April 22, 2009

Dr. Steven Novella, why is this so hard to understand?

Grasping straws By J.B. Handley
I’d never heard of Dr. Steven Novella until I read his recent blog piece HERE rebutting Generation Rescue’s recently introduced website, FourteenStudies.org.
I don’t know Dr. Novella and I certainly having nothing against him personally, but I was stunned by the utter lack of knowledge and critical thinking that went into his critique of our new site. In general, I think the site so resolutely exposes the dirty underwear of the mainstream’s weak science on the vaccine-autism debate that most critiques of the site seem to center around the idea that “you have no need to go look at the site, and please pay no attention to the dirty underwear behind the curtain…”
Before I explain why Dr. Novella is so wildly ignorant and off base when it comes to the topic of vaccines and autism, let’s look a little more closely at who he is:
Dr. Novella is a clinical neurologist and assistant professor at Yale’s school of medicine. His areas of specialization are neuromuscular disease and botulinum injections (see appendix below). He appears to have done both his undergrad and med school at Georgetown University. Looking at his biography on wikipedia (which he undoubtedly wrote himself), he became a doctor 11 years ago and turns 45 years old this July. It doesn’t appear that autism, vaccines, immunology, toxicology, nutrition, or gastroenterology are part of his area of focus, expertise, or study.
I have been astonished by the culture of arrogance and elitism that medical schools appear to breed in their doctors and scientists. The culture tends to produce an “us vs. them” mentality, where doctors collectively back each other up on controversial issues, typically without understanding the issue for themselves. Somehow, if you have a medical degree and you practice conventional medicine, you get it, and if you don’t, you don’t.
Stephen Greenspan, a psychologist and expert on gullibility, explains this recurrent experience of smart people falling for the b.s. of others they relate to as due to "the tendency of humans to model their actions—especially when dealing with matters they don't fully understand—on the behavior of other humans."
I’m not intellectually intimidated by any of these jokers. Their degrees mean zippo to me, because I knew plenty of knuckleheads in college who went on to be doctors, and they’re still knuckleheads (I also knew plenty of great, smart guys who went on to be doctors and they’re still great, smart guys).
I chose a different path and went into the business world. In the business world, having a degree from a great college or business school gets you your first job, and not much else. There are plenty of Harvard Business School grads who have bankrupted companies and gone to jail, and plenty of high school drop-outs who are multi-millionaires. Brains and street-smarts win, not degrees, arrogance, or entitlement.
On of the most fascinating aspects of the autism epidemic is how the mainstream health community seems to get away with a stunning paradox: they are so damn smart that they are certain as to what doesn’t cause autism, but they haven’t a clue as to what does. How can that be? Why aren’t the smarts being applied to finding the cause?
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For those of you who haven’t read it, FourteenStudies.org is a website that not only deconstructs the myth that “the science has spoken and vaccines do not cause autism” but also is the only place on the web where you can actually find all the scientific studies the other side makes reference to. As I have written about repeatedly, the mainstream medical community, and people like Dr. Novella, continually misrepresent what has and hasn’t been studied, make glaring over-generalizations, and falsely reassure parents that the science has been done to study the possible relationship between vaccines and autism. They seem perfectly willing to set aside any critical thinking of their own, and reference studies that don’t remotely do what they claim they do, because, dammit, they know more than you do.
Consider the following:
Children receive 36 vaccines by the age of 5 in the United States. Of those 36 vaccines, 2 have ever been studied for their possible relationship, the two doses of the MMR. But, children receive 23 vaccine BEFORE THEIR FIRST MMR SHOT, and no work whatsoever has been done to consider these other vaccines and their relationship to autism.
According to the CDC’s website, vaccines contain 53 separate ingredients, but only 1 – thimerosal – has ever been looked at in terms of its relationship to autism.
At my son’s 2-month vaccine appointment, he received the following vaccines simultaneously: Hep B, Rotavirus, DTaP, Hib, PVC, and Polio. He developed eczema, was lethargic for weeks, and went on to develop autism. Have any of these vaccines or the co-administration of so many vaccines ever been considered for their relationship to autism? Not remotely.
The science that has been done to date to look at the relationship between vaccines and autism has only been done to quell legitimate concerns raised By SafeMinds (thimerosal) and Dr. Andy Wakefield (MMR), it’s never been done to answer the recurrent testimonials, now numbering in the hundreds of thousands, of parents who lost their kids to autism after vaccine appointments.
Back to Dr. Novella. His critique of FourteenStudies.org seems to be largely based on the naïve idea that his colleagues couldn’t possibly be mistaken on this issue, which means that I must be:

“It is also remarkable that Handley himself quotes many professional, expert, and advisory bodies who also have read the studies and concluded that they overwhelmingly support the conclusion of a lack of correlation between vaccines and autism - including the Centers for Disease Control, the American Academy of Pediatrics, The American Medical Association, the Institute of Medicine, and the March of Dimes. Handley casually and self-servingly assumes that all of the professionals in these organizations are incompetent or they are lying.”

“And keep in mind what it would mean to lie on this issue - Handley believes that many doctors who have chosen the career path of public health are deliberately condemning millions of children to autism simply to avoid admitting past error, because they cannot face the horrible truth, or to receive their Big Pharma kickbacks. It’s no wonder their rhetoric often become hysterical - they really believe this is going on. For some reason it is easier for them to believe this astounding horrible claim than even consider the possibility that perhaps they have misinterpreted the science and that trained experts who have dedicated their lives to understanding the science may know better. This is what we call the ‘arrogance of ignorance.’”

Arrogance of ignorance? Dr. Novella asserts, “I personally know of many people, including myself and David, who have both read all the studies and are telling the truth about our opinions that they do not support a link between autism and vaccines.”
He’s read the studies. The ones that cover 2 of 36 vaccines, 1 of 53 ingredients, never consider unvaccinated kids, and are almost all funded by conflicted parties and they clearly show ALL VACCINES don’t cause autism? And I’m the ignorant one?
Taking his ignorance to a new level, Dr. Novella then chooses to defend, as one example, one of the Danish studies looking at the relationship between thimerosal and autism. You can read about a critique of that study HERE. He concludes:
“In addition to a lack of correlation between thimerosal and autism, this study supports the conclusion that the rise of autism rates in the 1990s and beyond are due to changes in the definition of autism and efforts to make the diagnosis in the population. That is the common element between Denmark and the US. Exposure to thimerosal and the vaccine schedule differed between these two countries, and yet autism rates were similar.”
And, in making his point, this is the only study Dr. Novella points to. To summarize, Dr. Novella demonstrates an incomprehensible level of ignorance in the following four ways:
1. He argues that I suffer from the “arrogance of ignorance” because many of his self-interested colleagues disagree with me and they must surely be right. Do I really need to cite the thousands of examples in human history where the consensus of the day turned out to be wrong? He calls himself a “skeptic” but I’m wrong because his friends think I’m wrong and surely my brain is not as big as theirs?
2. He cites a study that solely looks at the relationship between thimerosal and autism (1 of 53 ingredients in vaccines) as PROOF that “vaccines do not cause autism.” This is a reckless over-generalization that has no basis in fact.
3. Of all studies, he chooses to defend the Madsen Denmark study (see above) that has without question the most egregious data-trick ever used in a thimerosal-autism study, and a study that has even been discredited by the CDC and NIEHS as “unhelpful.”
4. He states that “autism rates were similar” between the US and Denmark. Yet, a fifth grader could look at the Madsen study he himself cites and read on page 605 of the study that the autism rate in Denmark was under 5 per 10,000, while the U.S. rate is somewhere between 60-100 per 10,000, which means our rate of autism is 12-20 times higher than Denmark’s, which would mean our rates are “similar”, so long as you define similar as the U.S. rate being twenty times the rate of Denmark.
Dr. Novella claims to be a scientist. For all I know, he is great at neuromuscular disease and injecting botox. When it comes to vaccines and autism, his “critique” of FourteenStudies.org demonstrates an unacceptable level of ignorance, non-critical thinking, and parroting of the words of others. My only guess for why Dr. Novella would publish such rubbish is that he knows his friends demonstrating similarly narrow and misguided views will tell him how smart he is.
As an aside, Dr. Novella does appear to have expertise at injecting the botulinum toxin in people’s bodies, as his webpage characterizes this as an area of expertise:
“Yale Neurology provides diagnostic and therapeutic treatment of patients with hyperactive neurological disorders, such as cervical dystonia, hemifacial spasm, blepharospasm, limb dystonia and spasticity. Using both botulinum A (BotoxTM) and botulinum B (MyoblocTM) toxin, we will evaluate and design a treatment plan for patients and work with referring physicians to assist in their care.”
Wikipedia tells me many interesting things about botulinum including this winner: “Despite Botulinum toxin being one of the most lethal naturally occurring substances known to science, it is still widely used for cosmetic purposes in a purified and isolated form.”
“In September 2005, a paper published in the Journal of American Academy of Dermatology reported from the FDA saying that use of Botox has resulted in 28 deaths between 1989 and 2003, though none were attributed to cosmetic use.”

“On February 8, 2008, the FDA announced that Botox has "been linked in some cases to adverse reactions, including respiratory failure and death, following treatment of a variety of conditions using a wide range of doses," due to its ability to spread to areas distant to the site of the injection.”

“In January 2009, the Canadian government warned that botox can have the adverse effect of spreading to other parts of the body which could cause muscle weakness, swallowing difficulties, pneumonia, speech disorders and breathing problems.”
J.B. Handley is co-founder of Generation Rescue.