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Just what Dr. Egnor wanted for Christmas: Some not-so-Respectful Insolence!
By oracknows on December 24, 2008.
It's Christmas Eve.
I know, I know, it's all supposed to be Peace On Earth, Good Will Towards Men (and Women), and all that jazz. Really, that's exactly what I had intended for today and tomorrow. Indeed, my plan was to do nothing more than a quickie post today and a maybe a couple of brief (and hopefully amusing) Christmas-related posts this afternoon and tomorrow. Really, I had.
Then it came, and it came from a direction that I least expected. Yes, yet another "old friend" of the blog had to go and and not just ask but beg for a heapin' helpin' of not-so-Respectful Insolence. My readers know that I seldom turn down such heartfelt requests. I may be cranky, arrogant, and cantankerous, but I'm a benevolent box of blinking lights, and it is Christmas Eve. That creationist neurosurgeon with a love of pseudoscience and logical fallacies, that surgeon who embarrasses me with his frequent fusillades of misinformation about evolution, so much so that I have joked about wearing either a paper bag or a Doctor Doom mask to hide my face, that man with a knack for perseverating about the same misinformation over and over and over again no matter how many times he is corrected, Dr. Egnor, has gone off the deep end again, launching a direct frontal assault against me and fellow skeptical and science-based physician Dr. Steve Novella. My Christmas present to him is to give him the not-so-Respectful Insolence that he's clearly asking for.
Now, you'd probably expect that, as usual, Dr. Egnor's broadside would be about evolution (replete with his repetitive perseveration that the "only contribution" that "Darwinism" has ever made to medicine is eugenics) or about dualism and his belief that the physical brain and central nervous system are insufficient to explain the mind. Most recently, he was going on and on about how he has taught medical students for decades and how his experience as a physician and in clinical practice allows him to "recognize B.S." when he sees it, in this case the claim that evolutionary biology contributes to medical advances. My words at the time (a mere two weeks ago) now seem prescient:
Actually, those who have been regular readers of this blog almost certainly realize that Dr. Egnor holds far too high an opinion of the utility of medical practice as an "effective check on b.s." In fact, it is science that serves as a "very effective check on b.s.," not medical practice. Indeed, I've argued that time and time again. Yes, it's true that science is often wrong, that sometimes it takes a maddenly long time for incorrect paradigms to be overthrown by new experiments and observations, and that the process of correcting accepted scientific dogma with hypotheses that more closely fit the data and make better corrections can be incredibly messy viewed from the outside, but science is inherently self-correcting. Eventually, b.s. is cast out. Not so when it comes to pseudoscience like ID creationism and--yes, you knew I'd mention it eventually--unscientific medical practices.
After all, what is the whole concept of "complementary and alternative medicine" (CAM) but incredibly concentrated b.s.; yet medical practice seems to have no effect preventing so many physicians to believe in a variety of unscientific and ineffective treatments. Indeed, unscientific CAM has infiltrated bastions of scientific medicine, such as Yale, Beth Israel, and others. Medical practice didn't stop Dr. David Katz or Dr. Andrew Weil from falling into pseudoscientific woo. It certainly didn't stop Dr. Jay Gordon from deciding that his clinical experience leading him to believe that vaccines cause autism trumps the strong science and epidemiology that say they do not, from making brain-meltingly ridiculous claims that there are "toxins" in vaccines that cause all sorts of terrible complications, or even giving speeches to rallies organized by people and groups who are antivaccine. He even exasperates the normally mild-mannered Steve Novella.) Practicing medicine didn't stop any of these people from diving headlong into pseudoscience, even in areas directly related to their medical practice.
And it certainly didn't stop Dr. Egnor from falling headlong into the antiscience of ID creationism.
Sometimes I amaze even myself. I came so close to hitting on what Dr. Egnor would do next that I scare even myself. So, let's see. We've seen Dr. Egnor deny evolutionary theory using pseudoscience and logical fallacies. We've seen him go through all sorts of logical contortions and twisting of evidence to argue that the brain is not sufficient to account for the mind. So what's next?
That's right: The full court press attack on scientific medicine and medical "arrogance." Witness his post at the house organ for pseudoscientific evolution denial, Evolution News & Views entitled Advice to an Arrogant Medical Priesthood: Wash Your Hands.
True to Dr. Egnor's form, it's the single longest non sequitur I've ever seen. Despite Dr. Egnor's denials that he supports "alternative medicine" or antivaccinationism, it's also chock full of attacks on scientific medicine and the "arrogant medical and scientific priestcraft" that would not be out of place on Whale.to, NaturalNews.com, Mercola.com, or even Age of Autism. Get a load of it:
There is an internet cottage industry of physicians and scientists who regularly excoriate alternative medicine and other non-traditional or even fringe approaches to health or to scientific understanding. Steven Novella, Orac, and a host of other faux "defenders of science" decry the danger to the public from vaccine "denial," homeopathy, acupuncture, chiropractic, among others.
Now, I'm more than proud to be part of this "cottage industry," along with Steve Novella, Dr. R.W., PalMD, Mark Crislip, Harriet Hall, and other skeptical physicians. Occasionally, I get e-mails from people thanking me for helping them turn away from woo or for supplying them with ammunition to argue against woo with a family member or friend. These occasional e-mails are reward enough for what I do. If I can lead just one person to see the light and avoid falling into the clutches of quacks, the last four years of blogging will have been worth it.
Interestingly (to me, at least), I can't help but notice that Dr. Egnor chooses to use the word "industry," as though we're all in this to make money. Doesn't it have the connotation of a certain industry, big pharma, perhaps? Maybe I'm being a bit paranoid, but it sure sounds like an insinuation that we're in "industry's" pocket or that we're somehow making money off of our efforts. Or maybe I'm giving Dr. Egnor credit for too much subtlety. In any case, to clarify, of all the skeptical physicians who blog, the only ones I know of who make any money at all for their efforts are PalMD and I, and, trust me, it's not exactly a lot. Because we blog for ScienceBlogs, we are paid a small amount based on our traffic. It doesn't matter; if ScienceBlogs didn't exist or never invited me to join the collective, I'd still be doing this, either on my old (and currently mothballed) Blogger blog or on a different platform.
In any case, after insisting that he is not a "supporter of 'alternative medicine,'" Dr. Egnor launches into a huge hunk o' burnin' stupid in the form of the silliest non sequitur I've ever seen. Really, there are lots of things Steve and I or the science-based medicine we routinely defend might be criticized for, but what Dr. Egnor latches on to is about as silly as it gets. Logic? Who cares? Science? Who cares? Dr. Egnor, desperate to brand Steve and me "hypocrites," decides to fixate on...washing hands:
Yet there is an irony in the efforts of "defenders of science" to protect the public from treatments and theories that are outside of the mainstream of medical practice. The greatest iatrogenic danger to patients isn't chiropractors or homeopaths or vaccine "deniers." It's the doctors, nurses, and other medical personnel working in the traditional medical paradigm.
The data is uncontestable. Each year in the United States, errors of traditional science-based medical practice kill at least a hundred thousand people, probably substantially more. These errors include medication errors, surgical errors and unnecessary surgery, preventable bedsores, infections caused by poor technique and the failure of medical personnel to practice good hygiene such as hand washing, and many others. Note that none of these deaths are caused by homeopaths, vaccine "deniers," etc.
The harm done by traditional practitioners of medicine is one of the leading causes of death in the United States. Where is the introspection by "skeptics" and "science defenders" like Drs. Novella and Orac about the enormous harm done to patients by themselves -- traditional medical practitioners? What hypocrites.
What a moron.
I've tried. Really, I've tried not to call Dr. Egnor a moron or to insult him. I've told him he's wrong. I've pointed out his logical fallacies and statements that are simply not correct. Unfortunately, he now leaves me no choice. He calls me an arrogant hypocrite based on a huge logical fallacy? I'll return the favor by calling him a moron, and an obtuse moron at that! Yes, he's a neurosurgeon, and he possesses knowledge and skills that I don't have and will never have. No doubt he is highly intelligent in some ways and skillful at what he does; unfortunately, aside from his surgical knowledge and skill, elsewhere his intelligence has apparently been placed in the service of his ideology and religion. In contrast, I'm a scientist and a cancer surgeon. I possess knowledge and skills that Dr. Egnor does not and will never possess, the most important of which are an understanding of the scientific method and a skeptical mind. That's why, after Dr. Egnor's ignorant broadside, I now feel justified in saying that, when it comes to science, Dr. Egnor is a moron.
Dr. Egnor gets it all wrong anyway. No one's saying that doctors can't be arrogant and lazy. They are human beings, after all, and human beings with power at that. Besides, it's not science or science-based medicine that's leading doctors not to wash their hands enough between patients. Indeed, science, and science-based medicine tell us that we should, that it decreases the chances of spreading pathogenic microbes from one patient to another. It's a message that begins right in medical school. The problem isn't that doctors don't accept that washing their hands is important for infection control; they do. Ask any physician if it's a bad idea not to wash his hands between patients, and virtually every single one will agree that it is. The problem is that physicians are human, and human nature makes it easy for them to forget to do it--even leading them sometimes to misremember doing it when an objective observer can see that they did not--especially when they are rushing busily about on rounds. That's one reason why hospitals have tried to make it easier for physicians and other health care personnel to remember. These days, in most hospitals, there are dispensers of alcohol-based antibacterial lotion or foam outside of every patients' room. Just a quick spritz between patients is all that's needed, and it works.
Dr. Egnor also doesn't earn much in the way of scientific style points for linking to a post from Mercola.com called Death By Medicine to make his point against Steve and me. The damned article is even co-written by über-quack, HIV/AIDS denialist, coffee enema maven, and antivaccinationist Gary Null! Really, Dr. Egnor should look into his sources a bit more closely before citing them. He couldn't have chosen less credible or less reliable sources if he had tried (well, maybe if he had also included Mike Adams of NaturalNews.com). Besides, this article was thoroughly taken apart by Harriet Hall not too long ago, and Peter Lipson has also discussed the exaggerated claim that iatrogenic causes are among the top causes of death in the U.S. Finally, it should be pointed out that, besides being science-based, one area in which science-based medicine distinguishes itself from "alternative" medicine is in a rigorous, ongoing attempt to reduce medical errors, as Peter also discussed here and as I've discussed when I lamented the Office for Human Research Protections putting the kibosh on a test of a checklist for placing central lines.
In any case, just when I thought Dr. Egnor couldn't sink any lower, he then pulls out the favorite of apologists for "alternative medicine" everywhere. That's right. He likens defenders of science-based medicine to an "arrogant priesthood":
Arrogance of scientists and physicians is an old scourge. Alfred Russel Wallace, who helped develop the theory of evolution in the 19th century and who confronted the scientific arrogance of his own day, famously commented on medical arrogance in a different context (i.e. eugenics), calling it
... an arrogant scientific priestcraft. (1)
Of course. Dr. Egnor can't discuss medicine without invoking eugenics. He seems utterly incapable of not bringing up eugenics any time he discusses medicine. It seems to be in his DNA. I am, however, surprised that he did not bring up Ignaz Semmelweis, the physician who discovered 150 years ago that simple hand washing could prevent the spread of puerperal fever among women giving birth. I suppose I should be thankful for small favors. Or maybe Dr. Egnor isn't familiar with Dr. Semmelweis. Suffice it to say that his results were not as controversial as quack apologists like to claim, and he brought some of the abuse he received on himself. Whatever the case, what comes next is painful to read, not because it cuts me to the quick or anything like that, but by how embarrassing it is to me as a fellow surgeon:
Far more damage is done to patients by doctors and other mainstream health care providers than is done by vaccine "deniers," acupuncturists, homeopaths, etc. Fatal disease is much more likely to be spread by a doctor's unwashed hands than by some (mostly misguided) parents who fear that a vaccine may harm their child. I've never known a patient to be harmed by a chiropractor. Tens of thousands of patients each year are harmed in preventable ways by their (usually well-intentioned) surgeons.
Dr. Egnor labors under the delusion that we who advocate science- and evidence-based medicine either aren't aware, don't care about, or don't pay attention to the shortcomings of modern medicine. Nothing could be further from the truth. We do, as I pointed out above. Our patients demand no less. Science demands no less. I emphasize again to him that the very data about the dangers of physicians not washing their hands comes not from creationist neurosurgeons like Dr. Egnor or supporters of quackery like Gary Null or Joseph Mercola. Rather, they come from physicians doing scientific studies. They come from science- and evidence-based medicine. They come from the application of science to the question of identifying shortcomings in current medical practice and identifying ways to remedy them.
How unlike "intelligent design" creationism, for example!
I have to wonder: For all his protestations that he does not support "alternative medicine" or antivaccine fear mongering, does Dr. Egnor realize that the comparison of scientists and science-based physicians to a "priesthood" and of science-based medicine to a "religion" is straight out of the playbook of quacks? Dr. Egnor assures us in his post again and again that he does not support the quackery that is most of "alternative medicine," but he seems blissfully unaware that he is using exactly the same rhetorical techniques that quacks and apologists for quacks like to use. There is, of course, a reason for that. The same rhetorical techniques are what Dr. Egnor routinely uses when attacking evolution and "materialist" neuroscience, and it's probably very easy for him to slip into using them in this new context. Still, I'm guessing that Dr. Egnor doesn't know that he's echoing the rhetoric of the pro-quackery underground, but he is, especially with his next comment:
My advice to Dr. Novella, Orac, and other arrogant medical clergy: go easy on the parents concerned about autism from vaccines, even though the evidence suggests that their fears are unfounded. They're not idiots, and they shouldn't be treated with scorn. A little humility on the part of doctors, and some respect for the right of people to hold other views (even if those views are wrong), and to act on those views, would be a good thing. Respectful discourse with patients who disagree with our advice, not scornful excoriation, is much needed.
What Dr. Egnor is blissfully ignorant of is that none of us--and I mean none of us--attack typical parents who are fearful of vaccines, at least not the vast majority of these parents. Rather, we excoriate a small subset of these parents who not only believe that vaccines cause autism, but have taken it to the level of becoming leaders and activists in the antivaccine movement. I mean parents like Jenny McCarthy or J.B. Handley, not Joe and Jane Sixpack, who hear Jenny McCarthy's idiocy or come across the Generation Rescue website and, without a scientific background and not knowing any better, wonder if there might actually be something to the hysterical claims that vaccines cause autism. I can't speak for anyone else, but my contempt is not reserved for parents; it is reserved for the leaders and opinion shapers of the antivaccine movement, be they parents of autistic children (like Jenny McCarthy) or opportunists (like David Kirby and Robert F. Kennedy, Jr.). They are the ones who foment resistance to vaccination based on pseudoscience, not the parents these leaders scare. These frightened parents need evidence-based explanations of why Jenny McCarthy and her ilk are wrong. In essence, Dr. Egnor might as well be Robert F. Kennedy, Jr. ranting that those of us who oppose antivaccine pseudoscience hate mothers.
Dr. Egnor can't resist finishing:
Doctors should be less arrogant with our advice and we should denounce faux "skeptics" like Dr. Novella and Orac who exhibit no skepticism about their own dogma and behavior and are coarsening this discourse because of their own ideological commitments rather than for any rational commitment to public health.
My irony meter just exploded, leaving nothing but a quivering, molten pile of circuitry, capable of releasing only the occasional whimper.
Ideological commitments? Faux skeptics? It was an ideological commitment to his religion over science that led Dr. Egnor to reject the science of evolution. It was Dr. Egnor's lack of skepticism towards his own dogma and behavior that has led him to become the attack poodle of the Discovery Institute, which exists not for science but to push an ideology! If anyone's "arrogant," it's Dr. Egnor. He has the arrogance of ignorance, at least about evolution. He seems to think that his "clinical experience" inoculates him from "B.S." and that his education as a neurosurgeon provides him with sufficient knowledge and understanding to make pronouncements about evolution. Indeed, he is the most "faux" of faux skeptics in that his "skepticism" is nothing more than opposition that no amount of evidence can sway. I realize that Dr. Egnor will never believe me when I say this, but if, for example, well-designed scientific and epidemiological studies started to show a clear link between vaccines and autism, I would rethink my position. I really would. Ditto if good studies came out clearly supporting the efficacy of various alternative medicines above that of a placebo. In contrast, I'd ask Dr. Egnor the question: Is there any evidence that could ever make you change your mind about evolution or neuroscience? If so, what is it?
I think we all know the answer to that question.
Depressingly (for me, at least), Dr. Egnor appears to be branching out. No longer satisfied with just denying evolution and blaming Darwin for eugenics and the Holocaust, or even with espousing dualism when it comes to the mind, apparently Dr. Egnor wants to start defending antivaccinationists, homeopaths, and other quacks against justified attacks based on science. Worse, he does it not because he actually believes in the quackery but rather because such attacks are nothing more than a convenient tool for him to attack those who call him on his pseudoscience.
And, lest I forget: Merry Christmas, Dr. Egnor! Consider this loving application of not-so-Respectful Insolence a Christmas present from Orac to you. Clearly, judging by your post, it's just what you wanted for Christmas. How else to explain a broadside against me and Steve a mere two days before?
Antivaccine nonsense
Intelligent design/creationism
Quackery
Skepticism/Critical Thinking
Brain and Behavior
Smackdown, please (yes, Egnor, I'm talking to you)
Arrogance. It's always about arrogance. Arrogance is the Great Distractor in science. It is a half-a-dozen logical/rhetorical fallacies rolled into one---argumentum ad ignorantium, non sequitur, tu quoque, ad hominem, straw man (yes, that's not six yet, but I gotta give myself some flexibility…
A belated Christmas present for a certain creationist neurosurgeon from SUNY Stony Brook...
...more not-so-Respectful Insolence, courtesy not of Orac this time but of other skeptical physician-bloggers! Enjoy: Smackdown, please (yes, Egnor, I'm talking to you) (by blog bud PalMD) Defending science-based medicine (by skeptical neurologist Dr. Steve Novella, who's been known to spar a bit…
Scientific medicine is "truly nonsense"? Orac says no!
Orac note: Congratulations on California and everyone who reads this blog who helped pass SB 277 to protect California's children. Here's hoping Governor Jerry Brown signs the bill! I had a big talk to give this morning that required a massive rewrite of my slide set last night; so there wasn't…
The "triumph" of New Age medicine? The Atlantic strikes again
Note added 6/16/2011: The author of the target--I mean subject--of this piece of insolence has responded in the comments. Note added 6/17/2011: Steve Novella has also commented. He is unusually harsh (for him). What is it with The Atlantic lately? It used to be one of my favorite magazines. In fact…
"Attack poodle"?
For some reason I tend to see him as the 'attack duck' of the Discovery Institute.
What is it that ducks say again?
By Sigmund (not verified) on 24 Dec 2008 #permalink
Now, the real question, do I respect the submission of Egnor's recent musings for the upcoming (Darwin) edition of Grand Rounds, or do I choose the route of respectful insolence?
I'll have to think on it...
By moneduloides (not verified) on 24 Dec 2008 #permalink
I'm one of those that appreciates the ammunition--thanks so much. It really is helpful to have teh stupid cataloged and referenced.
I don't know where you find the energy for this. It is becoming clear to me on several fronts that we've reached a point of intractability. The "This American Life" show that you referenced earlier this week (which I have since cited and used elsewhere--thanks) demonstrated that. They continue to convince themselves they are right despite all data to the contrary.
I'm doing battle where I can so that the unwitting Googlers will see the other side. But I don't know if it does any good.
By Mariah (not verified) on 24 Dec 2008 #permalink
I wonder where he found out about it.
You could always include this post and a post from a couple of weeks ago:
http://scienceblogs.com/insolence/2008/12/facepalm_thy_name_is_dr_egnor…
Or even a couple of my really old posts:
http://scienceblogs.com/insolence/2007/03/dr_michael_egnor_the_gift_tha…
http://scienceblogs.com/insolence/2007/03/the_energizer_bunny_of_antiev…
Truly, I wish this Grand Rounds weren't next week. Because of the holidays, I'm going to be very busy the next few days, and I'm not sure I could come up with something serious and up to the standards of Grand Rounds by then. (I may even--gasp! horror of horrors!--post a couple of reruns.) I'll try, but no guarantees. If I fail, there are, of course, these very old posts by me that you might like, though:
http://scienceblogs.com/insolence/2006/03/medicine_and_evolution_part_2…
By Orac (not verified) on 24 Dec 2008 #permalink
It was a third-party submission.
I can't wait until I'm considered a skeptical physician. Three more months to go.
Anyway, I read Egnor in my crank feed when he made this argument, and I couldn't quite believe it. I think this is an example of crank magnetism but it's even more than that. It's part of a new attack in general that suggests that any criticism of other ideas of others is "arrogance". A perfect cover for creationists who have some of the stupidest ideas of all.
By MarkH (not verified) on 24 Dec 2008 #permalink
Thanks for being easy on us parents who don't have a scientific background. As you know, my daughter has heterozygous familial hypercholesterolemia, and when I started researching FH, cholesterol drugs and so forth, I looked at some pretty unreliable sources on the web and wondered if what they were saying was true. Fortunately, I went and read some of the actual FH studies and consulted with some cardiologists and other knowledgeable physicians and eventually educated myself pretty well in the area (for a layperson).
By Marilyn Mann (not verified) on 24 Dec 2008 #permalink
So...is Engor saying that alternative practitioners never forget to wash their hands or that, because they are alternative, they don't have bacteria? Neither seems...likely.
By Dianne (not verified) on 24 Dec 2008 #permalink
So... isn't Egnor a surgeon? Doesn't that make him an arrogant hypocrite who spends his time killing his patients, by his own admission? So why should I listen to a thing he says?
By Chayanov (not verified) on 24 Dec 2008 #permalink
isn't Egnor a surgeon? Doesn't that make him an arrogant hypocrite who spends his time killing his patients, by his own admission?
Ah, but Egnor is different. He's a Mavrick(TM) and therefore you can trust him.
My! Dr. Egnor's encyclical on physician arrogance just blew out all the irony meters in my lab. This is going to take weeks to repair! It took over an hour just to clear out all the smoke!
Seriously, though, does Dr. Egnor not see how his arrogance - his absolute certainty that he is right despite over 150 years of scientific data supporting evolution - completely negates his entire "point"? Apparently, in the bizarre world of Dr. Egnor, his vast experience opening patients' skulls trumps decades of work by thousands of dedicated scientists and yet he's the one being arrogant?
At least, being a surgeon, he washes his hands before he operates.
I read his epic-length rant and came away with the impression that it is largely about how upset he is that we mere mortals (i.e. non-neurosurgeons) haven't simply taken his word that he's right and all the thousands of scientists over the past century and a half are wrong.
That has got to sting. After all, isn't he at the very pinnacle of the "Arrogant Medical Priesthood", being a neurosurgeon? Shouldn't we all prostrate ourselves before his towering intellect? Yet, perversely, we fail to acknowledge his self-evident rectitude and persist in our sinful, skeptical ways.
Actually, I don't feel that favoring evolution over Creationism (Excuse me! "Intelligent Design") quite rises to the level of "skepticism", any more than it is "skepticism" for an adult to not "believe in" the Tooth Fairy or the Easter Bunny (I'll not mention a certain red-coated gentleman out of respect for the season).
It sounds as though Dr. Egnor wants all of us to stop listening to the "Arrogant Medical Priesthood" - and, I suppose - the "Arrogant Scientific Priesthood, as well - because they won't listen to him. From this latest Jeremiad, it would appear that he wants us to submit our minds and reason to the "Maverick Doctor Priesthood", instead.
He spins off on a long tangent about iatrogenic deaths and injuries without showing any sign that he is aware that "alternative" medical therapies have killed and injured, as well (and, as far as we can tell, do not have the efficacy of real medicical therapies). In fact, he completely ignores the fact that we know - in meticulous detail - the drawbacks, side-effects and failings of modern medicine because modern medicine (unlike "alternative medicine") keeps records of its failures and tries to learn from them.
Dr. Egnor's argument seems to be that since modern medicine causes injuries and deaths, that it is inherently inferior to "alternative" medicine, which in most cases does nothing at all.
Can he even smell the bullshit he's shoveling? Is he still doing surgery? If so, my hypocrisy meters are in grave danger. I must remember to keep them unplugged when I surf the 'net.
Personally, I'd rather "believe" the work of thousands of scientists supported by reams of data over the fanciful religious delusions of a fringe group of pseudoscientists. Dr. Egnor offers us no data, no explanation and no support for his arguments and claims apart from his assertion that he knows more than we do. In his opinion, we should believe him because he is...well, because he know's he's right and we're wrong.
In essence, Dr. Egnor is telling us to trust him when he says that doctors can't be trusted.
Now that's arrogance!
Or a paradox.
By Prometheus (not verified) on 24 Dec 2008 #permalink
Don't forget, Dr. Egnor is also a professor in the Dept. of Pediatrics at Stony Brook. Maybe he and "Dr. Jay" Gordon can get together at meetings to revel in their antiscience-based notoriety, while the other pediatricians cover their heads in embarassment.
Egnor's parade of tu quoque irrelevancy includes the statement "I've never known a patient to be harmed by a chiropractor." Is Egnor really such a fool that he's never stopped to consider how many people delay or forego effective medical therapy in order to pursue useless, expensive treatment for non-musculoskeletal conditions at the hands of chiropractors? Just googling "neck cracking" and "stroke" should disabuse him of his idiotic notions about chiro safety.
I think I'd pay to see a tag-team debate between (on the one hand) Doc Egnor and Jay Gordon, facing Orac and Steve Novella. The first team to 100 logical fallacies is sentenced to having all their future medical care provided by Drs. Mercola and Hulda Clark.
By Dangerous Bacon (not verified) on 24 Dec 2008 #permalink
Egnor's parade of tu quoque irrelevancy includes the statement "I've never known a patient to be harmed by a chiropractor."
Less than 5 minutes of searching on medline yielded numerous reports of people being harmed by chiropractors. For example, this one If Dr. Egnor hasn't found any data suggesting that people can be harmed by chiropractors then either he's never looked or he really doesn't know how to use the internet.
Am I missing something here?
Surely the logic of Egnor's view is that he should abandon neurosurgery (which like anything in medicine will have finite rate of complications, adverse effects and iatrogenic injury) and take up chiropractic... or even alternative neurosurgery. Actually, given his belief in Mysterious Divine Forces, a career in Neurosurgical Reiki (or even Faith Healing) must be beckoning.
Over in the UK our Chiropractors are currently suing a well known science writer for having pointing out that their interventions have no demonstrable benefits (outside of treating lower back pain) and do have established downsides. I will be hoping that the British Chiropractors Association call Dr Egnor as an expert witness, at which point some highly paid and supercilious London libel lawyer would be able to question him about his beliefs on evolution and the nature of scientific evidence. Now there's a tasty prospect.
By Dr Aust (not verified) on 24 Dec 2008 #permalink
If Dr. Egnor thinks nothing the brain does can explain the mind, why does he bother operating on the brain? After all, Terri Schiavo was somehow still "in there" after her brain had disappeared, right?
If Egnor can't grasp the fact that minds are what brains do, then he can't possibly agree that life is what cells do. So he's a vitalist. The fact that we don't know everything about the operation of the cell proves that there's some "vital force" that runs the whole thing. We know even less about how the brain generates the mind, therefore there must be some immaterial agent, the "soul" in there, too.
Is my understanding of his idiocy correct, or am I missing something?
By Lurkbot (not verified) on 24 Dec 2008 #permalink
No, Lurkbot, that's pretty much it.
By PalMD (not verified) on 24 Dec 2008 #permalink
I have said this at Steve Novella's place and will repeat some here. I am disgusted and outraged at E(I)gnor(e)'s defense of quacks, quackery, fakes and frauds. CAM has affected my near and dear - my father who was claimed by acupuncture (crudely alcohol sterilized needles->pinpricks->wounds->sepsis->toxic shock->multiple organ failure) and my mother-in-law who suffered for over 20 years from rheumatoid arthritis, and saw succession of quacks including chiropractors. I know at least one person who has and carry a withered arm all her life because her father - an extreme religionist - would not inoculate her against polio when she was a child. CAM kills, ask me. How can an ignorant moron be allowed to practice? I feel the seething rage my uncle expressed. Michael Egnor, you should be ashamed of yourself. Remember you can't bring back me and wife our parents. So that is all your fake innocence is worth.
By thurgood (not verified) on 24 Dec 2008 #permalink
Interesting hit job. I admit that Doctor Egnor is weird, even crazy, but surely there's something in his work worthwhile?
http://sciencedefeated.wordpress.com/
By notedscholar (not verified) on 24 Dec 2008 #permalink
While it may not Dr. Egnor wanted for Christmas, that is some not-so-Respectful Insolence. I will take the opportunity to wish you, your family, and your readers a Merry Christmas, Happy Holidays, Happy Spaghetti Monster, or whatever else they are into. I look forward to reading your lengthy, sometimes over worded prose, but at time amusing to read prose in the coming New Year. All the best in the New Year!!
By Danimal (not verified) on 24 Dec 2008 #permalink
One piece of good news about doctors in the media: I was listening to KGOE 1480 earlier this week, and someone called in to Dr. Dean Edell asking on behalf of his father about some "alternative" cancer treatments at a Mexican clinic. The father had recently been diagnosed with a recurrence of his bladder cancer after surgery etc. and was hoping to avoid having his bladder removed.
Dr. Edell calmly and concisely explained why these "cancer cures" you hear about on the Internet are just quackery, that there is no "highly lucrative cancer industry" suppressing the true cure. Not only did he explain that it would be very easy to just document the success of a treatment, publish, win a Nobel, and get rich, but that when physicians or their families get cancer, they go to a regular oncologist.
The caller said this all made perfect sense and he would relay the information to his dad and steer him away from the quacks. I hope this made an impression on the rest of the radio audience, too.
Have a wonderful holiday season, and good luck with the winter storms.
--Kathryn
By Kathryn (not verified) on 24 Dec 2008 #permalink
notedscholar:
Yes, there is something worthwhile about Dr. Egnor's work. It is an excellent example of "your brain on creationism".
By T. Bruce McNeely (not verified) on 24 Dec 2008 #permalink
"Not only did (Dr. Edell) explain that it would be very easy to just document the success of a treatment, publish, win a Nobel, and get rich, but that when physicians or their families get cancer, they go to a regular oncologist."
If they were thinking rationally, alties would realize that physicians want the same quality, evidence-based care for themselves as they do for their families, friends and patients. In conspiracy-fantasy land, though, docs are suppressing all the cheap, safe, effective natural remedies for the sake of money, even though it condemns them and their loved ones to death.
Dr. Egnor would probably view the above statement as evidence of my "scorn" for people who use alternative treatments. I have a certain amount of scorn for quacks who exploit the vulnerable with their fakery and scams, but the highest level of scorn is reserved for health "professionals" who promulgate pseudoscience and give aid and comfort to quacks.
It's just another Egnorant diatribe from a Discovery Institute pawn. Never mind the huge non sequitur - but the very fact that he turns this into an attack on "materialism" (whatever the heck that is) once again proves that ID ideologues will misappropriate just about anything.
And the man has no integrity - how can he on the one hand pretend to be against alternative medicine, and then portray quacks as people who present a genuine challenge to the "worldview" of sensible folks who rely on evidence-based medicine?
By NP (not verified) on 24 Dec 2008 #permalink
Err, what? Am I not following Dr. Egnor's logic here? I can stuff a homeopathic remedy down my throat any time. If I see the inside of a hospital, though, it is because there is something dangerously wrong with me. So who is surprised that there are more often negative outcomes in the latter case?!
By nomuse (not verified) on 24 Dec 2008 #permalink
Re: the arrogance of ignorance
Never forget that Dr. Egnor's name has become a synonym for that.
By Inquisitive Raven (not verified) on 24 Dec 2008 #permalink
I read both Orac and Dr Novella's blogs, as well as Science-Based Medicine. It was at one of these places I left the comment that willful ignorance of the scientific facts should be labeled "Egnorance", and that one who exhibits these traits should be labeled as "Egnorant".
For Dr Egnor, in case he happens to read this:
Doctor, you are entitled to your opinion, even if that opinion flies in the face of reality. No one is trying to take that from you, or stifle your voice. However, if you persist in denying our reality and substituting your own, you should expect being laughed at and derided.
By DLC (not verified) on 24 Dec 2008 #permalink
I am currently at the sharp end.
One child receives a vaccine on day one and has severe problems - screaming for hours and then developing jaundice.
At age 8 weeks several more vaccines including round 2 of a vaccine for persons who may get into drug using or multiple sex partners. Again reactions are severe. Projectile vomiting, high fever, seizures and doctors who laugh when asked by the famlily if they would lodge an adverse reaction to vaccine report for them.
At age 16 weeks several more vaccines including a yet another repeat of the one to protect the baby from any multiple sexual activities or drug using she might be involved in.
The head blows up to a third bigger in less than a day.
Baby dies and the last parent with the child gets forced to confess he has abused and killed the child and is in prison with the other parent aware she has indeed married a monster.
But where, what or who is the monster?
Why do we need to give Hep B at age one day to a healthy child who then gets so unhealthy that the doctors who told the family to go home had to rescind his order?
Why do we need to repeat an inappropriate vaccine several times if vaccines are supposed to protect the first time round?
Why do companies say there is not mercury in their vaccines when mercury still goes in through the gates of the factory?
Why do people say this is definitely abuse when they look at the end result and havent the time to look at the family history?
Why do we pretend the Nobel Prize winner for 1913 or so does not exist?
The normal unwanted reaction to a repeat vaccine is DEATH.
Merry Christmas but not to those anaphylactically killed by repeat toxic inappropriate vaccines or those put in prison by quack doctors only able to see their own arrogance and not able even to look at complete medical histories if its more than 1 day ago.
And why dont we listen to parents who don't have qualifications but do possess the same type of brain cells that their doctors have and aren't indoctrinated but have open minds as they were obviously vaccine believers before their sad loss.
Today this family might not repeat the same vaccine schedule but in free USA they have no choice.
Take the lot or take none.
What choice is that?
Madness, indoctrination and death to the unlucky few. If 1 in 200 is the few?
By John Fryer (not verified) on 24 Dec 2008 #permalink
John Fryer:
I'm not sure what you're saying here.
I get the sense of a horrible story about the death of a child and someone falsely imprisoned. However, I could be wrong.
Who is the Nobel Prize winner that you mention? What is this stat 1 in 200 referring to? What do you mean: "I am currently at the sharp end"?
I can at least say that jaundice in a newborn is common and has nothing to do with vaccines. That does make me suspect the entire truth of the rest of your story.
Frankly, if you want us to pay attention to what you say, you could use plain English rather than rhetoric.
Any idea why Egnor chose Orac's account of the embarrassing (for CAMsters) episode of the SoH's attempt to censor the Quackometer to link to?
By Mojo (not verified) on 25 Dec 2008 #permalink
Merry Xmas, Orac. Hope you are enjoying the weather there. My mum says it's not bad today.
@T Bruce McNeeley: Almost sounds like John Fryer is using the antivaccinationist's excuse that they tried to keep Alan Yurko out of prison for. The man battered his baby to death, then tried to blame it on the vaccines. Fortunately, the legal system had more brains then that. I don't get the other references. As you said, jaundice is very common in newborns. I can't imagine ANY MD laughing at a request to submit to VAERS if there was a true reaction. Besides, you don't have to be an MD to submit to VAERS; anyone can do it.
Egnor is very embarressing. I almost hate to admit I have a MSN from SUNY Stoney Brook since that's where he's located. He may be a super neurosurgeon, but I'd never go to him nor would I recommend family members to use him. I prefer to have my doctors grounded in science and logic as much as possible.
By Dawn (not verified) on 25 Dec 2008 #permalink
Edit: I should have stayed polite (and checked my spelling).
DR Egnor is very embarrassing.
The John Fryer who commented here appears to be the same character who runs around to various blogs posting similar antivax nonsense and identifying himself as "John Fryer MSc BSc Vaccine Adverse Effects Researcher".
I haven't been able to locate any publications involving John and vaccines on PubMed, so maybe he can enlighten us as to what "research" he's done on the subject, as opposed to pulling lurid scare headlines out of his nether regions.
Merry Xmas to all.
Dangerous Bacon:
Good catch. Although I don't think scholarly publications makes someone automatically authoritative, it says something when a person fakes a publishing record! I've never published anything for example, but I wouldn't claim I had just to bolster my arguments!
I'd comment on John Fryar's poor logic, worse references and attempt to impress by anecdote and innuendo, but Casablanca (1942, Humphrey Bogart) is on.
I've never known a patient to be harmed by a chiropractor.
And I've never known anyone to be harmed by firearms. Therefore, by Dr. Egnor's impeccable logic, firearms are harmless.
In contrast, Dr. Egnor's certainty regarding the horrors of medicine as practiced by, e.g. neurosurgeons, no doubt reflects the fact that such harm is commonplace in his practice. I'll keep that in mind should I ever have need of one.
By D. C. Sessions (not verified) on 25 Dec 2008 #permalink
"Although I don't think scholarly publications makes someone automatically authoritative, it says something when a person fakes a publishing record! I've never published anything for example, but I wouldn't claim I had just to bolster my arguments!"
To clarify, I didn't suggest he was faking a record of publishing. He's described himself as a "researcher", his emphasis here is alleged vaccine dangers and a major point of research is to accumulate evidence and publish it for peer review. I couldn't find any such vaccine research involving Mr. Fryer in Pub Med so I asked about it.
I acknowledge referring in somewhat denigrating fashion to whatever efforts he may have expended in this area as "research", mainly because I doubt that anyone characterizing the results of immunization as "Madness, indoctrination and death" is sane enough to contribute anything of value.
These folks are the whacked-out Santa Clauses of the antivax movement, winging their way from forum to forum to drop their venomous turds down the chimney.
I knew a guy who was by all accounts an excellent neurosurgeon, clearly a brilliant man, who never seemed to meet a scam that he didn't like. He got taken over and over. I've heard it said that con men love surgeons, because surgeons often, believe, like Dr. Egnor, that their expertise in the operating room carries over into other areas, and that they are possessed of a general ability to detect "b.s."
Although many physicians imagine themselves to be scientists, most actually receive only rudimentary training in scientific reasoning. They learn a great deal of biology, anatomy, and physiology, but they are learning the conclusions that have been reached by scientists--they get little training or experience in drawing their own conclusions from scientific evidence. Of course, there are physician-researchers such as Orac who have acquired such experience, but it is not something that is part of the standard medical curriculum, and for good reason--learning the practical intricacies of medical care is enough of a challenge without spending time learning how to do scientific research, something most doctors will never actually do.
Medical practice itself is a curious mix of solid science and "old doctor's tales" -- therapeutic strategies that have been handed down from doctor to doctor, often based upon plausible physiological reasoning, but that have never actually been tested in a rigorous way. The very existence of the term, "evidence-based medicine," reveals that much of medicine lacks a rigorous evidentiary basis. The notion that practical experience treating patients somehow renders physicians immune to such mechanisms of self-deception as confirmation bias and the placebo effect is belied by the history of medicine. Over and over, well-accepted therapies that have been used on huge numbers of patients have been found to be valueless or even harmful when evaluated in well-designed randomized controlled studies.
By trrll (not verified) on 26 Dec 2008 #permalink
Only two people have been shot in my kitchen. Far more people have been shot and will be shot outside my kitchen. Thousands of people each year will by shot, likely by random gunmen, and the majority will not be shot by the crazy guy in my kitchen with a gun.
By Citizen Z (not verified) on 26 Dec 2008 #permalink
I suppose that Ignor accounts for the differences in the number of patients cared for in scientific settings versus those cared for by quacks. Of course he does.
I'd also guess that far fewer quacks wash their hands than to 'scientific' caregivers. Wonder if I could get a grant to study this?
Far more damage is done to patients by doctors and other mainstream health care providers than is done by vaccine "deniers," acupuncturists, homeopaths, etc.
It doesn't really take much smarts to see the flaw in Egnor's argument.
Consider an effective treatment that saves the patient's life 99.9999% of the time, and harms the patient 0.00001% of the time.
Compare it to an ineffective treatment that does absolutely nothing.
What is the ratio of harm done by the effective treatment to that caused by the ineffective treatment? Why it is huge--in fact it is infinitely greater!
Obviously, we should always prefer ineffective treatments to effective treatments.
You know, being a crank on the subject of evolution is probably somewhat benign, at least for a surgeon. So long as he adheres to standard guidelines about the use of antibiotics, he probably won't cause much harm to his patients.
But in this case, Dr. Egnor's argument calls into question his basic competence as a surgeon, because even a surgeon needs to assess and communicate to his patients the risks and benefits of surgical options. Anybody who would make such a basic and obvious error regarding benefit and risk lacks the fundamental competence to make any kind of medical decisions regarding patients.
I have to wonder: For all his protestations that he does not support "alternative medicine" or antivaccine fear mongering, does Dr. Egnor realize that the comparison of scientists and science-based physicians to a "priesthood" and of science-based medicine to a "religion" is straight out of the playbook of quacks?
Not only that, how does the religious guy make "priesthood" an insult?
By Ryan Cunningham (not verified) on 29 Dec 2008 #permalink
Turning out the lights and moving on: Goodbye, old ScienceBlogs blog, hello new blog
Today is the last day that ScienceBlogs will exist. Sometime today the site will go into read-only mode. A few days later, it will disappear completely from the Internet. It's a sad thing to contemplate after all these years. Whatever happened later, I will always be grateful for the start in…
A quick update on the migration to a new domain
Here's a brief update on the move, announced last week. Things are progressing, and most of my old material has been transferred to the new blog, which is located at respectfulinsolence.com. Of course, there are still some things to tweak and fix, which is why, given how insanely busy this week is…
A change is gonna come. Respectful Insolence is moving.
Well, QEDCon is over, and this box of blinky lights is on its way back across the pond to its home in the US, having had an excellent time imbibing skepticism from its (mostly) British and European partners in skepticism. Before I left, I made a somewhat cryptic remark about "major changes" to this…
And the box of blinky lights has arrived in Manchester for QEDCon
As you probably noticed, I didn't manage a post yesterday. Nor did I manage one today, other than this. That's because I was busy preparing for QEDCon, where I will be on a panel and giving a talk, and, of course, putting together my talk. As I write this, I'm horrendously jet lagged; so I probably…
On the "integration" of quackery into the medical school curriculum
QEDCon is fast approaching (indeed, I can't believe I have to leave for Manchester tomorrow night), and because my talk there will be about the phenomenon of "integrative medicine," I've been thinking a lot about it. As I put together my slides, I can't help but see my talk evolving to encompass…


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redpajama_set_name: RedPajamaCommonCrawl


Blog Elevated 2014 will be held at the luxurious Moody Gardens, in tropical Galveston, TX.
Just a short drive south of Houston is Galveston Island, home of Moody Gardens. We are proud to present Blog Elevated 2014 in this amazing setting.
Imagine hearing our incredible speakers and spending the day connecting with like-minded bloggers, then taking a break to enjoy the palm trees swaying in the breeze and run your toes through the white sand of the private beach. Indulge in some down time to gaze at the ocean or just lounge in your luxurious hotel room. Moody Gardens is relaxing and inspiring, the perfect place to launch your blog to the next level.
Break up the blogger monotony, step away from your desk, and join us in this oasis on the water. Finally take that tropical vacation as you combine business with pleasure and unwind in the resort-like setting. Moody Gardens is offering Blog Elevated attendees a special room rate making your visit economical and a wise investment.
Sit back and blog while enjoying gorgeous views from the Viewfinder's Terrace overlooking Galveston Bay. Bring your swimsuit and take a dip in the indoor/outdoor pool or schedule a few moments of free time for yourself in the full service spa. At night you can choose to dine at Shearn's Seafood and Prime Steaks or grab a drink in the lounge with friends new and old, watching the beautiful sunset over the Moody Gardens Pyramids. Grab an ice cream with a fresh wafflecone from Blossom's Creamery while you network. There is so much to do without even leaving the hotel!
It's well worth it to take some extra time to explore the area. We will be offering a special package just for conference attendees including full passes to Moody Gardens attractions for just $43, good for any Moody Gardens attractions while you are staying at the hotel. Watch your email and the group for more details on the special passes, and book your hotel room today!
You can't miss the iconic Pyramids gleaming in the sunlight as you drive into Galveston. This is Moody Gardens! Housing an Aquarium, a Rainforest and a Discovery museum, you'll find within a 1.5 million gallon aquarium full of creatures such as penguins, sting rays and sharks. If you want to escape to a wild habitat full of parrots, monkeys and other exotic rainforest animals, explore the gorgeous and lush Rainforest Pyramid. The Discovery Pyramid showcases key roles played by science and math if you are looking for more technical themed diversions.
After the Pyramids there is still more to see. Grab a ride on the Colonel Paddlewheel Boat, catch a movie in the interactive 4D Special FX theater, or explore the private white sand beach.
If you want even more fun, grab a ride down to Galveston Beach or walk The Strand to explore all that historical Galveston has to offer.
Relax and learn at Blog Elevated 2014 and Moody Gardens.
We can't wait to see you in Galveston!


I would never have considered doing Viking Knit with leather until Stephanie Eddy, the co-inventor of the Lazee Daizee showed how it can be done! She also sent me a 1 mm leather cord kit for me to try it out for myself. I had fun doing this and came up with two different designs. In order to keep the posts to a manageable length, I have divided the tutorial into two.
This tutorial covers a basic leather viking knit bracelet tutorial with a few technique modifications and tips of my own.
I used the large 1/2 inch Lazee Daizee Viking Knit tool for this black leather cord tutorial (the smaller tool will be used for the second tutorial later this week). You could also use the wooden dowel method but I personally prefer the Lazee Daizee tools because you do not have to make and try and attach a wire clover. The less hassle the better!
But first here is Stephanie's own tutorial which outlines how she makes her leather Viking Knit pieces. She goes over the major differences working with leather as opposed to wire. You do not need a draw plate although the leather work does stretch a little.
She demonstrates the use of large crimp tubes (like these 3x3 mm ones) to join leather lengths. She also told me in an email, "Some of my students have had good luck just tying the leather splices together with no crimps."
But since we are not working with wire, I decided to experiment and see if I could eliminate the need for crimps and splicing altogether. This requires working with a long length of cord. You cannot do this with wire as it will get bent and will overly work harden too.
Well it worked! It took a little patience to work the entire length of cord through especially at the beginning but it got easier as the bracelet got longer!
I actually began with some scrap 26 G wire so I wouldn't have to cut the leather loops at the top when I finished. I also used every other hole of the large Lazee Daizee tool.
This results in a looser weave compared to every loop on the smaller 1/4 inch tool as shown in the brown leather piece below. So it is down to personal preference.
One tip, do not trap the leather end at the beginning into the work - we usually do this for wire. Once the scrap wire is cut and the work removed from the tool, use the leather end to go through all the leather loops.
Tighten and make a knot or two. Then add a drop of Super New Glue (this is not the same as the regular Super Glue) or some other glue like E6000 to seal.
As the leather stretches, the work looks uneven.
So, roll it between your hands till it is a uniform length. It will also get a little longer.
I created a six inch length of leather Viking Knit as measured while on the tool but was longer than that with the rolling. If this is still too short for you, just add some pretty beads after the bead caps!
I decided not to use the flat glue-in clasp which came with the kit. I've mentioned this before about decorating channel bead caps with resin clay. So this was the ideal project to show how I do it.
I received these beauties from Tierracast for review a while ago. These particular ones below have holes which will require some wire work. If you cannot get these, they also make the glue-in variety with or without the channels. If you use these, Super New Glue works very well and is less messy than E6000 for this application. Just add a few drops inside the caps and then insert the cord.
I used black Apoxie Sculpt resin clay. I bought a larger quantity but you can also buy smaller amounts if you aren't going to use buckets of it.
I used gloves to mix 2 approximately equal sized balls taken from Part A and Part B. The gloves is because resin clay is also an adhesive clay and is sticky. Mix until the color is well blended i.e. no streaks. Remember that resin clay will cure to a hard consistency in a few hours.
I made a small snake and applied a little of it onto the channel portion of the caps.
Pat smooth. Some clean up on the edges might be necessary with a sharp tool like an Xacto knife.
Then press in whatever you wish - metal rondelles, chain, beads, flatback crystals etc. Let the resin clay harden overnight.
As I did not use glue-in cord ends, I had to do a little work work. Cut a short length of 20 G wire - about 5 inches and insert through the top of the leather work. One end of the wire should be shorter.
Basically make a wrapped loop using the short wire end. Trim.
Feed the end cap through then make a bend just a bit past the cap. If you want to lengthen your bracelet, add a bead or two before you make that bend.
Then finish up with a wrapped loop. You can add the clasp at this point. Or, if you still need a little length as I did, I used additional jump rings.
That is just one of an infinite number of possibilities with leather Viking Knit. Part 2 for the brown leather bracelet is here.
What a great concept. With some different end finishings this would make a great bracelet for men..especially if using the smaller size daisy.
It is a very interesting idea and I too have never considered using leather to knit before. I love the look of the brown bracelet and hope to learn how to do it in the second tutorial.


I was so tired this morning when I woke up. I thought I would be as I did not do much relaxing this weekend but I did not anticipate being so sore. My legs and back ached so much from walking up and down so many flights of stairs so many times this weekend. I definitely need to do far more exercise next year so that is one of my resolutions for the New Year.
I think work should consider themselves rather blessed to be graced by my presence today. I was so tired I could easily have slept on, for another 10 hours or so.
But no, I was up and at it. Neither bright nor so early as usual but I was still in just after 8am. The Shard looked slightly mystical in its shroud of pink cloud. As seen from Waterloo East station. I went for a stroll and a shop at lunch time with my namesake colleague. She suggested Tsuru which I had never been to before. I was slightly tempted by the Sushi but decided instead to go for something hotter. I like this part of London very much. It was quite mild today and I would have enjoyed sitting in one of the deck chairs under an orange blanket. I may have been stuck in the deckchair; they can be tricky to negotiate at the best of times and with sore back and legs, impossible so just as well we didn't have time. Back at work I enjoyed the Miso. But I did gag slightly at the very firm and slimy green stuff. Some kind of seaweed I assume so I ate it and tried to think of the goodness in it. I hope there was some goodness as it tasted vile. I chose the chicken Teryaki from Tsuru. It was served with pickled vegetables which were lovely. And far too much white rice. It tasted good and was a lovely consistency but I felt a bit blobby after all that white carbs.
Sadly not so blobby I didn't go on to eat 2 very large cookies later. Plus I had 2 lattes today. It is difficult to keep on track when you work in a large office. You are surrounded by people who eat sweet things and it is often someones birthday, leaving do, recovery from the night before or other such event which seems to necessitate large boxes of doughnuts/chocolates/cakes which are offered round. I shouldn't use it as an excuse as I did manage 2 months with no sugar but today I was very tired and weak! Despite a snooze on the train I remained tired back at home so we had a very simple supper. This little lot fed myself and Harvey; one packet of prawns and 1 large tomato shared between us and 1 pitta bread each. I threw away the mayonnaise when I removed sugar from the house. I intended to make some but the first lot I made was inedible and I have never had another go. Harvey has really missed mayonnaise in sandwiches as he can't eat butter and I refuse to buy margarine. So we tried this tonight and it was ok. A very quick and easy supper.
Off to bed any minute now!
Zoe, I rarely eat mayo unless I make it, so I substitute Coconut Oil for butter and ½ an avocado for mayo. It works great. I still eat butter, but more often at lunch I will use Coconut Oil if I am having bread, which I don't have very often during the week.
I am sure your body is reacting to the sugar consumed after doing such a great cleanse and it may give you a temporary burst of energy, it drops down just as fast and makes you feel even more tired.
I know it is the holiday season, but I have been reading your posts religiously and I definitely noticed how much more energy you had when you removed the sugar from your diet.
And, yes, I am going to say this. Why on earth are you going to wait for 2014 to start adding more exercise? What is wrong with starting tonight or tomorrow? Hmm? Please don't say the busyness of life because if you can't give yourself ½ an hour of ME Time for your health, your muscles, your weight, you are robbing yourself of feel good endorphins being released into your system and serotonin after only 10 minutes and this sets you up for more control of the cravings and guaranteed a better sleep for your body to re-energize and heal. There are all kinds of walking videos or whatever kind of exercise you want to do on You Tube for free that you can do inside.
I replied to this yesterday but can not see my reply now. Sorry if this is repeating.
Thank you so much. It is far from over. I got a call today from the doctor saying that the sodium levels are still very low, which she didn't have to tell me. I didn't get to talk to her because I let the call go to voice mail when I didn't recognize the name because she called from another doctor's phone. She is closed on Wednesday afternoon and Friday and asked me to call on Monday. She wanted to let me know if I experienced any headache that was severe or dizziness I had to go to ER. Just want I want to do. Go to ER on the weekend, one more time when everyone is so sick. Happy Holidays and Friday to you.


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La liste suivante répertorie les personnalités atteintes de nanisme.

Liste

Bouffons et nains de cour
 Seneb, nain  officiel de la cour de l'Ancien Empire égyptien.
 Nicolas Ferry, surnommé Bébé par Stanislas Leszczyński.
 Comte Józef Boruwłaski.
 Pierre Hervé, nain officiel de la cour de Louis-le-Grand.
 Helena Antonia, dame de compagnie de Constance d'Autriche.
  (1619-1682), nain de Charles  et d'Henriette de France,  à 18 ans,  à 30 ans,  à sa mort.
 Triboulet nain de François .
  Grand-Jean nain de Henri II.
 Jean Etrix, nain réputé pour sa finesse d'esprit, possédé par le Duc de Parme (vers 1592).

Phénomène de foire, nains de cirque et de spectacle
 Charles Sherwood Stratton, connu sous le surnom de Général Tom Pouce.
 Lavinia Warren, femme de Charles Sherwood Stratton
 Harry Earles et ses sœurs Grace, Daisy et Tiny
 La famille Ovitz
 Spidi, nom de scène de Peter Wetzel, clown suisse
 Dylan Postl , connu sous le nom de Hornswoggle (WWE ), catcheur

Comédiens
 Michael J. Anderson
 Kenny Baker, interprète original de R2-D2
 Billy Barty, aussi fondateur de l'association .
 Désiré Bastareaud, célèbre pour son rôle de Giant Coocoo, dans la série Le Miel et les Abeilles.
 Gary Coleman
 Warwick Davis, acteur principal de Willow
 Peter Dinklage, célèbre pour son rôle de Tyrion Lannister, dans la série Le Trône de fer ().
 Michael Dunn, célèbre pour son rôle de Miguelito Loveless, dans la série Les Mystères de l'Ouest.
 Mimie Mathy
 Angelo Muscat
 Piéral (1923-2003), acteur français.
 Jib Pocthier, comédien de la série Kaïra Shopping et le film Les Kaïra.
 Jack Purvis
 David Rappaport
 Roberto, dit « le nain Roberto », comédien français notamment dans la série de films des Angélique.
 Zelda Rubinstein
 Felix Silla
 Verne Troyer
 Jimmy Vee
 Hervé Villechaize
 Weng Weng
 Danny Woodburn
 Ben Woolf

Animateurs
 André Bouchet, Passe-Partout dans Fort Boyard
 Jason « Wee Man » Acuña, animateur dans l'émission Jackass
 Patrick Petit-Jean, apparu dans Papy fait de la résistance (né en 1952)
 Alain Prévost, Passe-Temps dans le jeu télévisé Fort Boyard
 Anthony Laborde, Passe-Muraille dans le jeu télévisé Fort Boyard

Artistes
 Bushwick Bill, rappeur américain
 Joe C., rappeur américain
 François de Cuvilliés l'Ancien, architecte
 Alexander Pope, poète anglais
 Henri de Toulouse-Lautrec, peintre français
 Michel Petrucciani, pianiste et compositeur de jazz.
Lucía Zárate, artiste mexicaine

Sportifs
 Eddie Gaedel, joueur de baseball.
 Ellie Simmonds, nageuse.
Olivia Broome, haltérophile
Maisie Summers-Newton, nageuse.
Rico Emanuel Abreu, pilote de stock-car.

Dirigeants associatifs

 Élisabeth Fuchs, pionnière du scoutisme féminin et fondatrice d'un foyer de jeunes filles.

Religieux

 Jean Colobos, saint catholique et orthodoxe.

Notes et références

Annexes

Bibliographie

Articles connexes
 Nanisme

Nanisme

redpajama_set_name: RedPajamaWikipedia


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THE continuing strength of the local housing market appears to be further confirmed by new figures showing solid demand in the building industry.
And a prominent local builder has backed the figures, saying the interest has turned around his business.
Figures released by Glenelg Shire Council show that there were 284 building permits issued by the council and private contractors within the region for 2018, for a total of more than $13 million of work, with significant government spending included in this figure.
That was down from the 304 issued in 2017. The council said the most significant investment was in the health and tourism sectors, but the residential property sector has also seen a boost.
There were 37 permits for new homes issued in the shire last year, an increase of three on 2017.
The council traditionally releases building permit figures for the financial year, rather than the calendar year, and these are usually found in its annual report.
In 2017-18 there were 288 permits issued in total. The number has fluctuated in recent times, with the 338 in 2014-15 the highest figure in the past five years.
The number of permits for new homes has been as high as 55 in 2013-14, when several subdivisions were being built, down to 23 in 2015-16.


A true annual is a plant that completes its life cycle in one year. This means it goes from seed to seed and then dies off, during the course of one growing season. The whole mission of an annual is to produce seed and propagate. That's why deadheading or removing spent flowers before the seed matures, produces more flowers and therefore more potential seed is important.
Annual flowers give you the opportunity to have a totally different look to your garden every year.
1. Planting and spacing: Plant transplants closely so they fill in quickly. Usually, the tag will say to plant 8 to 12 inches apart, so pick 8 inches for a great show of flowers more quickly. Take a ruler into the garden, or measure off the spacing with a trowel. If the plants are a bit pot-bound (roots circling around), cut an X into the bottom with a knife or use your fingers to tease them apart so they make better contact with soil.
3. Feed your plants: Once a week, feed your plants with a balanced all-purpose 20-20-20 fertilizer that you mix with water. You'll find traditional or organic fertilizers – either will do the job. One good organic is fish emulsion, which is excellent when mixed together with a kelp-based fertilizer. Your annuals will grow even better if you mix some compost or manure into your soil before you plant.


To speed up the check-in process and ensure that you are highly satisfied with your experience in our office, we kindly request that you complete the following new patient paperwork prior to your first visit.
Please bring the completed paperwork with you to your appointment. English and Spanish forms are available for your convenience.


To create a supportive and productive work environment, you need to be skilled in organizational change and business development. Our clients understand that to thrive in today's global marketplace, organizations must find new ways to learn. Our professional advisory services assist in the development and creation of an organization's continual growth and success.
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"Stepping back and thinking about what I am doing first was most useful.
"Great pace -- not too hurried, not too bare. Sense of humor made laughing at yourself easy. Very practical to bring new methods as a benefit I didn't expect."
Getting together is always useful. More of this should occur, it builds a better team."


Social Responsiblity & Crisis Communication- Are Banks listening?
This past week both KSL TV and Utah Business leaned on PilmerPR for insights regarding crisis communications and social responsibility. On KSL I remembered back on the 9/11 crisis while working with Novell and their then new CEO Jack Messman. In the interview, I also talked about the principle that it's more important to "be good" first before talking about being good.
We've published a 5 Step document for CXO's seeking to better prepare for future crisis. For those already in the middle of one, the KSL and Utah Business pieces offer help. Working from a plan during a fire fight is always preferable to winging it. Don't you think?


What can you see through this 150mm Celestron reflector?
With a short 750mm focal length and a huge light grasp 459 times that of the sharpest dark-adapted eye, the scope produces bright and wide-field images of the thousands of faint fuzzies outside the solar system – nebulas, galaxies, open star clusters, and more. With its 6" aperture, compact deep space objects – globular clusters, close binary star pairs, etc. – are sharply resolved. Using optional eyepieces and/or a Barlow to boost the magnification, you can also see subtle solar system details that are virtually invisible in smaller aperture scopes. You can study complex lunar craters, rilles, mountain ranges, and low contrast lunar ray detail. With reasonable seeing conditions, detail in Jupiter's cloud belts and the Great Red Spot (actually closer in color to the Faint Pink Spot at this point in time) are visible, as are dusky markings on the face of Saturn and Cassini's division in Saturn's brilliant rings. Because of its great light-gathering capacity, you may need an optional neutral density filter to cut down the brightness of some solar system objects for maximum resolution.
Optically and mechanically refined, and very reasonable in cost for a big 6" aperture reflector, this Celestron Omni XLT 150 has enough optical performance to keep you busy for the rest of your life.


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Origin and Meaning of the Name Arya
Discover in this article the origin and meaning of the name Arua, which became a trend thanks to a character in the series Game of Thrones.
Last update: 15 August, 2022
Choosing the right name for your baby can become a challenge for parents, as it will accompany your child for a lifetime. For this reason, you should opt for one that's beautiful and representative in every way. That's why, in this article, we'll teach you the origin and meaning of a beautiful choice for girls: The name Arya.
Arya, or Aria, has several meanings, but all of them are very delicate and beautiful. If you're looking for a cute name, which sounds good and at the same time draws attention due to its originality, be sure to read the following article.
Know the origin and meaning of the name Arya
Aria means 'song' or 'melody' in Italian, whose literal translation is 'air'.
At the same time, an aria is a musical term that refers to a piece for a soloist within an orchestra and that, in addition, is part of an opera. In Greek, Aria is areios and means 'lioness', while in Persian, it's used as a noun referring to the 'honorable' and the 'noble'. The correct pronunciation in that language is Are-ee-uh.
In both the Latin and Greek versions, the name Aria is reserved for girls, but in the Persian language, it's used for boys. The latter version is also used in Indian, Hindi, and Malayalam for both sexes. In these cases, the most common spelling is Arya.
In Greek mythology, Aria is a Cretan woman who, together with Apollo, gave birth to Miletos. The name is also related to Ares, the god of war. In Rome, Aria was a woman martyr.
The character of Arya Stark, from the "Game of Thrones" saga inspired thousands of parents around the world and made this name popular.
The diffusion and popularity of Aria
The name Arya wasn't always popular, but only appeared on the most popular lists in 2000. Its preference among parents was scarce, until finally, in 2012, it appeared among the 100 most chosen names in the world. From there, its popularity took off: A year later, it was among the top 50, and in 2017, it reached the top 20 in the rankings.
The rapid spread of the name was mainly due to the character of Arya Stark, from the television series Game of Thrones. Arya is the daughter of Lord Eddard Stark and Catelyn Tully, and the sister of Robb, Brandon, Rickon, and Jon Snow. She's one of the most beloved characters of the successful saga, and for that reason, in millions of homes, her name was chosen for little girls.
In addition, we also find the name Aria in Pretty Little Liars. There, the character of Aria Montgomery was played by the American actress Lucy Hale.
Finally, Aria appears in the children's series My Little Pony as the character of a mermaid who's part of the group of dazzlings in the Kingdom of Equestria.
Variations of the name Arya
It has become common to see the name Arya written in several ways. Let's look at some of the variations that became trendy in recent years:
Ariana (especially popular thanks to actress and singer Ariana Grande)
Famous people with the name Arya
Throughout history, there have been people from public life, arts, and sports named Aria. Let's meet some of them:
Aria Aber: American poet and writer.
Aria Barzan: was an Iranian prince and military commander who led the Persian army's last stand in the Battle of the Persian Gate against King Alexander the Great.
Aria Pullman: American actress, model, composer, and musician.
Aria Wallace: American actress and singer.
Aria Clemente: Filipina singer and actress.
Aria Curzon: American actress known for her role as Ducky in the series The Land Before Time.
Aria Fischer: American water polo player.
Arya Nasimi-Shad: Iranian swimmer who competed in the 2016 Summer Olympics.
Have you been captivated by this sweet name?
Aria, in itself, is a very beautiful and sweet name to identify your daughter. Besides, it will be even more tender to call her by the diminutive Ari.
After knowing the origin and meaning of Aria, it won't be difficult for you to choose this name for your baby. She's sure to love it!
Origin and Meaning of the Name Mia
These three letters contain a precious jewel. Today, we'll present you with the origin and meaning of the name Mia, a most precious option.
Albaigés J. Diccionario de nombres de personas. 3° Edición. España: Publicacions Universitat de Barcelona; 1993. Disponible en: https://books.google.es/books?hl=es&lr=&id=A_KHaYiixzwC&oi=fnd&pg=PA14&dq=significado+del+nombre+de+Aria&ots=-J8s1dta6g&sig=1pFgu3ucu82p8C16CKBTb_QGqGo#v=onepage&q=significado%20del%20nombre%20de%20Aria&f=false
Albaigés J. El libro de los nombres de niño y niña: Su origen, historia y significado. 1° Edición. España: RBA Libros; 2011. Disponible en: https://books.google.es/books?hl=es&lr=&id=yT_ODwAAQBAJ&oi=fnd&pg=PT2&dq=significado+del+nombre+de+Aria&ots=wFSBXUxj9S&sig=oAGkU3IzRZBW-6vbDmWatUQfbi0#v=onepage&q=significado%20del%20nombre%20de%20Aria&f=false
Mendoza C. Nombres propios de procedencia latina. Rev. Escritura y Pensamiento. 2005; 8 (17): 153-182. Disponible en: https://revistasinvestigacion.unmsm.edu.pe/index.php/letras/article/view/7849
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