t going to generate the content to cover all the long tail Google searches of generate the clicks that a splashy and optimized headline will. It’s easy to line up all the top pages for cancer. It becomes difficult to when people search for arcane cancer treatments and celebrity mountebanks peddling their wares.

I think Googles general system of punishing egregious profiteers and creating a search feature for medical information that includes a strange picture and link to an authoritative website is probably as good as it will get. It can be tweaked and improved, but there are simply diminishing returns below the top 3-4 hits.

What google can do is no longer accept paid advertising for supplements or medications. This would clear up the clutter of nonsense results.

Cue the resident antivaxxers complain that they, too, have been harassed on the comments section of your blog posts. Of course, the definition for harassment is different for them. For them, spreading lie after lie is okay. For them, us correcting their lies is harassment. Never mind that they keep showing up in the comments for more “abuse.” Never mind that their lies keep being corrected over and over again. And never mind that they accuse so many of us of corruption and other behaviors that, if true, would have us disciplined or terminated from our job… All without any evidence, of course.

Hell, if we talked about their kids the way they do, they’d be calling for our heads. Antivaxxers looove their double standards. The only measure they will accept is “Does this show I’m right?”

One could ask Dr. Prasad why he’s “wasting time” questioning clinical trials of pharma drugs when the real problem is lack of access to good medical care for billions of people. Or maybe he should be devoting all his efforts to ending world hunger.

The best response to this sort of criticism is that we all have particular areas of interest and expertise, and should be encouraged to tackle the problems we’re most interested in and have a zest for solving.

A common slam by the woo-prone involves bringing up the subject of medical errors and insisting that those who fight quackery should devote themselves to that problem instead, as if Orac and other physicians (including me) don’t spend thousands of hours in quality assurance efforts and continuing education already.

Noting that supporters came to the defense of Dr. Nicole Baldwin after she was attacked on social media and had fake negative reviews posted about her practice, I suggest that more of us should be involved in such efforts, perhaps volunteering to be part of a rapid-response team that (among other things) works to get phony reviews deleted and threats reported to appropriate authorities. It would also be great if sympathetic attorneys could be mobilized to respond to defamation and threats to employment (not necessarily by filing lawsuits, but to at least let these people know that their actions could have consequences).

A common slam by the woo-prone involves bringing up the subject of medical errors and insisting that those who fight quackery should devote themselves to that problem instead

I’m… sensitive to this argument.
Myself and a few other laypeople feel too often that medical boards act like police unions: slow to say a few words to a colleague in need of discipline, quick to circle the wagons whenever an outsider accuse a colleague of incompetence or malfeasance.
Coming to this, also slow at supporting their colleagues confronting/confronted by science denialists. And slow at supporting the official vaccine schedule.

Additionally, a criticism I may have feel like voicing, when I first discovered this blog, was the annoying feeling that things were presented like there was a clear divide – on one side, physicians who graduated from a real medical school, and on the other side, all the pretend-doctors and other quacks. Whereas, the reality is that there are physicians who fell fully to the dark side of quackery. And plenty of healthcare workers – and laypeople – in grayer and grayer zones between following science and following unproven treatments.

For one thing, Orac or the regulars are never shy about pointing out a MD or scientist who took a wrong turn, ethically or scientifically (quacks, OTOH…)
For another, my argument about a spectrum linking science-based physicians to outright quacks? It could be used the other way round. The infiltration of quackery into proven medicine is encouraging sloppy thinking. If your guts feelings or aunt Anny’s anecdotes about her herbal tea are as valid as epidemiology or a double-blind phase III trial to determine what constitutes an efficient medical treatment or protocol… This is going to result in more medical errors, not less.

tl;dr: yes but no. Because I go to a protest about pollution doesn’t mean I cannot spend time cleaning up the street litter on my way home.

“One could ask Dr. Prasad why he’s “wasting time” questioning clinical trials of pharma drugs when the real problem is lack of access to good medical care for billions of people. Or maybe he should be devoting all his efforts to ending world hunger.”

There could be a case to be made that if all medical endeavors were stopped because – for some reason – that was the way to get clean water to everyone in the world, it might be an even or better trade-off.

The charity effectiveness analyzer group GiveWell says that the best bang for your charitable buck, when it comes to human health, is deworming programs. But even they don’t suggest that everything else stop in the meantime.

Well, I have (in a reply to a similar OP at SBM) suggesting both Prasad and Orac are wasting time with relative trivia because the real problem is an impending climate apocalypse that will likely yield casualties in 9 or 10 figures in the lifespans of people alive here and now.

The best response to this sort of criticism is that we all have particular areas of interest and expertise, and should be encouraged to tackle the problems we’re most interested in and have a zest for solving.

If that’s the best you’ve got, you should give up, because that excuse is pathetic.

First, there’s a rather obvious logic error If the problems you’re most interested in are mooted by some more fundamental problem, So yeah, the efficacy of pharmaceuticals is relatively meaningless when billions don’t have access to any effective health care. More to the point, access to health care will end for billions more when climate catastrophes — collapse of food supply ecologies, coastal flooding, refugee migrations etc. etc. — lead to global economic collapse and resource wars.

Second, interest and zeal alone aren’t worth very much without competence. Prasad and Orac may fancy themselves as “science communicators” or “science advocates”, but while they both seem quite competent in the science stuff, their chops in advocacy communication — i.e. ‘rhetoric’: “”the faculty of observing in any given case the available means of persuasion” — are strictly amateur hour (or, as Orac might put it, the Dunning-Kruger is strong in them).

OTOH, the impending climate disasters will likely mean the end of social media, so maybe that’s a silver lining /s.

Says the guy who has yet to convince a single person skeptical of his assertion among regular commenters here and limits himself to kvetching, belittling, and lecturing in the comments section of a relatively obscure blog, where he reaches few people and persuades almost no one.?

Seriously, I never claimed to be an expert in science communication; so I’m always looking for opportunities to learn and up my game. Unfortunately, for someone who’s supposedly such an expert, you waste opportunity after opportunity to teach by example. Show us how it’s done right, if this truly is your area of expertise. Your sitting behind your keyboard kvetching and making increasingly dismissive snide comments from the sidelines in a forum where not very many people will benefit from your “wisdom” does not impress me anymore, if it ever did. (Actually, there was a time when it sort of did, but what good is that if you can’t or won’t teach us how it’s done?)

Come on, sadmar, show us idiots how it’s done right!

(I also fixed your screwed up blockquotes to make your comment clear. You’re welcome.)

In the scheme of things, humans aren’t all that important. Terrestrial life has survived things much worse than the global climate crisis (see Snowball Earth). What are you doing to stave off the solar expansion crisis, which will destroy the Earth itself? And shouldn’t we all be doing something to stave off the Big Freeze (by which I do not mean glaciation)?

(Warning: This post may comtain peanuts, by which I mean unmarked irony.)

@ John Cowan

“And shouldn’t we all be doing something to stave off the Big Freeze (by which I do not mean glaciation)?”

There is a plan for the big freeze:

Basic idea is extracting energy from the angular momentum of black holes during the big freeze by intrumentalizing their ergosphere. Which should be able to power a civilisation during this period.

Any other easy peasy question with easy peasy answers?

For the time being, I’d rather focus on nuclear fusion.

Thanks for fixing the HTML error. My eyesight’s not so good these days, and the font in the comment box is awfully small. Yeah, I know a lot more about persuasion and communication than either you or Prasad. Yeah, I have, at times, given you “opportunities to up your game”, which you have sometimes taken slight advantage of, though I doubt you’d admit it, though mostly you and the minions have crapped on them. But no, my comments have most often NOT been exemplars of any model of effective persuasion strategy. More little yelps of pain. The main thing is, as I noted at SBM, that these days I am barely functional psychologically. I rarely get off the couch that serves as my bed, much less get out of the house. I worked up the phrase “helplessly flailing as I am sucked down into a Charybdis of despair” just to prove to myself I could still generate some wording that meets my own standards. More often, I’m half-to-full-Biden, halting in mid-thought, struggling to find the word I intend, which is somehow veiled behind… some… what? I don’t know, just beyond my reach… receding. Look, I taught this stuff for over three decades, and very well if I do so say so myself (yes i have evidence, but no I won’t cite it), but my psych problems got bad enough that I had to quit teaching in 2009. That was, of course, before the US government was taken over by full-bore fascism (if you think Trumpism is anything less than that, Google “head on a pike”), and before I became aware of just how deep the climate sh!t we’re in goes. On top of that, my cat is sick, the vet thinks it’s bone marrow cancer, but she (the cat, not the vet) is too anemic to ungergo a biopsy. Around the first of the year, we thought she might not make it through the weekend, but she did, the vet started her on Prednisone, and she seems stable for now, but…. So, even I was still capable,of teaching you or anyone else much of anything by example or otherwise, even if you/they were open to it – which I’m emphatically NOT – I’m not at all in the f-ing mood right now.

But seriously, Mr. “trust-the-experts” when have you ever been open to listening to any expert from the Humanities on things like communication and persuasion? I can’t recall any evidence of that whatsoever. Not one citation, not one sign of reading in the field. Just the occasional credulous (to use one of your favorite words) invocation of pseudo-scientific idiot data-manglers like Brendan Nyhan – though I’ll give you credit in being nowhere near as far down that rabbit-anus hole as Novella. It’s not like anything I know on this subject is particularly novel. There’s are oodles of books. As i’ve said before, one could start with any decent modern intro explication of Aristotle’s Rhetoric. There are any number of pragmatic “popular” books on ad and PR campaigns.

And, you know what? If you’d read some of that stuff, you might have been able to come up with a decent rebuttal to my accusation that you don’t know squat about persuasion. Heck, I bet you could identify the logical fallacy of responding with an ad hominem attack in less than 2 minutes on the Google machine. You might also easily identify the logical fallacy in asserting “I never claimed to be an expert in science communication”. You did identify yourself as one “communicating science” in the first two sentences of the OP. I can point you to a Trumpist logician who’ll absolve you on the basis you didn’t use the specific word “expert”. You don’t think the tact you’ve been dishing communcating science with insolence for well over a decade isn’t come implicit claim of expertise? Fine then, you’re engaging in an activity at which you are clueless, which is what i said, which is what got you so PO’ed, which absolutely undermines your claim to have never claimed expertise.

See, I just very insolently debunked your reply. Did \you learn from it? Have your reactions in this exchange taught you anything by example? No??
Orac tries to bark back at sadmar. It does not go well. Disagree? It’s your “trope”.

“I’m always looking for opportunities to learn and up my game.” In all seriousness and ‘objectivity’, I’m curious what such opportunities you have found, what you learned, and how you feel they upped your game. When you calm down…

Orac writes,

“As for everyone else, doctors, scientists, and interested lay people, we welcome you.”

MJD says,

Unfortunately, this well-intended invitation appears hierarchical e.g., doctors, scientists, and interested lay people. Orac is unique in that he allows “everyone else” to voice their opinion at RI. In my opinion, medical “quacks” seem to have the innate ability to promote the following hierarchy: interested lay person; everyone else; doctors; and scientists.

@ Narad,

Does this make ANY sense to you?

“Does this make ANY sense to you?”

Makes sense to me. You’re an obssessive fixated mind-meltingly-tedious loony who has long since won at boring the utter nuts off our lovely host and all his other guests.

Your bed—you made it. Lie in it, or fuck off.

has writes,

“You’re an obssessive fixated mind-meltingly-tedious loony who has long since won at boring the utter nuts off our lovely host and all his other guests.”

MJD says,

Geez, where’s the sanity and logic in that outburst? My deepest apology if I’ve offended your sense of well-being.

@ Orac,

How many times is a guest allowed to say “fuck off” before you intervene?

How many times is a guest allowed to say “fuck off” before you intervene?

Personally, I’d rather not see that coming from anyone however you, like they have the power (and maybe the file code) to ignore.

@ Orac

“David Nutt, Edmond J. Safra professor of neuropsychopharmacology at Imperial College London. He was fired as chair of the UK Home Office’s Advisory Council on the Misuse of Drugs for saying that “alcohol and tobacco were more harmful than LSD, ecstasy or cannabis.”

Thank you! Thank you! Thank you!

This one got me completely nuts and threw me almost in berserk mode when I heard of it… Glad you didn’t shrug this one under the carpet!

Yes, scientists and other people involved in expertise have a problem with social media. They have been accustomed for too long a time to having the ears of governmental officials and administrative officials that they still have this idea in their minds that the public cognitive market is not a place they should worry about in getting their positions known. This is flying apart with social media nowadays.

But it also means paradoxically that random people on the internet also WANT officials and experts to be more thorough in their explanations. And speak in simpler terms too: At the same time that science is pushing through into public life, with the emergence of stuff like evidence-based policies (a good thing IMO), people also fear losing the right of making their criticisms heard (as if they had it in the first place anyway…). Ideology will indeed never go away, but if the communication channel that social media opened isn’t put to good use by experts, people will also lose confidence in experts even more than they have until now, because not answering questions and criticisms is bound to backfire seriously.

And David Nutt is a good example of this: I use his paper rather frequently when I encounter misinformation coming from officials on the misuse of drugs. I expect them to defend their position, but they never do…

For instance, here’s a website that seems informally tied to a faction in the French expertise apparatus.

It explicitly uses the study of David Nutt. Do they use this study to explain that alcool is on the top of the classification when it comes to harm? No. They single out addiction (because they only care on presenting that part of the evidence, and not explaining what Nutt’s report really said…) and they come out with this classification: 1: Heroin 2: Cocaine. 3: Nicotine 4: Barbiturates 5: Alcool.

Wow! Alcool is now the least dangerous of these drugs! Fantastic: how to use David Nutt’s study to convey PRECISELY the opposite message that his study made explicit.

Where’s my shotgun? (N.B.: That last sentence is r h e t o r i c a l…)

We do have problems in recognizing that alcool is not that light a drug. Not just France, but Europe. And I guess, the world. Also, tobacco.
Things improved over the last three generations, our alcohol consumption has been going down a lot, but there is still much to be done.
Because I am a bastard, I love to tell people that I don’t mind cannabis to be regulated at the same level as tobacco or alcool. And then watch them trying to figure out if I mean for cannabis to be de-regulated, or alcool more regulated.
(although, most people do honestly catch my drift – everybody knows someone who is or has been drinking overmuch)

In a similar vein of cultural/ideological bastions, a recent spat by a stupid French deputé who tried to score points by claiming that glyphosate is no more carcinogenic than delicatessens got me in an angry spiral. As it happens, the nitrites we use to cure meat do make it carcinogenic, and I learned this more than 3 decades ago, and we did nothing about it (although, since last year, we do find deli without nitrites in the supermarket – about time). So, if this politician was trying to say that glyphosate is safe, that was a very nonsensical argument. More infuriating, he got shouted at for daring to besmirch French saucisson, because, eh, we cannot have that.

@ Athaic

The alcool/hemp debate is overly ridiculous. But to pull off the gloves, the person targeted in my singling out of this website is Jean Costentin, member of the National Academy of Medicine and of Pharmacy in France. To say that he is ideologically biased would be an understatement, but his status as an expert still “baffles” me, to be polite.

Whenever I tried to mention his name to criticize some of his outrageous claims on french medical blogs, censorship is immediate. I am not sure people realize the extent of the damage this kind of situation does among lay people to the notion of expertise and to the credit of scientific inquiry on matters of social science and its influence on policy.

Moreover, this kind of medical beliefs are not anecdotal, as they trigger feedback loops and self-fulfilling prophecies among the mind of not-so-subtle psychiatrists, typically. It’s not merely an issue of denial backed by our wonderful culture of grape juice booze. It has real world consequences.

If you want to defend a cultural model, fine, do it. But do not do it by instrumentalizing the science. The same applies to GMOs, glyphosate, saucisson, or cheese filled with tasty green mold.

For instance, I perfectly understand people saying “GMOs? Not in my backyard!”. I get it. But do not tell me tall “scientific” tales on that topic. Similarly, whatever science may say on Roquefort, I’ll defend to death my right to eat cheese filled with mold: I’d say “Fuck science” for my right to eat Roquefort. But no need to deny science in order to defend a cultural model. “Fuck science” is enough… Hopefully Jean Costentin will one day get it, though I’m quite sure he’ll never act on it, as he is on a crusade.

And thank you for “being a bastard”. Much appreciated.

And long live mold!

@ F68.10:

Whilst I’ve never heard of anyone getting sick from eating blue cheeses, a popular “healthier” food option has had so much trouble with contaminated Romaine letuce that they lost value as an investment, had to shut down to train workers and will replace Romaine with another green
I don’t fear the Roquefort..

The same applies to GMOs, glyphosate, saucisson, or cheese filled with tasty green mold.

Don’t forget casu marzu.

@ Denice Walter

If there is one cheese you should fear, it is Epoisses. This is pungent chemical warfare. Perfect for binge watching episodes of Pepé Le Pew, the “french lover”…

“I mean it’s still sealed, and I can still smell it…”

No kidding.

I tried really hard to find a source for something I heard on a TV program about food in Britian in the 1980’s that there was a great scare about Stilton (a cousin of Roquefort), but sadly I couldn’t find anything specific.

Personally I’ve never worried about the blue cheeses (until they grow new and different colored mold in my fridge). Young unpasteurized cheeses, sure, I don’t feel like messing with listeria, but I thought most blue are either made from pasteurized milk or are more than 90 days old?

(Some days being a public health person sucks all the fun out of eating interesting food, like runny cheeses and raw oysters.)

I tried really hard to find a source for something I heard on a TV program about food in Britian in the 1980’s that there was a great scare about Stilton (a cousin of Roquefort), but sadly I couldn’t find anything specific.

Could it be this?

@ Narad

“Control measures were implemented, and included a voluntary withdrawal of the implicated Stilton cheese from sale on 23 January 1989 and a subsequent decision to use pasteurized milk in production of the cheese.”

Pasteurized milk for Stilton cheese? That’s clearly a case where I claim gourmets have a right to override scientific advice. Because gourmets are the REAL experts in these matters!

@Narad: I guess it must have been! The show I was watching was the highly non-technical “The Supersizers Eat the 1980’s”, with the lovely Sue Perkins and some funny-but-awful guy (Giles something).
I’ve seen other British programs elude to unpasteurized Stilton as some kind of amazing contraband, so it seems to be a thing.

Pasteurized milk for Stilton cheese? That’s clearly a case where I claim gourmets have a right to override scientific advice.

It appears that unpasteurized, small-batch “Stichelton” is still available from Neal’s Yard Dairy.

^ I forgot to say that I hope lilady is enjoying this digression from some unknown location.

@ Narad

Didn’t know about cazu marzu! Thanks! I’ll give it a try if I can one day.

As I recently noted at SBM, the cranks who chase me are using 2 strategies that we have no tools to combat. Disqus is becoming the crank stalking horse of choice. Anything I post anywhere–even if it’s about puppies or lunch, gets 20+ downvotes by my stalkers. And we know who the stalkers are. Disqus refuses to do anything about this. But at places that don’t moderate, they manage to suppress the comments of scientists and farmers on any piece.

The other thing they use is SourceWatch. Because we don’t have ratings and practices on Yelp like doctors, their attempt to harm the reputations of folks who talk about biotechnology get Sourcewatch pages written about them. They source cranks, they let a journalist write with a fake profile–and the journalist later uses the fake info as “evidence”. It’s a perfectly circular system for the cranks.

It doesn’t hurt me because you can’t get me fired (I work for myself). But this stuff is aimed at harming the careers of anyone who speaks out on these topics.

“I see some things getting worse.”

Of course it will. For those doing the harrassing this is their means to power. They’re not going to give that up, not willingly or without a richer target. As for support, I don’t think it must always be active or overt; not everyone can afford that, and even those who would whish to must draw a line somewhere, or else be sucked into an infinite number of battles, losing all those and themselves too.

Still, even a private word just to say “you’re doing good” must be greatly reassuring to a lone activist; that they are not going unheard and are indeed on the right track—that the rest of the world does, in fact, give a crap too. On which note, from this hopeless nothing-and-nobody to Orac and his colleagues:

Folks, you are Doing Good.

p.s. I’ll also leave this here:

@ has

“As for support, I don’t think it must always be active or overt; not everyone can afford that, and even those who would whish to must draw a line somewhere, or else be sucked into an infinite number of battles, losing all those and themselves too.”

There’s one tactic I like, but it is much longer term than what you people are dealing with.

Stroll methodically on the Internet. Find a feud anywhere on the Internet where a poor guy with sensible ideas is being harassed by a crank with crazy ideas (not necessarily medical ones) that can be refuted by science. Then intervene and defend the poor guy with scientific evidence and good rhetorics.

You won’t convince the crank. That’s not the point. But you’ll convince the poor guy that is being harassed that science is on his side, that he’s not crazy, and that he has a sensible way to argue his position based on scientific evidence.

It’s a quick way, though an unreliable way, to make a pro-science advocate from someone who doesn’t yet know better. He won’t be able to argue against cranks for sure (and he may even become one, who knows…), but in time, he’ll get the gist of the game: follow the evidence. And in 3 years time, he’ll eventually be able to start arguing against nonsense.

If we don’t do that, we won’t be able to build momentum in favor of a scientific mindset.

At RI, we have all witnessed how cranks behave close up so we can describe and perhaps even study how resistant they are to education. what we don’t see as much are people who have doubts or sit uneasily on the fence; perhaps it’s difficult to phrase uncertainty or show how confused they are about important topics – so they may remain silent.

As a sceptic, here and previously at a few other places, I’ve been accused of being a pharma shill, being complicit in “destroying children” and been insulted in many juvenile and uncreative ways. I have recently gone out of my way to NOT divulge much information about my background** ( personal, education, career related) so to give them a blanker canvas on which to project their fantasies about sceptics.

Surveying scoffers’ responses to Orac’s minions, I sometimes discern a divide based on gender: cranks seem to get more riled up when women speak up against woo/ anti-vax. Perhaps these partisans, on average, have more traditional views about women’s roles than sceptics do. Bur a few of us certainly know the drill. I originally thought I should use a more androgynous or masculine nym but felt that feminists should always stand up for themselves.

re Gary Null: Orac is correct- atheism is his common criticism of sceptics HOWEVER I predict that soon sceptics will have a field day when Null publishes/ trumpets his ‘de-aging’ study.
-btw- if anyone is a Wikipedia editor, respond to me here, I may have something for you concerning his bio.

** scoffers’ insults illustrate how they can’t evaluate others’ abilities in diverse areas. They may not like me but should be able to identify that I have certain skills that they lack.

I predict that soon sceptics will have a field day when Null publishes/ trumpets his ‘de-aging’ study.

I expect that Grecian Formula or Just For Men will take a prominent role.

@ TBruce:

Oh no! This involved sequestering people age 70s-95 for 8 weeks on one meal a day ( vegan) plus juices and supplements ( juices only on weekends), having them exercise/ do yoga multiple times a day and listen to 5 hours or more of the host’s lectures/ “wisdom” with strict rules ( no leaving the retreat, no phones, no television, silence during the meal, energy healing. de-stressing sessions) then, having them comply at home for 4 more weeks. There will be a re-play in March.
No details about the cost but he is seeking out GoFundMe money to film and write up. Usually he gets money as a WBAI premium.

He will change their DNA. Supposedly results are great ( what else!) ” These people lost weight! The lowered cholesterol! They lowered blood glucose” Nobody died though AFAIK

So if you dislike an older person, you might want to tell them about it.**

** I’m joking, I would never advocate mistreatment of older people.

He will change their DNA.

Guess what happens when your DNA is changed.

That’s right – cancer! Hey, sign me up.

I have recently gone out of my way to NOT divulge much information about my background** ( personal, education, career related) so to give them a blanker canvas on which to project their fantasies about sceptics.

I didn’t get comments through at AoA by being anything less than suave.

I sometimes discern a divide based on gender: cranks seem to get more riled up when women speak up against woo/ anti-vax.

I wonder if another explanation might be that a lot of the modern anti-vaxx talk is based on the ‘warrior mom’ imagery, appropriating feminism to bolster their fight against the patriarchal role of doctors.

Having women argue against them thus undercuts one of their primary lines of argument, and it is also a line of argument that is treated very personally by a lot of people.

Of course,women arguing against anything tend to get folks more riled up, so it’s hard to separate the effects.

It’s hard to say, but there is definitely an element of misogyny in the backlash. I might get the odd death threat every now and then in addition to the usual abuse, insults, and threats to harass me at work, but I don’t have to put up with the unending torrents of misogyny and rape imagery that women online do. I was fairly oblivious until several years ago, when at TAM several female skeptics showed me examples of the sort of stuff they have to put up with on a daily basis. Honestly, if I were a woman, I don’t know if I could do this. A similar dynamic is at play for people of color, who have to put up with racist attacks on top of the usual abuse.

Of course I’m not nearly as visible as many sceptics are and it’s subtle stuff**- not about violence or rape- like insinuations that I am being paid ( Hah!) or that I am not too bright ( Double HAH!)

I think it’s possible that anti-vaxxers/ woo-ists react differently to women than to men ( or people they assume are men because of a neutral nym) because of their own issues: that many mommy warrior feminists are not the most enlightened individuals as my reading of anti-vaxxers leads me to cautiously believe- they respect their cohorts’ input because they are MOTHERS even when it defies reasonability. So possibly, a more traditional outlook.? Seeking out sister travellers but male leaders?

That might go along with the more conservative values and lower educational achievements found by some surveys of anti-vax demographics ( such as the most recent comparing beliefs of those who completed secondary vs graduate school; political alliance) although there is also that more ‘white/ more affluent’ trend.

** except that I think that Jake once hinted that I was a Nazi!

That most recent research is by Pew 2019. Beliefs about vaccines, parental choice, SES. race, education al level.

Gwyneth Paltrow has been employing this “feminist” rhetoric in her Goop campaign. And I have a lot of feminist friends who readily buy into this sort of nonsense.

Yeah, I ran into that kind of “feminism” when I was majoring in engineering during the late 1970s. They tried to tell me I was studying “men’s science”, whatever that was. It was like they thought that biology and the laws of physics had different ways of working depending on if one had a Y chromosome.

Well, I don’t have a Y chromosome and the laws of physics as we know it work fine. Also I don’t consider very them good feminists if they think shilling for supplements is more important than making sure old white men do not dictate the access/quality of medical care for women, especially poor women:

From AoA:
Joshua Coleman’s video wherein his anti-vax compatriots are not greeted too fondly at the Women’s March in LA. I didn’t watch the whole thing ( 22 minutes) but I did catch a guy arguing SB points to their BS.
So actual feminists don’t accept anti-vax’s brand as spouted by Kim et al.

Interestingly, an report about Trumpers gathering in one of the red spots in very blue NJ mentions that the righties didn’t appreciate the anti-vaxxers there as well.

@ Chris

“Also I don’t consider very them good feminists if they think shilling for supplements is more important than making sure old white men do not dictate the access/quality of medical care for women, especially poor women.”

Indeed… There’s also been an interesting development in France on the topic of abortion: Leftist parties have been arguing that we should do away with the “clause de conscience” which allows doctors to not perform an abortion if it goes against their core (religious…) values. And there indeed still is an issue in some places (near Le Mans, typically, if I recall well) where almost all doctors fail to permit abortions (if allegations are correct, which I find hard to fully believe).

But our health minister recently argued something sensible: if there weren’t this “clause de conscience” and doctors were obliged by law to perform an abortion, unwilling doctors would delay it endlessly with subterfuges like “think it over for a few weeks, then come back”.

Access of women to healthcare is therefore not only an issue of abstract legislation, but also an issue as to how things unfold pragmatically in real life.

Your article about the fate of poor women with poor insurance is indeed problematic. Though I must confess I’ve been on the other side of the problem: I’ve been begging my insurance to stop paying for my medical care in order to send a strong signal to hospitals about my utter lack of consent to medical procedures. In the US, I believe I would have had a better time opting out of any medical insurance scheme to ensure that treatments would not been paid, hence easing my way out of hospitals.

“I would have had a better time opting out of any medical insurance scheme to ensure that treatments would not been paid, hence easing my way out of hospitals.”

Yes, my issue is not just abortion, though those doctors could also be killers of mothers when religion overrides actual medical science:

It is mostly access to healthcare. The problem with your plan is that this country has “collection agencies” that will make you pay those bills:

@ Chris

“It is mostly access to healthcare. The problem with your plan is that this country has “collection agencies” that will make you pay those bills:”

That would be fine with me. I wouldn’t pay as a point of honor for treatment I explicitly opposed. I’d be glad to make that point explicit anytime: you do not get paid for that kind of behavior, collection agency or not. Period. Whatever the consequences may be for me, I’d be fine with them.

I must say that access to healthcare for women seems to be much easier in my country (which is Good ®). People pay very little hospital bills in France, amazingly. The downside, however, in government-controlled medicine (because to a large extent it is just that) is that if you have a legal or malpractice issue, you end up dealing with The State ® as your opponent in court. And they have special jurisdictions here, called the administrative courts where you simply cannot win.

The judge is The State ®. The opponent is The State ®. The law is made by The State ® outside of control of Parliament (that’s the beauty of our “Conseil d’Etat” which is the non-elected lawmaker for administrative courts), and the law is simply that as long as the hospitals (i.e. The State ®) filled the administrative forms “correctly” (cough… cough… cough…), you cannot win. That’s why these courts are called “administrative” courts in the first place anyway: No outside evidence are allowed. At bit like Trump’s wet dream…

Been there. Huge fun.

“cranks seem to get more riled up when women speak up against woo”

IMO, this is all about punching down, and finding the easiest, most effective ways to do it.

Men belittle women, as that’s the accepted traditional route to dismissing them, and easy AF to perform; and men are nothing if not lazy and plain as glass. Under-educated SOH women attacking educated professional women is more complex, but I believe it’s because the latter lend the lie to their own social standing and status simply by being more successful than they are. Kids, of course, are just props, to be used in garnering attention and pity from peers, or as human shields to defend against incoming criticism, even [especially?] when that criticism is coming from educated professional moms.


Digression: Of course, the best defense is to attack first.

Terms such as “feminism” and “sisterhood” are simply rhetoric to be wielded as weapons; like any cult of absolute zealots, words describe whatever they want them to describe, and Good Words = themselves and Bad Words = us. It is also I’m sure why a good chunk of their dialog sounds uncannily like mirror universe versions of our own; thus we publicly point out they actively promote and commit child abuse (e.g. embracing shaken-baby murderers, forcing autistic kids to drink bleach) and they play the pedo card in response.

Even if their extremist language alienates the wider public, it strengthens belief and bonds amongst themselves and justifies increasingly extremist responses to this critical immediate threat they perceive to themselves (both directly and to their child proxies). We’ve already seen the Trump/AltRight/QAnon movement driving individual members into pizza parlours with weapons and into crowds with cars, and history’s replete with nation-scale tyrannies forged on the same foundations.

Because it’s all well and good being able to punch down like a pro, but what they are getting really desperate for now is the permission to punch outward as well. And that is the reason for this slow but inexorable escalation. Like a gang of unruly kids loitering on a street, the first shouts, the second spits, the third hits, the fourth pushes over, the fifth kicks in the head… and next day the local fish wrappers are full of stories about Loving Father of Three Beat To Death Outside His Own House. The autopsy may say blunt force trauma to the brain did it; but that would not have happened without all those little increments before it, each one gaining its collaborators social acceptance and permission for the next.

At least when the first pediatrician is murdered by an antivax extremist, they can die knowing that at least their valid public criticisms of those child-harming wackjobs must’ve really hit their mark.

So it goes.

There is one anti-vax extremist who is very upset that I reply to her inane comments on this blog. She claims I am a stalker out to harass because she is a woman.

No, it is because I am a mother who had to take care of a six month old baby with chicken pox a year before the vaccine was available. I saw how much pain that child was in, and now that the kid is in grad school I know they have a higher chance of shingles in their twenties. Because getting chicken pox as an infant makes a person more susceptible to shingles when they are young, especially with the stress of grad school. (also the oldest child had seizures as a toddler from a now vaccine preventable disease)

I despise anyone who declares kids should get chicken pox, measles, mumps, Hib, etc. I think they are sadistic child haters who love to see kids get high fevers, pneumonia, seizures, etc.

@Chris: Luckily it’s only a blog. If crazy lady saw you on the street, she’d throw herself under your feet and then tell police you assaulted her as well.

You mean that people other than Orac can focus and address more than 1 subject at a time?
Unheard of!
Perhaps that is Dr. Prasad’s problem – He is OCD on his topic and can’t seem to overcome this personality disorder like the rest of us and address multiple topics at the same time.
I think he should have his monoscopic** OCD disorder checked into… But, then again, IANAPsy.
** I don’t even know if this is a word but Humpty Dumpty told me it means “ability to focus on only one subject”.

Have fun.

What a facile, brain-dead response it is to regurgitate the cliche-of-the-year.

It’s not a question of what we can do, but what we should do. Energy resources are finite, and every calorie spent on chewing gum is one not spent on walking. How we allocate our resources is a matter of moral consequence.

Fwiw, I do not offer this as a defense of Dr. Prasad, who does indeed come off as a arrogant and condescending… such a surprise for a physician .

That depends on the gum; a gum made with sugar initially provides additional calories that can be used for walking or chewing or thinking.

See, I too can be unhelpfully pedantic.

If you really want to do something about climate change go found a bunch of schools for girls in developing countries. G’on, scoot. (Education delays age at marriage and reduces number of children. Often also increases economic independence and success, also reducing number of children and improving local economy.)


IKR? What’s sadmar doing wasting his time criticizing docs pushing back against antivaccine pseudoscience and other forms of quackery if he really believes that the “climate apocalypse” will wipe us all out if we don’t do something now? (I’m not disagreeing that climate change could be an existential threat, only pointing out the ironic inconsistency in sadmar’s words and actions, given that he’s lecturing us for worrying about antivaccine pseudoscience and cancer quackery when climate change is going to destroy civilization.)


@JustaTech and Orac:

I’m giving Orac grief because he has a platform and he’s not totally fucked up like I am, he;’s got some fight left within him, and I’m just lost and waiting to die and ranting really, not so much at Orac, or DB or ScienceMom or anyone in particular, but against the wind — in the material world of a doomed civilization yes, but also the won blowing sand and detritus inside my doomed subjectivity.

@ sadmar

” I’m just lost and waiting to die and ranting really.”

I’m not fully in that situation, but I do relate: It indeed becomes a tough time when the only (or rather the main) option you have to act upon the world are your words.

Luckily, we have the Internet nowadays. Had I been in that kind of situation 40 years ago, I would have strived as much as possible to hasten the end as fast as possible as there is no point ranting in a hospital or an institution where people make it a point of honor not to care about what you think, even less listen to what you have to say.

Now, we have to opportunity to rant on the Internet: it’s not clear what we can achieve in these situations, but at least, it makes it easier to attempt to achieve something by ranting.

I’m just lost and waiting to die and ranting really, not so much at Orac, or DB or ScienceMom or anyone in particular, but against the wind

Like in Twister?

@ Narad

At least sadmar isn’t confessing on CraigsList that he has weird Twister-based sexual fantasies….

@ sadmar
@ F68.10:

although you are unique individuals, I will try to write this in a manner that may be too vague but is inclusive

I enjoy reading your writing and feel that you are talented people with valuable stories to tell and although your recollections may be painful they may eventually be liberating for you. Both of you have suffered and may be damaged by that fact but not destroyed. Why not embark upon a long, expository work about whatever you feel has set you apart from the usual run-of-the-mill life experience. Or other stuff. Perhaps a book someday? Why not?

For a comparison, my friend experienced a life shattering event when she was quite young: a family member , eating lunch at a pub, was blown up in a terrorist bombing. Because the man’s mother was ailing, she had the responsibility of identifying the body- more accurately, view the pieces of him. She still carries around a keychain fob made of steel that is the only thing solid that was left. Other things concerning him and his life affected her: he left a book unfinished ( Tess of the D’Urbervilles) and she kept it at that particular page for decades until she finally read the book to the end. A closet filled with clothes and sporting goods. People in her family named children after the victim, both male and female variants of his name. She experienced nightmares and re-lived that fatal day over and over. It became her central vision although she did have relationships, a career and friends.

She wanted me to read her stories- some of which were influenced by Irish folklore. I encouraged her to integrate the stories with her written real life memories of what had troubled and shaped her outlook She’s been doing that and she says that it has helped her: it may be that unloading a burden lightens its load as it is now a shared with others. Or could potentially be shared. I don’t know if she will ever try to publish it but that’s not what’s important- she has built a reliquary of her grief and her transformation through this .misery.

Both of you can write and have something to say. Really. .

@ Denice Walter

“Why not embark upon a long, expository work about whatever you feel has set you apart from the usual run-of-the-mill life experience. Or other stuff. Perhaps a book someday? Why not?”

Honestly? Because no one cares about stuff like that. It’s that simple.

In fact, I’m currently having fun on another blog: As my pseudonym is an ICD code for what you know, some jackass are very busy making fun of that kind of torture. I contend it goes a tad further than rape apology, but you know, I enjoy contemplating how thick a skin I now have…

JustaTech made me remember Tom Lehrer. And it occurred to me that the Masochism Tango quite accurately captured my life experience…

Bottom line: very busy making fun of people making fun of torturing babies and kids. No point writing a book when the fruit is hanging so low… Tom Lehrer is enough to get them to start thinking. One day…

@ Denice Walter

I’ve thought about something like non-non-fiction. Unfortunately, I’m not good enough a writer to entertain this idea, and I lack imagination/creativity and energy. I’m trying other avenues.

For instance, the blog on which I’ve been having “fun” is the blog of a magistrate who had to judge an MSbP case that made headlines over here. (I guess he must have had a hard time sentencing someone on the sole basis of the misuse of four prescription forms that were misused by the MSbP perpetrator, who committed suicide, and of whom he was judged to be an accomplice). I hope to convey a message or two indirectly by intervening on his blog.

More seriously, when you reach a certain point, as sadmar seems to have reached too, priorities change. In sadmar’s own words, he’s waiting to die, and the thing he now cares about is climate change. It may obsess him a tad too much as he’s likely to have little impact on this matter on his own. But still, it does mean that he now cares about other things than merely his health or well-being, which he may have stopped worrying about to some extent.

This is a logical development. The problem is what to do with that with the time that you have at your disposal in this context, and the limited capacities you end up being endowed with. The solution to this problem is seldom obvious.

Hey sadmar, two things. First, maybe go have a chat with an IRL friend? Have a cup of tea and check in?

Second is a little more complicated to explain. When I was a kid I started reading a lot of science fiction. I started with the usual stuff, but then I was stuck digging through the corners of the library, finding lots of stuff that was written in the late 1970’s and early 1980’s. I was struck by how so much of it was very post-apocolyptic. So many different authors just assumed that the world would end and used that as a starting point for their writing.

Later I read some “recent history” about world politics in the 1970s and 80’s and I realized that there was an intense amount of fatalism in many forms of art and culture, because everyone was expecting the bomb to come and so why bother.

But it didn’t. For lots of reasons, but at least partly because plenty of people decided that the world was not going to end and did something, small and large about it.

The world is full of people who are just not ready for the world to end and are doing something about, small or large. Even planning for the future and having hope makes a positive impact.

If there’s one thing you can say for humans, we’re persistent. Don’t write us off yet.

Simon Wessely, professor of psychological medicine at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London. An expert in chronic fatigue syndrome who’s shown that two approaches, graded exercise therapy and cognitive behaviour therapy, can help CFS patients manage their symptoms, he’s been falsely attacked by patient groups for not treating CFS as a serious illness. In one instance, a conference slide of his was altered to reverse the meaning.

Hang on one second. I don’t know about the final item, but David Tuller has been pointing out the flaws in GET/CBT over at for some time (for everything, see here).

If you want to read a heart-rending but hilarious post about the price one pays for defending Science, don’t miss James Lyons-Weiler demanding a retraction, correction and apologies from CBC for their “thoughtless and callous” blow to his reputation. CBC recently did a piece in which an undercover reporter talked with L-W about what it’d take to get him to speak at an (antivax) event. He reportedly responds by saying he wouldn’t ask payment, instead taking money for doing a ”science” event the day before (supposedly this would avoid his being classified as an ”international lobbyist”).

In his demand for retraction/obeisance from CBC, L-W goes into a labored explanation as to how he wasn’t really asking for a quid pro quo (if possible, it’s even more convoluted and dubious than a Trump apologist describing how the Ukraine thing wasn’t a quid pro quo). But what apparently stung the most about the CBC piece was that L-W felt it cast aspersions on him as a Man of Science.

”Your reporter also hurtfully and irresponsibly claimed in the published video report that I “want to be seen as a Scientist”. I attach my NIH Curriculum Vitae which includes my past and present employment…To date, none of my research studies have been retracted (pause for laughter). I am now, and will die, a Scientist, regardless of your reporter’s insensitive and uninformed implication that I am not.”

L-W says he is working with Christopher Shaw on a new study of aluminum hydroxide in infant mice, which will demonstrate that aluminum adjuvant in vaccines is really Bad, or something like that. Does he know that Shaw has had four retractions to date? That might not bode well for L-W keeping up his perfect record of never having had one of his own papers retracted.

“Does he know that Shaw has had four retractions to date?”

All hail The Grand Cremaster, Retractor of All Bollocks!

Wow, Lyons-Weiler isn’t just a scientist but a Scientist?! I’d have a hearty laugh about the numpty duo’s upcoming study but animals needlessly suffered and died for what will invariably be more shit pseudo science from the anti-vaxx brigade.

There is a saying that you can judge someone by the company they keep. If Lyons-Weiler wants to be seen as a real scientist, publishing with cranks like Shaw won’t get him there. Anti-vaxxers already treat Lyons-Weiler like a ‘scientist’, but their discernment in scientists leaves a lot to be desired. If nothing else does, this fully establishes Lyons-Weiler as a crank.

this fully establishes Lyons-Weiler as a crank.

Surely that was not in doubt, after L-W came out against every existing vaccine (inventing new ad-hoc reasons to oppose the ones that don’t contain adjuvants), while still clinging to the mendacious claim that he’s not antivax.

Surely that was not in doubt

Not among those who have been following his activities carefully. For everyone else there is publishing with other cranks.

Um, he refers to “Priest et al.” for a single-author paper. Draw your own conclusion.

Looking into Priest’s paper, I noticed that there’s a follow-on comment by Exley. I can only hope that the editors of the Journal of Environmental Monitoring were laughing their heads off when they let through this petulant bomb of asshurt.

Um, he refers to “Priest et al.” for a single-author paper. Draw your own conclusion.

He also refers to his co-author as Dr. Paul. Apparently, Dr Paul’s careful watching “with the parent for signs of potential autoimmunity following vaccinations” trumps all objective data.

This effort by Lyons-Weiler looks like it is going to provide endless entertainment.

“I can only hope that the editors of the Journal of Environmental Monitoring were laughing their heads off when they let through this petulant bomb of asshurt.”

That’s an awful lot of words just to say “Priest didn’t cite enough of my papers so he must be a shill for the aluminium industry”.

“where he demonstrates his unfamiliarity with math and statistics.”

Mr Crosby is not so much unfamiliar with maths and statistics, as hostile to them and their disagreement with his vision of the way the world should be.

Nothing actually wrong with the study, to my mind. After 36 years collecting data in umpteen different countries, the authors found what we already know: no elevation of brain-Al levels in autism or ALS, or in other neurological conditions except for Dialysis Dementia, Downs Syndrome and Alzheimers.

But someone thought it was a good idea to write two manuscripts based on the same data, and submit one version to an OMICS spigot and the other to a real journal… so the real version had to be retracted (because it spent longer in review than the OMICS two-day turnover).

Govern yourself accordingly.

Well, I suppose I do, for certain values of “accordingly.” Nonetheless, I did stumble across a Concordia University joint on demand letters (PDF). I found it to be lawyerly but amusing (footnotes omitted):

“On a recent April 1, marketed a fake product called ‘Canned Unicorn Meat’ with the tag line: ‘Pâté is passé. Unicorn, the new white meat.’

“Reflexively, lawyers representing the National Pork Board responded to this joking riff on its trademark ‘The Other White Meat’ with [a] twelve page acerbic demand letter.”


QAnon is going gaga over MMS as cure for the coronavirus. Because, of course. That virus, you see is the fruit of Bill Gates’ global depopulation campaign…

Lest ye give a haughty laugh, consider that whether this is slightly less or slightly more credible than the defenses mounted by Trump’s “legal team” at the Senate “trial” yesterday would be a matter of hotly contested debate…

Everywhere, there is madness,..

WOW, four authors of a 2018 aluminum study dead!!! Could it be that since their paper noted aluminum toxicity affecting regulation of innate immunity, they were done in by a pro-vax hit squad??!?

I am gonna alert Erin Elizabeth to this HIGHLY suspicious occurrence, so she can update her list of Holistic Doctor Murders.

Connect the dots, sheeple.

There is no end to the perfidy of the Big Pharma ninja assassins, killing doctors and disguising the deaths as old age!

Maybe the assassins are senior citizens. After all they’re a demographic group with time to kill. Would that qualify as death from old age?

Erin is trying to link Kobe Bryant’s death to his supposed feuding with a drug company. The Conspiracy widens and deepens.

I’m suddenly morbidly interested in the theory that she is actually Erin Elizabeth Finn and thus a former high-priced L.A. prostitute, given that it ties right into a connection to Patricia Finn.

On working to make a difference in one’s sphere of influence and expertise:

Awhile back, the gift shop at the main hospital where I practice started offering a line of highly dubious supplements, including an Endocrine Boost formula derived from the thyroids and adrenals of cows and pigs. I pointed out to the gift shop manager (and more importantly, the chief of internal medicine) that this stuff was likely to be useless and/or dangerous, both to visitors and any inpatients gifted with it by well-meaning friends and relatives (Uncle Bob probably wouldn’t have benefited from unexplained T4 fluctuations or mad cow disease on top of his congestive heart failure). Thankfully this crap vanished from the shelves soon afterwards.

I suppose I could have focused public effort on More Important Things, like writing an impassioned letter on climate change to Mitch McConnell (or emoting on the subject in comments following a blog article), but I suspect helping get rid of the potentially harmful supplements was more meaningful.

You saw something wrong that you could do something about, and did something about it – sounds good to me. Of course, there’s nothing stopping you from writing that letter to Mitch McConnell, although somehow I don’t think it will get quite the same results!

Seriously, good for you. Good job too of using your knowledge of the human relationships in the system to get results, finding an effective social avenue for evidence.

If you sincerely thought my screed was intended to denigrate actions like that – sh!t right in front of you, undercutting your work with your own patients, addressable through a clear path with minimal effort, and a reasonable expectation of positive results – I shall assure you it did not. So yes, I’d much rather you did that than writing a useless letter to McConnell. (Is he your Senator? Eek!) But then individual letter writing about anything is a waste of time. So that’s a straw man.

To clarify, my reply was addressed only to the general principle you articulated, which was offered without qualification. Perhaps, as often happens in comment threads, your words did not adequately frame the intended thought. You wrote we all “should be encouraged to tackle the problems we’re most interested in and have a zest for solving.” That does not reference either one’s sphere of expertise, or sphere of influence, or most importantly the intersections of those spheres with the immediate sphere of what Berger and Luckmann call ” the reality of everyday life”.

So, to me, the words were to easily associated with what Orac would call Dunning-Kruger, the sort of Internet-enabled discourse filled with interest and zeal, yet to often, at best, pulled out of the commenter’s ass, and, at worst, dredged from the fever swamps of hateful and fearful conspiracy theories. My point, most broadly, was simply that moral purpose matters. Judging the morality of mattering is obviously a complicated calculation that can’t be solved by merely suggesting everyone should spend all their time addressing the worst prospect we face, even in that individual’s calculation, much less someone else’s.

Though I wound up responding to replies to my earlier comments, I actually only came here intending to post this verse from Charles Bukowski (titled “Dinosauria, We”), cut-and-pasted from a climate change thread at The Graun.

Born like this
Into this
As the chalk faces smile
As Mrs. Death laughs
As the elevators break
As political landscapes dissolve
As the supermarket bag boy holds a college degree
As the oily fish spit out their oily prey
As the sun is masked
We are
Born like this
Into this
Into these carefully mad wars
Into the sight of broken factory windows of emptiness
Into bars where people no longer speak to each other
Into fist fights that end as shootings and knifings
Born into this
Into hospitals which are so expensive that it’s cheaper to die
Into lawyers who charge so much it’s cheaper to plead guilty
Into a country where the jails are full and the madhouses closed
Into a place where the masses elevate fools into rich heroes
Born into this
Walking and living through this
Dying because of this
Muted because of this
Because of this
Fooled by this
Used by this
Pissed on by this
Made crazy and sick by this
Made violent
Made inhuman
By this
The heart is blackened
The fingers reach for the throat
The gun
The knife
The bomb
The fingers reach toward an unresponsive god
The fingers reach for the bottle
The pill
The powder
We are born into this sorrowful deadliness
We are born into a government 60 years in debt
That soon will be unable to even pay the interest on that debt
And the banks will burn
Money will be useless
There will be open and unpunished murder in the streets
It will be guns and roving mobs
Land will be useless
Food will become a diminishing return
Nuclear power will be taken over by the many
Explosions will continually shake the earth
Radiated robot men will stalk each other
The rich and the chosen will watch from space platforms
Dante’s Inferno will be made to look like a children’s playground
The sun will not be seen and it will always be night
Trees will die
All vegetation will die
Radiated men will eat the flesh of radiated men
The sea will be poisoned
The lakes and rivers will vanish
Rain will be the new gold
The rotting bodies of men and animals will stink in the dark wind
The last few survivors will be overtaken by new and hideous diseases
And the space platforms will be destroyed by attrition
The petering out of supplies
The natural effect of general decay
And there will be the most beautiful silence never heard
Born out of that.
The sun still hidden there
Awaiting the next chapter.

Thanks for bringing Olivier Bernard Le
to my attention. After reading two or three of his postings, I can see why he might get harassed. And he does great cartoons!

“The chief executive of Britain’s National Health Service has criticized Gwyneth Paltrow’s lifestyle brand Goop and her new Netflix series, warning it carries “considerable risks to health.”

At an event in Oxford on Thursday, NHS chief Simon Stevens slammed Paltrow’s brand for giving prominence to “quacks, charlatans and cranks” in promoting untested treatments like vampire facials and unusually scented candles.”

Shame on Stevens! Doesn’t he know Goop is a ”soft target” and he should be talking about climate change instead???!?!?!?

I’d just like to say that while I don’t understand all the science (I spent my college years dossing around in Accounting), I am glad of the efforts you and others put in to educate the likes of me and, more importantly, showing where the purveyors of nonsense are trying to mislead us. Keep up the good work sir, and chapeau!

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