Archive for the 'medical_science' Category

Novella on Alexander’s Proof of Heaven

Thursday, October 11th, 2012

It’s easy to be superstitious, to believe in mysterious forces beyond our ken that shape the reality we live in. Because there are mysterious forces beyond our ken, and they do shape the reality we live in. But the difference between superstition and actual knowledge is that with actual knowledge, there’s objective evidence that supports the belief. With superstition, it’s just what we want to believe, for whatever reason, bolstered by confirmation bias.

I’ve given up a fair amount of superstitious belief over the last several years, and it makes me kind of a Debbie Downer in discussions involving mystical belief, especially discussions with people I care about. So I mostly don’t discuss those things. Which is an easy course of action for me to adopt, since I’m an off-the-charts introvert whose go-to response in pretty much any social situation that carries a hint of potential conflict is a stony silence. (Or what appears from the outside to be stony. From my perspective, it’s just silence. I guess stones, if they could speak, might have the same complaint.)

Anyway, what I actually wanted to talk about was a recent noteworthy bit of wishful credulity by neurosurgeon Eben Alexander in Newsweek, Heaven Is Real: A Doctor’s Experience With the Afterlife. Alexander was in a coma for 7 days after contracting meningitis. After recovering, he came to believe that he’d experienced a cloud-like realm, a sense of universal love, and another being with whom he conversed, and that he had done so (this part is key) while his higher brain functions were clinically, demonstrably inactive.

Letting the air out of this story is (who else?) neuroscientist, noted skeptic, and man-crush Steven Novella: Proof of Heaven?

While his experience is certainly interesting, his entire premise is flimsily based on a single word in the above paragraph – “while.” He assumes that the experiences he remembers after waking from the coma occurred while his cortex was completely inactive. He does not even seem aware of the fact that he is making that assumption or that it is the central premise of his claim, as he does not address it in his article.

Of course his brain did not go instantly from completely inactive to normal or near normal waking consciousness. That transition must have taken at least hours, if not a day or more. During that time his neurological exam would not have changed significantly, if at all. The coma exam looks mainly at basic brainstem function and reflexes, and can only dimly examine cortical function (through response to pain) and cannot examine higher cortical functions at all. His recovery would have become apparent, then, when his brain recovered sufficiently for him to show signs of consciousness.

Alexander claims there is no scientific explanation for his experiences, but I just gave one. They occurred while his brain function was either on the way down or on the way back up, or both, not while there was little to no brain activity.

It’s not that the world isn’t mysterious. It is. It’s just that our desire to explain the things we don’t understand needs to be grounded in some sort of epistemological framework, one that takes into account things like the well-documented, easily reproducible fact that a human brain, deprived of oxygen or otherwise taken outside the relatively narrow constraints within which it likes to operate, quickly becomes an unreliable narrator.

Kloor, Frauenfelder, and Hiltzik on Attitudes Toward and the Politics of GMO Foods

Wednesday, September 26th, 2012

Keith Kloor has an excellent article at Slate on how scientific denialism is not the exclusive province of the Right: GMO Opponents Are the Climate Skeptics of the Left.

This hit home for me, because I’ve been following this issue for a while. People like Dan Kahan (whom Kloor quotes in his article) have been (gently) taking people like Chris Mooney to task for their willingness to paint science denialism as a conservative-specific thing.

It also was kind of depressing for me to see how Mark Frauenfelder at Boing Boing, a site I like a lot (obviously, since I repost stuff from there all the time) was willing to run a really propagandistic piece attacking the No on 37 campaign (the campaign to defeat California’s Proposition 37, which would require labeling of [some] genetically modified food). It especially saddened me to have a couple of comments (including my own) that I think were quite civil and reasonable, but criticized Fraunfelder for doing that, quietly deleted from the comments there.

Anyway, links for that stuff:

The thing that bugged me about Frauenfelder’s original piece, even after he updated it to acknowledge that the “GMO corn gives rats tumors” study was problematic, was the glib way he seemed to assume that by simply looking at the budgets and list of donors on either side of the Proposition 37 campaign, he could determine which side was the Good Guys and which were the Bad Guys. Here’s what he said:

When I visited the site I was impressed by processed food conglomerates’ desperation to defeat this bill. Monsanto is one of the corporations spending money to defeat 37 (According to Yes on 37, Monsanto, DuPont, Bayer, Dow, BASF and Syngenta have donated $19 million to No on 37).

Big food companies are indeed pushing to defeat Prop 37. And somewhat smaller organic food companies are pushing to pass it. In each case, the financial incentive of the people trying to influence the outcome is clear. But the reality of whether GMO foods are, in fact, dangerous, and whether the public interest will be served by mandatory labeling, has nothing to do with how you feel about the companies that stand to profit if the measure passes or fails. It’s a scientific question, and it’s true or not based on how the universe actually works.

Michael Hiltzik had a good piece about this in the LA Times last week: Prop. 37: Another example of the perils of the initiative process.

ragnar kjartansson’s Ég Anda Video (Sigur Rós)

Monday, June 18th, 2012

I didn’t buy valtari (the new Sigur Rós album) until a few weeks ago. I’m not sure why I waited, but I’m glad I finally broke down, because it’s wonderful.

The band has commissioned a series of low-budget videos with the directors having complete creative control. Here’s the first one to be released. It’s by ragnar kjartansson, for the track Ég Anda (I Beathe):

Awesome Sigur Rós music and an important safety message! Cool!

Novella on Lehrer on the Decline Effect

Sunday, December 19th, 2010

Recently-acquired mancrush Jonah Lehrer had a cool article in the New Yorker recently: The Truth Wears Off (PDF of the otherwise-paywalled full article). It concerns something called “the decline effect”, which seems to afflict a broad range of scientific pursuits. In a nutshell, a new and exciting discovery is announced. Other scientists replicate it, and confirm that yes, the effect appears to be real. But then, over time, a curious thing happens: The magnitude of the measured effect begins to decline in subsequent studies. It’s almost as if, as Lehrer puts it in his title, the truth “wears off.”

Several of the scientists Lehrer spoke to for his article were uncomfortable being quoted. The decline effect calls into question some of the fundamental underpinnings of the objective, science-y stuff to which they have devoted their lives. The article apparently has been somewhat controversial; witness the cranky review given to it by my other recent mancrush, Steven Novella: The decline effect.

Novella quotes Lehrer’s conclusion (somewhat out of context), and rants on a bit:

And this is why the decline effect is so troubling. Not because it reveals the human fallibility of science, in which data are tweaked and beliefs shape perceptions. (Such shortcomings aren’t surprising, at least for scientists.) And not because it reveals that many of our most exciting theories are fleeting fads and will soon be rejected. (That idea has been around since Thomas Kuhn.) The decline effect is troubling because it reminds us how difficult it is to prove anything. We like to pretend that our experiments define the truth for us. But that’s often not the case. Just because an idea is true doesn’t mean it can be proved. And just because an idea can be proved doesn’t mean it’s true. When the experiments are done, we still have to choose what to believe.

This paragraph sums up what I was describing above – Lehrer is ultimately referring to aspects of science that skeptics have been pointing out for years (as a way of discerning science from pseudoscience), but Lehrer takes it to the nihilistic conclusion that it is difficult to prove anything, and that ultimately “we still have to choose what to believe.” Bollocks!

I find Novella’s relatively impassioned response to Lehrer really interesting. Rather than simply acknowledging that Lehrer, as a writer selling copies of the New Yorker, faces a different set of contingencies with respect to hyperbole and colorful language than does, say, a neuroscientist selling science-based medicine, Novella really goes for it, taking Lehrer’s statements way past the point where I, at least, think he intended them to be taken, erecting a strawman he can then knock down. Novella talks past much of Lehrer’s argument, ignoring those points where Lehrer offers explanations for the decline effect. For example, Lehrer talks about the too-human fallibility of scientists chasing significance, and the problem of a publication and review process that rewards the dramatic and “interesting” result, which at first is the result that demonstrates a new and hitherto unrecognized effect, but eventually becomes the result that undercuts the now-established wisdom.

Lehrer writes:

The problem of selective reporting is rooted in a fundamental cognitive flaw, which is that we like proving ourselves right and hate being wrong. “It feels good to validate a hypothesis,” Ioannidis said. “It feels even better when you’ve got a financial interest in the idea or your career depends on it.”

I thought about this dispute while listening to D.J. Grothe’s recent interview with paranormal investigator Joe Nickell. Nickell is a skeptic, as is Novella, but his approach impresses me more than Novella’s. Nickell recognizes that the things he’s researching are almost certainly bunk, but he doesn’t just rant (as Novella too-frequently does on the otherwise-awesome podcast he heads up, the Skeptic’s Guide to the Universe) about what delusional fools paranormal believers are. Instead, Nickell wants to know what’s really going on. It’s easy (and probably satisfying, on some level) to just cry “Bollocks!” when confronted by belief in something that flies in the face of the best evidence. But what Nickell emphasizes in his interview is that to stop at that point is to miss out on the opportunity to solve the real mystery. So Nickell investigates, in the sense that he actually goes to the site of the latest “haunting” (or whatever), listens to the witnesses with as open a mind as he can muster, and digs until the truth emerges.

As Doyle’s Holmes pointed out in “A Scandal in Bohemia”:

It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.

Novella is quick to dismiss Lehrer’s article — too quick, I believe. There’s something there, and it’s worth taking a look at. But someone who believes he has the answers already, and is driven by an apparent need to denigrate those who believe differently, is going to be unlikely to do much looking.

How Do You _Know_?

Wednesday, December 1st, 2010

A word I like to throw around (especially when someone believes something different than what I believe) is epistemology. That’s the branch of philosophy that deals with the theory of knowledge, or how it is that we know what we know. When I think about epistemology I tend to think about the operation of my prefrontal cortex, as it carries out the so-called “executive function” of my brain: The evaluation of information gathered by the senses (these days, often via the distance-shrinking “perception engine” of the Internet), the use of logic, the rational weighing of evidence, and so on. There is also bias, including the predisposition to believe certain things because they match my a priori belief (see confirmation bias), but here I assume we’re still talking mostly about the prefrontal cortex.

But there is another aspect of knowledge that I too-frequently ignore. That’s the feeling of truth, the sense of certainty that accompanies knowing something. Here I suspect we’re moving beyond the prefrontal cortex into evolutionarily older structures. Where does that feeling come from?

An interesting disorder that may shed some light on this is prosopagnosia, or “face blindness”, in which a person has an inability to recognize faces, even if their ability to perceive the specific differences between one person’s face and another’s remains intact. Even more interesting (at least to me) is the somewhat-related disorder called the Capgras delusion, in which a person becomes convinced that someone they know well (like a close relative or loved one) has been replaced by an identical-looking stranger. In an NPR story from earlier this year (Seeing Impostors: When Loved Ones Suddenly Aren’t), Jad Abumrad and Robert Krulwich spoke with neuroscientist V.S. Ramachandran about a possible explanation for the Capgras delusion:

According to Ramachandran, when we see someone we know, a part of our brain called the fusiform gyrus identifies the face: “That looks like mom!” That message is then sent to the amygdala, the part of our brains that activates the emotions we associate with that person. In patients experiencing Capgras, Ramachandran says, the connection between visual recognition and emotional recognition is severed. Thus the patient is left with a convincing face — “That looks like mom!” — but none of the accompanying feelings about his mother.

Ramachandran holds that we are so dependent on our emotional reactions to the world around us, that the emotional feeling “that’s not my mother” wins out over the visual perception that it is. The compromise worked out by the brain is that your mother was somehow replaced, and this impostor is part of a malevolent scheme.

I see this as tying in with Justin Barrett’s notion of a Hyperactive Agency Detection Device. The idea is that humans have evolved to experience a deep-rooted, powerful sense of “agency” when perceiving certain kinds of phenomena, and (this is important) to do so even in cases when there is no agent. As just one example, in evolutionary terms it may have been beneficial for us to believe that that rustle in the bushes was a large, hungry predator stalking us, rather than the wind, and to believe that viscerally, on an emotional level, rather than treating it as a passing supposition that we might or might not be bothered to act upon. The energy our ancestors wasted by overreacting to windblown leaves was more than made up for, the theory goes, by the survival benefit conferred by being hyperalert to actual threats.

Having evolved this generalized mechanism for “knowing” things that are not necessarily so, we now experience all kinds of interesting consequences: A propensity to believe that the universe was created specifically for us by an imaginary, omnipotent being or beings. A belief that intelligent aliens from other worlds are kidnapping people, taking them aboard invisible spaceships, and subjecting them to anal probes. A belief that some dramatic, emotionally traumatic event (the assassination of John F. Kennedy, the 9/11 attacks) must have been the result of a conspiracy in which our own government was complicit. For a significant subset of the population, these and other conspiracy theories are not merely things that they suspect. They are things that they know.

Jonah Lehrer blogged yesterday about a recent study examining the role of a brain structure called the insula in mediating between physical sensations (like the feeling of warmth or cold one receives from holding a hot or cold object) and a willingness to extend trust to a trading partner: Trust and temperature. I especially liked this part:

We like to see ourselves as Promethean creatures, mostly liberated from this sack of meat we have to carry around for support. (John Updike, as usual, said it best: “We think we are what we think when in truth we are upright bags of tripe.”) But what the insula and these studies of embodied cognition demonstrate is that our mind is impossibly intertwined with carnal changes we can’t explain or comprehend.

I know what I know because my rational mind has analyzed facts and evidence, sure. But that’s not the whole story. The sensations delivered to me by my body — by chemical cues, sensations of warmth and cold, and the murky actions of older, deeper mechanisms that reach me as visceral emotions — play a large part. Perhaps the major part.

I just know it.

Novella on Germ Theory Denial

Friday, November 5th, 2010

Man-crush Steven Novella writes awesomely on germ theory denial:

Denialism is always fascinating – the bold-faced denial of facts that are fully in evidence and easily verifiable. It is a testament to the profound psychological effect that ideology can have on the human brain, and the mechanisms by which it is maintained. And before we wax too self-righteous as skeptics in this regard, we must always remember that we are all susceptible to these psychological mechanisms. We are all human. That is precisely why we need the rigorous, transparent, and self-critical process of science to sort through complex questions such as disease and immunity.

I’m stealing his conclusion here, but the whole thing is very much worth reading.

Steven Novella on the Unreliability of Memory

Wednesday, September 15th, 2010

Skeptic and actual neuroscientist (and target of the previously mentioned intellectual mancrush) Steven Novella has an interesting writeup of some recent research demonstrating the frailty of human memory: More Evidence Our Memory Stinks.

Our memories are not an accurate recording of the past. They are constructed from imperfect perception filtered through our beliefs and biases, and then over time they morph and merge. Our memories serve more to support our beliefs rather than inform them.

Penn & Teller vs. the Antivaxxers

Monday, August 30th, 2010

I’ve got a bit of an obsession with skepticism lately, so let’s keep rolling. Courtesy Phil Plait (who, by the way, has a new TV show), comes word of this cool clip that I assume is from the latest episode of Bullshit! (I don’t get Showtime): Penn and Teller take on vaccines:

Update: Some followup items inspired by Knarly’s comments in the comments:

Steven Novella on Hyperactive Agency Detection

Monday, March 22nd, 2010

Remember my new man-crush, neuroscientist and skeptic Steven Novella? He’s got a great item on his NeuroLogica blog today: Hyperactive Agency Detection.

When HADD is triggered and we think we see the hidden agent, it speaks to us in a very primal way. For some people the perception of hidden agency becomes overwhelming, dominating all other thought processes. We know these people as conspiracy theorists. But there is a little conspiracy theorist inside each of us.

He talks about the evolutionary underpinnings of humans’ tendency to partition the world into two classes of entities — agents and objects — and the possible role this may play in our collective tendency toward conspiracy theories and religion.

Telegenic Blondes

Friday, February 5th, 2010

Jenny McCarthy believes that MMR vaccines’ preservatives caused her son to be autistic, and that her changing his diet cured him. She has written best-selling books in which she advances these claims, and appears in front of millions of TV viewers at every opportunity to make the case. And apparently a lot of parents believe her, such that vaccination rates have fallen in the US, and lots of babies (including those whose parents choose to vaccinate them, based on information obtained from more credible sources than former Playboy models and TV personalities) are at increased risk as a result.


It’s not that complicated. There’s this thing called science. And it has a specific process you go through to evaluate claims like this. And the scientists have done it. And Jenny McCarthy is wrong.

There was a decent op-ed by Michael Fumento in the LA Times this morning talking about this: The damage of the anti-vaccination movement. So go read that, even though it will probably make you angry. And if it doesn’t, I bet this will:


Anyway, if I’m going to subject you to telegenic blondes trying to indoctrinate you with their views about science, let’s close on a more positive note: ZOMGitsCriss on the evidence for evolution:

Jobs Undergoes Radical Shrinking Procedure…

Friday, January 29th, 2010

…but gets to keep his iPhone.

(Lucy’s joke, not mine. But I thought it was funny when she tweeted about that.)

USA Today: Are celebrities crossing the line on medical advice?

Wednesday, December 23rd, 2009

From USA Today: Are celebrities crossing the line on medical advice?

In her book Mother Warriors, McCarthy, who declined to be interviewed for this story, says she learned about autism from “the university of Google.”

Explaining complex science – especially in the few minutes allotted on a TV program – is challenging, Carroll says. Audiences sympathize with McCarthy, who says she doesn’t need science because she observes her son, Evan, every day. “At home,” she writes, “Evan is my science.”

“How can you argue with that?” Carroll asks. “It’s her child. It’s her body. They win.”

This really gets to the heart of what worries me about what I’ve taken to calling “The Perception Engine.” We’ve entered an era in which the distance between a human mind and the confirming (or disconfirming) information that would support (or undercut) a pet theory is essentially zero. Just as previous generations amplified their muscle power with steam and the internal combustion engine, we’ve amplified our senses. How will we use this newfound power? Will there be a flowering of reason and understanding? Or will a thousand conspiracy theories bloom, as people give in to the lure of confirmation bias?

Both, it sounds like.

Audiovisual Commentary on Healthcare in the US

Sunday, August 30th, 2009

I really enjoyed the Fresh Air interview with T.R. Reid, author of The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. He does a good job of cutting through the B.S.

So does Kevin Drum, in Back to Basics:

Let’s recap: the United States spends about twice as much on healthcare as any other developed nation in the world and in return receives just about the worst care. Can someone remind me again why there’s even a debate about whether we should put up with this?

Finally, as I think about a good friend of mine who’s currently in the hospital, I keep hearing Matthew Good’s “99% of Us Is Failure”. Here’s a live solo version:

Obama on the Healthcare ‘Debate’

Sunday, August 16th, 2009

Apologies for leaving adrift in the waves of outrage washing back and forth from the folks who get their healthcare-reform information from the likes of Sarah Palin and Glenn Beck. There have been lots of high-profile lies I could have been commenting on, but Cheney-like, I had other priorities.

And look, along comes the Debunker-in-Chief to summarize the grownup response to all the silliness, and save me the trouble of running after every little bit of crazy, in today’s NYT Op-Ed: Why We Need Health Care Reform.

Downtowner’s Health Insurance

Wednesday, July 8th, 2009

Daily Kos: How I lost my health insurance at the hairstylist’s.

Stemwedel on Elsevier and Merck’s Fake Medical Journal

Monday, May 4th, 2009

Janet D. Stemwedel talks about the recently uncovered case of pharmaceutical giant Merck paying publisher Elsevier to produce a fake medical journal:

Clearly putting together something that looked like a medical journal and that contained articles (and excerpts from articles) that had only good things to say about Merck products reflects an intent to deceive. A real medical journal, one would assume, contains articles that have been scrutinized by scientists who are concerned to uphold standards of evidence and sound scientific reasoning. Peer review by experts lets the consumer of the articles in the journal regard the articles as legitimate contributions to a body of scientific knowledge. Moreover, real medical journals consider manuscripts examining the safety and efficacy of drugs from a number of competing manufacturers, and, presumably, manuscripts reporting problems with drugs, not just successes with them.

Australasian Journal of Bone and Joint Medicine was a fake journal. But, because it was put together to look like a real one, it was intended to capitalize on the credibility that articles in a real medical journal would command.

Merck, obviously, crossed an ethical line here. So did publisher Elsevier.

Mark Hoofnagle on Autism, Vaccines, and Conspiracy Theories

Tuesday, February 10th, 2009

From Mark Hoofnagle, writing at the Denialism Blog: the autism/vaccines fraud.

It is obvious to me that no matter what the field, the problem is crankery – the defective thought processes that allow people to believe in nonsense, no matter what obstacles reality throws in their path. Every description of every crank in every field ultimately boils down to these same factors. Cranks believe in something contrary to observable reality. They will do anything to prove it. When reality gets in their way, they ignore, subvert, lie, cheat, or obfuscate to create confusion. And when it’s proven beyond all doubt they’re wrong? That’s when the conspiracies come out.

Drum on Dunning-Kruger

Friday, June 22nd, 2007

In a postscript to an item on Giuliani’s lack of foreign policy expertise, and Giuliani’s simultaneous belief that he alone is competent to handle the demands of 21st-century foreign policy, Kevin Drum offers the following interesting aside (from Commander in Chief):

By the way, the academic name for this is the Dunning-Kruger Effect [PDF download]. Impress your friends by knowing this! Dunning and Kruger, in a famous series of tests, found that “Incompetent individuals, compared with their more competent peers, will dramatically overestimate their ability and performance relative to objective criteria.” Also: “They will be less able than their more competent peers to recognize competence when they see it – be it their own or anyone else’s.”

I tend to view Bush’s pattern of behavior as willful disregard, an intentional act of denigrating real competence due to his own emotional need to deny his inadequacy. But I guess it could just as easily, or more easily, be explained as a completely unconscious process on his part. He might really just believe that he’s competent, and that the toadies he hires based on their willingness to accept and repeat that fiction are also competent. Which doesn’t really change anything in a fundamental way; he’s still an incredible doofus, and a menace to the country as long as he and the people he empowers retain their authority. But the realization might be helpful to me in getting past being really, really pissed off at the guy.

Phony Doctor Gives Free Breast Exams

Thursday, April 20th, 2006

From Reuters: Phony doctor gives free breast exams.

MIAMI (Reuters) – A 76-year-old man claiming to be a doctor went door-to-door in a Florida neighborhood offering free breast exams, and was charged with sexually assaulting two women who accepted the offer, police said on Thursday.

One woman became suspicious after the man asked her to remove all her clothes and began conducting a purported genital exam without donning rubber gloves, investigators said.

Meyerson: Bush the Incompetent

Sunday, January 29th, 2006

If you know anything about, you know I could not pass up a headline like this. From WaPo op-ed columnist Harold Meyerson: Bush the Incompetent.

It’s the president’s prescription drug plan (Medicare Part D), though, that is his most mind-boggling failure. As was not the case in Iraq or with Katrina, it hasn’t had to overcome the opposition of man or nature. Pharmacists are not resisting the program; seniors are not planting car bombs to impede it (not yet, anyway). But in what must be an unforeseen development, people are trying to get their medications covered under the program. Apparently, this is a contingency for which the administration was not prepared, as it has been singularly unable to get its own program up and running.