A limerick in response to Dr. Gorski

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Dr. Gorski has expended literally thousands of words on me, but I don’t think he’s worth more than a few of mine. Here’s my response in the form of a limerick:

There was an old skeptic from Boston
Who mourned babes when midwives lost ’em.
Then an ass from Detroit,
Conflict keen to exploit,
Salved his ego and carelessly tossed ’em.

  • Moderation

    As a regular reader, but only rarely commenter, I wanted let you to know how disappointed I am to see this on your blog. I am a physician and I have occasionally referred people I know to your site that have questions about homebirth. This post demeans the rest of your work. I can understand that you have some conflict with and feel you were wronged by Dr. Gorski, but this makes your blog look like the Facebook page of a high schooler. I look forward to perhaps seeing more of your usual analytical and “snarky” posts about homebirth.

    • Amy Tuteur, MD

      I’m sorry that you are disappointed, I’m also curious. What do you think is the appropriate response to someone who is harrassing you in order to salve his enormous ego?

      • Moderation

        With the exception of your posts about your lawsuit, which I think are appropriate material to show the lengths to which homebirth advocates will go to hide the truth, I would hope that this would be your forum to present the case against homebirth (and occasionally other unscientific points of view). I even get the need to counter the inaccuracies in the post on Grounded Parents. I do not see how this post helps do that. At some point, you have to just stop feeding the beast if you want it to die. I have said it before, but as a physician who has had to clean up the damage done by homebirth, thank you for your continued work.

      • Guest

        Maybe ignore him?

  • yentavegan

    OT Happy Purim Dr. A

    • fiftyfifty1

      I make a mean hamantash (for a goy).

    • Amy Tuteur, MD

      Thanks!

  • auntbea

    Orac ‘ s post is problematic in several ways, but his takedown of the MANA study is fair. Are you trying to goad him into taking a stronger stance? Because that might work, but at the cost of making you look quite petty.

    • NoUseForANym

      Agreed. And I think the stronger stance would not be the one that we want. I think he would be more likely to dig in his heels about how the absolute risk is low just to be contrary to Dr Amy.

      • Trixie

        So far, he hasn’t done that. He’s actually agreed with the substance of her analysis

        • NoUseForANym

          Absolutely. So far. It wouldn’t shock me to see him slide more and more toward Bernstein’s conclusion simply out of assholery.

          • Trixie

            I don’t think he will directly contradict himself on basic facts and math.

          • Irène Delse

            Or put his reputation of “serious skeptic” in jeopardy by making it look like he changes his mind on medical matters because of personal annoyance.

    • Trixie

      This isn’t Dr. Amy’s first day on the internet. Or Gorski’s, for that matter. While there’s no doubt they actually irritate each other, this whole thing has also been click bait, and I suspect both of them have had pretty good page views over this issue. Dr. Amy may be simply willing to play along with the kerfuffle in exchange for the opportunity to reach new skeptics who may not have even realized that CPMs and CNMs were different before.

      • Amy Tuteur, MD

        Actually traffic is down. Most people find it boring.

        • Trixie

          Okay, well, there goes that theory lol

        • Rochester mama

          It’s a bit too “inside baseball” for non doctors and non bloggers like me to really follow or get worked up about.

          • Certified Hamster Midwife

            The lawsuit, that at least drew outside attention and people from Gina’s audience who she claims never come here.

  • GuestingIt

    I think this is great! The Daily Show does this sort of thing all the time. A stupid post by Orac deserves a stupid response.

  • guest

    Wait. What? What about the post you just wrote about him claiming he was jealous of you? Now you have written TWO posts about him. You look incredibly childish, like a little whiny kid stomping their feet. And dissing on Orac is not giving you brownie points in the skeptic community. People are taking you less and less seriously everyday.

    • Ellen Mary

      I totally disagree. Dr. Amy is on fire right now, love her or loathe her, whereas Orac is on the way down. JMO.

  • Amazed

    OT: ACNM seems intent on digging itself into a greater hole. Pity for midwives like Medwife from the post before that.

    http://time.com/4653/home-births-lead-to-more-deaths/

  • Amy Tuteur, MD

    I did want to point out one thing that may be confusing for lay people. You may have noticed that besides Dr. Gorski, there aren’t many if any physicians criticizing my creation of 2 separate comparison groups: low risk and all risks. I suspect that it may be because they recognize the methodology from other areas of medicine like contraception.

    When we counsel patients about contraception we advise them of the theoretical risk of failure and the risk of failure in real world usage. Why? Because patients need to know more than the failure rate when the method is used perfectly. They also need to know the failure rate in the real word, where people forget to take the Pill, put the diapghram in incorrectly, etc.

    The two comparison groups for homebirth represent the same thing. Comparing low risk homebirth to the CDC data is the equivalent of theoretical risk (the risk when CPMs follow their own supposed guidelines). The comparison of all risk homebirths to the CDC data represents real world risk, the risks that patients actually take on when they hire a CPM.

    Most women who hire a CPM believe that she will tell them of risk factors and transfer to the hospital when complications warrant. The difference between the perfect world death rates and real world death rates alert mothers that this is not the case.

    It would be absurd not to include them in real world calculations of risk because they represent how CPMs really practice. Both theoretical and real world risks are included so that readers of the analysis can understand and make their own judgment as to which comparison matters to them.

    • Amazed

      Two days ago, I coined out a new phrase: dream birth stats. Meaning, stats for truly low risk homebirths only.

    • NoUseForANym

      I agree completely with this. Why not write a post on this instead of this silliness directed at Orac?

      • auntbea

        This. A million times.

      • prolifefeminist

        I totally agree. This blog has such an important message – I hate to see it devolve into posts like this one. And I have to admit that I cringed a bit reading a limerick about dead babies. 🙁

      • Amy Tuteur, MD

        Because it doesn’t merit a post. It was a personal attack. I know many people view this within the context of the skeptic community; I view it within the context of academic medicine where I spent quite a few years. The senior attending (particularly a surgeon) feels that he is not receiving enough deference from another physician (often a woman, though not always). So the sernior attending throws his weight around in an effort to ensure dominance.

        That’s what I see happening here. But I’m not a junior fellow. I don’t have to accept that kind of treatment from someone who, by his own admission, has no interest in the topic about which I am quite passionate.

        The attack was the result of mind boggling pomposity. It seems to me that the appropriate response is to puncture that pomposity.

        • NoUseForANym

          I’m talking of a post on the perfect use versus real life use birth control point you made.

          This does not accomplish what you are wanting to and it just gives orac more fuel to the ‘Dr Amy is a ridiculous blowhard’ crap he’s spouting. I don’t agree with him but this response to his post is just embarrassing, Dr Tuteur. Things like this can make it very difficult to defend you and they simply distract from your very important message. Your post in the private fed up group about not getting mired in the personal attack aspect of orac’s post was spot on. ..and you should follow your own advice in the matter.

          • Amy Tuteur, MD

            You don’t need to defend me. I’ve asked several times in several different ways for people to stop trying to defend me on Gorski’s blog. This is exactly what Gorski wants, to discuss me, not the issues.

            I have great respect for the terrific work Gorski has done on vaccination. I have great respect for his intelligence and fund of knowledge in his areas of expertise. But I don’t think it’s news that the guy is a pompous ass, and is apparently growing more pompous as the years go by.

            I want to highlight the fact that laypeople call themselves “midwives” and let babies die. He wants to talk about me; to the extent that anyone tries to defend me, they play right into his hands.

          • auntbea

            But this limerick IS ABOUT YOU. Which is what we are all reacting to.

          • Amy Tuteur, MD

            I really, really appreciate the concern, but I read the situation differently. I’ve seen this so many time before. When a senior physician tries to show everyone he’s boss and tries to humiliate a colleague to soothe his own ego, the best response is not to try to defend yourself; he already knows I didn’t do anything wrong and he doesn’t care. The best response is to make it clear that you are not subject to intimidation.

          • NoUseForANym

            I think you could accomplish that better by simply writing a fantastic post on the subject. But I’ve said all I can say and I’m just repeating myself over and over here. I think you badly missed the mark on this one.

          • NoUseForANym

            Well I’m not just talking about defending you to Gorski but to others who denigrate you in the name of defending homebirth. However I think you’re doing the same to distract from the issue. This also doesn’t highlight the danger of pseudomidwives. It’s just petty backbiting that’s damaging what we are trying to accomplish.

        • auntbea

          But the average reader neither understands that dynamic nor even knows what it going on. You are not going to be able to take him down on your own anyway. It makes you look like you are pounding the table when you have plenty of facts to pound.

          • NoUseForANym

            Exactly.

            And Dr Amy you said you loved having readers who point out when you are wrong and you listen. Listen now. Please.

          • Trixie

            I don’t think she’s wrong. And look, I’ll still read Orac. His anti-vax and anti-quack stuff is too good. And idiots like Dr. Oz and Joe Mecola deserve every bit of scorn he can heap on them. He just doesn’t seem to want to dial it back a notch for someone who is actually, basically, on the same side he is. Because, ego.

          • expat

            I understand the dynamic she is describing and I agree that changing the topic and nodding politely just reinforces the inflated ego, especially in situations where there is a lot of he said she said and all that management is likely to see is an underling who is making trouble, but if I counterattacked with a limerick on a group mailing list, I would have a hard time getting my contract renewed. Dr. Amy is flouting convention because she has tenure and is throwing that in another tenured colleague’s face. She gets the bonus of keeping things buzzing on her webpage. All well and good. Management (readers) might get turned off or they might say, anyone who does their job passionately is fine by me.

    • It is also a fair comparison (hospital CNM to all risk home birth) because hospital CNMs are not limited to ONLY low risk.

    • Hannah

      Hmm, I’m not sure that analogy is convincing. I don’t think anyone has objected to quoting both risk percentages as stand alones as you did in the bar chart, it’s then using them to calculate ratios between non-equivalent cohorts. To extend the contraception analogy, you might want to say that a particlar type of natural family planning is less reliable than the pill, and you’d probably be correct. To do that, you might calculate the ratio of perfect use failures between the two or calculate the ratio of IRL use failures. On the other hand, if you quoted the ratio of IRL use failure for the natural method against the perfect use failure rate for the pill you’d be on dodgy ground even if your underlying thesis was correct. If you want to then say that the NFP figures are unreliable for whatever reason and the ratio of equivalent failure rates is a conservative estimate, for x, y and z reason then that would be perfectly legitimate, but it wouldn’t make it not dodgy to quote the ratio of the non-equivalent failure rates.

      • Trixie

        But again, CPMs aren’t even qualified to assess risk, and they don’t risk people out regardless. There is no “perfect” low risk home birth population.

        • Amazed

          … but there is a good deal of pretty unlow risk home birth population that is indeed sure and repeatedly ASSURED that it’s low risk.

          To me, this is the crux of the matter. The fact that most not low risk homebirth mothers are not low risk isn’t something that happened by chance, human error, lapse, or what not. It is due to the fact that they are actively assured that they are low risk. They think they are perfectly low risk and so expect that their outcomes will be in the success rate.

          Low risk mothers are not simply unfortunate occurence that happened to CPMs. They take them knowingly and assure them deliberately that they are low risk.

          • KarenJJ

            I think it would be an interesting exercise to survey mothers choosing to give birth at home and whether they think they are low risk or high risk and what potential symptoms they are showing. Plenty of people seem to believe that twins, breech, VBAC do not make them high risk and the midwives do not appear to encourage that line of thinking. It might be a measure of how they are getting informed consent from their midwives.

          • fiftyfifty1

            “I think it would be an interesting exercise to survey mothers choosing to give birth at home and whether they think they are low risk or high risk”

            I would be interested in this as well. I think of baby Wren who died at home who was high risk in 2 ways: mom was GBS positive and Wren was born one day short of term (37 weeks). Did Wren’s parents realize that they were not just high risk but doubly high risk? Because if you said “Mom with first tri UCx positive for GBS now in labor at 36+6”, what a doctor (or even medical student) is immediately going to realize is “Holy shit, ascending GBS infection resulting in pre-term labor, get this woman to the hospital NOW”. But the labor went easily. Wren’s mom *felt* fine. I can’t believe they truly understood.

          • Amazed

            I said something similar in yesterday’s post, I mean: I’d be interested to hear how many women hear that they are high risk and they have a significantly higher risk of their baby dying or sustaining a brain damage and say, Right, that’s fine with me, let’s go choose the curtains for my lovely homebirth.

          • WordSpinner

            This is another case where obstetrics has become a victim of its own success. Vaginal breech is hellaciously dangerous (as MANA’s data proves) but we now have c-sections… which are nearly as safe as vaginal births, so women don’t panic when they hear breach, so NCB types think it is a “variation of normal”, and then babies die because the only reason breech isn’t too dangerous in a hospital is because of interventions.

          • Busbus

            I think that is very true. In my own case I had a – luckily uneventful – homebirth at 41+6 with a 9’13 baby that my midwife knew was big (as she told me later, not before the birth). I was not fully aware that that took me out of the “low risk” category I assumed that I belonged. That was the whole thing for me – I was only considering homebirth because I thought that I was low risk and that therefore, homebirth was “as safe or safer” than hospital birth.

            I was never a “die hard” homebirther, had parallel care with an OB etc. Neither my CPM nor my OB ever had a talk about risk with me in any way or fashion (the OB knew I was going to have a homebirth and, as far as I could tell, he was on board – or at least he must have had a policy not to discuss these matters with his homebirth patients.)

            I also opted out of the GD test (it seemed absolutely reasonable at the time, and the most my midwife said to it was, “many of my patients opt out of it” and that my diet was good… Now I feel quite foolish), and in that case, too, no one – not even the OB – said a single word.

            If anyone – my OB, my CPM – had sat me down and said, look, you are past 41 weeks, the baby is very big, these are the risks, we recommend an induction in the hospital – I would have absolutely taken the induction. (Now, if the OB had said induce and the midwife had said wait, I’m not quite as sure what I would have done in the frame of mind I was in then. But I think I would have still been more likely to follow the OB’s recommendation than the midwife’s, because, again, I wasn’t trying to run any risks.)

          • Amazed

            Yes, that’s what I mean. You didn’t take any risks – to you, there were no risks. In your past state of mind, you’d be shocked to find yourself in the high risk stats – and I don’t think it’s fair to lump you there because you weren’t warned and aware.

            So happy you ended up on the right side of statistcs. I wonder whether some of these unknowingly high risk mothers who still defend homebirth feel this way because they ended up on the right side.

            I think of a regular commenter here (I think it was Bomb) who had to take herself to the L&D after a failed homebirth and I don’t understand. They lie, miscalculate, run risks with other people LIVES and then they let them own their outcome. A dead baby, a brain-damaged baby, a trip to the hospital without the midwife – who cares.

          • Lindsay Beyerstein

            We need a meta-statistic to quantify the risk having your risk incorrectly assessed if you start prenatal care with a CNM vs. a hospital midwife or an MD.

        • Hannah

          That would certainly be another reason for not having a homebirth with a CPM but within the context of this discussion actually goes against the point you’re trying to prove. Your saying that the “low risk” homebirth cohort is adulterated with women who are in actual fact at higher risk. This doesn’t mean that the all risk homebirth cohort is more equivalent to a verified low risk hospital cohort, in fact the opposite.

          • Box of Salt

            Hannah, a full five years ago I asked a midwife proponent on another forum how being “trained for normal birth” taught her how to recognize what was no longer “normal.”

            I didn’t get an answer then, and I still haven’t gotten one from anyone.

            Could there be a problem here?

          • Hannah

            Almost certainly yes, but that wasn’t what my point was about.

          • Captain Obvious

            The low risk cohorts seem have shown to have an increased risk comparatively. The MANA survey shown that. The Cornell matched birth and death certificate study shown that. Judith Rooks’ Oregon review shown it. And even the Netherlands demonstrated that. The high risk CPM homebirth clients (FTM, AMA, twins, breech, HBAC) take the cake demonstrating even more risk. If you are low risk or high risk and want to take that higher risk at home, than so be it. But don’t say Homebirth with the right client or the right practitioner, or the right scenario is as safe or safer as hospital.

            http://www.bmj.com/content/341/bmj.c5639

          • Hannah

            I’m not disputing any of that (apart from perhaps to say that the Birthplace study did perhaps show that homebirth could be equally as safe as hospital birth in a very specific system and circumstances). The point is the appropriateness of a specific comparison.

          • Amazed

            What’s the purpose of such a comparison How appropriate is a comparison when it WON’T BE USED IN THE WAY YOU WANT IT TO BE DRAWN to give a truly informed consent because MANA STILL DECLINES TO ADMIT THAT LOW RISK SHOULD FALL UNDER CERTAIN PARAMETERS?

            I am not shouting. I just wish you finally addressed these points that we keep making than repeat “we should draw the right comparison”. What purpose will it serve? In the moment, the only purpose is to satisfy YOUR scientific integrity but NOT MANA’S PRACTICE.

          • Irène Delse

            Indeed. It’s not like MANA was an academic research institute engaged in pure intellectual exercises. It’s not ethical to wait and see, or reject what studies do exist on HB because the control groups are not perfectly matched. Not that you can really achieve that with real world situations like, oh, human health: it would be wildly unethical as well as impractical to randomize women to home or hospital birth, so researchers have used data from the CDC (Grunebaum and al., 2013, and Brooke Orosz, PhD more recently). Or they analyzed data in areas where all birth outcomes are recorded (like the Oregon and Colorado official reports on homebirth, and the data from the UK and the Netherlands). This way, one can have a fairly accurate idea of what homebirth entails as it is practiced in the real world. And this is important both at the level of individual women who want to make informed healthcare decisions, and more broadly from a public health perspective, to help lawmakers and administrators be aware of who is a responsible professional and who is not. (Hint: MANA doesn’t have a great track record here…)

          • Amazed

            In the linquistics of my own language, we have a term… I don’t know how to say it in English, it’s something like overproper. Meaning, one is so strict in order to be correct that they make mistakes because they are so focused on the rules that they lose sight of the exceptions. Like, say, womans instead of women, badder instead of worse and so on.

            I do think there might be some researchers suffering from its medical equivalent. Fortunately for linguistic sufferers, words don’t really mind when one maims them.

          • fiftyfifty1

            Overscrupulous? We use that word for patients with eating disorders such as the so-called orthorexia. So concerned with avoiding toxins and transfats and on and on and on so that eventually there is nothing but kale left to eat and they starve themselves.

          • Amazed

            That might be it. But it really should be dissuaded among medical researchers because they will “starve” the patient community.

          • NoUseForANym

            Pedantic

          • Amazed

            No, we have the word pedantic. No, it’s strictly linguistic and it’s part of a local dialect concerning a particular grammatical rule. Much like the principles of scientific research regarding homebirth midwives: people want to be fair to the principle and end up beig unfair to the reality of the situation because MANA has no interest in observing any principle other than “Take the money and shrug it off.”

          • fiftyfifty1

            Yeah, let’s say we really did have the perfect low-risk comparison: home vs. hospital for vertex, normal well positioned placenta, non-gestational diabetes, GBS-negative, non-birth defect, non-macrosomic, ideal pelvis, non-hypertensive, non-anemic, 39-41 weeks.

            Great! Those numbers would be interesting. But what use would they really have for a real life woman contemplating homebirth with a CPM? How could she be sure her baby is vertex? How could she know she didn’t have gestational diabetes or carry GBS? How does she know her baby doesn’t have deformities? How can she know if her pelvis is well shaped (unless she has already had one easy delivery)? What about the cord and placenta? Are there 3 vessels? Where’s it located? How does she know her baby isn’t macrosomic? How does she know her blood pressure measurements are accurate? Are they even being measured? What about the hematocrit? What about her dates?

            How does a woman even begin to determine that she fits “low risk”?

            And then, how does she begin to determine that her CPM isn’t one of those bad ones that even Aviva Romm acknowledges are everywhere out there?

            Really, how the hell is a regular real life woman supposed to know all this?

          • Amazed

            I suppose a regular real life woman is supposed to ask her very competent CPM who, of course, is supposed to inform her adequately and conscientiously. If not – well, there is the cohort of high risk homebirth for the stats and not every baby is meant to live.

            Sorry for being sarcastic on such a topic. I am just losing my cool at seeing how people among our own ranks involuntarily enable those oh so competent CPMs by insisting that knowing the dream birth stats is so important without paying attention to the fact that CPMs are, unfortunately, FAR from dream birth attendants.

          • NoUseForANym

            And truthfully, well hopefully, even the high risk homebirth pts aren’t the same as ALL high risk hospital patients. I think comparing to cnm hospital births is probably perfectly valid.

          • Amazed

            Hopefully indeed! My gut is telling me that should MANA somehow fall into their own trap and get ALL their outcomes reported, this hope will be buried not twice but thrice.

            But that’s just me. I’ve got a suspicious little mind. Then again, it isn’t as if they didn’t give me a cause…

          • Trixie

            Except CNMs can and do attend many of the types of hospital births that should be risked out of home birth — VBACs, gestational diabetes, etc.

    • Ellen Mary

      And noting how really important having access to these two calculations is for decision making:

      Recently I was helping my BFF decide on contraception and she was definitely interested principally in a method where the gap between perfect use and typical use was tiny/non-existent, due to her personal history around the issue & current obligations/schedule.

      I am comfortable with a larger gap for my method, & am willing & able to trade a lot of compliance for some level of adverse event risk reduction, but having both calculations helps me maintain an accurate perception of my possible outcomes, when I find my perfect use faltering a bit. Information about the gap lets me know how strictly I have to practice family planning. I would argue that we are dealing with three numbers, typical risk, perfect risk and the number representing the size of the gap between these two figures . . .

  • Sue

    There once was a skeptic oncologist
    Who admitted he was no gynaecologist
    He weighed in no less
    To the homebirth data mess
    And now perhaps needs the psychologist.

  • Ellen Mary

    How appropriate for St. Patrick’s Day!

  • juniper1991

    As someone who admires the hell out of both Drs. Amy and Gorski, this whole thing is like watching my mom fight with my dad.

    The only winner here is woo and pseudoscience.

  • Aro

    As skeptics, I think it’s totally fair to police each other, question each other’s work in comments or on our respective blogs and stand our ground when things like credibility and intellectual honesty are called into question.

    But I think the mutual history here has taken things beyond what’s called for. This was a time for both sides to bring their absolute A game, making watertight arguments and triple checking to make sure personal feelings about each other weren’t leading to erroneous/lazy conclusions. But that Orac still has an axe to grind with Dr. Amy is apparent, especially in the comments. And this post from Dr. Amy… Orac has certainly displayed a lack of intellectual curiosity about the issues surrounding CPMs, but just because he didn’t turn the full force of his napalm-grade insolence in MANA’s direction, I don’t think it’s fair to say he’s tossed dead babies aside.

    I hope that next time it’s time to debate our own, this will be the side that represents gold standard skepticism.

    • R T

      He literally said it doesn’t interest him, so yeah…

      • KarenJJ

        Well at least another skeptic has admitted it outright. One of the biggest issues I have with skepticism is the selective skepticism when it comes to “women’s issues”.

      • S

        I have no problem with his lack of interest in homebirth. We can’t all be interested in/experts on everything. But i do have to wonder why he felt so compelled to weigh in at such length on a subject he doesn’t care or know very much about.

        • R T

          I was responding to Aro claiming its not fair to say he tossed dead babies aside. I’d say it’s very fair to assert he’s tossed dead babies aside when he literally says he has no interest in them. I also think using the term “interests” was creepy on his part to begin with!

          I do have a problem with his lack of “interest” in home birth deaths for the exact reason you pointed out. For someone who doesn’t give a hoot about it he sure did spend a long time writing a post that’s sort of about it. This whole mess of in-fighting is such a complete waste of time and so very detrimental to the babies and families who are so much more than “interests” to the people who love them.

          • S

            Ah, i see what you were saying, and i agree. His purported lack of interest is his passive aggressive way of avoiding responsibility for his comments. Sure he’ll throw his opinion out there, but it’s not like he really _cares_ all that much, or anything. Pretty disrespectful to those who’ve put actual time and effort into this issue, and to those who’ve been hurt by fake midwives.

          • Amazed

            But he cares about defending Jamie. He starts with announcing that he isn’t interested in obstetrics and ends up with, “I rather expect that I’ll be accused of standing up for a friend (as if this were a bad thing), that somehow I don’t “understand” the data; that I’m too stupid to figure out how to replicate Dr. Amy’s search of the CDC Wonder Database, and the like. ”

            Umm, yes, doc. It IS a pretty bad thing to defend a sloppy friend like this whose “work” MANA promoted to keep lining their pockets, aka killing babies. No, doc, in fact you are smart enough not only to understand the data but TWIST it to defend said sloppy friend. No, doc, I am quite sure that you could figure out how to replicate Dr Amy’s search if you had cared to look two posts above the one you tried to shred in pieces.

            And you didn’t say it, doc, but I name you a liar for claiming that you had no time or idea that you should look two posts above. You did it when you tried to harp on Dr Amy for the whole women skeptic issue. You certainly had the time and idea when you had to defend your sloppy friend. You just aren’t that all interested in obstetrics, aka saving babies. Right, doc?

          • Irène Delse

            One thing I noticed: even though he kinda supported Jamie against Dr. A’s “attacks”, his post ends up not being flattering to her, overall. Some friend! But then, playing the part of the wise old man of medical skepticism was probably the most important thing… Well, a limerick is just what his attitude deserves, then. And at least, the words “neonatal deaths” are right there on RI, at the top of his post, associated with homebirth and MANA.

          • Amazed

            Medicine if far from being my specialty. Written texts are, though. And what I gleaned from this one is that he tried to appoint himself moral judge and wise old doctor at the same time. It’s a labyrinth one can hardly scramble out of and he hasn’t.

    • Amy Tuteur, MD

      Not only did I not bring my A game, I didn’t bring any game at all. I apparently missed the memo where a random skeptic blogger made himself the arbiter of all other skeptics on the web, including those who write about issues that, by his own admission, he neither knows nor cares about.

      My work has been evaluated by a statistics professor and comports with the work of Dr. Grunebaum and Judith Rooks. Gorski’s opinion on my analysis is worthless. Moreover, it is obvious that this was a personal attack based on some perceived slight to his enormous ego.

      He doesn’t like my work? Fine. He wants to demonstrate his ignorance on the topic? He’s more than welcome to do so. Do I care? Beyond noting his immature, unprofessional behavior, I don’t.

      • NoUseForANym

        But why be immature and unprofessional in return?

        • expat

          Because it is entertaining for readers.

          • Trulyunbelievable2020

            I’m not entertained. This strikes me as petty and immature. I’ll still come here to read this blog, but not if it devolves into this sort of silliness. I honestly do not care about this personal conflict.

          • auntbea

            Honestly, your posts on this stuff are the best ones going. I would quite disappointed to lose you in our comments.

          • Trulyunbelievable2020

            How nice of you to say that! In all honesty, it will take at least 6 more limericks, 2 sonnets, or a combination thereof to chase me away 🙂

            But seriously, I’m not a huge fan of this kind of post. I’ve said my piece, and now I’ll back off until more interesting material comes along.

  • Sullivan ThePoop
  • NoUseForANym

    Dr Amy I love you but this is a bit immature and certainly beneath you.

    • NoLongerCrunching

      Meh, if anyone deserves to blow off a little steam, it’s Dr Amy.

      • NoUseForANym

        Perhaps, but she would be much better served to do it in a way that doesn’t make her look petty and immature.

    • S

      I agree completely. Better to just let posts like Orac’s stand on its own. He did a fine job of sullying his own credibility on this topic. This “I care less than you do!” posturing isn’t helping anything. Let it go.

  • Squillo

    With all due respect, Amy, this fight has become a distraction from the real issues and does none of the parties any credit. By continuing to expend your time and bandwidth on it, you are ensuring the focus remains on you rather than on your message. It undermines the good work you do, and that’s a terrible shame.

  • Trixie

    How DARE you waste his time trying to replicate your results in the CDC Wonder Data? Don’t you know his time is precious? I can’t believe you didn’t make some kind of tutorial to walk people through how you obtained the numbers…oh, wait.

    • guest

      He has a single malt waiting! Never mind the dead babies.

      • KarenJJ

        Well because I’m feeling immature maybe I should inform him that I deigned to write on his blog while enjoying a champagne by the beach?

        • Amazed

          Karen, be a friend. He might be delighted by your benevolence but there are those of us who can only dream of the beach right now…

          • KarenJJ

            More than happy to give you some beach if someone out there could send us some rain.

          • Amazed

            Try painting your nails grey. It worked for me – we had some snow here on Monday, I painted my nails bright yellow to wheedle the sun out of hiding and turned to my inner goddess to send us some. The next day, it started getting warmer.

            I now have to apply two coats of liquid sand. Hmm, I think I’ll make them three, just to be on the safe side.

          • Box of Salt

            KarenJJ, I’m in SoCal. If I had any rain, I’d share it. Last weekend it drizzled for 3 days straight with a lot of wind. My 7-yo thinks the drought is over, and we had to explain to him the 1″ we got is still 9″ less than what we need.

          • KarenJJ

            I have a friend in So Cal who was over recently and telling me about the drought you guys are having. We can both paint our nails grey and send the kids out to do a rain dance then. There was just enough rain here one morning last week to rearrange the dust on my car into interesting splotch-like patterns. The first rainfall we’ve had in months.

  • Irène Delse

    That’s a fitting response 😀
    But if I may, I’d suggest changing the article to address it to “Orac”, since the good doctor used that persona and his own Respectful Insolence blog. At least one commentator here was confused and looked for the article over at SBM blog.