Ed’s corner of the web

I can get a little moody and punchy when I’m short on sleep, so my reaction was not particularly favorable a few mornings ago when I opened up the AMA Morning News in my inbox and read the first headline:”Study indicates MMR vaccine may not be linked to autism.”  I think I nearly had a stroke.  I may have yelled, “Gee - you think?” out loud to the empty room, but I can’t fully recall.

For background, AMA Morning News is a daily digest of medically relevant news that’s compiled and sent out by the people at the American Medical Association.  The idea is to keep the busy doc apprised of what’s going on in the world of medicine and medical science.

The article attached to this particular headline referenced a newly-published study on PLoS ONE (the online journal for the Public Library of Science) that shot down the contention, made 10 years ago in a much-derided study by Dr. Andrew Wakefield, that measles virus - obtained through MMR immunization - persisted in the guts of kids with autism and possibly was involved in autism’s pathogenesis.  What followed from Dr. Wakefield’s study was heightened vaccine fear-mongering and strengthening of antivaccination movements in the the US and UK, the unfortunate results of which can been seen now in the recently reported outbreaks of measles in the UK and the US (without - it should be noted - any change in the incidence of autism).

In the last few years, the idea of a link between vaccination and autism has been thoroughly debunked by several large, rigorous scientific studies.  Unfortunately, the public has been a little slow to catch up with the data (which is actually one of my big gripes with the American Academy of Pediatrics), and a lot of unwarranted, even counterproductive, fears regarding vaccines still remain.  This headline, instead of reflecting the consensus state of the medical scientific community (minus a few whackjobs), played more to those unfounded fears of vaccines.  The likelihood of vaccines being linked to autism is vanishingly small, well beyond what any reasonable person would require for convincing.  But a headline that says “MMR vaccine may not be linked to autism” gives a very different impression.  To someone who has been fighting against those fears and misinformation for years, it was not a welcome sight - and especially upsetting coming from the AMA.

So I wrote a letter.

To Whom It May Concern,

I was greatly dismayed when I opened up my inbox this morning to see this headline in today’s edition of AMA Morning Rounds: “Study indicates MMR vaccine may not be linked to autism.”  I’m not sure how this headline made it past your editors, but the implication it gives is that there is still significant doubt as to whether MMR is linked to autism, when in fact there is none.  This lack of association has been established and reestablished by study after stronger study, and for the AMA – of all organizations – to imply that there is still doubt is a reflection of either base ignorance or refusal to accept the data.  I’m not sure which is worse.  A more appropriate headline would have been, “Study reaffirms lack of link between MMR vaccine and autism,” which is a much better reflection of the article’s actual contents.  If the AMA is going to continue to be a trusted source of news and information for doctors as well as patients, it needs to work harder to avoid the irresponsible, obfuscating language that I read today.

Sincerely,
Edward Chung, MD

In my irate, sleep-deprived state, I wrote a complaint letter to the feedback email address at AMA Morning News.  I didn’t really expect to get a response; I just felt better having aired my opinion.  And a little part of me thought that maybe somewhere, somehow, someone would read it and realize that what they had pulled was not cool.

You can imagine my surprise, then, when a couple days later I got this:

Dr. Chung,

Thanks for writing. You’re right…that headline could most certainly have been written better. In fact, you already wrote what would have been a more appropriate headline for that news item. I’ll discuss this with the editors at U.S. News Custom Briefings, which the AMA partners with to produce Morning Rounds, in hopes of not repeating this in future issues.

Thanks again for writing, and thank you so much for your membership with the AMA.

Sincerely,

(name redacted)
Manager, member communications
American Medical Association

Not bad!  It wasn’t defensive, back-pedaling, or falsely apologetic (ie. “We’re sorry if you were offended by what we wrote.”).  It was, “Our bad, you’re right, we’ll fix it.”  Kudos to member communications at the AMA.  Now they’ve gotta be careful.  If I continue to get positive feedback for airing my opinion, I just might have to do it more.

A tip of my hat goes out to David Campbell, a biology teacher at Ridgeview High School in Orange Park, FL.  The NYT recently published an article detailing his difficulties in teaching evolution to his Biology I class.  I thank my Dad for pointing the article out to me.  The battle of evolution versus creationism (or Intelligent Design or whatever else they’re trying to disguise it as these days) has been particularly heated in the past several years, and public schools and their school boards have been the front lines in this debate.  The fact that there’s a battle at all is somewhat of a sad indictment of the status of science education in this country, but that’s a topic for a whole other series of posts.  Beyond all the posturing and rhetoric in the blogosphere is this single human trying his darndest to make a difference in an steeply uphill struggle.  It’s easy to sit at the keyboard and say, science teachers should do such and such, evolution should absolutely be taught in the classroom, etc.  But the details of how to do that in a real school with real kids is a much more complex issue.  Here is a dude who is actually there, walking the walk, pursuing not only the noble goal of teaching science, but also promoting the concepts of evolution.  In Florida.  Hard core, man.  Keep fighting the good fight, sir.

I gotta hand it to the Chinese - with their remarkable Olympic opening ceremony this last week, they showed just what a strong authoritarian regime directing a large population acculturated to obedience and uniformity can accomplish.  And I truly don’t mean that in any negative sense.  China’s amazing display was all the more amazing because we all knew that such a thing could never be replicated anywhere else in the world.  I’m not sure what London has planned for 2012, but I think the planners for that event just started sleeping a lot more poorly.

News broke earlier this week about the fake firework “footprints” that were part of the opening ceremony.  Most people were either not terribly surprised or not terribly concerned.  Now today we have news that the cute pigtailed girl in the red dress singing “Ode to the Motherland” was, in fact, lip-synching.  Why?  Because the seven-year-old with the wonderful voice, Yang Peiyi, wasn’t as pretty as the nine-year-old Lin Miaoke that we all saw on TV.  The solution to this non-dilemma was to dub Yang’s voice over Lin’s singing.

To me, this is much more upsetting than some computer-generated fireworks, not the least because you’re teaching a little girl that it’s not true talent that matters, but good looks.  The corollary lesson is that you can cover up deficiencies with a pretty veneer.  But why stop there?  If you’re going to make a substitution with these two girls, why not have Chow Yun Fat at the piano dubbed with a Lang Lang recording?  Or have Zhang Ziyi become president while Hu Jintao continues to pull the strings in the background.  Why not?  Because it’s ridiculous, that’s why.  It’s ridiculous and it rails against the values we should be promoting in a society (crap - now I’m sounding like a Republican), not to mention in seven-year-old girls.

Much talk has been made of the pretty facade that China has worked so hard to place over the country in the workup to the Games.  Every now and then we scratch or rub away the gold plating and are disappointed by the leaden core we glimpse beneath.  This definitely wasn’t the first peek, and I’ll be shocked if it’s the last.

This story came to my attention via P.Z. Myers and his Pharyngula blog. I’ll let you read the story for yourself.

Say what you want about whether the kid, Webster Cook, was malicious in his intent or not. There’s little excuse for the reaction from the church and its supporters. Physically confronting the kid? Calling it a hate crime? Comparing it to a kidnapping? Sending death threats? Overblown and totally inexcusable.

The fact that the campus Catholic organization receives university funds is also troubling, if not entirely surprising.

If any of the hateful people who sent this kid emails damning him to Hell or phone messages threatening death think that Islamic fundamentalists are wacko, they should look in the mirror.

For all of the ridiculousness that seems to happen in Massachusetts (stupid bomb scares, gorillas on the loose, the Big Dig, Mitt Romney, I do like to think that we’re ahead of the curve overall. So I was pleased to read that our state legislature was seeking to ban gifts to doctors.

Coming up through the ranks, it was easy to see the pervasiveness of drug company marketing in the form of gifts and freebies. Pens, notepads, microfiber lens cloths, and the occasional pocket guide were just the tip of the iceberg. The “Cipro breakfast” was well known among the medical students as a good place for a nice free meal. Drug-sponsored lunch conferences were always popular, and the exalted drug dinner, which we were rarely privy to as mere medical students, was sought after highly. Luckily, the idea that accepting these sort of inducements was, at best, ethically iffy and, at worst, altering our medical decision-making was filtering up through the medical school and medical staff. The behavior, if not frowned upon sternly, was at least questioned.

Unfortunately, here I am almost ten years later watching the same conflict play out. We already have a strong inkling that pharmaceutical company contact with physicians changes prescribing practices. Indeed, one would hardly expect the pharmaceutical companies to continue pursuing this expensive tactic if it didn’t work. Yet still we allow them easy access to medical students (this thread is disturbing to me), residents, and physicians through free meals, freebie items, drug samples, sponsored CME, and other such means. And even if you don’t believe a simple logo pen could affect someone’s medical practice, you have to admit it looks really fishy to a patient when you sign a prescription for them using a pen with the same drug’s logo on it. It’s just a bad idea medically and ethically.

So I, for one, will cheer on Therese Murray’s efforts in this regard, and I support other states’ efforts with similar measures. If you, as a physician, would rather not see the government stepping in in this way, then alter your actions so they don’t see the need to step in. As a practicing physician, I’ve tried hard to refuse any and all gifts or inducements from drug companies, even pens. I’m such a bastard that when I cover for another doc’s primary care practice, I won’t even sign for the practice’s drug samples. (And it even turns out that free drug samples aren’t the safety net we like to believe they are.) I think if everyone moves in a similar fashion to stem the tide of these inducements, the end result may very well be the better practice of medicine - based on the best scientific evidence, not on what ad we last saw - and possibly more cost-efficient medicine as we forego the latest shiny name brand drug for the generic that works just as well.

With all of today’s talk about ricin found in Las Vegas, I have to tell a little story. I remember first learning about ricin way back in Prof. Krieger’s 7.20 class (Human Physiology) in college. The class distinguished itself from most other biology-major fare by being immediately and directly applicable to real life. The mention of ricin, however, was especially memorable to me because it was mentioned in the setting of the Bulgarian umbrella murder. It wasn’t a particularly positive use of biology, but I was pretty impressed. Espionage! Assassination! Secret spy gadgets! All made possible with science. If I remember correctly, one single molecule of ricin was capable of killing a human cell. That’ll make you pay attention.

I knew that there was a lunar eclipse that was supposed to happen, but I wasn’t sure I’d be able to see it from my Boston apartment. Still, when 10 pm rolled around, I walked outside, looked straight up, and was pleasantly surprised to see this:

I ran upstairs, grabbed my camera, and grabbed a few shots.  I had only seen one lunar eclipse previously, one summer night many years ago when I lived in Michigan.  I was excited to see one again.  I even dragged Carisa downstairs in her pajamas to see it, and she appreciated the sight nonetheless.  Astronomical events like this make me want to get a place out in the boonies and shoot cool pictures of the sky all night.  Maybe someday.

Today marks the 199th anniversary of the birth of Charles Darwin, a man who came to mean much in his day and even more so now. Whether you dine with fellow evolutionists at a “Phylum Feast” complete with “primordial soup,” or you just ponder for a moment how much of modern science has been shaped by the theory of evolution, I hope you are able at some point to stop and appreciate this one man’s work.  I’ll admit to still be slogging through Origin of Species, but I’m undoubtedly a fan for life.  Happy Birthday, Chuck.

Read more at http://www.darwinday.org/

Having lived just two blocks from the Scientology branch mentioned in this article, this strikes close to home. I would pass by the building a couple times a day on my way to and from classes, and I admit to some curiosity about what went on inside the building. The people milling around outside always seemed so nice and happy - a little too nice and happy. When I later learned about the true nature of Scientology, my inner fears were confirmed and then some. Those cute kids walking around on marathon day with bunches of yellow Dianetics balloons became suddenly very sinister and sad. People should never be sad about seeing a kid with a balloon.

(thanks to Benjamin Gleitzman for the photo)

When I heard about anonymous’ declaration of war on Scientology a couple weeks ago, I became very interested. I was glad that the true bad news about Scientology was spreading, but I frankly wasn’t sure if anonymous’ tactics were the best way to approach the problem. Still, I rooted them on, not sure the effort would last more than a week or so. So I was happy this morning to see the Globe’s report about the protest outside of my very own branch of the Church of Scientology. Good work!

CIA chief Michael Hayden admitted today that interrogators used waterboarding on terror detainees. I guess this comes as a big non-surprise, especially after Hayden admitted that CIA interrogation videotapes were destroyed. I think we’re still only just scratching the surface of what the CIA has perpetrated in recent years. I’m not looking forward to seeing what else there is.

Link to the BBC article here. (Side note: why the heck isn’t this on the CNN frontpage? There’s a link about Britney spears, of course, but to read news about my own country’s intelligence service, I have to ask the Brits.)