Critical Thinking with Bill Maher

So endeth the seventh season of Real Time with Bill Maher, or so it did, anyway, more than a month ago now. I miss it. I miss Bill's weekly take on the relevant news issues of the day, mostly facing America, but sometimes encompassing the rest of the world.

It's no secret that Bill's a particular hero of mine, but - in keeping with his own secular stance - I don't worship at his altar. I've always liked the fact that people I've chosen to be my particular heroes, all have feet of clay. From Richard II to John Lennon, right down to Bill, I wouldn't have it any other way. For me, my heroes' perfection lies in their imperfection ... and more than a bit in their own quixotic tendencies to tilt at metaphorical and hypothetical windmills. (No surprise, either, that Don Quixote, also happens to be a particular literary hero!)

Although Real Time and Bill have been off the air for more than a month, the 'aftershock' of his last two episodes are still being felt around the cybersphere and the scientific community, in general, dating from the penultimate episode which contained an interview with Dr Bill Frist, the former Senate Majority Leader and practicing thoracic surgeon.

Of course, the controversy in question is Bill's purported stance on vaccines, which several areas of the media and cybersphere have enlarged to include his alleged controversial ideas concerning antibiotics, diet and germ theory, in general.

Bottom line from the media and the medics: Bill's a quack, whose 'unorthodox' views on eating, antibiotics and 'Western' medicine (in particular, vaccines) ally him with the likes of Pat Robertson, Glenn Beck, Michele Bachmann, and card-carrying Creationists and distance him from any self-respecting, rationalist person of science and good sense, who believes in the efficacy of science instead of the blindness of faith.

Pardon me. I'm a secularist, myself, and a pretty rational person. I was under the obviously misguided conception that this sort of person was noticeably more open-minded and open to debating issues, rather than blindly shutting out an opposing viewpoint, by excoriating its proponet with diatribe, invective and dialogue, condescending to the point of ridicule. That's the stuff of the teabaggers, town maulers and Palinistas with small minds and small, faith-based messages, not the rational-minded, who adhere to science and its defined parameters.

Yet Bill's been lambasted royally in the past month, by everyone from P Z Myers to Michael Schermer, and by various other people, whom, I imagine, assume the pained expression of perpetual constipation, when they rather pithily remark that it pains them to have to agree with the likes of Bill Frist. In fact, that they dismiss Bill totally out of hand in this matter positively reeks to high heaven (pun intended) of small-mindedness.

To recap the controversy, Bill had invited Frist onto the penultimate program of the season for the interview, which traditionally takes place before the panel discussion. When I first realised Frist was going to be on the program, I initially thought that his appearance was in relation to his recent comments in support of healthcare reform, which decidedly went against the current grain of his party; but in retrospect, I'm not so sure.

Bill began the interview with a question about the purported Swine Flu pandemic, and it was Frist who took up the baton about vaccines, by stating that he 'knew' Bill 'didn't believe' in vaccines, and the interview deteriorated from that point until the end. Frist the surgeon morphed quickly into Frist the politician in his skill at spinning an argument and turning the interview on the veritable dime to the point that the interviewer, himself, Bill Maher, was suddenly put on the defensive about his perceived beliefs, with each man successively talking over the other and interrupting points. What should have been a discussion about Frist's stance on healthcare reform degenerated into Frist turning the discussion into a quasi-argument about the efficacy of the H1N1 vaccine, with Frist cleverly managing to make Bill's comments look like the meanderings of a whackjob.

Of course, this episode followed the relatively minor detail, which - in hindsight - fanned the flames of controversy: Bill's Twitter tweet on September 26th, stating, 'If u get a swine flu shot ur an idiot.'

For some people, hindsight - or Twitdsight - is 20/20 vision.

As a result of that episode, the ensuing one, and the innocuous tweet, Bill's been subjected to a veritable meltdown of attacks by the scientific and rationalist community, who've called for everything from his returning his recently-received Richard Dawkins Award to his head being sacrificed and served up on a silver platter.

Suffice it to say, he's been called a barrage of unkind names by these selfsame, so-called educated and rational free-thinking scientists.

It reminds me of the Inquisition in reverse, with the scientific community aptly enacting the role originally undertaken by the Catholic Church in squelching any sort of reasonable debate on this subject.

And, like Bill, I do think the subject of vaccines - and, indeed, the American approach to medicine, in general, needs to be addressed and debated.

I'm not, by any means, a scientist. In fact, I'm probably the least scientific person I know. I've always had an interest in biology and may, at one time, in my youth, have even been considering a career in medicine; but chemistry and a particularly frightful algebra teacher scared me away from any remaining pretensions of following a medical career. Yet, I think Bill, in his latest blog in defense of his beliefs and a lot of his statements which were cherry-picked by various critics, raises pretty valid concerns.

Let me state, from the onset, that I am not an anti-vaccinationist (to coin what sounds distinctly like a Bushism), but I've never ever had a flu jab. I think I've probably had what's deemed to be proper flu (as opposed to a really heavy cold) about twice in my life: once in my last year of high school, which meant missing a week of Shakespeare class and the study of MacBeth, and once again, ten years ago, when Asian flu swept the US and Western Europe. That particular strain, I recall, seemed to target the Baby Boomer generation, of which I'm a part. As I'm writing this blog, I think it's safe to say I lived to tell the tale.

Bill and I are of a similar age and generation, so I would imagine that, as a child, he - like I - was exposed to all the 'normal' childhood illnesses - measles, mumps, chicken pox etc - as the rule of thumb, then, was that a child should suffer each infection, in order that the body develop a natural immunity to them. I can recall my mother and my aunts dragging my cousins and me around to each other's houses as, one by one, we succumbed to whatever, in order that we all might be exposed to the particular virus in question. So various cousins caught measles from me, and I caught chicken pox from them. (I recall Valentine's Day being a non-occasion for my third grade class, so many of us had chicken pox). I never did get mumps, and my mother told me that my pediatrician told her I most probably had a 'natural immunity.' So that, in part, is proof of Bill's statement that our bodies do possess the ability to fight off or even be immune to certain viruses. After all, our bodies have the innate ability to heal ourselves in the instances of wounds and injuries - albeit, I do accept the fact that sometimes, they need a medical boost. For example, I broke my leg some years ago. I needed medical help to set and correct the fracture.

Of course, vaccines are necessary in the abolition of diseases such as smallpox, diptheria and polio, which have pretty much been eliminated. I do understand the concept of 'herd immunity' - that by vaccinating the majority of a population, this prohibits the disease from spreading to the unvaccinated element, until the disease, in that particular population, becomes virtually extinct.

But is it wrong for Bill to wonder if we aren't, now, becoming over-vaccinated, as well as over-medicated?

I don't think it is.

In 2004, the oldest son of a friend of mine in Italy, was hospitalised with a mystery virus, when the child was only 8 months old. He virtually remained in hospital, first in Bologna and then in Livorno, until he was 18 months. He was diagnosed with Kawasaki syndrome, or infantil polyarteritis, which could have had potentially serious repercussions. Later, it was discovered that he contracted the illness as a reaction to the vaccines he'd just had administered. Specifically, the attending pediatrician at the last hospital which treated him told his parents this. So, there, Bill ... you've got an independent pediatrician, actually, admitting to parents that a child's medical condition was the result of a reaction to a particular vaccine he had received.

I'm also cognizant enough to admit that, whilst this child suffered from this particular reaction, another child - the boy's cousin, for example, did not. Again, I would point to a point Bill raises about "the terrain in which bacteria can thrive is crucial and often controllable" - or rather, the fact that an infant's immune system may have been compromised as it hadn't been, as yet, fully developed.

Is this idea so strange?

Well, hell, no less than my fellow Virginian and fellow graduate of the University of Virginia, Francis Collins, says virtually the same thing: that genetics loads the gun, and the environment pulls the trigger. (Francis Collins, I might add, is the current director of the National Institute of Health; and the father of the child, in question, is a Type I diabetic, which means his auto-immune system was compromised, as well. Could not this reaction have been genetic?)

Carrying on from Collins's assertion, Bill is constantly making his audience aware of how not only our environment, but also our lifestyles compromise our immune system. It's not 'woo' to talk about toxins in our body making us feel crappy. We're exposed to any and all sorts of toxins in our daily lives - exhaust fumes, poor air quality, secondary smoking, closed environment air conditioning ... it all adds up, not only in the realm of global warming and climate change, but also with our health concerns. We've all heard tales of men down the mines forty years ago, dying from black lung, or people infected with asbestos poisoning, or soldiers exposed to radiation in early atomic bomb testing. We learn from our environmental mistakes, but unfortunately, some of those mistakes prove fatal.

As I said, initially, I like my heroes to have feet of clay, to recognise and embrace their humanity and their fallibility; and Bill does just that in his own defence. He admits openly that sometimes he tends to go off 'half cocked' on the health issue sometimes. He even apologises for it, but explains that it's only because he's found a health and dietary regime that makes him feel better. That's good. What's better is that he wants to encourage his listening public and, indeed, all of us, to eat better, instead of mindlessly over-gorging or eating fast food rubbish and things chocked full of additives and high-fructose syrup.

Obesity is rampant in the United States and is rising remarkably in the United Kingdom and northern Germany. Childhood obesity is becoming a particular problem. As Bill opined in a recent editorial, "The elephant in the room is your child."

That particular topic really does need to be addressed and urgently, so whilst a proportion of people might want to label Bill Maher a kook for consistently bringing this topic to the attention of the public, maybe we should praise him for introducing this concern and begin a debate about how we might make healthy food and exercise more affordable for lower-income families.

Another thing for which Bill's taken his fair share of flak from the scientific rationalists is their perception of him as a conspiracy theorist, who thinks the likes of Big Pharma, the medical community and the government are conspiring to make us a society totally over-dependent upon medicines and pharmaceuticals in an effort to keep us ill enough to supply the corporate profits of the lot. He's even been labelled a 'truther' and lumped with the likes of Glenn Beck, Michelle Bachmann and the fundamentalist Right.

But ...

On my recent visit home to Virginia, I spoke with several relatives and friends, many of whom had medical issues. My uncle, who's in his late 70s, lines up a row of 7 different capsules each morning to be taken with his breakfast cereal ... and then he has his Metamucil. Once a month, he has to have a blood test, because one medicine that he takes might make his blood too thin to interact with another type of medication he's prescribed. Go figure. My aunt, his wife, is on medication for arthritis, diverticulitis and osteoporosis. These meds are prescribed to her, by three different specialists. She should be having two blood tests per month, but she only has one. Why? Because the private health insurer who tops up her 80% Medicare will only cover one blood test monthly.

These people are in the twilight of their lives, and they should be relaxing and enjoying themselves. Instead, they have to be quasi-chemists and pharmacists in keeping track of which medication they have to take on what day and at what time. It's confusing, to say the least.

I think it's a credit to them both that they're able to keep track of such a regime, because I certainly couldn't; they're totally honest in their assessment of the situation too - that (in their own words) it's a racket, and if the doctors can keep you coming back to them in droves, it lines the medicos' pockets. (You see, I was raised in a nest of country cynics). If these sort of honest, unsophisticated people can realise this, why is Bill labelled a 'truther'? It's not rocket science ... it's basic common sense.

To say we, as a people, are over-medicated is an understatement. Even now, I'm always shocked when I return to the States at the plethora of commercials advertising prescription drugs. 'Ask your doctor for this ... for that.' Ask your doctor? Doesn't your doctor have the Hippocratic duty to diagnose first? And here's another pitch in Bill's favour: one of his best quotations is a musing that if a person has to ask his doctor for drugs, doesn't that, in fact, make the doctor nothing more than a dealer?

Think about it.

The other thing this latest trip Stateside impressed upon me was the incessant reporting about the H1N1 virus - the shortage of vaccines, the queues of people lining up all over to be innoculated, the sheer panic. I was amazed.

I was equally amazed at the attitudes of my family and friends, none of whom have undertaken to get the vaccine. In fact, like me, none of my relatives - old or young - have ever had a flu vaccine. When I asked about this particular vaccine, their reaction was unanimous.

"It's the flu! That's all. Good God, if we got a shot for everything they told us to, we'd be moving into the doctor's office!"

How succinct a reply is that? Their second assessment is that this strain of flu virus has been blown out of all proportion by the media; in fact, it's the media who overinflate a lot of issues, according to them.

No shit, Sherlock, guess what! That's another pet peeve Bill's complained about consistently throughout the course of the Real Time season - the total irresponsibility of the media, the fusion of fact, opinion and entertainment to morph into the ubiquitous 'infotainment', which people buy readily as fact. The very idea that a social satirist/political pundit can post an abbreviated musing on a social networking site, and the news media in the form of 60 Minutes can interpret this as being an ad hoc warning to society in general is less than a joke and more than indicative of just how much our society has been trivialised.

In such an atmosphere, the flu can become the 21st Century equivalent of the bubonic plague, and all a state's resources can be compromised in the urgent pursuit of a non-existent child in a homemade hot-air balloon in a chase that captured the attention of a nation and deflected the media's attention from other, more important but less exciting events of the day.

I don't think Bill's wrong in questioning medical science about his concerns. I think it's a duty. In fact, I was always raised to question doctors' diagnoses and assumptions. After all, doctors are human. They make mistakes. And part of the scientific process, a great part of it - or so I thought - entailed critical thinking and the ability to admit error. Science is based on theories, which hold intact, until other theories disprove the previous ones.

Several from the scientific community have ridiculed Bill's citing Barbara Loe Fisher as a source. I knew nothing about this woman, so I researched her. She's someone who's raised doubts about the efficacy of over-vaccination due to a very traumatic incident in her personal life: her son was disabled after vaccination. As a result of that, she's devoted her life to researching this issue and even has worked with Congressional committees in that research.

I see nothing untoward at all about that. In fact, when my mother was firs diagnosed with cancer, I read every book available in an attempt to familiarise myself with her disease, what it would entail, how it would affect her, the treatments, why she contracted it ... You do that, when something affects or interests your well-being. I would welcome hearing this woman's views on Bill's show. The snotty attitude of the medical community in dismissing her, because she has no medical qualifications, because she has a liberal arts' degree, speaks volumes.

That attitude reminds me of an incident that occurred years ago, when I was a coed. I shared digs with a nursing student, which was a Class A ticket to a wonderful social life. After all, she knew every available medical student on campus. I was a language major, with a free pass to all the med school parties. One Saturday evening, I spent about two hours at such a revel being chatted up by a medical student from the same gene pool as no less than Richard Gere. Finally, after a lot of talk and a fair amount of canoodling, he asked which 'department' was I covering at the moment.

I looked at him, baffled. I didn't understand. He clarified. What clinical rotation was I covering at the moment. He'd assumed, because I came with some nursing students, that I was, also, a nursing student. When I admitted to being a senior, majoring in Spanish and French, his ardour dampened. "Oh," he sniffed. "I thought you were someone medical, someone I could relate to."

Enough said.

It just seems to me that Bill's exercising a method of thinking, which the medico-scientific community seem to have forgotten: critical thinking. Have they gone so far within themselves that they've forgotten that a science, first and foremost, has a base in nature, and that scientists are groomed and trained to question? I think they have.

Questioning science doesn't make one 'anti-science'. Denying science does. Bill's not denying anything; he's critically thinking, and that's an art we could all do with honing.