I Read the Anti-Vaccine Doctor’s Manifesto so You Don’t Have to

YoureWelcomeIt is a frequent theme in anti-vaccination circles that you should not follow medical advice just because a doctor told you to. I 100% agree. Any doctor who cannot articulate her reasoning to you, acts like you aren’t capable of understanding the issues affecting your own body and mind just because you aren’t a doctor, or answers your question with any variation of “Because I said so,” deserves your mistrust. As is true for most professions, some doctors are stars, most are competent and worth working with, and a few need to find another line of work. Even great doctors make mistakes, or just get the wrong end of the stick on certain issues. You shouldn’t take anything a doctor says as gospel just because of the degree he holds. After all, some unlucky day you might find yourself in the care of a reprehensible sleazebag that has somehow oozed through the cracks in the medical system and is still allowed to call himself a physician–someone like Jack Wolfson.

If you’re lucky enough to have missed out on this man’s recent antics, I am so, so jealous. Anyway a few days ago this dude went on his local NBC affiliate station to discourage people from vaccinating, and then got on CNN and into USA Today. It is frowned upon for medical students to call doctors names (hi residency programs!), so please know that I did not make the decision lightly to say the following: a white coat stuffed full of kegel weights would give better medical advice than this guy.

Now he has put out a piece of writing on a site called Vaccine Impact (whatever the farts that is), titled “Why all the anger?” Jack Wolfson is really, really confused about all the anger, see. So confused. It is definitely a problem that the people who are angry at him are having. It’s definitely not a rational reaction to something he did. It’s like if you woke up one morning to find a sounder of warthogs had moved into your apartment, you would totally ask, “Why all the warthogs?” It would be really confusing. It’s kind of like that.

I’m not going to link to the original piece because I don’t care to boost its traffic any higher. Google it yourselves if you want it that bad. I will, however, be quoting from the piece below, and answering his title question for him.

Take it away, Jack:

I recently did an interview which was aired on NBC Phoenix. I was asked my opinion on vaccinations in response to the current measles outbreaks that have occurred at Disneyland in California. My reply has generated quite a bit of anger in thousands of people.

In case you missed it, 84 people in 14 states now have measles from this outbreak.

There has also been a tremendous amount of support to my comments and opinions. In short, The Society Against Injecting Our Kids With Chemicals (TSAIOKWC for short) has a lot of followers.

Well we’re mad about this part, because here at The Society Against Infecting Other People’s Kids With Lethal Contagions (TSAIOPKWLC), we love injecting children. The flu mist and the oral vaccines for polio and rotavirus are great, but there’s nothing quite as satisfying as making a child cry. When I get home from work, even if it’s been a really long and frustrating day, the first thing I do is release one of the children from the cage area, let it run around for a bit, then tackle it and give it a Hep B shot. Once I have harvested its tears to power my jet pack, I let it go, cackling, “That’s just round one of three!” It really clears my head.

And that’s nothing compared with the high you get knowing you’ve injected a kid with chemicals. I mean–chemicals! They’re so sinister and awful. Sometimes when I can’t sleep I like to wake up one of the cage children by whispering, “We’re all made of chemicals. The very oxygen you breathe is a chemical.” They never get back to sleep, but I’m out the second my head hits the pillow. Infectious agents on the other hand are totally natural, good-smelling, and benign. Mumps, I mean the word just sounds cute, doesn’t it?

Some of my fellow TSAIOPKWLC members have argued that we’re depriving the world of an important source of child tears by drastically reducing the risk of these children contracting a disease that would cause real suffering, but I just can’t help it. I love the needles.

I want to address all this misguided anger and see if we can re-direct it where it belongs.

Jack Wolfson knows where your anger belongs. Your anger just got disoriented on the way to Water Aerobics and lost its way–he’s going to redirect it for you.

1. Be angry at food companies. Sugar cereals, donuts, cookies, and cupcakes lead to millions of deaths per year. At its worst, chicken pox killed 100 people per year. If those chicken pox people didn’t eat cereal and donuts, they may still be alive. Call up Nabisco and Kellogg’s and complain. Protest their products. Send THEM hate-mail.

That’s right, folks. Cupcakes are worse than meningitis. Pol Pot, Idi Amin, Cookie Monster. That’s pretty much the whole list. In fact, because Kix kills millions of people (I’m pretty sure that’s true. Also pretty sure those people are children. Right?), you should stop calling Jack Wolfson out on his nonsense. Someone over there is doing a bad thing, therefore what I am doing is right. The logic is so compelling. He didn’t even wait to pull out this classic derailing tactic, it’s right up there at number one.

2. Be angry at fast food restaurants. Tortured meat burgers, pesticide fries, and hormone milkshakes are the problem. The problem is not Hepatitis B which is a virus contracted by drug users and those who sleep with prostitutes. And you want to inject that vaccine into your newborn?

Interestingly, one of the groups of people at greatest risk for Hepatitis B are newborns, who can get the disease from their mothers. But FYI, if you have an addiction to an injectable drug, perform sex work, or have sex with someone who does, Jack Wolfson would like you to know that you are less important than the cows that become hamburger.

3. Be angry at the companies who make your toxic laundry detergent, fabric softener, and dryer sheets. You and your children are wearing and breathing known carcinogens (they cause cancer). Call Bounce and Downy and let them know. These products kill more people than mumps, a virus which actually doesn’t cause anyone to die. Same with hepatitis A, a watery diarrhea.

What do we have to say to someone who stops to explain the definition of the word carcinogen, but provides no explanation for his claim that everything that does not kill you is safer than clean laundry? We say, “Spoken like a man who has never had a scrotal abscess caused by mumps.” It is true that mumps is not typically fatal, but it does cause fun things like male infertility and deafness. I’m sure Jack Wolfson is working tirelessly to change our built environment to accommodate Deaf children and adults and allow them the full pursuit of their civil rights. And you don’t want grandchildren anyway, so no biggie. As for Hep A, merely a few weeks of watery diarrhea and a touch of liver disease. That’s no big deal for a kid, or for their parents, I’m sure your job will totally give you those weeks off to care for your sick kid. Not many people wind up needing liver transplants, it’s fine. Dryer sheets are way worse.

Seriously does anyone know where this claim comes from? Because I have not been able to find it.

4. Be angry at all the companies spewing pollution into our environment. These chemicals and heavy metals are known to cause autism, heart disease, cancer, autoimmune disease and every other health problem. Worldwide, these lead to 10’s of millions of deaths every year. Measles deaths are a tiny fraction compared to pollution.

Haaaaa ha ha ha ha. Known to cause autism. And every. other. health. problem. There is literally no health problem that is not caused by environmental pollution. And also the fact that pollution exists means you should stop being mad at Jack Wolfson.

5. Be angry at your parents for not breastfeeding you, co-sleeping with you, and stuffing your face with Domino’s so they can buy more Tide and finish the laundry. Breastfeeding protects your children from many infectious diseases.

Parents are so selfish. Trying to finish the laundry–can you imagine? Their precious children are right there in front of them, but they just love Tide more than they love their children.

On the reals now, though, breastfeeding does protect children from infectious diseases, but only a) while you are breastfeeding and b) provided you yourself have immunity against those diseases.

6. Be angry with your doctor for being close-minded and not disclosing the ingredients in vaccines (not that they read the package insert anyway). They should tell you about the aluminum, mercury, formaldehyde, aborted fetal tissue, animal proteins, polysorbate 80, antibiotics, and other chemicals in the shots. According to the Environmental Working Group, newborns contain over 200 chemicals as detected by cord blood. Maybe your doctor feels a few more chemicals injected into your child won’t be a big deal.

Some thoughts on vaccine ingredients follow.

Aluminum: Also found in pots and pans.

Mercury: Even if it were unsafe, which it isn’t, mercury is no longer an ingredient in routine vaccines.

Formaldehyde: Way less in a vaccine than in a banana.

Fetal tissue: This is a lie.

Polysorbate 80: Commonly found in ice cream.

Animal proteins: Also found in ice cream.

Antibiotics: I like my medicine contaminated, thank you very much. That’s why I go with un- to loosely regulated treatments like homeopathy.

Over 200 chemicals: Cord blood containing zero chemicals would be made of anti-matter, and that would be pretty weird.

It must really suck to have to deal with a closed-minded doctor.

7. Be angry with the cable companies and TV manufacturers for making you and your children fat and lazy, not wanting to exercise or play outside. Lack of exercise kills millions more than polio. Where are all those 80 year olds crippled by polio? I can’t seem to find many.

He just can’t find them. Where could they possibly be? Dr. Wolfson–can I call you Jack?–Since you’re too lazy to do a google search, I would love to introduce you to my grandmother, for whom I was named. I can’t, because she’s dead, but also because she would have very little patience for your shenanigans. She got polio at age 3, leaving her permanently disabled. Among other consequences, this was the reason she was not allowed to enroll in teaching school–they said having braces on her legs meant she couldn’t get the kids out fast enough in a fire. Two of her eight siblings were also permanently disabled as a result of their polio infections. ETA: Also, nice choice of words.

Iron Lungs

These children’s breathing muscles were not paralyzed. They are just playing hide and seek inside these iron lungs.

8. In fact, be angry with Steve Jobs and Bill Gates for creating computers so you can sit around all day blasted with electromagnetic radiation reading posts like this.

Posts like this are indeed a reason to regret the invention of the computer.

9. Be angry with pharmaceutical companies for allowing us to believe living the above life can be treated with drugs. Correctly prescribed drugs kill thousands of people per year. The flu kills just about no one. The vaccine never works.Never...

Five children have already died from the flu, just here in Wisconsin, just this year. Fifty-six across the U.S. In adults, death from influenza is much more common. Over a 30-year period the CDC estimates the yearly rate of influenza deaths as ranging from “a low of about 3,000 to a high of about 49,000 people.” Where Jack Wolfson’s estimate of “just about no one” comes from is unclear.

Nor is it clear what basis he might have for his claim that the vaccine never works. Some scientists using data on actual people found that the flu shot reduces the number of children hospitalized with a life-threatening infection by 75%, and reduces adult deaths from influenza by 71%.

Finally, be angry with yourself for not opening your eyes to the snow job and brainwashing which have taken over your mind. You NEVER asked the doctor any questions. You NEVER asked what is in the vaccines. You NEVER learned about these benign infections.

Jack Wolfson knows you really well. You have never met him, but he knows everything he needs to know about you because you are angry at him. That means you have NEVER asked questions of any doctor. Because the only possible outcome of asking a doctor questions is to stop being angry at Jack Wolfson.

Also, benign infections. I forgot he actually used those words. I was just kidding before. But he actually said it.

Let’s face it, you don’t really give a crap what your children eat. You don’t care about chemicals in their life. You don’t care if they sit around all day watching the TV or playing video games.

Wow. Those are mean things to say. Because you have a problem with what he said about vaccines, you don’t care about your kids?

All you care about is drinking your Starbuck’s, your next plastic surgery, your next cocktail, your next affair, and your next sugar fix!

Maybe it’s just the exclamation point, but…it kind of seems like Jack Wolfson hates people who don’t agree with him. Like…he needs to create a straw man to argue with? And, hang on…is it just me or does it seems like that’s a straw woman?  If I didn’t know any better I would have said he seems…almost…angry.

This post was created with love and with the idea of creating a better world for our children and future generations. Anger increases your risk of suffering a heart attack. Be careful.

He is so much better than anger. All he does is threaten people that if they don’t leave him alone they’re going to get a heart attack. This is so lovingly full of love. Yeah that’s probably what it’s full of.

I wonder why people don’t trust doctors.

Let’s Talk About Intentional Weight Loss and Evidence-Based Medicine

You are a doctor. You are trying to get through a busy clinic day when there is a knock at your office door. It is a pharmaceutical rep. Before you can say anything, he lets himself in, saying, “I’ll only take up a minute of your time, but I just have to tell you about this exciting new weight loss drug. It’s 95% effective at treating obesity in adults.” Sounds good right? Oo, he’s giving away a free pocket knife with the drug’s logo on it. Maybe you do have a minute to spare. You know you have some questions about the study that got this new drug approved.

You start by asking how much weight the study participants lost on average. Turns out it’s about 10% of their body weight in the first year. So women weighing 250 pounds at the start of the study weighed, on average, 225 pounds after a year.

Well ok, so it’s not a cure for obesity, but it still sounds useful. Everyone’s always telling you how small weight loss can have a dramatic effect on health. And besides if you took the drug for five years you could lose 50% of your body weight, right?

Well…the rep tugs at his collar…not exactly. By the end of the second year, people in the study had started to regain the weight. At the end of the study subjects taking the drug weighed, on average, about six pounds less than the control group. In fact, by the end of year five, less than half the subjects had sustained their modest weight loss. Somewhere between 20-80% of subjects (depending on who you counted and how long they stayed in the study) had gained even more weight than they lost.

Ouch. So in the long run this drug could actually hurt more people than it helps? That can’t be right, can it? Still, that’s still a lot of people who are able to sustain weight loss in the long term. Given the terrible consequences of obesity, maybe a small chance at weight loss is worth the risk. Well, actually, now that you think of it, what are the other risks? That is, what are the side effects?

The rep clears his throat and begins to mumble a list. Depression, worsened self-esteem, difficulty concentrating, constant hunger, obsession with food, increased risk of eating disorders. Also bone loss.

But the side effects were rare, right? Was the drug well tolerated? The rep scratches the back of his neck. Actually not so rare. Actually about half of people assigned to take the drug dropped out of the study and no one’s sure what happened to them.

Whoa. That doesn’t sound harmless at all. Still, if it’s a choice between depression and obesity, you know most of your patients will choose depression. So which of your patients might be good candidates for this new drug?  It’s a new treatment, so maybe all of your patients should try it, just in case it works.

But then the rep starts shuffling his feet. He mutters something and you realize that this supposedly new drug is just a reformulation of a drug that has been around for a long, long time. In fact, it’s been around so long that people accept it as dogma that it works, despite its lack of evidence base. It’s extremely popular. In fact, now that you think about it, you don’t have very many obese patients who haven’t tried this drug in one form or another, on and off for most of their lives. Does it really makes sense to make them try the same drug that has failed them so many times?

But you’re not ready to give up yet. What about the control group in this drug study? What about the poor souls who did not even get to try the drug, who were just abandoned to their disease? I mean, whatever the drug’s effects, it can’t be worse than just continuing to live with obesity, can it?

The rep is ready for this. There was a control group in this trial, he is excited to tell you. He is excited, because it turns out the numerous prior studies of this drug rarely have a well-chosen control group, they just compare different formulations of the same drug if they even have a comparison group. But this control group was given no weight loss intervention at all! Instead of being encouraged to lose weight, they were just counseled on their “health” (the rep uses air quotes for this word, as though people like that could even have health). They were given mental health interventions, including learning how to read their body’s cues for hunger and satiety, and support for body image issues. They were encouraged and supported in physical activity, and taught to find ways to move their body that felt good and were sustainable. The rep is giggling now.

So it sounds like the control group must have gained a lot more weight? He stops giggling. Actually no. And how did the two groups compare in terms of other metabolic outcomes like blood pressure and cholesterol? The control group did better. And mental health outcomes? The control group did way better (though the rep whispers But who cares, it’s not like mental health is really health.) And did half of this group drop out too? No, they mostly stayed.

You politely escort the pharmaceutical rep out, thanking him for the pocket knife and accepting his card. He has given you a lot to think about.

Will you recommend the new drug? To anyone? Only to the few people that have never tried it before? How many times should you require your patients to try and fail with this drug before you recommend they stop?

Well friends, by now you see where I’m going with this: the drug in this story is not really a drug invented by some sleazy big pharma boogeyman. It is every weight loss intervention there is. It is Weight Watchers, Jenny Craig, Nutrisystem, the Atkins Diet, the Paleo Diet, the Blood Type Diet, the French Woman’s Diet, the Aerobic Housecleaning Lifestyle, the Grapefruit Diet, the Sugar-Free Diet, the Ice Cream Diet, a sensible low fat diet, and MyPyramid. It is Orlistat (slower regain but more fecal incontinence) and all the other weight loss drugs. It is gastric bypass surgery and lap bands (those probably produce slower regain, but no one really knows because the quality of the evidence is so poor, though it clearly involves greater risk of being hospitalized for things that happen when someone surgically remodels your stomach). The diets, the pills, the surgeries, they all work the same–for the vast majority there will be temporary weight loss followed by weight regain, often at serious cost to mental and physical health.

Please remember this when some recommendation comes out suggesting “treat the weight first” and that all other health problems will have to take a back seat. Remember this when academics are slap-fighting about whether BMI is linked to mortality. None of it actually matters at all to the patients you have today, because existing weight loss interventions don’t work. Even with outcomes for which weight loss could be beneficial, the benefit will be temporary if and when the weight comes back. Quickly or slowly it will come back for all but a very few. The best most people can expect for their pain and suffering is to be about five to ten pounds lighter, and those are the minority for whom the treatment succeeds. It doesn’t matter how big a problem you think obesity is, and it doesn’t matter whether or not you’re right about it, because we do not have any tool that will make obesity go away.

Like the villain in this story, there are a lot of people and a lot of companies who make money off of the promise of weight loss. It’s a great business model; the more the intervention fails, the more money people pour into it. These people and companies have a vested interest in perpetuating the lie that anyone can and should become thin. But medicine doesn’t have to be a part of it.

To any reader who would like an overview of these issues in scientific language rather than in the form of a short story, I highly recommend this review article by Linda Bacon.

Update 1/24/2015: It’s been great to see how much interest this post has generated, and I hope that it will start a lot of productive conversations. Hello and welcome to everyone that’s new here. Out of more than 1,000 visitors that have stopped by in the past 24 hours, only one person has felt the need to leave hostile comments, which I have since deleted. However in the interest of keeping the dialogue constructive I don’t think I can continue to leave comments unmoderated, and since I can’t commit to moderating them in a timely manner I have disabled comments. Thank you to everyone who is contributing to a civil discourse around these complex issues.

Three Healthy, Easy Recipes for Winter Vegetables

It might be spring as far as the solar system is concerned, but that I think we can agree that is a delusion. The weather, while no longer technically colder than a polar bear’s poop chute, is still completely unpleasant. But never fear. I have compiled three of my favorite vegetable recipes–easy, healthy dishes, road tested in my own kitchen–that have gotten me through this unusually heinous winter. And now I’m going to share them with you, cause we all know there is no excuse for not cooking fartloads of yummy healthy vegetables on the regs, and because you totally asked.

Roasted Beets with Arugula and Blue Cheese

Beet-Arugula-Salad3 medium-sized beets
1 bag pre-washed arugula
1/4 lb blue cheese, crumbled
1 clove garlic
1 tbsp olive oil
salt and pepper to taste

  1. Purchase beets at the co-op.
  2. Upon arriving home, realize you forgot to buy cheese.
  3. Reject the idea of roasting beets without cheese, as husband is only eating the beets with cheese because you’re snotty about it, and probably can’t manage to swallow plain beets.
  4. Buy cheese at next trip to co-op.
  5. Use cheese as topping for popcorn.
  6. Forget to buy cheese for three subsequent trips to co-op.
  7. At next trip to Costco, suddenly remember urgent need for blue cheese. Buy only available quantity.
  8. Return home triumphant, to discover beets have gone squishy and gross. Discard beets.
  9. Stare gormlessly at 1.5 pound tub of Gorgonzola.
  10. Make popcorn.

Warm Herbed Carrot Salad

1 lb baby carrotsCarrot-Salad
1 tbsp olive oil
2 cloves garlic
3 fresh basil leaves
Kosher salt and pepper to taste

  1. Begin as you would to roast carrots. Toss carrots in olive oil to coat, adding minced garlic and fresh basil, salt and pepper.
  2. Place in oven at 450 degrees for one hour.
  3. After 20 minutes, lose patience. Remove carrots from oven, and rechristen dish Warm Herbed Carrot Salad. Serve immediately.

Perfect Steamed Broccoli

Did you know that boiling vegetables leeches 62% of all nutrients into the cooking Broccoliwater you pour down the drain? I got that figure from the guy selling juicers at Costco. Steaming is a great way to use less water and keep all that nutritiony goodness. Light, crispy steamed vegetables are easy when you have a rice cooker with a steaming tray. Follow these instructions to cook broccoli florets so adorable you’ll feel conflicted about eating them.

1 medium head of broccoli
1 tbsp olive oil
Salt and pepper to taste

  1. Chop the broccoli head into small florets, and the stem into 1/2-inch wheels.
  2. Place the chopped broccoli into the steaming tray.
  3. Realize the volume of the broccoli is roughly three times the volume of the tray.
  4. Mutter “I don’t have time for this,” dump the broccoli into a pot of water and bring to a boil.
  5. Pour 62% of your nutrients into the sink, and serve the remaining 38% with olive oil, salt, and pepper to taste.

Image credits:

Beets: Muy Yum via photopin cc
Carrots: jazzijava via photopin cc
Broccoli: meg’s my name via photopin cc

On the sauce while up the pole? I have some thoughts on that.


Image from hellogiggles.com

Believe it or not I blogged eight whole years ago on the issue of alcohol and pregnancy, inspired by one of many rows I had with my mom while eating crêpes (I used to live a block away from a crêperie; it’s not weird). Yet somehow that one blog post did not permanently settle the issue for all human beings everywhere. As more and more of the women in my cohort get pregnant, I am learning that lots of them think the injunction to avoid all alcohol is just another moral panic–or, as my mom put it, a Scheme to Deny Women PleasureTM (she drank while pregnant with me). In fact, some of my very smart non-pregnant doctor-ly friends agree with them. I’ve endured quite a lot of scientific training since the demise of the blog of my youth, and it has emboldened me to question a lot of medical dogma. But this is one issue of which I am more convinced than ever.

One of the frustrations of being pregnant is that it involves being surrounded by people who believe it is their god given right–nay, their duty–to tell you what to do. I’m not trying to add myself to that list. Let me be very clear: I am not trying to tell any woman whether or when to drink. But I do want every woman who faces this decision to understand the issues clearly, so that she can decide without everybody shouting.

You will have realized by now that this is a Serious Post, so if you would rather scroll down to the scrotum jokes, now’s the time. Everybody else with me? Let’s go on. Continue reading