An acupuncture fallacy in action

...confusing correlation with causation (among other things…)

For the last 6 weeks, Sam the dog had been seen and treated with acupuncture for an undetermined lameness by a local “natural” veterinarian who specializes in Chinese Medicine and Acupuncture therapy. Sam was being seen by a conventional vet and wasn’t responding typically to palliative treatment. That is, he would get better and then get worse intermittently.

After declining, for the moment, further diagnostics this veterinarian grudgingly ceded to the clients wishes to pursue alternative treatments making clear –to her credit- the difference between science and non-science based modalities. This is an unfortunate, yet fairly common scenario among a percentage of many a veterinarians client roster. The ever present, albeit usually tiny, clad of holistically oriented people who innocently –and sometimes tragically- muffle and slow the course of getting to the bottom of a case like Sam.

On the other hand, this is fairly familiar territory and many veterinarians will attempt to establish some kind of continued interaction with these folks in the interest of their patients. In fact, to some alternative veterinarians’ credit there are those who insist on some type of interaction with science based practice and require that a “conventional” diagnosis be given.

That most of these cases are either chronically or terminally ill patients undergoing a constellation of naturally occurring waxing & waning cycles of disease seems to be overlooked –especially when they are experiencing a usually quite temporary upswing. Anything good is ultimately and erroneously attributed to whatever strange concoction or instrument is used.

Because Sam wasn’t responding “as expected” it was determined -quite correctly by the attending alternative vet- that a clearer diagnosis was needed. The regular conventional veterinarian was called on to now pursue a diagnosis after the clients’ discussion with their alternative vet. Yes, the irony is duly noted.

However, by claiming that the acupuncture treatment wasn’t working and actually making the problem worse he used the wrong reasons. Whether an animal is getting better or worse, without a profound knowledge base of the natural history of disease and a good dollop of solid science based studies and data supporting the therapy being used, you really can’t claim anything –good or bad.

It turns out Sam the dog was dying from a severely malignant form of spinal bone cancer. He was basically terminal from day one and is now under focused conventional and humane end of life care…and Chinese herbs for cancer. Any improvement quite possibly will be attributed to the herbs.

The main point of this tale is that when something bad happens in the realm of alternative medicine, the problem is often attributed to an equivocal diagnosis, or that the alternative treatment was started too late, or that some diseases are made worse by one alternative modality…all mostly claims made without any solid evidence (including -on balance- acupuncture studies).

…and here’s one of the big problems. There is always something else to try or mix with the science…often without really knowing what’s going on. This brings all involved dangerously close to the edge of a dark abyss.

Without the proper tools -the light of reason- we're destined to stumble through interminable blind alleys and false hopes...armed with little more than hat tricks to bide the time.

World of the small

Every now and again, the MSN home site presents some interesting stuff that's relatively free of the medias general tendency to -all too commonly- report sciency things in a short sighted dim witted sort of way.

Here is a fascinating exposition of winning images from Nikons annual small world phot0micrography competition. Check it out!

Some of my favorites:

Artists rendering of an alien cyborg? Actually a chicken embryo photographed at 6X. ( by Tomas Pais de Azevedo of Lisbon, Portugal, using stereomicroscopy.)

A Borg mother ship? Really, a 14x image of rare mineral called arsenuranospathite. (It was submitted by Stephan Wolfsried of Germany.)

Rows of towels hanging in the midst of some Florence neighborhood? No, this beauty is a 100x magnification of scales on the wing of Urania riphaeus, the sunset moth. (The fiber-optic illumination was submitted by Charles Krebs from Issaquah, Wash.)

A myth busters' obsession

Adam Savage of “Myth Busters” fame demonstrates, in this talk, some of the qualities that define the essence of human inquiry and discovery so crucial to authentic enlightenment. Could this be called a healthy obsession? Yep…and the type of focus and energy needed to look under the mask of mystery to reveal untold riches of knowledge.

Tim Minchin asks at the end of his beautifully brutal deconstruction of credulity in his poem “Storm”,

“ Isn't this enough? Just, this world? Just this Beautiful, Complex, Wonderfully Unfathomable, Natural, World? How does it so fail to hold our attention that we have to diminish it with the invention of cheap man-made myths and monsters?”

Indeed. One wonders if the opiate of the masses –credulous belief- will ever be put back on the shelf of human character quirks’. Perhaps still vital to a degree, but best taken off the pedestal it’s on.

(hat tip Bad Astronomy)

Understanding Chopra woo

Another reason to support separation of "church" and medicine...

Being that there are a lot of folks who think Dr. Chopra has unique qualifications and solidly researched support for his quest to "integrate" scientific medicine with whispy shades of a strange belief based system -religion- here are two well put together posts regarding Deepak Chopras modus operandi.

Pharyngula 2006:

"Chopra is a doctor, supposedly, but every time I read something by him that touches on biology, he sounds as ignorant as your average creationist. He also writes incredibly poorly, bumbling his way forward with a succession of unlikely and indefensible claims. "

Skeptico 2005
"Skepticism has become a legitimate form of inquiry that Deepak parenthetically acknowledges (in a left-handed sort of way) as occasionally laudable, another refrain we often hear in the form of “I’m a skeptic too, but…,” where skepticism is fine as long as it is someone else’s codswallop under the microscope."

It is important to note that Chopra, over the years, has developed whole made up world views from stunningly naive, flimsy and often outright wrong assumptions about the actual nature of phenomena around him.

Mind you he has said some pretty interesting things regarding human wisdom and how we can all get along but this guy is just as fallible and screwed up as any of us. He really needs to get off that high horse and admit it though.

If Chopra wants to promulgate a belief system, that's fine. What he can't -or at least shouldn't be aloud to do- is force this system on everybody else. This is exactly what he would like to do imposing "magic" based medicine onto science based medicine.

He should just get real, put on a priest robe, stick to teaching ancient Hindu wisdom and call it good.

Deepak Chopra does it again...

...or on being an uncritical CAM apologist
...or how to insert foot in mouth

Orac has a nice response to Chopras most recent "rebutal" against reason which just so happens to be related to yesterdays post about Steve Salernos very fine take down of the "Integrative" medicine movement. For good measure, Chopra calls on the "authority" of alternative medicine experts Andrew Weil and Rustum Roy to shore up his vain effort to claim scientific legitimacy -failing miserably.

As Orac notes "... Basically, the argument being made by the Woo-meisters Three boils down to an attack on evidence-based medicine based on exaggeration and cherry picking, topped off with a huge dollop of conspiracy-mongering and playing the victim. There is not a single positive, science-based argument that Chopra's woo or Andrew Weil's "integration" of the dubious with the evidence-based produces better health outcomes than the evidence-based medicine they attack..."

Yep...you can dress it up with the finest of imaginary cloth...but it still comes down to one simple fact...the emporers' still butt naked!

The bigger problem though, as Salerno points out so eloquently, is that in spite of the fact that most of the alternative movement is more illusion than real...more belief based than fact based...more bullshit and sofist rhetoric than a real reflection of reality...it is poised to adversely influence and contaminate an already severely strained health system.

The Chinese did something like this decades ago. They dressed up -made up- a scam health system to "appease" the populace who were devoid of access to science based medicine. It was called Traditional Chinese Medicine.

Orac nails it with this ominous warning:

"...Chopra's article demonstrates beyond a shadow of a doubt is that advocates of unscientific medicine and quackery apologists are a potent political force, and their new strategy has become clear. With the impending inauguration of Barack Obama as the President of the United States, they see a huge opportunity in his plans to overhaul the government health care system to insert into legislation provisions that will pay for unproven and pseudoscientific CAM/IM modalities. They will sell these provisions as "reform" and as "health maintenance," when they represent neither."

It is my hope his voice and the many others calling for reason be heard.

-adendum-

It appears Dr. Chopra has earned an additional well deserved laser guided intellectual thumping from Skeptico:

"Chopra’s piece is just one logical fallacy after another. This is Chopra's article, summarized:
Ad hominem
Appeal to authority
Red herring
Science was wrong before
Appeal to other ways of knowing
Straw man

Add claims of “concerted research and clinical practice” that his woo works, without one shred of evidence that his woo works, and you have Chopra’s entire article. (He should employ me as his editor.)"

"Alternative" Medicine and Bullshit

...either way, the stink still comes through

"The Touch That Doesn't Heal" is a very insightful article regarding the rather sad tale of the insiduous and undeserved penetration of unproven...and disproven (within the realm of reason) "alternative' or "integrative" therapies into more mainstream medicine.

Steve Salerno nicely articulates the problem of incorporating therapuetic modalities built on smoke and mirror "logic" into the real world of disease, limited funds and the false assumptions of efficacy proffered by CAM (Complementary and Alternative Medicine) to a credulous population (many doctors included).

"...A survey of 32,000 Americans by the National Center for Health Statistics, released earlier this month, suggests that 38% of adults use some form of "complementary and alternative medicine," or CAM -- now aggressively promoted for everything from Attention Deficit Disorder to the Zoster virus. The survey polled consumers on 10 provider-based therapies -- for example, acupuncture -- and 26 home remedies, such as herbal supplements.

On the other hand, it should be noted that all is not lost. The reality of CAMs inroads may not be as entrenched as appears as suggested by Mark Crislips excellent post at the Science Based Medicine Blog . Still, there is a critical disconnect -a collective cognitve dissonence- opening a "back door" and for non-science based practices to garner a legitamacy that doesn't exist. You can use all the perfume you'd like...but bullshit is bullshit and that ol' smell eventually comes through!

Salerno continues "...This should be a laughing matter, but it isn't -- not with the Obama administration about to confront the snarling colossus of healtallowing h-care reform. Today's ubiquitous celebration of "empowerment," combined with disenchantment over the cost, bureaucracy and possible side effects of conventional care, has spurred an exodus from medical orthodoxy. As a result, what was once a ragtag assortment of New Age nostrums has metastasized into a multibillion-dollar industry championed by dozens of lobbyists and their congressional sympathizers..."

"Indeed, one of the great ironies of modern health care is that many of the august medical centers that once went to great lengths to vilify nontraditional methods as quackery now have brought those regimens in-house. "We're all channeling East Indian healers along with doing gall-bladder removal," says Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics. Mr. Caplan harbors no illusions about what's behind the trend: "It's not as noble as, 'I want to be respectful to Chinese healing arts.' It's more, 'People are spending a fortune on this stuff! We could do this plus our regular stuff and bill 'em for all of it!'..."

"...Meanwhile, CAM has secured its own beachhead within the National Institutes of Health in the form of the National Center for Complementary and Alternative Medicine (NCCAM). "Special commercial interests and irrational, wishful thinking created NCCAM," writes Wallace Sampson, a medical doctor and director of the National Council Against Health Fraud, on the Web site Quackwatch.com. And Sen. Tom Harkin (D., Iowa), who credited bee pollen with quelling his allergies, was single-handedly responsible for the $2 million earmark that provided seed money for NCCAM, chartered in 1992 as the Office of Alternative Medicine. Despite the $1 billion spent in the interim, the center has failed to affirm a single therapy that can withstand the rigors of science..."

This article is well worth reading. One take away is that the battle for reason goes on...and on. Here's to a great year of critical thinking!

STORM by Tim Minchin, 2008

An instant classic........Tim Minchins' masterfull performance "Storm" can be heard on his latest DVD... well worth ordering if you are a fan of sublime musicality and awe inspiring comedic irreverence.

Though not doing it justice, here is the transcript of this wonderfully sharp and witty poem....enjoy!

--------------------------------------------------------------------------

Storm

Tim Minchin

In a North London top floor flat,
All white walls, white carpet, white cat.
Rice paper partition, Modern art And Ambition

The host's a physician,
Lovely bloke,
Has his own practice,
His girlfriend's an actress -
An old mate of ours from home,
And they're always great fun,
So to dinner we've come -

The fifth guest is an unknown,
The hosts have just thrown us
together for a favour.
The girl's just arrived from Australia,
And she's moved to North London,
And she's a sister of someone.
Or has - some connection.

As we make introductions,
I'm struck by her beauty,
She's irrefutably fair,
With dark eyes and dark hair.
But as she sits, I admit:
I'm a little bit wary,
As I notice the tip,
Of the wing of a fairy,
Tattooed on that popular area,
Just above the derrière,
And when she says "I'm Sagittarius!"

I confess, a pigeonhole starts to form,
And is immediately filled with pigeon,
When she says her name is *Storm*

Conversation is initially bright and light-hearted,
But it's not long before Storm gets started.

"You can't know anything.
Knowledge is merely opinion."

She opines over her Cabernet Sauvignon
Vis-à-vis,
Some unhappily empirical comment made by me.
Not a good start I think,
We're only on pre-dinner drinks,
And across the room my wife widens her eyes,
Silently begging me "Be nice!"

A matrimonial warning,
Not worth ignoring.
So,

I resist the urge to ask Storm,
Whether knowledge is so loose weave,
Of a morning, when deciding whether to leave,
Her apartment by the front door,
Or the window on the second floor.

The food is delicious,
And Storm whilst avoiding all meat,
Happily sits and eats,
As the good doctor slightly pissedly holds court on some anachronistic aspect of medical history.

When Storm suddenly insists:
"But the human body is a mystery
Science just falls in a hole
When it tries to explain the nature of the soul."

My hostess throws me a glance,
She, like my wife, knows there's a chance,
I'll be off on one of my rare, but fun, rants.
But I shan't, My lips are sealed,
I just want to enjoy the meal.

And although Storm is starting to get my goat,
I have no intention of rocking the boat,
Although it's becoming a bit of a wrestle,
Because, like her meteorological namesake,
Storm has no such concerns for our vessel.

Pharmaceutical companies are the enemy,
They promote drug dependency,
At the cost of the natural remedies,
That are all our bodies need,
They're immoral and driven by greed,
Why take drugs when herbs can solve it?
Why do chemicals when
Homeopathic solvents can resolve it?
I think it's time we all return to live,
With natural medical alternatives.

And try as I like,
A small crack appears in my diplomacy dyke.

By definition, (I begin)
Alternative medicine, (I continue)
Is either not been proved to work,
Or been proved, not to work.
Do you know what they call
'Alternative Medicine'
That's been proved to work?

-- Medicine


So you don't believe in any natural remedies?
On the contrary, Storm, actually,
Before we came to tea,
I took a natural remedy,
Derived from the bark of a willow tree.
It's a painkiller, virtually side-effect free.
It's got a, a weird name,
Darling, what was it again?
Maspirin?
Baspirin? Oh, yeah -
Aspirin!
Which I paid about a buck for,
Down at the local drugstore.

The debate briefly abates,
As my hosts collect plates.
But as they return with dessert,
Storm pertly asserts,
Shakespeare said it first:
There are more things in
Heaven and Earth,
Than exist in your philosophy
Science is just how we're trained, to look at reality,
It doesn't explain, Love or spirituality.
How does Science explain
Psychics, auras, the afterlife,
The power of prayer?

I'm becoming aware,
That I'm staring,
I'm like a rabbit suddenly trapped,
In the blinding headlights of vacuous crap.
Maybe it's the Hamlet,
She just misquoted,
Or the fifth glass of wine I just quaffed.
But my diplomacy dyke groans,
And the arsehole held back by its stones.
Could be held back no more.

Look up, Storm, So I don't need to bore ya,
But there's no such thing as an aura,
Reading auras is like reading minds,
Or tea leaves, or star-signs,
Or meridian lines.
These people aren't plying a skill,
They're either lying, or mentally ill.
Same goes for people who claim
To hear God's demands,
Spiritual healers who think
They've got magic hands.
By the way, why do we think it's okay,
For people to pretend they can talk to the dead?
Isn't that totally fucked in the head?
Lying to some crying woman whose child has died,
And telling me you're in touch with the other side?
I think that's fundamentally sick.
Do I need to clairify here,
That there's no such thing as a psychic?

What are we - fucking two?
Do we actually think that
Horton heard a Who?
Do we still believe that Santa brings us gifts,
That Michael Jackson didn't have facelifts?
Or are you still so stunned
by circus tricks,
That we think the dead would,
Wanna talk to pricks like John Edward?

Storm, to her credit,
Despite my derision
Keeps firing off cliches
With startling precision
Like a sniper using
Bollocks for ammunition.

You're so sure of your position,
But you're just close-minded,
I think you'll find that
Your FAITH in science and tests,
Is just as blind as the
faith of any fundamentalists,

Wow, that's a good point,
Let me think for a bit.
Oh wait, my mistake,
That's absolute bullshit.
Science adjusts its views
Based on what's observed.
Faith is the denial of observation,
so that belief can be preserved.

If you show me that, say,
Homeopathy works,
I will change my mind,
I will spin on a fucking dime.
I'll be as embarassed as hell,
Yet I will run through the streets yelling,
It's a MIRACLE!
Take physics and bin it!
Water has memory!
And whilst its memory
Of a long lost drop of onion juice is infinite,
It somehow forgets all the poo it's had in it.

You show me that it works,
And how it works,
and when I've recovered,
from the shock,
I will take a compass and carve
'Fancy That',
On the side of my cock.

Everyone's just staring now,
But I'm pretty pissed and I've dug this far down.
So I figure.. In for a penny, in for a pound!

Life is full of mystery, yeah,
but,
there are answers out there.
And they won't be found,
By people sitting around,
Looking serious,
And saying: Isn't life mysterious,
Let's sit here and hope,
Let's call up the fucking Pope,
Let's go on Oprah,
And Interview Deepak Chopra.

If you must watch telly,
you should watch Scooby-Doo,
That show was so cool!
Because every time
There was a church with a ghoul,
Or a ghost in a school,
They looked beneath the mask.
And what was inside?
The fucking janitor,
or the dude who ran the water slide!
Because,
throughout history,
every mystery
ever solved,
Has turned out to be -
Not Magic!

Does the idea that
there might be knowledge frighten you?
Does the idea that
one afternoon on Wiki-fucking-pedia
Might enlighten you,
Frighten you?
Does the notion that there might not be a supernatural,
so blow your hippy noodle,
that you'd rather just stand in the fog of your
Inability to google?

Isn't this enough?
Just,
this world?

Just this,
Beautiful,
Complex,
Wonderfully Unfathomable,
Natural World?

How does it so fail to hold our attention
That we have to diminish it
with the invention
of cheap man-made
myths and monsters?
If you're so into your Shakespeare,
Lend me your ear
To gild refined gold,
To paint the lily,
To throw perfume on the violet,
Is just fucking silly
Or something like that.
Or what about Satchmo?
I see trees of green,
Red roses too...

And fine, if you wish to,
Glorify Krishna and Vishnu,
In a post-colonial,
Condescending,
Bottled-up-and-labeled
kind of way,
Whatever, That's okay.

But, here's what gives me a hard-on,
I'm a tiny, insignificant
Ignorant bit of carbon.
I have one life,
And it is short and unimportant,
But thanks to recent scientific advances...

I get to live twice as long,
As my great-great-great-great
uncleses and auntses.

Twice as long!
To live this life of mine,
Twice as long,
To love this wife of mine.
Twice as many years,
Of friends, of wine,
Of sharing curries and getting shitty,
At good looking hippies,
With fairies on their spines,
And butterflies on their titties.

And if perchance, I have offended,
Think but this, and all is mended,

We'd as well be ten minutes back in time
For all the chance you'll change your mind.