Archive for the ‘Education’ category

The 116th Meeting of the Skeptics’ Circle:The Wooful ER

July 30, 2009

It’s time for your favorite blog carnival and mine, the Skeptics’ Circle!

 I had the most horrible dream the other day. After watching a Mitchell and Webb Sketch about a homeopathic ER, I had nightmares of being trapped in an ER just chock full of Woo, and other nonskeptical gibberish.

Walk with me, through the valley of woo, in the nightmare that is the wooful ER.



Daniel Hauser and Informed Consent

May 19, 2009

I’ve been avoiding commenting on the Daniel Hauser Saga. Partially because I haven’t had time and I’ve been trying to crank out some more posts about my experiences on OB, Jadedness, and Hard Conversations. Partially because I feel it’s been well covered elsewhere.

There’s one quick, teachable moment here though, that I feel hasn’t been talked about enough.

Daniel Hauser could not have “revoked his consent”, it’s not about Daniel Hauser “making his own decision”. It’s really about informed consent. Even if you ignore age, Daniel Hauser couldn’t have given, or revoked, informed consent.
What’s that mean anyway?

Swine Flu: What should you do right now?

April 27, 2009

I’m interrupting our series on Vaccines and Autism now to discuss the recent swine flu issues. My apologies to those looking forward to a picking-apart of Jim Carrey’s drivel today.

I’m going to be aiming my posts on swine flu at the general population; I’ll also be keeping them short and posting pretty regularly. If you find my coverage overly simplistic and you’d like a more technical breakdown, I highly recommend Effect Measure – the coverage on that blog is just excellent.

First things first:

Don’t panic.

That’s important. So I’ll say it again

Don’t panic!

There is a lot of media attention, and a lot of CDC activity trying to spread information right now. That’s not a bad thing! That’s the system in action – and it’s why the US right now, is better prepared for this outbreak than Mexico, or Indonesia. Mexican and Indonesian readers: it’s not an insult, but the public health systems in your respective countries just haven’t been prepared for a flu outbreak.

Right now, the hype isn’t because Swine Flu is killing more people than cancer. The hype is because this virus is new. Since the virus new, we don’t know exactly what to expect.

What should you do right now?

First, you should wash your hands, and then go buy a bottle of alcohol hand sanitizer that you can carry with you. It might look like this:

Why? Because the evidence says that this virus is spreading from person to person – from people sneezing on you, shaking hands with you after sneezing on their hands, etc. Wash your hands regularly, and use hand sanitizer when you can’t wash your hands, with that alone you can do a lot to prevent the spread of almost infections you come into contact with. Swine flu is just another flu virus. The flu virus spread through respiratory secretions – stuff that comes out of your lungs. Sometimes it’s the stuff you’ve wiped onto your hands. If you’ve wiped it onto your hands – wash your hands! Especially if you’re working with other people, wash your hands! Even if you don’t work with people, wash your hands!

You can still eat pork. Respiratory secretions are NOT in your pork chop, delicious pork is in your pork chop. You cannot get swine flu from eating a ham sandwich.

If you’re feeling sick, stay home! Another reason the flu virus is so quickly passed around is that people come to work sick and sneeze all over everyone. Then things spread. Also, cover your mouth and nose when you sneeze, preferably with a tissue paper, then throw the tissue paper away. After that… wash your hands!

Now that has a flip side. Just because you haven’t seen someone sick, doesn’t mean you haven’t been exposed to something. Viruses have an incubation period, where you have the virus, and can conceivably spread the virus, but you don’t LOOK like you have the virus… yet.

Just having the sniffles does not mean you have swine flu. If you are a little sick, don’t panic! A quick guideline: If you have high fevers (>100.4 F, or 38C) – use a thermometer!), respiratory symptoms (runny nose, dry cough, or sore throat), muscle aches, fatigue, and you’ve been sick longer than 2 days go see a doctor! But if you just have the sniffles, don’t go to the doctor, you have more to lose by exposing yourself to sick people there!

 What shouldn’t you do? Don’t panic. Don’t go buy homeopathic remedies for flu prevention – even hyped up water is just water. I mention this because more than 1 person has reached this blog in the last day by googling “homeopathic swine flu prophylaxis”. Don’t go buy “alt med” preparations to save you from the flu. They don’t work!

Next up: What exactly is going on?

If you’d like more information right away, the CDC has put up a pretty informative website here.

Please note: I will be taking an especially heavy hand to the comments in any swine flu related post. This is a public health matter, and there is no room for hysteria. You may have a right to free speech, but you cannot shout fire in a theater. That’s how I’ll be treating any comments that I deem ridiculous. If you have a legitimate fear, please voice it, and I’ll respond if appropriate. If you post some ridiculous theory about how this is all a government conspiracy to boost Tamiflu sales, or some such crap, I’m banning right away, I’m not in the mood to suffer fools lightly.

The Relativity of Wrong Writ Large

April 13, 2009

All the way back in Part 1 of Vaccines and Autism, I touched on the relativity of wrong.

Either I didn’t do a good job describing it then, or people didn’t read whatI wrote before posting.

The basic question is this: “Does science really teach us anything? If science isn’t objectively right, then aren’t we all just wrong?”

In Asimov’s essay, the answer to the former question is “Yes”, and the answer to the latter is “Yes, but not all of us are as wrong as you!”.

For example. We once said the earth was flat. The earth is not flat. Science later said the earth was spherical. The earth is not spherical. More scence tells us that the earth is an oblate spheroid – that means it’s ‘width’ at the equator is bigger than it’s ‘hieght’ through the poles.  Even later, more ridiculous science with satellites shows that the earth isn’t even an oblate spheroid, it’s also a little pear shaped – a little bulgier on the southern half.

So are the people who said the earth is flat just as wrong as the people who said the earth is spherical? Did science teach us anything? Absolutely! As a culture we still mock the flat-earthers. Why? Because they’re REALLLY wrong. Spherical is wrong, but much less wrong.

So lets put this idea into practice. Suppose we ask two chldren to spell “quantum” – . If they answer “kwontum”, and  “noidea”, they’re both wrong, but “kwontum” is alot closer. Noidea boy has no understanding of how to spell, at least as far as we can tell. Kwontum boy may not know about the sound “qu” makes, but he knows some phonetics, it’s a start.  If noidea boy said he was equally wrong, rather than more wrong, most people would disagree, and it’s easy to see why. This is the relativity of wrong in action.

Now that you know this, you too can refute half of the pseudoscientists on this very blog. Generally our aspiring pseudoscientist will couch this declaration in word salad to make it more inconspicuous, but the gist is the same. The latest, and most egregious example of this is Chuck.

There are many problems that evidence based sciences cannot currently address and may never be able to address. Not all sciences are evidenced based due to subjectivity. Evidence based sciences may never be able to answer many problems because reality is often very unethical.

The subjectivity of reality handicaps a great many possibilities for evidence based sciences. (emphasis mine)

Chuck’s entire comment is written in what seems like really smart important words. Subjectivity, ethics, we must be on to something here! Unfortunately, that entire first paragraph reduces down to “everything is subjective, and science can’t learn about anything unethical”. 

First lets dispatch that whole “ethics hinders science” gibberish. I disagree. Our adversaries here seem to only understand the most direct of trials – “well if we want to test vaccines, we must have a group of people unvaccinated! Thats unethical so we can never know if vaccines work!”

I’ve already covered the evidence on how we can show that vaccines aren’t connected to autism without directly putting childrens lives at risk. You can see that it is alot more subtle than Chuck’s understanding. Science doesn’t depend on the direct test. Science depends on a working hypothesis. Once you have a hypothesis, you can find a question to test. It doesn’t need to be the direct question!

What I really love though, is what I’ve emphasized in bold print. This is an amazing piece of work. Chuck makes the blanket claim that reality is subjective. Reality is not subjective. Reality is real.

Many people may make subjective interpretations about reality. Heck, you could even reasonably say everyone makes subjective interpretations about reality. That doesn’t make reality subjective. This is beyond an epic fail. This is a fractal fail.

What’s Chuck saying when he says “everything is subjective”? He’s really saying “we’re all equally wrong.” He had a bunch of big words around it, but his comment comes right back to the relativity of wrong.

The entire point of science is to reduce the subjective interpretations we all make. It may not always suceed right away. Thats we rely on levels of evidence, and why science produces better answers over time.

So why would Chuck and all of the other pseudoscience crew would have you believe that because “reality is subjective”? Once you believe that drivel,  his answers to lifes questions, devoid of any data, become just as valid as Science’s.

However you know better than that now! We may be wrong today. We may be wrong tomorrow. But we will always less wrong than Chuck.

My guidelines for “Hard Conversations”

March 31, 2009

Soon I’ll be posting the first in a new column of posts for me – “Hard Conversations”. In Hard Conversations I’ll be discussing a variety of science or medical issues generally being talked about in the popular press. Generally speaking, these will be posts discussing what many call pseudoscience, mocktroversy, or otherwise what I’ll call “Bad Medicine.”

I want to be clear; there isn’t any scientific controversy in what I’ll be writing about, only media hype. I’m calling them “Hard Conversations” because I will be discussing things people hold strong and cherished beliefs about, in long, generally multi-part posts. Often we’ll be discussing things people hold responsible for their own pain and suffering. For example the first Conversation will be about vaccines and autism. I understand just how polarizing these issues can be. I’m not aiming to just shout at suffering people and say “Can’t you see the science! Don’t be stupid!” I think a lot of bloggers do that sort of thing much better than I would. Make no mistake though, I will not compromise science. Ethically, and morally, I have an obligation to explain these issues to the best understanding we have in the medical world. I’m not going to pander to people who specialize, knowingly or unknowingly, in giving people false hope or false beliefs to make money, or for their own perverse pleasure.

These posts to be a resource for people affected by the conditions I write about, or people who believe the ideas I explain. These posts aren’t aimed at the advocates on either side of the debate. Generally you guys already have far too strong opinions on these subjects for me to attempt to influence.

Since I’m aiming these posts at people affected by serious conditions, or their loved ones, respect is extremely important. I will take a heavy hand to disrespectful comments by anyone, on either side of the issue. Please take a second look at my disclaimers page and review my policy on banning users.


Once again, the first Hard Conversation will be about vaccines and autism, part one will be coming to a blog near you soon!

As for now, Enjoy!

-Whitecoat tales

Hanging up my shingle

March 29, 2009

I never know where to start things so I’m just going to start in the middle, and work my way to the edges. This is what I’d like to do with this blog, and why.

1. I’d like to Teach people about medicine as it relates to their health. I’ve noticed the average person doesn’t really understand what medicines they’re taking why they’re taking it, or why that would even be important.

I want to be clear about this; I will not treat people over the internet. By writing an article about hypertension I’m not giving you medical advice about hypertension, and you cannot print my blog off, take it to the pharmacy and get some pills.

What I am trying to do, is educate you. I want you to read, and then go to your doctor and say “Hey so I read this about hypertension, is that kid full of it, or is this something we should think about?”

This absolutely includes debunking bad medicine, but I hope to do it in an educational way: rather than saying “Honey doesn’t cure cancer stupid”, I’ll try to say “This is honey doesn’t cure cancer, heres the evidence.”

2. Speaking of evidence, I want to introduce science and evidence based medicine (EBM) to people who don’t know about it.

EBM is a movement in medicine away from anecdotes and “this is just how I do it” as a reasons for what we do, towards using science, statistics and the experiences of lots of doctors, as evidence to decide what we do.

I want you to know why this is important, and how this affects you. Rather than get your information about medicine from the 10th ad for Cialis that leaves you thinking “Well I know Mike Ditka likes it, but what the heck does it do?” Everyone should be able to proficiently google, or talk to their doctor, about the real evidence.

3. Debunk ER, House, and even Scrubs: The popular media describes doctors in completely unrealistic ways: somehow all the good doctors are poor and drive beat up cars, and all the bad doctors are flashy Mercedes driving tools. For some reason good doctors usually have bad tempers, bad manners and can’t talk to someone for three minutes without being condescending.

I’d like to bring you a realistic view of medicine, from behind the curtain. I’ll be writing about my personal experiences in medicine and hopefully show you that medicine is harder, stranger, cooler, and far more rewarding than you’ve ever seen on TV.

4. I’d like to write clearly enough that people with a high school education can read it. But I’d also like to be substantive enough that the discriminating blog-reading public will be entertained, and hopefully informed. Along the way, a few laughs would be nice.

To help with all that, I’d love for all you readers out there to contact me directly. Click here to get my email address (it’s only hidden to avoid spam) or leave a comment anywhere on the blog -I’ll make every effort to reply. I guarantee that I will read every email, and I will reply to as many as I can. I will never share your information with anyone without your permission, see my disclaimers for all questions about privacy. If you want to give me permission to blog about your question (without revealing any information about you) please say so in your email.

Just to be clear, I absolutely don’t want you to email me saying “Hey Whitecoat Tales, my blood pressure was 170/100 today, what should I do?” My answer will ALWAYS be “Go see your doctor!” I do want you to email me saying “Hey Whitecoat Tales, I saw this article about Echinacea, is it for real? Feel free to blog about this.”

Hopefully that’s enough of a rundown that everyone will check back again for a real update, or email me questions. For now, Enjoy!

-Whitecoat Tales

This post last edited 3/29/09