Dr. Jay Gordon’s profound misunderstanding of science

@Orac:

Which one of those cited examples (or changes in any other facet of medicine) came about because of anecdotes and Internet-fueled fears in direct opposition to scientific evidence, Jay?

Jay responds:

Initially, Bacon, all of them.

To be fair to Jay, I think that he meant that in the sense that “anecdotes can be used to generate hypotheses which are then tested”. At least thats what I get out the “Initially”.

Well, haven’t the antivaxers done a great job exposing the fraudulent vaccine-autism link to “greater scrutiny”? Their calls were heard, the matter was researched, thorroughly, and settled. They have don their job. Can they now please stop?

And another thought, since Jay seems to believe that the “change” in medicine will ultimately lead any fact, theory or hypothesis to be found wrong… will he be willing to accept the same for his side of the trench? That antivaxers will, nay MUST, one day find their ideas to be utterly wrong, even harmful?

Discussions with Dr Jay are like arguments about death between a devout person and an atheist. Nothing the atheist says can move the devout’s faith in eternal life. Nothing the devout person says make sense to the atheist. Both start from points so distant there is almost no path to common ground. Absolute proof is lacking on both sides so the argument can only end when death settles it.

The difference between theoretical debates on death and scientific ones on vaccines is, as Orac states, the evidence. And of course the damage done to herd immunity and by resurgence of vaccine preventable disease.

I will credit him with one small thing: he IS right that people view “Science” as “RCTs”, an ideology that is definitely promoted at the post-graduate medical education level (try talking to a doctor about the lab science behind chemotherapy rather than what the clinical trials say).

Also, today’s SMBC seems rather well timed.

Bloodletting actively caused damage to people, even killed them, increasing mortality by a factor of ten according to one crude clinical trial. It is very obvious to us now that removing several liters of blood from a weak and sick person is very unlikely to do any good (leaving aside some rare conditions involving iron overload). Yet doctors like Benjamin Rush who were at least as intelligent as Jay Gordon insisted that their own clinical observations proved to them that bloodletting was beneficial for almost every illness.

If clinical observation was unable to distinguish a large increase in mortality from an intervention, how reliable is it likely to be at detecting the relatively rare adverse effects attributed to vaccines by Dr. Gordon?

Teach the controversy Augie! Then wipe the funyon grease off your hands, get off the computer, and head back upstairs. You’re using up your mom’s 500 free hours on the AOL CDROM she got in the mail.

Augie troll,
Where’s the evidence? Not anecdotes, credible evidence?

Not a question of wanting or not wanting. That is a child’s approach to debate.

Maureen, you hit the nail on the head. I was thinking the same thing about the “clinical pathways” that we attempted to create on our surgical floor when I worked as an RN. Some of our residents would protest that they didn’t need no (stinkin) pathways! They were doctors after all: They knew everything they needed to know and didn’t need any protocols.
I guess that finally answers my question as to why physicians can embrace such utter nonsense as homeopathy, reiki, etc….Arrogance! They really think they know more, have more experience, have greater “intuition” based on anecdote, etc. Their egos allow them to become delusional.

Methinks Augustine needs to watch Monty Python’s argument clinic sketch. He might thereby learn that “Wrong!” and “Right!” are not what we technically term “arguments”.

I think it’s a little more complex than Sharon suggests.

Those opposed to vaccination (the most extreme ones anyway) seem to me to exclude as unreliable any evidence that does not fit with their prejudices. They also seem to me to frequently distort, misquote or otherwise misrepresent evidence to fit their prejudices.

Those favoring vaccination seem to me to have looked at all of the evidence and weighed up its relative reliability and implications. They have come to the conclusion that the probability of a serious adverse reaction to a vaccine is very much lower than the probability of an unvaccinated person catching the disease and experiencing serious complications from it.

As vaccination rates continue to rise and the diseases they protect against become rarer, at some point the (very small) probability of a serious adverse reaction to a vaccine will become higher then the probability of catching the disease and suffering serious complications.

This is when interesting philosophical questions of personal and social responsibility come into play. An individual could reduce their risk by not vaccinating, but if everyone did the same these diseases would return and thousands of people would suffer and die. The question then is just how selfish an individual is. I don’t think we have reached that point with any vaccine-preventable diseases yet, but we will eventually.

“As I see it the anti vaxer tries to convince people that vax is more dangerous than the disease.
Wrong!”

What is wrong about that statement?

From my perspective, the problem with that statement is that it implies that anti-vaxxers have actually thought about the real dangers of vaccination, and, more importantly, the risks of disease.

While there are certainly those who base their anti-vax positions on their denial of the risks of disease, I don’t think that is common at all among that group. For the most part, their position is “VACCINES ARE EVIL!!!!!!!!!!!!!!!!!!!,” generally involving a strawman about how they aren’t “perfectly safe” with absolutely no consideration of any of the risks of the disease.

If I thought that anti-vaxxers come to their positions through careful cost-benefit analysis of the effects of vaccination, it would be a different situation completely. In that case, we can have a rational discussion about what are the costs and what are the benefits. But when you hear the screeches of “OMG the TOXINZ!” it’s not about rational analysis.

I was actually going to respond to Sharon’s statement about this. I disagree with her characterization because I think it is far too generous to the thought processes of the typical anti-vaxxer.

What specific scientific evidence do you have to support your claim that vaccines cause asthma and all the other problems that you attribute to them?

To be fair, there is some evidence (will try to dig up studies if anyone’s interested) that might suggest that vaccination is involved in increased rates of asthma-but in the exact opposite way that anti-vaxxers suggest.

Decreased exposure to antigens may be driving an increase in asthma and allergies. So maybe having children exposed to a single, purified antigen instead of the whole mess of antigens in, say, chicken pox, contributes to the problem. But in that case, shouldn’t the rallying cry be not “too many, too soon”, but rather, “more, sooner”? If inadequate exposure is, as it seems to be, the problem, increasing the number of vaccines would be better than decreasing them. Especially in a herd immunity situation where exposure to the natural antigen is low.

Of course, there are safer ways to be exposed to antigens. Let the kid run around outside a bit. Stop autoclaving their toys. That sort of thing. They’ll get exposed in no time.

Final thought: there is some (weak) evidence that people with allergies are less likely to get brain tumors than those without. Maybe a little allergic rhinitis is no bad thing? Asthma is taking it too far though. Immunology is a tricky field and Dr. Jay et al can reasonably say we don’t understand it all yet. But we do know, as securely as we can know anything, that vaccines have nothing to do with autism.

Unfortunately, some doctors cater to the whims of patients because they see financial gain. Without caring for the consequences.

Education is the key, and unfortunately our country is failing this critical aspect of our community.

As I see it the anti vaxer tries to convince people that vax is more dangerous than the disease. The pro vaxer tries to convince people the disease is more dangerous than the vax.

I agree with this statement.

We are never going to change the minds of the dedicated anti-vaccine crowd. My goal in discussions with them, or any other supporter of pseudoscience is to persuade those who are undecided and coming to the issues without understanding that one side is backed by solid research and the other is not.

This is a great post. I’ll try to respond as soon as I can. I am flattered beyond words right now.

Science begins as someone’s thoughts and anecdotes and continues to serious research and serious clinical studies. Not everyone agrees as things begin to change. Sometimes the conclusions reached are 180 degrees away from the original hypothesis based on anecdotal experience. Sometimes conclusions reached in 2011 are 180 degrees around from those of 2008 or 2009.

Again, thanks for opening up this topic and I look forwarded to a spirited exchange.

Best,

Jay

Sometimes conclusions reached in 2011 are 180 degrees around from those of 2008 or 2009.

This is certainly possible. What specific conclusions do you have in mind? I can’t think of any major paradigm shifts involving vaccination that have occurred in the last 2 months, but perhaps I’ve missed it.

@MikeMa #29:

No, of course not. Dr. Jay’s personal clinical experience trumps all of medical science. We may as well give up– we only have science on our side. How can we possibly stand against one certain man? Why should he bother testing that which he knows to be true?

I personally hate argument by quotation, but Dr. Jay would be well-served to spend some time thinking about Feynman’s comment:

Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.

Research never ends – because you never know when the next big breakthrough (or incremental improvement / discovery) will occur. Quite a number of studies have started in one direction & ended up with results that were very much different than the original hypothesis. That’s why testing and research continues – and as new technology becomes available, things that we couldn’t test for in the past, we can now either confirm or deny with the new information that is available.

Now, do I expect that we’ll suddenly discover Homeopathy is real? Of course not – because the fundamentals are so incorrect (and physically impossible) that no amount of research will prove otherwise.

Will the development, manufacture, and dispersal methods of vaccines continue to improve? – of course. We already took a big step with the advent of oral & nasal vaccines, instead of additional shots (or in place of the original shots).

One only needs to look at the total number of antigens that are part of the current vaccine schedule, which number less than we had back in the early 90’s, even though we had fewer vaccines back then.

And to conduct research, we do need to have an original hypothesis – and in the case of regular medical science, these educated “guesses” are put to the test.

In the case of anti-vaxers, they have the original idea & it is just accepted without any evidence whatsoever.

Science begins as someone’s thoughts and anecdotes and continues to serious research and serious clinical studies.

But that’s not exactly what you said; you seemed to claim that anecdotes and Internet fear mongering lead to change. I suppose you might be right in one respect. Anecdotes and Internet fear mongering have led scientists to study whether vaccines cause autism. The resounding answer to that question is: No, there is no scientifically sound evidence linking vaccines to autism.

Not everyone agrees as things begin to change. Sometimes the conclusions reached are 180 degrees away from the original hypothesis based on anecdotal experience. Sometimes conclusions reached in 2011 are 180 degrees around from those of 2008 or 2009.

Ah, the old “science was wrong before” argument. How disappointing and predictable. Before you persist in this argument, Jay, you might want to read these two posts first:

http://skeptico.blogs.com/skeptico/2005/11/science_wrong.html

http://www.ukskeptics.com/article.php?dir=articles&article=science_has_been_wrong_before.php

Here’s the problem: Show me the evidence that science is wrong (or might be wrong) in this case. Simply asserting that it’s wrong or that today’s scientific findings might be overturned is not enough. Also, before you bring up the example of H. pylori, which almost inevitably follows the “science was wrong before” argument, you might want to read these:

http://www.csicop.org/si/show/bacteria_ulcers_and_ostracism_h._pylori_and_the_making_of_a_myth

http://www.sciencebasedmedicine.org/?p=4238

http://www.sciencebasedmedicine.org/?p=4418

The other example that almost inevitably follows is that of Ignaz Semmelweis. It’s a case that is more complex than it is typically represented, but I don’t have time to explain how right now.

this SMBC comic says it all

It seems to me that in a number of cases in which medical practice has changed, it’s simply taken some time for medicine to catch up with the science. So yes, people on the internet, or at conferences, or wherever, *may* know something that a practicing GP somewhere doesn’t know, especially in an area where practice lags behind research (for example, outdated approaches to the management of type II diabetes).

Then there’s the problem of subpar doctors. They start of thinking that it’s their job to approach patients with a mental flow-chart and they end up over-prescribing drugs in cases where the cost/benefit analysis doesn’t add up. Then when they notice that they’re doing more harm than good, they start trying to reinvent science from scratch, as if they just discovered it for themselves. And they end up working only with their own experience and observations. Reiki worked BETTER than the drugs! Simply not taking the drugs would have worked better than the drugs, if they never shouldn’t have been prescribed in the first place. Holistic approaches work BETTER than treating patients like statistics without ever looking up from their charts! And so forth.

@SW – That should read “start OFF” and “never SHOULD have been prescribed”. Also, I realize my post sounded condescending. The *best* GP’s are open minded because they really do understand the scientific process! But the relationship of clinical experience to the erroneous received wisdom of the medical tradition shouldn’t be confused with the relationship of clinical experience to the real conclusions of good research.

Off to work now–late as usual–but I’d like to clear up one misconception before I go. I don’t think my long clinical experience trumps or supersedes real research and expertise. I just think that it adds to a discussion. If I’ve ever implied that because I’ve seen “25 cases of X following Y . . .” and someone who studied thousands of incidents of Y not being related to X has lesser data, that was wrong. Large controlled studies are needed to draw real scientific conclusions. But blind faith in these studies has led to large errors.

In order to write most of your posts, David, you have to ignore how wrong “science” has been on countless occasions over decades. You have to ignore the initial responses to the ideas, hypothesis and instincts of experienced clinicians. Once you begin ignoring that, lapse into sarcasm and disdain, your fingers can fly over the keyboard. You can be so much better than that.

To summarize: My anecdotes and experience do NOT supersede real research. But that research, just like some of my anecdotal conclusions, can end up being found just plain wrong.

Best,

Jay

Jay – how exactly is research found to be wrong? Why, with more RESEARCH!!!!

People just don’t suddenly decide the X is wrong & Y is right – you actually have to take the time to do the work to find out if its true.

You’ve made a lot of suppositions here, none of which have been based on actual medical research and results. Thoughts, feelings, opinions, etc. mean nothing in the face of concrete evidence.

Again, sure, researchers have been wrong – but in the end, it is only more research that ultimately finds the right answer.

Last night I expressed my despair for Jake, now I feel similarly for Dr. Jay (who is probably my contemporary):

When I started college, I came to visualize a certain campus byway as a division between two worlds: on one side I got to do my “drawing and writing” gig, on the other, bio and social sciences(primarily, psych and economics). I was very fortunate in that I was able take a major/near-major in 4 areas and manage to fulfill degree requirements.

I hold that many educated, bright people do not see as clear a boundary as I do, that one area of endeavor may bleed into the other. They have strong feelings and can be tempted away from the rigours of the scientific method. Our linguistic designing and abstracting proclivites might pull us away from the facts, the data, the numbers, the stat: drawing up a “cleaner” sketch, creating a more elegant, less complicated “story”, so to speak. It’s how our minds work. Our minds *also* can see our own tendency to do this and implement controlling restrictions, taking account of our *feelings’* influences as well.

Of course, we might channel our expressive needs into the service of communicating facts, data, and stat precisely, exploring ways to engage an audience or in constructing arguments to convince opponents of the merits of our own view point.

However, cling we must to data, replication of studies, and RCT’s because of real world outcomes, the *physical* consequences that affect others profoundly, rather than just affecting ideas and opinions.

It’s easier

To summarize: My anecdotes and experience do NOT supersede real research. But that research, just like some of my anecdotal conclusions, can end up being found just plain wrong.

Here’s the problem. You clearly believe that the research IS wrong. No, no, don’t bother to deny it. I could easily do a bit of searching on this very blog and bury you with your own words saying that you believe that vaccines cause autism–based on your clinical experience, of course. Here’s the thing. That’s not enough. Moreover, just because you believe current science to be incorrect on this issue does not mean that someday in some mystical future science will come around to your point of view. Indeed, it almost certainly won’t, because the quantity and quality of the evidence from multiple sources and disciplines converging on the conclusion that vaccines do not cause autism is such that it is unlikely that future studies will find different results. Sure, it’s possible, but it’s quite unlikely. Clinging to such an unlikely hope that you will one day be vindicated by science is not an argument.

Jay: “In order to write most of your posts, David, you have to ignore how wrong “science” has been on countless occasions over decades. You have to ignore the initial responses to the ideas, hypothesis and instincts of experienced clinicians.”

Did you read the suggested links on the foolishness of relying on the “science wuz wrong before” argument? Might be well to do so before diving back into fallacy again.

Besides, Jay – in order to use homeopathy to treat children with ear infections, you have had to ignore not only anecdotal evidence of the uselessness of homeopathy, but a sizable body of research and elementary scientific principles debunking it. More than 200 years of woo-ful futility have ensued since Hahnemann first proposed them, but you’re still plodding along with homeopathic remedies.

If (as you said before) you think we have a lot to learn from you, you need to set a better example.

Interesting blog post. Its like a libel lawyers dream come true.

Shorter Dr. Jay@44:

Paragraph 1: Of course my experience doesn’t trump all of scientific research.

Paragraph 2: Sometimes science is wrong.

Paragraph 3: Based on my more than thirty years of clinical experience™ this is one of those times.

@ D.C. Sessions:

Beautifully put! That does seem to be the crux of it.

Jay’s The best science and the best research must also include observation and experience misses one important fact. If Orac finds a second tumor his pre-op work up has missed, he for sure will adjust the operation to deal with this. If he finds a second tumor five times in the next operation, he will adjust his procedures to deal with it, and – wait for it – publish the new observation for others to study. And only then will we find out if Orac just had six very odd patients, or there’s something wrong with the work-up and procedure that needs to be changed.
We’re still waiting for Jay’s published observations, documenting the frequency of vaccine induced autism, opening them up to public scrutiny.
Jay, the way science is proven wrong is by publishing a hypothesis, and backing it up with evidence. Waiting for science to be changed for you to fit your experience isn’t going to happen unless you make your experience part of the science. I’m sure AAPS is perfectly willing to publish your results.

Correct me if I’m wrong, but isn’t science the process by which we discover stuff? I mean, I could have been doing this all wrong all these years, but science directs me to look at a theory and test it. If my results are both plausible and reproducible, if I used controls and tried to account for bias and confounding, and if I was honest in the interpretation of the data, then the science is not wrong no matter if ten years or 100 years from now something comes along that modifies my conclusions.

What I’m getting at, Dr. Jay, (thanks for following on Twitter, by the way, I think)… What I’m getting at is that science really can’t be wrong. The people doing the science can do it wrong. The method by which the evidence is analyzed can be wrong. But, to paraphrase Seth Mnookin and someone else whose name eludes me (they were both on NPR):

I can go to the top of the building and jump off and fall to the ground. I can do it a million times. I can do it a billion times. Does that mean that humans can’t spontaneously fly? No. But it does tell me that a flying human is incredibly unlikely… So unlikely so as to not go jumping off buildings.

So you can try to associate vaccines with autism a billion times and still (somehow) say that vaccines cause autism… But the chance of you being right is so incredibly low that it’s better to move on to stuff with better odds of being right.

It’s been too long, doc. Put it to rest. Move on.

I’ve asked Dr. Jay several times in the past to tell us what his “experience” consists of in more precise terms. I’ve asked for figures, like number of autistic children in his practice, number of children who have regressed shortly after he vaccinated them (not referred to him because of his reputation), etc. He has always declined to respond.

Orac, you may be right about that. The quantity and quality of the research out now, rife with bias of the publisher and it’s pharmaceutical connections, may, frighteningly, continue to show results that are the same. I mean, you’re right. If they keep using stupid tricks like Madsen counting a new group of autism diagnosed kids after they decrease thimerosal so it looks like thimerosal removal actually caused more autism! And, if they keep being able to get away with crap like that, of course the results will continue to be the same. But don’t worry, people are joining forces to make sure that the stank of that kind of research is known.

At that point, he’s forced to believe his eyes and his instincts and change the plan without the proof he’d like. His eyes and and his experience guider him as he does the best for his patient.

However, he does have the options of obtaining that proof by calling for an intra-operative pathology consult (frozen section or cytology), intra-operative xray, or deferring definitive treatment for a second surgical procedure once that proof has been obtained. As in many other areas, a useful guideline in cases like these is “trust, but verify”.

Incidentally, it’s my opinion that inappropriate antibiotic use in large part stems from “personal clinical experience” rather than following scientific evidence.

#51 “Part of what we know now about pediatric practice will be deemed completely wrong within the next few months or the next few years. …”
Posted by: Jay Gordon, MD, FAAP | February 18, 2011 12:26 PM

Part of what you “know” about pediatrics is already deemed wrong. It is easy to find the literature in favor of vaccination.

T. Bruce McNeely says: “Incidentally, it’s my opinion that inappropriate antibiotic use in large part stems from “personal clinical experience” rather than following scientific evidence.”

Nope.

http://www.webmd.com/cold-and-flu/ear-infection/news/20110112/early-antibiotics-help-ear-infections-in-small-kids

There are still pharmaceutical industry funded researchers out there publishing articles at odds with both clinical experience and solid scientific research showing otitis media responds to watchful waiting as well as it does to antibiotics.

Jay

David, are all posts with a link in them held for review?

Jay

Jay plaintively asked: “David, are all posts with a link in them held for review?”

No, just the ones that threaten the New World Order.

Actually I’ve posted comments with and without single links that have been held for unknown reasons. And that’s despite being a Pharma Shill in good standing. 😉

Jay, have you ever considered that chemtrails are responsible for the Autism Epidemic? I mean, science has never demonstrated that there is such a thing as chemtrails, but science has been wrong before. A lot of people have faith that chemtrails exist (take note, jen), and they started getting prominent attention right around the time reported autism cases began increasing. Government claims chemtrails don’t exist, so what does that tell you?

This guy realized the truth, and it got him banned, in the same way that They are trying to keep Jay Gordon from posting!

Wake up sheeple!!!

There are still pharmaceutical industry funded researchers out there publishing articles at odds with both clinical experience and solid scientific research showing otitis media responds to watchful waiting as well as it does to antibiotics.

And the weight of the evidence wins out. What’s your point?

According to Dr. Gordon, “Part of what we know about pediatric practice will be deemed completely wrong within the next few months or the next few years.” Gee, I wonder which parts he means? Dr. Gordon also stated in another blog that he has learned from posters here about epidemiology and immunology and that he is working within his group (The American Academy of Pediatrics) to change opinions about vaccines. I don’t think he has been too successful as the Academy’s policy papers on childhood immunizations (available on the web at the AAP website) are in accord with the CDC recommendations.

Other policy statements on that site state succinctly why infants and children should have timely, complete series of vaccines. As a result of woo medicine practitioners such as Dr. Gordon and his fellow-travelers, the AAP has issued policy statements about “the autism-vaccine link”, “the thimerisol-autism link” and every other nonsense theory about the genesis of autism.

Dr. Gordon states he has learned about the science behind immunizations and the epidemiology of vaccine-preventable diseases from posters here. Really? Every one of the infectious diseases that he would ever see in a pediatric practice…their incidence, their prevalence, their epidemiology and the immunology science of each vaccine is covered in the AAP’s “Red Book”. I wonder if he has ever perused the book or the journal “Pediatrics” that the AAP publishes.

“Dr. Jay” was probably in too much of a hurry to notice that he contradicted himself in his response (#45):

“I don’t think my long clinical experience trumps or supersedes real research and expertise. I just think that it adds to a discussion. If I’ve ever implied that because I’ve seen “25 cases of X following Y . . .” and someone who studied thousands of incidents of Y not being related to X has lesser data, that was wrong.”

Seems to contradict:

“To summarize: My anecdotes and experience do NOT supersede real research. But that research, just like some of my anecdotal conclusions, can end up being found just plain wrong.
“

It seems to me that in the second excerpt “Dr. Jay” is implying that his “anecdotal conclusions” are no more likely to be wrong than real scientific research. Or, at least, that since there is a chance that science might be wrong, his “anecdotal conclusions” are no worse than large scientific research projects.

I suppose, as always, the Devil is in the details.

While it is true that scientific research is frequently superceded by subsequent work, it isn’t all that common (in the past 50 years or so) to find that legitimate research – replicated by other groups – is “180 degrees” wrong.

What “Dr. Jay” is trying to conflate with replicated medical research are the relatively few times when a “breakthrough” in research (usually by one research group) simply isn’t replicatable (i.e., the original data or conclusions were in error). An example of this is Dr. Wakefield’s “landmark” discovery of autistic enterocolitis and its association with the MMR vaccine. A better example might be the use of secretin in autism – initial (small, poorly controlled) studies showed promise while later (larger) studies found no effect.

On the other hand, I can’t think of too many cases where replicated studies have been completely overturned by later work. The usual examples given are estrogen replacement therapy and (as “Dr. Jay” provided) statins, but the later discovery of adverse health effects only modified the indications for these therapies; the beneficial effects remain, which is why both therapies are still being used.

The “science has been wrong before” argument isn’t a valid justification for trusting your own intuition, even if you call it “years of clinical experience”. Don’t forget, bloodletting, purging, mustard plasters and calomel were used for centuries because the collective “clinical experience” supported their efficacy. I don’t think that “Dr. Jay” is any less susceptible to mistaking coincidence with causation than the best medical minds of the 18th and 19th centuries were.

“Dr. Jay” (of course) continues:

“In order to write most of your posts, David, you have to ignore how wrong “science” has been on countless occasions over decades. You have to ignore the initial responses to the ideas, hypothesis and instincts of experienced clinicians. Once you begin ignoring that, lapse into sarcasm and disdain, your fingers can fly over the keyboard. You can be so much better than that.”

Wow! The “science has been wrong before” fallacy in combination with concern trolling! I would like to turn that back on “Dr. Jay” – “Dr. Jay, you don’t have to be fearful and hostile to scientific progress; you can be so much better than that!”.

Just because “science has been wrong before” doesn’t mean that it is always or even frequently wrong. In fact, what “Dr. Jay” labels as science being “wrong” is mostly science being incomplete. And the fact that “science” has been wrong before doesn’t mean that “Dr. Jay” is right.

Science has been wrong before – it has also been right a lot more often than it has been wrong (and, I suspect, “science” has been right a lot more often than “Dr. Jay”). In addition, science has a built-in correction mechanism – a researcher who successfully challenges the status quo wins fame and often even a little fortune. Anecdotes don’t have a self-correction mechanism – they just breed in the darkness.

Finally, “Dr. Jay” keeps referring to “anecdotal” data as if he actually had some – which, as far as I can tell, isn’t the case. Anecdotal data would be what “Dr. Jay” would have if he went through his patient records and looked at – for instance – the time lapse between giving the MMR vaccine and the first signs of autism.

What “Dr. Jay” has isn’t even up to the level of anecdote. What “Dr. Jay” has is his recollection – his impression, if you will – of what his anecdotal data might be if he were to actually look at them. This is like me saying “Boy, there have been an awful lot of red cars on the expressway this afternoon!” based solely on my impression that I’d seen more red cars that usual.

This is what “Dr. Jay” trusts more than scientific studies: his impression of his recollection of what his anecdotal data might be if he ever bothered to check.

Prometheus

“Logistic regression analysis identified three statistically significant predictors of subsequent atopic disease: maternal atopy immunisation with whole-cell pertussis vaccine and treatment with oral antibiotics in the first two years of life ”

Maybe that’s one reason whole-cell pertussis vaccine isn’t used anymore, Sid?

Personal Clinical Experience (frequently) = Cognitive Bias, which has several forms, but usually means “I see and experience what I want to experience”.

And in a lovely piece of synchronicity, or should I say, the universe offering fulfillment, this was posted today at Saturday Morning Breakfast Cereal…

http://www.smbc-comics.com/comics/20110218.gif

@Dr.Jay–

The first traffic light you come across today has been green before, therefore it is green now, and will be green when you approach it.

Do you really not see why this is a fallacy, or are you being deliberately obtuse?

I’m sure it hasn’t escaped notice that Jay avoids answering direct questions. He won’t put anything in writing that could jeopardize his standing with the anti- vax crowd.

@Pablo at #21, I refer to the end point not the means. I certainly did not claim anti vaxers give any serious consideration to their points.

@Augustine, I have given this issue plenty of consideration. I spend at least an hour a day on both pro and anti vax sites. Just because I made a concise point, does not mean I misunderstand.

Even if one takes the way science works to mean we can “never say never,” it doesn’t follow that we are therefore justified in keeping on at saying “someday, just you wait.” Especially not in the face of high quality evidence demonstrating the minuscule chance of that “someday” ever coming to pass.

Dr. Gordon, you claim that your beliefs about vaccination are due to your clinical observations. Those observations should be recorded in your files. I suppose I should add that I did the data entry in the study I described, and I went through years of records for that purpose. Why don’t you hire an enterprising college student to go through your records and find the evidence that is so unmistakeably present in your records. You don’t need a grant for that. The records already exist (don’t they?), and college students work cheap.

Jay – it seems to me that your supporters, including Jenny McCarthy, have some pretty deep pockets. Why don’t they front the money for all of these studies?

lilady, you must read more carefully: Dr. Gordon disagrees with anyone who opposes all vaccination. After all, he may be okay with rabies vaccination for someone severely bitten by an animal known to be rabid. I don’t believe he’s expressed opinions on that situation.

Well, then, I guess Dr. Jay aka “I disagree with anyone who opposes all vaccination” is at odds with Dr. Suzanne Humphries aka “Vaccines are dangerous and should never be injected into anyone for any reason.” Maybe he should go on over to the International Medical Council on Vaccination’s website and send some comments their way.

“I disagree with anyone who opposes all vaccination”

Wait, doesn’t one of Dr. Jay’s multiple personalities say that the problem is that we just give vaccines too quickly? That one was easy to dance around.

you have to ignore how wrong “science” has been on countless occasions over decades.

OK. Science has been wrong before, so it might be wrong now. Fair enough.

Here’s the thing: Overconfident, passive-aggressive online loudmouths and conspiracy theorists have been wrong at least as often as science. Particularly when they’re patting themselves on the back for being ahead of the scientific learning curve.

See why we might want some actual evidence? Or failing that, an argument based on something a little stronger than analogical inference + the old “God’s last honest man” routine?

Thanks Dangerous Bacon for picking up on my error. @LW: you raise a valid point, about what would Dr. Gordon recommend if a patient had a bite exposure to an animal known to have rabies. I also am wondering what his recommendations would be for a “possible” rabies exposure from a bat scratch or bite. Perhaps, because he has wide “experience” with vaccine reactions, he will recommend different “spacing” of the post-exposure rabies series of immunizations, as he does with other childhood immunizations.

I revisited Dr. Gordons website “Vaccine Link Library” to look at the rabies section. I found that every article cited and linked in the rabies section discussed the side effects of rabies prophylactic immunizations and HRIG (Human Rabies Immune Globulin) prophylaxis . Some of the articles were about reactions to the rabies vaccine given to domesticated animals, including the most recent puffery authored by Kent Heckenlively, Esq./science teacher. Is Jay Gordon FAAP also a practicing Doctor of Veterinary Medicine? Most of the articles were twenty years old and were devoted to human rabies vaccine that is used in other countries and rabies vaccine that is no longer used in the United States. Noticeably absent were links to to the California Department of Health website, the CDC website and the ACIP (Advisory Committee on Immunization Practices) websites.

I wonder if any of his young parents take exotic trips with their children to areas of the world where rabies are endemic in the local wildlife and in domestic animals. I also wonder what impact Dr. Gordon’s vanity press will have on them. If their child gets bitten or scratched by a domesticated animal, will they refuse rabies prophylaxis for their youngster because of their faith in him and because all vaccinations are bad.

The ACIP updated their recommendations for rabies vaccine and HRIG in 1998, based on intensive research. Their site has some very interesting data about rabies incidence in animals and humans in the United States. Immunize.org-Rabies Cases website provides case histories of the recent human rabies diagnosed in the United States.

lilady, I tried to look at Dr. Gordon’s website with respect to rabies. It is unbelievably unreadable — a muddy blue background with black text and blue links. The only way to read it without developing eyestrain is to highlight the whole page to get some contrast. Ugh. My ferrets could design a better website.

At any rate, before I gave up in disgust at the effort of reading that mess, I found the page that contains links for rabies. The sole link goes to … whale.to. That isn’t even the work of Dr. Gordon, FAAP.

I’m surprised no one has brought up the funniest part of Jay’s “science has been wrong before nonsense (perhaps it is too obvious).

Notice that “science has been wrong before, and therefore I am right on this issue” bears with it the implication that, while science has been wrong before, Jay never has!

I mean, if he admits that he has been wrong before is simply, “you have been wrong before, too, so why do you contend you aren’t now?”

“Science has been wrong” and “Jay has been wrong” and therefore Jay is right? The only way Jay can make his claim is to back it with the assertion that he has never been wrong.

I’m more than happy to discuss all other aspects of the etiology of this genuine epidemic.

Here’s an interesting one which sounds at least plausible: increasing paternal age. Discuss.

Dianne, as an IRB committee member, what would you say about a review of the records he already has? Acknowledging, of course, that he actually has no meaningful hypothesis, but if he did, would there be an approval issue with just going through his own files and documenting whatever it is that he claims is so convincing?

Retrospective chart reviews have a much lower bar to pass for IRB approval; so I doubt that such a study would have that much difficulty passing IRB review. SRB (scientific review board) review, on the other hand, might be problematic. Remember, there are two steps to getting a clinical trial approved (other than money, of course). First is the SRB review, which evaluates the study for scientific soundness. Then, if the study passes SRB review, there’s IRB review, which evaluates risks to the trial subjects and ethics. The scientific basis of any study Dr. Jay would propose would have to be a lot sharper, with a much more defined hypothesis than the vague one he has now.

I hope you don’t mind my following up, as I am genuinely curious about the ethics of this.

Suppose that a doctor, reflecting on his clinical experience over the decades, concluded that he had seen a new or at least unrecognized syndrome of some sort. He might not really have any hypothesis at all, just the impression that something is going on that should be looked at.

I would have thought that he could thumb back through his own files, or run various database searches on computerized data, without any kind of approval. Of course, as a practical matter he probably can — who would know? But would that be considered unethical to do without approval?

If this hypothetical doctor really is just fishing, then he can’t possibly present a study exhibiting any scientific soundness, and yet he really might have an insight that could be valuable if followed up — which it won’t be unless he looks back and confirms his suspicions.

At what point would there be a “study” requiring approval?

@augustine:

Human rights and personal responsibility are not black and white issues that are solved by armchair quarterback scientist wannabes…

I’ve seen anti-vaxxers spending a lot more time arguing against the effectiveness of vaccines, against the data the vaccine preventable diseases aren’t that serious of a health risk, and arguing for the idea that vaccines carry a high rate of adverse effects than I’ve seen them spending time arguing against the idea that children must be vaccinated before they can attend public schools and/or that non-vaccinating parents are leeching on herd immunity. But that’s just my experience.

Paul @ 84, I appreciate that you looked at the study ( I tried your link but it didn’t work). I maintain that just because they state one! Limitation of the study (there are many) doesn’t really make it any more valid. Denmark also changed the diagnostic code (for autism diagnosis) which would have further raised the rates. Pediatrics didn’t quantify the effect of them adding in older children to the study as well. Safeminds did a good summary of the problems with this study that supposedly “exonerates mercury”.
http://putchildrenfirst.org/media5.16.pdf

Jen, the “putchildrenfirst” website is not considered a reliable or credible source (and it is a broken link). Since we were rejecting Generation Rescue, why would you think that a site that says on its “about us” page?:

This site was created by the parent-founders of Generation Rescue, an all-volunteer organization of more than 300 families dedicated to sharing the truth about the cause and treatment of autism. Comments can be sent to: [email protected].

You were asked to provide credible critiques from qualified persons by supplying the journal, title, date and authors of the review. You may provide either the PubMed link, or the PubMed identification number.

One criteria that should help you figure out if it is acceptable is to limit your sources to those that can be found in a medical school library. Thank you.

Also, this is the link Paul was using (you just have to remove the “rel =” bit):
http://pediatrics.aappublications.org/cgi/content/full/112/3/604

MESSAGE————————————————

Shills and Minions,

Do you not see what is going on? I suppose that I might as well let you in on the delicate negotiations that the good doctor and I have been engaged in for some time now.

Of course, our Dr. Jay sees all of you in your bespoke Porsche Panamera Turbos, wearing your Rolexes and Dolce & Gabbana goatskin motorcycle leathers. But know this: it’s not the unending shower of PharmaWealth that draws him time and time again to suffer abuse in our little circle. No shills and minions, it’s love and acceptance.

Do you not see how he lights up at Orac’s merest mention of his name? I know how he feels. This means far more to him than the money, accolades and fawning of fickle, vacuous and self-absorbed celebrities. No shills and minions, it is the love and acceptance of his peers, nay, his scientific betters that attracts him to the heart of the Corpus.

But change takes time. Humans are delicate. It’s not a shopping spree at Carolina Herrera, a suite at the George V or front row seats to the Oscars™ he wants. These are but hollow and empty things to him. What he wants is more . . . human. It’s a lively and argumentative dinner with minion Bacon. Perhaps a merry game of badminton with Minion Wombles and family. Or a holiday spent side by side with our cybernetic host in the lab. It’s an honored place at the table at the Orbital HQ Summer Picnic and Phuntime Pharmarama™ he wants.

He’s moving towards our side in increments perhaps too small for your eyes to see, but move he does. So, forgive my intrusion into the thread, I offer no science or statistics to aid you in your battle. I don’t know, maybe it’s the reptiloid hormonal flush of a middle-aged despot with another batch of hatchlings on the way, but life can’t always be about profiting off planetary subjugation and drugging large swaths of populace. Maybe, just this once it could be about helping one struggling monkey to find his place in the vast, cold reaches of an uncaring universe.

Or maybe just eating him, I’m feeling awfully indecisive these days.

Carry on Shills and Minions, carry on . . .

Lord Draconis Zeneca, VC, iH7L

Forward Mavoon of the Great Fleet, Suzerain of V’tar and Pharmaca Magna of Terra

PharmaCOM Orbital HQ

0010101101001

—————————————— MESSAGE ENDS

“It’s impossible to prove a negative.”

Another little gem from the ‘scientists’. Too bad its completely wrong.

To play devil’s advocate, there are some circumstances where it is possible to prove a negative.

The easiest way is to prove an affirmative which contradicts the negative; I can prove the negative “Paul Smith was not responsible for the death of John Johnson” if I show that John Johnson is alive.

The other, more difficult way is in those circumstances where a true exhaustion of the possibilities is feasible. If I am looking for an elephant the size of my entire backyard, I only have to look briefly before I can say “no, the elephant is NOT in my backyard.” Either it is taking up the whole of my backyard or it isn’t there; in that circumstance the negative can be proved.

It should go without saying, however, that real-world circumstances are almost never this tidy, and outside those tidy circumstances, demanding proof of a negative is an unreasonable demand.

“give us ONE example of a negative that has been proven and how.”

Perhaps you’re right. I guess then proving that vaccines don’t cause autism is impossible. Therefore, by your argument, there exists the possibility that they do. Does the Orac know you are propounding that vaccines might cause autism?

@Antaeus Feldspar: Thanks – I concede that in very narrowly defined circumstances with few possible options it is feasible to prove a negative – and I suppose in theory it is possible to prove every negative via exhausting every other positive. I suppose I was thinking in practical and meaningful terms where proving a negative is rarely (if ever) so neat and tidy.

“I suppose in theory it is possible to prove every negative via exhausting every other positive. I suppose I was thinking in practical and meaningful terms where proving a negative is rarely (if ever) so neat and tidy.”

A valiant attempt at recovery, but you are still wrong, and no, it isn’t possible to prove every negative by exhausting every other positive (whatever that means). Some things are provable, others are not. It has nothing to do with – or +. Using your logic, I guess all those negative medical test results aren’t practical or meaningful? I fear for science if even simple logic seems to so easily confuse scientists.

Some things are provable, others are not. It has nothing to do with – or +. Using your logic, I guess all those negative medical test results aren’t practical or meaningful? I fear for science if even simple logic seems to so easily confuse scientists.

Someone (not you) correct me if I’m wrong, but it seems to me that your definition of “proving a negative” is wrong.
A negative test result is not proving a negative. I would have to say that is not proving a positive.

@130 Lord Draconis,

I’m still waiting on Dr. Jay to come back to Countering and explain why RFK’s piece was so brilliant. It must have struck him dumb the more he thought on it, so brilliant was it.

My dearest Lord Draconis, Grandest of Mavoons,*My* Suzeraine,

As you know, I have been working my long, perfectly manicured, delicate fingers to the bone ( please don’t take that literally : it’s a metaphor) for you. Your unencumbered generosity has proven to be beyond my wildest imaginings: despite your hectic life- conquering planets, implementing forced vaccinations, persecuting brave maverick doctors, and showing *less dedicated* minions and shills the error of their ways- you always manage to find time to acquire a *little trinket* for me. A perfect trinket. For this, I am eternally grateful, love.

Today I spent the afternoon in the most rarified atmosphere of the British Art Center @ Yale: I contemplated the lovely portraits of elegant, similarly compromised ladies of fashion. Paintings of great estates. Landscapes. Suddenly, it all became clear to me! I need a Turner! Just a small one. A trifle. I have served PharmaCOM Orbital and your majesty tirelessly for years! A Turner. Only one. A fuzzy one will do.

Your gracious Lordship will truly show mercy on me in my hour of need. My great need. I bow before your magnificent scaly majesty, in awe and wonder, contemplating your wisdom and unparalleled, universally-recognized perfection.

Your humble servant,DW

Methinks, the person who cannot consistently spell is own ‘nym just got caught up in his/her own challenge! If “Proving a negative is one of the most fundamental rules of logic”, then why doesn’t Gl*xologist do it?

Or are we seeing a true argument from ignorance in action?

“Methinks, the person who cannot consistently spell is own ‘nym just got caught up in his/her own challenge!

Meknows the misspelling was yours as I copied it directly from your comment above.

“If “Proving a negative is one of the most fundamental rules of logic”, then why doesn’t Gl*xologist do it?”

I just did, yet you didn’t seem to realize it. It is trivial to prove the phrase ‘you can’t prove a negative’ is false since if it was proved true, the phrase, being a negative itself, would be false. This is a proof by contradiction. It proves the statement ‘you can’t prove a negative’ is false. How much clearer can I make it? Its like if Pinochio were to claim “My nose will be growing’.

“Or are we seeing a true argument from ignorance in action?”

Indeed, I think we are.

@150 – that should be Sunday Edition

As I understand it, autism spectrum disorders are the result of the brain being wired differently. That is, the ASD child processes information differently than normal children do. As far as I know, the type, degree, and depth of this mis-wiring is such that it occurred prior to birth. That is to say, in fetal development. While a very young child’s brain is still largely in development, that sort of development we’re talking about in these cases occurred well before the child received any vaccines, or could even be considered for vaccines.

In short, based on what I know, vaccines could not have had any effect on brain development in the fetus, and if mercury was involved it would have to be from exposure to the mother and to such a degree that the mother would show signs of mercury toxicity herself.

This means that a two year old child is too old for vaccines to be the cause of what is most likely a pre-existing condition.

@130 Lord Draconis,

I’m still waiting on Dr. Jay to come back to Countering and explain why RFK’s piece was so brilliant. It must have struck him dumb the more he thought on it, so brilliant was it.

Another idiot troll proves the rule – “when you can’t argue facts, argue semantics!”

Glaxi person:

Meknows the misspelling was yours as I copied it directly from your comment above.

Actually, I copied directly from yours in #139. But you are just playing silly games, and shall be an ignored semantic troll.

I love how Dr. Jay drops drive by comments concern trolling while still ignoring the basic questions asked in the original post.

So Dr. Jay, when are you going to answer these questions?

What specific scientific evidence do you have to support your claim that the current vaccine schedule is unsafe?

What specific scientific evidence do you have to support your claim that vaccines cause autism?

What specific scientific evidence do you have to support your claim that vaccines cause asthma and all the other problems that you attribute to them?

Until you answer these questions any comments you post are just pissing into the wind, which you seem to enjoy.

DrDuran

As a casual reader (non-doctor, non-expert), Dr. Gordon seems more like an internet troll than a medical professional. He’s really good at it too.

But as an observer, he does come off a little wacky. Especially the “wait until you see I’m right” thing.

-bill

An imperfect analogy: A patient shows up in the office, with a large painful knot on his forearm. Hmmm, looks like a ruptured biceps tendon. But just in case, I get a stat Doppler to make sure it’s not, also or instead, a DVT. It’s negative, for which I’m very happy, assume that he is also happy, and we get him to orthopedics for repair. But he’s all bent out of shape, doesn’t want to see me anymore, because the “stupid NP didn’t find anything.” Do people not understand that, very often in medicine, a negative finding is something to be happy about? Actually in this case, multiple negative findings. Vaccines do not cause autism! Yay! We can protect our children without worrying about that particular consequence!

Complete figures for 2009 Notifiable Diseases Incidence (MMWR August, 2010); 16,858 pertussis cases reported in the United States (includes the 869 pertussis cases in California). 2010 figures for Notifiable Diseases Incidence will not be available until mid-summer 2011 from the CDC.

The California Department of Public Health (CDPH) issued new recommendations in July, 2010 when only 5 infants had died from pertussis (Available on the web at “CDPH Pertussis Immunization Policy”).

The “CDPH Pertussis Report January 7, 2011” reports 8,383 confirmed, probable and suspect cases of pertussis including 10 infant death’s. Nine of the ten infant deaths were in infant too young to have received the primary series of immunizations against pertussis.

So what does Jay Gordon MD FAAP, have on his web page today about vaccines in general?

“In my office, with families I know well, I believe the main idea I convey is that we should vaccinate later and slower. One shot at a visit starting later in the first year and perhaps in the second year of life. I have many children in my practice whose parents have chosen to give their children no vaccines.”

And, what does Jay Gordon MD FAAP have on his web page today about pertussis vaccine?

“Chickenpox vaccine was invented during the 1970s to protect high risk children against varicella severe complications. Natural disease immunity might have been better than that achieved from the shot. My take on this is to try to get your child natural chicken pox for 4-5 years and then get the shot later if you’re unsuccessful.”

I suppose Dr. Gordon is still “working from within the AAP” to change immunization policy.

Natural chickenpox immunity is better because it comes with bonus shingles, no extra charge.

@LW:

Natural chickenpox immunity is better because it comes with bonus shingles, no extra charge.

I recall reading that the attenuated chickenpox vaccine can also cause shingles, but less often and with less severity than the wild-type strain.

Dr. Jay Gordon MD FAAP on his website acknowledged the pertussis outbreak in California and the death of 5 infants as of June, 2010.

Dr. Gordon’s posting on June 25, 2010, begins “California declared a pertussis epidemic this week”

Further down in his posting he states:

“DTaP vaccine prevents whooping cough and may even prevent illness or lessen the severity of illness after the first vaccine. The routine schedule includes 3 doses in the first six months of life, a fourth at eighteen months of age, a fifth at age five and boosters doses of a new adolescent/adult vaccine. I don’t think your babies under a year of age should be given any vaccines, including this one…..The CDC and most doctors, including my colleagues in this office disagree…I do not recommend this vaccine for infants unless there are unusual risk factors in a baby’s life…Again the vast majority of experts disagree and I understand the need for public health considerations and preservation of herd immunity, but still would rather vaccinate only after 12-24 months of age and feel comfortable, in most cases, giving no vaccine at all.”

Yes, Dr. Gordon, most of your colleagues in your office disagree with you regarding this vaccine, as do “experts” at the CDC, the California Department of Public Health, the AAP and…I presume, the parents of the ten infants who died from pertussis infection.

Dangerous Bacon: Your post makes no sense at all. Again, not like you.
I give vaccines.
I give them later and far slower than most doctors.
I support parents’ rights to have no vaccines at all given to their children.
Vaccines are discussed at every single visit in my office.
I think that the current vaccine schedule is not the best we could do. I claim no proof for this.
What is unclear about that?

Pablo . . . all my patients know what the CDC/AAP and others recommend.

Matthew, thank you.

Lilady: Dig deeper into the cases you’ve mentioned. These tragedies were probably due to inadequate health care given to certain under-served parts of California’s population.

Jay

Lord Draconis,
I continue to await the good doctor’s return to Countering for an explanation of why RFK was brilliant. Perhaps he might like to visit the blog on how the granddaddy of all vaccine textbooks by Plotkin, Orenstein, and Offit has grown over the last two decades or the blog on Novella’s excellent lecture series; there’s lots of illuminating information there for him that he’s obviously missed out on. Or even gander at the youngest Wombling’s Raspberry drawings and bask in her dreams of peace?

Alas, I think Dr. Jay is too busy with his flu patients. We’re still waiting to hear from him if that’s because he failed to recommend immunization.

And Dr. Jay, I understood Dangerous Bacon perfectly.

🙂

I give vaccines.
I give them later and far slower than most doctors.

You also give them reluctantly:

http://scienceblogs.com/bookclub/2008/10/finally_science_pushes_back_ag.php#comment-1135651

Quote (from you):

gave a half dozen vaccines today. I gave some reluctantly but respected parents’ wishes to vaccinate.

In other words, apparently some parents had to drag you, kicking and screaming, to vaccinating their children. Why on earth would you be “reluctant” to give vaccines, Dr. Jay?

Then there was this gem from Dr. Jay (http://www.sciencebasedmedicine.org/?p=301):

I don’t give a lot of vaccines.

I still give DPT vaccinations to some children, chicken pox shots to kids who haven’t been able to acquire natural immunity by age ten years or so, and I give polio vaccines very infrequently. The polio vaccines are given for what I call “emotional” reasons because my exposition of the “numbers” (2000 cases of polio out of six or seven billion people) doesn’t counteract the very strong memory of a beloved aunt or uncle who had polio in fifties or sixties. And many parents feel much more comfortable traveling to India or parts of Africa with updated polio immunity for their children and themselves. By the way, 2007-2008 statistics don’t support that discomfort, but I don’t argue much.
In 2007, there were 1314 cases of polio on the planet and 127 of them were in “endemic” countries: 873 in India, 285 in Nigeria, 41 in the Congo, 32 in Pakistan and 17 in Afghanistan.

Yep. Overall, Dr. Jay’s attitude is that he doesn’t trust vaccines and poo-poos polio.

Here’s Jay Gordon on what immunizations he gives, commenting in this RI thread (post #293):

“My vaccine schedule? Either none or just a DPT in the first 24 months of life. I think that there’s a greater risk vaccinating males under 24 months and would prefer not to unless there are special circumstances. I use very few other shots except the Varivax as a child approaches ten years because teen and adult pox are nasty and even a little dangerous especially during pregnancy. I give Hep B vaccines to nursing student/moms and dads, other medical moms and dads and higher risk teens and college kids.”

So, we have you admitting that you give very few vaccines, one of those few is given according to a suboptimal schedule, and you give vaccines “reluctantly”. That’s a far cry from your current line, “I give vaccines.
I give them later and far slower than most doctors.”

Do try to keep your stories straight. And think about being upfront with your patients’ families (and potential future clientele), by acknowledging your non-evidence-based practices on your website (since you claim to be losing gobs of money on that site due to having to pay others to maintain it (and are soliciting contributions from the public to help out), at least get your money’s worth).

Note to Lord Draconis: I will be submitting an extra-large expense request this month to my Pharma Overlords, based on how long it took me to dredge up Jay’s “vaccine schedule” quote. And please stop stamping my checks “Filthy Lucre”. They’re starting to ask questions at the bank.

Oh, I love using Dr.Gordon’s website for his “feelings” about vaccine-preventable diseases and the reasons why he doesn’t give vaccines in the first year…or two…or ever.

Yes, Dr. Gordon I have “emotional” reasons about polio having a close childhood friend die of it, before the Salk vaccine was developed. Measles? I have “emotional” reasons about
this vaccine-preventable disease as well because of a cousin who developed measles encephalopathy.

More recently, I have “emotional” reasons about Pertussis having seen infants die of it, when I worked in public health.

Posters here need only visit Dr. Gordons website to make a determination about his vaccine “feelings.”

Wait, even if a child is travelling to parts of the world were polio is still endemic, he’s still reluctant to give them the polio vaccine?

Drvebyposterz: your comments make absolutely zero sense given that the vaccine issue has become political, not scientific. Pharma has pretty much put the screwS to most people who dare try and publish anything that shows a problem with vaccines or their ingredients. Keep on driving.

Jen @ 190: The absence of evidence that vaccines are injurious is proof that there is a conspiracy to hush up the injurious nature of vaccines.
There are words for this form of reasoning but they are not flattering.

jen: “Pharma has pretty much put the screwS to most people who dare try and publish anything that shows a problem with vaccines or their ingredients.”

Let’s hear it for Those Who Dare.

And may this be their theme song.

Dr. Gordon,
As you and Prometheus discussed, the word “wrong” is a relative term, not an absolute. You believe that many things that are current science are wrong in the most extreme extent. Could you name some and why you think they are wrong?
Thanks in advance.

“Could you name some and why you think they are wrong?”

You seem to have read only the first four words of the question.

“Pharma has pretty much put the screwS to most people who dare try and publish anything that shows a problem with vaccines or their ingredients.”

Citation needed.

@197: Could you support any one of those claims with evidence?

I am culling through the above posts for any common sense.

Polio is endemic to India. Last year there were 42 cases among the billion Indians. Someone please compute the likelihood of coming in contact with one of those patients. Nonetheless, I do vaccinate people going to India. Not for medical indications, because they’re more likely to be killed on the car ride to the airport, but because it’s a reasonable thing to do.

http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx

Lawrence, your post barely requires a response. But . . . no, I just can’t.

Dr. Jay,

I can’t tell you the number of times I’ve read comments by you here where I seriously hoped someone else had posted under your name.

I’m no longer convinced you could recognize common sense. There was plenty offered here and concern over your position. You didn’t defend your position. Is there some reason for that?

Which diseases would you let children get since you “think it’s wrong to vaccinate against an illness just because . . . we can”?

Jay – I stand by my post. I’m sorry if I’ve offended you, but in all honesty, you’ve taken a serious step off the deep end.

You’re against vaccinations, you’re against laser eye surgery, & you think it is perfectly fine for babies to be exposed to potentially life-threatening diseases – because “you can.”

If I had a choice, I would have elected not to be exposed to Chicken Pox – guess what, it really sucked. Now I have a chance of getting Shingles when I get older & I’ve seen those that have had it – and again, it sucks.

You’re making medical (and I would barely call what you do or what you recommend to be “medical” in anything but your own mind) recommendations to impressionable parents that could ultimately injure or even kill their children.

Given that you’re in California – and in the front lines of some of more recent major upbreaks of childhood diseases (including the San Diego measles outbreak) how can you possibly recommend to parents that they allow their children to be exposed to these dieases naturally? I’m sure you’re absolutely fine with any one of them coming down with one of these diseases, and if they roll the dice and happen to be one of those who are either blinded, rendered sterile, or suffer some other form of diabilitating injury, well, that’s the breaks, right?

The science supports vaccination – from even before there was a “Pharma” industry. You are, for lack of a better term, pro-disease. Of course, since you make far more money from treating the diseases, as a doctor, vaccines aren’t in your best interest anyway, are they?

And since you’re also not in favor of disease eradication – and again, why is that? Tell me please, how badly do you want Smallpox to return? Tell me how many more cases of measles, mumps, rubella & polio do you want to see?

Thank you for making it abundantly clear that you are in favor of more diseases, more children being sick – and against any sort of rational health care for children. I’m surprised you haven’t been reported yet – because you sure as hell aren’t a doctor.

What has happened, that the medical profession can’t yank the license of an anti-vax pediatrician with a mass media presence? How can this unholy situation be fixed?

why should eyes be off the table?

Because they should be inside of eye-sockets, not on top of tables.

*ba-dum-ching*

Jay Gordon: “I am culling through the above posts for any common sense.”

I repeat my earlier question @166 on why distributing vaccines with a preservative was “Not the safest way to do things”, and it is safer to increase the risks of infection and difficulties of distribution by taking the preservative out. Not enough common sense?

Bacon–Good points.

Suggesting things–without quotation marks around “wrong–may have confused you all. Please reread it with the implied “–”

Jay

Dr. Jay,

Fuck you!

I wore glasses and contacts for more than 30 years before getting LASIK surgery a few years ago, people don’t get corrective eye surgery “just because we can” they get it so that they can see. My vision was 20/850 in one eye and 20/960 in the other, now it’s better than 20/20 in both. Before LASIK I couldn’t get out of bed to use the head without finding my glasses, now I don’t need them at all.

You’re an idiot and a fraud, with any luck you’ll be out of business soon.

@jen – 190

Capitalizing the “S” st the end of screws really made your point…NOT!

The tone of my posts last evening was a bit harsh – but Dr. Jay’s flippant remarks (and continuing not to answer direct questions, repeatedly), plus a review of his website (the FAQ seems harmless enough, until you start reading about his vaccine recommendations – quoting a bunch of disease statistics, then saying its no big deal) really got to me.

I still can’t believe this man is a doctor – because based on my experiences with my own pediatrician, he comes across as heartless & dangerous to new parents.

Dr. Jay,

Next time Jenny brings Evan in, tell her you can’t support injecting Botulism toxin into her face just for vanity. Have you compared the LD50 of the Botox she uses to that of thiomersal or formaldehyde that you both freak out over?

“Bacon–Good points.”

Still awaiting responses, Jay.

Just…as a totally unrelated side question, what exactly does it take to get someone’s license to practice medicine revoked?

Do they need to kill someone with their own two hands?

Or can they just display a total disregard for the safety of their patients.

Jay Gordon sez:
It’s wrong to use psychopharmaceuticals in children as we do now in 2011.

If a child has bipolar mood disorder, the people around him/her should just learn to deal with it, right? I went to school with a gal who had that. Her medication need shifted just a teensy tiny little bit . . . and she was a complete wreck until that got sorted out. Need *inpatient* care until they could get the new dose right.

Yeah, psychoactive drugs are overprescribed, but to suggest it’s wrong to use them in children? Obviously, you haven’t had many kids with major psychological problems (which would raise the question of why you purport to know something about autism, but that’s another matter).

It’s wrong to perform eye surgery electively for refractive errors. (Not sure I used good terminology there.)

Really? I wear eyeglasses. Nearly all of my relatives wear eyeglasses. A few are trying out LASIK and other refractive eye surgery, most recently my brother-in-law. It has changed their lives. They have gone from requiring a prosthetic to being like any other normal person.

And then there’s a friend of mine who is legally blind. Glasses are no help. He has a congenital defect of the eye. He *could* have had refractive surgery to improve things to the point where he could manage on coke-bottle-thick glasses, like his mother. However, although his mother was able to get it done on insurance, by the time he got old enough for the procedure, it was deemed “elective” and insurance would not cover. He cannot afford it out of pocket. It would be nice if he could get it now in conjunction with his upcoming cataract surgery, but too many people think exactly like you do, Jay, that seeing clearly is a luxury, not a medical need.

Try going without glasses for a day when you can’t even recognize a person standing ten feet away. (That’s my vision, not his — his vision is so poor he needs a cane. I’m not quite that bad, and with my glasses I’m 20/20.)

Refractive surgery, when successful, means you never have to worry about becoming temporarily disabled (i.e. blind) because somebody sat on your glasses by accident, or worse, because your house burned down and you couldn’t find the glasses as you evacuated. Friend of mine’s house was destroyed in a tornado; they never did find his daughter’s glasses and had to get a new pair for her.

I’m too chicken to get refractive surgery; I’ll just come right out and say that. Eye surgery freaks me out. But everyone that I’ve ever talked to who had it done wished they hadn’t waited as long as they had. Yes, there have been problems, and probably the biggest has been the proliferation of woefully undertrained practitioners in storefronts. (If you want it done, go to an actual opthamologist, preferably one who has been doing it for a long time.)

It’s wrong to create a “war on germs” using hand sanitizers.

Duh! Science agrees! What’s your point, then?

I think we’ll find we are wrong in the way we measure and treat certain types of thyroid hormone conditions.

That’s a hunch, not an example of science being wrong. It’s also about as clever as saying you think there might be a flood this coming spring — while not absolutely certain, it’s extremely likely. It’s darn near inevitable that scientists will find ways to improve on current practice. So what, exactly, is your point?

It’s wrong to use statins as we do now.

And you know this . . . why? How do you think they should be used? What’s wrong with current practice? I’m not saying this to refute you, just to show that this isn’t much of an argument by itself.

And, I think it’s wrong to vaccinate against an illness just because . . . we can. We should be more judicious in our use of this medical intervention.

Given that Americans do not routinely vaccinate against yellow fever, I think it’s pretty obvious scientists don’t recommend vaccinating just because we can. Hell, when’s the last time you gave a rabies vaccination to a schoolkid who has never been exposed to rabies? You’re saying science is wrong for something that science doesn’t claim. The things that the CDC recommends vaccinating against are not merely because they can. There are actual reasons, and you really have no excuse whatsoever for not knowing them.

@Jay Gordon:

Suggesting things–without quotation marks around “wrong–may have confused you all. Please reread it with the implied “–“

Argh! What does wrong-in-quotation-marks mean?

Argh! What does wrong-in-quotation-marks mean?

I would assume it to mean someone else says it is wrong, but he doesn’t really believe it is so it is “wrong”? That is how I would read it except then it doesn’t make *any* sense (but it’s Dr. Jay, and making sense is not one of his strengths).

He’s backpedeling because people called him out on his foolishness. Just like he did when he was quoted as saying children shouldn’t receive any vaccines before 24 months. He didn’t make sense then either.

What does wrong-in-quotation-marks mean?

Weaseling room for Jay Gordon when he is shown to be full of shit as usual.

When you have no steak to sell the sizzle is very important.

Dr. Jay Gordon is likely more informed about marketing than you lot. The public do not listen so much to the words as to the status and style of the speakers.

Dr. Jay is here to enact a “debate” with the “scientists” so he may stand shoulder-to-shoulder with his peers before the public.

If a child has bipolar mood disorder, the people around him/her should just learn to deal with it, right? I went to school with a gal who had that. Her medication need shifted just a teensy tiny little bit . . . and she was a complete wreck until that got sorted out. Need *inpatient* care until they could get the new dose right.

Yeah, psychoactive drugs are overprescribed, but to suggest it’s wrong to use them in children?

You should read the book I mentioned @ #225.

Second try with the link: Chrysalis

Salty Current — I’ve got such a long reading list right now that there’s basically zero chance I’ll get to that book. So in lieu of directing me to a book I’m unlikely to read, what is the argument you’re making?

The single biggest problem with psychoactive drugs in children is that they are not adequately studied, frequently to the point that they are not approved for pediatric use. This leads to the second biggest problem — it encourages off-label use by normalizing it. Off-label use isn’t, in and of itself, a problem, but if doctors are using drugs off-label more often than not, there’s clearly something wrong, and doctors can become so used to it that they start feeling that the manufacturer’s instructions are really only guidelines and they can be more creative with them. That’s where you start getting kids without serious problems on antipsychotics meant for adults — or kids with autism taking Lupron.

So clearly, there are problems with the system (such as it is), but that doesn’t mean, as Jay seemed to be implying (he’s free to clarify, of course, but he hasn’t yet), that psychoactive drugs are never appropriate for children. It also overlooks that there ARE drugs which HAVE been studied in children, and for which ample prescribing information is available. The much-reviled methylphenidate (Ritalin, Concerta, etc) is actually a good example, and it is available in many formulations intended specifically for children. First synthesized in 1944 and identified as a stimulant in the 50s, it started being used in children in the 1960s. This is a rare case of a psychoactive drug with safety and prescribing data on children going back fifty years. It’s pretty hard to beat that.

Salty Current — I’ve got such a long reading list right now that there’s basically zero chance I’ll get to that book. So in lieu of directing me to a book I’m unlikely to read, what is the argument you’re making?

You really have to read it. You can also hear him talk about it here:

http://www.c-spanvideo.org/videoLibrary/event.php?id=184523

(Warning: He has a distracting nervous tic.)

He doesn’t speak much about children at this talk, but it’s a large section of the book, much of which appears to be available in the Google Books preview. He presents evidence from the scientific literature that the drugs are ineffective, have bad side effects, and lead to terrible long-term outcomes.

This is a rare case of a psychoactive drug with safety and prescribing data on children going back fifty years. It’s pretty hard to beat that.

Read the book.

He presents evidence from the scientific literature that the drugs are ineffective, have bad side effects, and lead to terrible long-term outcomes.

Pardon me for being reflexively skeptical of anyone who paints “psychoactive drugs” with that broad a brush.

Our Gracious Host and I have plenty of experience on MHK with that general line and the signature is pretty distinctive. Not conclusive, but strongly indicative.

Pardon me for being reflexively skeptical of anyone who paints “psychoactive drugs” with that broad a brush.

This has become a bizarre conversation. I was asked by someone spouting off on a subject but unwilling to read a recent and comprehensive work on the topic to summarize the arguments from one section (relevant to the topic under discussion), which I have. I’m suggesting that people read the book, and is easy enough to do. People (who apparently won’t even take a moment to google) are actually talking about the guy’s name. They’re making Dr. Jay’s “years of clinical experience” look good by comparison. I’m sure the book, as pretty much every book, is flawed in many ways, but there is no point in discussing its argument or evidence with people who haven’t read it.

Here are some citations:

http://www.robertwhitaker.org/robertwhitaker.org/Children.html

They can really only be fully addressed in context, though.

Thanks but I’ll pass on anything by Robert Whitaker, CCHR shill.

*sigh*

Salty Current,

I was asked by someone spouting off on a subject but unwilling to read a recent and comprehensive work on the topic to summarize the arguments from one section (relevant to the topic under discussion), which I have.

And now you just out-and-out lie. You have not presented a single argument in this thread, unless you consider citing a book an argument?

You claimed that studies showing the ineffectiveness/danger of psycho-pharmaceuticals have been ignored. That’s a damn big claim to make without giving a single shred of evidence.

On SSRIs, e.g.:

The story of research into selective serotonin reuptake inhibitor (SSRI) use in childhood depression is one of confusion, manipulation, and institutional failure. Although published evidence was inconsistent at best, use of SSRIs to treat childhood depression has been encouraged by pharmaceutical companies and clinicians worldwide. Last month, the Canadian Medical Association Journal revealed excerpts from an internal GlaxoSmithKline memorandum demonstrating how the company sought to manipulate the results of published research. Concerning a study of paroxetine use in children, the memorandum states “It would be unacceptable to include a statement that efficacy had not been demonstrated, as this would undermine the profile
of paroxetine”. Last year the UK Committee on Safety of Medicines prohibited the treatment of childhood depression with any SSRI except fluoxetine. Despite this, the Food and Drug Administration in the USA appears last week to have failed to act appropriately on information provided to them that these drugs were both ineffective and harmful in children.

In a global medical culture where evidence-based
practice is seen as the gold standard for care, these
failings are a disaster.

From CCHR shill, The Lancet (2004).

I’m trying to figure out why this refutes what I was saying, which is that there are big problems in how psychoactive medications are given to children BUT this should not be taken to mean that no psychoactive medications should be given to children. Heck, the article you quote is talking about problems with paroxetine, but suggests it is acceptable to use fluoxetine.

It says that it wasn’t prohibited in the UK at that time (I don’t know what the regulatory situation is now, but research since suggests that doctors weren’t in fact prescribing this as a substitute after the prohibition of the others). But in fact, the next item at the link I provided @ #250 is from the BMJ, whose conclusions are accurately summarized by Whitaker:

After reviewing the outcomes literature, researchers concluded that clinical trials did not provide evidence that SSRIs, including fluoxetine, were safe and effective in children and adolescents. As such, “recommending (any antidepressant) as a treatment option, let alone as first-line treatment, would be inappropriate.” [my emphasis]

You’re simply wrong in your claims that the problem is that for children research doesn’t exist for some, but that extensive evidence exists of efficacy and safety for others.

Read the book.

To yank this discussion back to Dr. Jay: his current position that any tweet that links to a video in which Dr. Offit appears must also include a disclosure of Offit’s putative COI

What started it off? I sent:

Why do we vaccinate against HIB? http://youtu.be/xNbVjCdvrdA

the URL is to one of CHOP’s excellent series on vaccination for expectant / new parents, “Vaccines and Your Baby”.

Jay responded:
RT @lizditz: Why do we vaccinate against HIB? http://youtu.be/xNbVjCdvrdA Video link to Paul Offit MUST have Conflict of Interest info

I responded with

.@JayGordonMDFAAP believes that anytime one mentions CHOP or @DrPaulOffit a COI disclosure required. Fine. http://bit.ly/e50ujA #vaxfax

the link is to my blog, in which I published Dr. Offit’s statement about his vaccine royalties and my own disclosure

and I went on to tweet:

are you confused, @JayGordonMDFAAP ? why should the rotavirus vax inventor have a COI disclosure for a different vaccine? #vaxfax

and then:

Be fair @JayGordonMDFAAP Where’s your demand that Bob Sears divulge his royalties from Vaccine Book, speaking enagements? #vaxfax

crickets on the last one, but this morning

From Dr. Jay:
@lizditz: Why should the vax inventor have a COI disclosure for a different vax? Dr. Offit makes his living with vaccines-should disclose

The bad guys are always making a big deal out of “chemical imbalance,” as if this short-hand were some sort of evil misdirection. Meh.

Salty you say Whitaker is not opposed to biological interventions for mental disorders. Name one he supports.

They’re all biological. Humans are living organisms.

That’s avoiding the answer.

How about “biochemical?” Or “medication based?”

This whole conversation has been very strange for me. The day before I started Anatomy of an Epidemic I read Ben Goldacre’s Bad Science (which I also recommend to anyone who hasn’t yet read it), and was reminded by it how tragic the results of bad, manipulated, or ignored/suppressed science can be. I didn’t know anything about Whitaker’s thesis until I saw him several months ago on BookTV, but it did catch my attention. I would have expected that people would want to investigate a possible problem of these proportions (these drugs are being given to children in huge numbers), even if they conclude differently in the end. Instead, this has largely concerned these weird ad homs about Whitaker (and, to some extent, it seems, me). Very, very strange.

:/

Here is a 13-page article on the topic published by Whitaker in 2005 in Ethical Human Psychology and Psychiatry:

CONCLUSION

A century ago, fewer than two people per 1,000 were considered to be “disabled” by mental illness and in need of hospitalisation . By 1955, that number had jumped to 3.38 people per 1,000, and during the past 50 years, a period when psychiatric drugs have been the cornerstone of care, the disability rate has climbed steadily, and has now reached around 20 people per 1,000. (Table 2). As with any epidemic, one would suspect that an outside agent of some type-a virus, a bacterial infection, or an environmental toxin was causing this rise in illness. That is indeed the case here. There is an outside agent fueling this epidemic of mental illness, only it is to be found in the medicine cabinet. Psychiatric drugs perturb normal neurotransmitter function, and while that perturbation may curb symptoms over a short term, over the long run it increases the likelihood that a person will become chronically ill, or ill with new and more severe symptoms. A review of the scientific literature shows quite clearly that it is our drug-based paradigm of care that is fueling this modem-day plague.

I haven’t got past the “plague” part; I don’t know how much more detail the book provides, but he states in one part:

Up until the 1950s, the number of hospitalized mentally ill provided a rough estimate of this group. Today, the disabled mentally ill typically receive a disability payment either from the Social Security Disability Insurance (SSDI) program or the Supplemental Security Income (SSI) program, and many live in residential shelters or other subsidized living arrangements. Thus, the hospitalized patient of 50 years ago receives either SSDI or SSI today, and this line of evidence reveals that the number of disabled mentally ill has increased nearly sixfold since Thorazine was introduced.

He doesn’t mention, however, that SSDI did not become law until 1956. One could state that the willingness to diagnose someone as disabled mentally ill has increased since the method of treating the mentally ill has changed from hospitalization to disability payments?

I figured out what’s wrong here. This is all a bunch of words games for you. Pseudonyms and pseudoscience. Orac, Prometheus, Dangerous Bacon. it’s all about semantics, perseveration, and monolithic “science.” For me, it’s my daily life.

The ideas of reference?

Dr. Jay rejects the scientific consensus concerning vaccines because he is good.

The doctors here accept the scientific consensus because they are bad and only interested in “word games.”

Got it, Dr. Jay.

If Mr. Whitaker’s book fails to represent the scientific consensus it can be safely ignored.

Of course you have no idea, since you haven’t read it. You’ve neither addressed the science nor engaged with the citations I’ve presented. Your comments have been oddly perpendicular to any substantive discussion, and can be safely ignored.

***

I don’t know how much more detail the book provides,

A significant amount, including about SSI/SSDI (which is no doubt a factor but wouldn’t account for the other indicators he notes there in the introduction in any event). The book presents a documented discussion of this timeline beginning prior to the 1950s, including specifically with regard to children. There are some elements it doesn’t discuss in depth enough for my taste (I don’t know if his previous book did), but it adds other pertinent ones.

***

I had said, “It’s wrong to use psychopharmaceuticals in children as we do now in 2011.”

Calli, you’re dishonest person. Simple.

Your wording was ambiguous at best. It could be read as “use psychopharmaceuticals in children, as we do now” – so all psychopharmaceuticals – or with “as we do now” referring to the specific practices or extent.

I figured out what’s wrong here. This is all a bunch of words games for you. Pseudonyms and pseudoscience. Orac, Prometheus, Dangerous Bacon. it’s all about semantics, perseveration,

You’re a master of projection. As I pointed out way back when, it’s a game to you: “So . . . drop the formaldehyde stuff? OK. Can I have the rest then?”

https://www.respectfulinsolence.com/2008/07/dr_jay_gordon_pediatrician_to_the_stars.php#comment-1010053

and monolithic “science.” For me, it’s my daily life.

No, for you it’s about arrogantly dismissing the science in favor of anecdote and unevidenced pet notions. It’s unethical in the extreme.

For me, it’s my daily life. I’m not the parent of a child with autism but I have cared for hundreds of these families over my career.

DIAF Jay!

I am a parent of two children on the spectrum. I live in the trenches Orac, Bacon, Callie et. al. are the ones educating parents like me. They don’t blow sunshine, or tell me to seek expensive (useless) “alternative” treatments: The truth is better. We don’t know exactly what caused my children to be where they are, but Orac doesn’t tell me to leave them susceptible to preventable illnesses on a hunch. You are a narcissistic ass! You act like your observations are the only proof needed to say all science is wrong; all knowing Jay has spoken.

You act like you are the only one here with empathy for our children? Prometheus has a child (only one? can’t remember) on the spectrum. So what, he doesn’t care as much as you because he knows the science is not there for vaccines being causative? What about Callie? Does she not know as much about it as you?

You don’t live in the real world, Jay and neither do most of your patient’s parents. I know I am being a little tense: I have a kidney stone and am in pain. I have my daughter’s IEP meeting this morning and can’t miss it. I have to wake her up in a minute and bath her before getting her dressed because she took her pull-ups off last night and wet her bed (she is five) I was too tired to do more than change her clothes and sheets. I deal with screaming tantrums from her and/or her brother every day. I can’t pay someone to clean or cook or watch my children. I take them to all therapy appointments and take their little sister (2) along. I feel guilty every day that I don’t get pay her the attention I would like to.

This is my real world, Jay, and the real world for so many parents of children with autism. So don’t you even suggest you know what it is like!

Unlike Jenny, I am not going to whine and cry and say ‘OMG look what the mean, mean pharma companies did to my babies!!!!!’ When we become parents we sign up for good, and for bad. Don’t get me wrong, my children bring me much more joy than pain and the rewards of having them in my life far outweigh the challenges. I just wanted to point out your egregious hypocrisy.

These children have genetic presdispositions to ASD and some of the triggers to autism are iatrogenic in nature.

Everything Orac writes has references. I believe you forgot your citation (maybe there is no hyper link for “pulled this from my ass”).

Good to see Dr. Gordon digging deep into the anti-science playbook with a “denialist” blast followed up by an all-too predictable “pseudonym” shot at Orac of all people.

Dr. Gordon, ask Rene how posting under his real name worked out. In fact, ask Orac how his closely guarded real name (…..) protected him from the idiotic attacks of young master Crosby.

The fact that your anti-science allies make real life attacks on the livelihoods of scientists and doctors who disagree with them should indicate why pseudonyms are necessary.

Of course, you being the champion of civility, perhaps you can work on the attitudes of your anti-vaccine buddies and maybe get them to behave and people might feel better posting under their real names.

Not that it matters, but the primary reason I don’t use my full name is that when I started visiting science blogs during my last post-doc I didn’t feel like having the hr staff at the non-profit tell me to put a disclaimer on everything I say online.

I believe you forgot your citation (maybe there is no hyper link for “pulled this from my ass”).

:). If there isn’t, there should be (maybe a LOLcat…). Hope your day gets better.

Even my dog, cats, and other quadrupeds have pledged to fight tooth and nail for me.

Well, that’s a given.

In fact, I might actually back off and fade into the background if I should ever have children.

I never really worried about it when mine were little (more cluelessness than anything admirable) and now that they’re grown you may see them chime in from time to time.

Grandchildren? Not yet, and besides they’re part of the reason I’m here.

@ Rene Najara: And I applaud you! And support you!( Only not tooth and nail).I know similar stories beyond your own and Orac’s ( and Barrett’s) that frighten me as well.

Personally, I am very cautious : I only comment on sites run by sane, respectable people with whom I’m in agreement and am semi-nymous ( I use 2 of my 4 names; thus, a penultimate rather than pen name).

You see, I has assets. I am familiar with charlatans and assorted cranks going after *homes* as well as jobs. A scientist calls out a crank and writes about it on his blog ( that earns nothing) and is dragged into court twice ( it gets thrown out, twice). Another de-constructs HIV/AIDS denialism and is re-paid by having his family harassed and experiencing interference with his employment.

So, more power to the Mighty Ren! But watch it out there. Charlatans often are assisted by legal teams. Which they obviously need more than do regular people .

D.C., You’re welcome. It was therapeutic, I felt better afterwords. I was just not in the mood this morning for his presumptuousness. 🙂

Salty, Thank you, my day did…a little. The school designated my daughter autistic (her official diagnosis is PDD-NOS) so she will get the help she needs without us footing the whole bill. I really couldn’t ask for more.

I had said, “It’s wrong to use psychopharmaceuticals in children as we do now in 2011.”

So what year would you prefer? Did you like the 1980s better, when we used Mellaril?

Of course that’s a rhetorical question. I don’t expect an answer or a productive discussion with you. I’ve downloaded your web site from the Wayback machine and so understand some of your business interests.

Jay @ 269:

Calli Arcale says: “Okay, so it’s a book arguing that as Jay claims (so I’m unclear how it works against his case as you stated) psychoactive drugs should never be used in children?”

I had said, “It’s wrong to use psychopharmaceuticals in children as we do now in 2011.”

Calli, you’re dishonest person. Simple.

Jay, I understood what you said to mean that you don’t think they’re appropriate in children. As I said before, if I have misunderstood, you are free to clarify. But you don’t; you’d rather go off on a brief rant. I can think of other possible interpretations, but after the way you treated me for posting the evidence needed to back up your claim for you the other day, I’m not really inclined to do you any favors.

I have to run some errands in a few minutes, but…

You read Whitaker’s book so you’re in the best position to answer the question: Does he summarize the scientific consensus?

On what? I’ve provided the link to several citations above.

If so, perhaps you could share a small portion of it –e.g., role of medication in treating aggression associated with autism.

I’ve shared a large portion of it. See my link @ #250; on the lefthand side of that page are links to more. I don’t believe he speaks about autism at all. (I won’t presume to speak for him, but I suspect that given the evidence he would consider the use of stimulants or antidepressants for this purpose dangerous, especially since you seem to be talking more about control than treatment. But I don’t know.)

From what you have presented so far I get the feeling Whitaker is arguing that child psychiatry is lies, basically. Well if that is the case, what does he propose we ought to do next?

He’s making very specific arguments about specific “treatments.” Seriously, the book doesn’t take that long to read. He does discuss some programs (including some newer ones for children in California and Alaska). Here’s a bit more:

http://www.robertwhitaker.org/robertwhitaker.org/Solutions.html

I don’t think he’s claiming to have the answers; just that treatments for mental illness, as in any area of science, should be evidence-based and consider both short- and long-term risks and outcomes. I can’t see anything objectionable in that.

Is Whitaker advocating for greater financial investment in the field, which arguably is tiny and poorly funded (you might use your fingers to count the full-time academic researchers in the US)?

Yes, with a broad understanding of “the field.” (The psychopharmaceuticals field is of course neither tiny nor poorly funded.)

Or perhaps Whitaker is arguing for love and spirit and chiropractic instead of “drugs.”

Look, not that it’s relevant, but I’ve seen no indication that the guy’s anything other than a science writer who became interested in this important issue. (I can’t really see anyone arguing against love in any event*….) The fact is that the brain is extraordinarily complex and plastic and we understand little of how these illnesses operate, but it seems to be the case, from the evidence, that these drugs do not produce good outcomes. Again, he’s arguing for the recognition of this and for trials and evidence-based evaluation of non- and limited-drug programs (I haven’t seen any woo in the ones he’s mentioned). (I personally would additionally focus more on large-scale social changes.) Even if many of these prove to be unsuccessful (which will undoubtedly happen), that won’t magically make the drugs any more successful. I mean, if they’re ineffective and highly unsafe, they’re ineffective and highly unsafe regardless of the success or failure of any alternatives. Doing nothing is preferable to doing something that doesn’t work and is also (costly and) harmful.

*Are you suggesting all forms of pet/animal therapy are necessarily bogus? 🙂

Have a nice day you bunch of denialists.

Denialist. You keep using that word. I do not think it means what you think it means.

But, just out of curiosity, I’ll bite. Please define “denialist.” Then tell us what we are “denialists” of and why.

I’ll wait.

But, just out of curiosity, I’ll bite. Please define “denialist.” Then tell us what we are “denialists” of and why.

Well, _I_ deny that gordon is the final arbiter on truth and that his 30 years of clinical experience has served to give him any special insight.

I figured out what’s wrong here. This is all a bunch of words games for you. Pseudonyms and pseudoscience. Orac, Prometheus, Dangerous Bacon. it’s all about semantics, perseveration, and monolithic “science.” For me, it’s my daily life. I’m not the parent of a child with autism but I have cared for hundreds of these families over my career. Their lives are not “miserable nor hopeless,” but they’re made much harder by autism and then by denialists like yourselves. These children have genetic presdispositions to ASD and some of the triggers to autism are iatrogenic in nature.

Word games and pseudoscience. Stop.

Oh, I assure you this is no game to me, Dr. Jay. I’m deadly serious in my dedication to combatting dangerous pseudoscience like the anti-vaccine movement. Humor and sarcasm are but tools to communicate, but never doubt the seriousness of my intent.

As for “pseudonyms,” really, Dr. Jay. After your buddies at AoA tried their damnedest to try to get me fired from my job last summer through a smear job claiming that I am somehow a pawn of Sanofi-Aventis with undisclosed conflicts of interest (a campaign that led the minions over there to write and telephone the board of directors of my university), you have the balls to make a crack about my using a pseudonym? For shame, Dr. Jay! That’s just plain despicable. After your buddy J.B. Handley has launched periodic smear jobs to pollute my Google reputation, you dare? Hypocrite. You play the wounded martyr to “civility” so well, but I have seen by your recent behavior that when it comes right down to it you can be just as nasty as those you castigate for “incivility.”

And you still can’t provide one whit of actual convincing scientific evidence to back up your claims that “These children have genetic presdispositions to ASD and some of the triggers to autism are iatrogenic in nature.”

Dr. Jay,

Kristen, as passionate as she might be, is a sample size of one. My larger experience with families of kids with autism does not match this.

I’m not following your point. How am I different (real question, no sarcasm meant)?

So, Kirsten, one data point, bad, epidemiology, millions of data points, bad, Dr. Jay, 30 years of experience, maybe thousands of data point, good. Interesting application of the bell curve there, I’m sure that its peak of importance matches perfectly with Dr. Jay’s opinion of his own importance is strictly coincidental.

Orac says (and bites) “Denialist. You keep using that word. I do not think it means what you think it means.”

“Denialism is choosing to deny reality as a way to avoid an uncomfortable truth.”

The uncomfortable truth is that there are frequent major side effects from all medication and other surgical interventions. This includes major side effects from vaccines.

Kristen, I get a biased cohort because most of the families I see with autism come because they know I’ll support their belief that their child’s autism was triggered by vaccines and/or that I’ll support their desire to look outside conventional (proven) treatment for their children. Your point of view not only deserves respect but may be more valid than mine. I apologize for any disrespect.

I’m sorry if some of you have had bad experiences when you used your real name. I, of course, get treated with nothing but love, respect and kind words for being open about my beliefs and my identity. For instance, the lovely title to this blog piece . . .

David, this is truly just a game for you. You don’t deal with autism or vaccine issues. Your a surgeon and a researcher. Everything you don’t agree with is a “gambit.” Have a good time disdaining my annoying statements about “30+ years of experience.” Your experience with families with autism, vaccine side effects, taking care of sick kids? Borders on zero, right? This “science” abstract for you. Not for me!

Jay

Jay–

If the title of this post is the worst you’ve had because of using your real name, good. But it means you don’t understand the larger risks.

I’ve read of people who stopped blogging because people who disliked their posts threatened to kill their dogs. Orac has just reminded us of the attempts to get him fired for his blogging.

Yes, there’s a difference: you are promoting yourself as a pediatrician who practices in a certain way, because of certain beliefs. If those beliefs are false, or that practice less than optimal, it’s reasonable to publicize that. (It would not be reasonable for me to suggest that people should boycott you, or any other doctor, because you posted for or against Obama in 2008.)

At long last, a partial answer from Jay.

“I give appropriate vaccines when people travel. Usually polio for Asia, Africa, Hep A for exotic travel, yellow fever for the countries which require it. DTaP boosters when indicated. I have also given measles vaccines but not very often. I give malaria prophylaxis when indicated, too. No, I don’t give multiple vaccines in one day.”

Unfortunately this raises more questions. “Appropriate vaccines” according to who? Apparently, not according to CDC recommendations. For instance: your answer seems to indicate that you disdain measles vaccines more than others for travel to “exotic” countries. By what logic? “DTaP boosters when indicated”. Whose indication? Does this constitute one shot, or the patented Jay Gordon DTaP (suboptimal) series?* Do parents planning foreign travel appreciate having to bring their kids in for multiple visits, since you say you don’t give multiple vaccines in one day?

“I talk to smart people who understand that different situations mandate different medical interventions.”

Who are these “smart people” who influence your decisions? Your selected database of like-thinking parents? Dr. Bob Sears? Barbara Loe Fisher? AoA?

*I’m curious about something, Jay. As you’ve already admitted that when you give the DTaP (assuming you can be prodded into it, however reluctantly) you give fewer than the number of doses recommended by the AAP and CDC, what other interventions do you individualize because of a conviction that modern medicine will be found wrong? Do you prescribe smaller doses and shorter periods of treatment with antibiotics, since their use was developed by cold-hearted scientists and benefits Big Pharma? Do you “optimize” other therapies in the same way according to Gordon Intuition?

Thanks for the enlightenment to date.

Dr Jay:

The uncomfortable truth is that there are frequent major side effects from all medication and other surgical interventions. This includes major side effects from vaccines.

Orac and other pro-science commenters do not deny that vaccines can cause adverse effects, even serious (or even fatal) adverse effects.

What you continue to persist in claiming, in the face of carefully-collected evidence, is that autism is one of those effects. What you routinely fail to do to defend your claim is provide evidence to support it.

Your clinical experience does not outweigh the available epidemiological evidence if you are not prepared to provide counter-evidence. If Orac made vague claims to the effect that his clinical (read: personal) experience outweighed the current agglomeration of evidence on some form of breast cancer or another, without providing at least some reasonably sound counter-evidence, he would be subject to the same criticisms as you are – indeed, you would be quite correct to call him out on it.

As far as your whinging on anonymity goes, it is simply absurd. Content is the most important part of any argument, followed by style. The identity of the arguer is usually not important at all. If, say, Timothy McVeigh said ‘murder is wrong’, would his statement be false just because Timothy McVeigh said it? Similarly, people on this blog using pseudonyms has no relevance as to whether the arguments they make are cogent, sound, valid, etc.

I, of course, get treated with nothing but love, respect and kind words for being open about my beliefs and my identity. For instance, the lovely title to this blog piece . . .

Using your real name does not magically give you the right to expect immunity to criticism, or even scorn, if you persistently fail to defend your positions on vaccines using evidence of comparable quality as that which informs the CDC guidelines for pediatric vaccinations. This appears to be a variant of the same error in logic that informs your opinion of Internet pseudo-/anonymity.

Lilady posts under her nom de post because of actual threats received in person while testifying on behalf of autistic adults at a neighborhood hearing for siting of a group home in a residential area. NIMBY is alive and well within a small group of homeowners who prefer to not have mentally retarding/developmentally disabled people living next door or down the block.

When I was required to give my real name attached to articles I’ve written in newspapers about the deplorable conditions in large institutions and the need for funding resources for parents who care for their disabled children at home, I personally received telephone threats as did my young daughter.

I worked down in the trenches in public health for years, not in a boutique pediatrics practice such as Dr. Gordon’s and I have quite a lot of experiences associated with infectious diseases and vaccine-preventable infectious diseases.

Dr. Gordon marches to his own drummer by deviating from recommendations for immunizing infants and children against vaccine-preventable diseases. I, on the other hand dealt with actual cases of measles, infantile pertussis cases and bacterial meningitis cases in children who didn’t received any or didn’t complete the vaccines series recommended by the CDC and by the AAP. Unfortunately, some of these infants and children died; others were left life-long disabilities, organ failure and limb amputations from invasive bacterial illnesses.

I suspect that Dr. Gordon limits his boutique practice to only well (healthy) children as stated in his post above.”I make no monay at all from kids with measles, meningitis, rotavirus, Hib, polio, because I see none. None”, which leads me to believe that he has no hospital affiliation.

According to Jay Gordon MD FAAP’s website, he stated (regarding pertussis) that two children in his practice had active cases of pertussis. I wonder how he knew that? Did he do a naso-pharyngeal swab and transport it in the proper medium to a laboratory? Did he prescribe antibiotics to lessen the severity of the disease and to decrease the chance of infecting others? Did he report the suspect or confirmed pertussis cases to the California Department of Public Health. Did he provide DTaP vaccine to any other children, especially infants that were exposed to his infected patients? Just wondering….

Too many people. I’ve talked to too many parents and heard from too many more to believe that this isn’t the the majority opinion among parents of children with autism. I wonder if anyone has actually done this survey. Do you know?

Of course a biased population leads to biased conclusions. I am biased in favor of the conclusion that vaccines can cause large side effects including triggering ASD and you are biased against that conclusion. The major difference being that my bias comes from experience and reading the literature and yours comes only from reading and no firsthand observation. You would make my bias seem wrong but yours right? That’s not very scientific of you.

Jay

Of course a biased population leads to biased conclusions. I am biased in favor of the conclusion that vaccines can cause large side effects including triggering ASD and you are biased against that conclusion. The major difference being that my bias comes from experience and reading the literature and yours comes only from reading and no firsthand observation. You would make my bias seem wrong but yours right? That’s not very scientific of you.

Uh, no, Dr. Jay. Your bias comes from confirmation bias, selective memory, confusing correlation with causation, and cherry picking the scientific literature. My conclusion is based on science. Now here’s the difference between you and me, Dr. Jay, and it’s not what you think. The difference between you and me is that, if you were to produce actual scientific evidence from well done studies and lab work that strongly suggest that vaccines do cause autism, I would reconsider my position. If the evidence were compelling enough, I might even change my mind. You have demonstrated that even a–if you’ll excuse the term–tsunami of evidence that not only fails to find a link between vaccines and autism but strongly suggests that such a link is incredibly unlikely cannot sway you. You believe what you believe, regardless of scientific evidence. You elevate anecdotal evidence above science, your denial that you do notwithstanding.

That, Dr. Jay, is not very scientific of you at all. But thank you again for reinforcing that the title of my post is very apt.

If I were a doctor, and a respected physician/scientist said of me that he had tried for years to get me to understand the science in my own field, but reluctantly pronounced me both ignorant and unteachable, I believe that I would (1) slink away in shame or (2) set to work and learn the science so that I would no longer be ignorant and would be demonstrably teachable or (3) set out to *prove* that I was in fact right all along, say by reviewing my thirty years of patient records and making the necessary effort to distill the truth out of them.

But of course, I am not Dr. Gordon.

Orac, if another cause were found for the huge increase in autism, I would reconsider my position just as quickly as you would. (What’s the next post in this thread, “Nyah, nyah, nyah nyah??”)

Froggy, I guess I do see rotavirus but in breastfeeding babies, in healthy families it rarely needs in-office care let alone inpatient care. And I never give the rotavirus vaccine. Again, breastfeeding babies do not need it.

Bacon queries: “Do you prescribe smaller doses and shorter periods of treatment with antibiotics, since their use was developed by cold-hearted scientists and benefits Big Pharma? Do you “optimize” other therapies in the same way according to Gordon Intuition?”

Yes, I do individualize care for my patients. I give shorter courses of antibiotics–as is becoming the standard of care:

“Clinicians need to evaluate whether the minimal short-term benefit from longer treatment of antibiotics is worth exposing children to a longer course of antibiotics.”

http://www2.cochrane.org/reviews/en/ab001095.html

It’s what clinicians do, Dangerous Bacon. We evaluate risks and benefits and individualize care. (Aaah, the “Big Pharma” gambit, Bacon!) And sometimes, by gosh, we have to combine science with experience and . . . intuition.

lilady, I have a medium-to-large-sized practice, not a boutique. I worked in the trenches, too. I like private practice better but in some ways it’s just different trenches taking care of kids every day instead of sitting and reading about it. I have been on staff at four excellent hospitals for thirty years. I see patients, I teach and I maintain privileges in good standing.

Orac, the title of your post assumes that you and your cohorts are the absolute arbiters of what is and isn’t good science. You’re not.

Jay

Silly me! I always assumed that the major “cause” for the “increase” was the publication of the DSM-IV.

Here is a scary account of a pathologist who placed his “experience” and “clinical impressions” above accepted scientific consensus. For a time, he was renowned in Canadian forensic pathology. Unfortunately, it was eventually discovered that he was responsible for some heartbreaking miscarriages of justice. He has lost his reputation and his license to practise. He is also facing multiple lawsuits.

I’m sure that his intentions were good and he sincerely believed that his experience was correct. Unfortunately, that is no substitute for knowing your limitations and recognizing that the easiest person to fool is yourself.

ORAC

Note how I did not simply say that I am right. That’s the way a scientist speaks; we always leave a little bit of room for doubt, for the possibility that our hypothesis might ultimately be falsified.

You are describing the characteristics of humility and humbleness of which a scientist should have. Yet you do not display those. You have years of posts that contradict those qualities.

You might as well have said “I’m not saying that I’m right. But I am.” That’s arrogance.

@Orac:

He thinks his personal recollections trump science. I know he’s denied that that’s the case, but I really think he doesn’t understand that that’s exactly what he is doing.

In his defense, his error might not be in thinking that his experience trumps science, but rather in thinking that studies which look for a vaccine/autism connection but find nothing have no evidential value. If it were true that those studies had no evidential value, then there’d be nothing there to be trumped.

Jay: “Yes, I do individualize care for my patients. I give shorter courses of antibiotics–as is becoming the standard of care…It’s what clinicians do, Dangerous Bacon. We evaluate risks and benefits and individualize care.”

My understanding is that good clinicians strive to follow the standard of care in all areas of their practice. They do not pick some standards of care to follow and discard others because of personal prejudice. Respect for the standard of care is why your fellow members of the American Academy of Pediatrics overwhelmingly support the value of vaccination and follow evidence-based vaccine schedules to protect their patients from dangerous preventable diseases.

I’m glad to see you referencing the Cochrane database of evidence-based reviews. Since you linked to one about otitis media, supporting the idea that Cochrane is an arbiter of good science, could you find for us the Cochrane Review that supports your use of homeopathy for treating ear infections? Or a Cochrane review validating the use of homeopathy to treat anything?

Here’s an accepted definition of standard of care:

“A standard of care is a formal diagnostic and treatment process a doctor will follow for a patient with a certain set of symptoms or a specific illness. That standard will follow guidelines and protocols that experts would agree with as most appropriate, also called “best practice.”

Here’s Jay’s definition (paraphrased): “The standard of care is what I say it is.”

Matthew, I think that the National Children’s Study is going to give us some accidental prospective data to look at. Non-randomized, of course. I agree: The studies that would offer proof can’t ever be done.

Jay

http://www.nationalchildrensstudy.gov/Pages/default.aspx

That’s a great question. Again, even with oft-admitted “confirmation bias, selective memory, confusing correlation with causation, and cherry picking the scientific literature” as David phrases it, I’m still stuck because I’ve seen so many families convinced that vaccines changed their children for the worse. I’ve witnessed firsthand temporal relationship between vaccination and regression.

Dr. Jay, why don’t you come back to us when you can present us with some form of evidence besides that which was used in the Salem witch trials?

“I just cannot reach any other conclusion than that witches who have sold their souls to the Devil are responsible for all our illnesses and woes. I’ve just talked to too many people who are convinced that their problems started right after Goodwife Wilson looked at them funny; I’ve witnessed firsthand temporal relationship between an old woman giving the Evil Eye and the sickness of cows.

“The uncomfortable truth is that some people are willing to do very bad things. This includes bad things which mean illness and death to people and livestock. That means that anyone who denies that some bad people are witches, who cause illness and death to people and livestock through dark powers granted to them by their evil master, Satan, are denialists. They’re rejecting the uncomfortable truth.”

Here’s a news flash, Dr. Jay: The world has moved on since 1692. Perhaps you should too. Otherwise, we’ll continue talking about your profound misunderstanding of science, because you’ll keep demonstrating it to the world.

Dr. Jay Gordon (#321):

“Orac, if another cause were found for the huge increase in autism, I would reconsider my position just as quickly as you would.”

Try it this way:

“If you could show me definitively what does cause all autism, I could let go of my unsupported attachment to the idea that vaccines – which I don’t like much, anyway – cause autism.”

This makes as much (or as little) sense as keeping a person in jail for murder – even though the only evidence connecting them to the case was that they were in the neighbourhood at the time of the killing – because you don’t know who did commit the murder.

The evidence connecting vaccines to autism is extraordinarily frail – it consists only of a weak temporal association – yet Dr. Gordon is afraid to let go of it until he knows what causes autism.

Well, Dr. Gordon, what if it turns out that there isn’t one or two or a dozen things that cause autism? What if it turns out – as seems likely – that autism is a multi-genic disorder that has no “cause”? What if nobody ever finds out the cause? How long will you cling to an unsupported idea? How much data will you let pile up before you admit that – even though we don’t know what does cause autism – we can be pretty sure that vaccines don’t?

And why am I sure that even if we found what caused 99+% of all autism, Dr. Gordon would hold out for that last 0.00001% being caused by vaccines?

Before today, I would have said that nothing could make me think less of Dr. Gordon. Clearly, I was wrong.

As has been said before, one difference between genius and stupidity is that genius has limits.

You are limitless, Dr. Gordon.

Prometheus

@D.C. Sessions:

all you can do is call pseudonymity “Stone cold 100% wrong” with no justification whatever.

He wasn’t calling those using pseudonyms “100% wrong”, but those anti-vaxxers who had caused real-life problems for pro-vaxxers.

So Salty you’re saying there is no evidence to justify the use of psychotropics in persons under 18.

So why do physicians use them?

Ritalin is not magic, for instance; it will not permanently transform a child into a paragon of virtue with a 4.9 GPA, yet the first study in his list complained that although teachers reported substantial improvement in behavior, parents didn’t. The study acknowledged that the dose is likely worn off by the evening, which could easily explain that, but seemed oblivious to other factors —

Argh, Calli, you’re confused. I don’t know where to start. First, you’re assuming, rather amusingly, that because Whitaker links to something it agrees with him. The people behind that study are not on Whitaker’s side in this; they’re precisely the people he’s taking issue with, and those are their outcomes. He criticizes the study design in the book, but notes that even given this manipulation and other attempts at spin this research still didn’t support the use of stimulants. (You really should have noticed that he presents it with “In the 1990s, the NIMH mounted a long-term study of ADHD treatments. As it did so, researchers acknowledged that the ‘long-term efficacy of stimulant medication has not been demonstrated for any domain of child functioning’.”) It would have been evident if you read the book and had some context, but really the language in the article should have been a giveaway. It’s fascinating that, because you believed it to be coming from a certain position, you read complaints and acknowledgments into it. Second, the first three articles are the same friggin’ study. It’s the initial short-term report, and then two follow-ups to assess long-term outcomes (which were not good).

You’re seriously confused.

Ah the “science was wrong before” argument. We’ve been through that, Dr. Jay. Yes, science is often wrong, but let’s compare it to how often “personal experience” comes to wrong scientific conclusions. Let’s put it this way, on the question of whether vaccines cause autism or not, who’s more likely to be right? Scientists or Dr. Jay? Until Dr. Jay can actually produce some scientific evidence as compelling as the science that fails to find a link between vaccines and autism, I’m putting my money on science every time.

Dr. Jay, I do have some advice for you. When you find yourself in a hole, stop digging.

Dr. Jay Gordon still has not addressed the issue of timely and complete childhood immunizations. Instead he substitutes his “thirty years in practice” and his science based on anecdotal information from parents. He refuses to counsel his patient’s parents about the efficacy of vaccines and in fact puts nonsense up on his website about the dangers inherent in vaccines. He will never get “nailed” by the California Department of Public Health on incompetence charges for not immunizing a child because his parents have the California “sincere personal belief” regulation to opt out of some or all of the recommended childhood immunizations.

You are so right Dr. Gordon about the patients you see versus patients I saw while working in public health. I saw actual case of TB and contacts of TB patients, some of them actually were infected with the HIV virus. I saw pediatric patients in public health clinics who, as you stated in a prior post “have little or no access to health care”. And, when there were shortages of Prevnar vaccine, I participated in a program to distribute limited supplies to infants who were most vulnerable. I immunized hundreds of children with doses of MMR vaccine, released by the CDC whenever we had a local outbreak and immune globulin against hepatitis A, when food-borne cases were identified. Recently when seasonal flu vaccines were in short supply, I worked tirelessly to immunize thousands of vulnerable children and adults with the limited amount of seasonal flu vaccine released by the CDC.

I and my colleagues (physicians and other public health nurses) did not sit around reading books but did refer to the CDC guidelines, the AAP Red Book and other updated texts for case surveillance, case reporting, proper testing to determine disease status and prophylaxis of contacts during out every day contacts with physicians, hospital based infection control practitioners school nurses and patients. We provided them with information based on the recommendations of the CDC, and the AAP. We also attended “grand rounds” meetings at all the hospitals under our jurisdiction,yearly teleconferences and frequent updates through teleconferences at the CDC and From the State health department.

If I messed up by providing wrong information or information based on patient anecdotes, or what I heard on TV on the Oprah show, I stood to lose my license. You,on the other hand are in little danger of putting your license on the chopping block, “because you basically see children for well visits” and because you have a select group of patients.

@PassionlessDrone: I missed that hearing for a group home in Norco; I was there in spirit and hope you still love me.

Dr. Jay @ 354:

The article you have linked describes doctors who continue using terbutaline to prevent premature labour, even though scientific studies have shown it to be ineffective. The doctors continue to use it because:

The truth is (whether they are willing to admit it, or not) many OB/GYNs prescribe terbutaline because they want to do something/feel helpless/hope the mother will feel better because she is doing something/think maybe it reduces contractions so they will get less calls (it doesn’t)

You know, that reminds me of another group of doctors who continue a practice (not giving vaccinations) even though there is no proof that it is effective (in preventing autism) for irrational reasons (they have seen infants regress at some point after getting vaccines and “know” that the vaccine is responsible).

Dr. Gordon, do you even read the references you post?

if another cause were found for the huge increase in autism, I would reconsider my position just as quickly as you would.

Alien abductions.

Thanks again, Kristen.

Don’t “mompetition” and “blame the victim” just infuriate you? They do me, because they’re all about self-justification without regard for anyone else. Least of all the children.

But then, we’ve known that about Jay for a long time.

@Dr Jay #344
>http://www.preemieprimer.com/terbutaline-and-preterm-labor->just-say-no/

Did you even read this? My favorite quote:

“The truth is (whether they are willing to admit it, or not) many OB/GYNs prescribe terbutaline because they want to do something/feel helpless/hope the mother will feel better”

Just to pound the point home–this article actually decrys a practice that sounds identical to Dr. Jay’s treatment of his autistic families. Dr Jay tells them what they want to hear and endorses unproven treatments because they make the parents feel better. Even if those treatments and practices are not supported by any evidence.

Dr. Jay really picked the wrong thing to quote. THe author is, in fact, using recent medical evidence to caution against a common clinical practice (I bet some of those OB/GYNs who prescribe terbutaline have *30* years of clinical experience too!)

I also notice that this blog has a recent article called “Show your love for a preemie: Get up to date on your vaccines”. What a nice idea.

MB

Dr Jay @ 344:

http://www.preemieprimer.com/terbutaline-and-preterm-labor-just-say-no/

Another bit of “science” bites the dust.

As documented by T. Bruce McNeely @348 & mb @354, Dr Jay is engaged in some serious (& ironic) quote-mining.

Supporting a claim Christopher Monckton-style, Dr Jay? Shame on you. What an appalling lack of integrity and intellectual honesty.

What an appalling lack of integrity and intellectual honesty.

Appalling, perhaps, but not unexpected.

Orac comments: “Let’s put it this way, on the question of whether vaccines cause autism or not, who’s more likely to be right? Scientists or Dr. Jay? Until Dr. Jay can actually produce some scientific evidence as compelling as the science that fails to find a link between vaccines and autism, I’m putting my money on science every time.”

Orac, there is no scientific proof that vaccines do not trigger autism in susceptible children. Period. Please understand that. No proof at all. Studies, evidence, yes, I agree they exist. There are also studies which you may not like which give evidence that vaccines may trigger the onset of autism. Simple issue. Case not closed.

Jay

Orac, there is no scientific proof that vaccines do not trigger autism in susceptible children. Period.

Oh, SWEET! I know those rules. Those are the rules where Jay Gordon has no proof, no proof at all, that he’s not a Reptilian!

Froggy states: “We will certainly be getting the vaccine for our newborn. It’s so sad and so telling that Dr. Jay demonizes Dr. Offit for inventing a vaccine that saves so many children worldwide from such misery.”

Paul Offit invented a vaccine that could save hundreds of thousands of lives in the Third World. He deserves praise and perhaps a large international prize if he manages to get this vaccine to the all countries where it belongs.

However, he is inextricably linked with the business end of vaccines and should disclose this whenever he writes or speaks.

Jay

Orac shouts, “That it has not sunk in yet either says that I’m a horrible teacher or that you are a horrible student.”

David, do you even read my posts?? The evidence is there on both sides. The proof is lacking. I might even admit that the bulk of accepted studies point to lack of association. BUT, there are too many lives at stake to continue the course we’re on based on incomplete, biased “scientific” evidence. We have to slow down the vaccine money juggernaut. The real danger is not resurgence of illnesses, it’s increased autism. I think if you had more experience “on the ground” as a primary care doctor instead of a researcher and surgeon you’d understand that better.

Jay

Orac, I’ll split the difference: You’re too arrogant and pedantic to be a great teacher and I’m too stubborn and arrogant to be a great student.

Even if the former were true, that does not explain the inability of many of my readers, some of whom have the patience of saints and have devoted much time to trying to educate you, to get through to you about science.

And, yes, I read your posts. Have you read mine, the ones where I analyze these “studies” that you seem to find so compelling and point out their extreme flaws, flaws that invalidate their results?

How about this? List some of these studies that you find so convincing. Provide the PubMed links. Let’s see how good your “evidence” really is.

Kristen, what you’re describing is not medically possible. (Except the part about my being an asshole. That’s very possible on my bad days.) Your child did not experience a 23% weight loss.

This speaks for itself.

Kristen, what you’re describing is not medically possible. […] Your child did not experience a 23% weight loss.

Jay, I could write a textbook about fallacious reasoning with no other examples than those you provide. You’re truly checking off the list at an impressive rate.

For instance, here we have Jay “I trust my patients’ parents impressions regarding medical causality” Gordon insisting that a 23% weight loss is impossible in an infant due to diarrheal illness. Why is it impossible? Because it would call into doubt Jay’s rock-solid faith that breastfeeding is sovereign against all forms of infant illness, of course (otherwise vaccines might have some value, which Jay knows is absurd.)

Since it’s impossible, there’s no need to consult the literature on the subject. How convenient.

Of course, not having thirty years experience™ I had to actually look up the numbers. How curious. So tell us, Dr. Jay, how much of a healthy infant’s body weight is fat, and how much can a healthy infant lose due to fever and dehydration?

Of course, this assumes that in thirty years experience™ you’ve actually had patients with fever and diarrhea; since yours are all breastfed maybe that never happens, since as we all know breastfed babies are all perfectly healthy — there was no infant mortality prior to the introduction of bottle feeding.

Dr. Jay:

There is no scientific proof that blue automobiles do not cause autism.

On the evidence, that’s a more likely hypothesis than that vaccines do, because the vaccine hypothesis has been tested, and the blue automobile one has not.

Let’s pretend for the moment that we had unlimited funds, and lots of help recruiting participants. Is there _any_ ethical experiment that could produce results that would convince you that vaccines do not cause autism?

I’m going to describe a hypothetical study below. It would be very expensive, but it might pass ethical tests. But take it as a hypothetical.

Suppose you could enroll every infant born in North America, at birth. We keep detailed records of what, if any, vaccines they receive, and when. This study will, of course, include parents who choose not to vaccinate, and children who have received very few vaccines because of allergies or other medical issues. We have, also, the records from all their pediatrician visits, both those for specific problems and their well baby visits. We have parental observations of the children’s development, including anything from birthday party videos to emails to grandparents saying “Mary said her first word today.” Those records are anonymized: each child is assigned a code number that is not connected to their name, location, or social security number. At some meaningful point or points (meaningful in terms of normal human development and when autism is likely to be diagnosed) a group of people use those anonymized records to identify the children with autism. (Yes, this would be a huge undertaking. We’re being hypothetical here.)

Those diagnosis records could be correlated with total number of vaccines received, and with the records for any specific vaccine.

If children who received a specific vaccine were twice as likely to be on the spectrum, that would be evidence that that vaccine was connected to autism. It might not be proof of causality–there might be some other reason for the correlation–but it would be evidence of a connection. I think we can agree on that.

Now suppose that there was no such correlation with any vaccine, or with the total number or timing of vaccines. Would that convince you that vaccines did not cause autism?

Dr Jay, I assume you are familiar with Shattuck 2006, regarding autism/ASD prevalence in the United States?

I think these two quotes from the paper are rather significant as pertains to your insistence that there is a vaccine-autism link:

RESULTS. The average administrative prevalence of autism among children increased from 0.6 to 3.1 per 1000 from 1994 to 2003. By 2003, only 17 states had a special education prevalence of autism that was within the range of recent epidemiological estimates. During the same period, the prevalence of mental retardation and learning disabilities declined by 2.8 and 8.3 per 1000, respectively. Higher autism prevalence was significantly associated with corresponding declines in the prevalence of mental retardation and learning disabilities. The declining prevalence of mental retardation and learning disabilities from 1994 to 2003 represented a significant downward deflection in their preexisting trajectories of prevalence from 1984 to 1993. California was one of a handful of states that did not clearly follow this pattern. [From the abstract.]

and

[T]he administrative prevalence of autism, as of 2003, in the majority of states was below what we would expect based on recent epidemiological estimates of the prevalence of autism among children ages 3 to 10 in the United States, which ranged from 3.4 to 6.8.^32,33 The mean administrative prevalence of autism in US special education among children ages 6 to 11 in 1994 was only 0.6 per 1000, less than one-fifth of the lowest CDC estimate from Atlanta (based on surveillance data from 1996). Therefore, special education counts of children with autism in the early 1990s were dramatic underestimates of population prevalence and really had nowhere to go but up. [Discussions, second paragraph of the section.]

I’m sure, however, that others have long ago tried to point out studies like this one to you.

@ Kristee and Grenouille: Thank you for sharing your experiences with your children infected by rotavirus. Yes, children who are breast fed do contract the virus, in spite of what Dr. Gordon states that they don’t. Dr. Gordon who fancies himself an “expert” in vaccines…in spite of his “experiences” and in spite of his never seeing rotovirus in his practice, categorically stated that breast fed children never get rotavirus. Obviously your children were misdiagnosed, according to Dr. Gordon. There is a preliminary report on the effectiveness of the rotavirus vaccine in partially immunized populations on the web at PATH: New Data on Rotavirus Vaccines From Mexico and Africa.

Grenouille posed a question about how parents in countries where there is no availability to get IV hydration manage to get their kids to the point when they can resume oral feedings. The answer is that their infants die quickly from lack of hydration and electrolyte imbalances, before they can reach a faraway medical facility.

Is anyone wondering how Dr. Gordon avoids censure from the licensing board in California and how many medical excuses he provides to parents so that children can attend daycare and school programs? The answer is none. California health and education regulations allow parents to opt out of childhood immunizations by declaring a “sincere philosophical objection” to any (pick and chose)…or all immunizations.

I suspect that Dr. Gordon has particular strong feelings about Rotateq vaccine due to his venomous hatred of Dr. Paul Offit.

There is no scientific proof that blue automobiles do not cause autism.

We have had a couple of folks come here with their own pet hypotheses about the causes of autism. Remember the commenter who attributed to the increase of fluorescent lighting? While most of ultimately thought that it probably wasn’t supported as strongly as the person claimed, it was also true that the idea was intriguing, and there was a case to be made to warrant further investigation. I have (only semi-facetiously) suggested that it is the increased use of the creamy version of Desitin. As I have noted, when I contacted Johnson and Johnson to try to find out when creamy Desitin came on the market, I got a complete run-around. They directed me to the website, but I pointed out that only mentioned the Original Formula (the thick, goopy stuff), and did not discuss the creamy version. Then I got brushed off.

For the statement, “People started doing more of X, and autism rates increase” there are countless values of X that can be postulated. If the only thing jay can come up with is vaccines, then he is just not trying.

Dr. Jay,

Also, in spite of docs crying poor about vaccines not being profitable, they are.

Since you don’t often vaccinate, how the hell would you know?

Your child did not experience a 23% weight loss.

Many years ago, a neighbours’ daughter went from 26kg to 19kg in a very short space of time. She had undiagnosed diabetes.
One last thing, Dr. Jay. I find it really distasteful and patronising that you regularly refer to Orac by his real first name.

Jay @ #360:

Orac, there is no scientific proof that vaccines do not trigger autism in susceptible children. Period. Please understand that. No proof at all. Studies, evidence, yes, I agree they exist. There are also studies which you may not like which give evidence that vaccines may trigger the onset of autism. Simple issue. Case not closed.

A few things.

1. Jay is right that the negative hasn’t been proven. Jay is wrong to expect that it should be. He can’t seriously want people to consider him a scientist (or at least scientific) with this kind or argument, can he?

2. The term “susceptible children” is probably deliberately undefined. Jay certainly doesn’t know how to identify “susceptible” from “non-susceptible,” I’m sure. It’s a medical-y science-y sounding word that is devoid of any real substance. This carries the advantage of morphing on-the-fly for the claimant as a quasi God of the Gaps argument: trot it out to criticize any study for a resolution insufficient to determine vaccine effects on some indeterminate sub-population that is merely asserted to exist and not demonstrated.

1. I would really like to see Jay’s citation list of the “studies which … give evidence that vaccines may trigger the onset of autism.” Let’s see ’em.

You’re right, the color of the automobile is irrelevant.

For biological plausibility, consider what comes out of an automobile while it’s running. Some of those chemicals have known, harmful effects.

That increased use of automobiles may cause decreases in exercise is probably irrelevant, given that the age of diagnosis is before kids might otherwise be walking or bicycling to get to school or visit a friend.

Jay: “Yes, I believe that much of my practice’s success is based on my willingness to be very supportive of parents who choose alternative vaccine schedules or no vaccinations at all.”

Of course – you fill a “niche”, such as it is. And that arguably gives you a marketing advantage over the overwhelming majority of pediatricians, who follow evidence-based immunization practice and thus lack appeal to your antivax parent base.

Despite your claims of relative poverty, we can’t accept that you make less money than other peds based solely on your say-so, any more than the other anecdotal “evidence” you throw our way.
And I think you’re going to have a hard time selling the idea that other pediatricians are making sizable bucks selling vaccines, while at the same time insinuating that it’s Big Pharma cleaning up on them. A complaint from many pediatricians, after all, is that for a number of vaccines, the costs are sufficiently high that they can’t recover them in fees and so are losing money per dose. So you’re going to have difficulty trashing both your colleagues (another reason your fellow FAAPs must love you) and the pharmaceutical industry at the same time.

“I would make much more money if I ran a far more more conventional practice. This financial success would be based on my standing and longevity in the community and how incredibly hard I work at my job.”

Oh no! How awful, having to contemplate the prospect of working hard at your job!

“My DVD is tremendously unprofitable.”

C’mon. As of today your antivax DVD ranks close to 37,000th on the Amazon sales list for movies/DVDs. That ought to be worth at least $1.25 a month, easy.

“My website has no ads and costs me money each month.”

How is your online solicitation of funds for that website going?

“Drjaygordon.com has been a tremendous help to tens of thousands of breastfeeding families, which was it’s original intent a decade ago and to this very day.”

And a most valuable service it is. I’m sure we all admire your standing as southern California’s most prominent male lactation consultant (as one of your admirers recently referred to you).

You do miss the point however, Jay. One doesn’t have to make a fortune from promoting a particular idea or product to have a financial conflict of interest. It’s sufficient that one derives income from such activities, period – so if you’re going to keep indignantly insisting that your opponents on the subject of vaccines have COIs and must reveal them, you’ll need to do the same – constantly. (the non-financial COIs in your case as pointed out by Orac may well be even more problematic than the financial ones).

Or, you could recognize that perpetually going on about COIs, pharma shills and the like (as done ad nauseaum by antivaxers and health quackery advocates in general) is an unworthy tactic meant to obscure and overshadow pertinent clinical evidence in favor of unwarranted personal attack.

I’m always willing to cordially discuss vaccine-related evidence with you, and suspect others here feel the same. We do get weary of the standard Gordon Riposte, i.e. medicine-wuz-wrong-before-my-30-years-of-clinical-experience-you’re-silly-dishonest-perseverating-arrogant-lying-shills-and-you’re-uncivil-to-me-science-will-prove-me-right-I’m-too-busy-saving-lives-in-the-trenches-to-provide-evidence-gotta-run-Bye!

It’s a wonder anyone still wants to engage you in conversation, as opposed to just pointing and laughing.

Let’s see: nobody has tested the idea that blue automobiles cause autism. Many people have tested the idea that vaccines cause autism, and found no evidence for it.

As a Bayesian, I have to be skeptical of the blue automobile hypothesis (on the grounds of prior plausibility). Evidence-based medicine tells me to be even more skeptical of the autism hypothesis, because it has repeatedly been tried and found wanting.

If we care about the causes of autism, it’s time to look elsewhere. Or, we can say that we don’t know what the causes are, but we know that there are a lot of people with autism, and ask what they need. After all, whether the cause is environmental or genetic, identifying it is unlikely to lead to a “cure” for people who already have autism. (And not all of those people want a cure, but that’s a separate argument.) Whether the causes are genetic, environmental, or some combination, these are people who can use specific educational services. (If I were recording books for blind users, I wouldn’t be asking how the person who was going to use this textbook became blind. It doesn’t matter for that purpose.)

No, Kristen is not being honest.

Please explain why. And how you know that.

It’s a wonder anyone still wants to engage you in conversation, as opposed to just pointing and laughing.

We all have guilty pleasures. Dr. Jay is one of mine, I confess. Right up there with leaving the toilet seat up in mens’ washrooms.

I find that as I get older I take pleasure in more and more trivial sins.

@Kristen

I am not a pediatrician, but I’ve been lurking on this blog long enough to have seen quite a few of your comments. You have never, ever given any indication of being a dishonest person. On the contrary, you have been very forthcoming in sharing details from your own life and, unlike the subject of this post, you have always acknowledged what you don’t know.

I think Jay owes you an apology. Of course, I know better by now than to expect much from that braying jackass.

does anyone else think I am lying?

Fibbing. He actually said fibbing. About your child’s illness. I would love to hear him say that to the mother of a child in his practice. It would be one thing if he had accused you of posing as a mother – it’s the internet and all – but he appears to accept that you are a mother and think that you would “fib” about something like that. Nasty and condescending. I guess his support and respect have their limits.

@Jay Gordon:

BUT, there are too many lives at stake to continue the course we’re on based on incomplete, biased “scientific” evidence.

How are they biased, and why the scare quotes?

Here’s my positive vote for Kristen’s honesty (and integrity and competence as a mother).

The quote marks around scientific are my feeble attempt at humor. The studies supporting the use of terbutaline were probably well done enough, and may have suffered from the “decline effect.”

It’s highly unusual for a healthy breastfeeding child to be hospitalized in my practice. I’ve thought harder about it and I think I have actually had a couple kids admitted for diarrhea and dehydration over the past ten years who tested positive for diarrhea.. The numbers below indicate tens of thousands but there’s no data in the first article for BF vs formula fed babies. I have articles which show the benefit of BF but don’t want this held for multiple links. Maybe using the word “dot” in the second and third articles will work.

http://www.idsociety.org/Content.aspx?id=16604

http://www dot ncbi.nlm.nih.gov/pubmed/17133157

http://www.nfid.org/publications/pediatric_archive/rotavirus dot html

Jay

“I’m terribly sorry you had to go through that frightening experience and even sorrier that I was insensitive enough to argue with you about it. ”

You didn’t just argue with her, but made an entirely unsupported accusation of dishonesty.

You, sir, have a very peculiar way of being ‘civil’.

Dr. Jay,

I could be wrong, but that read like the most insincere and condescending apology I have ever seen. My apologies if you weren’t being disingenuous, but it seemed a little forced.
What you have said has not upset me in the least, actually. What a person says is a testament to that ones character IMHO.

If you have a reason to disbelieve my story please share it, I really want to know if I am wrong-it is important to me to be accurate.

Han, Composer99, SC, lilady, Dedj, Chris and so many others,

Thank You

I try to be the first one to admit when I am wrong, especially here. I count it a privilege to converse with so many learned individuals. Due to the current complexity of my life it is highly unlikely that I would be able to hear diverse experts opine on things that fascinate me anywhere else (yay internet!). I have always been a slow learner, so my understanding of things is often incomplete but the commenters here point me in the right direction (nicely or not so nicely). I have always wanted to be a scientist, perhaps I will be someday, but for now this is enough.

I appreciate you allowing me to share my experiences, I have had some extraordinary ones. It is my personality to give TMI (I make no apologies for that).*

*Mushy, mushy comment, sorry. It has been a hard week and I get overly sentimental. I’m not looking for a pat on the back, just always tell what is on my mind. I don’t have much of an inner monologue. 😉

Kristen, what you’re describing is not medically possible. […] Your child did not experience a 23% weight loss.

Today I have learned that Dr Gordon believes in Listening to Parents and valuing their first-hand experiences, except for those times when he doesn’t.

Today I have learned that Dr Gordon believes in Listening to Parents and valuing their first-hand experiences, except for those times when he doesn’t.

Now now….everyone lay off of Dr. Jay.

I’m sure he is sincere and honest and totally incapable of many things, one of which is condescension.
And if his apology came across in such a manner, he is probably deeply grieved that you hate him so much to expect incivility from him.

It’s so civil of Dr Jay to blame his dismissiveness and his baseless accusations on other people.

Again.

Dr Jay appears to have a profound misunderstanding of what civility is.

Again.

Dr Jay appears to have a profound misunderstanding of what civility is.

Dr Jay seems to have a profound misunderstanding in general.

Dr. Jay, the idea that breastfed babies NEVER get sick irkes the heck out of me. It’s over-promotion of small benefits that make moms like me cry small rivers when no milk comes out.

Okay, now that we have all given Dr. Jay Gordon his just desserts about Rotavirus and Rotateq vaccine, can we move on?

I’d like to move on to his “expert” on breastfeeding who writes about “Thrush identification and Treatment” on his website. I give Dr. Gordon high marks for pursuing certification as a lactation specialist, which certification is only available to licensed medical professionals. I question why he has chosen this particular person who has no medical knowledge (her BA and MA are in music..she’s pursuing a Ph.D in music education)…and she has a CBE (Certified Breast Feeding Educator) “certification”. Now trying to figure out what the heck is CBE certification is another “trip” on the internet. I found some information on this “certification” on the “Lacatation Consultant Services” website.

Thrush (oral candidiasis albicams yeast infection) is a fairly common condition diagnosed in infants who are breast fed and formula fed. It can occur more frequently in infants and children who have taken courses of prescribed antibiotics recently. The first line of treatment is Nystatin and second line of treatment would be difulcam…for cases resistant to Nystatin drops in the mouth.

According to Cheryl Taylor, BA, MA, CBE who manages the entire section on breastfeed on Dr. Gordon’s website,

“Nystatin contains sugar to make it palatable, yeast feeds on sugar…”Difulcam (long harangue about possible side effects to mother and infant)… I prefer to begin with grapeseed extract as the first line of defense…Test have shown that GSE (grapeseed extract) is dramatically more effective than colloidal silver, iodine, tea tree oil and Clorox…

I’m not a lawyer…but I question why this “mommy blogger” manages Dr. Gordon’s breastfeeding web pages. She is prescribing treatment for oral yeast infections, doesn’t that constitute a crime like practicing/prescribing treatment without a medical license?

Test have shown that GSE (grapeseed extract) is dramatically more effective than colloidal silver, iodine, tea tree oil and Clorox…

Lilady wins the Silver Medal for the first sighting of colloidal silver quackery on Jay Gordon’s website.

I did some further internet research for citations (none were given by Cheryl Taylor BA MA CBE…doctor Gordon’s “expert” on breast feeding, diagnosing and treatment of oral candidiasis albicams) and keyed in the researcher who she cited “Dr. John Mainarich Bio Research Labs”. What came up was Livestrong.com. I visited the site to find all the research and products that contain the wonder drug GSE (grapeseed extract) along with references back to Jay Gordon’s website.

“Lilady wins the Silver Medal for the first sighting of colloidal silver quackery on Jay Gordon’s website.”

It’s worse than that, as noted here previously.

Jay has an article up on his site (in the “alternative” treatments section on managing colds) in which it’s recommended that you give kids colloidal silver as an “immune system booster”.

It’s bad enough that adults put themselves at risk of permanent skin discoloration and other serious side effects under the delusion that colloidal silves will work wonders for them, but to subject children to this is in my view unconscionable. From NCCAM’s website:

“There is a lack of evidence for effectiveness and a risk for serious side effects from colloidal silver products. The FDA does not consider colloidal silver to be safe or effective for treating any disease or condition…Argyria (blue-gray skin discoloration from silver deposition) is permanent and cannot be treated or reversed. Other side effects from using colloidal silver products may include neurologic problems (such as seizures), kidney damage, stomach distress, headaches, fatigue, and skin irritation. Colloidal silver may interfere with the body’s absorption of some drugs”

Variation in the amount of silver contained in supplements could also place children at heightened risk of side effects.

Do any of these warnings about using colloidal silver appear on Jay’s website? I haven’t seen them.

In addition, Jay describes treating ear infections with homeopathic remedies.

“I like to put mullein/garlic oil in the ears hourly for a day or two and give pulsatilla 6X or 12C (homeopathic strength–the range I have given indicates homeopathic ignorance… but it works) or lachesis homeopathically hourly for two days.”

His site also contains a denialist article blasting water flouridation as “a massive toxicological experiment”.

Dr. Jay Gordon, Crank Magnet.

Dr Jay @402:

Quote-mining. I’m not sure that word means what you think it means. I posted a link to an excellent article. Terbutaline for PTL used to be standard of care based on “scientific” studies. Now, it’s wrong.

And from the evidence posted by the blogger you linked to, Dr Jay, that is no doubt the case. Neither Orac nor other serious commenters here will deny that standards of care change and evolve in response to new and updated scientific evidence – indeed, such a response is held up as one of the strengths of science-based medicine.

However, where the quote-mining comes in is because you represented the article as just being about an old standard of care ‘biting the dust’ based on new evidence.

However, another thrust of the article, ironically given your position on vaccines & autism, is summed up in this sentence, which I have cut & paste from it (although someone else already did upthread):

The truth is (whether they are willing to admit it, or not) many OB/GYNs prescribe terbutaline because they want to do something/feel helpless/hope the mother will feel better because she is doing something/think maybe it reduces contractions so they will get less calls (it doesn’t). All of these are the wrong reasons to prescribe a medication.

You (or anyone else) may feel free to correct me on this next point, but unless I am mistaken terbutaline is available by prescription only. So for a woman to be taking it, she needs a prescrition from an OB/GYN who is ignoring the scientific evidence in favour of their personal experience, patient expectations, anecdotes, and the like.

This is analagous to a certain California pediatrician who persists in ignoring the scientific evidence regarding the etiology of ASDs and the safety/efficacy of vaccines in favour of his personal experience, patient expectations, anecdotes, and the like.

In short, the article favours Orac’s position more than it does yours.

I conclude that the accusation of quote-mining – or at least misrepresention of the blog post you linked to – stands.

(Here is a re-link to the arcticle linked to by Dr Jay.)

God forbid this woman walk into Jay’s practice –

http://www.cnn.com/2011/HEALTH/02/26/measles.exposure/index.html?hpt=T2

“God forbid this woman walk into Jay’s practice”

Lawrence, are you kidding? This is the ideal opportunity for his patients to obtain natural immunity! It’s time for a measles party! And with any luck, they can trigger an outbreak and infect everyone around them who is not immune, whether unimmunized, too young to have been immunized, immunocompromised, or simply a vaccine failure. A win all around!

Except for the possible deaths, grave complications, and permanent brain damage, of course.

Quote-mining. I’m not sure that word means what you think it means. I posted a link to an excellent article. Terbutaline for PTL used to be standard of care based on “scientific” studies. Now, it’s wrong.

And it turns out that it wasn’t science that was wrong, but rather our doc (jg) and his approach of using clinical experience. From the actual FDA press release:

Terbutaline is FDA-approved to prevent and treat narrowing of the airways (bronchospasm) associated with asthma, bronchitis, and emphysema. The drug is used off-label for obstetric purposes, including treating preterm labor and treating uterine hyperstimulation. Terbutaline has also been used in an attempt to prevent recurrent preterm labor. There is no evidence, however, that use of terbutaline to prevent preterm labor improves infant outcomes. Serious adverse events, including maternal deaths, have been reported with such use in pregnant patients.

Off-label use is based on clinical experience, jaygee’s favored method, not scientific studies. So what happened when they actually did do scientific studies for this usage?

The decision to require a Boxed Warning and Contraindication is based on the FDA’s review of post-market safety reports of heart problems and even death associated with terbutaline use for obstetric indications, as well as data from medical literature documenting the lack of safety and effectiveness of terbutaline for preventing preterm labor, and animal data suggesting potential risks. Based on this information, the FDA concluded that the risk of serious adverse events outweighs any potential benefit to pregnant patients for either prolonged use of terbutaline injection beyond 48-72 hours or use of oral terbutaline for prevention or treatment of preterm labor.

Had it gone through the normal route of clinical trials, it would probably never have made it past animal trials for this indication. Note that the studies do not call into question it’s FDA-approved use in asthma and the like, which were based on actual scientific studies.

Seems your jig, doctor, was a little premature.

[h/t lilady]

@ W. Kevin Vicklund: Right you are; I didn’t connect the dots properly regarding off-label versus licensed by the FDA for treatment…apologies.

The FDA continual monitors how drugs are marketed by manufacturers and has “nailed” a number of them for direct to consumer advertising and information provided to doctors by drug reps about “off-label” usage. In recent years drug and medical device manufacturers have paid hundreds of millions dollars in fines.

Apparently France is playing “catch-up” due to major outbreaks of measles during the past two years. Measles only became a “mandatory notifiable disease” in 2005, thirty or more years behind the United States classifying measles as a “mandatory notifiable infectious disease”.

An excellent report about measles outbreaks in France is available on the web at: “Spotlight on Measles 2010 Update on the Ongoing Measles Outbreak in France 2008-2010” (September 9, 2010). Of particular note is the high incidence of confirmed measles cases in unvaccinated or partially vaccinated individuals,the few cases “imported” from foreign countries and the under-reporting of suspect or confirmed cases by physicians.

NK:

Show me studies about the Colloidal silver causing the other side effects you mentioned.

First you must show that colloidal silver works as an antibiotic when taken orally and not just on surfaces.

NK “immune system booster” is usually a good sign of bullshit.

The known effects of silver are antibiotic, not “boosting the immune system”. Boosting the immune system is usually not a good idea anyway.

First you must show that colloidal silver works as an antibiotic when taken orally and not just on surfaces.

Or, as a first step, show that the silver particles are able to pass through the stomach/intestinal lining into the blood.

Oh, and if you are going to study sublingual administration and the stomach, you might as well study the colon/rectum as well.

NK, if you are claiming silver kills bacteria and colloidal silver is an effective oral antibiotic, then what about this article: Bacterial Killing by Dry Metallic Copper Surfaces? Will you now switch to colloidal copper?

I usually don’t respond to trolls, but NK did you read the article provided by Chris and the silly nuances in her posting? Before you look at the link again, try to understand the difference between disinfectants and antiseptics.

Everyone knows that copper bracelets (available on the internet) protect you from bacterial, viral diseases and…..

BTW copper is a trace element in the body and used by the body to maintain stasis; silver is not a trace element.

Chris and I are still waiting for citations from you about the effectiveness of colloidal silver against any microbe.

Thank you, lilady, I was trying to remember the word “antiseptic.”

NK, bleach is also effective at killing bacteria, I just don’t think I want to consume it!

(I listened a podcast about the copper killing bacteria, downloaded from http://www.virology.ws/2011/02/23/this-week-in-microbiology/ )

Excess copper is known to be toxic to the human body.

If you can’t metabolize copper at all it’s also a bad thing. Look up Wilson’s disease.

Link fail.
It was just the wiki on “cytokine storm”. Doubt NK is interested in detail anyway seeing as technical details often tend to interfere with belief.

@305 Jay Wrote, “Kristen, I get a biased cohort because most of the families I see with autism come because they know I’ll support their belief that their child’s autism was triggered by vaccines and/or that I’ll support their desire to look outside conventional (proven) treatment for their children.

It’s a walled garden. You get into a closed loop, spinning along, reinforcing each others beliefs, rejecting any conflicting information.

It’s not just the cohort that is biased, Jay. It’s you.

@456 quoting Jay @305

It as if when Jay Gordon finds himself in a hole, and the backhoe isn’t working out for him, he sends for a bucketwheel excavator.

@438 … just look up “argyria” on Google images.

http://www.silvermedicine.org/argyria.html

http://www.rosemaryjacobs.com/april27_2003.jpg is a nice picture.

this is pretty far off topic by now, but i figured since i mentioned it upthread i would actually dig out the reference.

in the human body
copper 72 mg / 70 kg
mercury 6 mg / 70 kg
silver: 2 mg / 70 kg
gold: 0.2 mg / 70 kg
uranium: 0.1 mg / 70 kg

from http://web2.airmail.net/uthman/elements_of_body.html which is sourced to “Emsley, John, The Elements, 3rd ed., Clarendon Press, Oxford, 1998”