The Skeptic's Dictionary Newsletter

Volume 14 No. 5

June 2015

"...for naturopathic believers, what matters is not about what science says, but about beliefs in an alternative, magical healing force."--Britt Marie Hermes

What's New?

New: in memoriam Wally Sampson, M.D.

New reader comments: Dr. Blaylock on forced vaccinations; begging the question; and Pamela Gellar & Megyn Kelly.

The begging the question and acupuncture entries have been revised.

There have been several updates: GMO's (corporate irresponsibility in promoting pseudoscience) and new rules; the warrior cop; fake diplomas from a fake university bring in millions; natural not necessarily better; a rebuttal to each of Ginger Taylor’s “72 research paper showing that vaccines can cause autism” (direct link; also posted inautismthimerosal.html); an unsatisfied customer of Dr. Nguyen; and natural cancer cures: mind-body medicine.

Group Acupuncture

What could be more relaxing and pain relieving than stripping down for a session with your own personal acupuncturist at $75 an hour? How about a session fully clothed with dozens of others at $20 an hour? Coming soon to your neighborhood, if it isn't already there, is group acupuncture. There's comfort in numbers. Learn more by contacting POCA  (People's Organization of Community Acupuncture), a very accommodating group. They use points on the scalp and below the elbows and knees in their sessions, "so there’s no need to undress." Also, "the shared state makes individual treatments more powerful." One person thinking about anything--say, ending world hunger--will have little effect. Get dozens of people in a group, however, and have them focus their thinking on the same thing--say, ending world hunger--and they can do great things, like end world hunger. Get millions of people to watch the same television show and they can affect random number generators in Switzerland, according to parapsychologist Dean Radin. If enough people wish for good weather, they get it, according to another parapsychologist, Roger Nelson. Get groups of people to pray for the sick, and they shall be healed, according to several well-intentioned folks.

The group acupuncture story, like the group prayer story, wouldn't be complete without a "scientific study" to prove that it "works." As you would expect, the study had a small number of participants, was non-randomized, had no control group, took place over a short period of time, used subjective reporting as the primary guide, and looked for several effects hoping to find at least one or two that were positive, even if not statistically significant. If successful in their quest, then the authors could boast about the benefits of group acupuncture. They could bank on the press not bothering to be critical of such a study. (I first read about this study in Cure magazine and there wasn't even a hint of skepticism or criticism in the article.)

The study included 43 patients who underwent at least four group acupuncture sessions over as many weeks through an integrative oncology program at a large community oncology practice in West Central Florida, and completed short assessments of seven cancer-related symptoms. The mean age of participants was 66.4 years, and they were primarily white, non-Hispanic and female.*

Why did the researchers stop at four treatments? Apparently, that was when they first got positive results for some of their seven data points: "patients reported significantly less pain/numbness and problems with digestion." There were no significant improvements in headache, sleep, fatigue, or dry mouth. The lead author, Cindy Tofthagen, could also boast that "this is first study that evaluates group acupuncture for cancer-related symptoms.” Always good to be first in an exciting field like integrative oncology. “The next step is that we’re (testing) four weeks of acupuncture twice a week, because (the acupuncturist) feels that’s ideal,” Tofthagen said, thus demonstrating that her rigorous standards will continue as she explores further the field of research she has pioneered.

The first group acupuncture study has not been published. Tofthagen presented her findings in a poster session at the 2015 Annual Oncological Nursing Society Congress.

I prefer no science to bad science. That said, however, I have grown to appreciate the value of such practices as acupuncture, meditation, yoga, tai chi, qigong, and other practices that aim at reducing pain or anxiety by relaxing or giving hope to people who are suffering. If these practices give some people some relief and help them carry on with life, so be it. It's their dime and their time. When I'm in my cancer support group and the discussion turns to ways to cope with suffering, I am not about to confront the woman who excitedly tells the group about the value of "tapping" while looking in the mirror. She's talking about Roger Callahan's Thought Field Therapy or Gary Craig's knockoff, Emotional Freedom Techniques. Many in my group are in pain or suffering from anxiety about dying young and I could not live with myself if I added to that pain. The only thing worse than challenging such people in such a setting would be to exploit their vulnerability the way Jon Edward and James van Praagh do.

What people believe does matter, and it affects how they are able to deal with stressful situations. It doesn't really matter whether what they believe is true. I think people would be better off believing what is true rather than putting their faith in various forms of placebo medicine or absolutely false notions about curing their cancer with baking soda or flaxseed oil. I think these people who are suffering anxiety over an early death would do better to think about the moments they now have rather than about the eternal moments they won't have. But it doesn't matter what I think. Everybody has to deal with their pain and anxiety in their own way. I'm not in the same situation as these folks. My children are grown and I'm starting my eighth decade on the planet feeling pretty good, thanks to chemotherapy. I don't share the pain or anxiety of a young parent whose cancer is taking its toll faster than mine is, so who am I to try to advise them on what is good or best for them?

Psychics in the News

The headline read: Fortune teller 'scams lovesick man out of $700,000'. 'Lovesick man' is pc language for 'mentally deficient fellow.' And 'fortune teller' is a euphemism for 'evil crook.' The 26-year-old crook told the 32-year-old man that evil spirits were keeping the girl of his dreams repulsed by him. According to the story: "After being told that he and the woman were 'twin flames' kept apart by negativity the man made payments over the next 20 months totaling $713,975." Unfortunately, he didn't get a money-back guarantee.

Priscilla Delmaro worked her scam from a Times Square shop. Where better to hook a fish with money coming out of his gills? She consulted another evil spirit, Bobby Evans. The lovely couple now face grand larceny charges.

To many readers of this story, it might seem that the scammed man had a very low IQ, now matched by his empty bank account. He was not a complete dimwit, however. Even though he gave the scammers $80,000 for an 80-mile bridge (which the psychic claimed would trap evil spirits in another realm), $30,000 for a gold Rolex watch (which would cleanse the sins of the past), $40,064 for a Tiffany diamond ring (to “protect his energy”), and another $40,000 (for various psychic interventions), he was smart enough to realize he was being scammed when he found out that the girl of his dreams was dead.

Will such cases deter others from consulting psychics? Of course not. Which is why I foresee a great fortune coming the way of James van Praagh, who has found a much cleaner way to pick the pockets of the grieving and lost souls seeking the advice of psychics. Van Praagh is going to teach others how to run this game. He's opened a school that he calls The James Van Praagh School of Mystical Arts. He doesn't call his potential students 'potential grand larcenists' or 'evil crooks,' however. He invites potential suckers to become--I couldn't make this up--"a certified psychic intuitive messenger." Certifiable? No doubt. Certified by whom? By the Great One himself, of course.

As Bob Dylan once sang: "Is there a hole for me to get sick in?"

Another "I Cured Myself of Cancer" Blog

While some people make a living deceiving others, there are those who spend a lifetime deceiving themselves. Do a Google search for 'cured cancer by diet' and you'll get about 5.5 million results. I once thought of doing a book on people who have web pages claiming they cured their own cancer but I gave up after reading about a dozen "stories." While the stories of self-deceivers can be just as instructive as those of psychic grand larcenists, they are also likely to be just as ineffective a deterrent to self-deception as the stories of people scammed by a 'psychic intuitive messenger' are a deterrent to deception. Case in point: Theresa's Story.

Though not mentioned by name, I am pretty sure that David Gorski was writing about Theresa is a recent post on the Science Based Medicine blog entitled "Another cancer tragedy in the making." I'll try not to cover the same ground.

Theresa deserves special attention because of a New Republic article--almost certainly based on her--by Dr. Sushrut Jangi, a physician at Beth Israel Deaconess Medical Center and researcher at Brigham and Women's Hospital in Boston. The article naively regurgitates Theresa's claim that she cured herself of multiple myeloma (MM) by diet, Gerson therapy, and the Gonzalez protocol. Jangi's article has been thoroughly deconstructed, dissected, demolished, and debased by David Gorski, leaving little need for further attack. Instead, I'll review Theresa's Story, posted on her blog, and explain why I think she is deluded.

First, a little bit about cancer and then some info on multiple myeloma from the Mayo Clinic.

There are hundreds of different kinds of cancer but one thing they all have in common is that they consist of cells that are virtually immortal. Both normal and cancerous cells are genetically programmed to divide and replace themselves. Normal cells are also programmed to die at various intervals, a process known as apoptosis. The program for apoptosis is turned off for cancer cells. They won't die a natural death. You have to cut off their blood supply, excise them, destroy their ability to replicate, or otherwise annihilate them to stop them from living and replicating. Also, normal cells stop dividing when they come in contact with like cells (contact inhibition). Cancerous cells keep dividing even after coming in contact with like cells. Cancer cells give new meaning to the expression "divide and conquer." Chemotherapy works by halting cell division.  "Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink." Chemotherapy also induces apoptosis.* An ideal chemotherapy regimen would use drugs that know how to tell the difference between a normal cell and a cancer cell. In the meantime, we bank on our normal cells rebounding and growing back.

While many humans would not consider immortality a defect, in living bodies it is not a good thing to have cells that replicate but do not die. Such cells accumulate and can eventually cause enough damage to the body to stop its functioning altogether. A healthy immune system will often pick off defective cells, including cancer cells, kill them and dispose of the debris. Some cancer cells avoid detection by the immune system and not only grow into tumors at their source, they migrate to other places in the body and take up a new residence. My cancer, for example, originated in the tail of my pancreas and eventually spread to my liver by the time it was discovered. Some people, when they hear I have cancer, think I'm going to be dead in the not-too-distant-future. That's true, but it's also true for every other human being on the planet. The fact is that some cancers are "indolent," i.e., slow growing. Some are so indolent that a person can live for decades with them and die of something else. Remember that fact when somebody claims they cured their own cancer with marijuana or turmeric or red clover or by some magical diet.

Why does the immune system not kill every cancer cell soon after it develops? Answer that question and collect your Nobel Prize. Many people, however, think that the answer is simple: food. That's what Theresa believes and I'll return to her story shortly. First, a few words about multiple myeloma:

Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs. Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause kidney problems.

Treatment for multiple myeloma isn't always necessary. If you're not experiencing signs and symptoms, you may not require treatment. If signs and symptoms develop, a number of treatments can help control your multiple myeloma.*

All it takes is one abnormal cell in your blood plasma to get multiple myeloma started. It's not clear what causes a blood plasma cell to mutate, but there is no evidence that a person's diet can cause multiple myeloma or any other kind of cancer. It should be obvious, however, that a healthy immune system requires good nutrition. But there is no evidence that any specific diet either causes or cures any type of cancer. To believe that you have caused or cured your cancer by your diet is a sign that you are deluded.

The first signal of Theresa's delusion shows up in this paragraph, early in her story (I'm ignoring her seeing her naturopath for what she self-diagnosed as shin splints and her reference to a real doctor as her "orthodox physician"):

I won't go into the complications associated with a bone marrow transplant but it's extremely toxic and risky. I would do a lot to avoid having one. Eventually, the disease becomes resistant to all the drugs and takes over. That's what they mean when they say myeloma is treatable but incurable. At any rate, with this approach, I'd be putting my (rather short) life in the doctor's hands.

Uh, yes, you the patient with no knowledge of your disease would be required to trust the people who are experts in the field to recommend what they think would be the treatments best for you. You should be proactive, as Theresa is, and try to learn as much as you can about your disease and about the various treatments available. You should get a second opinion from an expert in the field. And you ought to at least get some of the basic stuff right. When it is said by science-based doctors that a disease is treatable but incurable, they do not mean that the disease will become resistant to all drugs and take over. Theresa acknowledges that some people live for many years with MM but that those with her type (IgA MM) aren't usually among that group. The fact is, however, that some people in her group do live for many years and some of them don't get any therapy at all. She rejected her oncologist's advice and began Gerson therapy, a regimen of a special diet, coffee enemas, and various supplements. Others have tried Gerson therapy but didn't live long enough to tell a story like Theresa's. Jessica Ainscough, for example, known as Australia's 'wellness warrior', died of her cancer at the age of 30 earlier this year despite her claiming that Gerson therapy was curing her. Ainscough attracted thousands of followers on social media and survived for seven years after being diagnosed with epithelioid sarcoma. Her best chance of survival would have been to have her arm amputated at the shoulder. Ainscough's mother, Sharyn, also used Gerson therapy after being diagnosed with breast cancer. She died of her cancer in 2013. (For more, see Orac's post on Jessica Ainscough's life and death.)

In the paragraph from Theresa's blog cited above there is a strong hint as to why she would be attracted to something as useless as Gerson therapy: the word 'toxic.' That word is a red flag. For alties it indicates the worst of all possible scenarios. Anything toxic must be avoided or annihilated. Anything that promises detoxification is good and should be embraced with open veins. To skeptics, this is pure nonsense, as evidenced by the recent death of a child whose parents didn't want 'toxic' antibiotics used for his ear infection. You can't detox your body of evil things that are causing your cancer, and putting toxins in your body (chemotherapy) can be good for you. Theresa chose Gerson therapy because she believed it would detoxify her liver and rebuild her immune system. What does it mean to detoxify the liver or rebuild the immune system? She had no idea but she knew that once her body was clean and nourished, it would kill off her cancer cells and restore her body to optimal health.

Did it work?

"I barely left the house for two years," she writes. "At the end of two years, my disease was stable and I was tired.  I'd yawn all day and was ready for bed at 8:30pm.... I didn't feel good and I didn't feel comfortable that I would remain stable long term."

Did Gerson therapy stabilize her cancer? Not very likely. If it has, she probably would not have been as fatigued as she was. It sounds like her disease was progressing but is not as aggressive as her oncologist thought. (Yes, oncologists do err. What a shock!)

On to plan B. Revlimid? (One of the chemo drugs that has helped Tom Brokaw bring his multiple myeloma to a state of NDC, no detectable cancer.) No, Theresa didn't return to the oncologist. Why would she? He would just poison her, right? So she turned to another useless alternative cancer treatment, one touted by cancer non-expert Suzanne Sommers: the Gonzalez protocol. The treatment involves taking about 150 supplements of vitamins, minerals, and pancreatic enzymes (from pigs); daily coffee enemas and special diets allegedly tailored to the patient's metabolic system. She says that during her time at home she became a more spiritual person. Her faith is evidence by her testimony: "My odds of living a long, healthy life using conventional medicine are zero while my odds of living a long, healthy life on Dr. Gonzalez' therapy are 98%." Gonzalez learned everything he knows about treating cancer from an anti-vaccinationist orthodontist, William Donald Kelley (1925-2005). Kelley claimed that he had been diagnosed with pancreatic cancer in 1962 and told he had three months to live. He became famous among quacks by claiming he cured himself of his cancer with his diet, supplements, pancreatic enzymes, and enemas. If Kelley was told by a real doctor that he had cancer and three months to live, it wouldn't be the first time a doctor was wrong in diagnosis and prognosis.

Theresa says she was diagnosed with MM in June of 2009, so that would mean that she has survived for six years since diagnosis and was on the Gerson regimen until 2011. In May of 2014, Theresa posted an update to her condition. This update seems to be her last post. She doesn't mention it but MM can wreak havoc on the bones. Geraldine Ferraro, the first woman to run for vice-President of the United States, died of MM and described how she suffered many broken bones from the slightest activities. In the autumn of 2013, Theresa was hit in the back by a boy riding a bicycle. She suffered broken vertebrae, "had surgery and spent a month in the hospital." She concludes her update:

I was back on some of the Gonzalez Therapy within a few days of returning home from the hospital. With help and time, I was able to walk and do my enemas. To this day, the therapy continues to work very well for me and my cancer continues to regress each month. It takes time, commitment and determination but it is SO worth it.

Fast forward seven months – life is much better. Although this event set my cancer therapy back about a year, I am slowly re-building my health and making my way back to where I was before the accident.

In other words, I'm still not feeling well but I'm sure I'm curing myself. It's been a year since she's posted anything on her blog. An email to her inquiring about her current condition didn't bounce, but so far there has been no reply. [update: 6/26/2015. Theresa replied that she is doing well and still doing the Gonzalez protocol. She says that she is not blogging upon the advice of her attorney to not put anything about her health in writing while she is in a lawsuit associated with her back accident.]

Toxic Naturopaths in California

"Naturopathic medical beliefs include pseudoscientific ideas like vaccines cause more harm than good, any disease can be successfully treated with homeopathy, alternative cancer therapies are safe and effective, and nutrition can cure mental illness. These beliefs are dangerous and their promotion is unethical." So says former naturopathic doctor Britt Marie Hermes. Yet, these N.D.s (naturopathic doctors) who decry most pharmaceuticals as toxic (and therefore not to be considered good for your health) want the right to inject people with antibiotics and insert intrauterine devices to block contraception. What could be more natural than giving people injections and inserting devices to prevent pregnancy? Naturopaths will be permitted to do these and a host of other things now forbidden to them by law should Senate Bill 538 (which was passed by the Senate on a 21-9 vote) pass in the state Assembly. The bill's author, Sen. Marty Block, D-San Diego, defends the need for expanding the scope of what N.D.s can do legally on the basis of there being a "tragic primary care shortage experienced by many in California" especially in rural areas. “The changes will ensure that patients receiving primary care from a naturopathic doctor can receive the appropriate care without the time, cost, and health risk of finding another doctor for these routine procedures,” Block added. Who knew there was a health risk in finding a real doctor for routine procedures like getting an IUD or a shot of antibiotics? On the bright side, the new law will continue to prohibit naturopaths from performing acupuncture, unless, of course, the N.D. is also a licensed acupuncturist.

According to a puff piece advertorial masquerading as a news report by Sammy Caiola in the Sacramento Bee: "Advocates [of SB 538] argue that N.D.s can help expand health care access, particularly as more patients seek primary care providers under the Affordable Care Act. Their efforts come amid similar efforts by nurse practitioners, pharmacists, and optometrists to be able to provide some of the same services as medical doctors."

According to Caiola, a naturopath is "a health care provider trained in healing therapies, herbal medicine, clinical nutrition, homeopathy, and lifestyle counseling, in addition to many of the same basic sciences as a conventional physician." Actually, a naturopath is not part of any real medical system. These folks engage in a hodgepodge of unscientific practices, such as colonic irrigation and other unnecessary "detoxification" treatments, as well as herbal and supplement treatments to "enhance the immune system."

Fortunately, there are only about 500 licensed naturopaths in California, a state with nearly 40,000,000 people. I guess Sen. Block expects a large influx of N.D.s should his bill pass the Assembly and not be vetoed by our inscrutable governor, Jerry Brown. Block might think about amending his bill, however, to cut down on colonic irrigations in these times of severe drought.

The Anti-vax brigade

My local fishwrap gave the bully pulpit--called a 'soapbox' by the Sacramento Bee--to an anti-vaxxer campaigner recently, perhaps to appear being fair and balanced after giving so much coverage to California Senate Bill 277, which will eliminate most of the opt-out exemptions now allowed by law....eventually. To placate some of the more vocal opponents of the bill, compromises were made. The original language of the bill would have eliminated altogether and immediately the current provision in the law that lets parents, for religious or personal reasons, opt out of having their children vaccinated before attending public school. Children with good medical reasons for not being vaccinated would still be exempt. According to an article in the San Jose Mercury News:

The bill now reads: "This bill would eliminate the exemption from existing specified immunization requirements based upon personal beliefs, but would allow exemption from future immunization requirements deemed appropriate by the State Department of Public Health for either medical reasons or personal beliefs. The bill would exempt pupils in a home-based private school and students enrolled in an independent study program pursuant to specified law from the prohibition described above." There were other compromises: "But perhaps the most significant compromise was the authors' pledge to "grandfather in" many public and private school students whose parents have claimed personal belief exemptions. That would mean that more than 13,000 children who have had no vaccinations by first grade won't have to get their shots until they enter seventh grade. And nearly 10,000 seventh-graders who today aren't fully vaccinated may be able to avoid future shots because the state does not always require them after that grade."

Even that generous compromise didn't halt the anti-SB277 movement. In her soapbox opinion piece, Elizabeth Bell recited a litany easily recognizable by anyone familiar with David Kirby and the Age of Autism blog. Bell has children and had them vaccinated until her second child was diagnosed with autism. Now she is on the side of those who blame vaccines for autism in children.

I want to protect my son with vaccines, yet respected medical professionals are questioning vaccine safety in susceptible populations. Is my delightful 3-year-old boy among these?

SB 277 unnecessarily pits parents like me against parents who fully vaccinate when we all have a lot at risk.

Every medical professional is respected by somebody. I wonder who she has in mind? Jay Gordon? Russell Blaylock? Who are these susceptible populations? They've never been identified; they are assumed to exist even though there isn't a single scientific study to support the idea beyond a reasonable doubt. (I'll eventually get to the 19 studies Bell cites in support of the idea that vaccines cause autism.) The fact is that the risk of a vaccine causing autism is near zero, while the risk of the unvaccinated contracting a communicable disease and spreading it is much higher than zero. Even if we expand the argument to chances of being harmed by a vaccine versus chances of being harmed by the spread of a communicable disease, the odds are not equal. I won't hazard a guess at what the numbers are; I'll leave that to the statisticians and epidemiologists. Whatever the statistics are, they would probably be lost on Bell, who, for some reason thinks it is relevant to claim: "While 24 school-aged Californians contracted measles during the recent outbreak, 1 in 68 children are autistic." Arguing over whether that latter statistic is accurate is a red herring and, in any case, comparing it to the number of kids in a recent measles outbreak is irrelevant to the conversation about SB 277.

The next point in Bell's soapbox argument against SB 277 is a familiar one among anti-vaxxers: The federal government’s Vaccine Adverse Event Reporting System estimates 3,900 people annually report serious vaccine reactions, including “disability, hospitalization, life-threatening illness or death.” Autism, however, is not one of the serious vaccine reactions the government covers. Why? A ruling in 2009 found that the MMR vaccine given alone or with thimerosal-containing vaccines is not a causal factor in autism. Two appeals were unsuccessful and autism as a result of any vaccine has not been added to the the National Childhood Vaccine Injury Act Reporting and Compensation Tables (VIT).*

Bell then cited an opinion expressed eight years ago by the deceased Bernadine Healy, former director of the National Institutes of Health, that the autism-vaccine connection was still open. Bell does not mention, of course, that there are at least 75 studies that have found no link between vaccines and autism.

Bell then cites a favorite of the Kirby brigade: the case of Hannah Poling that was decided in her favor by the Division of Vaccine Injury Compensation, Department of Health and Human Services. I've written about the case and will note here only that:

No diagnosis of autism was made in the case and the ruling does not claim that there is a link between vaccines and autism. The decision may have some legal significance but the evidence presented in this case to support a causal connection between vaccines and any disorder is meager, and hinges on future research establishing that in some people their mitochondrial DNA predisposes them to react to something in vaccines that causes some sort of symptoms that are consistent with autism spectrum disorder.

The fact is that no such study finding such a predisposition has been done.

Next, Bell brings out a common Kirby accusation, that the Centers for Disease Control and Prevention (CDC) conspired to suppress evidence:

Consider senior CDC epidemiologist William Thompson, who admitted last August that a 2004 article in Pediatrics omitted statistically significant data suggesting that African American boys who received the MMR vaccine before age 3 were at “increased risk for autism.”

The cited study about African-American boys, the MMR, and autism was retracted by Pediatrics because "there were undeclared competing interests on the part of the author which compromised the peer review process. Furthermore, post-publication peer review raised concerns about the validity of the methods and statistical analysis, therefore the Editors no longer have confidence in the soundness of the findings. We apologise to all affected parties for the inconvenience caused." Whatever somebody at the CDC said is irrelevant. The real issue is the study itself, which was as flawed as Ms. Bell's argument.

(One issue Bell brings up that is worth investigating further, but has no direct bearing on whether SB 277 should be passed, is the charge of conflict of interest at the CDC.)

Another common trope among the autism-vaccine linkage folks is the claim that there are 19 studies (or 72 studies) in peer-reviewed journals that support their belief. Bell actually lists the 19 in the comments section posted with her article. What Bell doesn't mention is that the source of this list is Ginger Taylor, a paid anti-vaccine activist and that a group of pro-science bloggers and writers reviewed the list in detail and have found it wanting in oh-so-many-ways. One example, cited specifically by Bell, is the Stony Brook study:

A study by Stony Brook University Medical Center in New York found that newborn boys vaccinated for hepatitis B had three times the odds for autism compared to boys who weren’t vaccinated or were vaccinated after the first month.

Actually, the researchers compared 33 kids with autism to 7,455 without. The only charitable conclusion one could draw from this data is that "further study is needed."

Bell steps down from her soapbox with the concluding remark: "Legislators should not pass this poorly considered, reactionary bill." I hope the majority of legislators see through the poorly constructed arguments put forth by people like Bell and pass SB 277 for the benefit of the common good.

Many others opposed to the bill have argued that the bill would force children to be vaccinated and that their freedom to choose would be violated.The law would not force anyone to do anything, but it would provide a penalty for those who do not comply with the law, as is the case with every other law. Nobody has an absolute right to choose what to do or not do with regard to their children. Your child is not your property. You cannot abuse or harm your child, claiming it is your right as a parent and the state has no business in taking away your right to choose how to deal with your child in all matters. The state has a duty to protect children from abusive parents. Many states have made the mistake of allowing religious exemptions for parents who refuse proper medical care for their children, a policy that has led to the unnecessary deaths of many children. Your right to choose whether to vaccinate your child ends when exercising it threatens the general welfare. You do not have the right to jeopardize the community by spreading an easily preventable communicable disease. The state has the duty, as well as the right, to quarantine you and your children should you be a threat to the health of the community. You do not have the right to choose to harm us or to act recklessly in ways that threaten the safety of the community.

I was asked recently Do you believe people should be forced to inject any substance into their body against their will? My reply was Yes, I do, under extreme and rare circumstances. For example, if injecting you will prevent you from harming others in the community. I think it would be justified to force soldiers to be inoculated against certain diseases in particular circumstances where not inoculating them would jeopardize the entire unit in its efforts to protect society or accomplish a legitimate military mission. I do not support the death penalty, but if I did I would not object to forcing prisoners to be injected with drugs intended to kill them as a punishment. This issue is a red herring, however. No child is going to be forced to be injected with anything should SB 277 become law, as I hope it does.

(For more on the anti-vaccine movement and SB 277, see David Gorski's blog post: The war in California over nonmedical exemptions to school vaccine mandates.)

This just in: the American Medical Association has adopted a new policy to seek more stringent state immunization requirements.

And here is a graphic from the latest (6/17/15) anti-SB 277 ad in the Sacramento Bee:

The ad is paid for by the California Chiropractic Association and focuses on the All-American issues of freedom and equality. Of course, the whole point of any law is to treat people who obey it differently from those who don't because the two groups are not equals and people are not free to disobey laws they disagree with. The chiropractors oppose vaccinations and their fight for freedom and equality is a smokescreen. Their ad hints that Senate Bill 445, and Assembly Bills 233 and 982 exempt homeless children from having to provide proof of immunization to attend public school. SB 445 aims at bringing state law into harmony with federal law regarding the education of homeless children. SB 445 does not mention vaccinations. AB 233 and AB 982 amend the state education code regarding child care. Neither makes any mention of vaccinations.

The chiropractors ad appeals to our sense of fairness: why should 500,000 homeless children be exempt when 200,000 others want to be exempt but can't be because they are not homeless? My first question on seeing this comparison was "are homeless children really exempt?" I can't find evidence that they are or will be. My second question was "Are there really that many homeless kids in California schools?" The latest data I could find (from the National Center for Homeless Education) was for the 2011-2012 school year. While the number of homeless schoolchildren in California (248,904) is actually half of what the chiropractors claim in their ad, it is still an appalling number. The ad also states: everyone deserves medical freedom. The reader must supply his or her context, however, to figure out exactly what that means. Finally, the ad lists two swell-sounding support groups: Our Kids, Our Choice: a Grassroots Organization for Medical Freedom and California Coalition for Health Choice. The red, white, and blue website of the former group says it is "a growing group of over 9,000 Californian registered voters." The red, white, and blue website of the latter group says it is "a statewide umbrella organization that encompasses many of the grassroots groups fighting SB277," including Our Kids, Our Choice. Both are playing the "don't let government stomp on our freedoms" card, a card that plays well in many quarters of this country.

Another card that plays well in paranoid communities against SB 277 is the "we're under attack" card. This one is now being played by a new Big Three: Robert F. Kennedy Jr., the Nation of Islam, and Scientology. I wish I were kidding.

Skepticism and Zebra Medicine

About a year ago I became a member of a cancer community that uses a zebra image to identify us. The group attaches a message to the zebra image that is nearly the opposite of what some skeptical groups attach to the same image. Skeptics say, following the medical aphorism of Dr. Theodore Woodward of the University of Maryland School of Medicine: "When you hear hoof beats, think horses not zebras." My cancer community says: "You can't detect it, if you don't suspect it." According to Wikipedia (in the entry on Zebra medicine), "Zebra is American medical slang for arriving at an exotic medical diagnosis when a more commonplace explanation is more likely." The medical aphorism originated with Woodward in the late 1940s. He believed that medical novices tend to favor exotic and rare diagnoses rather than common ones. My group and the members of the Ehlers-Danlos Syndrome United Foundation, on the other hand, believe that many medical practitioners, both old and new, tend to favor common diagnoses over rare ones.

A common theme in the stories of those in my group is that of being misdiagnosed for many years before being correctly diagnosed with some sort of neuroendocrine cancer. For those who know nothing about neuroendocrine cancer, which probably includes most of you reading this, neuroendocrine tumors (NETS) are rare cancers found in only about 2% of all individuals diagnosed with cancer each year. There are many varieties, with carcinoid being most common. Other NETS include islet cell, VIPoma, gastrinoma, and insulinoma. We're often diagnosed with irritable bowel syndrome, Crohn's disease, or colitis. Some of us go undiagnosed for many years because we have no symptoms that would lead us to seek medical attention. The cancer in my pancreas had apparently been growing for five or six years before I started having symptoms that led me to see a physician. By then, the cancer had spread to my liver. I am fortunate that most NETs are slow growing and that my cancer is nonfunctional (i.e., doesn't release excessive hormones), but this is also my misfortune because by the time I found out I had cancer it had grown to a good size and had metastasized. I'm also fortunate that my chemotherapy has shrunk the tumors, is in pill form and very convenient to take, and is well tolerated by me with minimal side effects. I continue to live my life pretty much as I did before I started having symptoms, all of which have dissipated.

I bring this up because several people have asked me if having cancer has changed my beliefs about anything. The answer is 'yes,' but probably not in areas you might think. I haven't changed my beliefs about gods or the supernatural, for example. I have changed my mind about some kinds of anecdotal evidence, which I explained in a previous newsletter. While I think that physicians would do well to consider the unexpected and rare, rather than be guided by the availability bias, I still believe that it is wiser to consider natural explanations to supernatural or paranormal ones when one begins investigating strange phenomena.

Written by Bob Carroll
with the assistance of John Renish
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