David Henry Gorski is an American surgical oncologist, professor of surgery at Wayne State University School of Medicine, and a surgical oncologist at the Barbara Ann Karmanos Cancer Institute, specializing in breast cancer surgery.

Dr. David Gorski, who in real life is a breast cancer surgeon and researcher at Wayne State University, serves as the managing editor of the popular blog, Science-Based Medicine ¹⁾ where he and his co-bloggers, whose numbers include founder Steve Novella, regularly discuss the interface between science and medicine, as well as how medicine is corrupted by the introduction of pseudoscience. Having gotten his skeptical start battling Holocaust deniers on Usenet back in the late 1990s, Dr. Gorski also maintains his own blog under the pseudonym Orac, where his output is a lot more…insolent.

Insolent or not, he remains bewildered that so many readers want to read his regular blathering and even more bewildered that anyone, much less organizers of a conference as awesome as Skepticon, wants to see him speak in person about his usual topic of how pseudoscience is infiltrating even academic medicine. ²⁾

Oct 26, 2009 · David Gorski, MD, PhD (@gorskon) / Twitter David Gorski, MD, PhD @gorskon Surgeon/scientist exposing quackery and promoting science-based medicine. Editor, Science-Based Medicine blog. Opinions do NOT represent those of my employers. Detroit, Michigan, USA sciencebasedmedicine.org Joined October 2009 1,998 Following 72.1K Followers

David H. Gorski, MD, PhD, FACS, is a prolific essayist and managing editor of Science-Based Medicine, a highly-respected blog that exposes non-scientific research and practices. For the last ten years, he has been a major voice — as himself and pseudonymously — for science-based medicine. In addition to being Treasurer and on the Board of Directors, Dr Gorski also serves the Institute for Science in Medicine as head of its childhood immunization committee.

Dr Gorski is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as Team Leader for the Breast Cancer Multidisciplinary Team, Co-Director of the Alexander J. Walt Comprehensive Breast Center, Co-Leader of the Breast Cancer Biology Program, and the American College of Surgeons Committee on Cancer Liaison Physician, as well as Associate Professor of Surgery at the Wayne State University School of Medicine and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. An investigator whose primary research interests include tumor angiogenesis and the role of glutamate receptors in promoting the growth and metastasis of breast cancer, Dr Gorski also runs an active research laboratory at the Barbara Ann Karmanos Cancer Institute that has been funded by the NIH and the Conquer Cancer Foundation of ASCO.

[Disclaimer & Disclosure: Dr Gorski’s disclaimer and disclosure of potential conflicts of interest can be found here. Also at that link is a message for potential patients who may have encountered, through Google searches, attacks on Dr Gorski online by various supporters of pseudoscience.]

For all Science-Based Medicine essays by Dr Gorski: 2011, 2010, 2009, and 2008. Selected Blogging ³⁾

==== Objective Skeptic part of Quackwatch Family of Pharma Front Groups ==== ⁴⁾

January 14, 2018

THE UGLY AND UNACCEPTABLE FACE OF SCIENCE David Robert Grimes / Steven Novella / David Gorski The long read: an in-depth analysis of the problem

Author biography: I studied Biological Sciences at Oxford University, and I live in Vancouver, Canada.

Prologue

Part 1 – Introduction

Part 2 – Introduction to DRG and Cancer Research

Part 3 – ‘Six Stubborn myths about Cancer’, revisited

Part 4 – Critique of DRG’s follow-up article on Cancer

Part 5 – Summary of inaccuracies and logical errors of Grimes, Novella, and Gorski

It has been said that ‘tyranny is the deliberate removal of nuance’. I would go a step further and say that it is both: (1) the deliberate removal of nuance when nuance is sorely needed; and (2) the deliberate piling on of nuance to obfuscate and distract from the ratification of a likely truth, a simple fact, or a simple principle. Scientists who use nuance to keep society trapped in endless, pointless, and unhelpful rounds of ‘proof-seeking’ are playing ‘God of the Gaps’.

Dogmatists like Grimes, Novella, and Gorski are Merchants of Doubt, rather than harbingers of truth. They obfuscate, rather than clarify. Instead of seeking solutions, they waste inordinate amounts of time, and their privileged media platforms, on intellectual one-upmanship, which, given their paucity of intellectual rigour, can only be achieved by picking the low-hanging fruit and by focusing on fringe topics – the proponents of which are already castigated and ridiculed by the masses in society.

Dogmatic skeptics are loath to risk being exposed for their shoddy reasoning skills, and so they simply avoid debating bright people. And, they also stay clear of challenging orthodox positions in science, e.g. the deeply troubling problems within mainstream medicine and Big Pharma. They stay clear of these issues, even though they deserve orders of magnitude more scrutiny and overhaul than anything swirling around in the alt-med camp.

Yes, the erroneous logic and quackery surrounding homeopathy is a problem. But the hundreds of thousands of people dying from iatrogenic medicine and the correct use of pharmaceutical drugs is a much, much, bigger problem. Grimes has spent vast amounts of time, and media space, on homeopathy. But he hasn’t touched the tragic issues within mainstream medicine.

To reiterate, dogmatic skepticism is insidsuous and dangerous to public health because it stalls the implementation of reasonable health measures - i.e., the frivolity of intellectualising ‘’skepticism’’ becomes seen as more important than the much-needed and down-to-earth pragmatism of the precautionary principle. Also, and ironically, it paves the way for scientists to become lazy thinkers, even unscientific. This is because the knee-jerk and incessant ‘call for evidence’ encourages skeptics to focus on whether something is true or not, rather than how it could be true.

It inculcates a lack of critical thinking and, more importantly, it works against fostering a systems-thinking approach to complex epidemiological questions in medicine. Grimes, Novella and Gorski are stuck in immature black-and-white thinking, in part due to their aversion to logical evidence and first principles and their compulsive, unquestioning, appeal to an intransigent and limiting definition of 'evidence' - and due to their obsequious worshipping of the high priesthood of science at the altar of the orthodoxy.

They accept pro-industry consensus positions in medicine uncritically, even though many of those consensus positions have a relatively poor evidence base, and even though they have been reached on the back of decades of wrangling, corruption, and propagandising [via media 'Astroturfing' (see main article)] by Big Industry interests - as highlighted by Peter Gotzsche of the Nordic Cochrane Collaboration. In other words, they accept consensus positions as best evidence, even when they are repudiated by higher authorities in science, such as the Cochrane Collaboration.

Yes, believe it or not, consensus in medicine, and the views of the Cochrane Collaboration, are often at odds. As I discuss in the main article, consensus in mainstream medicine / academia is regularly conflated with best practice - whereas, in truth, and often, consensus positions in medicine reflect the monopolisation of treatment - as prescribed and lobbied for (using tyrannical authority) by the Medical-Industrial-Complex (see main article) - rather than what really constitutes the best overall systems-approach for treating (and preventing) chronic disease. These skeptics will tell you they’re in it for the public good and – bizarrely – they will use their lauds and prizes received from Big Industry interests to try to convince you of this! Gorski has been funded by Bayer (a major pharmaceutical company), and Grimes’s John Maddox award for ‘standing up for science’ came from Sense About Science (SAS) – which receives funding from pharmaceutical interests.

The prize would more accurately be called ‘standing up for corporate science’.⁵⁾

I was heartened to see John Horgan – a well-respected figure within the scientific establishment – take on the absurdity of the dogmatic skeptics of science in his 2016 article for the Scientific American: Dear ‘’Skeptics’’, Bash Homeopathy and Bigfoot Less, Mammograms and War More. It should be noted here at the beginning of this article that this call for action for skeptics to focus on critical issues - rather than relatively trivial and clickbait topics - has been around for at least a decade. For example, Dan Hind for The Guardian wrote this brilliant piece back in 2007, titled The Real Enemies of Reason. ⁶⁾

Horgan and Hind were speaking out against the implicit bias of supposed ‘’skeptics’’ in science (the quotation marks are his) who are highly selectively critical of certain ideas (e.g. alternative approaches to standard medicine) but who remain bizarrely uncritical of other ideas - ideas which deserve a lot more attention and scrutiny (e.g. iatrogenic death or injury as a direct result of medical practice – as highlighted by Peter Gotzsche of the Nordic Cochrane Centre – and the paradoxically poor evidence base for a lot of modern medicine, as also documented by the Cochrane Collaboration).

I’ve written about the Vaccine Adverse Events Reporting System (VAERS) database many times, particularly how antivaxxers have weaponized its contents to falsely portray COVID-19 vaccines as deadly and, before the pandemic, to falsely link childhood vaccines with autism, infertility and premature ovarian insufficiency, sudden infant death syndrome (SIDS), and more. It is a longstanding strategy that has been used by the antivaccine movement going back at least two decades. The reason for this is simple.

As a passive reporting system into which anyone can enter any adverse event after vaccination (e.g., that a vaccine turned one into the Incredible Hulk), VAERS was never intended to provide an epidemiologically reliable estimate of the frequency of specific adverse reactions to vaccines. Rather was intended to be a “canary in the coalmine,” a hypothesis-generating system in which increased reports of specific adverse events can raise safety signals that generate hypotheses.

These hypotheses are then tested in more rigorous active reporting systems, such as the Vaccine Safety Datalink. Because of its nature, VAERS is subject to serious reporting bias, both under- and over-reporting depending on the specifics, and antivaxxers who incompetently analyze its contents (including sometimes even those who aren’t antivaccine) often fail to consider the underlying baseline rate of the various adverse events in the database. For example, the number of deaths reported after COVID-19 vaccination might seem alarmingly large until one takes into account how many people in the US die each and every day (over 3 million/year, or over 8,000/day), vaccination or no vaccination and estimates how many people would be expected to die sometime soon after a COVID-19 vaccination by random chance alone, particularly taking into account the various age groups.

Given that the shortcomings of VAERS are now much more widely known, I was wondering when the antivaccine movement would try to dumpster dive in a different health database to demonize COVID-19 vaccines. Just such an effort has started going viral on social media as a result of Sen. Ron Johnson’s (R-Wisc) “COVID-19: A Second Opinion” discussion panel, held the day after the antivaccine “Defeat the Mandates” rally in Washington, DC two weeks ago and featuring a rogues’ gallery of COVID-19 contrarians, cranks, minimizers, and antivaxxers promoting misinformation.

During the panel, Ohio attorney Thomas Renz, a man associated with the COVID-19 misinformation group America’s Frontline Doctors and known for spreading antivaccine misinformation before the pandemic (e.g., among the orthodox Jewish community in New York) testified that there has been a dramatic three-fold increase in cancer among military personnel since the COVID-19 vaccines rolled out, citing three Department of Defense (DoD) “whistleblowers that he represents, Drs. Samuel Sigoloff, Peter Chambers, and Theresa Long, who downloaded what’s characterized as a “massive trove of unclassified data” from the Defense Medical EpidemiologyDatabase (DMED) and provided it in an Excel spreadsheet (because that’s how we love to analyze complex epidemiological data). This was not the only adverse event that the “whistleblowers” claimed to link to COVID-19 vaccines, either. In fact, I think I’ll just post this, which includes Sen. Johnson’s letter to the Secretary of Defense, which has gone viral on all social media platforms.

Unsurprisingly, this narrative is being promoted by those with a history of promoting antivaccine misinformation, such as Mike Adams, Steve Kirsch, and Dr. DMED was never even intended to look for adverse reactions to vaccines and that these “whistleblowers” simply looked at a timeline and assumed, as antivaxxers always do, that whatever changes they observed in the frequency of diagnoses must have been due to the vaccines. Never mind that there had been a pandemic raging for a year before these data.

Given that I’m a cancer surgeon and researcher, you might expect that I would immediately focus on the claims about increases in cancer rates since the vaccines rolled out to the military. You’d be right, and this will be where I take the numbers at face value, at least initially. The cancer numbers alone made me seriously question whether there was a problem with the database for two very simple reasons.

First, absent other explanations, cancer rates, while they can increase and decrease from year to year, never show incredibly rapid rapid and dramatic changes, such as the increases ranging from 395% (testicular cancer) to 894% (esophageal cancer) reported by the “whistleblowers.” Indeed, the claimed 487% increase in breast cancer from year to year really got my attention, because such an increase can only be accounted for by reporting issues. For example, as I’ve discussed a number of times before, breast cancer has been relatively stable over the last 30 years, as mortality from breast cancer has been steadily falling, trends that continue based on the 2022 cancer statistics reported last month by the American Cancer Society.

That’s why I can’t take these numbers at face value. Even before I learned more, I concluded that something must be wrong with the database. I’ll show you what I mean. Just for comparison, let’s look at the graph for yearly cancer incidence rates from 1975 to 2018

Spikes in cancer incidence in just one year reported by Renz’s “whistleblowers” are, quite simply, completely implausible from a biologic standpoint. Why is that? Cancer is the culmination of a process that, in general, takes years, from the initial insult that resulted in cellular transformation to the development of a cancerous tumor detectable by symptoms, physical exam, or screening tests. Even if there had been a spike in these cancers from roughly four- to ten-fold in just one year for an overall increase in total cancer diagnoses from 36,050 to 114,645 from 2020 to 2021), it could not possibly have been due to what Mike Adams, Thomas Renz, and his “whistleblowers” are claiming, namely COVID-19 vaccines, which only started rolling out to the military a year ago and were only mandated for all military personnel after the August 24 order by the Secretary of Defense.

Of note, the data from the “whistleblowers” only includes 2021 data through October, with the Army, for instance, not reporting a 98% vaccination rate until mid-December. While those promoting this DMED data dump as smoking gun evidence that COVID-19 vaccines are causing an epidemic of cancer in the military love to point out that the numbers included for 2021 are incomplete, in actuality that incompleteness makes them even more improbable as evidence for COVID-19 vaccines causing cancer, at least. A far more probable explanation is some sort of underreporting in the years prior to 2021.

A teachable moment

I can’t resist relating this DMED kerfuffle back to the primary mission of SBM. Longtime readers will recall that the founders of this blog originally proposed the idea that alternative medicine claims—indeed all medical claims—need to be considered through the lense of prior biological plausibility. That’s why, for example, we can dismiss homeopathy as impossible based on basic science considerations along, regardless of what bias- and error-prone clinical trials show. After all, as we have long pointed out, for homeopathy to be true, not only would huge swaths of what we know about physics, chemistry, and biochemistry have to be wrong, they’d have to be spectacularly wrong. While it is possible (just barely) for this to be true, it is up to homeopathy advocates to provide scientific evidence of sufficient quality and quantity to overthrow all the principles of physics and chemistry that homeopathy violates, not up to scientists to “prove them wrong.”

We can apply the same principle to the DMED data dump, which is marginally only somewhat less implausible than homeopathy. For the observed increases in cancer incidence reported by these feckless “whistleblowers” to be true increases, then not only would what huge swaths of what we know about cancer and carcinogenesis have to be wrong, but they’d have to be spectacularly wrong. You can safely ignore everything else reported in the data dump for the simple reason that what’s reported for cancer is so incredibly implausible that it has to be due to reporting error. That was true before the DoD issued that statement to Politifact and took the DMED offline to investigate, and it’s even more true now.

Add to that the fact that the man orchestrating the “whistleblower” report is a lawyer with a long history of suing for “vaccine injury” and promoting antivaccine misinformation and who filed a lawsuit on behalf of the COVID-19 minimizing group America’s Frontline Doctors alleging that the “true” number of deaths COVID-19 vaccines is being “covered up” and has a history of misusing other databases to misleadingly claim that COVID-19 vaccines are causing tens of thousands of deaths, and you can be quite confident that the claims of these whistleblowers are not supported by any actual science or epidemiological evidence. This is doubly true given that the “whistleblowers” didn’t bother to do checks on their data so simple that even an antivaccine crank like Dr. Robert Malone recognized that they were important.

Thus endeth this week’s teachable moment. ⁷⁾