Category Archives: Skepticism

Quickies for Christmas

No Virginia, There Is No Santa Claus, by Greta Christina

‘Twas the Night Before Reason, via The Friendly Atheist

“What an odd question . . . I adore Christmas. The fact that I know that Christianity’s origins lie more in Paul of Tarsus’s mental illness and [Emperor] Constantine’s political savvy than in the existence of the divine has no bearing on my ability to embrace this age-old festival of giving, family and feasting.” – Tim Minchin

And since we’re talking about Tim, here’s his Christmas song, White Wine in the Sun:

Merry Christmas!

Skeptical icons who look like Santa

I noticed the irony that Tom Flynn really looks quite a bit like Santa when he’s in his Anti-Claus getup.  Then I happened to read a tribute to Christopher Hitchens by Daniel Dennett, and the picture of Dennett made me investigate a bit further.  Now, I give you a surprising number of famous atheist “Santas.”  Mouseover for names.

I may not be posting new stuff until the 26th, as we’ll be busy partying with family.  Joyous Chrismahannukwanzaakah, Happy Yule, Merry Solstice, Felicitous Humanlight, and so on and so forth.  Whatever you’re doing during this season, I hope you have fun.  Tom, I hope you enjoy the easy drive to work and the peace and quiet once you get there!

Why I gave my children homeopathic cold pills

The placebo effect is real and powerful.  For many conditions that won’t cause harm if left untreated, it would be perfectly reasonable to give the patient a placebo to help them cope.  The problem is ethics: doctors cannot give a patient a medication and lie about what it contains.  That would prevent informed consent and would be a serious breach of trust and professional responsibility.

However, as a mom I can give placebos with a pretty clear conscience.  It’s my job to take care of my children’s health without their informed consent.  Of course as they mature, I will solicit more and more input from them, but right now I basically run their healthcare.

My older daughter in particular has inspired me to explore placebos.  She has extreme sensitivity to flavors and textures, and is largely unable to take children’s medications.  Of course if she has a high fever or needs antibiotics, I work with her to make sure the medicine goes down.  But it’s not worth cajoling, finagling, and risking  some spectacular reverse peristalsis to get some cough and cold medicine into her when she’s uncomfortable at bed time.  I offer, sure, but she always declines.

So I started to think about placebos.  I was sure if I could give her something and tell her it would make her feel more comfortable, she would be more relaxed and less likely to obsess about her symptoms, and could go to sleep.  My first thought was Tic Tacs, but I knew she’d catch on.  She’s 8, and she’s already familiar with them.  The telltale shape and flavor would surely tip her off.

Then I thought of homeopathy.  It’s just water!  Hyland’s makes tablets that dissolve immediately.  Perfect.  Well, the one drawback I thought of at the time was, of course, putting money in the pockets of scam artists.  But my immediate need overrode my boycott circuits, and I grabbed some Hyland’s C-plus.

It worked really well.  I have since used it several times for cold symptoms, and once with my three year old for boo boo pain drama.  I never actually said they would cure anything – I told them that the pills would make them feel better, or make it easier to deal with being sick.  (But yeah, I essentially lied.  I’m going to just assume that our Santa honesty balances it out.)

But when I did a little more research on the C-Plus tablets, I discovered they contain Yellow Jessamine at a mere 3X dilution.  I started to think about whether 3X means that there could be some actual molecules of this poisonous plant in the tablets, but I only got as far as a vague notion that it would involve molarity and Avogadro’s number before I had to go lie down.  So I decided to just function on the supposition that there could be a trace of actual factual poison in these things.  Between that and the issue of supporting snake oil, no more homeopathic remedies for us.

I will however seek out a more ethical and safer placebo for those times when my kids can’t stop focusing on their snotty noses and can’t sleep, or when there’s much wailing and gnashing of teeth over a small scrape.  I’m open to suggestions – they must get by a fairly sharp 8yo, as well as being easy to take.

(And yes, I will be filling them in on the ruse at some point before they go off into the world and might try to buy such remedies for themselves or their children.)

The Dangers of Being Insulting and Misleading

Darcia Narvaez, PhD, launched quite the volley two days ago with her Psychology Today article, “The Dangers of ‘Crying it Out’: Damaging children and their relationships for the longterm.”  Now, if you’re a reader of this blog, your first question might be, “Gee, that seems rather incendiary.  Does this person have a real PhD?”  Given that she’s a psychology professor at Notre Dame, I’m thinking yes.  But that doesn’t disqualify her from being a judgmental ideologue who has only passing acquaintance with honesty!

Introduction

She starts out by poisoning the well, linking “Cry it out” with discredited 19th century exhortations not to touch babies, to withhold love, not to be too kind, and the sentiment that watching and entertaining a baby is a waste of time.  She refers to “Cry it out” without defining the term and also talks about “letting babies cry.”  This vagueness about the very heart of her argument isn’t helpful to her case.  What does she mean by CIO?  Ferber? Weissbluth? Ezzo?  “Letting babies cry” for how long?  Does letting a baby cry for 5 minutes on one occasion “damage children and their relational capacities in many ways for the long term” and make the baby “less intelligent, less healthy but more anxious, uncooperative and alienated”?  Note she doesn’t give any citation as she lobs these firebombs.  She simply says “With neuroscience we can confirm [them].”  This is the debating equivalent of saying, “Increase the Flash Gordon noise and put more science stuff around!”  She’s trying to dress her philosophical opinion piece with science-y trappings without doing, you know, actual science.

Citing . . . herself, she declares that babies only grow when being held, and that basically you should never put your baby down, never mind sleeping apart from them.  Then she states, “There are many longterm effects of undercare or need-neglect in babies.”  While the terms “longterm,” “effects,” “undercare,” and “need-neglect” are left undefined, she has finally, in the fourteenth paragraph of her article about the risks of CIO, cited a scientific study that allegedly demonstrates the risks of CIO.  Well, it’s not an actual study.  It’s a survey of research used to make a public policy argument for early intervention “to provide an optimal environment in the first years of life.”

There are many longterm effects of undercare or need-neglect in babies”

The article by Dawson, Ashman, and Carter, does discuss postnatal stress as an influence on child development.  However, it’s difficult to pin down what is included in the term “stress.”  The authors discuss animal studies where “separation from the mother” causes a surge in cortisol and other hormones.  Unfortunately, some study abstracts don’t tell how long a separation they’re studying (and I can’t afford to buy all the studies!).  And of course that would have a big impact on our concern about the risks of CIO.  However, this one and this one  used a 24 hour separation, and this one used isolation for 6 hours daily during postnatal days 2-20.  The human studies of postnatal stress discuss the level of attachment exhibited by children, compared with their behavior and cortisol levels, but don’t inquire into what might cause poor attachment.  The most damning statement I could come up with was “later attachment security was related to greater maternal responsiveness and lower cortisol baselines,” i.e., maternal responsiveness, as measured during clinic visits, was associated with children showing greater attachment security when they returned for follow-up testing.  Needless to say, mothers who scored high on responsiveness during the day at the clinic might or might not have used CIO in some form at night, at some point.

When they discuss specific circumstances that cause stress for babies, Dawson et. al refer to babies in Romanian orphanages, and those with clinically depressed mothers.  Note that these are serious, long-term, global stressors, not simply a short period of stress, confined to a certain part of the day, for a limited duration.  Other circumstances they cite as influencing child development for the worse are fetal exposure to drugs and alcohol, developmental disabilities such as autism, poor nutrition, and violence.  So by “stress,” they seem to be referring to very long isolation from the mother, or significantly traumatic events and conditions.  There’s no indication that sleep training rises to this level, and Dawson et. al. never make any reference to sleep training or long periods of crying.

Moreover, the Dawson article undermines Narvaez’s confident doom-saying by noting that “the contribution of parenting factors to the development of self-regulatory brain mechanisms that have been hypothesized to relate to affective and attentional disorders is still poorly understood,” and “It needs to be determined whether psycho-biological measures such as neuropsychological performance, cortisol levels, autonomic responses, and brain electrical activity will be useful in identifying children at risk for psychopathology.”

So let’s go back to the statement she linked with this article: “There are many longterm effects of undercare or need-neglect in babies.”   It might more accurately reflect the article to say, “There may be many long-term effects of lengthy separation from the mother, maternal mental illness, and chronic deprivation in an institutional setting, but we’re not yet sure what those effects are, and while we are guessing that certain brain mechanisms relate to emotional and attention disorders, we’re not sure about the details, and we don’t know if or how much parenting affects such mechanisms.”

“What does ‘crying it out’ actually do to the baby and to the dyad?”

We’re told that “neurons die” due to “the toxic hormone cortisol.”  You know, that “toxin” that is needed for proper glucose metabolism, regulation of blood pressure, blood sugar maintenance, immune function, and inflammatory response.  Is it more charitable to assume that Dr. Narvaez is ignorant, thinking that cortisol is unremittingly evil, or that she’s disingenuous, purposely ignoring the beneficial, normal function of cortisol while focusing solely on its effects in cases of chronic stress, when the body is not given the chance to return to baseline after a stressful event?  I’m going to have to go with the latter, seeing as she follows up with the brazenly speculative cry, “Who knows what neurons are not being connected or being wiped out during times of extreme stress?” (That’s a fun game – I’m going to play.  “Who knows how many of my neurons have been wiped out due to reading Dr. N’s screed?”  “Who knows whether contact with her article might have given me an STD?”  “There’s no telling how much my credit score has fallen due to such extensive contact with this text!”  “Who can tell whether you’ll receive a pot of leprechaun gold if you write an angry letter to Psychology Today?”)

Next up, we’re told that “disordered stress reactivity can be established as a pattern for life.”  Again, both citations refer to extreme stress such as child physical and sexual abuse, psychiatric illness, and PTSD.  I admit I’m reading these late at night, but I’m pretty sure neither included “crying for 10 minutes” in their list of catastrophic stressors.

Likewise, when she argues that self-regulation is undermined, she cites a study that does indeed say “Stress during infancy that is severe enough to create insecure attachment has a dissociative effect,” but the stress they’re discussing involves experiences so severe they induce PTSD.

Next she argues that “trust is undermined,” referring to the philosophical work of Erik Erikson and delineating her personal belief that a baby left to cry (presumably for any period) learns to mistrust his caregivers, and the world at large.  Piling fantastic speculation on wild conjecture, she sums up, “And self-confidence is undermined. The child may spend a lifetime trying to fill the inner emptiness.”   Or, not.  Either guess is equally valid.

She is also concerned that “caregiver sensitivity may be harmed.”  Again, this is speculation.  It’s not totally nonsensical – it makes sense that becoming inured to your child’s cries in one instance could make you generally more insensitive.  On the other hand, every mom I’ve talked to who’s tried sleep training has agonized over her baby’s crying, and it’s equally plausible that empathy and good old mom guilt might make a sleep training mother more responsive, doting, and loving at all other times.  It would also make sense that a fatigued mother would be less responsive, while a well-rested mother would have more resources for engagement with her baby.  We’re dealing purely with “what-if” scenarios here, and Narvaez seems to acknowledge that by including the uncharacteristic equivocation “may,” and omitting any citations.

“But isn’t it normal for babies to cry?”

Here Narvaez really lays into parents, setting an impossible standard.  She states that if your baby cries, or even “displays discomfort,” it’s clearly because you are depriving them of something they need.  And she makes sure to remind you that your baby is rapidly growing – implying that your callous deprivation is particularly disastrous and cruel!

She continues, stating that any parent whose baby cries a lot is inexperienced and ignorant.  If only you stupid incompetent parents had researched how to properly soothe a colicky, fussy, or high-needs baby, your infants would hardly cry at all.  Get on that, would you?

Why Narvaez’s article is a double-scoop of obnoxious.

To sum up, this article really irritates me because it combines two things I hate.  First of all, you guys know it irks me when people abuse citations.  What’s billed as a research study supporting their assertion turns out to be an opinion piece or simply doesn’t say what the citing party says it does.  I’m annoyed that to get a real picture of the supposed “science” here, I had to spend hours combing through abstracts and pony up $6 to rent an article.  Narvaez no doubt has greater access to scientific publications than we lowly parents do – is it too much to ask that she not misrepresent what the studies say?

The second thing that makes me twitch is her intrusive, judgmental tone.  I’ll be the first person to present the evidence showing formula feeding is statistically more risky than breastfeeding, or even to opine that routine infant circumcision is unethical.  But I don’t charge into someone’s facebook status about their son’s bris screaming that they’re child abusers.  I don’t post here intimating that formula is “junk food” and accusing bottle-feeding moms of not loving their kids enough, or being ignorant and callous.  I acknowledge that people can choose parenting options that may be demonstrably inferior, all things being equal.  But I don’t live their lives, and I don’t know what factors are interacting to ensure that all things aren’t equal.  I just know that all things aren’t equal for most people, most of the time.  The vast majority of parents love their kids like no tomorrow, and make the best decisions they can given their unique circumstances.  The last thing they need is someone twisting the facts in an effort to make them look uncaring and stupid.

(By the way, that “formula is junk food” concept comes from another of Narvaez’s articles, which inspired a PhD in Parenting post saying that Narvaez was judgmental, vague,  ignorant, and lacking scientific support for her statements, and that she “gives greater legitimacy to the argument that lactivists are cold-hearted, uncaring, uncompassionate, ‘Breastfeeding Nazis.'” Whoa.  When a distinguished lactivist like Annie says you’re exemplary of the meme that lactivists are jerks, you know you’ve gone way overboard with the AP zeal!)

Adventures in skeptical parenting

One Million Dollars!

We were watching someone do something magical on a TV show, and Chloe said, “People can’t really do magic, right?”  I told her about the James Randi Education Foundation and their 1 million dollar challenge.  When I told her that anyone who can demonstrate paranormal powers under controlled conditions gets $1M, she immediately started plotting how to fool the judges.  “You could have something in your hand, and then have a trap door down here, and you’d go like this, and it would disappear!”  For the moment, I decided not to address the ethics of this plan, but to point out the practical drawbacks.  I told her that they require controlled conditions, so do you think they would miss the trap door?  I also told her that Randi is a professional stage magician with decades of experience, so the problem would be coming up with a trick he couldn’t see through.  She allowed that that might be difficult.

Christians & Penguins

Chloe was chattering about Christmas, the carols they’re singing at school,* and, most importantly, which Beanie Ball she wanted to buy with her allowance. She couldn’t decide between the penguin and the reindeer.  As she listed the pros and cons of each, she said, “I think most of the Christians in my class like penguins.”  Nonplussed, I said I don’t think Christianity has anything to do with penguins.  I understood that Christianity kind of has a link with reindeer: Christian–>Christmas–>Santa–>reindeer.  But I assured her that there was no Christmas-related penguin lore that I was aware of.

The same week, she read the part of Bridge to Terabithia where May Belle says, “If you don’t believe in God, you’ll be damned to hell!”  Chloe was shocked that such bad words would be in a kids’ book.  So I got to explain that “damn” and “hell” have serious meanings to some people, and not just as swear words.  Then I tried to explain the basics of substitutionary sacrifice, sin, hell, and “accepting Jesus Christ as your personal savior.”  It’s remarkable how hard it is to convey these concepts to a child who hasn’t been indoctrinated as she grew up.  She got stuck on Jesus being Yahweh’s son and Yahweh himself at the same time.  But as she furrowed her brow and said, “That doesn’t make any sense!” I said, “Look, it’s magic, just go with it.”  She accepted that as far as it goes, and now knows a little more about Christian doctrine.  I told her it’s important to understand the beliefs of 80% of your countrymen, and she seemed to get that too.

Luckily, she didn’t ask specifics about what hell is.  The conversation was already pretty dense with new concepts, and I’m glad I didn’t have to tackle that at the same time.  When it does come up again, I plan to use Dale McGowan’s brilliant inoculation against the fear the concept could bring: “Hell is silly.”

Science fair

When Chloe comes home from school, I always tell her to wash her hands.  Recently she countered, “Why? I’m just going to do my homework and get school germs all over my hands again anyway.”  Instead of saying, “Just do what I told you,” or “OK, nevermind,” I said, “You know, we could test whether that’s true.”

Together we’ve worked out a protocol for swabbing her hands at certain times and comparing the amount of bacteria they’re harboring.  We’re going to compare and see if her hypothesis is right.  Not only will it be a kickass science fair project (timing was perfect – the fair is on 1/23), but if it turns out she’s right, I’ll lay off her about washing her hands – at least until she’s done with her homework!

*Yes, they sing carols at her public school.  No, I don’t mind.

The Cynical O.B.

I was really excited to see a blog called “The Skeptical O.B.”  Having read The Thinking Woman’s Guide to a Better Birth, I knew that standard O.B. practices are often more about intuition and tradition than evidence-based medicine.  I thought it would be so cool to see an actual O.B. looking at the risk/benefit analysis on interventions like induction, epidural, and c-section.

Whoops!  Boy is my face red.  The blog could better be named, “The Hidebound Ideologue Against Natural Birth.”  Now, I am interested in skepticism of natural birth practices as well as hospital practices.  You don’t automatically get a pass from me because you’re doing something crunchy.  But god damn, Amy Tuteur is so vituperative, condescending, and obnoxious in her approach, and so obviously devoted to propping up standard hospital practices, that I can’t read her blog even if it might offer some interesting info on homebirth safety or midwifery guilds run amok.

Amy typically storms into each post with a haughty and self-assured stance, declaring her position to be self-evidently correct and everyone else to be feeble-minded.  Most recently, she announced “The largest, most comprehensive study ever done of homebirth has released its results and there’s nothing left to argue about: homebirth increases the risk of perinatal death.”  The study she’s citing though, states almost the opposite take-home message in its Conclusions:

The results support a policy of offering healthy women with low risk pregnancies a choice of birth setting. Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes. For nulliparous women, planned home births also have fewer interventions but have poorer perinatal outcomes.

In my experience of her work, this is representative.  She is the opposite of a skeptic – she decides on her position, and then twists and cherry-picks evidence to support it.  It also doesn’t help matters that she is absolutely vile and superior to any commenter who dares to question her pronouncements and offer counter-evidence.  In other circumstances, I’d be very interested in her information about the Midwives Alliance of North America keeping their statistics on births secret, and appearing to require almost a loyalty oath before giving someone access to it.  But a.) I don’t trust her to give me all the information, and b.) I don’t want to don a bile-proof jumpsuit to wade through her excoriating commenters who offer other perspectives.

This was such a wasted opportunity.  In my opinion, all birth practices need a good review based on the most recent evidence available.  Honestly, I probably agree with Dr. Amy on a lot of things.  I think unassisted childbirth is a terrifying new trend that exposes mothers and babies to too much risk.  But I think that it’s useful to look at the hospital practices and insurance structure that drive women to birth without any attendant whatsoever, and try to reform our institutions so mothers can feel safe and secure in a hospital, or have access to a well-trained, licensed midwife.  Dr. Amy thinks the answer is to sneer and call these mothers fools.

Vaccine Avoidance and The Trolley Problem

Mention the vaccine debate to a skeptic, and their blood pressure will rise precipitously.  Vaccine opponents like Jenny McCarthy leap to mind – people who are loud and aggressively irrational, who cling to discredited theories and practitioners and invoke tinfoil-hat level conspiracy theories to explain why the evidence is against them.  It’s no wonder that vaccine supporters distrust and even revile anyone labeled as “anti-vax.”

But it’s not just a belief in Wakefield and his faked data about autism that motivates vaccine-cautious parents.  Between those who adhere to the CDC schedule and those who hyperventilate about Congress forcibly turning children into “mercury-laced vaccinated guinea pigs”  there are a lot of parents who are just worried about their kids’ health.

To be honest, I think a lot of their motivation originates in emotion rather than reason, but that doesn’t make them fringe loonies.  They hear that a doctor wants to stick needles in their tiny, vulnerable baby and inject, well, stuff.  Not only are they being injected with dead viruses and such, but there is some mystery about what else is floating in that syringe.  Moms who scrupulously avoid pesticides, preservatives, dyes, and even sugar are told that the doc is going to deliver an industrially-produced cocktail of substances directly into their infants’ muscles.  You have to admit, that’s kind of scary.  And most people don’t emulate Mr. Spock and dispassionately weigh the relative risks of each decision.  They are guided by their gut reactions.  And in this case, their gut says, “that seems bad.”  Humans aren’t really built to look at statistics and risk in a logical way – we react, then interpret evidence in light of that initial emotional reaction.

Humans are also really, really prone to the post hoc ergo propter hoc fallacy.  Even if someone intellectually knows that one event closely following another doesn’t imply causation, the emotional impact of watching a child have a serious health problem shortly after a vaccination can’t be underestimated.  And of course, some children really do have serious reactions that are related to vaccines.  It’s quite natural and prudent for parents to withhold future vaccines from such children if there is an elevated risk of further reactions.

Generally, the reluctance about vaccinating on schedule  is not due to parental neglect, but quite the opposite: parents who avoid vaccines tend to be extremely cautious about their children’s health.  As alluded to above, many of the alternatively- or non-vaxing parents I know are exceedingly careful about birth interventions, breastfeeding, sleeping safety, car seat safety, nutrition, and every variable they can control in the slightest to maximize their children’s well-being.

Now, to some extent this caution may be misplaced.  Parents may think that the risk of not vaccinating is lower than the risk of vaccinating.  If vaccine inserts had a well-founded comparison chart that laid out the relative risk, maybe some of these parents would feel more comfortable vaccinating.  The vaccine information statement I just got for the flu vax just states, “The risk of a vaccine causing serious harm, or death, is extremely small.”  Well, the risk of my kid getting serious harm or dying of the flu is “extremely small” too, right?    The statement goes on to warn that the vaccine could very rarely cause life-threatening allergic reactions.  But veryvery cautious parents are going to read that and have serious harm . . . death . . . life-threatening jump out and stick in their memory, then compare that to the time they had the flu and felt a bit unwell for a week, and they will conclude that there is no way the risk is worth it.  If the information statement had a table showing “Risk of death from vaccine = .000001” and “Risk of death from the flu = .000005” maybe people would have the data to make better decisions.  (I totally and completely made up those numbers, just to demonstrate what I’m saying, by the way. I also realize that some may look at the research and conclude that the risk of death from a vaccine is actually higher than the risk from the disease.  Personally I’d like some expert statisticians to analyze the data for parents.)

I also think that the vaccination decision is related to the ethical reasoning displayed in The Trolley Problem and its related hypothesis, The Fat Man.  In those hypotheses, people are pretty willing to divert a train from a track that has five potential victims tied to it, even if that will accidentally cause the death of a single person.  But people are generally reluctant to agree that they would push a fat man off an overpass to derail the train as it is about to hit five people.  In both cases, the number of people saved compared to the number sacrificed is the same.  But people are not willing to take deliberate action to harm someone, even in situations where they are willing to take an action they know will probably cause the same harm as an unintended consequence.

I think that parents who don’t vaccinate on the CDC schedule are functioning according to this pattern.  They will risk their children happening to encounter a serious vaccine-preventable disease and being harmed.  But they can’t accept the possibility that they might choose to inject shit right into their kid’s bodies and thereby cause them harm.  That might not be a logical reaction.  It might be frustrating to vaccine proponents and public health officials.  But it is a profoundly human reaction.

Skeptical Quickies

I had important things to do today like physical therapy, and shopping, and going out to lunch.  I just got to sit down in front of the computer, and my kid has to get ready for a sleepover, so here are some links of interest.  Monday we’ll do alternative yeast therapies, I promise!

Self-help guru gets 6 years in sweat lodge deaths – a newage self-help guru basically roasted a bunch of people alive, in the name of enlightenment.

FDA revokes Avastin’s approval for breast cancer treatment – but you can still get it prescribed off-label.

Science fights fluoridation – do modern opponents have some real science on their side?

American Pain Foundation creates informational website for CAM – it does talk about some of the risks of CAM treatments, but not comprehensively (aortic dissection isn’t mentioned in regards to spinal manipulation, for instance), and seems quite dewy-eyed and trusting when it comes to efficacy.

Canadian Medical Association Journal: natural health products should be subject to the same regulations as pharmaceutical drugs – “it is a near-universal truth that any substance that exerts a beneficial effect on a biological system will also have the potential for adverse effects.”