May 15, 2008
Category: Evolution Denialism
There's been much written around here about the NYT's David Brooks' foray in to non-materialist neuroscience. Well, today the letters to the editor are in, and some of them are interesting (although most aren't particularly sophisticated).
One in particular highlights some failures we've had as science educators (including a failure to educate editors):
To the Editor:
As an engineer, lawyer, computer programmer and Roman Catholic, I have a problem with the concept that the evolution of the species just happened. From an evolutionary perspective, we are probably somewhere in the chicken and egg debate.
As man supposedly evolved from a single-cell amoeba to the complex organism that he is today, we had to develop a complex brain to manage the process.
The first problem facing a self-developing species in its early stages would be the need to know that there is something out there to see, feel, hear, touch or taste. The second problem is that a complex brain could not survive the incredibly complex development process without the five senses in operational mode. And you can't get the senses in operational mode until you have developed a sophisticated brain with the ability to communicate and interact with the senses.
Therein lies our chicken and egg dilemma.
Ken LeBrun
Stony Brook, N.Y., May 13, 2008
Ken has a few gaps in education, and it's worth a bit of fisking:
Read on »
Posted by PalMD at 4:09 PM • 21 Comments
Category: Medicine
A few months ago, I gave you a short primer on the immunology of vaccines. It's time now for another short, oversimplified primer, this time on the immunology of HIV. This was originally up on the old blog, but it will provide some necessary background for upcoming posts (I think).
HIV denialists form a persistent little cult, and one of their newest leaders is Gary Null. Despite their small size and dearth of academic heavy-weights, they are quite loud, and can affect health policy.
Let's delve into the immunology, and, once again, please forgive the over-simplification.
HIV---nasty non-critter
Read on »
Posted by PalMD at 8:59 AM • 12 Comments
May 14, 2008
Category: Carnivals
The new Tangled Bank is up over at The Beagle Project, and as usual, it's a great read.
Also, I want to give a quick shout-out to my internet buddy Ames who's hit the blogosphere running, so to speak, with his first carnival post.
Posted by PalMD at 6:29 PM • 0 Comments
May 13, 2008
Category: General Discussion
A lot of folks around here like primates. In fact, all of the bloggers around here are primates. So a number of us are pretty riled up about a recent story out of Georgia (although I don't advocate another apocalyptic March to the Sea). There is another poll to crash with the linked story, so go have at it.
In a similar vein, I posted a piece on my old blog a little while back about an article that wasn't written by an ignorant redneck, but by a writer for a prominent conservative news outlet. What follows is the repost.
Read on »
Posted by PalMD at 8:38 PM • 16 Comments
Category: Medicine
Well, I'm back from a great vacation, and buried under an avalanche of work. Just to give you a hint of what an internist actually does...
My office schedule is full---really full. Everybody needs to see me, plus the various sick people I have to squeeze in. It's great; being busy is fun, but it's time consuming.
Then there's my desk. It is covered in lab results, home care orders to be signed, hospice orders, medication refills, prior authorizations...
And of course, back to teaching, including evaluations, etc.
So, it may be a bit quieter around here for a while, but I wanted to point out a few interesting things. MarkH is finally getting around to practicing some real medicine, that is, internal medicine, and he has discovered what I love about it---the mysteries (and it ain't House, folks). One important point in particular he raised is how sick medical patients really are these days:
The more realistic medicine patient would be someone over the age of 50 with at least 5 or 6 chronic problems, and just one (or two, or three) that has put them over the edge requiring hospitalization.
Hospitalized patients are much sicker than they used to be. This may sound a bit odd, but many diseases are now successfully managed outside the hospital. Also, as hospitalization has become more costly, you have to be pretty sick to get in the door. For example, 25 years ago, it wasn't unusual to admit someone for a "work up" of one kind or another. Now, patients must meet certain criteria of "intensity of service" and "severity of illness" to have an admission qualify for coverage. This usually isn't a problem, but sometimes it is. Just something to think about.
Posted by PalMD at 12:49 PM • 6 Comments
May 12, 2008
Category: Cranks
So on the blog birthday we asked our dear readers what they've learned over the last year, and as a test we gave them this crank who attacks the bisphosphonate anti-osteoporosis drugs in his article "the delusion of bone drugs".
I think the reader with the best grade is LanceR or Martin, but SurgPA would have done better if he had shown his work.
But let's talk about some signs that something you're reading is unscientific crankery. In this case, we don't have a particularly sophisticated crank, and he let's the cat out of the bag in his very profile:
Because of Bill's increasing concerns about the serious, sobering and perilous times we are living and being manipulated into, his intentions will be mainly devoted (as he has been) to posting articles that will alert, inform, expose, and wake up a sleeping reading public. This involves the issues that are not covered, or not covered truthfully by the "National News Media." "In the time of universal deceit, telling the truth is a revolutionary act." - George Orwell. To warn the public of the present and coming danger of permitting the federalizing of local police departments across our nation is of the utmost importance. If allowed to continue, the federalizing of local police departments, will result in the planned replication of the infamous "Nazi storm troopers" reminiscent of Hitler´s Germany in recent past history. "A prudent person foresees the danger ahead and takes precautions; the simpleton goes blindly on and suffers the consequences." -
The guy mentions Orwell and Hitler in his profile! He's already way behind in presenting himself as a rational source of information that should be listened too. But let's give him the benefit of the doubt, it was written in the third person, maybe his profile-writer was the crank. What does he have to say about bisphosphonates?
Read on »
Posted by MarkH at 2:12 PM • 41 Comments
Category: Education • Medicine
I'm sorry I've been buried the last couple weeks, as I've just started my general medicine rotation. Today is my post-call day, which means I get to sleep in and then study all day long. The fire hydrant of information is cranked open full bore again, and the shelf exam for medicine is supposed to the hardest. There is an incredible amount to know, and only a limited amount of time to assimilate it.
Inpatient medicine is especially challenging. It's funny because most people's perception of medicine is from all the TV shows about medicine and you see doctors constantly fixing some patient's problem and then they get better. If I had to pick one thing to change about the fictitious practice of medicine it would be this idea that people ever have a single problem. The more realistic medicine patient would be someone over the age of 50 with at least 5 or 6 chronic problems, and just one (or two, or three) that has put them over the edge requiring hospitalization. It's not about solving the medical mystery of the one thing wrong with your patient, it's about first stabilizing people who are very ill and then figuring out why someone who already has half a dozen things wrong is suddenly getting worse.
Let's do some recaps of fake medicine versus real medicine for fun. Let's start with a good House patient (spoilers abound):
Read on »
Posted by MarkH at 12:57 PM • 40 Comments
May 9, 2008
Category: HIV/AIDS denialism
HT erv.
This is truly annoying because it is so patently wrong. It's wrong in lots of different ways, but I'll help point out some of the major flaws. What happens when journalist becomes the story, rather than reports it?
You see, there is this journalist, Celia Farber, who apparently has been following the HIV denialists since the beginning. From reading this interview with her in Discover Magazine, it would seem that she is suffering from some sort of Stockholm Syndrome. Not only that, but the journalist interviewing her shows a complete lack of suspicion, and seems to be one of those modern journalists who thinks that everything has two valid sides to report on. Not everything does.
Instead of chronicling the history of HIV denialism, she has truly drunk deep of the Flav-R-Ade. Ever wonder how to tell if a journalist has lost her objectivity? How about this?
It's changed in that so much of what the orthodoxy proclaimed has not come true. The paradigm has failed miserably on virtually all counts. So the orthodoxy right now is particularly venomous and vicious against anybody who is what they call an AIDS denialist.
Uh oh. I sense someone
begging the question. The interviewer follows up with a WTF.
What are the failures of the paradigm?
Good question, but I would have also asked, "WTF is the 'HIV paradigm'?"
Response? Right out of the HIV denialist handbook: (all emphasis mine, --PalMD)
Read on »
Posted by PalMD at 11:57 AM • 44 Comments
Category: Skeptics Circle
It's a really good edition up at Skepbitch (who is surprisingly nice). Don't miss it!
Posted by PalMD at 11:54 AM • 1 Comments
May 8, 2008
Category: Medicine
As the death toll in the immediate aftermath of Cyclone Nargis becomes clear, new dangers loom. Complete breakdown in essential services and sanitation will conspire to kill thousands more via disease unless the world moves quickly (and maybe, even if we do).
Arthropod-borne diseases such as malaria and dengue fever are likely to flourish as standing water serves as breeding ground for mosquitoes. Malaria kills around a million people a year. Dengue is most often a disabling illness characterized by fever and severe pain, but in endemic areas it can lead to dengue hemorrhagic fever, a fatal illness resembling Ebola and Marburg viruses (but not as contagious).
Diseases related to lack of clean water, such as diarrhea, cholera, and hepatitis A can be especially nasty with little fresh water available for rehydration.
Tetanus, acquired from wounds, is a particularly grizzly death, and was seen frequently in victims of the Pakistan earthquake.
As bad as the initial death toll is (perhaps around 100K), it can get much worse quickly. Hopefully the world will respond as it did after the Great Tsunami, and hopefully the Burmese Junta won't stand in the way. If they do, they may not have much left to rule over.
Posted by PalMD at 3:12 PM • 8 Comments
Mark Hoofnagle has a PhD in physiology from the University of Virginia and is currently a 3rd year medical student. His interest in denialism concerns the use of denialist tactics to confuse public understanding of scientific knowledge.
