AmyTuteurMD

AmyTuteurMD
Bio
Dr. Amy Tuteur is an obstetrician-gynecologist. She received her undergraduate degree from Harvard College and her medical degree from Boston University School of Medicine. Dr. Tuteur is a former clinical instructor at Harvard Medical School.

Editor’s Pick
DECEMBER 18, 2009 7:21AM

Homeopathy: nano-doses or mega-stupidity?

Rate: 11 Flag

molecules

The hallmark of homeopathy is the belief that tiny doses of medicinal substances have big effects. It's like insisting that the less salt you put in water, the more salty the water will taste. In other words, it defies common sense, is scientifically unfounded, and has been thoroughly debunked.

Even more inane than the concept of homeopathy are its proponents’ attempts to explain how it works. Homeopathy is, perhaps, the paradigmatic pseudoscience, and like most pseudosciences, it invokes science while at the same time ignoring the scientific evidence.

One of the best (and inadvertently funniest) examples can be found on today’s Huffington Post. Dana Ullman has written How Homeopathic Medicines Work: Nanopharmacology At Its Best.

Pseudoscience advocates have learned the benefits of clothing pseudoscience in "scientese," language that sounds scientific but makes no sense. "Nano" sounds scientific, so Ullman insists that homeopathy is "nanopharmacology.' As Ullman breathlessly explains:

Although the word "nano" also means one-billionth of a size, that is not its only definition. In fact, "nano" derives from the word "dwarf," and "nano" is the only word in the English language that is used on common parlance as denoting extremely small AND yet extremely powerful.
Sounds cool and so scientific, doesn't it? Just a few minor problems, though. First, nano does not mean powerful and has nothing to do with power. Second, there is a scientific discipline of nanopharmacology and it means something very different than what Ullman pretends it means.

According to Nanopharmacology.com:
Nanopharmacology is the use of nanotechnology for -- discovery of new pharmacological molecular entities; selection of pharmaceuticals for specific individuals to maximize effectiveness and minimize side effects; and delivery of pharmaceuticals to targeted locations or tissues within the body. Nanotechnology will generally be defined as the science of constructing and assembling objects on a scale littler than one hundred nanometers. The end results of nanotechnology may be miniature particles (in powders, lotions or coatings) or macro-scale objects with nanoscale modules and unique characteristics.
In other words, nanopharmacology refers to the size of the medication delivery system, NOT the dilution of the medication.

How does homeopathy work? Well, it doesn't work; copious scientific evidence has thoroughly debunked homeopathy. Ullman ignores that point to speculate on various possibilities, each more ridiculous than the last.
Scientists at several universities and hospitals in France and Belgium have discovered that the vigorous shaking of the water in glass bottles causes extremely small amounts of silica fragments or chips to fall into the water. Perhaps these silica chips may help to store the information in the water, with each medicine that is initially placed in the water creating its own pharmacological effect.
Or, perhaps these silica fragments do nothing. Certainly it doesn't help water "store information" since that is a chemical impossibility.

Or maybe it's the bubbles:
Further, the micro-bubbles and the nano-bubbles that are caused by the shaking may burst and thereby produce microenvironments of higher temperature and pressure.
If it's not the silica fragments or the bubbles, maybe it's the waves:
Normal radio waves simply do not penetrate water, so submarines must use an extremely low-frequency radio wave. The radio waves used by submarines to penetrate water are so low that a single wavelength is typically several miles long!

If one considers that the human body is 70-80 percent water, perhaps the best way to provide pharmacological information to the body and into intercellular fluids is with nanodoses. Like the extremely low-frequency radio waves, it may be necessary to use extremely low (and activated) doses for a person to receive the medicinal effect.
Of course every self-respecting quack must invoke, and profoundly misinterpret, quantum mechanics:
Quantum physics does not disprove Newtonian physics; quantum physics simply extends our understanding of extremely small and extremely large systems. Likewise, homeopathy does not disprove conventional pharmacology; instead, it extends our understanding of extremely small doses of medicinal agents.
But quantum physics is involves sub-atomic particles of very small size, NOT small numbers of particles.

Homeopathy is nothing more than pseudoscience, and a particularly inane pseudoscience at that. It is not involve nanopharmacology. However, we can say that belief in homeopathy is evidence of mega-stupidity, best defined as startling gullibility combined with a profound deficit of scientific knowledge.

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I'm so sick of scientists dismissing anything that can't be "rationally explained." There are things that are perhaps beyond our understanding. Homeopathy does work in some cases. I once had severe bronchitis for eight months and nothing the traditional doctors did gave me any relief. As a last resort, I took a homeopathic medicine and my condition completely healed in one week.
A holistic vet gave my overly aggressive cat a homeopathic medicine which I still treat him with. He is like a different cat on this medicine: calm, sweet and playful. This is ample proof to me of homeopathic medicine's benefits. My cat is not capable of experiencing a placebo effect. He doesn't even know I'm giving him medicine. Salon used to be an open minded website, but lately it's starting to look more and more like a right wing newsletter. Open your mind!
Thom, it's called the placebo effect. It's been very well studied but as yet is unexplained exactly how it works physiologically, but the idea that no treatment (or sham treatment) may sometimes work because of the patient's own anticipation of said treatment, especially in the case of subjective determinations like pain and relief, is very well known in the medical and scientific world.

Also, personal anecdotes are subjective, and science is objective. It's not about an open mind, it's about the evidence. And there is no evidence that homeopathic medicine does anything but invoke a placebo effect and allow real disease to fester.

BTW, isn't the fact that the HuffPo writer didn't know what the hell they were talking about in regards to nanopharm and quantum phys good evidence that they just don't know what they're talking about? Sheesh, you ask others to be open minded when you yourself are closed minded, determined to make homeopathy look good.

Oh, and Amy, interesting article.
I actually read the Dana Ullman piece before I read yours. His article is more than ridiculous. The comparison to sonar waves is not only silly, but seems to contradict rather than enhance his theory. This low frequency wave, in his words, might be a mile long, which to me implies that it's huge in size, not "nano."

The one thing that I do believe is that the absence of evidence isn't ALWAYS proof of something, but possibly reflects a lack of understanding of what scientists should be looking for.

I believe in science as long as scientists acknowledge that they don't know everything.
Sorry, Thom, I just read that you mentioned placebo effect in the middle of the second paragraph, didn't mean to sound completely condescending. But your cat does know he's getting medicine. He's getting some sort of attention when receiving it that is likely lifting his spirits. Or the homeopathic medicine actually contains something. That's a possibility, too.
I've never taken a homeopathic drug. So if the effect increases with smaller doses, I really should be dead from a massive overdose a long time ago.
Science education. Or a serious lack of it.

It's a national travesty that people come out of high schools not understanding the basics of the scientific method, and not understanding what a scientific study really does.

Sorry, Thom Jackson, I don't doubt your experiences, and I'm glad you're better. But one person saying "I got better" is NOT data. It is an anecdote.

If someone had designed a study, with 50 selected people (or 100 people, or 1000 people) with your exact condition, and given half the same remedies as you got, and half a placebo (thinking they were getting a remedy but actually got nothing), THAT is data.

Some people, like Thom Jackson, will get better with homeopathic remedies. But unless you compare their rates with the general population who did nothing, you can't say that the homeopathic remedies caused the healing. It's basic logic. You could just as easily attribute healing to a magic feather, or a change in the weather, or a new main squeeze, or any of a number of factors.

"My neighbor's kid did ..." is NOT data.

"150 children given X in a controlled study, experienced Y result" IS data.
@ Roger Fallihee

Yes, scientists acknowledge that they don't know everything. That's the point. That's why they do experiments and studies, to find out. That's why they repeat each other's studies, to make sure the data can be replicated.

One study does nothing more than establish one fact in a universe of unknowns. One study is a single brick in a vast, half-built wall. Any scientist will happily tell you "These bricks over here are the things we know. We've proven them and can replicate them. That's why they're bricks."

The rest of the wall remains to be built. And there's a lot of it. Sometimes the bricks further down the wall turn out to be wrong too. But that's part of the process.
Well pseudoscience (or placebo effect) or not, it has certainly helped a lot of people. Even pe0ple that mainstream medicine could not. So I think it deserves some respect, rather condescending treatment like this. You're just worried about losing market share. Whose payroll are you on btw? Pfizer? Novartis? Good luck shilling for Big Pharma.
Sean, homepathy is never going to be acknowledge by any reputable medical journal or book for the same reason that faith healing isn't going to be acknowledged: There is no scientific evidence to show that it works!
The fact that some people have reported that they have gotten better after using homeopathy/having somebody pray for them is down to a)the placebo affect and b)the fact that by the time most people seek help for ailment they would usually be getting better anyway.
If you honestly believe that everybody who argues against homeopathy is getting a share of some pharmaceutical companies profit I can only recommend Ben Goldacre's book Bad Science to you. He does a brilliant job explaining how valid scientific studies work (and why being funded by a pharmaceutical company usually makes them invalid) and why there do seem to be occasional reports about the success of homeopathy.
Im actually not against homeopathy, for the simple reason that it has been shown to do nothing whatsoever, so at least it isn't doing anybody harm. However considering it as a valid alternative to established medical treatments can be dangerous, thats why in my opinion there can never be enough studies or articles pointing out the bogus science behind it.
Um... if people BELIEVE it will help them, then it may well help them. The AMA and big pharma corps don't have to demonize homeopathy. If there's nothing to be afraid of... then there's nothing to be afraid of.
@Gordon: Well the simple reason that the AMA isn't exactly in favour of homepathy is the fact that they would be burried under negligence claims if they actually recommended a treatment that amounts to giving somebody sugar pills. Because every once in a while you get somebody who forgets to read the small print (i.e. cannot be used as a substitute for real medicine) and stuff like this happens: http://www.guardian.co.uk/world/2009/sep/28/homeopathy-baby-death-couple-jailed
Norwonk:

"I've never taken a homeopathic drug. So if the effect increases with smaller doses, I really should be dead from a massive overdose a long time ago."

That's one of the best arguments against homeopathy that I've ever heard! Thanks for the laugh.
"Whose payroll are you on btw? Pfizer? Novartis? Good luck shilling for Big Pharma."

Wow. Why does it seem that paranoia and homeopathy go hand in hand?

Btw... you accuse people that believe in the scientific method and modern medicine as being condescending? I think I understand where you are coming from... BUT in my personal experience there is an equal (or greater) amount of smugness on the homeopathy side of things. I have (inadvertently) gotten into debates with folks who are EXTREMELY condescending of anyone that buys into "big pharma propaganda."

So let's just say there are smug assholes on either side of this debate.
froggy:

"Yes, scientists acknowledge that they don't know everything. That's the point. That's why they do experiments and studies, to find out. That's why they repeat each other's studies, to make sure the data can be replicated."

Yes!!!
Sean Fenly:

"So I think it deserves some respect"

I deserves no respect because it is a giant lie. It is well known that you can make people feel "better" by lying to them, but that doesn't make it ethical to do so. And it certainly doesn't make it ethical to profit by lying to people.
Gordon Wagner:

"The AMA and big pharma corps don't have to demonize homeopathy."

I am neither the AMA nor Big Pharma, so please don't try to smear me by connecting me to them.

Moreover, anyone who knows anything about science demonizes homeopathy because it is a fraud.
Great point Gordon, doth protesteth to much... I have never seen science explain to me why some alternative medicines/therapies do work (if/when they work). Maybe I'm the ignorant one, if any one can point me to that information please do.
Well Dr. I can see you are mired firmly in your worldview, and your mind is not open in the least (as I would have suspected from anyone who would pen such a screed). Good luck demonizing something that many find a lot of solace and hope in. Heavens knows that mainstream medicine is feared, and treated with suspicion by many folks. I would think you would want to promote and put your practice in a better light, rather than raining on other people's parade.
Sean, seriously check out the book I recomended above. The author does a pretty good job explaining why "alternative medicine" sometimes does SEEM to work!
Also can I just point out that most scientists aren't actually demonizing alternative medicine, they're just saying it does not work. And as scientists testing what does and does not work is kind of in their job description. Hence they don't recomend that a cancer patient should go to church and pray even though that can indeed also be very comforting for a lot of people but there is no scientific evidence saying it actually will make you better!
@flora + fauna

I'd add a bit to what you said. I don't think a scientist or physician would tell a patient NOT to go to church and pray. But, the scientist/physician would say, don't skip your chemotherapy and go to church instead.

There's a difference, and I think it's worth noting. Many scientists are not anti-religion. Many are religious. But what happens in the lab (or in the patient's body) has nothing to do with religion. So pray all you like. Just take your medicine while you're doing it.
I would agree with Flora and the Dr. is that it looks like (based upon what we currently know) that homeopathy does little to nothing. The effect probably does has more to do with something psychological (or possibly even metaphysical), but I don't think what the effect is has been proven yet. I'm not sure what percentage of homeopathic treatments do succeed either; but some have, and on some very serious conditions too. Therefore, I don't see what mainstream medicine fears if it has no belief in homeopathy and its treatments.

p.s. Just surfing the web you can find many M.D.'s who also (or only) practice homeopathy. Why are they practicing something so diametrically opposed to their training?
Sean, the problem doctors have with it is that it kills people, which they spend their lives preventing. If they decide to forgo a reasonable treatment of a curable disease for holy water or massage or snake oil and die, why just let that happen? Why allow a population to exist in sickness when there's no need for them to be sick? There's a difference between allowing one to choose their course of treatment and allowing them to be ignorant and kill themselves.
Amy, you should know better than to poke sleeping dogs with a stick.

Having said that, and knowing all about the placebo effect, the fact remains -nothwithstanding the ludicrous theories they propound, some of the remedies do work on occasion. And I really don't believe that cats can experience a placebo effect, not having an imagination to work with.

However, the entire concept of homeopathy grew (I think that's the right word) from herbology....and herbology or naturpathy does work.

Or do they? What's your opinion on that?

I must run off to buy some herbs (chinese food) Will check in later.
sagemerlin:

"Or do they? What's your opinion on that?"

As a general matter, they don't work either.
I am a fan of Dr. Amy's columns, for the most part. This one is no exception.

The reason that I made the point about scientists not knowing everything is that often times Dr. Amy states her opinions in such absolute terms that she doesn't seem to even leave open the possibility that she could be wrong.

I'm a six-year cancer survivor and the reason that I am still here is that I was treated by scientists (MD's) who knew what they were doing.
For starts, I am an amateur herbal practitioner. I became an herbal student when prescription medicines failed to work, and the herbs I tried were successful. A had a bladder infection that spread to my kidneys. I started taking antibiotics while it was just a bladder infection. I continued taking antibiotics for over a month, until a neighbor challenged me to try herbs. I copied the list of bladder infection herbs from her herb book and went to the local herb shop.
I told the clerk I wanted a dollar's worth of herbs. I did not tell him what I wanted to treat. He only had two of the listed herbs in stock. A few days of drinking peach leaf and cubeb berry tea cleared the infection. Since then, I try herbs first. They are much easier to get than a doctor's appointment and much less expensive than prescription drugs. I also use homeopathic products. Some work and some don't. I do not think it's mega-stupid to treat infections quickly, effectively, and inexpensively.
I have a hard time believing a placebo effect could work on a cat too... but placebo effect isn't the only explanation. Sometimes our bodies just heal, ya know? The timing of the healing and taking the homeopathic remedy could have been completely coincidental.

Have any real studies been done on homeopathic remedies -- or is at all just anecdotal?
Dr Amy,

Since some medicine is made from various herbs and other plant forms wouldn't you get some of the effect from taking the herb? I'm sure you would get very little and maybe not enough to help in most cases, but are there zero benefit or just to small to do any good on a regular basis?
An additional note. I've suggested peach leaves and cubeb berries to dozens of people over the years and they have all had a 100% success rate treating bladder infections. The recipe for 1 quart of the tea (you drink one quart per day) is 2 TBSP peach leaves (dried) and 2 tsp cubeb berries (dried). cubeb berries are also sold as java pepper.
Amy, I am on your side. Homeopathic "medicine" defies logic. However, if people consume harmless substances that make them feel better, is that a bad thing? If a placebo creates happiness, why destroy the helpful delusion?

This issue is completely different from that of vaccines. Choosing not to vaccinate puts your children and humanity at grave risk, whereas using homeopathic treatments poses zero risk to the body.
Alicia,
I don't think you know what homeopathy is. Your comments suggest you know nothing about it. We shouldn't put either/or situations that are hypotheticals out there. I've yet to hear a case of homeopathy killing someone, but mainstream medicine has done it, through reactions to medications (big pharma and doctors use cost/benefit analysis, this is an unconscionable thing to do; I read of a case the other day where a small boy was paralyzed by the flu vaccine), and surgeries that weren't needed that were done (when folks didn't solicit a second opinion or even more than that).

I can't believe Salon would headline this tripe. Makes me wonder what Salon's agenda is with this website.

p.s. Perhaps Salon is headlining things that stimulate debate, I hope that's what's going on here.
Over the past year that I've been a regular here you've created some interesting and sometimes controversial posts, if nothing else you have a gift for crafting an explosive title!

Lately it seems like you've dumbed down your work. Nothing new, nothing I didn't already know. Hats off for continuing to garner the EPs and cover picks, but I'm a bit in the dark over why. Again, nothing new.

The human body should present an endless source of topics that someone as brilliant as you are should have no problem crafting engaging articles about. Time to head back to mine Amy and dig a little deeper, this stuff is slag.
CrankItToo11:

"Have any real studies been done on homeopathic remedies"

Yes. Not a single study has shown any benefit.
Catnlion:

"Since some medicine is made from various herbs and other plant forms wouldn't you get some of the effect from taking the herb?"

You could, but you would still face serious issue. Many herb preparations don't contain the active ingredient or enough of it to have any effect. The dose is extremely variable. You might take a lot of active ingredient in one dose and none in the next. In addition, you are subjected to any contaminant in the herbs themselves.

Consider, digoxin is derived from the foxglove plant. The foxglove was used for years to treat heart failure. Some got better; some didn't; and some died from poisoning due to overdoes. When you take prescription digoxin, you get the correct dose every time, and no contaminants to go along with it.
BikeLizard:

"However, if people consume harmless substances that make them feel better, is that a bad thing?"

In my judgment, one of the biggest problems is that they probably wouldn't consume it unless those who make money from it encouraged them. In the end, it's about people making money by lying to trusting people. That's unethical.
Here is an article on homeopathy improving the life of an autistic child: http://www.psychologytoday.com/articles/200403/the-strange-case-homeopathy

There are a plethora of articles like it on the internet (it is one of the better ones that I have come across, of course, such pieces will not impress the skeptics, b/c because they dismiss any and every benefit as a placebo effect).

This looks like an interesting article that says a lot of the 'miracle' drugs pushed by Big Pharma (and the 'results' achieved by them) can be chalked up to placebo effect: http://www.wired.co.uk/wired-magazine/archive/2009/10/features/the-placebo-problem-big-pharma%27s-desperate-to-solve.aspx?page=all. So I guess homeopathy is in good company, according to many of the folks who have commented here (who seem to be true believers in what Big Pharma is selling).
If I didn't know better, I'd swear this woman has convinced herself she knows of what she's speaking. But I don't.
Want to see what honest homeopathy looks like? Take a look at the "about us" page at Fair Deal Homeopathy (http://www.fdhom.co.uk/about.asp). Some excerpts:

What is a homeopathic remedy?

The main idea behind homeopathy is that "like cures like". A homeopathic remedy takes an ingredient which can cause illness, and then dilutes it down in ordinary water so much to ensure not one atom of that active ingredient remains in the remedy. This means that it's safe, but must not be used as an alternative to evidence based medicine. A homepathic remedy is not a medical product.

How does it work?

Homeopathy works through a complicated interaction with the human body and mind known as the "placebo effect". The placebo effect is still not fully understood, but is very effective for certain conditions†.

What conditions can FairDeal Homeopathy treat**?

FairDeal Homeopathy can be used to treat any self-limiting condition. Examples include non-specific aches and pains, mild headache, unlikely allergies and intolerances, implausible phobias, vague nausea, surprising bruises, UDIs and most other conditions for which your GP may find difficult to give you an instant cure.

I'm actually ill - can FairDeal Homeopathy help me?

Go to your doctor immediately. Fairdeal Homeopathy will not be able to cure you. However, the placebo effect generated by taking FairDeal Homeopathic products may reduce the unpleasantness of some of the symptoms. Homeopathy of any sort is not a medical treatment, neither is it a substitute for evidence-based medicine and proper medical opinion.
"Proof that homeopathy worked was widespread. Every epidemic in Europe and America starting with the cholera epidemics in the 1840s became an advertisement for the virtues of homeopathy. Homeopaths saved lives in large numbers and compared to the competition it was obvious that allopathic methods were a complete failure. In rapid order, the practice of homeopathy became widespread in New England, the Middle Atlantic States, and the Midwest. True to form, while the South had been slow to catch on, the 1878 yellow fever epidemic converted many patients and doctors there, too.

The formation of the American Medical Association in the 1840s was in direct response to the onslaught of a superior medical system. From the beginning, the AMA stood firm with a hostile “them or us” attitude about members consorting with the competition. Well-educated homeopaths, often graduates of Harvard, Yale and other such schools, were banned from joining the AMA. In AMA meetings, any discussion about homeopathy was banned. If any member of the AMA, or its state chapters, were seen consorting with a homeopath, that doctor was expelled. "

I was trying to locate an article I'd read about an MD who set out to debunk homeopathy, specifically its seemingly absurd dilution, but found to her consternation that it was effective. I don't have a position either way. But I always root for the underdog. I'm not suggesting that someone rely on homeopathy instead of "real" medicine. Personally, I prefer to just not get sick...
The Ox:

"I'm actually ill - can FairDeal Homeopathy help me?

Go to your doctor immediately. Fairdeal Homeopathy will not be able to cure you. However, the placebo effect generated by taking FairDeal Homeopathic products may reduce the unpleasantness of some of the symptoms. Homeopathy of any sort is not a medical treatment, neither is it a substitute for evidence-based medicine and proper medical opinion."

One thing we can say for sure: even if homeopaths believe in their treatments (and some clearly don't), their lawyers certainly don't, and homeopaths follow legal advice.
After reading the doctor's blog on Homeopathy as well as a couple of the comments, I have to say that I think everyone is missing the point on this topic! First...because I read this particular comment last...if anyone can actually make me believe that a cat can benefit from the so-called placebo effect, I'm going to start taking asprin to prevent the bleeds I suffer from Hemophilia A! How dumb can someone with a Phd be? Not that dumb, but obviously illiterate because when you make critical comments that are as misleading as your's was, I can only imagine that you got your degree in Eubonics!

At the same time, Dr. Amy while quite articulate and impressive even, doesn't seem to be looking at the big picture! How can I say this without being cruel or crude? Well, she's ignoring the whole wonderous world of the Enchalada and complaining about the the wax paper wrapped Taco! Of course medical specialists are known for this kind of thing. They find an area they think they're good at and for which they can charge twice as much as anyone else, then prescribe the latest pill that a salesman dropped off at their office a few days before without any concern for new, multiple, and injurious side effects that their patients will now have to suffer instead of simply checking with a real pharmacologist first! Hell, most corner druggists know more about the medications they're told to dispense than the doctors who prescribe them! And now here we go again...a so-called medical professional is making noise about a long used methodology that has actually been around since before the first amputation...using narrow and critical definitions that barely touch upon the actual topic to support opinions that are mainly politically and economically motivated! We've all heard this kind of bs and negative missinformation before. Why can't Cancer be cured? It's not as profitable as maintaining it! Why is Homeopathy such a bad medical choice? Well it has a lot more to do with ego and economic viability than it does nano-anything! I don't know if you're a good doctor Amy, but if you ever need a change, you should definetly go into politics because you can really cnfuse an issue!
FFOman:

"Why can't Cancer be cured? It's not as profitable as maintaining it! "

Yeah, we all know that doctors NEVER die of cancer. They don't even get cancer. They arrange for everyone else to get cancer so they can make money.

LOLOL. Are you really that gullible, or are you just pretending so the rest of us can have a good laugh?

As Einstein said:

"Two things are infinite: the universe and human stupidity; and I'm not sure about the universe."
Amy: "The hallmark of homeopathy is the belief that tiny doses of medicinal substances have big effects."

I don't think that's what you meant to say, is it? Based on my read of the remainder of your article, what you seem to be saying is that people think that smaller doses in homeopathy have bigger effects than larger doses. Right? Because unless you're defining "medicinal substances" in some really funky and limited way (that excludes botox, or penicillin, or anything else that can be really effective in pretty tiny doses), what you're saying in your intro doesn't make much sense.
I'm really late coming back to the table on this one. I give my cat his doses mixed in food. He is not having a placebo effect, he doesn't know he's getting it nor does he receive any special attention. He went from attacking me and drawing blood to being a sweetheart. Man, you people will say anything to justify your position. So much for openmindedness.