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Nine Breakthroughs and a Breakdown

In his new book Breakthrough! How the 10 Greatest Discoveries in Medicine Saved Millions and Changed Our View of the World Jon Queijo describes what he believes are the 10 greatest discoveries. 9 of them are uncontroversial discoveries that have been on other top-10 lists, but his 10th choice is one that no other list of top discoveries has ever included. He realizes that, and even admits in his introduction that a former editor of The New England Journal of Medicine refused to review his book because there is no such thing as alternative medicine, only treatments that work and treatments that don’t. But he “respectfully disagrees.”

Hippocrates’ discovery that disease had natural causes, sanitation, germ theory, anesthesia, X-rays, vaccines, antibiotics, genetics, and treatments for mental disorders are all worthy candidates for the list. But Queijo ludicrously lists the “rediscovery of alternative medicine” as the tenth “great discovery.” He presents no evidence (because there is no evidence) that alternative medicine has “saved millions” or that it has saved anyone. He doesn’t realize that alternative medicine represents a betrayal of exactly the kind of rigorous scientific thinking and testing that led to all the other discoveries. His list of ten breakthroughs is actually a list of 9 breakthroughs and one breakdown.

He tells compelling human-interest stories about the discoveries. The complexities, the mis-steps, the near-misses, and the ups and downs make fascinating reading. He describes farmer Benjamin Jesty leading his wife and children on a two mile trek through the fields in 1774 to steal cowpox pus from a neighbor’s cow and inoculate his family with a sewing needle to protect them (successfully!) from smallpox. He describes the many chance events that had to conspire for Fleming to see the effects of mold on his culture plate and the long, tortuous course between his observation and the therapeutic use of penicillin. He tells how the pea-gardening monk Gregor Mendel’s discovery of genetic principles went unrecognized until decades later after 3 other researchers had unknowingly replicated some of his experiments.

He offers fascinating tidbits of historical information. Anti-vaccine activists are nothing new: he tells how they sabotaged the use of an early typhoid vaccine in the Boer War by such tactics as dumping vaccine shipments overboard from ships. As a result, the British Army suffered more than 58,000 cases of typhoid and 9000 deaths.

He recounts Roentgen’s early comments about his discovery of x-rays:

I still believed I was the victim of deception.

I have discovered something interesting, but I do not know whether or not my observations are correct.

Before he announced his discovery, he studied the characteristics of the rays, investigating whether they could penetrate various materials or be deflected by a prism or a magnetic field. One can only wish that today’s students of “energy medicine” would employ his cautious, self-questioning, and scientifically rigorous approach!

My favorite was a delightful anecdote about Thomas Edison: in the early days after the discovery of x-rays, Edison received two requests in the mail, one from an apparent voyeur asking him to fit a set of opera glasses with x-rays and the other asking him to

Please send me one pound of X-rays and bill as soon as possible.

There are hints of trouble before we get to the chapter on alternative medicine. Queijo claims that one of Hippocrates’ accomplishments was to believe that respect for a higher power was a necessary precondition for good health. What does that even mean? Why would it be important? He offers no evidence that such respect has ever saved lives or had any positive effect on medical practice.

In the chapter on genetics, he starts by describing the ancient superstition that “maternal impressions” could affect the development of the fetus: for instance, after watching a fire, a woman delivered a baby with a flame-shaped birthmark. He demolishes that possibility with a reasoned discussion of genetic principles and DNA. But then he inexplicably cites a modern study by Ian Stevenson, who holds a number of strange beliefs, is convinced he has solid evidence proving reincarnation, and could be classified as a maverick if you wanted to be polite. Stevenson collected a number of case reports and opined that

In rare instances maternal impressions may indeed affect gestating babies and cause birth defects.

Queijo agrees with him, saying

In the brave new world of genes, nucleotides, and SNP’s it’s easy to dismiss such mysteries as playing no role in the inheritance of physical traits — no more than, say, DNA was thought to have for 75 years after its discovery.

He’s wrong: Stevenson did not find any “mysteries” but merely the kind of coincidences that will be inevitably found if you look hard enough for them.

In the chapter on alternative medicine, Queijo loses it entirely. He seems to think that modern medicine has become so fixated on diseases and technology that alternative medicine had to rediscover that diseases occur in people. He criticizes the reductionism of the scientific approach, but offers no evidence that a non-reductionist approach has ever resulted in discoveries or provided better patient outcomes. He sees the struggles between scientific medicine and alternative medicine as politically motivated turf wars rather than as efforts to establish the truth. He claims that by 1998, Americans were seeking alternative care practitioners more often than their own primary care physicians. If this is true, offering that statement without qualification would be misleading to say the least. Anyway, popularity is no guide as to what treatments work.

He accepts homeopathy uncritically and even suggests that it is now supported by science. He likes the idea of homeopathy because it “shares some underlying values seen in ancient traditional medicines” such as vitalistic energy concepts, detailed interviews to inquire into every detail of the patient’s life, stressing the healer-patient relationship, and deriving many of its remedies from natural products.

He says,

Alternative medicine offered something Western medicine had too often abandoned: the view that every patient was an individual, that natural treatments were sometimes better than dramatic surgery and dangerous drugs; and that the essence of medicine begins with a caring relationship between healer and patient.

This is a straw man argument that badly mischaracterizes mainstream medicine, and it fails to show that alternative medicine has any advantage over scientific medicine practiced with judgment and empathy. If every patient is an individual and the whole person should be treated, why do chiropractors fixate on adjusting spines and acupuncturists fixate on improving the flow of qi through meridians?

He even goes as far as to accuse the stethoscope of being a nefarious device that distances practitioners from patients! He calls its invention “a dark omen for the terrible turn Western medicine was about to take.” Now, really!

Much of this book is an eloquent paean to the value of science. Unfortunately, it abandons science in its discussion of alternative medicine. It deteriorates into apologetics for belief-based medicine based on misunderstandings and opinions rather than on any evidence. Alternative medicine represents a breakdown of the process that led to the real breakthroughs.

If you read this book, I recommend skipping chapter 10.

Posted in: Book & movie reviews, History, Science and Medicine

Leave a Comment (105) ↓

105 thoughts on “Nine Breakthroughs and a Breakdown

  1. daijiyobu says:

    Wow. It’s just amazing how sCAM as a subject is like a stealth aircraft when it comes to analysis overall: it simply turns off all critical faculties and then it can do what it wants, say what it wants, claim what it wants.

    Mackay published “Extraordinary Popular Delusions and the Madness of Crowds” in 1841 in which he wrote:

    “Men, it has been well said, think in herds; it will be seen that they go mad in herds, while they only recover their senses slowly, and one by one.”

    Perhaps this book by Queijo can be regarded as:

    “9 Great Medical Discoveries and One Horrid Fiction / Crowd Delusion Slipping Under the Analysis Radar.”

    I highly suggest also posting a short review at Amazon.com, as their reviews are highly placed in Googe’s rankings.

    -r.c.

  2. David Gorski says:

    How can this guy hold such contradictory views without his brain exploding?

  3. weing says:

    Thanks for the review. I think I’ll skip the book. I don’t want to support nonsense like this with my money. His criticism of western medicine is more of an indictment of the delivery of health care. This has more to do with government regulations, legal and economic realities, and insurance company constraints.

  4. The Dicklomat says:

    It sounds like he wrote the book in order to promote SCAM via misleadingly associating it with the best successes of scientific medicine. “Wow, those other nine things are great so this one must be just as good”. Very sneaky.

  5. TsuDhoNimh says:

    Queijo claims that one of Hippocrates’ accomplishments was to believe that respect for a higher power was a necessary precondition for good health. And where in the writings of Hippocrates does that appear? Hippocrates specifically rejected divine origin of diseases, including the “sacred” nature of epilepsy.

    He even goes as far as to accuse the stethoscope of being a nefarious device that distances practitioners from patients! I’m sure I want to revert to the cuddly, old-fashioned technique of ear to naked chest.

  6. Reporting as a retired alt-med practitioner, I can tell you that nearly all of my former colleagues are hung up to some degree on this fiction that doctors are cold and arrogant and stubbornly refuse to consider the “whole person.” Conflation of “the system” with “doctors” is pretty much universal.

    The propaganda didn’t take with me because I actually know some real, live doctors … and they are compassionate, humble and certainly interested in the “whole” patient. I particularly lucked out because I had an especially good GP during my 3-year training to be a massage therapist, and that dude was a walking, talking contradiction to the evils-of-allopathy theme. I always came away from his office a little bit startled by his intelligence and decency, because it was glaringly obvious that he was extremely different from the alt-med caricature of a doctor.

  7. cervantes says:

    It is true that most physicians care about their patients and try to understand them as people and in their social context. I say most, not all. (I study physician-patient communication for a living and I have read hundreds of transcripts of clinical encounters.) However, physicians’ training is almost exclusively biomedical, and they are taught interviewing mostly as an instrumental process to elicit information according to their own priorities. Primary care visits are probably too short — they haven’t actually gotten shorter, as many people think, but the increasing complexity of medicine, an aging population, and piling up of screening and prevention guidelines, etc., makes the typical 15 minute visit seem shorter.

    M.D.s aren’t necessarily good at listening, they don’t take kindly to patients who are nonadherent or question their recommendations, and often don’t bother elicit the reasons but just lecture and scold people. True! I have the evidence. They do this because they care and they want the patient to do what they believe will achieve the best outcome but a) the tactic doesn’t usually work and b) it’s one reason why some people go to other practitioners who they find less intimidating and judgmental, and who have more time for them.

    Lots of people just need to talk and unburden themselves, and docs don’t always have time to listen or much of anything to offer when people are in distress. They also don’t realize how little people understand or remember of the information they provide, which they often spout in impenetrable form. Then they just say, “Do you understand?” which is the most useless phrase in any language. Of course the person says “yes,” but that has no relationship to whether or not they understand whatsoever.

    So there are real issues here which should not be dismissed.

  8. rosemary says:

    “Alternative medicine offered something Western medicine had too often abandoned:”

    Western medicine? As in chopsticks belong to the Chinese and Japanese cultures and scientific medicine belongs to European cultures? I think not. I think that there are and, since the advent of scientific medicine always have been, fine scientists and MDs of many different ethnic backgrounds practicing scientific medicine in all cultures and that it is erroneous and insulting to claim otherwise.

    Alternative medicine is pre-scientific medicine and was practiced by all of our ancestors no matter what culture they were born and raised in. It was pulled out of the garbage pail that contained what rigorous studies showed to be useless and dangerous “remedies” and “therapies” by people, who I would guess but am not certain were of European descent, with romanticized views of the past who deluded themselves into believing that they had discovered cheap, easy, solutions to complex problems. They repackaged and relabeled the useless and dangerous things sometime around the 1990s and called them “alternative medicine”. AM quickly spread all over the world although as it became apparent that it was useless, it was soon transformed into CAM. Now it is used as “insurance” – just in case it works – and to make people happy only they don’t say “happy”. They say “healthy”.

  9. wales says:

    DG said “How can this guy hold such contradictory views without his brain exploding?”

    I recommend reading “Opposable Mind: Winning Through Integrative Thinking” by Roger Martin (Harvard Business Press, 2009)

    Martin states that “the human brain’s ability “to hold two conflicting ideas in constructive tension”-is an intellectually advantageous evolutionary leap through which decision-makers can synthesize “new and superior ideas.”

    This echoes F. Scott Fitzgerald’s quote “The sign of a first-rate intelligence is the ability to hold two opposing ideas in the mind at the same time and still retain the ability to function”.

    Queijo’s book sounds interesting, if I do read it, I will not “skip chapter 10” Thanks, but I prefer not to censor my reading (nor have it censored for me).

  10. brilyn says:

    @Wales

    “Queijo’s book sounds interesting, if I do read it, I will not “skip chapter 10” Thanks, but I prefer not to censor my reading (nor have it censored for me).”

    It’s not being censored, you are being given a recommendation against reading it. Learn the difference between ‘censorship’ and ‘recommendations against’. It’s not a small one.

    Personally, I prefer to read as little crap as I can, and I welcome Dr. Hall’s attempt to filter some out for me.

  11. wales says:

    “crap” is a subjective judgment. I prefer to make my own judgments.

  12. cloudskimmer says:

    Dr. Hall: thank you for a great review; it’s good to see that you posted one at Amazon, which will hopefully make people think before buying the book. Whenever I read something like this on SBM, I’d like to know what the target would think about it. You raise many important issues, and the author should be able to respond. Some authors have websites, but that doesn’t seem true of Jon Queijo. The bio I found is minimal but calls him a senior medical writer for “Total Learning Concepts,” which is “a leading provider of pharmaceutical and biotech sales training.” As an author with a new book, I hope he notices your review and comes over to this website to explain to us why he abandoned science and logic in the last chapter.

    DG & wales: The best book I’ve seen for how you can hold two contradictory thoughts in your head without it exploding is Deborah Tannen’s book “Mistakes Were Made (But Not By Me)” all about cognitive dissonance. It isn’t hard; we all do it every day, and it’s hard to avoid.

    It sounds like Mr. Queijo was writing a book largely about the past and wanted to bring in something modern to top it off. Sadly, he chose something which is neither pioneering, nor medicine.

  13. weing says:

    ““crap” is a subjective judgment. I prefer to make my own judgments.”

    Smell is enough for me. I don’t need to step in it nor to taste it to know.

  14. wales says:

    Brilyn said “Learn the difference between ‘censorship’ and ‘recommendations against’. It’s not a small one.”

    One dictionary definition of “censor” is a person who examines materials (publications or films) for objectionable matter. The dictionary doesn’t explain what that person does with the “objectionable matter”, presumably destroys it or recommends against it. My point is that we are all intelligent, educated adults and it is unnecessarily patronizing to recommend that readers avoid what one reviewer found to be “objectionable” in a book. What is “objectionable” to one is “interesting” or “thought provoking” to another. Enough said on that topic.

    Cloudskimmer: I too was interested in learning more about Jon Queijo. Elsewhere I find a bio stating that in addition to the former position you mentioned he was a Senior Medical Writer at New England Journal of Medicine’s Weekly Briefings.

    I have read some of Tannen’s books, she focuses on gender issues in communication. The book you mentioned appears to be written by Carol Tavris and Elliot Aronson, not Tannen, about why we justify our mistakes. That was not my point at all about the ability to hold opposing ideas in mind. My point was about the ability to use cognitive function to reconcile apparent paradoxes, or find creative synthesis between opposing ideas, especially in complex decision making situations.

  15. Harriet Hall says:

    Wales said, “I prefer to make my own judgments.”
    Fine, but that makes me wonder why you would bother to read book reviews. What would be the point of reviewing a book if the reviewer didn’t offer judgments?

    Cloudskimmer,
    I notified the PR person who sent me the review copy that I had reviewed the book here. I’m assuming she will notify the author, and of course he is welcome to respond.

  16. weing says:

    I think the author is doing it for the money. He wants to market his book also to the believers in CAM. He can say the NEJM refused to review his book and claim he is an underdog fighting the man.

  17. Geekoid says:

    @Wales – You pick the definition for the job title of censor then twist it to your own little, and incorr3ect, presumption.
    A censor reviews material and my dictate which part, if any, violates existing standards.

    When the person clearly wrote ‘censorship’. A review of a book, even a negative one, is in no way censorship. It is simple rendering an opinion. IN the case an opinion with a detail explanations and examples of why the review didn’t like the book.

    “..it is unnecessarily patronizing to recommend that readers avoid what one reviewer found to be “objectionable” in a book.”

    No it is not patronizing. It’s the point of a review.

    With all recommendation, there needs to be a level of trust. I choose to think that Harriet Hall statements about what is in the book is accurate. I think this for two reasons:
    1) History. I have never seen her intentional state something that is wrong, or lie about it.

    2) Risk/Ramifications. If she lies about it, even by taking something out of context, she will be called out by many critics who believe wishful thinking is a valuable medical modality.

    What next? you going to read a review of Iron Man and then write a post about how you hate Superhero movies?

    “Enough said on that topic.”
    Typical of people who have no real argument.

  18. squirrelelite says:

    Wales,

    It’s good to have confidence in your own judgment, to examine the original sources, and arrive at your own conclusions.

    But, none of us have enough time to try everything, so we have to occasionally rely on other sources that we respect and trust to help us do at least an initial round of filtering.

    For instance, I’ve seen enough of my sons’ playing Halo III to know that I probably don’t have enough time to spend to get into it to the level needed to enjoy it.

    I don’t get to watch real movies in a real theatre very often now, so I take advantage of other sources to pick one that seems likely to be interesting and entertaining.

    On movies, by the way, did you happen to watch Expelled when it was out? If so, what did you think of it?

    I usually like to get a second or third opinion if possible, so I’ll be curious what you think of Breakthrough! How the 10 Greatest Discoveries in Medicine Saved Millions and Changed Our View of the World, by Jon Queijo.

  19. weing says:

    “For instance, I’ve seen enough of my sons’ playing Halo III to know that I probably don’t have enough time to spend to get into it to the level needed to enjoy it.”

    I play Halo ODST everyday but my son still beats me.

  20. squirrelelite says:

    weing,

    Happy FPS-ing!

  21. “He even goes as far as to accuse the stethoscope of being a nefarious device that distances practitioners from patients!”

    Gosh, I admire the stethoscope. It’s how my asthma was diagnosed and how my doctor can tell when it’s flaring up. And, I kinda like a little distance when I’m coughing and breathing deeply, thanks. :)

    But I have a follow-up question for Dr. H and commenters. Once you’ve nixed alternative medicine, what would your #10 spot be?

  22. Zoe237 says:

    Huh, sounds like an interesting book. Does anybody have a better one on the history of medicine? I wouldn’t buy it, but I might borrow it from the library. I doubt I could quite trust anything the guy says though if he buys into homeopathy.

  23. JMB says:

    Jon Queijo has judged progress in medicine using the criteria of what he seeks in medical care. Others who seek medical care seek it for different reasons. Those who provide medical care will tend to use the success they observe as the criteria. They are obviously all different criteria.

    Although by no means an all inclusive classification, I would venture 3 classes of those reasons that people seek medical care.

    1. Example, “I twisted my ankle and can’t walk on it, what can you do?” There are those that have a problem and simply want it fixed. Science based medicine is optimal for this type of patient. However, science based medicine will succeed a certain percentage of time, and we cannot tell a patient before all is completed, if they will be in the group of patients who receive a benefit. There is a gap between the science of medicine and the art of medical practice.

    2. Example, “I want an MRI of my ankle!” There are those who have heard or read about a certain treatment or test, and want to receive it. You can differentiate greed, fatigue, or defensive medicine from science based medical principles by how long the doctor is willing to argue with the patient before giving in to the request. Medicine can succeed in giving the patient the test or treatment. That’s simply a matter of economics.

    3. Example, “I was rushing to the store when I tripped getting out of my car. My leg turned sideways and I went down hurting my ankle. I almost hit my head! My arm is a little sore, too. I was so embarrassed. I tried three times to get up. Finally, I succeeded with help of a friend. I could barely get back into my car and drive home. It hurts so much to put weight on that foot. Now, my shoe even hurts when I try to put it on that foot. I think I may have done something terrible to that ankle. Do you think I broke it? Did I tear a ligament? Do I need an xray or MRI? Do I need a cast? How am I going to finish the work I have got to do? Will I be okay to go on a trip next week? How long will my skin be blue?” There are those who want somebody with knowledge to listen to their story and understand their problems so that they might receive enlightenment on their life’s path turn for the worse, through thoughtful discussion and strategic planning.

    We would wishfully think that a medical doctor would be trained to address each of those types of patients to the satisfaction and benefit of the patient. Those who seek “a caring relationship between the healer and patient”, what I would classify as type 3, are often disappointed because you cannot always establish that type of relationship between two people.

    Before we had a scientific basis for medicine, most of what was effective was the placebo effect maximized by a caring relationship between the healer and patient. Ancient medicine evolved to emphasize that relationship and amplification of placebo effects. It would not be unusual for some of those type 3 patients to find what they seek in ancient medicine. Although we can condemn the alt med practitioner if they claim there is a scientific basis for the therapy, we cannot condemn the patient’s choice to seek alt med. The patient has not received what they were looking for in modern medicine. Modern medicine is not geared to provide inexpensive placebo effects, doctors cannot connect with all patients.

    I think the author would probably be a patient who places much value on the caring relationship. Perhaps, he has been swayed by interviews with patients how have benefited from alt med placebo effects. That could explain his valuation of ancient medicine. I do not think that modern medicine has to revive the techniques of ancient medicine to provide for a caring relationship between healer and patient. However, modern medicine will never succeed with all patients, so there will always be room for alt med practitioners.

    It’s your guys job at SBM to just make sure that the alt med practitioners don’t try to claim a scientific basis (or tax money). Keep up the good work.

  24. JMB says:

    Just a clarification, the majority of those that I classified as type 1 or 2 will still appreciate the caring relationship, they are just less likely to seek another provider if they didn’t establish the relationship with the doctor. There are only a minority that prefer the curt, gruff, I’m not wasting any time type of provider.

    Also, the type of medical care an individual seeks may depend on the specialty of the provider. It would be unusual for a patient not to seek a caring relationship for obstetrics. There are other specialties in which the caring relationship may be less important. Obviously, the caring relationship is not often important in nonclinical specialties.

  25. wales says:

    Squirrelite: “But, none of us have enough time to try everything, so we have to occasionally rely on other sources that we respect and trust to help us do at least an initial round of filtering.” I agree wholeheartedly.

    In answer to your question, I haven’t seen “Expelled” or even heard of it until now. So I cannot give an opinion on the movie, but I do have opinions on the subject matter. From a glance at Wikipedia the movie appears to be yet another examination of the “creationism/intelligent design/evolution” issue. I have never understood why so many people think that all spiritual beliefs must be at odds with science. I have personally known scientists who have strong religious/spiritual beliefs, and there are nobel laureate scientists with publicly stated religious/spiritual beliefs. I also know spiritually/religiously inclined people who believe in scientific theories such as evolution. This is relevant to earlier remarks about holding opposing/conflicting ideas at the same time. In a complex world we are faced with what appear to be conflicting ideas on a daily basis. Thoughtful people try to make sense of it all somehow. Some make sense and simplify by outright rejection of certain ideas, be they scientific or religious. Others see validity in both realms and continue to ponder. As usual, the complex and varied reality of human beliefs about spirituality and science are more complicated and rich than any simplistic “either/or” stance would have us believe. There is no tangible, scientific proof of the-existence of a spiritual reality. Faced with this, some choose to believe that the lack of proof supports non-existence. Others faced with the lack of proof choose to keep questioning and exploring. For those who feel the need to reconcile their belief in evolutionary theory with their belief in religion, there is plenty of room for figurative rather than literal interpretation of religious texts. Unless of course one is a fundamentalist/literalist.

    By the same token, there is no tangible, scientific proof of efficacy/effectiveness/benefit for many clinical interventions. BMJ’s “Clinical Evidence” posits that only 12% of clinical treatments are proven to be beneficial; 23% are likely to be beneficial and the remaining 65% of treatments are not known to be or are unlikely to be beneficial or effective. This appears to be equivalent to basing 65% of clinical treatments “on faith” or on “clinician anecdote”.

    http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp (see figure 1)

  26. JMB says:

    “For instance, I’ve seen enough of my sons’ playing Halo III to know that I probably don’t have enough time to spend to get into it to the level needed to enjoy it.”

    “I play Halo ODST everyday but my son still beats me.”

    Maybe it’s just placebo effect, but I’ve noticed a certain beneficial effect to FPSs. They are better than caffeine for waking myself up. When I have to wake up on call at 2 in the morning, and have to wait 30 minutes to see the CAT scan, I benefit from playing the FPS. I will be wider awake and more alert. To get back to sleep, I just watch of those lectures on quantum physics available on you tube… better than a sleeping pill (although I still wish I could understand quantum physics).

  27. DREads says:

    He accepts homeopathy uncritically and even suggests that it is now supported by science. He likes the idea of homeopathy because it “shares some underlying values seen in ancient traditional medicines” such as vitalistic energy concepts, detailed interviews to inquire into every detail of the patient’s life, stressing the healer-patient relationship, and deriving many of its remedies from natural products.

    Homeopathy is one of my litmus tests. Asserting homeopathy is well-supported by science reflects a severe lack of understanding of science that nothing else asserted should be taken seriously. Arguing from false premises is just silly and unproductive. Imagine a book on breakthroughs in aviation that ends with a chapter on cardboard wings, flubber, and warp drive. It’d be hard to take seriously, wouldn’t it? ;)

  28. BillyJoe says:

    wales,

    “There is no tangible, scientific proof of the-existence of a spiritual reality. Faced with this, some choose to believe that the lack of proof supports non-existence. Others faced with the lack of proof choose to keep questioning and exploring. “

    Of course, then there is proof of non-existence, but let’s not spoil a good delusion. ;)

  29. BillyJoe says:

    wales,

    “There is no tangible, scientific proof of the-existence of a spiritual reality. Faced with this, some choose to believe that the lack of proof supports non-existence. Others faced with the lack of proof choose to keep questioning and exploring.”

    Of course then there is the proof of non-existence, but that would spoil a popular delusion wouldn’t it? ;)

  30. wales says:

    BJ: By all means, have at it with your “proof”. But please don’t kid yourself into believing that you’re less deluded than everyone else. The either/or approach to spirituality/science as the basis of reality is a false dichotomy. We don’t live in a world limited to binary choices. It is a messy, complex world full of shades of gray. Even “science based medicine” is full of shades of gray, with only 12% of clinical treatments based upon solid proof of effectiveness. This amounts to the unproven treatments existing as some sort of “rites”. Quite primitive, no?

    If I had to bet on what is the basis of reality I would bet that scientific theory has it 30% right, spiritual theory has it 30% right, and the remaining 30% of the pie is composed of A) a creative, integrative synthesis of ideas from those two realms or B) a completely novel paradigm that is beyond our ken at this stage of humanity’s cognitive evolution.

  31. Wales,

    I often disagree with you, but this time you just aren’t making sense. At all.

  32. wales says:

    Make that “remaining 40% of the pie”

  33. wales says:

    Alison: Well then let’s leave the philosophy behind and address factual information only. Any comments on the BMJ Clinical Evidence suggestion that only 12% of clinical treatments have proof of effectiveness? Does it “make sense” to you to continue to treat patients with unproven interventions? Do unproven treatments provide a placebo effect and is that worth the expense of medical treatment?

  34. weing says:

    wales,
    I never heard of spiritual theory. How do you test it?
    You seem to imply that only 12% of science based medicine is has solid proof of effectiveness. I think it’s more like 12 % of medicine is solidly science based. We hope to increase that percentage.

  35. wales says:

    Joseph Albietz’s April 16 post on homeopathy cites a 2007 Ben Goldacre article from the Lancet as “definitive” evidence that homeopathy has no effect beyond placebo. Goldacre’s article states that “And yet homoeopathy can still be clinically useful. During the cholera epidemic in the 19th century, death rates at the London Homoeopathic Hospital were three times lower than those at the Middlesex Hospital.”

    “To ban homoeopathy would be an over-reaction, as placebos could have a clinical role. However, whether the placebo effect is best harnessed by homoeopaths will remain questionable…..” The question appears to be not whether or not homeopathy can be clinically useful, but whether or not homeopaths be allowed to “harness” that clinical usefulness. So it’s about who should own the right to prescribe or oversee homeopathy as a treatment.

    It boils down to how important/effective is the placebo effect? Well as Goldacre states, the 19th century cholera epidemic perhaps speaks for itself. Placebo effect would also appear to be the only rational justification for the “clinical usefulness” of the 65% of conventional clinical treatments which have no scientific proof of effectiveness.

    Weing, the BMJ Clinical Evidence comments are not about what percentage of treatments are based in science, but about what percentage of treatments have scientific proof of effectiveness. My take on this is that though the treatments may have a basis in scientific theory, they have not been proved. Though your comment is rather interesting, if only 12% of modern medicine is solidly science based, what is the remainder based upon? If the majority of conventional medical treatments as well as homeopathic treatments have a valid and effective placebo effect, shouldn’t they both be “harnessed” for the benefit of patients?

  36. rosemary says:

    JMB you bring up very relevant points about most people wanting varying degrees of emotional support and relationships with doctors, things I think many Skeptics often overlook. But one of the things that galls me about AM is that it promotes itself as a health care system in which offering emotional support to patients is one of its primary functions, if not its primary function. It goes further than that in stating that a physician cannot simply treat physical ailments but has to treat the “whole person” which includes his emotional and spiritual needs as well as his physical ones. Making matters even worse in my view is that as far as I can tell these practitioners don’t have any natural talent or training in treating any needs be they spiritual, emotional or physical. Hugging, listening and saying, “I care,” and sending a bill just don’t cut it as far as I’m concerned.

  37. rosemary says:

    Zoe, I don’t know of one great book on the history of medicine, but there are several that I value greatly. Off the top of my head: The Knife Man by Wendy Moore; The Fever Trail by Mark Honigsbaum; Genius on the Edge by Gerald Imber; Michael Bliss’s books on Osler and Cushing. I think he also has one on Banting that I read long ago. They are all easy, enjoyable reads.

    I also pick up old medical textbooks when I see them although with the Internet I see them less and less. Many are fascinating. Also if anyone has the time and is near a history of medicine library, browse through the old journals. I’ve done a lot that researching silver because the silver quacks give lots of ancient references to “prove” that their quack claims are accurate.

  38. Harriet Hall says:

    Wales,

    The reason for the increased survival rate in the 19th century cholera epidemic was not that homeopathy improved survival. It was that conventional treatment decreased survival. 19th century conventional treatment was essentially pre-scientific. Whatever the percentage of evidence-based treatments in scientific medicine today, that percentage is increasing and is far superior to anything alternative medicine can claim.

  39. Harriet Hall says:

    micheleinmichigan asks “what would your #10 spot be?”

    There have been many lists. A BMJ poll listed these as the top 15: sanitation, antibiotics, anesthesia, vaccines, discovery of DNA structure, germ theory, oral contraceptives, evidence-based medicine, medical imaging, computers, oral rehydration therapy, risks of smoking, immunology, chlorpromazine and tissue culture.

    These lists are all very subjective and there is no rational way to quantify and compare such different benefits to humanity, but I would be tempted to list effective birth control.

  40. TsuDhoNimh says:

    Wales: I’m reposting from something by DC Sessions ….

    “Homeopathy advocates like to cite the 1854 London cholera outbreak, where “homeopathic hospitals” had a case mortality rate of about 20% compared to about twice as high in the mainstream hospitals nearby.

    There are all sorts of reasonable explanations. For one, the mainstream hospitals may well have been killing their patients; it was a popular practice of the times. The “homeopathic hospitals,” from all accounts, also practiced supportive care in advance of the times.

    However, the key statistic is that the overall mortality for the London outbreaks was 53,000 deaths for at least 250,000 cases. Do the math.

    *******************
    “Homeopathy” of that time was not just diluted stuff on sugar pills, it was a whole treatment modality in favor of fluids ad-lib, cooling baths, light coverings and cool air in the rooms- what we now consider standard “supportive care” for feverish patients. The standard treatment in non-homeopathic hospitals was to withhold fluids, and try to provoke a sweat by heat and lots of blankets … they were killing people through their ignorance of the importance of hydration and their misplaced focus on “breaking the fever” (confused cause and effect).

    The admissions to these hospitals were not coming from the same social class, and the claims of superiority of homeopathy don’t seem to have corrected for the socioeconomic differences.

    The Middlesex Hospital was a charity hospital where patients usually came in with the added health burdens that a lifetime of Victorian poverty inflicted on them.

    The homeopathic hospital was also expensive and private, drawing its patients from the wealthy and aristocratic strata … they were basically in better health to start with.

  41. Scott says:

    Any comments on the BMJ Clinical Evidence suggestion that only 12% of clinical treatments have proof of effectiveness?

    Take a look at a “friend” of SBM’s takedown of what I believe to be the listing you’re referring to:

    http://scienceblogs.com/insolence/2010/04/the_return_of_dana_ullman_2010.php

    Particular points which render it rather meaningless include:
    – The 12% is of a list including sCAM treatments.
    – There’s no weighting of the treatments. Something used once for an extremely rare condition has equal weight with taking NSAIDS for a headache.

    It really has no significance to much of anything.

  42. weing says:

    “The 12% is of a list including sCAM treatments.”
    I suspected as much but I couldn’t find out what the set of medical treatments included from the link posted.

  43. wales says:

    Thanks for the comments. I already read orac’s piece. Citing one newspaper article is not exactly a “takedown”. We are not told what percentage of all the treatments reviewed by BMJ were alternative. But given that the majority of treatments used by MDs are conventional ones, it’s likely that the majority of treatments reviewed are also conventional. As no one reading here appears to have a subscription to Clinical Evidence I guess it’s a moot point for the moment. There also isn’t sufficient evidence that one newspaper article is representative of all the reviews published by Clinical Evidence for the past ten years.

    It is curious that goldacre credits homeopathy with clinical usefulness during the cholera outbreak but fails to mention the high risks of conventional treatment at the time. I appreciate the readers’ theories and observations on this, but still, no reference citations or data.

  44. wales says:

    I was curious about the claims made here that the two London hospitals referenced in Goldacre’s article had patients from different socioeconomic backgrounds and the impact this had on the different cholera mortality rates. I found that The London Homeopathic Hospital was opened in 1854 “ for the free treatment of the capital’s sick poor.”

    http://www.homeoint.org/morrell/londonhh/preface.htm

    And this excerpt from an earlier written history of the hospital “To-day, few charitable institutions are better known than the London Homœopathic Hospital, and there are none where the professional enquirer or benevolent visitor can receive a more cordial welcome. It was founded in 1849, twenty-one years after Dr. Quin had established himself in practice, in order to demonstrate, by the treatment of the sick poor, the truth and importance of this reformed system of medicine.” Now it makes sense why Goldacre made no mention of “charity” hospital as both hospitals were charity hospitals.

    In fact, most hospitals at the time were populated with the poor or those without families. Those with financial means had the benefit of house calls from their doctors. “Despite the continued discussion about the cause of cholera, over the course of the 19th century the actual treatment of the disease did not change much. Patients with families were cared for at home.” http://ocp.hul.harvard.edu/contagion/cholera.html

    Well, real life calls. No more time for this at the moment.

  45. Dr. H. – regarding what should be the #10 spot.

    I was racking my brain, it is pretty hard question. Don’t want to be to general or too specific.

    But, effective birth control – good one.

  46. Scott says:

    @wales:

    Orac’s discussion is hugely more information on the subject than you provided. So unless your intention is to demand that others do the research to prove your point for you, you’ve got no leg to stand on.

  47. edgar says:

    As some of you may I know, I work in Indian Country, and I really struggle with this issue. Because the concept of medicine is traditionally so very different. With the coming of ‘western’ or modern, or whatever you want to call it, there has been a separation between the physical and the spiritual that wasn’t there before.
    So the issue for me isn’t, ‘does it work’, but is it appropriate? One of the reasons (and there are many) for loss of culture in this instance is this separation. Is that OK, is it right? We can say now that medicine and culture do not mix, but at one time, in these populations, they did. And this, along with other forms of cultural imperialism, led to much more disease due to historic trauma.

  48. wales says:

    Scott: you’ve got it backwards. Readers so inclined to do any research will be doing it for themselves, not for me. My legs are just fine, thank you.

  49. Scott says:

    LOL. You made some very clear implications. Burden’s on you.

  50. rosemary says:

    Edgar, “We can say now that medicine and culture do not mix, but at one time, in these populations, they did.”

    Edgar, I think that until not so very long ago with the advent of scientific medicine that that was true if not in all populations in most of them. Living cultures evolve for better or for worse. It is something people have to work out for themselves.

    My paternal grandmother was what my cousin aptly called “a fanatical Irish Catholic”. I don’t think any of her grandchildren even consider themselves Catholics. Although they love and respect her and her culture, they laugh at her superstitious beliefs which I’m pretty sure were cultural. They have held on to what they feel are important and relevant aspects of her culture and relegated the rest to history and I believe that if she had been born around the time that we were, that she would have done the same thing.

    My cousins and I all feel that the Irish Catholic culture has greatly influenced us and made us who we are. We are proud of it. For me, unlike my cousins, it gets more complicated because my mother’s family were all Russian Jews. I could not intentionally mimmic an accent in English if I wanted to, but because of my early exposure when I speak with someone with a brogue I speak with one too, unintentionally of course, until they ask what part of Ireland I come from. I do the same with a Yiddish or German accent. I grew up in two cultures and am proud of both and feel that both have been wonderful influences on me personally although even growing up I understood that my father and mother’s families didn’t understand each other because their cultures were so different. Back then both families opposed their marriage which was called a “mixed marriage”. But they got over it.

    I haven’t been to Spain for about 30 years, but now I can watch Spanish TV on the Internet and am amazed by the way attitudes, especially about women and their role in society, have changed although I suspect that the Spaniards who have been living through the changes aren’t amazed by them because for them they happened gradually whereas for me they appeared quite suddenly.

  51. JMB says:

    @Rosemary
    “Making matters even worse in my view is that as far as I can tell these practitioners don’t have any natural talent or training in treating any needs be they spiritual, emotional or physical.”

    From my experience as a medical student, and medical educator, I would observe that students have a wide variation in their communication/empathy skills. While you might achieve slight improvement in a student’s skills, you could never take a student from weak interpersonal skills to a level of strong skills. Throwing in CAM training would just produce a thin veneer over the weak interpersonal skills. If we were really to produce physicians who could treat the whole patient, we would observe and grade the students on their interpersonal skills. The students with top scores in interpersonal skills we would certify as IM physicians, and encourage them to enter a specialty where such skills would be greatly valued. IM can simply be the blend of strong interpersonal skills and SBM.

  52. wales says:

    “Burden’s on you.” What burden? There is no burden of proof for me. I am not trying to prove anything. I have no horse in this race. I am neither an advocate nor adversary of either “side”. I am a doubter, in the original sense of the word “skeptic”. I doubt that all of conventional medicine is as beneficial as its promoters make it out to be. I doubt that all of alternative medicine is as worthless as its detractors make it out to be. I point out misstatements of fact when I see them along the way.

  53. BillyJoe says:

    wales,

    “BJ: By all means, have at it with your “proof”. But please don’t kid yourself into believing that you’re less deluded than everyone else.”

    I’m sorry, but god, in any meaningful sense of that word, has been disproven. This is not a delusion. It is a scientific and logical fact.

    “The either/or approach to spirituality/science as the basis of reality is a false dichotomy. We don’t live in a world limited to binary choices. It is a messy, complex world full of shades of gray.”

    It IS a false dichotomy. The horse called Spirit has broken down and is no longer in the race and Science is leaping towards the finish line.

    “If I had to bet on what is the basis of reality I would bet that scientific theory has it 30% right, spiritual theory has it 30% right, and the remaining 30% of the pie is composed of A) a creative, integrative synthesis of ideas from those two realms or B) a completely novel paradigm that is beyond our ken at this stage of humanity’s cognitive evolution”.

    Me? I’m going with the scientific assumption that everything is physical. It has been the only assumpton that has had any legs in the past few centuries. Everything else has run straight up against a dead-end sign.

  54. wales says:

    BJ: You are entitled to your opinions. Richard Dawkins has made some clever arguments in support of atheism, but the only thing he proves is that atheists crave certainty as much as the “believers” they deride. The unprovable remains as unproven as ever (for both believers and atheists).

  55. edgar says:

    Absolutely Rosemary, but I am not speaking of the voluntary relinquishment of old customs, I am talking about cultural imperialism, which does in fact lead to illness.
    It is not that these traditions were phased out, they were forced out.
    Cultural and political marginalization almost always leads to ill-health.

  56. rosemary says:

    Edgar, I’m sorry. I don’t understand. I realize that many native Americans died of diseases they had not previously been exposed to when the Europeans arrived and that many today suffer from very serious chronic diseases as a result of the “modern” diets and lifestyles they follow, but I don’t see the connection between that and your previous statement, “… the concept of medicine is traditionally so very different. With the coming of ‘western’ or modern, or whatever you want to call it, there has been a separation between the physical and the spiritual that wasn’t there before.”

    Perhaps, it is too complicated to cover in a comment. If so, can you suggest reading material, a link or a book?

  57. weing says:

    I have no idea what he’s talking about either. Do you mean they didn’t die of appendicitis before the white man came? I don’t see any separation between the physical and the spiritual because I don’t know what spiritual is.

  58. BillyJoe says:

    wales,

    “BJ: You are entitled to your opinions. Richard Dawkins has made some clever arguments in support of atheism, but the only thing he proves is that atheists crave certainty as much as the “believers” they deride. The unprovable remains as unproven as ever (for both believers and atheists).:

    They are not opinions, they are empirically derived facts.
    It isn’t certainly true that god does not exist, it’s just almost overwhelmingly true, so much so that natural explanations have now completely displaced supernatural explanations as the default position.

    Additionally there is no longer any reason to believe in supernatural explanations because they do not add anything to what is already known. Apart from this there is the fact that there is no coherent, consistent, universal story to be told here.

    It’s just timidity, cognitive dissonance, or ignorance, probably a combination of all three, that keeps people believing otherwise.

  59. BillyJoe – I consider myself agnostic and generally don’t worry to much about the God, No God thing. But, just for the sake of argument.

    If there was a God and they felt that faith rather than proof was important and they were also omnipotent, couldn’t they easily hide their presence from scientists, physicist, humans as they wish?

    I do actually think about religion a bit though. My conclusion, there may be no scientific reason for religion or faith in a deity, but it does not follow that there are no social, psychological or spiritual reasons. From an artist’s perspective I don’t need much better reason than the Sistine Chapel to believe that religion has a place. Of course that may be completely self-indulgent.

    There, now I’ve done my self assigned task of defending a belief system that I don’t believe in. For whatever that’s worth.

    *I’m using they rather than he/she/it, which was rather awkward.

  60. wales says:

    “It’s just timidity, cognitive dissonance, or ignorance, probably a combination of all three, that keeps people believing otherwise.” Judge much? Smug much? As an agnostic, I don’t judge why others believe as they do. They may have very good reasons, better than the ones you have pulled out of a hat.

  61. wales,

    You’re an agnostic, but you believe that probably 30% of reality is explicable using science and 30% using spirituality.

    It sounds to me as though you believe in both the detectable things that science explains and undetectable things that are the subject of spirituality.

  62. wales says:

    Alison: I am agnostic in that I am not committed to believing in god or not. I think anything is possible. I think some things are unexplainable. I think some things about physical reality have been inadequately explained by physics. I have yet to read anything, including Dawkins, that convinces me that the possibility of spiritual reality has been disproved. I respect the beliefs of others and don’t pretend to be privy to an ultimate truth that makes others’ beliefs ridiculous.

  63. Ok, you’re agnostic because you aren’t committed to either belief or disbelief in god.

    But you believe in both science and spirituality.

    What is spirituality without god?

  64. wales says:

    dunno, ask the buddhists. gotta go to dinner now.

  65. wales says:

    I forgot, I wanted to mention this as well. Dr. Crislip said“I see no reason why consciousness should exist beyond physiologic brain function.” I think it is possible, maybe even probable, that consciousness is not derived solely from the brain. I cannot explain it and do not really have a theory for it. But I respect the beliefs of Dr. Crislip and do not pretend to have the answer.

  66. wales says:

    One more thing (dinner has been postponed temporarily): BJ said “It isn’t certainly true that god does not exist, it’s just almost overwhelmingly true” In other words, it is improbable.

    The probability that a chain 141 amino acids long would be a usable hemoglobin molecule can be calculated as roughly 1 in 10E33. Improbable? Yes. Impossible? No. Is the burden of proof high when it comes to “disproving” a spiritual reality? Yes, given the length of time that humanity has exhibited spiritual beliefs.

    I am starving now.

  67. weing says:

    wales,

    Don’t feel too bad. I am an agnostic too. I will stop being an agnostic once I know the answer which will be when I cross the event horizon.

  68. Edgar, I’m also not quite clear of what you are saying. Perhaps an example would be helpful,if you have time?

    I’m going to take a shot at reinterpreting your thought, though, and you can tell me if I am hot or cold.

    So, many cultures have evolved a spirituality that incorporates some forms of medicine, hygiene and diet because life, birth and death are domains that evoke both spiritual, health and medical responses. One example of this is the Jewish prohibition of pork.

    Culture and spirituality can be inseparably intertwined, so dimished spiritual participation may have unforeseen consequences in terms of diet, exercise and hygiene in individuals and groups.

    In other words, a group adapts a system that may keep them relatively healthy within their environment. When that system is disrupted, there can be negative health consequences, unless that system is replaced with a new system that is of equal or greater effectiveness. In order to be adopted by this society, the new system would have to be equally or more compelling to that society AND that society would have to have sufficient access to that system.

    When looking at marginalized groups where the culture and spirituality has been undermined or lost, you may see a greater risk of a loss of the health benefit associated with the loss of their system, with no great health benefit from the new system (in this case conventional medicine). This may be due to inadequate access due to financial, geography or infastructure. Or it may be due to an unwillingness of that group to adopt the new system, due to cultural distaste, resentment of adopting the usurper’s system, disinterest or lack of understanding.

    So you may end up with a net loss.

    Just a (very long) thought.

  69. Alison “What is spirituality without god?”

    The belief in the spirit. What is spirit? – That’s the start of spirituality.

  70. wales says:

    Alison I have an example that I think fits your request. I believe you asked for something mysterious that has not been adequately explained by science, that may be related to spirituality and medicine. This is one example that all MDs and parents can relate to: sleep. There’s an interesting article in May’s National Geographic about sleep. Sleep expert William Dement was mentioned, who has been studying sleep at Stanford for 50 years. When NG asked him about the reason we sleep he replied “As far as I know the only reason we need to sleep that is really, really solid is because we get sleepy.” Studies done in the 1980s and again in 2002 by depriving rats of sleep until they died revealed no organ damage and no “unambiguous cause of death” in the rats. “The predominant theory of sleep is that the brain demands it.” It appears that sleep is necessary for the brain (and/or consciousness?) People with “fatal familial insomnia” lose sleep for about a year and then die. We still don’t know what exactly kills them. So here is a behavior that we spend one-third of our lives doing and which created considerable risk for our distant ancestors (sleepers are easy prey for predators). “What can possibly be the payback for such risk? If sleep doesn’t serve an absolutely vital function, the renowned sleep researcher Allan Rechtschaffen once said, it is the greatest mistake evolution ever made”. Still searching for that function…… I read Dr. Dement’s book “The Promise of Sleep” years ago. Don’t remember many details but I do remember coming away with the thought that after reading 500 pages that it boiled down to “we need to sleep because we get sleepy”.

    Of course there are other mysteries too, this is just one. I won’t delve into quantum physics again, I think I beat that horse to death in earlier posts. Alison I think you said you had another mystery in mind, I’d like to hear about it.

    I know you didn’t ask for my opinion on this subject, but I’d like to address just one of the reasons why I think Richard Dawkins is off-base with his promotion of atheism as a solution to the violent atrocities committed in the name of religion. As an agnostic I think I can address this somewhat objectively. One of Dawkin’s leading reasons for why we should pitch religion is that it is dangerous (citing 9/11 as an example). Shall we pitch science too, because it is dangerous? Both religion and science are simply vehicles, subject to hijacking by individuals/nations. The political wars of history have taken far more lives than the religious wars. Advanced weaponry (thanks to science and technology) has escalated the body count. 9/11 made Dawkins stand up and say “enough” with this dangerous religious stuff. Many felt the same way about science after Hiroshima and Nagasaki. Throwing the baby out with the bath water solves nothing. Science and religion are deeply embedded in our culture. Neither one is going to disappear anytime soon, and swapping one for the other is not an answer to the problem of “vehicular hijacking”. Dawkin’s reactionary “enough” reminds me of the 1970s bra-burnings. It may feel exhilarating at the time, but down the road many people began to miss those bras.

    The immediate death toll of Hiroshima and Nagasaki is estimated at about 110,000. The five year bomb-related death toll for the two cities is estimated at about 340,000. This is from two bombs alone. (These are US figures, I am curious that know about Japanese estimates.) The conservative estimated death toll for the political wars WWI and WWII combined is about 50 million. Some estimates are two to three times that. I have no idea how accurate the Wikipedia figures are, but close enough for this discussion. The four religious wars shown in Wikipedia’s table have a conservative death toll of 7 million (with one war lasting 30 years). The lower death toll has something to do with the lack of sophisticated weaponry. Shall we do away with governments too? They seem to be the source of most wars, especially the most modern and “advanced” governments in history.

    I am always stunned by photos of the atomic bombings. We see holocaust photos in the media quite often, but Hiroshima and Nagasaki not as much.

    http://www.cfo.doe.gov/me70/manhattan/hiroshima.htm

    http://en.wikipedia.org/wiki/List_of_wars_and_disasters_by_death_toll

  71. wales says:

    PS just wanted to mention that I was always a fan of Dawkins science writings. “The Selfish Gene” was required reading for my university classes in anthropology/zoology. Sad to say, I think he has become somewhat foolish in recent years.

  72. wales says:

    Wow, I hadn’t even read the entire Manhattan Project link that I cited. Here’s an example of science being hijacked to inspire terror in an entire civilian population “By August 9th, American aircraft were showering leaflets all over Japan informing its people that “We are in possession of the most destructive explosive ever devised by man. A single one of our newly developed atomic bombs is actually the equivalent in explosive power to what 2,000 of our giant B-29s can carry on a single mission. This awful fact is one for you to ponder and we solemnly assure you it is grimly accurate. We have just begun to to use this weapon against your homeland. If you still have any doubt, make inquiry as to what happened to Hiroshima when just one atomic bomb fell on that city.” Yes you can say that Japan was committing its own atrocities in war, but did the innocent civilian victims of Hiroshima and Nagasaki deserve to be terrorized for that? Even so, it doesn’t inspire me to turn my back on science. We have got to get beyond binary thinking.

    Enough writing for a Saturday morning.

  73. wales says:

    Sorry, one more. I promise this is the last. Here is a well-written and thought provoking editorial on binary thinking and why scientists may be prone to such.

    http://www.geoff-hart.com/articles/2005/binary.htm

  74. wales says:

    Oh my, moderation now? Please don’t wait too long………..

  75. Thanks, wales.

    Actually I was asking for an example of something that you *know* cannot be adequately explained by science, that would benefit from a spiritual explanation, and that was relevant to the practice of medicine.

    I see absolutely nothing about sleep that is fundamentally beyond the scope of science.

    1) Science can observe it.

    2) Science can observe the effects of not sleeping. I had thought that the rat studies showed immune system failure, but I will accept “no unambiguous cause of death.” How do you *know* that no matter how much we study sleep-deprived animals that we will science will never be able to explain why they eventually die? Alternatively, why do you set the odds as 70:30 that the answer is more likely to be spirit or an unknowable paradigm than disruption of a physiological system? (Has spirit or an unknowable paradigm done better than science in the past when we didn’t understand how something worked?)

    3) Science can explain why animals evolved sleep.

    4) If I don’t get enough sleep, my doctor will advise me on sleep hygiene to improve my mental and physical health. If I am unable to sleep, or if I sleep too much, my doctor will be interested in what is wrong and try to help. Are you suggesting that she is probably misguided and that I should probably ignore her and pray or meditate instead, because sleep is probably not a physiological requirement but a spiritual one?

    There are things that are currently not completely known, but that doesn’t mean that they can’t be or that we have any reason to think that they can’t be. I don’t know exactly how much I weigh, although I know how to get that information to the degree of certainty I require. That doesn’t make weight a spiritual phenomenon, it just means I don’t know the exact answer right now. It doesn’t occur to me to think that because I don’t know my exact weight, that the difference between my guess (about 80 kg) and whatever my exact weight turns out to be can only explained by an unknowable paradigm. The difference has lots of very scientific explanations and I see no reason to introduce other realities to account for them.

    Similarly for sleep. Is there a reason to think that other realities are probably needed to account for it?

    To me simple ignorance is not a mystery. If that is all it takes to be a mystery – not knowing the exact answer right now – then of course the world is full of mysteries. That’s trivial. That’s why research continues to be done. By *definition,* all scientists know that they don’t know every answer in all detail. That’s what research is: choosing a question without a sufficient answer and trying to figure out how to answer it. Ignorance *is* exactly the domain of science.

    My own example is individual consciousness. I can’t wrap my mind around why “I” am “me” and not somebody else. Steven Novella tells us that this is not an actual problem, and he should know. He points out that everything is itself and not another thing and that consciousness is no different.

    Well, it feels different to me. It feels very much like a mystery. It’s possible that it’s just something I don’t understand. When I was little I hated not understanding why people on the other side of the planet were not upside-down, and thrilled when I finally grasped it. This could be the same thing. I’m not that worried about it.

    On the other hand, it doesn’t have anything to do with the practice of medicine. Breast cancer will respond – or not respond – to various observable and measurable interventions whether consciousness is an emergent property of a complex brain or whether it is the ghost in the machine. Non-observable, undetectable interventions have never been shown to have any effect at all on the progression of breast cancer and we have no reason to think they would.

  76. BillyJoe says:

    wales,

    Truth does not depend on whether it is good or bad. Quantum Theory is still correct even after Nagasaki. Evolution is more tooth and claw than reciprocal altruism. If religion was true it would be true regardless of the pogroms, crusades, and inquisitions. And whether or not equal rights for females is good or not does not depend on whether burning bras is the right way to fight for it. So, so much for that. I’m not promoting atheism over religion. I’m saying one is true and the other is false. And there is a fact of the matter based on science and logic that makes one true and the other false. What we do with that fact that god does not exist is another matter entirely.

    And, when I said the it is almost overwhelmingly true that god does not exist, I meant with a probability that is practically the same as the probability that the Earth is flat. The only god that has not been disproved via science and logic is the deist god. The deist god, if you remember, is the god who simply set the universe in motion and then played no further part in it. Such a god is indistinguishable from his absence. And for such a god there is no bonus afterlife to entice you to believe in him. A really completely utterly useless god.

    As for the existence of mysteries. The existence of mysteries is no excuse for making mysteries out of phenomena that have perfectly satisfactory natural explanations. It is a mystery why there is something rather than nothing. It’s possibly also a mystery how entanglement and uncertainty works in quantum physics. But god is not one of those mysteries. God does not serve any purpose. Nothing is explained by god that is not explained just as well without god. God is an unnecessary hypothesis.

    And sleep? The best explanation I have heard is that, throughout evolutionary history, there has been a progression from inanimate matter to unconscious life to conscious life. It’s just that the job is not yet complete and hence most conscious animals still spend about a third of their lives unconscious (ie asleep). If there is a pay off, perhaps in a few million years we won’t need to sleep. If there is not, then we will simply presumably sleeping.

  77. wales says:

    BJ: Again you have a lot of opinions, to which you are entitled. Proof? Not so much. Please read this about the perils of binary thinking:

    http://www.geoff-hart.com/articles/2005/binary.htm

  78. BillyJoe says:

    wales,

    “I think it is possible, maybe even probable, that consciousness is not derived solely from the brain. I cannot explain it and do not really have a theory for it. But I respect the beliefs of Dr. Crislip and do not pretend to have the answer.”

    No phenomena have ever been shown to have supernatural explanations. If there are phenomena with supernatural explanations, why have none ever been discovered? In fact, only natural explanations have ever been found.

    The assumption of science is that all phenomena have natural explanations, and that assumption has gotten us pretty far along the way to explaining most phenomena or at least seeing possible, if not yet unproven, natural explanations.

    There is simply no reason to think consciousness is any different.

  79. wales says:

    From the link on the perils of binary thinking: “Even the basis for scientific “proof”, the statistical test of probability, divides neatly in two: something is either true or false—never true to some extent—depending on which side of an arbitrary statistical divide it falls on, and many scientists frown on reporting results as nearly significant or somewhat significant. Yet when it comes to the really interesting issues of science, this binary thinking can distract us from important discoveries, and can be profoundly misleading. A few examples:….”

    As the author says, scientists may be more prone to this mode of thought than others.

  80. BillyJoe says:

    michelinmichigan,

    “I consider myself agnostic and generally don’t worry to much about the God, No God thing.”

    In other words, you fall into the ignorant category!
    (only joking :))

    “If there was a God and they felt that faith rather than proof was important and they were also omnipotent, couldn’t they easily hide their presence from scientists, physicist, humans as they wish?”

    They could. That is the definition of a deist god – a non-interventionist god. But the universe would be no different without such a god. And no afterlife to boot. Such a god is an unnecessary hypothesis.

    “I do actually think about religion a bit though. My conclusion, there may be no scientific reason for religion or faith in a deity, but it does not follow that there are no social, psychological or spiritual reasons. “

    Yes, but social, pschological, and spiritual reasons are reasons why people believe in god, not reasons why god exists.

    “From an artist’s perspective I don’t need much better reason than the Sistine Chapel to believe that religion has a place. Of course that may be completely self-indulgent.”

    Yes, I’m not saying religion does not have a place. I think many people cannot live without religion.That does not make it true though.

  81. wales says:

    More about binary thinking: “Truth itself is very similar, with most of life’s “truths” coming in a bewildering shades of grey rather than simple black and white. The second and more serious problem is that, as the debates over sentience and taxonomy demonstrate, binary thinking divides the universe into us and them, opposing camps who can only agree on the need to fight until one camp declares victory. Lost amidst the melee is the potential gain that comes from understanding the value of both sides in the debate and using each side’s tools whenever they’re most effective.

    As scientific communicators, our responsibility must be to avoid the traps of binary thinking. Life, the universe, and everything are far more interesting and complex than binary logic acknowledges, and we do our readers a tremendous disservice when we oversimplify that reality.”

  82. BillyJoe, I realize that the conversation is between you and wales, please pardon intrusion, but…

    It may be true that a friend’s wife is cheating on him, but it may not be necessary to insist on that evidence based fact in conversations with him.

  83. BillyJoe says:

    Alison,

    “My own example is individual consciousness. I can’t wrap my mind around why “I” am “me” and not somebody else. Steven Novella tells us that this is not an actual problem, and he should know. He points out that everything is itself and not another thing and that consciousness is no different. “

    Imagine two identical blocks of wood. They are identical in every way. Same number of atoms in the same distribution. Same length width and breadth. They are identical, but they are not the same block of wood. They are different blocks of wood, each individually different from the other.

    If that doesn’t work, choose one of the blocks of wood and think about only that block of wood. Feel its width. Feel it length and its breadth. Feel the distribution of the atoms within it. Then imagine that it is conscious. Consciousness residing in that block of wood and only that block of wood. Not the other one.

    Hope that helped. :)

  84. wales – I don’t follow Dawkins much, so I can’t really say if I agree/disagree with him on religion. But I can say that my father (who was an athetist) espoused a belief that was similar to the one you attribute to Dawkins. That religion or belief in a god was responsible for so many atrocities that it should be discouraged.

    I was always confused by this idea. If there is no god, then religion is nothing more than the workings of the human brain and societal pressures. What evidence is there that the human brain and society would change the way it works because you eliminate one expression of those workings?

    There is evidence that the brain and society would not change. I don’t believe that governments that discouraged religion, Republic of China – Soviet Union’s various countries, ended up with fewer atrocities.

    Sometimes people are just mean, with or without religion.

  85. BillyJoe – “Yes, I’m not saying religion does not have a place. I think many people cannot live without religion.That does not make it true though.”

    But there’s the rub, if you realize that someone can not live without a religion which requires them to have faith in a god and you insist to them that it is factual that there is no god, then there is a dilemma.

  86. BillyJoe – “They could. That is the definition of a deist god – a non-interventionist god. But the universe would be no different without such a god. And no afterlife to boot. Such a god is an unnecessary hypothesis.”

    Well, actually I was imagining a god that intervenes, but hides it, sort of a omnipotent slight of hand.

  87. BillyJoe says:

    wales,

    “BJ: Again you have a lot of opinions, to which you are entitled. Proof? Not so much. Please read this about the perils of binary thinking:

    http://www.geoff-hart.com/articles/2005/binary.htm

    That link seems to argue my case rather than yours.

    Life:
    There is the fact that there is no clear demarkation between living and non-living things. Is a bacteria alive? Probably yes. Is a virus alive? Maybe yes, maybe not. Is a prion alive? Probably not. This lends support for the theory that non-life gave rise to life by imperceptible degrees.

    Consciousness:
    Same as life. Is a prion conscious? No. Is a bacteria conscious? No nervous system, so probably not. Is an ant conscious? Maybe a little. Is a mouse conscious? Yes – a little more so. A dog? Yes – a lot more so. A monkey? Yes – considerably more so, and probably a little self-conscious as well. Humans? Yes, conscious and self conscious.

    No vital force. No spirit or soul.
    Just gradual imperceptable changes from non-life to life and from unconsciousness to consciousness to self-consciousness.

    Otherwise does an ant have a little bit of something apart from the brain by which it is a little bit conscious?

  88. wales says:

    Michele you have made some cogent points. Probably won’t be heard by those claiming that they have found the “Truth”, something humans have been searching for for thousands of years.

    I have no problem with people choosing atheism or religion. But I find proselytizing repugnant, on whichever end of the spectrum it occurs.

  89. BillyJoe says:

    michelinmichigan,

    “But there’s the rub, if you realize that someone can not live without a religion which requires them to have faith in a god and you insist to them that it is factual that there is no god, then there is a dilemma.”

    Such a person is, in my experience, unable to be swayed by any reasonable arguments, let alone fool proof ones. In fact, he is likely to regard it as a strength of his faith that he can continue to believe in the face of proof to the contrary.
    I’m not joking.

    There is also the ever reliable cognitive dissonance that saves many a scientist from otherwise almost certain suicide.
    Okay, joking a bit there.

    ————–

    Wales,

    I have a reply to your link but it lingers in moderation.

  90. BillyJoe says:

    wales,

    My reply to your link is still in moderation.

    “Michele you have made some cogent points”

    I think you mean that she seems to agree with you. ;)

    “Probably won’t be heard by those claiming that they have found the “Truth”, something humans have been searching for for thousands of years.”

    People have mostly always looked for things to confirm their prejudices and biases. It’s only since the invention of science that they have had to come slap bang up against the truth. But there a several escape hatches for them if they wish to make use of them.

    “I have no problem with people choosing atheism or religion. But I find proselytizing repugnant, on whichever end of the spectrum it occurs.”

    It is not a choice.
    Some people need religion and will preserve it at all costs.
    Then there are those who are only satisfied with the truth.
    And telling the truth is not proselytising.
    In any case, my comments were only in response to posts that seemed to take for granted that everyone accepts that belief in god and in a special something outside the brain tol explain consciousness is a reasonable hypothesis. I just felt compelled to correct them on that point. It is not a reasonable hypothesis at all.

  91. “In other words, you fall into the ignorant category!
    (only joking :) )”

    :) too true, when it comes to available knowledge, I’m pretty sure I’ve barely scratched the surface.

    Also, sorry, I think some of my responses are jumbled and were posted without knowledge of some previous comments. I’m not up to dealing with the server backlog/space/time continuum issues.

  92. wales says:

    BJ: Your interpretation of the editorial explains a lot.

  93. wales says:

    “People have mostly always looked for things to confirm their prejudices and biases.” your interpretation of the editorial is a great example.

  94. BillyJoe says:

    micheleinmichigan,

    “It may be true that a friend’s wife is cheating on him, but it may not be necessary to insist on that evidence based fact in conversations with him.”

    As I said before, there is the truth of the matter, and then there is what you do with that truth. You may choose to spare him that information. Someone else might feel he needs to know. He may already know but be in denial. But the truth remains the truth in all three situations.

  95. wales says:

    “And telling the truth is not proselytising.” I believe I have heard this from some evangelical preachers.

  96. BillyJoe says:

    wales,

    I don’t mind if you explain what you mean in a little detail.
    I will promise to read it like I have all you other considerable contributions.

    In any case, I find nothing in that article to disagree with and nothing that disagrees with what I said – unless you think a general statement could possibly cover all possible situations. Even the author would agree that there are no shades of grey on the question of the heliocentrism.

  97. wales says:

    “People have mostly always looked for things to confirm their prejudices and biases. It’s only since the invention of science that they have had to come slap bang up against the truth.” You seem to be saying that science is immune from bias……..

    Jolly good fun, but real life calls.

  98. BillyJoe says:

    micheleinmichigan,

    Yes, I’m finding more of yours that weren’t there before and now are there nestled between posts that were there before.
    Frustrating!!!

    ——————–

    BillyJoe – “They could. That is the definition of a deist god – a non-interventionist god. But the universe would be no different without such a god. And no afterlife to boot. Such a god is an unnecessary hypothesis.”

    micheleinmichigan: “Well, actually I was imagining a god that intervenes, but hides it, sort of a omnipotent slight of hand.”

    You mean like causes scientists to not look while he pulls a swifty? :)

  99. BillyJoe says:

    wales,

    <b<"You seem to be saying that science is immune from bias"

    In science there is a self correcting mechanism which means that slowly, ploddingly, through error and correction, by remodelling and extension, it winds and meanders relentlessly towards the truth.

    As opposed to personal experience and opinion which have no such attributes and hence are an extremely unreliable paths towards the truth.

  100. BillyJoe says:

    …anyway, it’s now 3am down here and it’s Anzac Day tomorrow, so I’d better hop to it and get some sleep.

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