Science Friction
by Hilary Butler
Once upon a time, when you as a parent were told that a new vaccine was going to be introduced, you assumed that the experts were right. That of course they wouldnt say such things without black and white proof, multiple studies looking at every variable, turning over every stone. We assumed it was all "looked at" very carefully. "Science". Right?
Most of the long-time subscribers to WAVES are a little wiser these days, after having studied 12 years of published "science". They may also have wised up to the fact that immunisation isnt the only area of medicine deficient in fact.
One way or another, this newsletter deals about the making of myths "science fiction" which is the cause of much friction between the dos and the donts. You will read about vaccine damage cases that "dont exist", about so-called incontrovertible evidence which is a load of bunk, and things people have said and done, and continue to say and do, which they shouldnt. But because these "experts" have created myths, they will remain in the folklore of medicine, to be trotted out for the next X years ad nauseum.
So that you can better understand the factual enormity of the issues in this newsletter here are some foundation stones from the medical literature:
Where is the wisdom ?
"The poverty of medical evidence" BMJ Vol. 303, 5 October 1991:
"There are perhaps 30,000 biomedical journals in the world, and they have grown steadily by 7% a year since the seventeenth century. Yet only about 15% of medical interventions are supported by solid scientific evidence, David Eddy, Professor of Health Policy and Management at Duke University, North Carolina, told a conference in Manchester last week. This is partly because only 1% of the articles in medical journals are scientifically sound and partly because many treatments have never been assessed at all. "If," said Professor Eddy "it is true, as the total quality management gurus tell us, that every defect is a treasure then we are sitting on King Solomons mine."
It was put more realistically in a very personal way in 1973 by Dr Robert Good, on pgs 514-515 in a book called "The Immunoglobulin A System":
"I sat in the front row of every class. I took down everything the professor said, complemented this body of knowledge with the information I learned from my instructors in the laboratory, from relevant information I would glean from reading and digesting the best textbooks on each subject, and even from extracting the substance of the most relevant articles in contemporary scientific journals. All this I included in my notes for study in beautiful Morocco-bound notebooks. The scheme seemed to work because it gave me very high grades in school, top scores in state and national board examinations, and my choice of training spots and fellowships. I closed my notebooks, however, for 10 years. When I opened them again and studied them 10 years after so carefully completing them, I was astonished to find that they were almost entirely filled with lies. Except for a few descriptions, such as well-established anatomy, everything that seemed so orderly and beautiful with the rather comprehensive treatment I had given it for one moment in history had changed, grown and been reordered by the scholarship of the intervening 10 years."
Conscientious readers of WAVES will know that our son was in Middlemore Hospital last year for a week which I wouldnt want to repeat, but which was worth its weight in gold, because for the third time in 18 years we experienced first hand, the possible ramifications of "experts" who were mentally working from moroccan-bound notebooks of the past. While being well informed meant being able to intervene on several occasions to prevent incorrect clinical interventions, our experiences could also be described as "how to survive, when youve just made an enemy of every expert on the ward."
One of the greatest critics of modern Epidemiology was a doctor called Petr Skrabanek, who smoked like a train, and could be as myopic as the best of them. He had some ingrained prejudices of his own, which defy explanation, but at least, unlike most of his colleagues, he stood aside and started to see medical science for what it was before he died. Unfortunately his early death did not allow him to complete his metamorphosis, but even so, he wrote many articles, and a book called "Follies and Fallacies in Medicine", which should be compulsory reading for all medical students, despite its shortcomings. He had some pithy opinions about the use of predictory statistics. In a 1992 article (in Perspectives in Biology and Medicine) entitled "The Poverty of Epidemiology" he said:
"A perusal of the abstracts of papers presented at the 23rd annual meeting of the Society for Epidemiological Research made me wonder whether epidemiology, in the absence of epidemics, is not a misnomer for scaremongering made respectable by the use of sophisticated statistical methods, and whether one of the reasons for this state of affairs is not a high prevalence of epidemiologists when the incidence of problems solvable by epidemiological methods is low."
(Note the word SCAREMONGERING, a tactic constantly used to bulldoze parents these days.)
"As so many scares have been disseminated by epidemiological research and avidly taken up by the media, who could hardly be blamed, further research is deemed necessary to confirm or deny previous reports."
Which of course comes back to the question, "What is the truth?"
Take, for example, happenings this year in the US Senate hearings regarding autism and MMR. We are facing the largest "anecdotal" increase in autism that New Zealand has ever seen, and all the experts are ducking the issue, according to journalists. (Everything is always anecdotal except when it is the opinions of experts.)
A very telling event happened this year in the US congress hearings on vaccine safety. All relevant scientists were assembled at the hearings. Those saying there is a link between MMR and autism, and Dr Taylor from England who is the most vehement in saying there is not, and who is the one the medical world holds up as the paragon of truth. Starting with Dr Andrew Wakefield of the Royal Free Hospital in England, the scientists present were asked if they would hand over all original notebooks, research, etc to be evaluated by an independent enquiry. Without hesitation, everyone except Dr Taylor said yes. Dr Taylor refused. You would think that if he was as certain as the others that his science was absolutely rock solid, there would have been no hesitation. But with this issue, we are not talking about medicine or childrens lives we are talking about politics. And I would go further and say that in my opinion those vehemently denying any association between MMR and autism have scant regard for the children involved they seem to fixate solely on the percentages vaccinated, and their own self-defence the impact of negative articles on their reputation, prestige, and validity of previously published comments, and Wall Street shares.
We have experts spouting in the Herald on Wednesday May 10th (A2) saying "We have children dying in this country from vaccine preventable diseases. Why the hell is there not a public outcry about it." Any intelligent person can see this kind of statement for what it is. But this statement is not aimed at intelligent people. It is aimed at people who dont know how to analyse glib throwaway lines.
Any person with any Internet savvy just has to look at the Health Departments web-site, to see that most of the children with whooping cough are vaccinated, and the only death so far was in an 8-week-old baby. And where did the baby get it from? Chances are vaccinated children. Once again, scare tactics and misplaced righteous indignation as a form of emotional blackmail are used.
Any why is this the main weapon? Because it is one of the few things people like Nikki Turner can say that isnt considered politically incorrect, or racist.
Why not come out publicly and state that the principal cause of child ill-health is parental ignorance about diet, breastfeeding, living standards and a whole host of other things which have nothing to do with vaccines, and everything to do with racial and cultural characteristics? Why not come out and detail the real factual basis of proper preventive medicine? Because youd have Maori, Polynesians, and socio-economically deprived people on your backs. Why not have a real go at alcohol consumption, and certain "attributes" that contribute to suicide statistics? Because youd have Pakehas on your back. Why is it that the plain truth cannot be spoken? Because the truth hurts. Its easier to spout about something politically neutral than to do anything about the social ills in this country. The only people who would be upset are those who do not vaccinate their children. But thats okay, because people who spout this sort of stuff rarely have to deal with those people in hospital anyway.
Why not admit that the healthiest group of children in this country is brought up by those people who make a conscious decision NOT to vaccinate, and therefore make a special effort to ensure a well-rounded quality upbringing for their children? Because to do that would be to admit that the real path to health involves changing peoples daily habits and lives, and that is TOO HARD. And that is why the experts are still blaming politicians for doing nothing, as well as parents who say nothing. The fault does not lie with politicians. It lies directly with every medical person in this country who makes no effort to convince every mother in front of them that simple basic things can change the world. All they want is a needle for every problem. Easy. Jab in pull out. And I feel like a stuck record.
None of which is new to regular readers of WAVES.
Meantime, back in the camp of the well-meaning populace who dutifully obeyed every call to war against immunable diseases, and produced their kids for the jab in pull out solution, there is a whole new huge crisis on our hands. Dont believe me? Ask the Autistic Assessment Centre in Auckland, who appear close to collapse under a huge new epidemic of autism. Parents are facing new hurdles called bureaucratic duck-shoving a refusal to consider X diagnosis as valid. Some have complained about specialists who require every test under the sun to implicate everything else, and yet when faced with the obvious, try to blame it on neurotic parents who emotionally batter their children. Some of the stories told border on a callousness which I have never heard before. Im used to parents perhaps exaggerating from their own perspective, but the extent of it is so bad, that Im wondering "if theres smoke, is there fire?" Some parents are also starting to wake up, because medicines present mindset has nothing to offer. They are getting on the Internet, and finding out that honesty and disclosure and ANSWERS lie overseas. The only thing saving the bacon of New Zealand experts at this moment is that bringing up drugged children like those seen on 20/20 on Sunday May 8th is so exhausting and time-consuming that most parents dont have the energy to consider just who the blame lies with. But those who are finding out the truth are getting very angry, something which has nothing to do with IAS. Most of them dont even know of our existence. American "approved" experts have been burying their heads for a long time, but the weight of evidence will drag them kicking and screaming into the financially impossible situation they have created fortunately, they have a statistical base which is very useful to those experts who are saying there is a link. New Zealand doesnt have a statistical base at all, which leaves our medicos feeling cushy and confident.
When this new wave of out of control or autistic kids hits schools, there is going to be exactly the sort of trouble which provoked the Senate hearings in the first place. It will be interesting to analyse the responses from these current experts who so glibly trot out their opinions. I suspect, though, that they will have carefully extricated themselves from the situation. In the meantime, they have created a new industry which will be to their financial benefit, not that of parents.
Neither the pharmaceutical companies nor those who currently publish useless studies saying vaccines are safe and effective will be billed by the US or the NZ Government. It will be taxpayers who foot the bill. And it will be worse here, because of our ACC legislation, and the apathy if not downright antagonism of the medical and media "club of believers" who refuse to face the reality of real preventive medicine.
In a recent vaccine damage case, the lawyer I was working with sent a letter to an American who had done a lot of research into vaccines, asking him if he could give her a list of experts with eminent CVs and status who were held in high esteem. Words to that effect anyway. The reply stated that he could give her a list of "experts" who, until they voiced a contrary opinion, were considered the creme de la creme, but that unfortunately, as soon as they opened their mouths, were no longer acceptable. In other words, acceptable experts are manufactured from the "club of believers" only.
This is the key to how the "club of believers" deals with controversy. Whatever the subject, they first try to divert attention from it by highlighting anything else of use. Using the MMR vaccine and autism as a hypothetical example, if you did a word analysis from the first reported connection till now, you would find something similar to this: Someone publishes an article saying MMR might be causing big problems. The "club" goes into damage control and says "there is no evidence", demands a meeting with the heretic, reviews the evidence, and pronounces that their experts disagree. But they have a problem because they have no scientific evidence to back their opinion. So the "club" scurries everywhere find facts to fit the rebuttal, and "retrospective" articles start appearing which say "they have found no evidence" which according to them, refutes so-and-sos hypothesis. (Note that the controversial information is always "anecdotal" or a "hypothesis", whereas the "clubs" rebuttal is always "evidence".) Then the "club" meets, usually excluding the heretic, to produce a consensus statement. "Fact" is not available, so a majority opinion from several doctor is crafted to create "rule by numbers" or "weight of authority" in order to submerge the dissenting individual. The corporate consensus statement might read "It was generally accepted by " that "Bloggs" is out of line. They often quote studies, which interestingly, when you go and read them, show that they didnt study that specific aspect. But most people, especially the media, just accept references and rarely bother to check them out to see if they say what they are alleged to. Within a short space of time, review articles of retrospective articles, and consensus opinion written by other enthusiastic "club" members elsewhere in the world appear, saying that "It is now well established" that the theory of X nutter is bunk. Then someone in CDC writes that so many hundred people have now written articles saying that MMR is wonderful, they must all be right (never mind the absence of science), which dribbles down to lesser mortals, such as New Zealand media and doctors who, with total commitment to the cause say that of course, "It is now self-evident" that MMR is safe.
In other words, they are sucked in by mountains of articles written by people with letters after their names, which mean nothing apart from extending their list of published articles. However, this is the key to what is now called "risk management".
Skrabanek loved writing about these mountains of useless studies. Heres one of many examples:
"And what about a report showing that "cardiovascular disease has overall protective effect" against traffic accidents among drivers? Would a national diet of three eggs a day reduce carnage on roads? Have you fastened your seat belt and buttered your toast?"
The end of Skrabaneks article reads:
"Following the critique by Feinstein of the poverty of epidemiological methods ("despite peer-review approval, the current methods need substantial improvement to produce trustworthy scientific evidence"), we should also look at what is being studied by these methods. The subject matter does not inspire trust either."
And how right he is. As the 1990 Herrera article, which has spawned other studies, (one of which recently appeared in the Herald) stated:
"Overall, the data reviewed suggest that a small risk of coronary heart disease due to baldness may exist "
Now we have bald people, with a small risk of coronary disease, who might reduce the road toll because they eat the "wrong" foods? And if they ate the right foods, we might have less coronary disease, but more road deaths. Hmmmm Skrabanek also talks about other fallacies in medicine. One of them is the Fallacy of Authority:
"The fallacy of authority is believing things to be true because of the authoritative source of the information. It must be true because I read it in the paper, saw it on television, the surgeon said so, The Lancet published it. Authority is deeply rooted in medicine because the patient seeks advice in order to obtain an explanation which is more credible than that of friends and relations.
"A respect for authority is the basis for most medical education. Students may become so used to memorising that they become prey to the illusion that the reason for learning to parrot lectures and textbooks is that they are the truth (Pg. 33) .Authorities naturally support the status quo, which gives them the right to that accolade. When William Harvey published his discovery of the circulation of the blood he was given the cold shoulder. He complained to his friend Aubrey that after the book came out, he lost most of his patients, as it was believed by the vulgar that he was crack-brained and all Physicians were against his Opinion, and envied him: many wrote against him."
(One of the many examples which proves the truism that progress is always caused by unreasonable people that is, people considered "unreasonable" in the eyes of the "club")
"There are good reasons for distrusting the opinion of authority, not only in medicine but in science proper one of the best practical tests of the trustworthiness of authorities is to see how they respond to the question: what is your evidence?
"The more intelligent the authorities, the more idiotic will be some of their claims. "
Like the one doing the rounds with the pretty teddy bear, about how many kids will get encephalopathy or die if theyre not vaccinated compared to what would happen if you did. We sent a stack of the information sent out by this group to a professor of Medical Ethics. His opinion, which he would not put in writing, was that this was not scientific fact, but propaganda, written by someone with no understanding of disease etiology, shoe-leather epidemiology (that which happens outside of a lab or calculator), or the reality of disease in a community but who had an agenda. He was disgusted, but not surprised.
"This paradox was explained by Francis Bacon (the philosopher, not the painter) who said that when such a man sets out in the wrong direction, his superior skill and swiftness will lead him proportionally further astray .Fashions on medical treatment are the rule and if they are supported by the voice of authority are difficult to dislodge before they decline into inevitable and tardy death."
With regard to immunisation, so enamoured are these people with their mathematical crystal ball clarity, that the fallacy which fits best is called the fallacy of Simple Explanation. This is of course, the one which the Health Department throws back at us, but in a different context:
"In their survey of medical bandwagons, Cohen and Rothschild noted that physicians often accept a new idea because it offers a simple solution to a complex problem. But as H.L. Mencken pointed out, for every complex problem there is a solution that is simple, direct and wrong."
We would say that the solution of vaccination is simple, direct and wrong. It is simple, because it involves no real preventive medicine, or any effort to deal with a complex problem primarily consisting of factors such as socio-economic problems, diet, immune system problems etc. It is direct, because vaccines are easy, visible (directly into the arm), and give a very photogenic opportunity for doctors and politicians to say they are "doing something". The fallacy of Authority kicks in to dismiss any argument by ordinary people, who just might be able to see the wood for the trees. And when you point out that it is primarily fully vaccinated individuals right now succumbing to whooping cough, the experts run convoluted miles to explain how people who say that have misread the statistics.
Vaccination as a solution is wrong, because it is a medico-political flyswat for a problem that is not simple, and those who are its greatest protagonists refuse to face, understand, look at or study the flip side of the coin; that is, the very real damage that vaccines can, and do, cause. In their minds, their personal opinion is all, their maths is all, and the coin is glued to the table so tightly that they are pathologically unable to see the other side. They give lip service to side effects, by using the minimisation strategy a little word called "BUT" . "Oh yes, it can happen, BUT it is so rare, one in a million (a mythical statistic pulled out of the air, for which there is no scientific justification). Yes, it can happen BUT it is usually coincidental." The "BUT" list is endless, the excuses mindboggling.
Skrabanek details a sequence familiar to all of us who have learned to smell a rat a mile off:
"Martin gives the following list of strategies used by scientists when faced with
data which do not fit their preconceived theories:
"Bertrand Russell pointed out: Even a learned scientific article about the
effects of alcohol on the nervous system will generally betray by internal evidence
whether the author is or is not a teetotaller; in either case he has a tendency to see the
facts in the way that would justify his own practise. In this we ourselves are
inevitably guilty. Those who can read between the lines may come to know us better than we know
ourselves." One of the most common emotional manipulations used by doctors on journalists is
"How could what they say be true? Why would we say anything other than
the truth? What have we got to gain by making kids sick? We got into medicine because we
love children
" I love it. I simply lead journalists to the filing cabinets, the
medical articles, the masses of information, and let the journalists judge for themselves
the motives of such accusers. But when I say to journalists "Youve seen all my
hard data, now where is their evidence? Where is their hard fact? Where is their
proof?" the situation changes. Such is the conditioning of journalists that they
cannot confront the realisation that they have demanded total factual accountablility from
me yet walked out satisfied that the letters after someones name guarantees
authenticity of every word said. So they fall back on the fallacy of authority. Sometimes doctors make statements, or give journalists articles, which, unknown to the
doctors, contain errors. They dont know this, because in subscribing to the fallacy
of authority, they disobey the number one rule of "check it out first". They
think everything written in medical journals or handbooks is factually bulletproof. When
we point this out, with proof, it puts the journalists in a very interesting position. Who
are they to believe? The "club", or the clubs medical evidence? Most
often, articles questioning immunisation dont get published, primarily because of
editorial personal bias, or "its not win/win journalism" or "the Health
Department says its against the public interest." (There is a Public Health Act which
gives them the right to do this like banning cigar web-sites). Sometimes the
journalist just finds the issue "too hard too confusing". Its much easier
just to get paid for "reportage" where you repeat what the experts say, and be
damned to any thinking. Just occasionally someone perseveres
particularly if it is
not a "sacred cow" issue with huge financial implications for Wall Street. For your entertainment, and education we present the most recent occasion when someone
opened their eyes, and realised that there was something wrong with that august deity
which plays such a huge role in formulating the opinions of our experts, and New
Zealands immunisation policy
, the CDC, Atlanta, USA:.
The Washington Post
STYLE (Section C: Pg. 1, and 10)
Saturday, APRIL 29, 2000.
A Tax on Both Your Poxes Feds Report Is A Strange Brew
What were they Drinking The CDCs Stats on Gonorrhea & Beer
)By Ken Ringle
Washington Post Staff Writer.
As every genuine yuppie will tell you ad nauseum, obscure, expensive microbrews are vastly better than Budweiser. But did you realise cheap beer gives you gonorrhea?
If this loony assertion has somehow escaped you, youve failed to absorb the full implications of the latest study from The Sky Is Falling School of Scientific Statistics, which this week appears to have settled at the governments Centers for Disease Control and Prevention in Atlanta.
On Thursday, the CDC which normally knows better released a report of a national study of alcohol policy changes from 1981 to 1995 headlined "Gonorrhea Rates Decline with Higher Beer Tax."
"CDC researchers," the departments summary of the report says, "estimate that a 20-cent state tax increase per six-pack of beer could reduce U.S. gonorrhea rates by almost 9 per cent." Gonorrhea is one of the most common sexually transmitted diseases.
Hundreds of newspaper and broadcasting outlets, including The Washington Post, ran stories about the study without questioning its basic premise. That premise, says David Murray of the Statistical Assessment Service, is akin to saying, "the sun goes down because we turn on the street lights."
Murray, whose Washington based group attempts the impossible job of watchdogging fraudulent statistics in science and government, says given the amount of disposable income Americans have on hand, "the idea that you could reduce even unprotected sex, much less disease with a 20-cent increase in the price of a six-pack is so wildly improbable as to be ludicrous."
But he says the study is a perfect example of how real science is increasingly taking a back seat to the mining and tweaking of statistics to further a political agenda.
"Im not sure what the agenda is here," he says. "Maybe were getting ready to sue Seagrams to cover the cost of treating sexual diseases."
But he pointed out that the four-page study has all the ingredients to stoke a major media feeding frenzy sex, youth and alcohol.
Plus, of course, a potential corporate or governmental scapegoat for whoops-I-guess-I-shouldnt-have-done-that behaviour.
Cynthia Clocker, media spokesman for the CDCs sexually transmitted disease division, says radio and television journalists across the country have flooded her office with requests for information and interviews.
More than a few appeared to be skeptical of its findings, as, indeed, the CDCs own editors apparently are. Though the report seems to suggest a causal relationship between higher beer prices and lower gonorrhea rates among 1519-year-olds in 24 out of 36 states, an editorial note accompanying the report says its findings are subject to "at least two limitations. First because state gonorrhea reporting practices vary, state-specific gonorrhea rates should be compared with caution. Second, the analysis may be subject to confounding effects of unobservable factors. Omitting these variables could cause substantial bias."
Well, yes. Variables like the intelligence of the young people involved, the intensity of the beer party, the hygiene practices of the participants, their income level and whether theyre swiping the beer from their parents cooler.
"Given these limitations, the study findings are consistent with but do not prove a causal relation between higher taxes and declining STD rates," the editorial note said.
So whats the point of the study?
"The study findings are consistent with the idea that higher taxes can reduce STD rates," says Harrell Chesson, a health economist with the CDC.
"The simplicity of this approach is that we dont look at the individual factors that might affect the relationship between alcohol consumption and risky sex. Alcohol use has been shown to be associated with risky sexual behavior All we look at is the relationship between alcohol policy and STD rates We said higher taxes could reduce the rate. We didnt say they would."
"But if the governments alcohol policy is related to sexual behaviour, how does he explain the nations experiment with Prohibition in the 1920s? That touched off the greatest outbreak of alcohol consumption and uncontrolled sex seen in the nation until then.
"Our study didnt address Prohibition," Chesson says, sounding amused. "I dont know."