Wednesday, 14 September 2011

House, M.D.

Ever since St. Elsewhere -yes, I am really, really old- I am addicted to hospital series, from ER to Grey's Anatomy. My favourite, since I like caricature, and the overt references to the House of God, is Scrubs. There are more series, and one of them is annoying beyond description: House, M.D.. Apparently nobody shares my dislike.

Why do I have a problem with this particular series?
  1. House simultaneously works as a paediatrician, gynaecologist, nefrologist, gastro-enterologist, radiologist, surgeon, et cetera. For some reason his hospital does not need medical specialists. Internists do know alot but those I have met never attempt to be any other type of physician.
  2. Oddly enough, his diagnosis will ignore more obvious possibilities, and instantly requires us to accept a more unlikely scenario.
The first point should be self-evident, the second I will explain in more detail. Let me be absolutely clear, in no way am I suggesting the presented diagnoses are incorrect. One can argue that technically every episode is medically possible. Whether the sequence of events is plausible is something else.

From experience I can tell you that the series explores medical conditions that rarely, at initial presentation, offer sufficient information to instantly suggest their highly unusual diagnoses. The list of enigmas, i.e. uncommon diagnoses, I encountered consists of:
Only carotenaemia (jaundice without yellow eyes), and fièvre boutonneuse (eschar), were an on-the-spot-diagnosis, the others involved extendsive investigations. Eventhough I worked in highly regarded hospitals, no physician was able to pull any rabbit out of his hat. House, of course, would have known the answer within seconds. Utterly unrealistic, especially those that invlove a diagnosis per exclusionem, it is ridiculous to let House skip the exclusionem part.

Add to that the convoluted, and at times incomprehensible, decisions and you understand my being underwelmed. In all honesty, his diagnostic and therapeutic approach are so aberrant it immediately removes any credibility for me. Even the caricature Scrubs has an air of authenticity.

His Asperger-like antisocial personality I find less offensive, it resembles many physicians I have worked with. Totally incapable of thinking of others, and convinced of their infallability. Admittedly, like House, they do tend to know their stuff. Strangely enough this part of the character is true to life.

His magician-like ability to conjure up the right answer out of thin air makes me incapable of watching the series.

Sunday, 28 August 2011

Agnotology: or denialism as policy

When I entered medical school I strongly believed that knowledge was the answer to most, if not all, problems. By the same token I thought that in any debate, just offering your opponent a well-supported argument had to lead to its acceptance.

Not so. Apparently, for psychological reasons humans reject evidence that contradicts strongly held beliefs. Hence the need for denialism. Because of that I coined the phrase: there is no cure for stupidity. As I remarked before, there are two sides to that coin. One, there are those that sincerely refuse to accept scientific facts, mostly through lack of understanding. Eventhough studies show increasing their knowledge does not help, I sincerely hope it does. Unfortunately, they evade venues that offer critical thinking courses.

Unfortunately, there is another group. They do not reject science, they understand and accept it. However, their monetary gains, religious and political powers, are severly damaged should certain scientific facts become known and accepted by the general public. To protect profitable companies, policies, et cetera they attempt to keep uncomfortable information hidden, and are actively aided by politicians. And if that does not work they soften the blow by pointing out the science is not settled, or even making us distrust science.
We were first shown that tactic by the tabacco industry (PDF) , which despite increasing evidence smoking is detrimental to our health, made it possible to stall legislation. Their trick: manufacturing scientific doubt.

Following that success new acolytes appeared: global warming does not exist, vaccination kills, evolution is merely another opinion, the financial industry Ponzi scheme, non-medicine-medicine, only plebeians commit crimes, we guarantee your safety, privacy will be the end of us all, militarism and ignoring the law breeds democracy. The recurring theme is misinformation, misrepresentation, and fullblown denialism.

Putting as many sticks as possible in the wheels of the bicycle called science has become a major strategy which is detailed in Merchants of Doubt. The cause is self-evident: if people hear smoking kills you lose customers, once evolution is accepted and the bible is proven to be a set of fairy tales that book can no longer be used to indoctrinate the rabble, if global warming is true you need to make costly adaptations to factories and cars, if security theatre does not prevent terrorist attacks we won't spent billions on the military-industrial-complex incarnation called security firms.

That technique of creating confusion is known as agnotology. According to Dah Wiki this:
is the study of culturally-induced ignorance or doubt, particularly the publication of inaccurate or misleading scientific data.
The term was invented by Robert Proctor in 1992. An example is given by Stéphane Foucart for The Guardian:
A famous internal memo issued by the US cigarette manufacturer Brown & Williamson put it bluntly: "Doubt is our product." The campaign by the tobacco industry to spread ignorance, which became a deliberate ploy in the 1950s, has since been copied in other fields.
Hmm, doubt as a product, where have I heard that before?

Today the intertoobs are a highly effective method of disseminating misinformation. There are numerous echo chambers promoting "alternative views" by experts without knowledge. Countering the deliberate manufacture of debate becomes increasingly difficult. Especially when exposing those fabricating facts results in abuse like the recent unpleasantness.

Not only facts are misrepresented, also language is conscripted  in this war on reason. Something Orwell years ago explained to us, which is why today we call such abuse of language Orwellian.

The sad thing is I expect powerful factions to mislead in order to gain money and power, I have been turned into a cynic by Il Principe combined with a lack of interest in the latest Hollywood gossip. What annoys me is that the one institute whose raison d'être should be exposing such blatant fraud is refusing to do so. Or, in the case of one news organisation, participating in the scheme to mislead us. Commenting on the P.R.-departments we call media David Roberts writes:
There's one thing we haven't learned from climategate (or death panels or birtherism). U.S. politics now contains a large, well-funded, tightly networked, and highly amplified tribe that defines itself through rejection of "lamestream" truth claims and standards of evidence. How should our political culture relate to that tribe?
We haven't figured it out. Politicians and the political press have tried to accommodate the shibboleths of the right as legitimate positions for debate. The press in particular has practically sworn off plain judgments of accuracy or fact. But all that's done is confuse and mislead the broader public, while the tribe pushes ever further into extremity. The tribe does not want to be accommodated. It is fueled by elite rejection.
At this point mainstream institutions like the press are in a bind: either accept the tribe's assertions as legitimate or be deemed "biased." Until there is a way out of that trap, there will be more and more Climategates.
Confronted with such opposition to change, i.e. advancement of knowledge, I am reminded of my school days. During physics lessons Lenz's law was introduced to me.
An induced current is always in such a direction as to oppose the motion or change causing it.
Add to that a pinch of Newton:
To every action there is always opposed an equal reaction.
which completes my version of quantum-woo to explain The Force is behind the anti-science movement.

Update: Added image borrowed from Waldenswimmer.

Update II: Yet another brilliant picture from Joe Romm, for Think Progress:


Nice flow-chart of The Denier Industrial Complex.

Monday, 22 August 2011

Attack of the anti-science movement

One of the last resorts left to the anti-science crowd is bullying more saner individuals into submission. Since they cannot win the debate on its merits they regularly use the legal system to stifle critique: i.e. those exposing their nonsense. However, it is not the only tactic available, death threats are always a very effective way too to show you are not pleased with science. The similarities in modus operandi with that other group of ideologues, Scientology, is striking. For this post I limit myself to the litigation-crowd. Behaviour that in the past made me remark:
This is because the intrepid ideologue will start by simply denying anything that contradicts his/her erroneous opinion since the Galileo-gambit proves he/she is right. This method is not without risks. More and more people realise they are the victim of propaganda. Another avenue for maintaining your discreditied position is legal bullying. As we have seen, in the case of Simon Singh, litigation -using the U.K.'s libel laws in particular- is a preferred method, employed by cranks, of removing science-based criticism from public discourse.
That post was a response to how this tactic:
resulted in cancelling the publication of Paul Offit's latest book Deadly Choices: How The Anti-Vaccine Movement Threatens Us All.
Based on the past weeks it appears this method of silencing reality-based criticism is on the rise. First, the recently unleashed Google Plus requires users to disclose their true identity. That is, even a well established pseudonym will lead to suspension of your account. Eventhough numerous legitimate reasons exist for people to keep their personal details hidden. Nevertheless, Google is not always in favour of disclosing that type of information:
Yet, it’s precisely for defending three bloggers’ right to anonymity that its Brazilian subsidiary was fined this Thursday by a local judge.
Following that kerfuffle the Overlords at Scienceblogs have also chosen to prohibit anonymous/pseudonymous blogging. Strangely enough both organisations were able to miss the fact that a blogger, named Samuele Riva, was threatened to stop writing about the factually correct observation that there was no scientific support for the claims (pun intended) being made by a producer of homeopathic remedies. In the words of Steven Novella:
this time the international homeopathy producer, Boiron, is threatening a lone Italian blogger because he dared to criticize their product, Oscillococcinum. The blogger, Samuele Riva, wrote two articles on his blog, blogzero.it, criticizing what our own Mark Crislip has called “oh-so-silly-coccinum.”  The blog is entirely in Italian, but he is maintaining a page in English with updates on the Boiron vs Blogzero affair.
As a result of this legal thuggery the Center for Inquiry (CFI) and the Committee for Skeptical Inquiry (CSI) are begging to be sued too:
We are inviting Boron [sic] to litigate not because we think their suit might have merit; quite to the contrary, such a suit would have absolutely no merit. If sued in any American court, we are confident we will prevail. Homeopathy has no scientific basis. Instead, we are inviting litigation because we do not believe Boron should be able to silence critics by picking on isolated bloggers.
Working on a post documenting this schoolyard approach to science I noticed the most recent incident involving EpiRen, who is a great force for reason. Liz Ditz wrote that his employer, because of legal threats, forced him to stop writing his science-based articles debunking the plethora of claims by the ideology-trumps-science-crowd:
Last weekend, Mr. Najera had a heated exchange with a pharmaceuticals "entrepreneur", Mr. X-- I put that in quotes as Mr. X. made some claims that don't stand up.  Mr. X also made a series of ad hominem attacks on Jen Gunter MD, to which Mr. Najera responded.
Rather than responding to Mr. Najera, Mr. X escalated in a particularly virulent way. Mr. X sent a series of emails--complaining about Mr. Najera's opinions, complaining about Mr. Najera's defense of vaccination,  and threatening legal action--to a great many people senior to Mr. Najera in his department -- starting with Mr. Najera's immediate superior.  Mr. X was able to do so because Mr. Najera was blogging under his own name, named the state in which he worked, and because the name René Najera is rather uncommon -- especially in a small, East Coast state.
Commenting on this incident Orac adds:
René was ordered by his superiors to cease all blogging, Twittering, and other social network activity related to public health.
You will find his blog is no longer available, a truly disgusting result. This tendency to prevent pertinent information from being shared with the general public -i.e. censorship- is the hallmark of ideologues. Why am I not allowed to hear facts that are incompatable with your preferred/perceived version of reality?

In the absence of media that adequately report on pseudoscience -you must know this is a particular peeve of mine- it is frightning to witness the blatant use of threats, instead of reasoned discourse, to get rid of opposing voices. Especially, when it has been repeatedly shown that there is absolutely zero evidence to support those anti-science claims. The fact the anti-science crowd will stop at nothing to hide criticism is one of the main reasons I keep my personal details hidden, though luckily I am hardly important enough for them to bother me.

In light of the above, an article by Glenn Greenwald detailing the war on whistleblowers, combined with an expanding Surveillance State, add a somewhat sinister argument as to why ones identity should be allowed to remain seperated from real world interactions.

Update: The internet has reacted with strong emotions over this incident, since the underlying debate is about the ability to adopt an anonymous/pseudonymous alter ego, for whatever purpose. From Liz Ditz we learn that @epiApril has suggested Epigate for this circus. She also keeps a list of posts by others detailing this thuggery. An excellent observation of these events is written by Dr Judy Stone. The effect the internet has on the age old exchange of ideas amongst the medical profession is reviewed by PalMD. To remind us of the law of uintended consequences Scepticemia discusses the Streisand effect while listing the numerous responses.

Update II: Regarding nymity Chad Orzel adds some points, while Tara C. Smith stresses its importance and asks National Geographic to reconsider the ill-advised Scienceblogs-thingy. Thinking on the methods used by the let's-reinstate-the-Dark-Ages-brigade I am reminded of another type of strongarming. It is defined as:
acts intended or calculated to provoke a state of terror in the general public, a group of persons or particular persons for political purposes (took part of the definition to offer my view on what it is)
Which, after my selective quoting, sounds like the definition offered by Lord Lloyd of Berwick:
The use of serious violence against persons or property, or threat to use such violence, to intimidate or coerce a government, the public or any section of the public, in order to promote political, social or ideological objectives.
Obviously, the similarity is a misunderstanding on my part. We all know that only brown people with islamic sounding names embrace such tactics.

Wednesday, 17 August 2011

The Galileo Movement

Last year I, though I was not alone in this, noticed the tendency of cranks to invoke Galileo as proof of the inherent scientific basis of their refusal to accept the scientific consensus.

This time it is discussed by Scientific American as part of the epidemic, involving global warming denialism, in Australia. Apparently there is a new anti-science group Down Under:
Launched in February, the Galileo Movement is getting much of its lift from its influential "patron," conservative radio personality Alan Jones, one of the most popular broadcasters in Australia, who has touted the effort on his daily morning show.
For the casual observer this is yet more evidence that Merchants of Doubt was spot on, which makes Scientific American observe:
By casting doubt on the science, the need for behavior change is blunted – an approach the tobacco industry successfully employed throughout the 1980s and '90s to delay efforts to warn the public of smoking's dangers.
Independent Australia has more details on the who, and what, here and here. This campaign is part of the current non-debate over there on how to tackle the consequences of global warming. As expected there is vocal opposition to science whenever it interferes with ideological and/or monetary interests. As I noted before:
What these "sceptics" fail to notice is that Galileo made observations based in science, something they invariably refuse to do. Since his conclusions contradicted religious dogma, i.e. ideology, the Church attacked him. His findings were opposed not on their merits but by appeal to authority: the bible. Enter the anti-science brigade. The mere fact their stance is rejected too proves they, like Galileo, are persecuted. Wrong. They clearly misunderstand the meaning of the word.
Strangely enough the Galileo Movement missed the discovery that Galileo was wrong, although Ethan Siegel and Orac are less certain of that proposition. For those interested in the less fantasy infested version of reality I suggest visiting Skeptical Science, Open Mind, New Anthropocene, Climate Shifts, and RealClimate.

Update: Borrowed picture from Matthew Francis who also discusses this incarnation of the anti-science movement.

Update II: Found a post by Bycicle User on this topic.

Update III: The Galileo gambit is also explained by The Tracker.

Wednesday, 3 August 2011

Apps for the iPhone

It is about one year ago that I acquired my first iPhone. It replaced my previous toy which has moved on to a better world. Since then I have been playing around with it, and today it has more or less the apps I like, and need.

For the benefit of future reference, and for those of you who might think it useful, I will discuss what I am currently using.

For starters the iPod-function makes it possible to bring my favourite music with me, although I evade the use of iTunes to sync my music, and as it has an adequate camera-funtion I take my pictures with it too.

The apps I have put in seperate "folders," below I reproduced their names and contents:

Utilities
  • App Store (for searching and downloading apps)
  • Settings (to personalise the iPhone)
  • Compass (fun, but not sure if it can replace the real thing)
  • Clock (helps me get up in the morning)
  • Battery Life (nice )
  • Flashlight (when your skulking around in the dark this will add some light)
  • Wi-Fi Finder (great for finding free spots, CAVE: phonebill when abroad)
  • Handy Level   
iPhone
  • Messages
  • Contacts
  • ContactSync
  • PhoneCopy
  • MacMost
  • Find iPhone
  • Remote
  • RDP
  • Discovr Apps, cool way to find new apps
  • 12 Days
News
Social
  • Echofon, interface for Twitter
  • Facebook, 
  • Google+, new alternative to Twitter and Facebook, for those who want to follow, or add, me: click here   
  • Fring, alternative for Skype, and it works on 3G
  • Foursquare, let people now where you are 
  • Skype, contrary to Fring it only works on Wi-Fi
  • Hoccer
  • Bump
  • PingChat
  • Tango
  • eBuddy XMS
Weather
  • Yr.no,
  • AccuWeather
  • MyWeather
  • AeroWeather
  • Weather
  • Skiinfo
  • Ski Club Snow Report
  • Snoveo
  • Snow Report
  • Ski Montagne
Travel
  • Tripit, keep track of your travels
  • PF Free
  • FlightStatus
  • Tripwolf
  • iTrailMap
  • MetrO
Navigate
  • Google Earth
  • Navigon
  • Google Maps
  • SkyView Free
  • Layar
  • AroundMe
  • GPS Tracker
  • EveryTrail
  • Yubify
Television & Radio
  • StreamItAll
  • P4
  • 22Tracks
  • Top 100 Hits
Audio & Video
  • VLC, this allows me to bring my favourite fims with me
  • YouTube
  • TED Mobile
  • Shazam
  • SoundHound
  • iTunes
  • iTalk
  • Voice Memos
  • Nike + iPod
Photography
  • Camera
  • Photos
  • Gorillacam
  • Genius Scan
  • Instagram
Cullinary
  • Epicurious
  • VintageChart
  • BigOven
  • DrinksFree
  • Cook's
Medical
  • NEJM App
  • PubMed Tap
  • Student BMJ
  • MedCalc
  • Eponyms
  • Skyscape
  • Medscape
Shopping
  • Groupon
  • IKEA
Productivity
  • Notes
  • 2Do Lite
  • Easy Note
  • EasyTask
  • UYIH
  • Evernote
  • Camcard
Reference
  • Wikipanion
  • Wikipedia
  • Science
  • Planets
  • KnotsGuide
  • SearchIt
  • Merriam-Webster
On the Town

Language
  • myLanguage
  • Google Translate
  • WordPower Norwegian
  • WordPower Spanish
  • Word Lens
Literature
  • Book Reader
  • iBooks
  • Poe
  • Shakespear
  • Stanza
  • Audiobooks
Readers
  • NeoReader
  • RedLaser
  • Scan
  • ShopSavvy
Converters
  • Xe Currency
  • Currency
  • Coverter
  • Stocks
Excercise
  • MapMyTracks
  • Runtastic Pro
  • RunKeeper
Games
  • Inception
  • Zen Bound
  • Paper Pilot
  • WordFeud
  • Solitaire


Note: Not all applications are linked, so I will be updating that part of the post in the coming days. Second, if any of you know apps I need to check-out let me know.

    Tuesday, 8 March 2011

    Ideology using legalities to stifle scientific critique

    Throughout history many have found ideology to be a trustworthy window on reality. As such it is the basis of many misconceptions. When science increased our knowledge of the world surrounding us inevitably this contradicted many beliefs. The solution people have found to that contradiction is the following:
    1. Confronted with evidence your opinion is flawed you amend your view accordingly
    2. Confronted with evidence your opinion is flawed you amend (read: ignore, or misrepresent) the evidence accordingly.
    Anyone interested in sanity, and reason, will adopt option 1. Of course, the anti-science movement, without exception, chooses option 2.

    This is because the intrepid ideologue will start by simply denying anything that contradicts his/her erroneous opinion since the Galileo-gambit proves he/she is right. This method is not without risks. More and more people realise they are the victim of propaganda. Another avenue for maintaining your discreditied position is legal bullying. As we have seen, in the case of Simon Singh, litigation -using the U.K.'s libel laws in particular- is a preferred method, employed by cranks, of removing science-based criticism from public discourse.

    The latest incarnation of the "let's-prohibit-those-pesky-reality-based-objections-to-our-nonsense"-method resulted in cancelling the publication of Paul Offit's latest book Deadly Choices: How The Anti-Vaccine Movement Threatens Us All. It is discussed by Orac describing how he:
    found out about this when a British blogger, who had been originally sent a copy of Dr. Offit's book to review, received an e-mail from Dr. Offit's British publisher, Basic Books, requesting the review copy back and informing the blogger that "for legal reasons we have had to cancel the publication of this book." I had to tell the blogger that I had no idea what this was about, but it didn't take me long to find out that Richard Barr was threatening legal action against Perseus over one sentence.
    He continues to note:
    that usually the goal of cranks is not to win a judgment, but to shut down criticism by any means necessary. To that end, even though it would have been pretty pointless for Barr to sue Dr. Offit directly, legal threats against his U.K. publisher are very effective. All Barr has to accomplish is--if you'll forgive the term--to raise the bar on the costs of publication to the point that publishing Dr. Offit's book can't be profitable. Given the low profit margin of most books, likely Dr. Offit's included, a few legal fees spent to fend off threats like that of Mr. Barr go a long way towards discouraging publishers from publishing critical or controversial books. That's the point.
    Unfortunately, the anti-science movement, like Hydra, appears impossible to debilitate. The purveyors of woo disingenuously invoke freedom of speech to make the most outlandish claims, while simultaneously insisting that this right does not apply to those pointing out these claims are factually incorrect. One can only hope Libel Reform will be effectuated before more attempts are made to keep the public from knowing experts have debunked the medieval beliefs promoted by the anti-science brigade.

    In the mean time, whenever you see an organisation/individual, engaged in making controversial claims, trying to limit the availability of information exposing possible misstatements on their part be very sceptical towards those claims. Especially regarding health related claims where they simultaneously, yet always coincidentally, sell something related to that "controversy."

    Update: Then again, "I'll sue you" is so 1980's. To show your superior intellect in the 21st century you need to use a more sophisticated method of bullying, enter the Distributed Denial of Service Attack (DDoSA). Scienceblogs, a source of science information, is the latest to come under attack. Details by Greg Laden, Pharyngula, Aardvarchaeology, Orac, Mike the Mad Biologist.

    Friday, 18 February 2011

    Propaganda posing as journalism

    My interests are very diverse. Much of what I might want to share is done by others, and probably better. Medicine and quackery are covered by -among others- Orac, Steven Novella, Science-Based Medicine, and PalMD. Scienceblogs, Scientopia for science in general. Analysis of U.S. Policies regarding the War of Terror can be found at Glenn Greenwald's blog. Information on Global Warming can be found at Skeptical Science, Open Mind, Watching the Deniers. For other suggestions look at my blogroll.

    Though I try and discuss whatever has caught my attention it is impossible to ignore the absolutely inadequate, bordering on willfully ignorant, stories presented to us by the media. Regardless of the topic you will find journalists are:
    1. Insufficiently schooled to appreciate the intricacies involved, as such they fail to intervene when factually false statements are made,
    2. Insufficiently schooled to evade, or expose logical fallacies,
    3. Insufficiently aggressive to confront powerful interviewees with inconsistencies, factual inaccuracies, or logical fallacies, (just imagine their special status being revoked, thereby limiting their access to the inner circle)
    4. Frequently employed to disseminate the talking points of politicians and religious leaders, also known as propaganda, see point 3,  
    5. Trained to obey the wish of their government (an offer they can't refuse?) to conceal information negating statements made by said government,
    6. Not inclined to ask for expert advise, when confronted with the previous points, because they are abundantly unaware of the limits their knowledge has,
    7. Inherently disinclined to support anyone who forgets to adhere to the above, i.e. those who engage in actual journalism 
    With that in mind I am genuinly surprised that any selfrespecting individual would dare to claim to be a Serious Reporter while adhering to those principles. That is, it is not as if they act like those amateuristic bloggers who never fact-check and lack any credentials to be considered trustworthy.

    Of course, newsorganisations have to cut down their costs and inevitably the number of (qualified) journalists goes down. As a result the public feels they become untrustworthy, which in turn makes them buy less newspapers. This leads to more lay-offs, as income for newsorganisations keeps dwindling. Under these circumstances I propose a radical thought: invest in quality journalism, even the investigative kind. That is, create the environment needed to present a factual and accurate story, as opposed to ideology driven misinformation. Naive as I am I would not be surprised if this would increase their audience. Why else are people reading blogs and fora? They still want to know things. And no, not only about who does so and so with whom.

    Scary thought: what if news reports go beyond hollywood scandals, petty gossip, propaganda and turn out to actually contain existential topics using real experts; i.e. global warming does exist, Intelligent Design is inherently unscientific, vaccines do not cause autism, the exaggerated threat of terrorism is used to abolish civil rights, et cetera.

    One can, and should, dream.

    Update: Added point 5. You will note that the linked article there is an example of combining point 4 and 5 in an attempt to shape public opinion. Also known as Psyops.

    Update II: It is becoming tedious, but Glenn Greenwald again notes the principal thing journalists consider to be in their job description: never reveal actual information but actively strife to keep it hidden from the public while dutifully reporting the propaganda. Or, in his words:
    That's what our establishment media outlets largely are for:  to disseminate and amplify the messages of our most powerful political, military and financial factions without any accountability.
    His article also clarifies that today the widespread use of "anonymous" sources is essential to ensure nobody can be held accountable for evidently false statements, even as they drive the perception of things. Quoth Glenn:
    Anonymity does have a valid purpose in journalism:  its legitimate purpose is to protect the vulnerable and powerless when they expose wrongdoing by those who wield power. But most establishment journalists have completely reversed that, so that anonymity is used to protect those with the most power: to enable them to make all sorts of public claims and launch all kinds of attacks on critics without being accountable. When anonymity is used for those purposes, it is inherently and incomparably corrupt (that, of course, is the dynamic that led to public acceptance of patently false claims justifying the Iraq War). But this perversion of anonymity from what it was supposed to be (a means of holding the powerful accountable) into a power-shielding weapon is simply a microcosm of the broader reversal by establishment journalists of the old dictate to "afflict the powerful and comfort the powerless." Most establishment journalists -- by definition -- do exactly the opposite, and their eagerness to indiscriminately grant anonymity to the nation's most powerful officials is simply one manifestation of that power-serving mindset.
    Contrast that with the way anonymity of whistleblowers is respected. But hey, let's not forget not forget how hard it is to be a Real Journalist. You need to fact-check, use your elaborate journalistic skills, and above all you need to refrain from taking sides!

    Update III: The claim Real Journalists are objective, as opposed to those unprofessional bloggers, is shattered by Jack Goldsmith, according to Glenn Greenwald. Apparently U.S. media feel their duty is to show allegiance to the U.S. administration:
    ... allowing such loyalties to determine what one reports or conceals is a very clear case of bias and subjectivity:  exactly what most reporters vehemently deny they possess.  Many establishment journalists love to tout their own objectivity -- insisting that what distinguishes them from bloggers, opinionists and others is that they simply report the facts, free of any biases or policy preferences.  But if Goldsmith is right -- and does anyone doubt that he is? -- then it means that "the American press" generally and "senior American national security journalists" in particular operate with a glaring, overwhelming bias that determines what they do and do not report:  namely, the desire to advance U.S. interests.
    He then notes:
    A desire to promote American policy or its "interests" will often directly conflict with core journalistic obligations.  It's often the case that disclosing the truth about the American government (a journalistic duty) will undermine the government's policy aims or subvert government "interests."  The same is true for serving as an adversarial watchdog on government officials: exposing their false statements and lies, uncovering their corruption and deceit, contradicting their propaganda; doing that can also undermine American interests.  Reporters who engage in journalism with the goal of advancing U.S. interests or promoting their nationalistic allegiance -- which Goldsmith suggests is the majority of them -- are engaged in activism and propaganda, not adversarial journalism.  That's fine, I suppose, if they acknowledge their biases, but those who are driven by these allegiances while pretending to be "objective" are engaged in a game of deceit.
    Usually I write about science, but this intermezzo was meant to show this behaviour, of replicating talking points for ideological reasons while hiding inconvenient information, is not limited to science reporting: i.e. global warming, vaccination, evolution, et cetera. Whatever else is true, journalists are far from objective regarding any topic, which is the point I keep making.

    Update IV: Strangely enough the NYT appears capable of "taking sides." Eventhough we have a classic example of a "he said, she said"-situation they have no problem choosing one version over the other. Would that have anything to do with the "controversy" involved?

    Update V: After years of being "objective," i.e. not taking sides, the NYT has started writing about waterboarding as a form of torture. Could it be because the alleged perpetrator is not from the U.S.?

    Update VI: Another newsarticle incapable of  being accurate, whether its writer is intentionally misleading his readers I leave up to you.

    Update VII: To quote Pharyngula:
    Science journalists, you really piss me off…at least some of you. Here are a couple of headlines about that recent paper I summarized that make me want to slap someone.

    Monday, 14 February 2011

    Valentine's day

    Like every year today is Valentine's day. Of course, an utterly commercialised event. Despite that I hope everybody will have a great and romantic day.

    Update: The insect input for romance, Shellac:
    is an insect-produced product that may be part of your Valentine’s candy (and many other things). 
    More is explained by bug girl for Skepchick.

    Update II: For the Guardian Jason Goldman gives us:
    seven tips from science that just may help you find a date on Valentine's Day. You've heard of evidence-based medicine? This is evidence-based dating.
    And Pharyngula introduces some loving hedgehogs.

    The House of God

    When I began as a resident I was allowed to ask for any diagnostic tool. The only requirement was that I needed to show the specialist I worked for how the results would influence my decisions. Imagine ordering an X-ray of the left foot to evaluate a possible heart attack. As it is impossible to make any reasonable connection between the two (foot-heart) no radiograph would be allowed.

    Before that, as an intern, I was impressed to see an orthopaedic surgeon evaluate patients in order to find reasons not to operate. Later, as a resident I found that it is a trait seldom found among those trained to use a scalpel. The reasoning was, obviously, that we as physicians do cause complications, and as such may end up hurting patients.

    With that in mind I just read an article, by Harriet Hall, which underscores that point:
    We are healthier, but we are increasingly being told we are sick. We are labeled with diagnoses that may not mean anything to our health. People used to go to the doctor when they were sick, and diagnoses were based on symptoms. Today diagnoses are increasingly made on the basis of detected abnormalities in people who have no symptoms and might never have developed them. Overdiagnosis constitutes one of the biggest problems in modern medicine. Welch explains why and calls for a new paradigm to correct the problem.
    To me, this is not rocket science. If anything, we were already warned by Samuel Shem that medical interventions inevitably introduce risks. His "good medical care is to do as much nothing as possible" I interpret to stand for:
    1. There are so-called self-limiting conditions. This means they resolve by themselves without any treatment: i.e. common cold.
    2. Medical interventions are inherently dangerous, there is always the risk it leads to complications.
    These points should make any physician question the necessity of any intervention. The following examples are meant as illustration to those points, and of how I view diagnostic and therapeutic interventions.

    One day a patient did not sufficiently produce urine. The medical history showed abdominal surgery the previous day, while the current status showed an i.v. drip with NaCl 1 liter/24h, an NSAID to counter the post-operative pain, blood tests suggesting deteriorating kidney function, and diuretics to correct for the diminishing urine production. At this time I was consulted to look at the kidney function. To the trained eye there already are several clues.
    • Fluid replacement at 1 l/24 h is not much (the patient did not yet eat or drink), especially in abdominal surgery. This alone might cause dehydration. After evaluating the patient I concluded this was what happened,
    • Of course, once a patient is dehydrated using diuretics appears somewhat counter productive: you need fluid to urinate, not lose more by stimulating diuresis,
    • Then the use of NSAIDs, they are known to cause stomach, and kidney problems. In a patient that already has a compromised kidney function these drugs should be immediately discontinued, and replaced by another type of analgesic,
    After concluding this was prerenal kidney failure, or dehydration, the fluid volume parenterally administered was increased to 2 l/24h, the NSAID and diuretic were stopped. Several hours later the urine production, and lab tests, returned to normal. This is not meant to embarrass any colleague but as a warning that something trivial as a painkiller may have devastating effects. In this case the patient might have ended up requiring haemodialysis.

    An example of the risk diagnostic methods pose is perforating the colon, which is rare, when taking a specimen to evaluate polyps. To prevent you from falling asleep I will stop illustrating the point. You undoubtedly understand my point.

    Thinking about these possibilities today my view is that we should always ask ourselves: is the possible complication from the therapy/diagnostic method I want to prescribe worth the expected benefit?

    In short, is this test required for a diagnosis, and is non-treatment more dangerous than treatment? Only then should one proceed with the intended intervention. Or, "good medical care is to do as much nothing as possible."

    As an aside, this maxim is applicable to other professions too.

    Wednesday, 2 February 2011

    MedGadget

    Be sure to help your favourite medical blog by voting at MedGadget:
    After a careful analysis and consideration, we are pleased to present the finalists of the seventh annual Medical Weblog Awards.
    There are several categories:
    After reading my musings you will be pleasantly surprised, or shocked, to find there are much, much, much better bloggers around. (h/t PalMD)

    The red moon

    A highly informative and interesting post by Ethan Siegel explains why the moon turns red during an eclipse. You should read it in full so I won't bother you with my take on it.

    Update: Still wondering how the universe came into being, from nothing? That is, how could there be a Big Bang without some sort of creator? Be sure to read his new post on how something can come from nothing. 

    Friday, 14 January 2011

    Facts are overrated anyway

    This blog was started to share my thoughts on science, rationality and why they are continuously attacked. Today I am convinced intra-personal psychological processes create the caustic responses from humans that are confronted with scientific conclusions which contradict their ideology.

    Even before I began writing this blog I was not impressed by what journalists produce. Knowing a little about medicine I was repeatedly surprised by the either outdated, incomplete, or even incorrect articles I read covering medicine. When I became a resident I was taught how to read, and write, articles. In every hospital I worked we would discuss two articles from medical journals -i.e. NEJM, JAMA, Annals of Internal Medicine, BMJ, Intensive Care Medicine, et cetera- on a weekly basis. By talking about the strenghts, and weaknesses, of the article this has increased my critical thinking skills. Undoubtedly one of the reasons this ritual is part of hospital life.

    Unfortunately this is not part of journalist school. As such I wonder how this may influence the viability of nonsensical ideas in society. The type of journalism media currently practice does the general public a disservice by making the "fair-and-balanced"-fallacy a popular point of view. This doctrine increases the dumbing down of society, which has given us numerous absurd opinions. Also, the need for celebrities to engage in misinforming the public has devastating effects. Terri Judd, for The Independent, writes about these effects and on how the public sees manufactroversies. To illustrate the spread of the "I-refuse-to-adequately-inform"-virus, within the media, below are stories covering different topics that fall within the "facts-are-to-be-treated-as-opinions"-category.

    Regarding vaccines:
    Just recently there was a concerted effort to counter the misinformation being spread by the infectious-disease-promotion-movement. It was hugely successful. So much so that today radiostations have been enlisted to help keep us scared of science. One wonders how effective the fearmongerers would be without the complicit media wich refused to point out the numerous, and huge, inaccuracies being presented as facts. A review by David Gorski of:
    two — count ‘em, two! — books taking a skeptical, science-based look at vaccines and, in particular, the anti-vaccine movement.
    can be found here. Astonishingly, even after Brian Deer in a leading medical journal concluded the father of the current infectious-disease-promotion-movement, Dr. Andrew Wakefield, made up the article which started the recent anti-vaccination scare journalists refuse to discard the "fair-and-balanced"-doctrine. As Cyril Washbrook, for MediaSpy, reminds us:
    As Ben Goldacre notes in a well-known critique of the media's reporting on the issue, the so-called "quality" press stood shoulder-to-shoulder alongside trashy tabloids in peddling fears that lacked a credible basis.
    What does the Serious Reporter do?:
    But even now, purportedly respectable media outlets continue to trot out their post-modernist, we-shall-never-adjudicate routine, showing that the lessons have not been learned. Step forward, CNN.
    A now-retracted British study that linked autism to childhood vaccines is an "elaborate fraud," according to a medical journal - a charge the physician behind the study vigorously denies.
    Note the immediate establishment of the basic heuristic: one person says the study is a fraud, the other person says it isn't. Unsurprisingly, the entire article proceeds along these very lines. Wakefield says it's a smear campaign; the BMJ says it's a genuine exposé. Wakefield says Deer has been paid off; Deer says he's independent.
    There is no sign journalists realise that informing one's audience about the veracity of claims, not merely reporting the claims themselves, is what journalism should be about.

    Regarding the placebo-effect:
    We all have heard of the placebo-effect. A recent study suggests we underestimate the power of the placebo. According to what has been reported in the media it works even when patients are aware they are taking fake medicine. Predictably, the popular press has not been sceptical enough, as Orac points out.
    I don't have a huge problem with the study. After all, it's a pilot study. The biggest problem I have is with how the study is being sold to the press, as though it were evidence that placebo effects can really be triggered without at least some degree of deception. It shows nothing of the sort.
    More on this by PalMD and David Gorski.

    Evolution is not science:
    Once Darwin irked the religious with his theory their response has been: attack, attack, and attack. The reason for this is clearly their fear science might prove The Bible is not The Truth. One can imagine religion being shown to be nothing more than mythology. The horror. There was initially the Scopes trial and recently through slight of hand, introducing the sciency sounding reincarnation of creationism: Intelligent Design. Despite the fact ID has been shown to violate the basics of science they keep claiming this is proof of an Evil Atheist-plot to take over the world. Surely, the media have come to the rescue by promoting, and continuing, the teach-the-controversy-fallacy. Still, I am waiting for journalists to use this argument to report on the Holocaust-controversy, and the Flat-Earth-controversy.

    Regarding global warming:
    Despite the fact the science is settled ideologues keep telling us AGW is a hoax. An example of inadequate reporting is Climategate. This purportedly showed a conspiracy of scientists to keep The Truth from us. A fact journalists felt compelled to share with us. After it became abundantly clear this was not the case, and the scientific method was exonerated, the media could not be bothered to share that with us. At least, not with the same zeal, and headlines, as the alleged corruption. 

    War of Terror:
    The breakdown of journalistic standards became painfully apparent when the Bush administration was allowed to make the wildest accusations towards Iraq. Worse, the media themselves were the main purveyors of misinformation. Even today, while those claims have turned out to be unsupported by the then available evidence, the media are incapable of learning from that experience. Like Saddam then both Iran and Julian Assange are now The Biggest Threat In The World. Again, no questions are asked to counter that premise.

    Political discourse in the US:
    For decades it has been bon ton in the US, and it is spreading beyond its borders, to use the most antagonistic and inflammatory ways of discussing topics. It is called freedom of speech. In short, use ad hominems and never relevant arguments. Politicians, and newsmedia, have engaged in sharp descriptions of individuals. After Obama became President of the US the Republicans, their ministry of truth, and other supporters have used terms like traitors, terrorists, un-american (and much more) to describe members of the Democratic Party. Then, this week, a Democrat was shot. In light of the recent rhetoric by the political Right some have suggested a correlation with the toxic political climate. While it is difficult to prove any causality one has to be blind to ignore the possibility. In the words of Mike the Mad Biologist:
    As I've said before, words do have meaning. Words should have meaning: if they don't, then do us all a favor and shut up. I believe Representative Trent Franks. I believe them when Rush Limbaugh and his millions of regular listeners believe we're the problem. And the anti-abortion movement has shown what happens when people post cross-hairs over people's names.
    So let's not be so concerned with civility, but instead demand honesty and accuracy. That will serve us far better.
    He also discusses a NYT article, by Matt Bai, on the shooting which employs the usual "but-both-sides-do-it"-meme.
    ........, John Cole succinctly sums it all up:
    And then my personal favorite: "He was just crazy!" No shit. You have to be crazy to walk into a crowd of people and start spraying bullets, killing a bunch of elderly people and a little kid. That is crazy.
    The point we have been trying to make for the last couple of years is that Republicans need to stop whipping up crazy people with violent political rhetoric. This is really not a hard concept to follow. There are crazy people out there. Stop egging them on.
    The problem Bai has is that, if you report the obvious story--Republicans have been engaged in eliminationist and exclusionary rhetoric that has some of the hallmarks of fascism--there's nothing new there. It doesn't establish you as a 'contrary' thinker who comes up with devastating counterintuitive insights. But if you can 'establish' (even though you actually can't) that the Left does it too, then you have something different to say.
    Another comment on the incident is made by We Beasties:
    There's been plenty of talk about the violent rhetoric that's been spewed for the last 2 years, and many have blamed talk radio, Sarah Palin's map with cross-hairs over congressional districts (including congresswoman Giffords') and the like, and I don't have much to add on that front. There's been no direct connection, and there may never be, but I find it hard to believe that this atmosphere of violent hatred had nothing to do with this gunman's actions.
    If you are wondering how this relates to my criticism on journalism I refer you to the fact-free, and at times delusional, opining by Glenn Beck, Rush Limbaugh, Sean Hannity, Bill O'Reilly, and many others which contributed to this climate. In all fairness, yes: they are not journalists but propagandists. Responding to the "the-guy-must-be-crazy"-view, by David Brooks, We Beasties notes:
    Vaughan Bell has a devastating critique of this sort of thinking in Slate, noting that the most complete scientific research on the effects of mental illness show very little increase in risk of violent behavior.
    More on mental health and violence can be found here.

    Wikileaks exposes journalists as not doing their jobs:
    As I noted before without the massive failure of journalism we would not have Wikileaks. Their recent disclosures appear to be based on Bradley Manning, who allegedly confessed to a total stranger, Adrian Lamo. His newfound friend then turned informant, and contacted Wired. Note the curious treatment he recieves while he is supposed to be innocent until proven guilty. This tellingly has led the U.N. to start an investigation.

    To aid those favouring all sorts of conspiracies Wired refuses to confirm, or deny, the ever changing narrative being told by Adrian Lamo. Kept hidden from us, by Wired, is how he met Manning and what his relationship is with journalist Poulsen, quoth Greenwald:
    That's what so much "journalism" now is:  a means of shielding secrets from the public -- usually to protect friends and the agendas of "sources" to ensure further access.  Ironically, it is that very mentality -- the Cult of Secrecy that American journalism has become -- that gave rise to the need for WikiLeaks in the first place.
    He concludes:
    The chat logs that Wired has but is withholding -- and about which they are refusing to comment -- are newsworthy in the extreme.  They cannot but shed substantial light on what really happened here, on the bizarre series of events and claims for which there is little evidence and much cause for doubt.  I expect government officials to shield the truth from the public and to conceal key evidence and facts.  But those who claim to be journalists should not be aiding in that effort.  Wired is doing exactly that.
    Totally unsuspected the media in general also fail to tell about Wikileaks without incorporating copious amounts of inaccurate statements. How journalists, in this story, have become the voice of the Obama administration's PR-department is described by Greenwald. Of course, Wikileaks does things real journalists never do, they endanger lifes, or this is what we are being told. Therefore we should not be afraid of governments limiting free speech for the real media, who never publish secret information. Strangely enough The NYT itself is now endangering National Security with a new article. In the words of Greenwald:
    In The New York Times today, Mark Mazzetti and Dexter Filkins expose very sensitive classified government secrets -- and not just routine secrets, but high-level, imminent planning for American covert military action in a foreign country.
    He rhetorically asks:
    The question that emerges from all of this is obvious, but also critical for those who believe Wikileaks and Julian Assange should be prosecuted for the classified information they have published: should the NYT editors and reporters who just spilled America's secrets to the world be criminally prosecuted as well?  After all, WikiLeaks has only exposed past conduct, and never -- like the NYT just did -- published imminent covert military plans.  Moreover, WikiLeaks has never published "top secret" material, unlike what the NYT has done many times in the past (the NSA program, the SWIFT banking program) and what they quite possibly did here as well.
    Just to remind us of what we have learned because of Dah Evil Wikileaks, which Real Journalists failed to uncover, read this, this, this, and this.

    With the above in mind, combined with the numerous examples I left out, what I notice about journalism today is that it does not matter what you are writing about, to be seen as a Serious Reporter the following characteristics are mandatory:
    1. There are always two sides to a story, 
    2. In the absence of any dispute pretend there is one, and present any discredited view as if the topic is still debated: failing to point out opposing opinions is a tell-tale sign of bias, hence point 1,
    3. Never point out any incorrect statements, or factual inaccuracies, by the parties involved: that would be taking sides, 
    4. Never reveal anything that damages those in power, i.e. see the hounding of anybody even remotely linked to Wikileaks. Limit your reporting to nefarious pawns and your career is a guaranteed success. 
    5. Never explicitly admit error on your part,
    6. A source is anyone who shares information with you, regardles of its veracity or factual accuracy,
    7. Expertise, or lack thereof, should not influence your decision to use a source, i.e. expert opinion is equivalent to that from laymen, and celebrities, which have studied at the University of Google,
    8. A priori you are required to keep the identity of a source, and any possible conflict of interest on their and your part, from the public. Especially when it turns out your source willfully lied to you in order to advance a political agenda,  
    9. Should you feel overly generous you might include ad hominems, straw men, and other invaluable arguments to get rid of those annoying people trying to steer the article/interview into a more rational position.
    Concluding, the abysmal state of reporting is not limited to scientific manufactroversies. As long as journalism school teaches the above characteristics there will be the need for organisations that understand the adagium Serious Reporters find tedious and outdated:
    is this a reasonable representation of the facts (NB: opinions do not equal facts) involved, and am I merely reporting a story, or is my reporting the story? In other words, is this a realistic portrayal of the facts involved and can it be supported by independent reliable sources?
    Are the media to blame for all that is evil? No, but their habit of having propaganda pose as news is certainly not helping us in making informed decisions, i.e. should I vaccinate, or who do I vote for, does The Law look backward? Those on Planet Reality need to keep pointing out that they sure act like willful footsoldiers in the War on Reason and Sanity.

    Update: Nice reading tip on "making mistakes," by We Beasties, for non-journalists too. Also, amended post slightly.