Longing for a past that never existed
There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone by, the average life expectancy was … 35! That’s right. For most of human existence, according to fossil and anthropological data, the...
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February 18, 2010
Science by press release
Last week I wrote about a study that purported to show that antidepressants have no effect in mild to moderate depression. A careful reading of the paper shows that the authors dramatically overstated their findings, particularly in their public statements to the media. The study has another implication beyond the misleading claims about antidepressants. It is an object lesson in an ongoing...
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February 11, 2010
Study shows antidepressants useless for mild to moderate depression? Not exactly.
As Harriet Hall has written, psychiatry bashing is a popular media sport. There seems to be a bias against treatment of psychiatric disabilities, and a common claim is that antidepressants are no better than placebo. The New York Times illustrated both the perpetuation of the myth that antidepressants are ineffective, and the increasing and disturbing tendency of major media organizations to confuse...
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February 4, 2010
Reflexive doubt
Those of us who study, practice and write about medicine cherish the hope that explaining the science behind medicine (or the lack of science behind “alternative” treatments) will promote a better understanding of medicine. Certainly, I would not bother to write about medical topics if I did not believe that promoting science based medicine would lead to increased understanding of medical recommendations...
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January 28, 2010
Big Placebo says Medicine never cures anything
Kudos to Lindsay Beyerstein of Majikthise for coining a new appellation “Big Placebo.” Big Placebo is the alternative health counterpart to Big Pharma. Both are special interest groups designed to promote their products, whether they are worthy of promotion or not. There is one big difference between them: Big Pharma makes products that usually work (though not always, and sometimes not safely)....
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January 21, 2010
Is breech vaginal delivery safe?
Between 3-4% of babies begin labor in the breech (bottom first) position, increasing the risk of neonatal morbidity and mortality. Pre-emptive C-section has become the preferred method of delivery for breech babies, but now some are questioning this recommendation. The controversy is fueled by differing appraisals of the danger and by differing assessments of the whether any risk of neonatal death can...
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January 14, 2010
The case for neonatal circumcision
Imagine if we could save lives from a dread and often fatal disease simply by performing a minor surgical procedure. People would hail this simple victory and rush to adopt it… Not exactly. The disease is HIV and the simple surgical procedure is circumcision and anti-circ activists oppose it under almost any circumstances. In this month’s edition of the Archives of Pediatrics...
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January 7, 2010
Oppose “Big Floss”; practice alternative dentistry
We survived almost all of human history without it. Yet in the last 100 years people have allowed themselves to be hoodwinked by a huge corporate conspiracy into believing that we “need” their products. They cite studies and claim we don’t understand science; they ignore ancient folk wisdom and have no respect for our intuition. They peddle their products without regard to...
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December 31, 2009
“Toxins”: the new evil humours
They say that everything old is new again and that is certainly true in the world of “alternative” health. One of the axiomatic premises of contemporary “alternative” health puts its believers behind the times … by approximately 500 years. A fundamental premise held by believers in “alternative” health is that we are swimming in a world of “toxins” and those “toxins” are...
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December 24, 2009
Are the benefits of breastfeeding oversold?
As a mother, I am a passionate advocate of breastfeeding and I breastfed my four children. As a clinician, though, I need to be mindful not to counsel patients based on my personal preferences, but rather based on the scientific evidence. While breastfeeding has indisputable advantages, the medical advantages are quite small. Many current efforts to promote breastfeeding, while well meaning, overstate...
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December 17, 2009