Why FDA Approval?

With the desperate search for a coronavirus vaccine and medicines to reduce the seriousness of the disease comes a lot of discussion about FDA approval. One side argues that speed is of the essence and we need to accelerate the process. The other side argues that we can never be sure of a drug’s effectiveness without proper testing. (This will reflect some of the information from last week’s entry, “Understanding Experiments.”) 

The FDA admits, “It takes on average 12 years and over US$350 million to get a new drug from the laboratory onto the pharmacy shelf.” The first step requires about three years of laboratory testing before testing on humans. “Only one in 1000 of the compounds that enter laboratory testing will ever make it to human testing.” 

Next comes a three-phase process. First they must test for safety. Next they need 100 to 300 volunteers to test for basic effectiveness. Finally 1000 to 3000 patients in clinics and hospitals are monitored for effectiveness and to identify adverse reactions. Each phase can easily take years to complete. (And some people wonder why drugs cost so much and why the companies fight and scheme to protect their patents.)

In the interim some drugs that have been previously approved for other diseases are being tested on coronavirus patients. This practice of prescribing drugs off-label is really quite common in the US. WebMD writes, “Off-label prescribing isn't necessarily bad. It can be beneficial, especially when patients have exhausted all other approved options.”

This is why FDA approval is so valuable and why makers of so many pills, salves, ointments and medical devices are so eager to try to take credit for having cleared this hurdle. Otherwise the law requires them to post the familiar disclaimer: “The statements made regarding these products have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.” (But the disclaimer is familiar only to those who bother to read the fine print.)

If companies fail to do this, it’s not the FDA but the Federal Trade Commission (FTC) that comes after them for misrepresentation, as they did in this case – one of many that show up almost weekly.

“Under a settlement with the Federal Trade Commission, the marketers of an electrical nerve stimulation device called Quell have agreed to pay at least $4 million and stop making deceptive claims that the device treats pain throughout the body when placed below the knee and is clinically proven and cleared by the Food and Drug Administration (FDA) to do so.” (From an FTC press release.)

I checked their website and found that they no longer show the device as FDA approved (to treat or cure), but still do try to give that impression through endorsements and research posters. They continue to mention the FDA at least twice on the site, referring only to registration, not approval – big difference. In summary, the “FTC alleged that the defendants lack scientific evidence to support widespread chronic pain relief claims…” but the site lists no such disclaimer. It’s big business and a $4 million fine pales in comparison to a $350 million development cost.

That it is “100% drug free and non-surgical” while it “stimulates sensory nerves with safe and precise electrical pulses to trigger a natural pain relief response” appeals to people with chronic pain trying to avoid addictive drugs. It’s understandable how such a device would tempt people, and if placebo does the trick it might be worth $300 plus an on-going expense for fresh electrodes.

Like so many other health and medical decisions, avoiding such questionable products is all about a little research and critical thinking.

Keeping an Eye on the Doctors

Over the past few weeks a number of shady healthcare situations have come up. There is often not a lot patients can do about doctors with bad intentions or to recognize their illegal behavior, but there are usually clues.

The first case involves medical fraud. A cardiologist was convicted on two counts of fraud for double billing insurance companies and using a procedure to treat problems it was not designed for.

The doctor administered an outpatient treatment known as External Counter Pulsation (ECP). “ECP involves the use of a specialized bed equipped with pressure cuffs, which exert pressure upon patients’ lower extremities as a means to increase blood flow to the heart.” Insurers only reimbursed doctors when this treatment is given to patients with angina and only when a physician is present.

The doctor operated 25 beds at numerous locations in three states where, in many instances, no doctor was supervising. Even for his patients who never experienced chest pain, he “instructed his employees to indicate that every patient had disabling angina on billing sheets that were used to support false insurance claims.”

Although they couldn’t do anything about the billing, the patients should have been very suspicious. It came out at the trial that in order to acquire new patients he advertised the procedure “as ‘the Fountain of Youth,’ claimed that it made patients ‘younger and smarter,’ and offered the treatment for a range of ailments other than disabling angina, including obesity, migraines, high blood pressure, low blood pressure, diabetes, and erectile dysfunction.” When a single medicine or procedure is advertised as curing so many unrelated ailments and uses come-ons like Fountain of Youth, patients should smell fraud miles away – not insurance fraud, but someone definitely trying to sell them snake oil.

In another case at the behest of the FDA, a judge issued a permanent injunction against a stem cell company “to stop...illegal behavior after several attempts to provide the clinic and the individual defendants the opportunity to work with the agency to come into compliance with FDA regulations and protect patients from harm.” In an inspection the government  found “significant deviations from current good manufacturing practice requirements” including failure to establish and follow procedures to prevent microbiological contamination. “The FDA has not approved any biological products manufactured by [the company] for any use.”

Again the patients cannot know all the details, but the products were being administered “to treat a variety of serious diseases or conditions, including Parkinson’s disease, amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), heart disease and pulmonary fibrosis.” [Emphasis added.] 

These too-good-to-be-true qualifications should be a warning signal to everyone seeking medical help, even the most desperate. For every two that the authorities catch up with and go through the long, legal process of shutting down, there are probably two hundred still operating and advertising. As long as this kind of outrageous advertising continues to attract patients, the practice will continue.

It is not surprising that insurance companies cause frustration by being as careful/fussy as they are even about reasonable practices. Some healthy skepticism and critical thinking on the part of patients are our best, and sometimes only defense against fraud.

Here Comes the Easter Bunny

In a couple of days the Easter Bunny will visit homes of young children across America delivering baskets of treats. According to this source, the origin of the Easter Bunny may be traced to “early pagan celebrations” of “springtime renewal of life and fertility as well as the goddess of dawn and spring, Eastre." Some of these celebrations and myths were adopted and modified by early missionaries to make it easier to win over converts.

Like Santa Claus and the tooth fairy, the Easter Bunny is soon relegated to the dustbin of childhood stories as kids grow up, mature and develop the ability to easily separate fantasy from reality, no matter how appealing and comforting those fantasies might be. Unfortunately, many of their parents persist in beliefs that are equally outlandish long after they have grown up. Somehow the will to believe is so strong that it defies reality.

I am reminded of this when I saw the recent Pew Research report on the number of Americans drawn to “New Age” beliefs, particularly that 41% of adults believe in psychics. Now, I’ve written about psychics before, giving examples of how their annual predictions are consistently wrong, how those who claim to have the psychic power have been discredited again and again, and how they have been convicted for defrauding people. But no matter how often someone explains the techniques of hot and cold readings, no matter how often psychics are embarrassed or proven wrong, the fantasy survives and believers continue to be swindled.

The latest attempt to dissuade believers (February 25) comes from this rather long (21-minute), but quite amusing video from John Oliver. The subtitle on YouTube is “Psychics may seem harmless and fun on TV, but they can make a lot of money by exploiting vulnerable people.” In fact, it’s a $2.2 billion industry. 

This video has had almost 7 million views, and you would think the word would get out. However, when you turn on daytime TV or use a search engine to find out more about psychic powers, people selling the idea that these powers are real overwhelmingly dominate the information posted. As is the case in most social media situations, misinformation overpowers the truth serving up enough credulous customers to keep about 100,000 self-employed psychics in business.

When magicians appear on the stage or on television, they describe what they do as illusions. They are admittedly lying to the audience, trying to fool everyone with misdirection and slight of hand. When the show is over, people go home understanding that it was all a trick but wondering how they did it – what mechanisms, mirrors, technology or fancy moves were involved? What didn’t I see?

When psychics appear, they expect everyone to believe that they can predict the future or can communicate with the dead. When the show is over, people go home, sometimes in shock or with renewed grief, thinking it was real. This is dishonest on the part of the performer and the height of gullibility on the part of the audience. They don’t try to figure out what tricks were involved. They believe!

That’s why magicians are so good at debunking psychics, but how many times will it take? And how will America survive when 4 out of 10 voters are so easily duped into believing in a notion no more real than the Easter Bunny. (Note: Politicians and the news media don’t call it illusion or misdirection either, although it sometimes is.)

Critical Thinking: When to be Skeptical (Part 2)

Last time I wrote about a case where ill-advised skepticism leads to dangerous decisions, what the World Health Organization calls “vaccination hesitancy,” one of the ten threats to global health. About 1.5 million deaths per year could be avoided if global coverage of vaccinations improved.

In the case of vaccines, that skepticism is based on faulty evidence and discredited research promoted by unreliable sources. But in many other cases, with access to reliable sources, it makes sense to be a little skeptical of all the threats and warnings we encounter on a daily basis. After all, no one has enough time to be scared of everything the media warns us about.

Sometimes it’s a health issue where the underlying data is insignificant, e.g., when a certain habit is shown to increase the chance of getting a condition by 50%, when the original chance of getting it was miniscule. Sometimes organizations raising money and the media selling advertising space don’t present the full story. For example, data from the early 2000s on missing children shows that 99.8% of those children return home. “Only about 100 children (a fraction of 1% [of all missing children]) are kidnapped each year in the stereotypical stranger abductions you hear about in the news.” More die in swimming pool accidents, yet “stranger danger” gets much more attention than pool safety. It is very likely that the data have not changed since that original study.

Things are not always as they seem. Here is one example I intend to keep an eye on. At sciencemag.org a feature titled “Dubious Diagnosis” asks, “The war on ‘prediabetes’ could be a boon for pharma—but is it good medicine?”

The piece points out that the term prediabetes originated only about ten years ago as a “public relations catchphrase” to raise awareness at a time when the American Diabetes Association (ADA) “needed a pitch to persuade complacent doctors and the public to take seriously a slight elevation in blood glucose, which might signal a heightened risk of type 2 diabetes.” Indeed it has a catchier sound than impaired fasting glucose or impaired glucose tolerance. And notice the expression might signal in the explanation. Further along, the article tells, “the CDC's own data show progression from prediabetes to diabetes at less than 2% per year, or less than 10% in 5 years. (Other studies show even slower rates.)”

This increased public awareness probably benefited the ADA, but other health-oriented organizations such as the World Health Organization (WHO) along with some diabetes specialists argue “medical and epidemiological data give weak support, at most, for increasingly dire prediabetes admonitions.” One diabetes researcher goes so far as to characterize the effort as scaremongering directed at approximately 48 million Americans.

The result is that billions of dollars have been spent on “research, education, and health improvement programs – generally focused on weight loss and exercise – that have generated lackluster results, according to critics.” So far no drugs are effective, but some of those research dollars include “drug companies…testing dozens of drugs aimed at prediabetes in hopes of tapping a potential worldwide market of hundreds of millions of people.”

And the rising costs are already compounded by additional doctor visits, off label prescriptions, and the sale of continuous glucose monitor devices – all very likely unnecessary.

Meanwhile, the ADA continues to ratchet down the standards for various blood sugar measurements with the potential of adding another 72 million new patients to the prediabetes rolls in the United States and many more worldwide.

The article includes several interesting timelines showing changes in those standards and other key events. It then discusses at length the scientific and financial conflicts. So despite some very confident statements favoring prediabetes screening and treatment, the jury is still out. “Many public health organizations believe a mainly clinical approach to diabetes prevention [endorsed by the ADA and CDC] is ineffective.”

There seems to be plenty of reason to remain skeptical about this issue. (It does not affect me, but I find it very interesting from a critical thinking point of view.)

Critical Thinking: When to be Skeptical

It is usually better to be a little skeptical than to be gullible or credulous. A good way to do this is to question everything until several trusted sources have confirmed an idea. Lately journalists have often overlooked this safeguard of finding several trusted sources, allowing the drive to be first to block out the need to be accurate. A sarcastic comment used to be, “I know it’s true; I read it on the Internet.” But that can apply today to what were at one time reliable sources as they cite a single “unnamed source.”

One area where skepticism has run amok is the resistance to vaccinations. The anti-vaccination movement is becoming stronger, even as it continues to be the poster child for misinformation. Those opposed to vaccinations are not using critical thinking when they continue to question and challenge the safety of vaccines basing their position entirely on faulty evidence and discredited research promoted by unreliable sources.

The debunking of any connection between measles vaccinations and autism is old news, over a decade old. The original study was discredited; the doctor promoting the idea was accused of falsifying data and had his license to practice revoked. Yet some still believe.

Those believers are not just a bunch of ignorant crackpots. Less than six months ago, a chiropractor in Canada was under investigation by the regulatory authority for spreading anti-vaccination views. The CBC described her as making “unfounded claims about vaccinations and the negative effects they can have on people's health, including the disproved theory linking vaccinations with autism.” She did this through public speaking, her blog and social media page. 

Last November she was formally notified by those regulators that they “considered advice about vaccination and immunization on her Web site and social media platforms to be (a) outside the scope of chiropractic, (b) untruthful marketing activity, and (c) contrary to the chiropractic regulations [regarding] vaccination and immunization policy, code of ethics....” You can’t get more definitive than that! Rather than undergo a hearing, she surrendered her license.

The anti-vaccine movement deals in what is so obviously misinformation that even the Internet media giants are taking action. Google is very blunt: “Under YouTube’s Advertiser-Friendly Content Guidelines, we are and have been demonetizing anti-vaccination content under our longstanding harmful or dangerous advertising policy.” Facebook’s stated goal on this subject “is to reduce the spread of inaccurate information about vaccines by reducing its distribution in News Feed, removing groups and pages that promote misinformation from recommendation surfaces, and providing authoritative information to people who might encounter it.”

Likewise, Amazon removed “at least five anti-vaccination documentaries questioning the safety of vaccines from its Prime Video streaming platform.” These decisions are not motivated by a political agenda. They are made in recognition that the misinformation is dangerous.

Even with all the evidence that anti-vaccination sentiments are misguided, dangerous, untruthful and disproved, and even in the wake of the recent measles outbreak, state lawmakers have not gotten the message. With at least 333 cases reported in 15 states and discussions in Washington calling it “a growing public health threat," at least 20 states have introduced bills this year that would make it easier for people to opt out and for parents to exempt their children. Yes, they would pass laws to make it easier to put their children and others in danger.

Refusal to believe such well supported evidence, instead reacting emotionally to unsubstantiated horror stories, is not critical thinking. Critical thinking should lead to the proper, scientifically sound conclusions, but the fight against misinformation and irresponsibility continues. 

Making Your Feet Happy

I recently ran across an ad for a product that will make your feet happy, make your legs happy, make your back happy, and let you throw away your pain meds and lead a stress-free life. All this from a simple shoe insert! It sounded too good to be true! Being a skeptic at heart, it also sounded to me like the work of a company that follows a philosophy often attributed to P.T. Barnum: “There’s a sucker born every minute.” Time to investigate.

My first stop was the company website which confined their promises to a short video and gave some FAQ-type information below about sizing, care, cleaning and the warrantee. It does mention feeling better with every step and healing from the inside out, whatever that means. And it has a free shipping countdown clock which reset at 2:30:00 every time I opened the site – not exactly a deadline.

The video tells how these insoles, using 400 massage points and special magnets, work a number of wonders including: relieving overall body pain, cooling and soothing the feet and boosting endurance. The second is the most plausible.

The video continues by telling how one feature is directed “toward the chakra of personal power,” another “toward the chakra of body function” and still another “toward the chakra of body energy.” None of this chakra stuff has any scientific basis.

Finally, they will balance your mind and body, reduce stress and naturally flush toxins, all by hitting the right pressure points and using magnets.

Another related site looks like a more scientific explanation of the same product, except none of it sounds like science. It explains that the insole wearers were inclined “to visit the bathroom more often and were thirstier. This is your body’s way of naturally cleansing toxins and eliminating them from your body!” True, visiting the potty is a natural way to eliminate toxins, but do you need shoe inserts to make it happen? Then they tell us, “Based on the theory of reflexology, magnets are believed to balance your body’s natural electromagnetic levels.”

Well, the theory of reflexology may think so, but the FDA differs. “To date, the FDA has not cleared for marketing any magnets promoted for medical uses.” And the National Center for Complimentary and Integrative Health, a group typically sympathetic to these kinds of claims, says, “Magnets have not been proven to work for any health-related purpose.”

After searching through various sites for about 15 minutes, I finally found what I was looking for, the expected standard disclaimer. Here is an abridged form:

“ALL CONTENT AND INFORMATION…ARE FOR INFORMATIONAL PURPOSES ONLY AND ARE STRICTLY NOT INTENDED TO DIAGNOSE, TREAT, CURE OR PREVENT ANY DISEASE, FOOT PROBLEM OR ANY OTHER MEDICAL CONDITION. YOU SHOULD ALWAYS CONSULT WITH YOUR HEALTHCARE PROVIDER BEFORE USING OUR PRODUCT….

“Testimonials and comments found within our website are unverified results…which are…not intended to guarantee that everyone will achieve the exact same results.

“Our website content…is solely for informational purpose only…. We do not represent in any manner whatsoever that the content of our website contains the opinions of a healthcare professional.”

In summary, the shoe inserts will yield a large number of miraculous results from your head to your feet. You will have higher energy, less stress and all parts of your body will be happier – including your chakras! But if it doesn’t work for you, don’t blame the company.

But what about all those endorsements from satisfied customers? Can you say placebo effect?

The $3.5 Million Exorcism

Critical thinking continues to grow in importance as electronic media exposes Americans to thousands of sales pitches each day.  The snake oil salesman I referred to last week who pulled into town with his wagon to sell his magic tonic only arrived at long intervals.  Today’s equivalent arrives to our computers or phones every second.  Without a healthy skepticism, questioning before buying or believing, Americans can be tricked into buying all sorts of worthless products and services.

The latest example comes from Reuters, but was all over the Internet about 10 days ago.  “A self-proclaimed psychic who was paid $3.5 million by an elderly Massachusetts woman in exchange for claiming to cleanse her of demons pleaded guilty on Thursday to trying to avoid paying taxes.”  Was the 70-year-old woman a victim of the psychic or was she a victim of that airy-fairy-land that many Americans occupy in their minds, willing to believe in all kinds of mystical, new-age, super-food, and super-supplement mumbo-jumbo?  They develop imaginary allergies and fears of safe foods and life-saving vaccines by ignoring scientific evidence in favor of Internet rumors and unrealistic promises backed by celebrity endorsements.

The first question that comes to minds is:  If she’s a psychic, why didn’t she see the problem with the IRS coming?  The easy, and correct, answer is that she is not a psychic at all.  (No one has ever proven under controlled laboratory conditions that they have psychic powers.)  Anyone who is really a psychic would be winning money at the racetrack or at the roulette wheel.  But they claim they only use their powers for good – good apparently being defined as conning innocent people out of their hard-earned money.  (In some cases the victims of these scams include innocent taxpayers when police employ so-called psychics in crime investigations for fear of being accused of not doing everything possible.

I’m sure some of these people sincerely believe they have some extraordinary power, just like some who work in the media sincerely believe they are journalists doing the work of the people and not just trying to create juicy headlines to sell more airtime, and some politicians sincerely believe they are public servants more interested in the good of the nation than in their own reelection.  These days real journalists and statesmen are rare; real psychics are non-existent.

The second question is:  Where are those consumer protection agencies when we need them?  Obviously, it’s ridiculous to expect government agencies to protect us from our own ignorance and gullibility.  In these days of high velocity, sophisticated sales tactics, it takes critical thinking, a healthy skepticism and the understanding that being open minded does not mean accepting every whacko idea that comes along.

The psychic in question was sentenced to 26 months in prison, ordered to reimburse the woman and fined by the IRS.  Perhaps that will give her time to do a reading or two for herself and enjoy some of the spiritual cleansing and strengthening she was so eager to sell to others.

Blacken Your Teeth (to Whiten Them)?

Last time I gave an example of the desperation evident in people’s behavior to find some simple miracle to improve their health and wellbeing. All it takes is a celebrity endorsement, some anecdotal evidence on a TV doctor show, a news report about preliminary findings or a viral video and many people decide to adopt a new habit, product or procedure without any research.  The professionals are then forced to react with warnings and watch-outs to protect their patients from potential harm.

It happened again this month after a YouTube post by someone going by the name of Mama Natural became an instant success, reaching millions of viewers.  This was not about a miracle cure for your body, but for a miracle teeth-whitening solution.  Now, according to Fox News and others, dentists are “warning against using [this] DIY whitening trend that involves smearing a charcoal-derived black mixture on teeth” saying it “may lead to enamel deterioration and tooth erosion.”

Activated charcoal capsules are available in health food stores or on line.  The video recommends that you break open a capsule and mix the powder with water to achieve a pasty texture.  Then either brush it directly onto your teeth or instead just swish the powder around in your mouth.  Rinse after three to five minutes (some say up to ten minutes) and see the results.  Endorsements, testimonials and spokespersons say you will see whiter teeth almost immediately.

The theory is that activated charcoal absorbs impurities.  It has been used in air filters and in emergency rooms to treat poisonings and drug overdoses.  More recently activated charcoal has been adopted into beauty products, such as skin creams and facial masks, to supposedly produce benficial effects by absorbing impurities on the skin.  The next logical step is to use it to deep-clean teeth, remove the stains and get them sparkling white.

Not so fast!  The responsible articles point out that not enough evidence is available to tell if charcoal brushing is beneficial or dangerous.  The charcoal itself might be too abrasive.  Over time it might actually be removing enamel along with those stains.  When you lose enamel, not only do your teeth get sensitive, but the tooth enamel is lost.  Enamel can’t grow back as cut skin or broken bones do.  Once it’s gone, it’s gone.

While dentists are concerned, the natural websites are spreading the news.  This one gives instructions, promotes it as a "natural" way to whiten teeth and mentions only the messiness as a potential downside.  (The pictures accompanying some of these stories are really disgusting, so messiness is indeed a problem, though a minor one.)

But dentists have only themselves to blame.  Over the past 10 to 15 years I have noticed more radio, TV, direct mail and Internet advertising for dentists with most of them emphasizing the whiteness of your teeth over the health of your teeth.  Catch phrases like “show me your teeth,” “perfect smiles” and similar ones stress the superficial side of oral hygiene.  Most dentists offer tooth whitening as an extra service.  So why are they surprised? How can they really blame patients when a potentially less expensive way to get the same results comes on the market or over the Internet?  When you start appealing to appearances over the practical need to see a dentist regularly, it may work to bring in business in the short run but you will soon find yourself in a different competition.

Deception in the News

Someone said:  “A lie told often enough becomes the truth.”  Some attribute it to Lenin, others to Hitler or Joseph Goebbels, and others to William James, the American philosopher and psychologist.  No matter – it seems to be true and becomes especially dangerous in light of the casual approach to the Internet information we see on social media.  People see things on Facebook or elsewhere and are thinking up a clever or cutting comment to make on the subject without considering that it may not even be true.

One that has been going around for more than 9 years now and promoted by environmentalists who have an ax to grind with Rep. Joe Barton from Texas, accuse him of saying:  “Wind is a finite resource and harnessing it would slow the winds down, which would cause the temperature to go up.”  (It is enshrined in one of those on-line, clip-art posters.  You may have seen it.)  This sounded strange to me, even though others in Washington have made equally foolish statements.  So I went to Snopes.com, easy research and a source I have found usually trustworthy.  (I also found another seemingly reliable source with similar information.)

What he said in February 2007 was:  “I am going to read a paragraph which is, if true, very ironic.”  Then he said, “And I quote” and read from a paper published by the executive director of the Carnegie Mellon Electricity Industry Center.  A group from Princeton University was at the time also doing researching along the same lines.  The irony Representative Barton referred to was the emphasis on the dangers of fossil fuel while overlooking possible dangers of the alternatives.  He said it was something to think about.

Now, I’m no particular fan of Rep. Barton.  I never heard of him until this supposed quotation appeared.  Based on the rest of his statement I wouldn’t rely on him for scientific advice, but neither would I rely on most of his colleagues or the people they often call in to their hearings.  The point is that a group or groups took words he was reading from a paper and attributed them to him in an attempt to attack his credibility, and this attack has been going around for over nine years.  Likely many have come to believe it and use it as a basis to discredit any governmental opposition to wind power.

This calls to mind a similar situation many years ago when George H. W. Bush was running for re-election and the New York Times portrayed him as out of touch, based on his apparent amazement over a grocery scanner demonstration.

The incident occurred when he was visiting the National Grocers Association conference.  A New York Times reporter, who was not even present but based his story on one in the Houston Chronicle, described Bush as having a "look of wonder" on his face.  The New York Times took the opportunity to mock the President for not recognizing something ordinary citizens knew very well.

Unfortunately, a little research shows that this was a gross misrepresentation.  “[Mr. Bush] wasn't being shown then-standard scanner technology, but a new type of scanner that could weigh groceries and read mangled and torn bar codes.”  At worst, some present interpreted Bush’s reaction as being slightly bored, but polite.  (Imagine attending a NGA conference with the expectation that you must ooh and ah over all the new technology.) 

The Times and others, however, chose to interpret this reaction as being amazed by technology that common people saw frequently with the intention of portraying him as out of touch, having lived in protected isolation since 1980 as Vice President and President.  “After 12 years' vacation from the real world, there will be a lot of catching up to do.”  If this is what we get from such a reputable source as the New York Times, who can we trust?

Again, I don’t feel any particular warmth toward the elder Bush, but it’s not honest to present your twisted version of reality to drive home your political (or any other) viewpoint, knowing that even with the highly sophisticated communications and information systems of today, people will not have the initiative or exercise the critical thinking to pick through the misinformation.  This lack of critical thinking and passive acceptance of the pronouncements from authority are more dangerous to our future than fossil fuels, wind power or any other subject of debate.