Bad Advice, by Paul A. Offit, M.D. (prologue)

Prologue: On Being Naïve Question: How can you tell the difference between introverted scientists and extroverted scientists?

Answer: When introverted scientists talk to you, they stare down at their shoes. When extroverted scientists talk to you, they stare down at your shoes.

I

n 1997, an executive producer at a local Fox station in Philadelphia asked me to appear on her show. It was September, back-to-school month, and the producer wanted to talk about vaccines. At the time, I was an associate professor of pediatrics at the Children’s Hospital of Philadelphia and had been studying vaccines for years. I thought it would be fun.

When I arrived at the studio the producer explained that the segment would have more energy if, instead of sitting at the desk with the two news anchors, I sat in the newsroom. She directed me to a high, unstable chair that rocked with the slightest movement, a cameraman just a few feet in front of my face. Because I couldn’t see or hear the news anchors, who were in a room behind me, the producer gave me an earpiece, which fit badly.

The segment following mine involved a legal comedy-drama premiering on Fox called Ally McBeal, starring Calista Flockhart.

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Ally McBeal featured several lawyers who wore miniskirts to work. Finding this fashion statement intriguing, the producer had asked four models, all in their early twenties, to wear progressively shorter skirts. Talking animatedly among themselves, the models stood next to me. People in the newsroom buzzed around, talking, joking, laughing; one was screaming. My chair rocked back and forth.

At this point, I wondered whether it was possible to be any more distracted. Where were the clowns, the dancing bears, the jugglers, the exotic animal handler searching for his escaped scorpion? Then my earpiece fell out. When I put it back in, I realized that one of the news anchors was asking me a question.

My segment, apparently, had started. “Dr. Offit, could you tell us what vaccines children get, how many they get, and when they get them?”

The actual answer to that question in 1997 would have been Children receive a vaccine to prevent hepatitis B virus at birth and then at one and six months of age; the combination diphtheria–tetanus–pertussis vaccine at two, four, six, and fifteen months and again at four years of age; a vaccine to prevent Haemophilus influenzae type b at two, four, six, and twelve months of age; a polio vaccine at two, four, and six months and again at four years of age; the combination measles–mumps– rubella vaccine at twelve months and four years of age, and the chicken pox vaccine at twelve months of age.

Apart from setting the field of health communication back about twenty years, there was no way I was going to remember all of that. The better answer would have been Children receive several vaccines in the first few years of life to prevent pneumonia, hepatitis, meningitis, and bloodstream infections, among other diseases. Parents should make sure that their children are up to date on their vaccines so that they don’t have to suffer these terrible infections.

Prologue: On Being Naïve

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I didn’t give either of these answers. I didn’t give the first one because I couldn’t. And I didn’t give the second one because I was too inexperienced to realize that you don’t have to answer the question exactly as asked. Rather I gave a variant of the first answer during which I got lost in the middle, forgetting which vaccines I had already mentioned and stumbling over exactly when they were given. It was pathetic. In fact, it was so pathetic that even the models stopped talking and stared at me sadly.

When it was over, the producer escorted me out of the newsroom, told me how much she had appreciated my coming to the studio, and never asked me to appear on her show again.

Since my Fox interview, I’ve written books about vaccines, antibiotics, alternative medicine, dietary supplements, megavitamins, faith healing, and scientific discoveries gone awry. In addition, between 1980 and 2006, I was part of a team of scientists at the Children’s Hospital of Philadelphia that invented a vaccine.

As a consequence, I’ve had many more opportunities to interact with the media. I’ve been interviewed on national morning and evening news shows, grilled on comedy shows like The Colbert Report and The Daily Show, collaborated on scientific documentaries on CNN, Frontline, and Nova, and appeared before congressional subcommittees. I’ve learned a lot along the way. Now I make a complete ass of myself much less frequently.

One thing I found that I never would have predicted was that I had inadvertently put myself in the crosshairs of powerful forces intent on defeating science: an unholy alliance working against the health of Americans. By standing up against these groups, which include hostile activists and personal injury lawyers, I’ve received hundreds of pieces of hate mail, been the target of four death threats, and been threatened with three lawsuits. I’ve also been physically harassed. It’s been an education.

My hope is that by reading this book, people will learn from my journey through the obstacle course of the current culture.

Because we learn about our health through the opaque prisms of newspapers, magazines, radio, television, movies, activist groups, industry representatives, celebrities, politicians, and the

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internet, we often fail to understand where the real risks lie. As a consequence, we don’t always make the best decisions for our health and the health of our children. This failure to appreciate how culture shapes knowledge will only cause more needless suffering and death—now and for generations to come.

OFFIT

“Bad advice about your health, firmly grounded in fact-free marketing, greed, and science denialism, is omnipresent in the new and old media these days. One of the few reliable sources of good advice is Dr. Paul A. Offit who, unlike all too many scientists and doctors, is ready to take on the hype and lies of celebrities, charlatans, ideologues, and money-grubbers with logic, evidence, and humor.

Take my advice: Bad Advice is just what you need to navigate the murky waters of an unending stream of really bad information about your health.”

$24.95

— Arthur L. Caplan , Drs. William F. and Virginia Connolly Mitty Professor of Bioethics, New York University School of Medicine

“Bad Advice gives us a front row seat to Offit’s role on the leading edge of

Or Why Celebrities, Politicians,

the vaccine fight as he shows just how important communicating good science can be. His rare storytelling blend of equal parts humorous anecdotes and serious facts leads to an entertaining and captivating read that is hard to put down.”

paul a. offit, M.D., is the director of the Vaccine Education Center at the Chil-

dren’s Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. He is an award-winning physician, coinventor of a rotavirus vaccine, and the author of several books on medical and scientific issues including, from Columbia University Press,

Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure (2007) and Vaccines and Your Child: Separating Fact from Fiction (2011, with Charlotte A. Moser).

Praise for

BAD ADVICE

“Offit is a pediatrician, a vaccine scientist, and one of our foremost explainers of science. In Bad Advice, he distills what he has learned—often the hard way—from standing up for science in the face of bogus theories, quack remedies, and the flat-out denial of empirical fact. Skillfully, Offit uses stories of his many missteps in the treacherous public arena to teach us how to confront pseudoscience effectively. In the process, without noticing, we learn fascinating lessons in the relevant science.

A forcefully written, indispensable book, particularly at the present moment.”

— Geoffrey Kabat , cancer epidemiologist at the

Albert Einstein College of Medicine and author of Getting Risk Right: Understanding the Science of Elusive Health Risks

and Activists Aren’t Your Best Source of Health Information

“With humor and a unique perspective, Offit takes us step by step through our

C O L U M B I A U N I V E RS I T Y P R E SS / Ne w Yo r k cup.columbia.edu Printed in the U.S.A.

$24.95

COLUMBIA

culture’s missteps (and some of his own), relating stories of real science and the difficulties of communicating complicated concepts clearly to a skeptical and sometimes hostile public. Bad Advice shows us how we can succeed in the battle against pseudoscience, seductive gurus with simple messages, and snake oil-hawking celebrities.”

— Adam Ratner, M.D. , New York University

Jacket design: Noah Arlow

BAD ADVICE

— Melissa Stockwell, M.D. , MPH , Columbia University Medical Center

BAD ADVICE

PAUL A. OFFIT, M.D.

science doesn’t speak for

itself. Neck-deep in work that can be messy and confounding, and naïve in the ways of public communication, scientists are often unable to package their insights into the neat narratives that the public requires.

Enter celebrities, advocates, lobbyists, and the funders behind them, who take advantage of scientists’ reluctance to provide easy answers, flooding the media with misleading or incorrect claims about health risks.

Amid this onslaught of spurious information, Americans are more confused than ever about what’s good for them and what isn’t.

In Bad Advice, Paul A. Offit shares hardearned wisdom on the dos and don’ts of battling misinformation. For the past twenty years, Offit has been on the front lines in the fight for sound science and public health. Stepping into the media spotlight as few scientists have done—such as being one of the first to speak out against conspiracy theories linking vaccines to autism—he found himself in the crosshairs of powerful groups intent on promoting pseudoscience. Bad Advice discusses science and its adversaries: not just the manias stoked by slick charlatans and their miracle cures but also corrosive, dangerous ideologies such as Holocaust and climate-change denial.

Written with wit and passion, Offit’s often humorous guide to taking on quack experts and self-appointed activists is a must-read for any American disturbed by the uptick in politicized attacks on science.