{"id":351,"date":"2007-03-17T21:18:56","date_gmt":"2007-03-17T21:18:56","guid":{"rendered":"http:\/\/scientopia.org\/blogs\/goodmath\/2007\/03\/17\/pigheaded-egnorance-antibiotic-resistance-and-tautologies\/"},"modified":"2007-03-17T21:18:56","modified_gmt":"2007-03-17T21:18:56","slug":"pigheaded-egnorance-antibiotic-resistance-and-tautologies","status":"publish","type":"post","link":"http:\/\/www.goodmath.org\/blog\/2007\/03\/17\/pigheaded-egnorance-antibiotic-resistance-and-tautologies\/","title":{"rendered":"Pigheaded Egnorance, Antibiotic Resistance, and Tautologies"},"content":{"rendered":"

So the Discovery Institute’s most recent addition has chosen to reply to my post about
\ntautologies.<\/a> (Once again, I’m not linking to him; I will not<\/em> willingly be a source of hits for the DI website when they’re promoting dangerous ingorance like this.) Typically, he manages to totally miss the point:<\/p>\n

\nDarwinist blogger and computer scientist MarkCC (why don’t they use their real names?) called me a lot of names a couple of days ago. The most profane was that I am a ‘bastion of s***headed ignorance.’ Profanity seems to be a particular problem with the computer-math Darwinists. A dysfunctional clad, perhaps. They’re dysfunctional because, as Aristotle wrote, effective rhetoric has three characteristics: logos, ethos, and pathos. Effective rhetoric appeals to the best in reason, ethics, and emotion. When I’m called unprintable names merely for expressing my skepticism about the relevance of Darwin’s theory to the practice of medicine, I’ve already won the ‘ethos’ and ‘pathos’ skirmishes. I can concentrate on the logos.\n<\/p><\/blockquote>\n

Yes, Dr. Egnor. Let’s make sure that we focus on issues of style rather than substance. Because we both know that you have nothing<\/em> to say in response to the substance of my criticism of your pigheaded ignorance.<\/p>\n

<\/p>\n

First – I do<\/em> go by my real name. As anyone who takes the most cursory glance at my
\nblog can see, my name is “Mark Chu-Carroll”, but since that’s a bit long, I tend to use the
\nabbrevation of my email address: MarkCC. Not that what name I go by has anything<\/em> to do
\nwith the points I made, but since Egnor feels that the fact that I abbreviate my name is an issue
\nworth commenting on, I thought it was worth pointing out what an idiotic comment it is –
\nparticularly since it’s quite clear that it’s part of a tactic: distract the reader, by focusing on
\nirrelevant issues like style, in order to obscure the fact that he has nothing to say about the actual issues<\/em> that were included in the post he’s allegedly responding to.<\/p>\n

Second – I don’t consider myself a “darwinist blogger”. I consider myself a math blogger with basic literacy in science. And anyone who’s actually literate in science recognizes the reality of the process of evolution. Calling someone a darwinist is part of the ongoing campaign by the DI and their cohorts to paint anyone who recognizes scientific fact as part of some kind of fanatical pseudo-religious movement of Darwin worship.<\/p>\n

And third – another style versus substance issue. Yes, I used profanity in my criticism of Dr. Egnor. When I watch someone who I care deeply about suffering, and someone like Dr. Egnor dismisses the cause of his suffering with a pigheadedly ignorant casual handwave, I get rather pissed off. Dr. Egnor isn’t personally responsible for my father’s illness. But people like<\/em> Dr. Egnor, with their practice of casually dismissing the ongoing process<\/em> that produced the bacteria that nearly killed my father, are<\/em>, to a great deal, responsible for the way that
\nthese highly resistant bacteria have developed and proliferated over the last several years.<\/p>\n

\nMark took umbrage at my podcast comment that Darwinism wasn’t indispensable to understanding antibiotic resistance in bacteria. His father seems to have had a very hard time with a resistant strain of bacteria, and he blames me and my view of Darwinism, sort of. I’ve treated thousands of people with serious infections, and I’ve dealt, in a very first-hand way, with the difficulties of bacterial resistance to antibiotics. I’m sorry about his dad’s illness. But Mark hasn’t shown any real insight into medicine or into what doctors actually need to understand in order to deal with serious infections.\n<\/p><\/blockquote>\n

Actually, Dr. Egnore is the one who isn’t showing much real insight into the science of the biology that underlies his medical practice. He wants to wave his hands around, shout “tautology, tautology” as if it actually said anything<\/em> about the actual science, and pretend that the
\ncause<\/em> of antibiotic resistance is no big deal, nothing to worry about.<\/p>\n

And that brings us to the point that Egnor continues to either ignore or handwave his way past. 20 years ago, there were virtually no<\/em> widespread strains of staphylococcus that were resistant to multiple antibiotics. 10 years ago, multiply resistant strains were becoming common – but staph infections that were resistant to methicillin and vancomycin were quite rare. Today, methicillin resistant staph is common<\/em> – infection with methicillin-resistant staph is one of the most common complications from major surgery in American hospitals. How did that happen?<\/b> The answer is: evolution.<\/p>\n

Dr. Egnor wants to ignore that, by dismissing the undeniable fact<\/em> of the process of change in common bacteria as a tautology: “Bacteria that don’t get killed by antibiotics don’t get killed by antibiotics”. Yes, that is a tautology. But as I pointed out in my previous post, any<\/em> legitimate scientific theory can be stated as a tautology. And in this case, that tautology is the most remarkably clear statement of exactly what’s happening<\/em> to common bacteria. We overuse antibiotics; the bacteria that don’t get killed by the antibiotics don’t get killed by antibiotics, and so they’re the ones that reproduce and spread. Repeat that process for a couple of decades, and you get bacterial straints like the staph strain that infected my father – a bacteria that’s resistant to all<\/em> penicillin family antibiotics, to 1st, 2nd, and 3rd generation cephalosporins, to methicillin, and to vancomycin.<\/p>\n

Dr. Egnor also wants to ignore the fact that the staph strain that infected my father is
\ndramatically different<\/em> than the staph strains of 20 years ago. It’s got a different
\ncell-wall structure; it uses different enzymes for a variety of its reproductive functions.
\nThrough his denial of the reality of evolution, Dr. Egnore further ignores the simple fact that
\nby careless prescription that doesn’t consider evolutionary effects, he’s helping to produce
\nthe truly terrifying superbug: at the moment, there are two distinct mechanisms that produce dramatic multiple antibiotic resistance: glycopeptide resistance, and β-lactam resistant. At the moment, we haven’t seen single straigns of bacteria with both glycopeptide and β-lactam resistance modes. But we know the genetics – and there is nothing incompatible<\/em> between the glycopeptide resistance mutation and the β-lactam resistance mutation. A staph strain with both of those would, effectively, be entirely resistant to pretty much every<\/em> antibiotic
\nwe know of. Good<\/em> doctors are incredibly careful about how they use antibiotics – to make sure that they do not<\/em> do anything that’s likely to help produce this terrifying new potential strain.<\/p>\n

Do Doctors need to be aware of evolution? Does awareness of evolution have anything to do with how Doctors should respond to infections? As an answer, let me tell you a bit about what my children’s pediatrician has told us:<\/p>\n