The Internet is full these days of eager skeptics, debunkers, anti-crank, and anti-Quack websites. In the harsh, absolutist language full of insults, innuendo, and invented terms like crank, woo, pseudoscience, and quackery. This has in turn led to a proliferation of counter websites using pretty much the same tone. Whether it’s global warming, physics, autism, herbal remedies, homeopathy, acupuncture, or the oldest and most overdone argument of all, God. The insults fly, the adrenaline rushes and the dopamine rewards. What is shut off is logic, understanding, and trust. Welcome to wonderful world of the Internet.
The problem is, this approach doesn’t influence anyone except like minded individuals, who become more stubborn and radical. These skeptics are doing more harm to their cause than good. Most Americans, by a large majority, don’t believe in evolution and it’s not for a lack of loud voices proclaiming the evidence. I think some of this is a natural reaction. Call me crazy, but I don’t think people like being told they are stupid. Not only that, I don’t think people who refuse to take scientist’s word on an issue are stupid at all.
Allopathic medicine emerged in the last couple of centuries from an open competition with osteopaths, chiropractors, snake oil salesmen, and a whole variety of health practitioners. They did so by aligning themselves with sciences. The germ theory of medicine it turns out had some real evidence behind it, by applying it we were able to keep scourges in check, even wiping smallpox off the globe. Three cheers for science. Doctor’s started wearing lab coats to emphasize their scientific grounding. Pharmaceuticals, technologies and procedures have mushroomed. Doctors, even today, are among the most trusted of professionals.
There is a dark side to this sea change, however. Science relies on a suspension of judgement until evidence is weighed. It requires an open mind, active reasoning, and even some healthy skepticism. It just so happens that skepticism may be a good way to approach medical questions of treatment, but it is one lousy way to approach a patient. Patients come to doctor’s sick and vulnerable. They want to tell their story. They want people to listen, spend time understanding them and the narrative of their illness. They want to understand themselves, what is wrong, and what their options are. They don’t want to hear that a diagnosis is uncertain. This will shake their faith in a physician like nothing else. Yet, for all our best efforts, most medicine is uncertain, especially when a healthy dose of skepticism is applied.
Where we have double blind placebo controlled studies, things are usually reasonably certain. However, the benefit of most drugs are relatively small in these studies. What might shock many people is that, especially with rarer conditions, we really don’t have a lot of scientific evidence. Gathering enough people to do a good study becomes difficult. Difficult as this may be for patients, it is often worse for the physicians themselves. Because we are so data driven, problems that are more fuzzy tend to drive the average physician up the wall.
The fact is that most health problems have an emotional or psychological component. Somehow, we have created a medical culture where that is a bad thing. So much of the office visit is learning to handle and help the patient’s (or their parents’) anxiety. This is the art of medicine. This is a vital component of healing, for which science really isn’t very useful. Science cured diseases. Science cannot heal illness, that requires something more in touch with our humanity than logic, evidence and data.
In some ways this is all about time. These days, Doctors don’t have a lot of time. Healthcare economics are such that time taking history, thinking out a differential diagnosis, and following through with a diagnostic plan are not what you are paid for. You are paid for seeing patients and doing stuff. If your specialty does less stuff, then you must see more patients. I belong to the king of history and physical examination specialties. It was a huge draw for me. Imagine a specialty where you get to actually spend more than 15 minutes an office visit. For the data driven crazed scientist, we now even have data that suggests that this factor, taking time to care and communicate, account for a lion’s share of the time tried placebo effect.
This is where the alternative, complementary, or holistic movement made all it’s inroads the past couple of decades. They aren’t limited by our healthcare system because they are free from the bounds of insurance, hospitals, etc. They also are into people. In order to be successful, they must gain the trust of patients. They do this by being understanding, comforting, polite, optimistic and believing strongly in what they do.
They have faith, anathema to many scientists. Sure there is probably a charlatan or snake oil salesman here and there, but I believe most of them believe in what they are doing. We underestimate the power of belief at our own peril. We underestimate the wondrous creation that is the human body if we neglect it’s ability to heal itself. If we ignore the power of the mind and soul, we are doomed to failure. We can cure all the polio we want, we will not heal anyone.
This sets scientists on the warpath. We spiral into a series of debunking propaganda wars. Proper scientists can do nothing but resent any recognition Eastern medicine, herbalism, or homeopathy may gain. Many get ferociously angry just to see grant money looking into these therapies. They rail against the fact that actual medical schools are starting to express interest in these ideas.
This is where a line is crossed, and objectivity is lost. Really and truly there are not natural vs manmade medical remedies, there are only proven and unproven therapies. There is only evidence or its lack. The anti-crank woo fighter movement would do well to remember this. Lack of proof for a therapy does not necessarily mean it isn’t effective.
They would do even better to develop a respect for why these types of therapies are attractive to people. Natural is such a soothing word. It evokes nature, landscape, Earth and simplicity. As society has left its agricultural roots and crowded into cities, it left us with a memory or longing for how we once lived. I can see how that in itself could be healing.
Here is the major question, for those folks who see a way that this approach can be “complementary” rather than an competing either/or choice, as long as it is not actively harmful, why get upset? Even if you take the position that all this stuff is placebo, (and that is far from a foregone conclusion), what is it hurting? If complementary and alternative medicine makes people feel good, isn’t that what doctoring is supposed to be about? I thought that was the goal. It seems scientists can get just as rigid and dogmatic as the fundamentalist religionists for whom they express so much disdain.
As opposed to alternative medicine, science looks unflinchingly at any possible down side to our therapy. We dutifully tally side effects. We develop medicines, usually based on natural chemicals that we then purify or modify. Here is the great secret, these modifications when they aren’t used just to keep a medicine on patent, are actually designed to improve potency and decrease the natural substances side effects. Go figure. There are some things medicine just has not communicated well.
We are losing the information war. Science is suffering. As a scientist myself, I think this is very sad. We need to learn to communicate. We need to learn to connect with our own humanity. I think we need to all borrow a page from Mehmet Oz. I think he is on to something with his fusion of the very best of East and West. We need to find our soul. If we don’t, it won’t matter how much better our data and inferences are. Patients will look elsewhere. No one will be left to fund inquiry. No one will be listening. There will be no one to left to help.
9 comments
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May 16, 2008 at 9:20 pm
mshealth411
Beautifully said Doc.
There are so many therapies and pharmaceuticals whose mode of action is actually unknown. I’ve sought treatments from non-traditional (read non-allopathic) practitioners which have provided great relief, although the mode of action is unknown. So much of medicine is based on faith and trial-n-error, this I know well as an MS patient.
Thank you for writing this,
Lisa
brassandivory.blogspot.com
May 16, 2008 at 11:54 pm
Allen
I have BS and MS degrees in Electrical Engineering and a MS in Computer Information Systems. So, I have an above average understanding of physics and our natural world. Yet, I’ve been using homeopathy for over 25 years. Except for being in the ICU in a coma for four weeks after an auto accident, I haven’t had a drug of any kind for over 25 years.
How does homeopathy work? I don’t know. Physics tells me there are no molecules of the remedy left because homeopathic remedies are diluted so much. But my experience with the remedies tells me they do work. Are they placebos? Perhaps. I don’t know. If they are just placebos, that is great, because the safest medicine is a placebo that works. I won’t be treated by a doctor who has a negative attitude towards homeopathy. I don’t require the doctor to also be a homeopath, but I do require that I not be ridiculed because of my belief in and use of homeopathy.
Thanks, Doc, for your attitude towards both Allopathic and natural approaches to medicine.
May 17, 2008 at 7:48 am
homeopathy4health
Thank you for a thoughtful and insightful critique of the situation. I hope for an integrated approach to health in the future.
May 17, 2008 at 8:19 am
Doc
Thank you all for your kind comments. Homeopathy is kind of a tough one for me. I wonder sometimes if it can really integrate with medicine. So much of its rhetoric from what I have seen is so anti-medicine, emphasizing side effects Maybe some of it is reactionary, but I don’t see the two viewing each other as anything but a threat. Homeopathy’s explanations seem to indicate that medicine has it all wrong. I think this is where a lot of scientists get defensive. People describe how their process works and it sometimes flies in the face of what we’ve learned works through experiment. However, we could all use a little mere humility. Sometimes the biggest breakthroughs are made by keeping an open mind. I’m willing to call a truce. Like Allen said, the best medicine is a placebo that works (I would add without causing any harm.) I am content to live and let live.
May 20, 2008 at 8:54 pm
Admin
Hi, I am the editor of the Freedom of Science blog. This is a nice post and I agree with your criticism of professionals’ narrow view of science by defining anything they did not learn in school to be illegal or wrong. When you write “I don’t think people who refuse to take scientist’s word on an issue are stupid at all” you use the word “scientist” to mean “professional.” In that case, your statement makes perfect sense. People refuse to take their lawyer’s or banker’s word as truth, why should they take self-serving theories of professional physicists as truth? But they do? Why? Because of the confusion physicists created about the meaning of the word scientist.
Professional physicists label anything outside legal physics to be stamp collecting or crackpotism. But despite physicists’ propaganda that they are the only true scientists, the fundamental physical quantity of physics, the Newtonian force, is like the missing ingredient in a placebo. Force terms do not enter computations of orbits. From this observation, as a scientist, I conclude that orbits are independent of force. Physicists, on the other hand, eliminate the symbol of force from orbital formulas but claim that force still remains in the formulas in spirit as the active ingredient of orbits. This is the old scholastic casuistry. I don’t see why my questioning of physicists’ casuistic practices should be classified as anything but science. Thanks for letting me see this from a new angle.
Doctors, even today, are among the most trusted of professionals.
This has not always been the case. In the 19th and early 20th century Doctors of medicine were unregulated professionals perceived as butchers who could not be held responsible for killing their patients for their own professional advancement. I recommend George Bernard Shaw’s The Doctor’s Dilemma, especially the author’s Preface, if you haven’t already read it. Today physics is where medicine was in the 19th century. Instead of killing human beings for professional reasons, physics corrupt human reason for professional gain.
It seems scientists can get just as rigid and dogmatic as the fundamentalist religionists for whom they express so much disdain.
Again your statement makes perfect sense if we understand your “scientist” to mean “professional.” In the case of physics, the war between physicists and religion is nothing more than the never ending academic turf wars between two types of professional doctors: doctors of philosophy and theology. They have been fighting to save the souls of the same constituency since the beginning of history. Doctors of Theology want to convert them to their organized religion and Doctors of Philosophy want to convert them to their own religion called Newtonism.
May 20, 2008 at 10:16 pm
Doc
I don’t agree with your view on physics but I respect your right to feel this way and express it freely. I won’t argue that physicists don’t have a self interest in promoting their profession, but I hope you realize that you are a party in this turf war as well, and as such may also be subject to your own bias. I really don’t see physics and religion necessarily in conflict. Something about the way that whole Galileo thing went down seems very overwrought to me. I would ask how would you expect physicists to react your arguments? This is the type of thing I refer to when I call it polarizing and only helping like minded people agree.
Assuming you believe it took place, Newtonian physics did put a man on the moon after all. It is not a “religion” that is without some significant accomplishments in its application. We are relying on a whole lot of engineers using Newtons ideas to keep bridges or skyscrapers from collapsing on us everyday.
May 23, 2008 at 9:08 am
Admin
I hope you realize that you are a party in this turf war as well, and as such may also be subject to your own bias.
It’s interesting to hear the perspective of a third party but I never thought of myself as a party in Doctoral turf wars. I am not a professional doctor, and I have no academic turf to protect and my bias is the scientific bias: Do not start from doctrine and fit nature into doctrine as physicists do but start from observations and ignore doctrines and laws. This is what I’ve been trying to do. Kepler’s rule R3T2 is not a law, it is a rule Kepler discovered in Brahe’s observations. I start from Kepler’s rule and I ignore Newton’s laws.
I really don’t see physics and religion necessarily in conflict.
I agree with you. Both physics and religion are professional bureaucracies based on hierarchy and rank held together by authority. They are the same exact thing.
Something about the way that whole Galileo thing went down seems very overwrought to me.
I agree on this too. Physicists turned Galileo into a Newtonian hero and demi-god who prepared the way for the great Newtonian scientific revolution. History says otherwise. Galileo was a human being and a true scientist, not a proto-Newtonian. Galileo was also a deeply religious man. His conflict with the Church has other reasons than the ones repeated in physics textbooks.
I would ask how would you expect physicists to react your arguments?
I believe that I have a lot to learn from physicists. After all, they study these things professionally while I try to steal as much time as possible from work and family to do research. But I am against argument by authority. When physicists say “we are right because Newton’s laws say so” that’s not a scientific argument. Otherwise I welcome any kind of criticism or advice or correction from anybody. I have nothing to sell. I do research for fun and to learn.
This is the type of thing I refer to when I call it polarizing and only helping like minded people agree.
You are right. But why is it polarizing? Only when both parties argue from doctrine there is polarizing.
. . . Newtonian physics did put a man on the moon after all.
Your assumption only proves how established Newtonian propaganda is. “Newtonian physics” did not put a man on the Moon, practical astronomy did. NASA uses nothing discovered by Newton to put spacecraft into orbit. NASA uses their Orbit Determination Program to calculate orbits. This program has over a million lines of code and not one of them refers to Newton’s laws or doctrines. It is all very precise curve fitting into observed orbits.
We are relying on a whole lot of engineers using Newtons ideas to keep bridges or skyscrapers from collapsing on us everyday.
Engineering is not Newtonian. Engineering is a different tradition. Can you list some of the ideas Newton invented that keeps bridges and skyscrapers together? Those things are built by practical engineering formulas and rules that have been developed for over centuries. As far as I know Newton contributed nothing to engineering. There is a proposition in the Principia where Newton attempts to speculate about how to build ships but according to an eminent Newton scholar it is total crap. Newton did not know engineering.
May 23, 2008 at 1:42 pm
Doc
Both putting spacecraft in orbit and reinforcing bridges involve taking seriously a little thing formulated by Newton called gravity. It figures in all their equations. Weight, force, and mass are central concepts in both engineering and aeronautics and I don’t think you will find many building plans that have not been calculated to take such things into account. Acceleration also figures into escaping gravity and going into orbit. Any physicist will readily tell you Newton’s laws of motion are not perfect, but for pretty much all our natural experience, they are good enough at predicting, measuring and describing what we see.
I also think people really do both religion and science a disservice when they try to discredit science by calling it a religion. It only tells me you take religious ideas less seriously than they deserve and that you would rather go on the attack than get into specifics about evidence or what newtonian physics actually is.
I am not so versed in Newton that I care to research out exact equations and laws right now. I am not a physicist and not really all that interested in debate. I readily conceed that, “because Newton says so” is not a scientific argument. My goal is not really to convince you. You have a large body of writing to tell me your mind is already made up, and that’s fine. I am just not sure I see any purpose in your “debunking” any more than I see it in those that will resort to ad hominem attacks in refuting your own ideas.
May 24, 2008 at 5:20 pm
dewey44
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