It’s rather amazing how sometimes the best laid plans of mice and men (and bloggers) come to naught. I had planned on doing a followup post to my previous post about the cancer quackery known as the German New Medicine by discussing a particularly nasty French variant of it. Unfortunately (or fortunately, depending upon your point of view), events conspired to move my blogging ire towards another target, particularly since I had addressed this isse before. Specifically, I’m talking about 2009 Recipient of the Richard Dawkins Award, comedian and HBO talk show host Bill Maher.

As you may recall, about a month ago, I wrote a rather long post (par for the course for me, I know) detailing ad nauseam how Bill Maher not only embraces germ theory denialism, anti-vaccine nonsense, and alternative medicine, in particular his apparent belief that “aggregate toxicity” or the typical unnamed “toxins” that alternative medicine mavens are so fond of blaming most disease on or, as Maher likes to call it, the “poisons” that we are eating and otherwise exposed to every day, but has been preaching this pseudoscience since at least 2005. Maher then followed this up a mere week before receiving his award named after a famous scientist with a hideously irrational promotion of cancer quackery. At that point, I thought I was done with the topic, at least as far as this particular blog goes (others know that elsewhere I’ve not been so quiet). At least, I had intended not to deal with this again on SBM.

Unfortunately, Bill Maher had other ideas. This is the perfect description for how I felt having to blog about this again:

Yes, it fits, particularly after Maher Tweeted to his fans:

If u get a swine flu shot ur an idiot.

In the last two episodes of this season of his show, Real Time with Bill Maher, Maher upped the ante, so to speak. In fact, he went far beyond even what I knew of his anti-scientific beliefs. I suspect he did it in response to criticism, too. The reason I suspect this is because Maher’s most recent tirades against the H1N1 (“swine flu”) vaccine and vaccines in general finally started to be noticed by the mainstream media, provoking not only a response by the New York Times last week but a full frontal attack by Linda Bergthold emanating from, of all places, what is normally a cesspit of anti-vaccine pseudoscience (The Huffington Post, or HuffPo for short). In the process, not only did Maher shred any last vestige of his claims that he is not “anti-vaccine,” but he showed that he has drunk deeply of the Kool Aid that is the anti-vaccine movement and clearly has zero clue about how science really works. All of this reinforces my view of Maher that he is a contrarian, not a skeptic. If it’s something that irritates conservatives (such as support for the science behind anthropogenic global warming, commonly abbreviated AGW) or ticks off fundamentalist Christians (such as evolution), he’s for it. Similarly, if it fits into his conspiracy mongering mindset in which big pharma and the government are all out to get you and keep you sick so that they can sell you prescription drugs, he’s credulously for it. Given this background and Bill Maher’s two latest assaults on science and reason, I thought it worthwhile to revisit the topic one last time. Well, maybe not one last time, but hopefully the last time for quite a while. Given that Friday represented the season finale for the latest run of Bill Maher’s talk show, I expect that it will at least be a few months until he has the opportunity to demonstrate how one can be seemingly rational in some areas (AGW, slapping down 9/11 Truthers, supporting evolution) and completely unscientific and even anti-scientific in another area (namely medicine). At least I fervently hope so.

It began (again) the Friday before last, when Bill Maher was interviewing former Senate Majority Leader Bill Frist on his show. Of note, Bill Frist is a physician and a cardiothoracic and transplant surgeon. He also made a name for himself (or should I say “shame for himself”) by trying to diagnose Terry Schiavo as not being in a persistent vegetative state by examining only a videotape of her, as our fearless leader Steve Novella discussed last year. Suffice it to say, Maher made Dr. Frist look like the voice of reason and science in comparison. Let’s start by “going to the tape,” as they say:

As you can see, Maher delved into his ignorance early in the interview with Bill Frist by asking:

Conservatives always say about health care, especially, you know, are you going to let the government run health care? They screw everything up. So why would you let them be the ones to stick a disease into your arm?

“Stick a disease into your arm”? I found this particular phrase puzzling at first. In fact, I didn’t know what to make of it initally, chalking it up to Maher’s choosing to use the most frightening image he could think of for vaccination. What I didn’t know is that it revealed real ignorance of how vaccines work, as the second clip will show. Patience. You’ll see what I mean soon enough. In any case, it is rather clever, as much as I hate to admit it, how Maher tried to coopt conservative distrust of the government into the service of his anti-vaccine views. Indeed, when I say that the anti-vaccine movement is truly bipartisan in its appeal, that is exactly one of the major rationales that right-wing anti-vaccine advocates like Representative Dan Burton (R-IN) or Ron Paul (R-TX) use to justify their dislike of vaccination programs. In this case it didn’t work.

After Bill Frist interjected to ask whether Maher was talking about the swine flu vaccine Maher continued with the arrogance of ignorance:

I would never get a swine flu vaccine or any vaccine.

Let’s just put it this way. Unlike what Maher seems to believe, the flu vaccine doesn’t give you the flu; diet and exercise will not make you somehow magically immune to the flu, the H1N1 strain or the seasonal strain.

Indeed, in comparison to Maher, Bill Frist looked like the epitome of science and reason, and that‘s saying something. True, he may have simplified things more than I would have liked, but in the face of such confident ignorance perhaps that’s the best way to go because you won’t get a lot of time to lay out the evidence. Be that as it may, I did so love the part where Maher said to Dr. Frist, “You say that as though I’m a crazy person,” and Frist replied, “Well, here you are. I think here you are.”

I couldn’t have said it better myself.

The look on Maher’s face was priceless. So was the smirk and shrug from Maher in reaction to Frist telling him point blank and in no uncertain terms, “You’re wrong” and “look at the science.” It was a beautiful sight to behold. Very likely, Maher lives in a bubble of yes-men (and women) too afraid to challenge his Oprah-like views.

After Dr. Frist discussed a sad case of a 30-year-old woman who came in with a case of H1N1 to his hospital, Maher went on to rant about how he cannot believe that a “perfectly healthy” person died of the flu, and things deteriorated from there into the purest nonsense. Here’s a hint for Bill: Reality doesn’t care what you do or do not “believe.” Really. It doesn’t. Worse, Maher tried to twist evolutionary arguments to claim that vaccines are useless because “viruses are always mutating,” after which he went on to give highly dangerous advice, namely that pregnant women should not get the swine flu vaccine, advice that is potentially deadly to women who listen to him. As Linda Bergthold pointed out:

People who warn against vaccinations do so most often with very little evidence that can be corroborated. News articles and individual physician opinions are not always accurate or based on more rigorous scientific evidence.

This is where Bill Maher is absolutely wrong and actually dangerous. He is suggesting that pregnant women should not be concerned, but he gave NO evidence to support his assertions other than his assertion. Dr. Frist totally disagreed, based on evidence from researchers but Maher didn’t listen to him.

This is typical of an anti-vaccinationist. Like Bill Maher.

Most pathetically, Maher had the cojones to quote Jonas Salk about live virus vaccines having the potential to cause the disease they are directed against, showing clearly that he doesn’t understand the difference between an attenuated live virus vaccine and a killed virus vaccine–or, these days, a vaccine made of recombinant viral protein antigens. Suffice it to say, since those days scientists have learned how to genetically engineer attenuated viruses so that they can’t revert to their pathogenic wild type form. Unfortunately, Maher wasn’t through yet. It turns out that his interview with Dr. Frist had raised the profile of his anti-vaccine views to the point where Maher was being noticed by the New York Times and criticized by Michael Shermer in an open letter. Clearly, Maher was feeling the heat, as this segment from his season finale, which aired on Friday, shows:

As you can see, Maher apparently decided to use the occasion of the season finale of Real Time with Bill Maher to answer some of the criticisms that had been leveled against him. In response, all I can say is this: I’m incredibly grateful that this is the season finale of Maher’s show. I don’t think I can take much more of his anti-science stances being so proudly trumpeted so often. I need a break.

I warn you. The segment above is painful to watch if you are in any way a supporter of science-based medicine. It shows very much that Bill Maher still just doesn’t get it. In fact, if anything, Maher escalated his quack arguments to a whole new level. Interestingly (to me at least), he stated up front that he isn’t a germ theory denialist. One wonders how that charge managed to penetrate the protective bubble of Hollywood celebrity and find its way to Maher’s attention, one does. While I’d like to think it was one of my posts (like this one) that had found its way to him, somehow I doubt it was. However, the charge found its way to Maher, he began his defense of his views by lamely claiming that maybe he had been a “bit too cocky” when he said that diet and healthy living (plus avoiding the ubiquitous “toxins”) would protect him from the flu. “Cocky”? More like the arrogance of ignorance. Recall what he said in 2005:

I don’t believe in vaccination either. That’s a… well, that’s a… what? That’s another theory that I think is flawed, that we go by the Louis Pasteur theory, even though Louis Pasteur renounced it on his own deathbed and said that Beauchamp(s) was right: it’s not the invading germs, it’s the terrain. It’s not the mosquitoes, it’s the swamp that they are breeding in.

Note how Maher said that Louis Pasteur’s theory was “flawed,” wrong, even! He even parroted the lie that Pasteur “recanted” on his deathbed, echoing the same sorts of false “deathbed conversion” stories that circulate claiming that Charles Darwin recanted about evolution. The implication was plain: That Pasteur had doubted germ theory on his deathbed and come over to the point of view of his rival, Antoine Beauchamp, who had claimed that it wasn’t the microbes that caused disease but rather the “biological terrain.” If that’s not germ theory denialism, I don’t know what is. Not only that, but Maher was using the same sorts of false rumors and lies as the ones that creationists use to cast doubt on Darwin. And that’s just one example of many. Now that Maher is confronted with the charge of germ theory denialism, he’s backpedaling. He’s hiding behind the claim that maybe he was too “cocky” in proclaiming that diet and avoiding “toxins” can protect him from the flu. To me, Bill Maher’s claim that he is not a germ theory denialist rings hollow. He mouthed the words, but his history belies his claim.

While it is true that immunosuppressed or debilitated patients are more susceptible to various infections, many, many pathogenic microbes can still cause serious disease in perfectly healthy people. The strain of virus responsible for the 1918 influenza pandemic, for instance, tended to kill younger and healthier people. Indeed, it got started in the U.S. in an Army barracks, and it doesn’t get much healthier than young men between the ages of 18-22 in the military. Similarly, the current H1N1 (a.k.a. “swine flu”) pandemic shows disturbing signs of similarly affecting the young more severely. Maher also said on many occasions that he views disease as being due to “aggregate toxicity” from all the “toxins” of modern life and the “poisons” that we ingest.

Then Bill went completely off the rails:

…I do understand the theory of inoculation. Yes, you give someone a little bit of the disease and it fools your body into providing antibodies which fight it. Brilliant! Bravo! Maybe there is some occasions where inoculation is a wise thing to do. I hope not. I hope I would never have to have one because, you know, to present it just as this genius medical advancement, no, it’s actually a risky medical procedure that begs long term cost-benefit analysis.

If anyone still doubts that Bill Maher is anti-vaccine, pure and simple, to his very core the above statement should lay to rest any doubts. Vaccination is not a “risky medical procedure.” It is among the safest medical procedures there is with the most favorable risk-benefit ratios. Depending on the disease, it is also among the most effective. Arguably, no medical intervention ever envisioned by human beings has saved more lives at so low a cost and so low a risk as vaccination. His ignorance is just as toxic as any of those “toxins” he fears, particularly his ignorance that vaccination has undergone and continues to undergo long term cost-benefit analyses, safety monitoring, and study.

Now I understand why Maher had previously referred to vaccination as “injecting a disease into your arm.” He doesn’t even appear understand what vaccination is! At the very least, Maher seems to be confusing vaccination with the more ancient practice of variolation for smallpox. In that procedure, discharge or crust from smallpox lesions was inoculated into the skin, typically between the thumb and forefinger, in a controlled fashion. Alternatively, it would be blown into the nose of an individual. As a result, the individual would contract a milder form of smallpox. Upon recovery, the person undergoing the procedure would be immune to smallpox. In contrast to the 30% mortality of smallpox contacted “naturally” (natural isn’t always better, Bill), only 1-2% of those undergoing variolation would die. Variolation was ultimately supplanted by vaccination, in which the related but much less virulent virus known as cowpox was injected into the skin. The immunity to cowpox derived from vaccination also rendered the person undergoing vaccination immune to smallpox.

Immunizations don’t “give someone a little bit of the disease,” as Maher phrased it. What they do provide is protein (antigen) from the microorganism that does not cause the disease in question. Rather, it mimics molecular features of the pertinent infectious agent well enough to induce the immune system to mount a response that will be effective against that agent. For immunizations against viral diseases the material used usually consists of killed viruses (for example, the Salk vaccine for polio) or attenuated viruses (for example, the Sabin for polio). Alternatively, the smallpox vaccine used a closely related naturally-occurring virus that is not dangerous to humans except in rare cases. But even these are more of historical interest than anything else. In the 2000s, many antigens are produced by genetically engineering bacteria or yeast to make important proteins from the organism that can provoke an immune response. Live attenuated vaccines are similarly made by genetically engineering the virus so that it is no longer virulent and its replication potential is low or nonexistent. In other words, Maher is talking ancient technology to, at the most recent, 1960s or 1970s technology for vaccination and using that ignorance to sow fear about the swine flu vaccine.

He then goes on to demonstrate his ignorance and antivaccine proclivities even more conclusively:

I mean if you don’t believe me, just look on the CDC website as to what is in the swine flu vaccine. You know, aluminum, insect repellent, formaldehyde, mercury, you know, that’s right on their website. Don’t take it from a talk show host.

Oh, no! TOXINS! Injected into the children, even! Oh, the humanity!

I suppose I should be relieved that Maher didn’t parrot anti-vaccine misinformation about “antifreeze” or “fetal parts” in the vaccines. I suppose I should be grateful for small favors. Of course, mercury is so….2004 or 2005. For one thing, it hasn’t been in chldhood vaccines other than the flu vaccine since late 2001. More importantly, numerous studies have failed to show a link between mercury and autism–or any other neurological condition, for that matter. The idea that mercury in vaccines somehow causes autism is a failed hypothesis, so much so that anti-vaccine zealots started to distance themselves from it two years ago. Why do you think they came up with “too many too soon” and “green our vaccines“?

Meanwhile, aluminum is the new mercury, even though it has an excellent safety record going back 80 years as an adjuvant in vaccines. Come to think of it, Maher had previously blamed the flu vaccine and its aluminum for Alzheimer’s disease, parroting yet another anti-vaccine lie from another anti-vaccine advocate named Hugh Fudenberg, and he was doing it back in 2005! So this latest misinformation about aluminum is nothing new for Bill Maher. As for formaldehyde, as I’ve pointed out on numerous occasions before, that’s one of the all-time dumbest anti-vaccine arguments of all. Indeed, when anti-vaccine apologist pediatrician Dr. Jay Gordon tried the “formaldehyde gambit,” he was schooled so hard that he never repeated that canard again.

I will admit that the “insect repellent” gambit was a new one on me. So I looked at the CDC list of vaccine ingredients and couldn’t find anything resembling a pesticide or insect repellant chemical. However, I freely admit that I may not know enough to have identified it right away. So I did a bit of digging. Guess where I found this one? Surprise, surprise! I found it on the conspiracy website, which complains about the adjuvant MF59, stating that it is made up of Tween 80, squalene, and Span85. About Span85, says:

Span85: Patented by the now defunct Chiron (bought by Novartis). Its chemical name is Sorbitan Trioleate. It is an oily liquid used in medicine, textiles, cosmetics, and paints as an emulsifier, anti-rust agent, and thickener. [Some factories in China specialize only in manufacturing Tween 80 and Span 85.] According to the Pesticide Action Network North America [PANNA], this chemical is used as a pesticide. It is also used as an adjuvant and is “toxic to humans, including carcinogenicity, reproductive and developmental toxicity, neurotoxicity, and acute toxicity.”(16)

This is just plain silly, because, as revere and Joe Albietz have pointed out, the H1N1 vaccines to be used in the U.S. this season don’t use adjuvants, MF-59, squalene, or otherwise. Indeed, he was concerned about the lack of an adjuvant because without an adjuvant the vaccine requires more antigen to provoke an immune response. Given that the U.S. has purchased a lot of antigen, thus squeezing the supply for other nations, revere concluded that the U.S. should use an adjuvanted vaccine as well, particularly given that MF59 has been used in Europe for a dozen years without mishap. Basically, Maher’s whine appears to be an even more ridiculous version of the “squalene gambit.” Again, remember that the dose makes the poison. As is the case for aluminum, there is no good evidence that squalene or MF59 is harmful at the doses used in vaccines and plenty of evidence that it is safe. It’s also possible Maher may have meant polyoxyethylene sorbitan, which is sometimes be used in an insect repellents. Whatever the case, it’s nothing more than using scary chemical names. I guess the “insect repellent” or “pesticide in the vaccines” gambit is the new “formaldehyde” or “fetal cells” gambit, if you know what I mean.

Next, Maher will be complaining about the dihydromonoxide in vaccines. After all, it’s the biggest component, and it can kill!

But, wait, there’s more! That’s not all the pseudoscientific nonsense that Bill Maher laid down. He immediately launched into a diatribe blaming his childhood allergies on vaccines or perhaps the “mercury they drilled into my teeth,” plaintively arguing, “So, I’m not a nut for asking…They do some stupid things, and you’re not a nut for asking.”

Oh, goody. The old “I’m just askin'” gambit. Actually, Bill, you are a nut for asking because the questions you ask reveal that you have no clue what you’re talking about. As Harriet Hall discussed, there is no evidence that mercury-containing dental amalgams are harmful or cause allergies.

But that wasn’t the worst. This was:

People have said, “Well, Bill, there are people now dying of the swine flu who were in good health.” By whose standards? Hospitals serve Jello. They have fast food franchises in their lobby. The autopsy report on Michael Jackson came back, and they said he was in good health. OK, to me he looked a little pale. So, I don’t always agree with what Western medicine says means good health.

Jello? That’s certainly one of the most flagrant non sequiturs I’ve ever seen. Besides, why was Maher hatin’ on Jello? The only thing I can think of is that it’s some sort of shorthand for unnatural evil junk foods that destroy your health. Or so Maher appears to believe, or maybe his connections with PETA lead him to hate gelatin, given its source. I’m also intrigued by his invocation of “Western medicine” yet again. Remember, when Maher says “Western medicine,” what he really means is science-based medicine. Also, I’d like to know what is different between Maher’s definition of “health” and the definition of “health” from science-based medicine. Seriously. I want specifics, Bill.

Finally, we have the “censorship gambit.” After Chris Matthews asked him why somany countries require vaccination before you can enter them, Maher pontificated:

What I know is that what Western medicine likes to do is to close off debate.

Wrong, Bill.

It’s scientific medicine where the debate occurs. There’s been endless debate over who should be vaccinated, how effective the H1N1 vaccine is, how bad the pandemic is going to be, who’s at most risk for complications and death. That’s exactly what scientific medicine (referred to disparagingly by Maher as “Western medicine”) excels at. The problem is that the debate over whether vaccination works and is effective has already occured and didn’t go the way Bill Maher believes. He doesn’t like that. True, flu vaccines are imperfect, but, unlike Maher’s previous claims they do work, they do not “suppress the immune system,” they do not cause Alzheimer’s disease, and they are not “injecing disease into your arm.”

Chris Matthews next gambit was brilliant, though, when he asked Maher why he’s “fighting this fight.” Maher’s response was:

Just to say that we need a debate about it. Just to say that the science is not settled. What I was attacked for was to say that I don’t believe in this, that we should look into it, and lots of people feel the same way. This is not settled science like global warming. That’s what they’re trying to say, that it’s as crazy as fighting global warming or evolution.

Does this sound like a creationist? To me it does. Teach the controversy!

Actually Bill, I’ll tell you something: Arguing against vaccination is arguably even crazier than arguing against AGW or evolution. As harmful as anti-evolution or AGW denialism can be, the worst consequences tend far off in the future, particularly for AGW denialism, where, although evidence of harm from global climate change is becoming apparent, it’ll be decades before the worst effects manifest themselves. That makes it hard for many people to understand the harm, and perhaps somewhat understandably so. For anti-vaccine pseudoscience like what Bill Maher spews, the public health consequences can be immediate and severe. People will die now, possibly lots of people, particularly children and pregnant women if people listen to the misinformation that Bill Maher is promoting.

Chris Matthews scored major points, too, when he compared Bill Maher to famous Scientologist Tom Cruise denouncing psychology and psychiatry. The horrified look on Bill Maher’s face after that accusation was priceless. I suspect that Maher had never had his medical ignorance so pitch perfectly called out before on national television. Moreover, Matthews’ attack had the virtue of being correct. Maher’s suspicion of “Western medicine” in general and vaccination in particular is based more on ideology and faith than on any science. Indeed, his fear of “aggregate toxins” as the cause of all disease derives more from primitive vitalism, beliefs in “evil humors” that cause disease, than from any science. Maher’s beliefs with regard to scientific medicine are just as religious at their heart as Scientology’s denial of the existence of mental illness and hatred of psychology. Moreover, his arguments borrow heavily from the techniques of creationists and denialists, as Michael Shermer pointed out:

As well, Bill, your comments about not wanting to “trust the government” to inject us with a potentially deadly virus, along with many comments you have made about “big pharma” being in cahoots with the AMA and the CDC to keep us sick in the name of corporate profits is, in every way that matters, indistinguishable from 9/11 conspiracy mongering. Your brilliant line about how we know that the Bush administration did not orchestrate 9/11 (“because it worked”), applies here: the idea that dozens or hundreds pharmaceutical executives, AMA directors, CDC doctors, and corporate CEOs could pull off a conspiracy to keep us all sick in the name of money and power makes about as much sense as believing that Bush, Cheney, Rumsfeld, and their bureaucratic apparatchiks planted explosive devices in the World Trade Center and flew remote controlled planes into the buildings.


Unfortunately, there’s little or no hope that Maher will change, I’m afraid, at least not in the short term. After all, his tirade on Friday’s show was clearly his response to criticism of his medical views. He obviously wanted to throw down the gauntlet to his critics, who, hilariously, threw it right back into his face. Hard. So hard that Maher’s arrogant smirk turned into a “deer in the headlights” look of shock. Someone who is truly a skeptic, truly science-based in his world view, would not have responded this way. Such a person, when faced with criticism from so many quarters who have reason to know better and when confronted with so much scientific evidence, would have probably asked himself if maybe, just maybe, he was wrong. He did no such thing. Instead, he confidently repeated his previous nonsense and even upped the ante. Indeed, Bill Maher is a classic case study in how someone who appears to support science (such as evolution) can be truly unscientific in another area (medicine). As such, he is a cautionary tale to us all in that he shows how it is possible to seem to support science but to do it for the wrong reasons and only when the science doesn’t conflict with his preconceived beliefs.

I’m just glad that Maher is nowhere near as popular as Oprah Winfrey, although I do wonder when he’s going to go onto her show to tell Oprah’s audience how disease is due to “aggregate toxicity” and how “natural” remedies will cure what ails them. Oprah’s audience would eat it up.



Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.