Apr 22 2009

A Personal Attack By J.B. Handley

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Comments: 69

It seems I have gotten under the skin of notorious anti-vaccine crank J.B. Handley, the founder of Age of Autism. He recently wrote an entire article dedicated to the character assassination of yours truly. It seems I had the temerity to critique the latest anti-vaccination propaganda initiative called fourteen studies, an attempt to discredit the scientific evidence against a link between vaccines and autism.

Handley’s attack is an astounding example of hypocrisy, logical fallacies, and tortured reasoning. He really exposes the intellectual bankruptsy of the anti-vaccine movement, which is only reinforced by the supporting comments left by his avid readers.

He begins:

In general, I think the site (fourteen studies) so resolutely exposes the dirty underwear of the mainstream’s weak science on the vaccine-autism debate that most critiques of the site seem to center around the idea that “you have no need to go look at the site, and please pay no attention to the dirty underwear behind the curtain…”

So he starts by saying that those who critique the site are trying to divert attention from it, rather than make a substantive analysis.  This is the central and profound hypocrisy of his article – for then he launches into a series of personal attacks against my credibility and never addresses the substance of my critique (except for one point, which he fails to get right).

His accusation is also false. My blog entry at Science-Based Medicine was a follow up to this one by David Gorski, who wrote an extensive and detailed substantive critique of both the methods and some of the specific conclusions of the fourteen studies site. I then extended David’s critique with some analysis of my own, adding analysis of one more study that David did not address.

At no point did either of us try to discourage anyone from looking at the fourteen studies site for themselves, and in fact we linked to it. This demonstrates that Handley, who cannot engage in a substantive debate on this issue, will rather just make up whatever fake criticisms he can think of.

The personal attacks begin softly:

Looking at his biography on wikipedia (which he undoubtedly wrote himself), he became a doctor 11 years ago and turns 45 years old this July. It doesn’t appear that autism, vaccines, immunology, toxicology, nutrition, or gastroenterology are part of his area of focus, expertise, or study.

I love it when people express certainty about a fact that is demonstrably false.  This is a small point in itself, but it reveals Handley’s intellectual laziness and clear bias. He tries to imply something about my ego by expressing his lack of doubt that I wrote my wikipedia entry myself. Apparently Handley lacks the internet chops or the minimal intellectual curiosity it would have taken to click the “history” tab on my wikipedia page. If he had he would have seen that the entry was contributed to by many people, but not at all by me. This is just more evidence that his diatribe is about character assassination (even if he has to make stuff up), and not substantive analysis or criticism.

He then comments that,  “It doesn’t appear that autism, vaccines, immunology, toxicology, nutrition, or gastroenterology are part of his area of focus, expertise, or study.” This is partly true – these areas are not part of my focus or expertise – nor have I ever claimed that they were. I do treat neuroimmunological disease as part of my neuromuscular focus, so it is not entirely true for immunology (but I am not an immunologist – expertise is relative).

But it is not accurate to say these topics are not part of my study – I have indeed studied all of them in medical school and beyond.  I also have a side career as a popularizer of science and science-based medicine, and in that role I make a point to study any topic I write about.

To be clear – I have never made any argument from authority. I have never asked my readers to accept any of my claims because of my expertise. I discuss logic and evidence and my analysis stands or falls on its own merits. I am also open to substantive discussion from anyone without ever even inquiring into their background or training, taking their arguments at face value.

So why is Handley even bringing up my areas of expertise? He must be making the argument that expertise matters, that we should therefore respect the opinion of experts who do focus in these areas.

Not so fast. He later writes:

I’m not intellectually intimidated by any of these jokers. Their degrees mean zippo to me, because I knew plenty of knuckleheads in college who went on to be doctors, and they’re still knuckleheads (I also knew plenty of great, smart guys who went on to be doctors and they’re still great, smart guys).

I chose a different path and went into the business world. In the business world, having a degree from a great college or business school gets you your first job, and not much else. There are plenty of Harvard Business School grads who have bankrupted companies and gone to jail, and plenty of high school drop-outs who are multi-millionaires. Brains and street-smarts win, not degrees, arrogance, or entitlement.

So apparently degrees and expertise do not mean anything to Handley. Handley should get his story straight.  He does not seem concerned with his self-contradiction. He smoothly transitions from saying I lack expertise to making the “elitism” gambit that expertise does not matter – only street smarts matter.

That is an old ploy we have heard from con-artists for centuries – “don’t listen to people who actually know what they are talking about, listen to me, I have street smarts.” The beauty of “street smarts” as a criterion is that Handley can define that any way he wants, and apparently he defines it as people who agree with him. Handley would have you believe that his utter lack of scientific training is not relevant, but my lack of expertise in autism (even though I am a neurologist) is.

But he’s not done with the elitism gambit:

I have been astonished by the culture of arrogance and elitism that medical schools appear to breed in their doctors and scientists. The culture tends to produce an “us vs. them” mentality, where doctors collectively back each other up on controversial issues, typically without understanding the issue for themselves.

Actually (genuinely) controversial issues are controversial because doctors and scientists fight over them, they don’t back each other up. Handley has apparently never been to a scientific meeting, or wasn’t paying attention as the scientists fought like cats and dogs over their respective positions. My favorite thing about the culture of science is that it is ultimately a meritocracy of ideas and evidence. Yes it is fraught with human failings, but the culture respects logic and evidence more than any other human culture, in my opinion.

Handley accusing scientists of arrogance is also precious – what is more arrogant than thinking you are smarter, more virtuous, and better informed than an entire profession?

Also – please read Handley’s article and the comments and then decide for yourself who is propagating an “us vs them” approach.

Finally we get to some discussion of vaccines and autism:

Children receive 36 vaccines by the age of 5 in the United States. Of those 36 vaccines, 2 have ever been studied for their possible relationship, the two doses of the MMR. But, children receive 23 vaccine BEFORE THEIR FIRST MMR SHOT, and no work whatsoever has been done to consider these other vaccines and their relationship to autism.

According to the CDC’s website, vaccines contain 53 separate ingredients, but only 1 – thimerosal – has ever been looked at in terms of its relationship to autism.

What is Handley saying here – is this tacit agreement that the evidence does not support a link between MMR or thimerosal and vaccines?  Why not admit that openly, if one is being intellectually honest? But he is probably not suggesting that, although he should have been clear that he still thinks MMR and/or thimerosal are the culprits.

But we see here the anti-vaccine strategy, which is deliberately ignorant of history. In the past 15 years or so the anti-vaccine movement was absolutely certain that MMR caused autism. When that hypothesis did not pan out, then they shifted focus to thimerosal. That hypothesis is now dead, so they are moving on to the other ingredients in vaccines. It’s endless, and clearly all they care about is blaming vaccines.

The claim is also demonstrably not true. Vaccine safety is closely monitored, and there are many published studies of vaccine safety – not just for MMR or thimerosal. Here is a list of such studies on the CDC website.

He comes back to me:

Back to Dr. Novella. His critique of FourteenStudies.org seems to be largely based on the naïve idea that his colleagues couldn’t possibly be mistaken on this issue, which means that I must be:

He then quotes me from my SBM blog article saying:

“It is also remarkable that Handley himself quotes many professional, expert, and advisory bodies who also have read the studies and concluded that they overwhelmingly support the conclusion of a lack of correlation between vaccines and autism – including the Centers for Disease Control, the American Academy of Pediatrics, The American Medical Association, the Institute of Medicine, and the March of Dimes. Handley casually and self-servingly assumes that all of the professionals in these organizations are incompetent or they are lying.”

“And keep in mind what it would mean to lie on this issue – Handley believes that many doctors who have chosen the career path of public health are deliberately condemning millions of children to autism simply to avoid admitting past error, because they cannot face the horrible truth, or to receive their Big Pharma kickbacks. It’s no wonder their rhetoric often become hysterical – they really believe this is going on. For some reason it is easier for them to believe this astounding horrible claim than even consider the possibility that perhaps they have misinterpreted the science and that trained experts who have dedicated their lives to understanding the science may know better. This is what we call the ‘arrogance of ignorance.’”

Again Handley is wrong – my criticism of fourteen studies was not based upon the assumption that my colleagues cannot be wrong. My criticism (combined with David Gorski’s) was based upon a thorough analysis of their methods and claims.

My point above was not a criticism of fourteen studies, but rather a criticism of Handley for behavior that he repeats in his new post. I am saying that Handley believes that he must be correct, even if that means that hundreds if not thousands of physicians and scientists are corrupt or inept. I think Handley has again shown that my observation is accurate.

He continues:

Arrogance of ignorance? Dr. Novella asserts, “I personally know of many people, including myself and David, who have both read all the studies and are telling the truth about our opinions that they do not support a link between autism and vaccines.”

He’s read the studies. The ones that cover 2 of 36 vaccines, 1 of 53 ingredients, never consider unvaccinated kids, and are almost all funded by conflicted parties and they clearly show ALL VACCINES don’t cause autism? And I’m the ignorant one?

Yes, Handley, you are. You failed to accurately read or represent what I wrote.  Scientists learn to be careful and unambiguous in their writing. I said the evidence does not support a link between autism and vaccines. Handley interprets this as “clearly show ALL VACCINES don’t cause autism.” This is not being pedantic – a lack of evidence for is not the same as evidence against.

It is not only my opinion but that of the scientific community that the evidence does not support a link between vaccines and autism. You cannot prove a negative, that vaccines play no role in autism, you can only say that the evidence available so far cannot be used to conclude that there is a link. So any link is likely to be smaller than the power of the current evidence to detect.

But I shouldn’t try to confuse Handley with my elitist “sciency” logic.

We’re getting close to Handley’s one substantive point. Be patient. He continues:

And, in making his point, this is the only study Dr. Novella points to. To summarize, Dr. Novella demonstrates an incomprehensible level of ignorance in the following four ways:

1. He argues that I suffer from the “arrogance of ignorance” because many of his self-interested colleagues disagree with me and they must surely be right. Do I really need to cite the thousands of examples in human history where the consensus of the day turned out to be wrong? He calls himself a “skeptic” but I’m wrong because his friends think I’m wrong and surely my brain is not as big as theirs?

He loves the elitism gambit. I never argued Handley is wrong because his views go against the mainstream – I argued he is arrogant because he has more faith in his street smarts than the training and years of dedicated study of thousands of experts.  Handley is wrong because his arguments are factually and logically challenged – his arguments do not stand up under scrutiny. Again – he largely ignores the substantive analysis that David and I did and chooses rather to engage is character assassination.

2. He cites a study that solely looks at the relationship between thimerosal and autism (1 of 53 ingredients in vaccines) as PROOF that “vaccines do not cause autism.” This is a reckless over-generalization that has no basis in fact.

Again – see above. I never said it was proof, just an analysis does not support a link. I also was not relying upon this one study. Handley has to be willfully misrepresenting my entry, in which I sated clearly that it was a follow up to David’s post which discussed the methods and several other specific studies. I also have written about many of these studies in separate blog entries, easily discoverable with a Google search or by searching on this blog.

3. Of all studies, he chooses to defend the Madsen Denmark study (see above) that has without question the most egregious data-trick ever used in a thimerosal-autism study, and a study that has even been discredited by the CDC and NIEHS as “unhelpful.”

I only chose this study because David analyzed many of the other studies. We had agreed to divvy up the analysis.

Handley does not provide a link or reference for his quote. The CDC still lists this study as part of the evidence for lack of an association between thimerosal and autism. In this recent review they write:

An ecological study in Denmark analyzed data from almost 1,000 children diagnosed with autism over 30 years. Thimerosal was used in childhood vaccines from the early fifties until 1992, and there was no trend for an increase in autism up through 1990. From 1991 to 2000, the incidence of autism increased, after thimerosal was discontinued from vaccines, suggesting no relationship between thimerosal and autism in Denmark.

To be clear, this one study does not by itself provide compelling evidence for a lack of correlation – no one study does. The totality of the evidence is what is compelling. And there are legitimate criticisms of this data. But what it shows is that autism rates failed to decrease in Denmark when the total dose of thimerosal was decreased in 1971 (a point ignored by fourteen studies). It also showed that the increase in autism diagnoses in the 1990′s in Denmark could not have been due to thimerosal since thimerosal was removed entirely from vaccines prior to the increase. Therefore something else was responsible for the increase.

4. He states that “autism rates were similar” between the US and Denmark. Yet, a fifth grader could look at the Madsen study he himself cites and read on page 605 of the study that the autism rate in Denmark was under 5 per 10,000, while the U.S. rate is somewhere between 60-100 per 10,000, which means our rate of autism is 12-20 times higher than Denmark’s, which would mean our rates are “similar”, so long as you define similar as the U.S. rate being twenty times the rate of Denmark.

Handley makes two significant mistakes here. The first is that he is comparing the incidence of autism in one age group in Denmark with the prevalence of autism in the US. Incidence is the number of new cases over a period of time, and prevalence is the total number of cases at any point in time. Prevalence for a chronic condition is always much greater than incidence.

Handley’s hypothetical 5th grader might see autism “rates” rather than an incidence or prevalence, because (like Handley) they lack scientific training or careful scholarship.  This is simply a rookie mistake on the part of Handley (so much for street smarts).

In fact, autism prevalence in Denmark is very similar to the autism prevalence in the US (about 80 per 10,000 in 2000). If Handley does not publicly admit or refute his clear mistake here, then that would provide further evidence of his intellectual dishonesty.

He also missed my point – in both the US and Denmark autism incidence were flat until the early 1990s when they began to steadily increase. In the US the vaccine schedule was increasing over this time, and thimerosal would not be removed until 2002. In Denmark thimerosal had just been removed, and vaccine rates were different than in the US, as Handley himself points out. Yet the change in autism diagnoses behaved the same over time, and with similar absolute numbers. The common element was not thimerosal, but rather diagnostic behavior.

After this profound display of scientific ignorance Handley writes:

When it comes to vaccines and autism, his “critique” of FourteenStudies.org demonstrates an unacceptable level of ignorance, non-critical thinking, and parroting of the words of others. My only guess for why Dr. Novella would publish such rubbish is that he knows his friends demonstrating similarly narrow and misguided views will tell him how smart he is.

I think I have clearly demonstrated who is ignorant and who has critical thinking on their side. Handley then conveniently repeats the behavior that I was criticizing above – casually assuming that those who disagree with him suffer from some critical vice – in this case a fragile ego. This is Handleys “only guess.” He really needs to expand his intellectual repertoire.

But wait, there’s more. Handley then includes an appendix:

As an aside, Dr. Novella does appear to have expertise at injecting the botulinum toxin in people’s bodies, as his webpage characterizes this as an area of expertise:

Wow – the Botox gambit.  How pathetic. He then lists the uses of Botox and descriptions of its potential for toxicity, as if this somehow impugns my character or judgment as a phsician. This is really low. First of all, I do not use Botox for cosmetic purposes, only for neurological purposes, for which its use is clearly established as the standard of care. But he tries to make some tortured argument that I use Botox, and Botox is used for cosmetic purposes, and therefore… What, exactly?

He is then impressed with what a toxin Botox is (uh, yes, it’s right there in the name – botulinum toxin). And yes there have been severe side effects (although he missed the fact that they were all in children and I don’t treat children, but this is not really important).

Yes, Mr. Handley, medical interventions have risks and side effects. But those who are familiar with clinical decision making understand that treatment decisions are based upon risk vs benefit. Botox, when used properly, has a very good risk vs benefit profile, and is extremely safe and effective.

This is really one of the most childish and ignorant scare tactics I have seen. And again I point it out to reveal the intellectual behavior of Handley and the anti-vaccine movement. Just astounding.

Finally, I encourage my readers to look at the comments left by readers of Handley’s blog. It reveals the culture of hatred, paranoia, and personal attacks that is being fostered by Handley and his cohorts. But bring a machete to cut through the irony.

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69 responses so far

69 Responses to “A Personal Attack By J.B. Handley”

  1. Michael Hutzleron 22 Apr 2009 at 1:26 pm

    I don’t have a big enough machete to deal with that that much irony, so I’ll have to rely on laughter. More than anything else, I enjoyed the utter hypocrisy of his accusing doctors of having an “us vs. them” attitude, when it is his core argument.

    I like that business is better training for toxicology and immunology than focus on treatment of neuromuscular disease, even though toxic and immunologic causes are important.

  2. sjones71on 22 Apr 2009 at 1:44 pm

    Two things about this make me profoundly sad:

    1. The genuine and sometimes aggressive discourse of science should be encouraged. When those who do not understand science attempt to argue it is confounding. They are not able to recognize their own biases nor is their machinery in place to have their biases pointed out. They seem to praise themselves on gut instinct. Simple assumptions seem correct and can overwhelm the truth and the pursuit of the truth. To them it seems obvious. “My child got vaccines. Soon after they got autism. Vaccines cause autism.” We want to believe this simple connections, but they just don’t hold up. They lack the mental mechanisms to recognize this and they lack the system of processes and debate to have these failings pointed out to them.

    2. They are so deep into their own conspiracies that they can not fathom the stupidity. Dr. Novella is trying to make the point that if their theory is correct, than every doctor has somehow been convinced to lie to get paid by “big pharma” despite children becoming sick. This is not even close to plausible. Doctors on this payroll would soon become overwhelmed by guilt and at least some of them would fess up.

  3. CKavaon 22 Apr 2009 at 1:44 pm

    Unbelievable but not surprising. Also the botox gambit is quite interesting… I wonder if we can expect a criticism from Handley of Jenny McCarthy for promoting the benefits of cosmetic botox treatments, I suspect not.

  4. jonny_ehon 22 Apr 2009 at 1:59 pm

    Botox? Isn’t that the ‘life saving’ stuff used by Handley’s hero Jenny McCarthy?

  5. TimKon 22 Apr 2009 at 2:14 pm

    Brilliant reply, as ever. Can’t wait to hear the SGU rogues tackle this one!

    I loved the Botox gambit. I think he was trying to make a connection between your expertise in “injecting toxins” and vaccines… but it was still way lame.

    The comments left by misled parents of autistics, however, make me sad. Shame on Handley.

  6. Intrepydon 22 Apr 2009 at 2:29 pm

    I left a comment, but it’s an echo chamber in there.

  7. Joeon 22 Apr 2009 at 2:35 pm

    Steve, you may be a bit thin-skinned. You were not directly accused of ‘putting on airs’ as was Mark Twain. Who needs that!?

  8. DevilsAdvocateon 22 Apr 2009 at 3:45 pm

    At first glance I thought the title read “A Personal Attack By Jack Handey”.

  9. Khym Chanuron 22 Apr 2009 at 4:35 pm

    Botox has non-cosmetic medical uses, huh? Learn something new every day.

  10. HCNon 22 Apr 2009 at 5:12 pm

    Oh, boy… I cannot wait to hear the next SGU podcast. Unfortunately I will be busy all day Saturday, but it looks like it will be worth the wait!

  11. tmac57on 22 Apr 2009 at 5:52 pm

    Steve, what ya gonna do with all that ‘Big Pharma’ money you been rakin in ?
    But seriously, it made me physically ill reading the comments on that site. There is an almost hysterical feel to it. Or more of an angry mob vibe. I’m not sure any amount of evidence at this point would satisfy vaccine critics, they are so emotionally committed to their ’cause’. Seems like the new rally cry from them is “where are the studies of vaccinated vs non-vaccinated children” Does anyone know if that has been done?

  12. Khym Chanuron 22 Apr 2009 at 5:59 pm

    Seems like the new rally cry from them is “where are the studies of vaccinated vs non-vaccinated children” Does anyone know if that has been done?

    See Prometheus’ article on why already-unvaccinated vs vaccinated study hasn’t been done, and Orac’s article on why a placebo-controlled vaccinated vs unvaccinated study will never be done.

  13. Khym Chanuron 22 Apr 2009 at 6:01 pm

    Oops, actually, look at this comment by Orac, not the article itself.

  14. Enzoon 22 Apr 2009 at 7:29 pm

    Begun, these blog wars have.

  15. HHCon 22 Apr 2009 at 8:32 pm

    Read the info about the Bailey Banks case. It looks like we have a case involving febrile seizures or more likely prolonged seizures of greater than 5 minutes. My training was that after 5 minutes you get brain damage even in already brain damaged persons. So do we need to vaccinate then educate the parents to get their kids the necessary tranquilizer prior to this 5 minute limit? If you think your family has a history of this type of reaction should you not retain a physician for an emergency? Courts are the last resort. Are some families litigious because of $ greed? Will they be readily negligent and not interested in diligence?

  16. HHCon 22 Apr 2009 at 8:44 pm

    The personal attack by J.B. Handley was motivated by his son’s autism which he claims was caused by vaccination. Real men take their cause to federal court. I suggest he file his claim soon.
    Otherwise, he is frittering away the time on blogs.

  17. Watcheron 22 Apr 2009 at 11:10 pm

    Wow, are they serious?

    That’s a rabid crowd right there … I may try to post on there. But what do I know, I’m probably a Pharma Shill too :P I’d really like to talk to one of these people in person. I wonder if it would make a difference? Probably not, they’ve taken on zealot aspects it seems.

  18. HCNon 22 Apr 2009 at 11:30 pm

    Good luck trying to comment there. They moderate with an iron clown glove!

    (to complete the visual check out http://twitter.com/ageofautism )

  19. abienerton 23 Apr 2009 at 12:25 am

    One thing that interests me is the psychology behind remaining closed to the possibility that the evidence doesn’t support ones theory. I can understand the desire to genuinely try to find a cause for the increased incidence of autism within the population, and in once sense I applaud their passion for it, but it is so misdirected.

    Where is the mental hurdle created to prevent people from looking at evidence objectively rather than remaining so stubbornly anchored to an unsubstantiated claim? To be able to admit to being wrong may cause some short term embarrassment, but it opens up the possibility of moving on with a whole new line of reasoning and research. And sadly this battle is not just wasting everyones time, but as we are now starting to see, costing lives!

  20. evawes1on 23 Apr 2009 at 12:29 am

    Wow Steve – it made my so frustrated to read the comments, how many were applauding the article and being hateful towards you and basically the medical profession. Definitely had the hysteric tone to it.

    Of course, we’re here applauding your article – but it was written so well :)

  21. Khym Chanuron 23 Apr 2009 at 12:56 am

    If you do get a chance to speak to one in person, make sure before hand that it isn’t John Best. He believes that people who deny the mercury/autism connection deserve to have the shit beaten out of them, and would likely be happy to do so himself.

  22. Steve Pageon 23 Apr 2009 at 4:16 am

    The comments on AoA are shocking. If any of them bother to read this article, Steve, it will not make a shred of difference, as they’ve made up their minds: You are in the pocket of Big Pharma, and everything you say, regardless of how well-researched or well-reasoned, can be utterly disregarded. It’s little short of tragic.

  23. occams baseball baton 23 Apr 2009 at 8:21 am

    I get paid my big-pharma shill checks every other Friday, but I hear they can now do direct deposit our dirty profit. Has any other of us gov’t shill, minion, bastards tried this? Seems pretty convenient.

  24. DevilsAdvocateon 23 Apr 2009 at 8:43 am

    abienert: “Where is the mental hurdle created to prevent people from looking at evidence objectively rather than remaining so stubbornly anchored to an unsubstantiated claim?”

    Numerous psychological events converge.

    Sometimes an emotionally satisfying conclusion is made before the evidence is in or properly assessed and the emotional attachment overrules the intellect. A conclusion based on emotion isn’t easily dislodged by cold, hard facts. That is, it is difficult to change an opinion with logic and reason when it was formulated quite without logic and reason.

    For someone with an autistic child it might provide some comfort to have a villain on which to blame the condition, which also provides a channel for expression, for release, of the painful emotion.

    Then there is communal reinforcement when the person who holds the emotionally based conclusion surrounds himself with no one except those who believe the same and for the same reasons. I haven’t visited the site where the commenting people are described as rabidly emotional and opposition comments may be screened out by moderators, but that’s a the definition of a community that reinforces belief by disallowing contrary evidence.

  25. studio34on 23 Apr 2009 at 9:33 am

    Great article Steve! Don’t let those idiots burn you up too much. It’s impossible to reason and have a logical debate with “believers” no matter what their ideology. S

  26. [...] and host of the popular podcast “Skeptics’ Guide to the Universe,” once again blows an ant-vaccination pseudoscientist out of the water: It seems I have gotten under the skin of notorious anti-vaccine crank J.B. Handley, the founder of [...]

  27. lurchwurmon 23 Apr 2009 at 10:49 am

    One of the commenters stated,

    “Until then, if you want to save the public’s confidence,
    you better find what it is. Spread out your wings, cast
    your net wide, and expose yourself to every possible black
    swan.

    Find it.

    Find it, damn you.”

    This is probably the most frustrating statements that reflects one of the main problems with the attitude in Mr. Handley’s article + comments.

    Regarding the black swan statement, philosophers tried that approach for millennia under Metaphysics. A general distrust of the scholastic philosophers by the public during those time periods stemmed from the fact that these philosophers were trying with all their mental prowess (and a lot of them were geniuses) to describe reality in general. Eventually, it took a philosopher like Kant to finally step up and definitively state that Metaphysics tried to go too far beyond experience. He even went so far as to assert that most of Metaphysics up to that point had no idea what the terms it represented actually corresponded with.

    Metaphysics (as accepted by the majority of the philosophical community during those early times) asserted that space was filled up with all the “substances,” and change only occurred when substances interacted with each other mechanistically. It wasn’t until Newton posited that forces existed in the universe that allow the possibility of voids, where substances can act on each other merely by their local proximity rather than adjacency in space. He did this by making scientific inferences from experience, and not simply positing that all space must be filled up with by metaphysical substance.

    This is a great illustration of how science actually makes discoveries. Instead of trying to “cast a wide net and expose one’s self to all possible black swans,” it actually finds black swans by limiting the net to only things that we can understand through our sensibilities. When the ancient and medieval philosophers tried to account for all space by filling it with substances, they got to a point where experience couldn’t be reconciled with the mechanics of their Metaphysics and thus positive knowledge about reality was stagnant. It wasn’t until a scientist’s (Newton) black swan, gravity, came through rigorous scientific enquiry to dispel a net that was being cast too wide.

  28. Jason Appleon 23 Apr 2009 at 10:49 am

    >>Wow Steve – it made my so frustrated to read the comments, >>how many were applauding the article and being hateful towards >>you and basically the medical profession. Definitely had the >>hysteric tone to it.

    Also funny to note that they chose not to post my comment, in which i invited people to read Steve’s response, and reveled in the irony of his botox jab in light of Jenny McCarthy.

    Really displays his intellectual dishonesty not to post a dissenting comment.

  29. lurchwurmon 23 Apr 2009 at 10:55 am

    That last statement should have been:

    “It wasn’t until a scientist’s (Newton) black swan, gravity, came through rigorous enquiry that real discovery was reached, as opposed to a net being cast too wide by speculative Metaphysics.”

  30. Doctor Evidenceon 23 Apr 2009 at 11:46 am

    Dr. N and Big Pharma?
    http://www.leesilsby.com/drnorder.php

    sorry, couldn’t resist. but this is a serious matter:
    what’s this about? “our kids”? what are kids being given?
    http://www.ourkidsasd.com/

    what, exactly, is a “compounding pharmacy”?

    (I followed an ad link from the site with Handley’s post)

  31. cheglabratjoeon 23 Apr 2009 at 11:58 am

    It seems like these last few antivax articles have been as bad as the worst of the creationism movement. Just straight-up pseudoscience at best, utter nonsense at worst.

    Of course, creationism probably isn’t going to directly kill anyone, so these antivaxxers are far more dangerous. We can only hope that the scientific community at large will start responding as it kinda-sorta has for creationism. Unfortunately, I think it’s going to take a bunch of childhood deaths from 19th century diseases to make that happen. It’s terrible.

    I also wonder what the response of these people will be when those deaths occur. Would they dare to say “better dead than autistic”? That would do wonders for the personal confidence and public perception of people with autism …

  32. daedalus2uon 23 Apr 2009 at 12:23 pm

    cheglabratjoe, a number of anti-vax and chelation advocates have said that children are better off dead than alive with autism.

    My hypothesis as to why ASDs specifically invoke such antipathy relates to the phenomena known as the uncanny valley.

    http://en.wikipedia.org/wiki/Uncanny_valley

    My hypothesis is that when two humans meet and start to communicate they in effect perform a Turing Test on each other, to see if the entity they are communicating with is “human enough” for an interaction to be valuable. The test isn’t really “human enough”; it is “enough like me”. Sort of like the apocryphal “green beard” gene which compels killing everyone without a green beard.

    All communication is only the exchange of mental states. The first entity has a mental concept, translates that into language, transmits the data stream, the second entity then receives that data stream and converts it back to the mental concept. The fidelity of communication can only be as good as the mutually shared “theory of mind” that the two entities use to translate the mental concept into and from the data stream of language.

    My hypothesis is that when the error rate goes up, and the fidelity of communication is poor, then xenophobia is triggered. This is the uncanny valley effect.

    There are two ways it can be triggered, by lacking the shared “theory of mind” that develops during childhood and which encompasses spoken language, body language, emotional responses and a great many culturally transmitted idiosyncratic customs/habits/ways of communicating. The second way is if one of the entities lacks the neurological structures to do the communicating with. These are the neurological structures that are disrupted in autism and ASDs and are responsible for the disrupted communication observed in ASDS.

    I think this explains the antipathy that people such as JD Handley have for those such as Dr Novella. Their child with autism invokes xenophobia, they need to rationalize the antipathy that they feel directed toward their child and so displace it onto something else. The hatred that xenophobia has invoked in them gets directed against the pharmaceutical industry. It isn’t rational, but the invoking of xenophobia isn’t rational either.

  33. Watcheron 23 Apr 2009 at 12:45 pm

    what, exactly, is a “compounding pharmacy”?

    It looks like a front for their Autism cures … which looks to me like they contain no active ingredients. The “cures” look like vitamin supplements to me …

  34. Calli Arcaleon 23 Apr 2009 at 1:05 pm

    And very highly priced at that….

    A compounding pharmacy is one that actually mixes medicines up, as was done in the olden days. There are a lot of restrictions on what they can do nowdays, to prevent bypassing of pharmaceutical regulations, but a lot of them break that rule, and I’d be extremely cautious of using one. (Okay, I’ll be honest. I can’t forsee any circumstance where I’d use one. I’d rather use medicines made in a more controlled environment so I can know what the hell I’m putting into my body.) Many quacks have partnerships with compounding pharmacies, so they can get their remedy made without interference from that pesky FDA.

    As I have a friend whose child is receiving HBOT (not for autism), I was intrigued to see they sell something to prepare patients for HBOT. It’s a multivitamin plus a few “natural” ingredients, sold for the amazingly good deal of $75 per 90 pills.

    Sheesh!!!! These crooks are making out like bandits! And I thought Airborne was absurdly overpriced, considering what it was. I am baffled that more than handful of people get regularly duped by these sorts of businesses. Even ignoring that their stuff doesn’t do what they claim, the price tag is downright insulting. I could treat ADHD with a collection of vitamins (which won’t be covered by your insurance) costing hundreds of dollars a month, and which won’t really do anything, or I could just spent eight bucks a month on her Ritalin prescription. Hmmm…… And yet so often, we hear alt-med types saying that it’s mainstream medicine that’s out for profit.

  35. AnneBon 23 Apr 2009 at 2:27 pm

    At your invitation, Dr. Novella, I read the comments under the AoA piece. My favorite was Kim Stagliano’s attempt to criticize you by saying that it’s almost like you have autism. Jeez, maybe Daedalus2u has a point.

    The main AoA post was typical Handley ad hom, somewhat mild in comparison to his attacks on others. You have a ways to go before you get to the rarefied level of hatred that Handley reserves for Paul Offit, proponents of the idea of neurodiversity, and maybe even Dr. Gorski.

    What Handley is doing is manipulating the feelings of frustrated parents who feel that their concerns are summarily dismissed by arrogant professionals who consider them ignorant. It’s an effective technique of grabbing people’s hearts so their minds will follow. I don’t envy you the job of trying to educate people without leaving yourself open to this type of attack.

  36. [...] handle himself against a booster of pseudoscience like J.B. Steve was more than able to write a devastating response to J.B.’s attack that eviscerated his every point, and I can’t wait to see what the [...]

  37. HCNon 23 Apr 2009 at 8:17 pm

    More about compounding pharmacies:

    Several polo horsed died suddenly in Florida recently, the cause may be due to a supplement created at a compounding pharmacy:
    http://www.google.com/hostednews/ap/article/ALeqM5g09QSRi5uzh2Zm3ci9WgthnvFpuwD97OFSKO0 … “FDA spokeswoman Siobhan DeLancey said the agency’s interest is now “heightened” with news the deaths could have been caused by a medical mistake at a pharmacy — one that not only produces drugs for animals, but also people.”

    Oh, like Calli said, they can be expensive. I have a relative who got her high priced homeopathic remedies at a compounding pharmacy. She later realized that homeopathy did not work, and went back to her regular (cheaper) meds.

  38. TsuDhoNimhon 23 Apr 2009 at 11:31 pm

    Steve –
    He’s just pissed off because you have a bio on Wikipedia and he doesn’t. Apparently he can’t figure out how to start a page.

  39. Reinison 24 Apr 2009 at 12:38 am

    This is a powerful smackdown. You make responding to trolls look so easy.

  40. DLCon 24 Apr 2009 at 5:06 am

    Steve — J.B. Handley has no clothes.
    The fact is, he can’t be bothered to actually read your post for comprehension as he’s so busy helping to save Hib, Measles, Mumps and Rubella from extinction. I’ve read his stuff on vaccines, and I’ve read yours, Orac’s and the other SBM bloggers on the subject. I’ve even read some of the studies in toto and others in summary. I’m no expert — hell, I don’t even boast J.B.’s level of “Street Smarts”, but I can see that the best evidence we have is that whatever causes Autism (or ASDs) the vaccines are not it.

    Thanks for fighting the good fight.

  41. Ian Willmoreon 24 Apr 2009 at 6:05 am

    Excellent post, as always. Having read Handley’s original article and the comments on the Age of Autism website, I selected this one, posted by “Twyla”, as summing up exactly where Handley and his followers are intellectually:

    “JC, nothing under the sun would convince me that vaccines do not cause autism. And do you know why? Because I saw it happening with my eyes… My beautiful, perfect little 4 month daughter got a cold and her stupid pediatrician gave me a solution: her 4 month vaccines (4). 2 days later we were at the ER and stayed at the hospital. And that brought her autism. I told her pediatrician 2 weeks later “there is something wrong”. His answer: “let’s wait”. She’s almost 8 years old and we are still waiting… (well, not really, since we are fully pursuing biomed)… But I KNOW that vaccines cause autism. I’ve seen it happen”

    This is more honest than Handley, actually. I have had a personal tragedy: my daughter has autism. I know what caused it: vaccines. No evidence of any kind could ever persuade me otherwise. Therefore there is no point in continuing the discussion. (Unstated implication: I don’t care how many other people face tragedy in their own family from illnesses caused by a decline in vaccination rates)

  42. DarwynJacksonon 24 Apr 2009 at 8:08 am

    I though Botox was totally kosher with these people. Even the Mother Warrior told me so…

  43. weingon 24 Apr 2009 at 8:47 am

    Don’t you get it? Botox is natural. The vaccines are not. These people are OK with the natural diseases.

  44. Watcheron 24 Apr 2009 at 9:01 am

    HA! I figured those horses dying had something to do with the “supplements” they were given. I’m not a big fan of going “all-natural.” To often now-a-days it means buying out of trunks from people who have little experience doing what their doing. I enjoy whole grain breads and the like, but I’m not going to pay 4x’s the price of a container of aspirin for a thing of airborne that may have natural ingredients, but does absolutely nothing other than give you a bunch of vitamins and herbal substances.

    Speaking of … my girlfriend brought home a sample of airborne the other day. I said, “Tell me you DIDN’T buy this …” She said, “No a co-worker gave it to me for headaches and whatnot.” Which was a good opening to discuss herbal remedies :) She usually hates when i start to “preach” as she puts it, but I feel like i actually changed her perception and didn’t get turned off :D

  45. Watcheron 24 Apr 2009 at 9:02 am

    … he’s so busy helping to save Hib, Measles, Mumps and Rubella from extinction.

    Is that a new lobbying group? :D

  46. Josephon 24 Apr 2009 at 10:12 am

    “JC, nothing under the sun would convince me that vaccines do not cause autism. And do you know why? Because I saw it happening with my eyes… My beautiful, perfect little 4 month daughter got a cold and her stupid pediatrician gave me a solution: her 4 month vaccines (4). 2 days later we were at the ER and stayed at the hospital. And that brought her autism.

    Clearly a bullshit anecdote. Autism can’t possibly be diagnosed at the age of 4 months. Even a diagnosis at the age of 2 is considered an early diagnosis and is not very stable.

    It seems to me the girl didn’t just have “a cold.”

    Anti-vaxer anecdotes rarely make sense.

  47. DevilsAdvocateon 24 Apr 2009 at 10:33 am

    RE: “Street smarts”….

    I was born and raised on the Detroit waterfront in the 1960s when its nickname changed from Motown to Murder City. I have what one might call street smarts. The primary feature of ‘street smarts’ is the same as for any sort of ‘smarts – it’s a given you know what you know, but it’s imperative to know what it is you don’t know.

    In this, Handley has neither street nor book smarts.

  48. HHCon 24 Apr 2009 at 11:25 am

    Following your thread about compounding pharmacies. I just called my local Illlinois compounding pharmacy about questions involving homeopathic medications. The licensed pharmacist stated that if the physician prescribes a “homeopathic” medicine they will fill it. I asked if they dilute the products as the homeopathic regimen prescribes. The pharmacist stated they do not. They use active ingredients, not dilutions of water. The pharmacist could not vouch for the over-the-counter homeopathic drugs that the pharmacy also carries. I have been satisfied with the level of pharmaceutical care provided by this compounding pharmacy. They assisted me in prolonging the life of my chocolate point Himalayan for a full year with their medecine. They had to compound human medication for my cat with heart and kidney failure. As a licensed pharmacy technician I have enjoyed watching the staff make compounds in their laboratory at an observation window. Everything is done visibly and with normal human error. I have caught any errors and they readily corrected it.

  49. Eliot89on 24 Apr 2009 at 11:39 am

    “I don’t treat children”

    I can see his response now: “He admits himself that doesn’t even treat children! How can he say anything about children’s vaccines if he doesn’t treat them!!!”

    of course he’ll completely miss the fact that you HAVE kids.

    Oh and that the beauty of medical (as well as scientific) training is that you can apply it across fields in medicine.

    Oh and that he’s so utterly wrong that at this point he’s wasting everyone’s time.

  50. superdaveon 24 Apr 2009 at 12:25 pm

    I cannot believe how many people on that site believe that you are somehow getting paid to write these blog entries!

    That’s just ridiculous. These comments are just disheartening to say the least.

  51. RickKon 24 Apr 2009 at 1:28 pm

    Well, it appears the Age of Autism folks are heavily filtering the comments they’ll post.

    This is no different than the science versus creationism debates – very few of the creationist blogs allow any commentary at all.

    Fear of dissent is diagnostic of a hollow argument.

  52. Oracon 24 Apr 2009 at 1:47 pm

    Age of Autism has long censored comments. It’s not even worth it to comment there with dissent unless your goal is simply to annoy the moderators. They do appear to have let one dissenter post on the Novella thread, but he seems to be the token that they can all take pot shots at.

  53. HHCon 24 Apr 2009 at 4:15 pm

    Devils Advocate really has a handle on why autistic parents need to blame a villain of their choosing, and its usually the health care professional which tried to assist them. Just for this commentary, I shall share with you my experiences with a parent who wanted autism to be separately funded and categorized. At a private social service agency I met a lobbyist, a parent of a autistic child who demanded that I agree with her that autism was a separate category, a special category, and it needed special funds to be thrown its way in Illinois. When I did not agree with her position during our civil conversation, she exploded and ran to the executive director of the private social service agency and had a temper tantrum. This same woman went to a state hospital for the developmentally disabled where I later worked and had another temper tantrum a year later, same issue. A female social work staff had to walk her around the center while she hollered loudly for everyone to hear. Well she finally got her special funding and a Republican state government job. She went around to the state facilities conducting her vigilante efforts.

  54. DevilsAdvocateon 24 Apr 2009 at 8:09 pm

    Well, thank you HHC.

  55. Magnuson 25 Apr 2009 at 7:34 pm

    I would love to have seen the look on J.B.’s face when he read this reply. The best part was how you exposed his crap-based use of statistics. I really, really hope he replies. If he weren’t so dangerous, this guy would just be another crazy quacksalver.

  56. christieon 25 Apr 2009 at 9:33 pm

    That’s OK Steve. I once ruffled the feathers of an anti-vaccinationist so much that her only response was “I wouldn’t give vaccines to my dog”. Talk about earning your skeptical bones…

    On a side note: this person repeatedly accused me of being a big-pharma shill. Ain’t it grand? :-D

  57. RickKon 26 Apr 2009 at 4:33 pm

    So, we have a national health emergency.

    Where are the biomed, holistic, crystal-infused, natural, homeopathic accupuncturists in the news now? What is their advice re swine flu? All I seem to see on the television is evil, allopathic, Big Pharma shills from the CDC.

    Of course, at a time like this, CDC folks seem to be the only people the press is interested in interviewing. I wonder why that is?

  58. HHCon 26 Apr 2009 at 4:59 pm

    christie, The comment was laughable! I am looking at my vaccination pamphlet from Pfizer Animal Health at http://www.pfizerah.com.

  59. christieon 26 Apr 2009 at 5:45 pm

    HHC, couldn’t get to your link, but I get your drift. I actually live across the street from a holistic animal hospital… needless to say I went 20 minutes out of my way when I wanted to get my new cat checked out by a vet.

  60. happy humaniston 27 Apr 2009 at 2:49 pm

    RickK: Sorry, the wingnuttia has started at Huffpo (is that an oxymoron?)
    http://www.huffingtonpost.com/kim-evans/swine-flu-protect-yoursel_b_191550.html

    I’ve got the same username there as here.

  61. HHCon 27 Apr 2009 at 10:45 pm

    happy humanist, Gosh I should colon cleanse instead of vaccinate according to the Huffington Post. Well, I don’t want to do it alone so everyone can have a bowel preparation cleanse recipe. Breakfast: Clear soup, strained fruit juices, flavored gelatin, soft drinks, black coffee or plain tea. Noon: Same as breakfast. 1:00pm Drink 1 full 8 oz glass of water or clear fluids. At 2:00pm, 3:00pm, 4:00pm, Drink 1 full 8 oz glass of water or clear fluids. 5:00pm Do the same as breakfast and lunch. 5:30pm Add contents of packet ofMagnesium Carbonate, Citric Acid and Potassium Citrate to 8 oz cold water in a 16 fl oz glass. Stir gently. After fizzing stops,stir, and drink the entire glass. Bowel movement will begin within 30 minutes to 4 hours. 6:00pm Drink 1 full 8 oz glass of water or clear fluids. 7:00pm Do the same as 6:00pm. 7:30pm Put 4 Bisacodyl tablets with 1 full 8oz glass of water. Tablets must be taken 2 hours after drinking the 5:30pm Magnesium drink. Tablets will begin to increase your bowel movements within 30 minutes to 4 hours. 8:00pm Drink 1 full glass of water or clear fluids. 9:00pm Do the same as 8:00pm. Be sure to have 4-5 toilet rolls on hand by the toilet.Merry Cleansing!

  62. mindmeon 28 Apr 2009 at 8:59 am

    ||Most estimates are that the average person has ten or more pounds of stored waste just in their colon, and I’d argue far more throughout their body.||

    Has anyone over there ever heard of a footnote? Geez.

    ||Kim Evans is the author of Cleaning Up! which outlines a powerful body cleanse to help remove the years of built up waste that the average person has stored in their body. ||

    How do I get my own column on huffpo to basically advertise my product or services?

  63. happy humaniston 28 Apr 2009 at 12:56 pm

    Kim Evans replied to my posts, but only gave anecdote, not data. I know this is a shock!!

    You should know that several people have posted similar fact-based replies. It’s a start.

    HHC, I had a colonoscopy last summer. I do NOT care to repeat that hell on earth! You’re on your own!

  64. jo5efon 29 Apr 2009 at 4:04 am

    I posted a comment, doubt it will get published but what the hell.
    I wonder how the anti vax loons are spinning this:http://news.bbc.co.uk/2/hi/health/8020837.stm

  65. [...] blog entries criticing their 14 studies website with a detailed analysis. Handley responded with a full frontal personal assault sprinkled with irrelevant accusations. He ignored the vast majority of our actual criticisms, and [...]

  66. [...] I discussed here) and “Fourteen Studies” website (discussed by Steve, leading to an all-out personal attack on him by J.B. Handley; Mark; and me). Suffice it to say, the intellectual incompetence on display by Carrey was very [...]

  67. Terry Simpsonon 09 May 2009 at 1:57 pm

    As a fellow skeptic, physician, and someone who enjoys the podcasts from Skeptic Guide to the Universe I was greatly bothered by J.B. Handley’s attack.

    For me vaccination is deeply personal. My father was raised in an orphanage in Alaska. An orphanage, because too many Alaska Native families were lost from communicable disease that were preventable.

    Dr. Novella did a marvelous job defending himself, so I shall not repeat. As a surgeon, we are more pointed, not as kind as our neurologist brethern. So when an attack goes to someone who I respect, it is difficult to keep my keyboard in check.

    I cannot imagine how it is to live daily with an autistic child. I cannot imagine how hard one looks for correlations and to wish to lash out against something. To find some cause.

    Dr. Novella and myself were classically trained in the scientific method – for which we apply with passion for the process. I would think our passion is for reason, for process, for detail.

    Handley is not trained as such. He is tortured daily by a disease, and then by a cause. I am not a father, I am not a kind man, but I have deep empathy for his personal pain.

    We are generations from when communicable diseases destroyed families, took away function, and left many with diminished intellectual capacity. It is that history Mr. Handley does not feel. And as he promotes a non-scientific approach to his cause, he dangerously is supporting a return to the dark ages.

    So while I wanted to sharpen my knife to take apart Mr. Handley – Dr. Novella did that well. While I am empathetic to Mr. Handley’s personal pain – but his views would lead to a body count that makes the epidemic of autism a small footnote.

  68. [...] the antivaccine movement has a tendency to launch vicious ad hominem attacks, as they recently did against Steve Novella and have done multiple times in the past against [...]

  69. [...] I bring this up because there is a common argument that the autism “rates” in places like Denmark and Sweden are much lower than those in the US and elsewhere. This is used to try to negate studies using those country’s populations in, for example, showing that there is no increased risk from thimerosal or the MMR vaccine. This error often stems from comparing “incidence” to “prevalence”. [...]

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