Blue Collar Scientist

Well, it has taken almost three weeks, but I finally have some definitive news to post about Jeff, aka the Blue Collar Scientist. When we last checked in on things, it was thought that Jeff had caught some kind of nasty, persistent infection. This hypothesis has since been disproven, and now we know for sure what is going on.

The bad news is that Jeff has liver cancer. He’s got two tumors in the liver; one is small, one is quite large, almost 10cm in size.

The good news is that Jeff has no risk factors for cancer or liver disease; he’s never been a drinker, he’s hepatitis-free, doesn’t have HIV, etc. (In fact, the etiology of his condition remains unknown.) He’s healthy in every other way, with no cardiac, metabolic, or other diseases to complicate treatment. He’s very physically fit, although he’s gradually lost much of his stamina over the last several weeks. He’s had a full-body MRI and thoracic and abdominal CTs that establish he has no tumors outside the liver. All of this is good news for someone who has a disease that normally kills 90% of the people who are diagnosed with it within six months.

Another piece of good news - he’s being seen mid next week by the University of Washington Liver Center, one of the best liver clinics in the world, to receive treatment recommendations and come up with a plan.

Jeff’s still working on several projects - he’s got some political activism going on in Alaska, he’s still working on some curriculum materials for astronomy and physics education for some of his area school districts, and he’s still working on adapting a couple of his lectures into study guides. He’s been polishing his talk about how anyone can help make the science education crisis better.

What isn’t clear is whether he’s going to have the energy to blog very often - he certainly hasn’t during the last couple weeks of daily tests and doctors appointments. What are your thoughts on this - should we try to keep the blog going? Should we bring on a staff of regular contributors to keep fresh content between his occasional posts? Should this turn into an all-hepatic-cancer, all-the-time blog? Should it just be retired? Your feedback is needed.

BTW, you can feel free to e-mail or Skype Jeff (see the “BCS Esewhere” sidebar on the home page), and he’ll see your comments to the blog as well.

I recently made reference to The Flying Trilobite’s posting about asthma, in a post of my own on the same topic. Now local paleoartist Zach at When Pigs Fly Returns has put up a post on living with cystic fibrosis. It is worth checking out; I knew relatively little about it until reading his account.

I guess the next step is for the three of us to get together and storm the Bastille¹ (after we take a suitable break to us our medications) and release all the other pulmonary-function hard-luck cases from their societally-imposed bondage.

Or not….

1. Just two months to go! [↩]

Researchers at Johns Hopkins and elsewhere published a study yesterday in Annals of Allergy, Asthma & Immunology¹ which establishes that asthma is associated with higher levels of suicidal thoughts with attempted suicides.

Doesn’t surprise me one bit.

The Flying Trilobite recently had a posting about asthma, a response to some google traffic that was coming his way, and over there I outed myself as an asthmatic from a very young age. When I was a kid, I had asthma severe enough to result in airway remodeling - in my case decidedly not good remodeling, though there is legitimate scientific debate whether remodeling in general is beneficial or deleterious - and today I walk around with significantly reduced lung capacity, compared to what I should have for my height and body weight, or whatever the norms are based on.

The reason that I’m not surprised to see asthma associated with suicidal thought and attempts is manyfold.

First, not being able to breathe properly is frightening and extremely painful, especially to the muscles that are used to breath - the shoulders, chest, and back in particular. Educated patients understand that few people die of asthma - but we are also taught that those that do often die of suffocation over a period of days or weeks of continuous and gradually worsening asphyxiation. We also understand that normal use of our life-saving medications can lead to refractory asthma - which is usually especially severe and frequently results in death; if you can walk out of the ICU, you consider yourself lucky.

Faced with an uncertain future, I know that I would feel a lot more comfortable about my existence if I knew that palliative care was available in the event that I faced a severe, probably terminal bout of asthma. But such palliative care is denied to asthma patients. We must tough it out, and that’s that. I can easily imagine that after a week or two of continuous symptoms, a perfectly rational asthmatic who cannot get any pain relief might be in the mood to take what the medical establishment would consider to be a few too many sleeping pills. I’ve never been down that road myself, but I’ve thought quite a bit about end of life care, knowing that if I don’t die of an accident or other sudden cause, I’m likely to die of asthma and its complications, and I’m unhappy in every way with what I know of how medicine treats the dying asthmatic.

The researchers sum up what I’ve just said in this way:

“Researchers have speculated that the relationship between asthma and suicidal behaviors is possibly because of ensuing mood and anxiety that results from disability and discomfort associated with asthma, which can be a lifelong disease,” they note. “Individuals might have frequent thoughts of death with increasing severity solely because they have a potentially life-threatening illness.”

To which my response is, no shit.

Technically, my evidence is anecdotal and personal; this hypothesis should be tested properly. But it rings true and I don’t consider it a high-risk experiment.

Second, much of my society does not accept asthma as a legitimate condition. Through the 1950’s, asthma was considered a psychosomatic condition - a disease that was entirely in the sufferer’s head. Until the mid 1960’s, treatment for asthma was dispensed by psychiatrists and psychologists in this manner²:

At that time, psychoanalytic theories described the aetiology of asthma as psychological, with treatment often primarily involving psychoanalysis and other ‘talking cures’. As the asthmatic wheeze was interpreted as the child’s suppressed cry for his or her mother, psychoanalysts viewed the treatment of depression as especially important for individuals with asthma.

Cry for my mother, my ass.

Asthma is now proven to be a real disease. In fact, it is an immune disease, a consequence of a too-active immune system. Remember this the next time a quack medical cure purveyor tries to sell you something that “boosts the immune system” - I have a boosted immune system, and trust me, you don’t want one. Asthma is an immune response in the bronchial airways, leading to constriction of those airways, excess mucous production, and is topped off with inflammation. All three of these leave less room for air to enter and exit the lungs.

Despite the objectively measurable physiologic symptoms, and despite the ability to induce asthma in anyone using a Methacholine challenge or similar test, the condition was considered until recently³ to be all in the patient’s head. Although the medical establishment changed its mind and recognized the condition as a real disease - and kudos to the medical establishment for responding to evidence, I’m not trying to say they were negligent in any way - the rest of our society has been slow to follow in the time since.

Despite medical evidence that prompt use of a rescue inhaler is necessary to save the lives of asthmatics, despite federal laws that protect the rights of asthmatics, and despite state laws mandating that schools allow asthmatic children to carry inhalers, there are still people who are too short-sighted to notice, or care, about asthmatics.

This school used to have an outright ban on medication, until I and others pointed out the illegality of the situation to an asthma activist organization. In response to massive pressure, the school changed the policy, and now if you fill out a form, the school says you can, they guess, have your medicine, if it is absolutely necessary that, you know, the student continue to live, or something. See also here,

Here is a school (pdf) that illegally requires the inhaler to be kept in the nurses office, and explicitly calls the use of the inhaler a “privilege” - at this school, the right to continue living is suddenly no longer a right. They also give broad, draconian powers to teachers who think the inhaler isn’t needed to deny its use to students. Here’s a hint for you - school teachers are not qualified to make medical assessments of respiratory function. This kind of thing is pretty widespread - one survey found that about a third of asthmatic kids had their inhalers taken away from them by school officials.

What happens when such practices are put into place? Students die. It has happened a number of times, but I’ll only link to the story of Catrina Lewis Michele Gaudin. Catrina died while school officials prevented her accessing her inhaler and spent a half hour trying to telephone her mother, before finally calling 911 to pick up the body. The life-saving murderous advice they gave to Catrina before she died was to go outside and get some fresh air. Her inhaler was locked in the school nurse’s office the whole time - they just wouldn’t let her use it.

Leaving the schools behind, there are still numerous examples of the asthmatic prejudice in the wider society that I’m sure any asthmatic could invoke. One of my favorites involves any time I was having an attack as a kid, and was told - and this happened often - to “just breathe” by some knowedgeable dumb-ass adult. I think I heard this from my gym teachers, parents of my childhood friends, extended relatives, and other well meaning, but very ignorant, people in my community.

Today, I’m active in athletics, despite having a significantly reduced lung capacity. Specifically, I like to ride bikes, and I have a high performance, tricked-out, all-carbon road bike with some nice components that weighs approximate 6/10^ths of an ounce that I like to ride as fast as I can. I ride in groups with some pretty fit riders, most of them about half my age. I can keep up, except when we hit the longer hills. Then my lungs just don’t allow it. I arrange ahead of time with my riding companions, telling them they can wait for me at the top, or they can just keep going and we need not finish together - it doesn’t matter to me. The few that wait? Well, when I get there, I’ve heard “just breath” a few too many times.

If we could breath, folks, we would.

Another is the admonishment that I’ve heard numerous times to just relax, and not sit up so straight during an attack. Got news for you - if I lay down during an attack, it gets way worse. If I recline on my couch, perhaps with some grapes and a couple of Roman slaves waving some white feather fans over me, the best that can be said is that I will have died in style. A kind of anachronistic, perverse style, but you see the point. Ignorant advice that I should just relax isn’t really needed here: Asthma isn’t a result of being high-strung. Being high-strung is a result of having to deal with idiots while I’m having an asthma attack.

The bottom line is that our culture views asthma in different ways; some see it as a medical condition and nothing more, and that’s fine. Others see it as a sign of personal weakness and a character flaw, and that’s not fine. That’s the heritage of the old establishment view of asthma as psychosomatic, requiring treatment with Freudian psychotherapy in order to make a better-adjusted person with fewer mental hang-ups.

Now, if you spent your life explaining to close friends and activity companions about certain of your limitations, in a responsible way so that they could make informed choices and not panic when confronted by these limitations - OR if you spent your life not disclosing these things and forcing others to deal in ignorance with what they considered to be unexpected and unexplained behavior on your part - and you had about half the people respond from the perspective of the “personal weakness” meme, would you consider suicide? How about some of your friends? I have no problem believing that this kind of social challenge would lead at least some people to suicidal thoughts and attempts.

Don’t get me wrong - I’m not piling on the researchers here. It is about time that someone took a look at the mental health attributes of asthma, now that 1 in 4 kids are getting it, and these researchers are doing a good thing. I reserve my ire solely for the irresponsible behavior and prejudices of people confronted by asthma. Fortunately, it is getting rarer as I age. Unfortunately, not as fast as I’d like, and until things get straightened out in the culture, an asthma-suicide link is going to have the ring of the obvious to me.

1. Clarke DE, Goodwin RD, Messias E, Eaton WW. Asthma and suicidal ideation with and without suicide attempts among adults in the United States: What is the role of cigarette smoking and mental disorders? Ann Allergy Asthma Immunol 2008;100:439-446. [↩]
2. Asthma and depression: a pragmatic review of the literature and recommendations for future research Clin Pract Epidemol Ment Health. 2005; 1: 18. Published online 2005 September 27. doi: 10.1186/1745-0179-1-18. PMCID: PMC1253523 Copyright © 2005 Opolski and Wilson; licensee BioMed Central Ltd. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1253523 [↩]
3. Within my lifetime. [↩]

It is almost too tempting to avoid making a Jenny McCarthy joke here, so I’m going to avoid it by the skin of my teeth. I’ll just point you to this bit of news.

In another sign pointing to an inherited component to autism, a study released on Monday found that having a schizophrenic parent or a mother with psychiatric problems roughly doubled a child’s risk of being autistic.

“Our research shows that mothers and fathers diagnosed with schizophrenia were about twice as likely to have a child diagnosed with autism,” said Julie Daniels of the University of North Carolina, Chapel Hill, who worked on the study.

“We also saw higher rates of depression and personality disorders among mothers, but not fathers,” she said in a statement.

This study has a pretty big n - 1,227 children with autism, compared with families of 31,000 children without autism.

The result is not new; previous studies have supported the conclusions. This study appears in Pediatrics.

No one knows what causes autism, but researchers think it is likely that several genes and possibly environmental factors contribute.

Blackwell Publishing has kicked out a press release with a slightly unfortunate hed:

Cholera Study Provides Exciting New Way Of Looking At Infectious Disease

Now, the study that this press release reports is kind of exciting. (And yes, you can read it for free.) Basically, the investigators are looking at Vibrio cholerae, the pathogen that causes cholera, a disease characterized by massive diarrhea and very rapid death if untreated.

It was long thought that humans were the source of cholera, but in the last several years there’s been quite a bit of evidence that it actually lives in aquatic environments. This study explores how cholera interacts with chitin, the polysaccharide that makes up the exoskeletons of insects and crustaceans. The findings of the researchers, in brief, show that cholera’s interactions with chitin explains a lot about how cholera lives, expands its range, and infects humans.

This is of course a good thing - knowing about this will lead to strategies that will save lives and greatly reduce suffering. And it is also good that the investigators are excited by their work. I’d hate for the evolutionary¹ and molecular biologists who work on human disease to be, you know, apathetic, or worse, bored about what they do.

But that hed…. I just can’t get past the idea that we should be careful about saying we are excited about infectious disease, for the same reason that when a client telescope crashes in a novel way, I avoid calling the event “awesome” or “cool” in front of the client - even though it is pretty cool what you can learn about these complex systems from their failure modes.

But the headline doesn’t really matter - the release is good, the science appears sound, and the utility of the findings is unquestionable. This time, I’ll take what I can get.

1. And guess what - this study did depend upon evolutionary theory and methods to come to its conclusions. Yet another example of the way that evolution helps us all. [↩]

Pull on the shoes of a 16 year old girl for just a moment, and walk with me:

You’ve been struggling with anorexia since you were 10. You’ve been in and out of hospitals, but you don’t have health insurance and you can’t afford to check yourself into a private treatment facility. You know your life is in danger, and you need to find help as soon as possible.

One day, someone tells you about a residential treatment program that has worked wonders for its graduates. This program, with treatment facilities all over the world, has taken girls suffering from eating disorders, mental health issues like depression and bipolar disorder, and pregnant teens, and transformed them, around six months later, into healthy, shiny and happy young women.

And the program is absolutely free.

Sound good?

When you visit the website of the organisation that runs the program, you realise they are a ‘Christian counselling’ group. Ok, no problem, you can handle the Jesus references and nightly prayer meetings won’t hurt you. You used to go to church when you were younger, anyway. Free access to medical professionals and healthy meals will be worth it.

So you start the application process at the Mercy Ministries website.

After being put on a long waiting list, you are finally admitted to one of Mercy’s residential treatment facilities. That’s when things get really bad.

Instead of medical treatment, you are told your eating disorder is caused by demons (not the metaphorical sort, you understand), and the prescribed antidote is prayer, speaking in tongues and the laying on of hands. An exorcism by any other name…

This story is not particular to any one person, but stories similar to it have been surfacing in the Australian media in the last few months. This media coverage has thrust Mercy Ministries into public discourse and debate in Australia, and two weeks ago, Mercy was referred to the Australian Competition and Consumer Commission for alleged breaches of the Trade Practices Act.

But it seems Mercy Ministries is continuing to operate in the US without much fallout from this. A quick online search shows that the controversy has not quite made its way across the Pacific Ocean.

The BCS asked me to write this post, geared towards a US audience, as an elaboration of a post on my blog about Mercy Ministries in Australia.

It is possible that the allegation of mistreatment made against Mercy Ministries in Australia is an isolated case, caused by a ‘bad seed’ at one treatment facility, but it is more probable that the common ideology of Mercy’s facilities around the world is to blame. If nothing else, this post serves as a cautionary tale against taking the word of a secretive religious organisation at face value.

Mercy Ministries was established as a public charity (which it still is) by Nancy Alcorn in 1983 in Louisiana, and has since spread to Australia, New Zealand, and the UK (don’t worry, Canada, it’s coming soon to a British Columbia near you). From their website, Mercy Ministries aims to:

…provide opportunities for young women to experience God’s unconditional love, forgiveness, and life-transforming power.

How does it do this? Once again, the US website speaks:

Our free of charge program serves a diverse population of young women from various socio-economic backgrounds, aged 13-28. Many of the girls, who come to Mercy for help, are facing a combination of debilitating circumstances and have been in various treatment facilities with unsuccessful long-term results. We are committed to providing the young women we serve with the most excellent program services that allow them to recognize their self-worth and prepare them to reach their full potential. Our non-conventional approach to healing allows young women to permanently stop destructive cycles and prepares them to take hope out into their communities.

If you had a Babel fish in your ear, this is what you would hear: Mercy recruits desperate and vulnerable young women, to indoctrinate them with a very specific brand of religious belief. ‘Conventional’ doctors, psychologists and dietitians are superfluous, as girls can only be healed if they become good enough Christians. All girls are descended from that hussy, Eve, and so are inherently gullible and/or evil. Their minds and bodies must therefore be strictly regulated.

Once a girl enters a Mercy Ministries treatment facility, she is effectively cut off from the rest of the world. Instead of teaching girls how to relate to other people living in the real world, Mercy teaches them the most important thing they need to do is to relate to the big invisible guy in the sky. Girls are allowed to send and receive mail (according to the application form, all mail must be opened in front of Mercy staff), and can make 15-minute phone calls to family only on weekends. Girls are not allowed to work. In Australia, girls are not allowed to continue with their secondary or tertiary education while attending the program. In the US, tertiary education is discouraged, and if a girl is still in high school, she can do a correspondence course with her current school or enroll in an online program designed for private schools.Mercy Ministries states:

The Director of Education works with the girls to keep up with the curriculum they are currently studying at school.

…with inappropriate bits like critical thinking skills taken out, no doubt.

But of course, education of that sort is not their priority. The Mercy day begins at 7am and ends at 10:30 pm. During the day, only 1.5 hours is dedicated to school. They have 2.5 hours of prayer/bible study, not including counselling sessions, which go for 3 hours (so essentially, its 5.5 hours of structured religious indoctrination). The rest of the time is spent on meals, chores and a bit of free time. There is no mention of time set aside for regular medical appointments.

Which brings me to the heart of the allegations made against Mercy Ministries in Australia. The girls who spoke out about their experiences said that they very rarely met with qualified medical professionals. Most of their counselling was conducted by bible college students, or counsellors trained in an in-house program by Mercy Ministries. Instead of visiting psychiatrists, girls were told that their problems were caused by demons, which would only disappear if girls worshipped in the proper way. They would be prayed over by Mercy staff, who spoke in tongues and laid hands on the girls. Relapses were a sign that they weren’t praying hard enough.

Girls in the Mercy Ministries program do not have access to their own doctors. Any general practitioners, dietitians and psychologists, when and if consulted, are hand-picked by Mercy. Contrary to any pesky progressive notions of privacy, the girls’ consultations with doctors are supervised by Mercy staff.

The girls do not have access to televisions or radios, and they are only allowed access to ‘Christian’ books and music. On the plus side, they can bring with them as many translations of the Bible as they wish, within the 5 book limit.

Removing people from destructive influences and habits is the basis for most treatment programs, but in the case of Mercy Ministries, the girls not only have to submit behaviourally, to rules and attitudes about drugs and eating and exercise, but are also expected to submit intellectually and emotionally. There is no room for questioning, and little recourse to outside medical assistance, because Mercy claims to operate according to god’s infallible word. As long as a girl questions or resists Mercy’s methods, she will never be healed because she has not accepted god.

On the subject of god, Mercy Ministries says it is:

…an independent organization that is not affiliated with any single church, organization or denomination.

WRONG. Mercy Ministries and its methods are entrenched in the Pentecostal tradition, with all the trappings: belief in the inerrancy of the Bible, in ‘Baptism in the Holy Spirit’ (outwardly manifested through happy-clapping and speaking in tongues), and in divine healing. The Australian arm of Mercy Ministries is closely allied with and financially supported by Hillsong, an Assemblies of God church in Sydney.

In keeping with its Pentecostal leanings, Mercy Ministries is strictly anti-abortion. Mercy’s website tells girls with unplanned pregnancies that:

The Mercy Ministries staff is dedicated to helping each expectant birth mother reach the best decision for herself and her child.

Very liberal of them, eh? But then, the knockout punch, from the program application form:

Mercy Ministries firmly believes in allowing you to make the choice between adoption and parenting. We believe that while you are here God will give you direction for your life and that of your unborn child.

The word coercion springs to mind. The silence on abortion as a choice is deafening. If you are doubtful of my conclusion, watch this Mercy Ministries promotional video.

Mercy Ministries has also been criticised for being anti-gay. It is common knowledge that Pentecostals don’t approve of homosexuality, so for Mercy to be anti-gay is not a huge leap. An article in the Sydney Morning Herald revealed that girls are shown videos like this one, from American ‘ex-gay’ speaker Sy Rogers.

The Mercy Ministries application form contains this gem:

Have you ever been a victim of rape or incest? How old were you?

Have you ever been the victim of sexual abuse, physical abuse or ritual abuse?

Have you ever been involved in prostitution?

Have you ever been involved in same sex relationships/lesbianism?

Have you ever tried to commit suicide? When?

Did they think they could slip it in, and we wouldn’t notice? I never realised being a lesbian was an –ism. And to group it with rape, incest, sexual and physical abuse, and prostitution gives you an idea of how homosexual girls or girls confused about their sexuality are dealt with in the Mercy program.

Mercy Ministries is paranoid about homosexuality. Those speaking about the Australian program mentioned ‘separation contracts’ between girls who had developed close friendships in the facility, and not being allowed to show physical affection of any kind towards each other. On a more amusing note, the application form also contains this:

Have you ever witnessed or been involved in the following occult activities?
…
Tarot Cards
Psychic Consultations
Levitation
Voodoo
Chanting
Ouija Boards
Witchcraft
Channeling
Reading
White Magic
Transcendental Meditation
Witches Coven
Dungeons and Dragons
Programming (color, number, location, etc.)
Putting Curses on Others

Reading through the application form, questions like those above, combined with questions about whether the applicant has committed her life to god make it pretty clear where Mercy Ministries’ allegiance lies. So why would a non-Christian (or non-Pentecostal) girl enter Mercy’s programs? One reason is the lack of publicly-funded resources and treatment centres for young women with these issues. Another reason is that the Mercy Ministries program is free. They keep telling us it’s free. It’s FREE!

Or is it?

From the Mercy Ministries website:

Mercy Ministries provides food and shelter, but we are not responsible for medical expenses or prescriptions. It is the responsibility of parents or guardians of minors, or their sponsoring agency to cover these expenses. Adult aged applicants should provide for their own medical needs.

Mercy Ministries only provides food, shelter and religious indoctrination for free. Everything else has to be paid for by the girl or her health insurer, sponsor or parents. It’s not free. It’s certainly not value-free.

Not all the girls who go through Mercy’s programs are complaining. In Australia, Mercy’s supporters are coming out of the woodwork to counteract the negative allegations against the program. Mercy Ministries claims a 90% success rate. There is no information about who conducted the ‘independent survey’ that yielded this result, nor are there any statistics to back up this success rate – only a few anecdotes.

At best, Mercy Ministries is misleading the public by claiming their program is not affiliated with any particular church or denomination, and by advertising their program as completely free. If their website, with its squeaky-clean models and liberal-sounding emotive language, is enough to lull skeptical old me into almost believing they’re not so bad, how much easier to lure in a young girl in need of help?

At worst, Mercy’s methods are dangerous. They deny medical treatment and counselling to vulnerable girls, and instead, teach that mental illness, eating disorders and homosexuality are the work of the devil and can be cured through prayer. Girls already confused now feel guilty because they are not good enough Christians to be cured; or they rebel and are expelled for being untreatable. Many of the girls who are speaking out against Mercy Ministries say they relapsed after leaving the program, and had to find other treatment facilities to counteract the effects of Mercy’s methods.

Mercy Ministries is currently being investigated by the Australian Consumer and Competition Commission, and I’ll be watching closely to see how that develops. I wonder if it will be too much longer before similar complaints about Mercy Ministries to emerge in the American media?

Further reading:

• See the Mercy Ministries application form for yourself, after filling out a few details.
• The Mercy Ministries Australia website.
• Sean the Blogonaut’s X-Mercy Stories: written by ex-Mercy Ministries women.
• Mercy Survivors - a website for ex-Mercy women from around the world.

There’s been quite a bit in the last few days on the science blogosphere condemning Clinton and Obama for ‘buying in’ to claims that vaccination causes autism. I thought it might be useful to go back to primary sources and see what was actually said.

Before we do that, a quick note about the issue (just skip all this and scroll down to the first quotation if you already know the history). The autism-vaccine “link” was dreamed up - or at least heavily promoted - by lawyers who want to make money at the expense of what they see as a rich pharmaceutical industry ripe for the taking¹. The plaintiff bar’s original focus was not on autism; it was on other sorts of vaccine injuries, some real, some make-believe.

Their litigation in the 1980’s essentially ended vaccine production in the United States; as a response to this critical threat to health, the government has had to take various steps to insure that vaccines are still made here, and are available to people who need them. One of those steps is the creation of the Vaccine Injury Compensation Program, put into place in 1988. It was originally a response to litigation over the pertussis vaccine, in which lawyers introduced evidence, leading to huge payouts, that was later found to be false. Under current law, the plaintiff’s bar goes after the VICP when they think that something might possibly have gone wrong with a vaccine. Although the program is paid for by a small surcharge on vaccines, the court is government-backed, and it hasn’t always remained within its budget; so in essence, every plaintiff’s award or frivolous suit through this court costs the taxpayer a bit of money. It is still, of course, better than not having any vaccines.

The vaccine-autism link doesn’t appear to have become popular until the late ’90’s, and originally the proponents of the link claimed that thimerosal, a vaccine preservative, was the cause of autism. Thimerosal was removed from vaccines given to children starting in 1999², and if this hypothesis were right, a reduction in autism should have been noted in the following years - but it hasn’t. Rather than admit that they don’t know anything about medicine, proponents of the thimerosal hypothesis have moved on to become full-blown anti-vaccination campaigners. Among the claims they’ve advanced is that vaccination is part of a vast government conspiracy to keep people in their place.

That is where we are today. Given the political muscle behind the vaccine conspiracy theorists, mainly in the form of the plaintiff’s bar - who currently have billions of dollars of autism-related claims against vaccine makers in the VICP court - and the predatory medical and quack-medical practitioners following a buck, the issue is now, apparently, one for the presidential campaign.

So here’s what the candidates actually said (with links back to sources):

Barak Obama:

We’ve seen just a skyrocketing autism rate. Some people are suspicious that it’s connected to the vaccines. This person included. The science right now is inconclusive, but we have to research it.

Note that where Obama says “this person included,” he gestured to someone in the audience - he apparently doesn’t mean “myself included.” That doesn’t excuse the fact, of course, that the science is very conclusive that there is no autism-vaccine link.

John McCain:

It’s indisputable that (autism) is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.

Strong evidence? John McCain basically accepts the conspiracy theory hook, line, and sinker.

Hilary Clinton:

Do you think vaccines should be investigated as a possible cause of autism?

I am committed to make investments to find the causes of autism, including possible environmental causes like vaccines. I have long been a supporter of increased research to determine the links between environmental factors and diseases, and I believe we should increase the NIH’s ability to engage in this type of research. My administration will be committed to improving research to support fact-based solutions, and I will ensure that the NIH has the staff and funding to fully explore all possible causes of autism.

What will you do to protect Americans, especially young children and pregnant women, from exposure to mercury through vaccines?

I will ensure that all vaccines are as safe as possible for our children by working to ensure that Thimerosal and mercury are removed from vaccines. I plan to fully invest in our research agencies so they can protect our children’s health, and so they can find the causes and cures for conditions such as autism.

There’s some more material there from Clinton, including something that I’d consider to be classical political weasel words.

Remember, folks, we live in the real world. Resources are limited. Every dollar we decide to spend researching this issue is a dollar we can’t spend some other, better way. What the candidates are talking about is the need to research an issue that has already been researched to death, with six or seven major - and expensive - studies already completed, and with thimerosal already removed from vaccines making a repetition of much of this effort pointless in the extreme.

1. Sometimes they are, and sometimes they deserve to be taken. But not over vaccines. [↩]
2. The only vaccines today that contain thimerosal are for influenza and tetanus, although if you get bitten by a snake, some antivenins contain thimerosal [↩]

I just did a quick google search on reviews of Expelled: No Intelligence Allowed, and have come up with the following gems for your entertainment. And I have to say, my respect for movie reviews has gone up a lot in this process - not that I disrespected them before, but I did not have a lot of (ahem) faith that movie reviewers would be able to engage with the scientific issues as well as they have. In my searchings, I didn’t find any positive reviews that weren’t associated with religious or right-wing political publications - and then only two of those.

The Star Tribune gives it one-half out of four stars:

According to “Expelled: No Intelligence Allowed,” the source of all evil in the modern world is Darwinism, a philosophy that, the film posits, is responsible for everything from atheism to abortion, euthanasia to the Holocaust.

The New York Times leads with:

One of the sleaziest documentaries to arrive in a very long time, “Expelled: No Intelligence Allowed” is a conspiracy-theory rant masquerading as investigative inquiry.

Mixing physical apples and metaphysical oranges at every turn “Expelled” is an unprincipled propaganda piece that insults believers and nonbelievers alike. In its fudging, eliding and refusal to define terms, the movie proves that the only expulsion here is of reason itself.

From Time:

It’s in the film’s final third that it runs entirely off the rails as Stein argues that there is a clear line from Darwinism to euthanasia, abortion, eugenics and–wait for it–Nazism. Theories of natural selection, it’s claimed, were a necessary if not sufficient condition for Hitler’s killing machine to get started. The truth, of course, is that the only necessary and sufficient condition for human beings to murder one another is the simple fact of being human. We’ve always been a lustily fratricidal species, one that needed no Charles Darwin to goad us into millenniums of self-slaughter.

From the LA City Beat:

One might accuse Michael Moore of similarly facile, manipulative techniques – and I have – but Moore has never gone to lengths nearly as outrageous as the makers of Expelled. (For what it’s worth, he’s also funnier.)

In the third act, Stein and company move beyond mere visual associations, when they build a case linking Darwinism to Nazism – which is not merely insultingly lame, but also ranks as one of the cheapest, most offensive exploitations of the horrors of the Holocaust I’ve ever witnessed (and I’ve witnessed plenty).

Expelled is another expression of the right wing’s victim complex. It’s classic paranoid thinking: Since we’re pure and correct, any setbacks we suffer must be the result of an Evil Conspiracy. Communists are fluoridating our water. Purity of Essence. We couldn’t be doing substandard academic work. Our poor advancement must have to do with a blacklist! (Stein himself used this idea to bully Norman Lear into giving him a writing job.)

From the New York Post:

After all of his efforts to unhook the ID caboose from the creationism train, Stein makes it clear that his beef with Darwinism is that it weakens religion.

In a long, greasy detour, Stein shows that the Nazis were Darwinists. So what? They also liked skiing. Having Nazi fans doesn’t make Darwin wrong.

From Slant Magazine:

For a film about American freedom of expression and the necessity for open dialogue, it’s hard to imagine Expelled: No Intelligence Allowed being more one-sided, narrow-minded, and intellectually dishonest.

To their film’s catastrophic detriment, Stein and director Nathan Frankowski fail to provide concrete examples of the flaws in Darwin’s theory, content instead to simply have speakers (many with impressive credentials) state that it’s problematic and then treat such unsupported statements as verifiable truth. Nor, ultimately, do they examine the obvious and crucial religious underpinnings of the “intelligent design movement,” whose onscreen adherents deliberately refuse to speculate on the source of this creative “intelligence” because their opinion on the identity of this fundamental biological architect—God—would conclusively reveal Expelled as propaganda for a Christian-right movement whose own champion, Ronald Reagan, Stein ultimately depicts as his spiritual counterpart.

From E! Reviews:

A flunkout of a documentary, this features Ben Stein—still best known for his monotone “Anyone…anyone?”—advocating creationism, er, intelligent design, in science classrooms. Stein’s credibility is blown on this poorly constructed diatribe, and you’d be smart to save your bucks.

Plus, he’s tedious and unfunny.

With a heavy, heavy hand, the pic punctuates every scene with over-the-top archival footage—the Berlin wall, Stalin and other Cold War imagery.

Despite insisting “intelligent design” isn’t pro-God propaganda, Stein argues we’re waging a religious war (cut to cannon fire) with Darwinists smiting the faithful with—gasp!—atheistic ideas. Most outrageously, he plays the overused Nazi card—he tours an old concentration camp and notes Hitler himself was influenced by Darwin. Yes, kids, studying evolution leads to this (cut to dead prisoners).

Expelled pretends it wants to encourage debate but shuts down and edits around every Darwinian scientist who attempts to explain complex issues, as Stein makes snide remarks in voice-over.

From the Colorado Springs Independent:

Nazis? It’s all about Nazis?

In a parallel universe even crazier than our own, Ben Stein, former Nixon speechwriter turned ironic symbol of the anti-hip, may be making a documentary about how the Nazis used the “controversial” theory of gravity to make bombs fall to earth — so, of course, the theory of gravity must be wrong. But we are here, and in this universe Ben Stein is actually telling us that because the Nazis thought it would be a good idea to breed people like animals, the theory of evolution must be wrong.

It’s nuttiness right from the opening moments of Expelled: No Intelligence Allowed. Images of Nazi atrocities and the terrors of life behind the Berlin Wall are smugly deployed in an attempt to editorialize away basic scientific fact.

Expelled isn’t about “intelligent design,” about an alternative scientific theory, or even about academic freedom. It’s about Stein believing he has proven that acceptance of evolution leads to atheism (and also, we’re told, to such horrors as birth control). Hence, evolution cannot be allowed to be true. Even if it is.

From Newsday:

Ben Stein, the actor, lawyer, columnist and onetime speechwriter for Presidents Nixon and Ford, is probably smarter than you. He’s definitely smarter than I am. What’s galling about his new documentary, “Expelled,” is that he seems to think we’re both slobbering idiots.

In an increasingly hysterical tone, Stein lambastes Darwinians as misguided, ignorant fascists, cutting repeatedly to old footage of the Berlin Wall - a metaphor for squelched thought.

Finally, he unleashes his biggest attention-getter, holding Darwinism responsible for Nazi atrocities and genocide. I’m no lawyer, but that’s a pretty lousy argument.

Did Stein really think audiences wouldn’t balk at being suckered into a propaganda rally? Or was he preaching to the converted from the start? Stein claims to denounce the tyranny of dogma, then browbeats us with his own.

From Variety, whose reviewer is predisposed to like the movie:

Even more offensive is the film’s attempt to link Darwin’s “survival of the fittest” ideas and Hitler’s master-race ambitions (when in doubt, invoke the Holocaust), complete with solemnly scored footage of the experimentation labs at Dachau. Evocations of the Berlin Wall, treated as a symbol of a bullheaded scientific establishment on the verge of collapse, are equally fatuous.

The Village Voice:

[Stein's] thesis: Teaching Darwinian evolution but ignoring intelligent design in America’s public schools and universities is the biggest threat to American freedom today—bigger, presumably, than Al Qaeda, Iraq, and the recession combined. A series of interviews with ID true believers has him playing Michael Moore–dumb—no hard questions for the folks at the Discovery Center

ID’ers protest that they’re simply interested in secular alternatives to Darwinian evolution; their scientific opponents, meanwhile, are potential Communists and Nazis. Bizarre and hysterical.

The Orlando Sentinel, whose review was also run by the Chicago Tribune:

….Expelled: No Intelligence Allowed, [is] a cynical attempt to sucker Christian conservatives into thinking they’re losing the “intelligent design” debate because of academic “prejudice.”

It’s a rabble-rouser of a doc that uses all manner of loaded images, loaded rhetoric, few if any facts, dubious ID “experts” and mockery of hand-picked “weirdo” legit scientists to attack those who, Stein claims, are stifling the Religious Right’s efforts to inject intelligent design into science courses, science curricula and the national debate.

It just isn’t particularly funny. Or the least bit convincing.

I lost track of the number of times Stalin’s image hit the screen, and in the ways the movie equated science with Darwinism with atheism with Hitler or Stalin. Subtle, it’s not.

Stein (he co-wrote it) builds his movie on classic Big Tobacco Tactics.

On Rotten Tomatoes, the movie currently has a rating of less than one out of ten.

Update: As of Saturday, April 19, this post is number four in a google search of “expelled reviews,” and it is getting a lot of traffic. This post keeps switching places on the google front page with “Expelled Exposed,” so I figured that I’d better do an update to reflect more reviews that I’ve found over the last day. Here you are:

The Waco Tribune:

[The] film’s arguments are a rhetorical mishmash of straw men, red herrings, guilt by association, quote harvesting, gotcha interviews and post hoc ergo propter hoc (after this, therefore because of this) associations that may cause your head to pop. It’s a propaganda form highly polished by director/activist Michael Moore on the other end of the political spectrum.

Those coming to Expelled hoping to learn something about any research behind ID, a fair appraisal of weaknesses in evolutionary theories or — perhaps the film’s most glaring and telling omission — how Christian evolutionists reconcile faith and science will leave sorely disappointed. The latter is quickly dismissed by a chain of quotes that brand them as liberal Christians and duped by militant atheists in their efforts to get religion out of the classroom.

From TV Guide:

It’s hard to pinpoint the most insulting aspects of this obvious propaganda piece from Ben Stein, the eye-drops spokesman, conservative writer and pundit whom most people remember from a bit part in FERRIS BUELLER’S DAY OFF.

But surely the film’s greatest offense is the utter shamelessness with which it exploits the Holocaust, veering far off topic for a side trip to Nazi killing centers at Hadamar and Dachau in an attempt to tar Darwin with the old “Evolution led directly to eugenics and the Final Solution” brush. The camera’s slow tracking shots through the death camps are followed by a similar creepy crawl through Down House, where Darwin wrote On the Origin of Species by Means of Natural Selection. None of this has anything to do with the validity of evolutionary theory or intelligent design, and only serves to point up how any theory can be used to justify evil ends.

From the Salt Lake Tribune:

The scholars Stein and the film’s producers interview say they just want an open debate where creationism - pardon, intelligent design - and Darwinist evolution can be discussed side-by-side. What’s wrong with that? Stein asks with mock-innocence.

Alas, the movie’s makers (Stein and co-writers Kevin Miller and Walt Ruloff, and director Nathan Frankowski) don’t debate honestly. Stein mocks university officials for not “getting off [their] script,” but says nothing about the repetitive talking points from the ID crowd. The ID folks complain that the term “evolution” is too vaguely defined, and yet never adequately define what “intelligent design” is. They swear they aren’t espousing religion, then try to discredit the leading evolutionary biologists - such as Richard Dawkins and P.Z. Myers - because they are atheists.

Oddly enough, the tactics employed in “Expelled” undercut the movie’s argument, most notably in the interviews with Dawkins and Myers and in Stein’s trip to Darwin’s British home (now a museum). Either the filmmakers suckered these participants under false pretenses, or the evolutionists are more open to debate than Stein suggests. Perhaps the intelligent-design proponents know that in a truly open debate, their argument isn’t fit enough to survive.

From the Seattle Times, hometown newspaper to the Discovery Institute:

Pop quiz: What is the real source of evil in the modern world? Greed? Intolerance?

Well, according to “Expelled: No Intelligence Allowed,” it’s Darwinism, described as a philosophy that posits the pointlessness of life and encourages the “de-privileging of human beings” — and as such is responsible for everything from atheism to abortion, euthanasia to the Holocaust.

But Jon Stewart is a lot funnier than Stein.

From BeliefNet:

Like the tobacco companies once they could no longer question the legitimacy of the scientific evidence connecting cigarettes and disease, Stein quickly shifts the debate from a head-to-head assessment of analysis of data to frame the issue as one of freedom of speech. The movie opens with archival footage not of science labs or the animal life on Galapagos Island, where Darwin first began to develop his theory, but of the construction of the Berlin Wall. Stein tries to draw a parallel between the wall that divided Germany and the impenetrable wall that keeps Intelligent Design out of the science establishment. But he is also associating Darwinian science with Godlessness, communism, and totalitarianism, with detours into Nazi atrocities and atheism so over-the-top that it becomes shrill and irrational.

The conservative Ayn Rand Institute:

“The premise of Expelled is that proponents of ‘intelligent design’ have been shunned, denied tenure, and even fired because of a conspiracy to quash the scientific evidence supporting their theory,” said Dr. Keith Lockitch, resident fellow at the Ayn Rand Institute. “But the truth is: there is no evidence supporting their theory. Intelligent design is completely devoid of any positive scientific content, and consists of nothing more than a religiously motivated attack on evolution. To the extent intelligent design advocates are facing obstacles in academia it is because they are not doing real science: they haven’t been ‘expelled’ they have flunked out of the scientific community, just as a faith healer would flunk out of medical school.

A Scientific American podcast reports on the movie’s dishonest quoting of Charles Darwin:

Toward the end [of the movie], Stein reads the following quote from the book Descent of Man: “With savages, the weak in body or mind are soon eliminated. We civilized men, on the other hand, do our utmost to check the process of elimination. We build asylums for the imbecile, the maimed and the sick. Thus the weak members of civilized societies propagate their kind. No one who has attended to the breeding of domestic animals will doubt that this must be highly injurious to the race of man. Hardly anyone is so ignorant as to allow his worst animals to breed.”

…I went to a full text of Descent of Man online and found the quoted passage. And then found the sentences that come right after where Stein stopped quoting.

So here’s Charles Darwin again, from Descent of Man: “The aid which we feel impelled to give to the helpless is mainly an incidental result of the instinct of sympathy, which was originally acquired as part of the social instincts, but subsequently rendered, in the manner previously indicated, more tender and more widely diffused. Nor could we check our sympathy, even at the urging of hard reason, without deterioration in the noblest part of our nature. The surgeon may harden himself whilst performing an operation, for he knows that he is acting for the good of his patient; but if we were intentionally to neglect the weak and helpless, it could only be for a contingent benefit, with an overwhelming present evil.“

(Update: It is now April 28, and this post is still getting a lot of traffic, so I wanted to provide a link to an article about the film by noted conservative columnist John Derbyshire and appearing in National Review. It is probably the strongest slapdown of the movie I’ve ever seen.)

National Review says:

…creationists have been morally corrupted by the constant effort of pretending not to be what they are. What they are, as is amply documented, is a pressure group for religious teaching in public schools.

…The creationists took the morally fatal decision to campaign clandestinely. They overhauled creationism as “intelligent design,” roped in a handful of eccentric non-Christian cranks keen for a well-funded vehicle to help them push their own flat-earth theories, and set about presenting themselves to the public as “alternative science” engaged in a “controversy” with a closed-minded, reactionary “science establishment” fearful of new ideas. (Ignoring the fact that without a constant supply of new ideas, there would be nothing for scientists to do.) Nothing to do with religion at all! I think this willful act of deception has corrupted creationism irredeemably. The old Biblical creationists were, in my opinion, wrong-headed, but they were mostly honest people. The “intelligent design” crowd lean more in the other direction. Hence the dishonesty and sheer nastiness, even down to plain bad manners, that you keep encountering in ID circles.

Our scientific theories are the crowning adornments of our civilization, towering monuments of intellectual effort, built from untold millions of hours of observation, measurement, classification, discussion, and deliberation. This is quite apart from their wonderful utility — from the light, heat, and mobility they give us, the drugs and the gadgets and the media…. Simply as intellectual constructs, our well-established scientific theories are awe-inspiring.

And now here is Ben Stein, sneering and scoffing at Darwin, a man who spent decades observing and pondering the natural world — that world Stein glimpses through the window of his automobile now and then, when he’s not chattering into his cell phone. Stein claims to be doing it in the name of an alternative theory of the origin of species: Yet no such alternative theory has ever been presented, nor is one presented in the movie, nor even hinted at. There is only a gaggle of fools and fraudsters, gaping and pointing like Apaches on seeing their first locomotive: “Look! It moves! There must be a ghost inside making it move!”

The “intelligent design” hoax is not merely non-science, nor even merely anti-science; it is anti-civilization.

The Daily Mail reports on the story of a man who received a heart transplant, and later committed suicide by shooting himself - which happens to be the same way the heart donor died.

Archaeoporn covers the story in fine detail, and I’m not going to rehash their material here. But I did notice in the course of my reading that the density of baloney in this story is very high - maybe even degenerate. Let’s count how many unproven concepts and faulty conclusions exist in this story, shall we? Here’s some material from the Daily Mail story:

For a few brave scientists have started claiming that our memories and characters are encoded not just in our brain, but throughout our entire body.

Consciousness, they claim, is created by every living cell in the body acting in concert.

Already we are stepping out into the great land of mystical nonsense: there is an active debate amongst scientists whether consciousness is an illusion or not. So that’s one.

They argue, in effect, that our hearts, livers and every single organ in the body stores our memories, drives our emotions and imbues us with our own individual characters. Our whole body, they believe, is the seat of the soul; not just the brain.

We know the brain exists, but so far there’s been no evidence of a soul. That’s two.

And if any of these organs should be transplanted into another person, parts of these memories - perhaps even elements of the soul - might also be transferred.

So transplanting a liver can transplant memories. Three.

And doing the same thing can transplant elements of the soul. We’ve already dealt with evidence for the existence of a soul, so we can’t use that again, but look how the writer snuck in a new concept here. The soul is made up of “elements,” which presumably have some characteristics by which they can be defined, and these “elements” can move along with a body part.

Four.

There are now more than 70 documented cases similar to Sonny’s, where transplant patients have taken on some of the personality traits of the organ donors.

Five: Attempts to characterize or measure personality have been fraught with very serious and persistent problems. Until the instruments used to measure personality can be developed to the point where they aren’t baloney, any claim that a personality has changed to more closely conform to another personality needs to be pushed back against with a healthy dose of skepticism.

Professor Gary Schwartz and his co-workers at the University of Arizona have documented numerous seemingly inexplicable experiences similar to Sonny’s. And every single one is a direct challenge to the medical status quo.

And six: Just because someone says it, doesn’t make it true. As we shall see, none of the examples listed in any way challenges the medical “status quo.”

And speaking of which, that would be seven: There is no medical status quo. Medicine is science driven, at least when we quite properly exclude homeopaths, alties, and other frauds; and science constantly refines its understanding of how the universe works.

In one celebrated case uncovered by Professor Schwartz’s team, an 18-year-old boy who wrote poetry, played music and composed songs was killed in a car crash. A year after he died, his parents came across a tape of a song he had written, entitled, Danny, My Heart Is Yours.

In his haunting lyrics, the boy sang about how he felt destined to die and donate his heart. After his death, his heart was transplanted into an 18-year-old girl - named Danielle.

When the boy’s parents met Danielle, they played some of his music and she, despite never having heard the song before, knew the words and was able to complete the lyrics.

Eight: Which is more likely: That the 18-year old boy, who apparently wasn’t widely noted as a good lyricist, wrote a song so derivative of the cultural memes in which he and other 18-year olds are immersed that just such an eighteen year old was able to make a passably accurate guess about where the song was going….

Or, could it be that “elements,” which haven’t been shown to exist, of his “soul,” which hasn’t been shown to exist, were “transplanted,” which hasn’t been shown to be possible, along with the organ, and that this led to supernatural knowledge of the song?

Professor Schwartz also investigated the case of a 29-year-old lesbian fast-food junkie who received the heart of a 19-year-old vegetarian woman described as “man crazy”.

After the transplant, she told her friends that meat now made her sick, and that she no longer found women attractive. If fact, shortly after the transplant she married a man.

Nine: Which is more likely? A woman gets a heart transplant and is put under enormous pressure by her doctors to follow dietary rules prior to the transplant and to continue following them after, so as to maximize cardiac health in an already extremely compromised patient. So she does everything she can to mentally adopt these new rules and follow them. She is praised for doing so. The ultimate result is that she comes to prefer her new, healthier diet and to view her old habits with distaste.

Or, could it be that small bits of the inner fairy transmigrated with the heart during transplant, leading to a new set of dietary and sexual preferences?¹

In one equally inexplicable case, a middle-aged man developed a new-found love for classical music after a heart transplant.

It transpired that the 17-year-old donor had loved classical music and played the violin. He had died in a drive-by shooting, clutching a violin to his chest.

That sounds remarkably similar to my coming to appreciate the music of Jimi Hendrix as an adult, even though I had previously preferred classical music. Just for the record, I’ve had no organ transplants and have never been involved in a drive-by shooting.

The correlation breaks down further when you realize that violins are used to make all kinds of different music. Not only classical, but also rock, fusion, easy listening, Swing, jazz, Dixieland, quadrille, Cajun, contra dance, Táncház, Cape Breton, Métis, Clare, Donegal, Sliahbh Luachra, Sligo, Tierra Calliente, Hardanger, etc, etc, etc. When you have such a long list of music genres to choose from, it just doesn’t look very remarkable when the donor played the instrument, and the recipient came to like one of the many genres of music the instrument plays.

So, that’s ten.

Nor are the effects of organ transplants restricted to hearts. Kidneys also seem to carry some of the characteristics of their original owners.

Take the case of Lynda Gammons from Weston, Lincolnshire, who donated one of her kidneys to her husband Ian.

Since the operation, Ian believes he has taken on aspects of his wife’s personality. He has developed a love of baking, shopping, vacuuming and gardening. Prior to the transplant, he loathed all forms of housework with a vengeance.

Unmentioned in this sexist viewpoint is whether Lynda Gammons actually loves baking, shopping, vacuuming, and gardening, or merely does them because they are things that must be done. Three of the four activities are hobbies enjoyed by many - but I don’t know many people with a love of vacuuming. In any case, we should again ask:

It is more probable that a person who experiences a life-threatening illness and undergoes a risky procedure to survive it might mellow a bit and start to do chores they previously abhorred? Particularly if they are now unable to do some of the tasks they previously undertook for the house, such as building additions or crawling under the car to maintain it?

Or do we need to attribute this to small fragments of surgically removed pixie dust which then took root in a new body and changed everything?

I’m counting this one as eleven. And I’ve not bothered going through the whole story.

It’s easy to dismiss such tales as hokum.

Yes, it certainly is. And that is because such stories really are hookum.

1. I’m not going to bother addressing her sexual preferences - she is at liberty to pursue any sexual preference she pleases, without the need for it to be explained by me as a result of stress, or reflection, or other mental processes; and without need for it to be explained by others as a result of spirits from the woods. [↩]

One of the ways that dogs differ from their mammalian cousins, Homo sapiens, is that dogs have a complete nictitating membrane, often called colloquially the “third eyelid.”¹ This membrane has a number of functions, one of which is to act as additional protection for the eye. It also houses a gland which accounts for about 30% of the tear production for that eye. Tears keep the cornea hydrated and oxygenated, and they deliver nutrients - a necessary task, since the cornea does not have blood vessels to fulfill these functions.

Sometimes people notice that their dog has a small red mass in the inner corner of the eye. It was once thought that this was a tumor, and the standard treatment was to remove it. But in the 1980’s, this practice changed after it was discovered that the red mass was actually the gland that is normally held behind the third eyelid by connective tissue. When the gland moves out of place, perhaps because of connective tissue that becomes loose, blood circulation to the gland becomes impaired, and the gland swells and becomes red. This condition is commonly known as “cherry eye,” and is seen mostly in young dogs.

The condition can occur in any breed, but certain breeds are especially susceptible, including english bulldogs, pugs, cocker spaniels, boston terriers, shihtzus, beagles, pekingese, bassett hounds, and neapolitan mastiffs.

The condition looks like this:

In the past, the standard treatment for this problem was to remove the gland. But since the gland produces 30% of the tears for that eye, removing it can lead to a condition called keratoconjunctivitis sicca - which we will mercifully shorten to KCS. It is also commonly known as “dry eye.”

KCS is a serious disease with no cure, and if untreated it is very painful. There are two different kinds of KCS. In the first type, the glands do not produce enough tears; in the second, the glands are not making the right type of tears. Tears are made up of three components. There is a lipid layer to prevent tears from evaporating, a liquid portion that helps to distribute the tears across the cornea as well as providing nutrients, and a mucous layer to help the cornea get the nutrients from the liquid layer into the cells of the cornea. Without the liquid portion of the tears, the mucous portion will stick to the cornea, and it will look as if there is a very bad infection. It also feels as if you have sandpaper on your eyelids as you blink. If the condition is bad enough, the eyelids will be unable to blink across the cornea. The cornea will start to dry out and die, and will become pigmented or darkly colored. At this stage, the animal will be blind.

KCS looks something like this:

So all this can be caused by the removal of a prolapsed gland normally held behind the nictitating membrane, which used to be the standard treatment. What about today? Well, science marches on, and we have much better methods of treating the condition now. The current standard of care is to replace the gland behind the third eyelid and suture it into place. There are a number of different ways to do this, and they have varying rates of success and difficulty. Over the course of the several days following surgery, assuming there are no complications, the swelling of the gland will go down, and the gland will return to normal, as though nothing had ever happened. A 100% recovery is the usual, but the most common complication is for the gland to pop out again, requiring additional attention.

A few breeds, notably bulldogs and mastiffs, have anatomical peculiarities that make it more difficult to get the gland to stay where it is put. Typically this is because the cartilage in the third eyelid is bent, or not as stiff as it should be. In these circumstances the surgical procedure is slightly altered for the patient in order to minimize the chance of a second prolapse - for example, the cartilage can be reconstructed and the gland sutured more securely as a result of the alteration.

If these surgical techniques are used, there’s a 17% chance that the animal will develop KCS, or dry eye. This may sound like poor odds, but not once you compare them to the alternative. If the gland is removed, there’s a 50% chance of developing the condition - just over three times the risk. In fact, it is better to leave the gland alone, in its prolapsed state, than to remove it - but best of all is to put it back into position where it can work normally again.

Naturally, such a medical success story is the subject of bad advice, mythology, and woo on the interwebs. You need not look far at all to find websites that discuss certain breeds of dog, and how horrible it is to repair a prolapsed gland. The flavor of the woo-meisters’ arguments is that veterinarians are ignorant and awful for doing replacement surgeries (with high success rate - yes, even on Neapolitian Mastiffs), rather than just doing the obvious thing and hacking out something that looks ugly and infected (leading to a 50% chance of disabling complications). KCS, and resulting blindness, is apparently an acceptable alternative.

At least these people are telling dog owners to go see their vets - but usually just to get prescriptions for medications that the writers seem to think will help. One of them talks about the use and dosing of atropine eyedrops to reduce the pain of the condition. Atropine is used as a pain reliever, but only in cases of uveitis (inflammation in the front chamber of the eye). Its use is so limited because it has serious side effects. It dilates the iris, usually for 2-3 days, and sometimes up to a week or more. Overdoses can cause ventricular fibrillation, tachycardia, dizziness, nausea, loss of balance, loss of balance, hallucinations, excitement, and death. A common mnenomic used to remember some of the signs of atropine overdose is “hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter” - referring to the fever, blindness, dehydration, red skin, and hallucinations that overdose victims experience. As a result of all these side effects and dangers, we don’t typically use atropine for cherry eye, either before or after surgery.

If cherry eye is untreated, or if the gland is removed, and KCS (dry eye) develops, there are some treatments that will help if it is diagnosed early enough. These range from prescription eye ointments that need to be administered 2-3 times daily, to artificial tears which can be given as many times in a day as you can give them. In both cases, this must be done for the rest of the animal’s life. Obviously, this results in a lot of annoyance and discomfort for the patient, and places heavy demands of time and effort on the part of the pet owner, so it is best to just get the correct surgical treatment in the first place. If these medications aren’t administered properly, or don’t work, and the condition progresses, the complications from KCS can be severe enough that it is best to remove the eye entirely.

This doesn’t sound like an option that is worth the risk.

1. Homo sapiens has a vestigial version. [↩]