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Science And The Game Of 20 Questions

An audience member at a recent NYC Skeptics meeting asked me how I handled conflict surrounding strongly held beliefs that are not supported by conclusive evidence. As a dentist, he argued, he often witnessed professionals touting procedure A over procedure B as the “best way” to do X, when in reality there are no controlled clinical trials comparing A and B. “How am I to know what’s right in these circumstances?” He asked.

And this is more-or-less what I said:

The truth is, you probably can’t know which procedure is better. At least, not at this point in history. The beauty of science is that it’s evolving. We are constantly learning more about our bodies and our environment, so that we are getting an ever-clearer degree of resolution on what we see and experience.

It’s like having a blurry camera lens at a farm.  At first we can only perceive that there are living things moving around on the other side of the lens – but as we begin to focus the camera, we begin to make out that the animals are in the horse or cattle family. With further focus we might be able to differentiate a horse from a cow… and eventually we’ll be able to tell if the horse has a saddle on it, and maybe one day we’ll be able to see what brand of saddle it is. Each scientific conundrum that we approach is often quite blurry at the onset. People get very invested in their theories of the presence or absence of cows, and whether or not the moving objects could in fact be horses. Others say that those looking through the camera contradict one another too much to be trusted – that they must be offering false ideas or willfully misleading people about the picture they’re describing.

In fact, we just have different degrees of clarity on issues at any given point in time. This is not cause for alarm, nor is it a reason to abandon our cameras. No, it just gives us more reason to continue to review, analyze, and revise our understanding of the picture at hand. We should try not to make more out of photo than we can at a given resolution – and understand that contradicting opinions are more likely to be evidence of insufficient information than a fundamental flaw of the scientific method.

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I have noticed that impatient photo-gazers have a propensity to demand answers before accurate ones are available. And this leads to all manner of passionately held, but misguided beliefs both in the scientific community and beyond. We must somehow find a way to make peace with limited information, eagerly seeking more, without being dogmatic about premature conclusions. My dentist colleague should not feel pressured into choosing sides on an issue that cannot be fully evaluated yet – and will have to wrestle with ambivalence as he waits patiently for more data.

But far more worrisome than living with ambivalence is living with stagnation. I would argue that one of the greatest red flags in the scientific world is an unwillingness to learn – an unyielding commitment to a set of beliefs, despite increasing evidence that they are not accurate. I think of homeopathy and acupuncture as good examples of this phenomenon – since they have not evolved significantly since their inception, their proponents therefore must admit that they have learned almost nothing new since the dawn of their use. The lack of refinement of treatment protocol is evidence of the system’s belief-based (or placebo-based) nature. As John Cage, US composer of avant-garde music, once said,

“I can’t understand why people are frightened of new ideas. I’m frightened of the old ones.”

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As I mulled over my fuzzy image analogy, an even better one came to mind: the game of 20 questions. For those of you who didn’t play this game growing up, its rules are simple: one person must think of a person, place, or thing and the other(s) have 20 questions that they can ask in order to guess who/what the first person had in mind. The challenge is that the questions have to be asked so that the response is either yes or no. If the questioners can’t devine the name of the person, place or thing within 20 questions, the respondent wins. If the questioners guess the identity of the object within 20 questions they win.

Science is a little bit like 20 questions (of course we have unlimited questions that we can ask) in that we constrain our research to answer a very specific question under a very specific set of circumstances (formulating a “yes” or “no” type question). No one question or answer is likely to unlock the solution to the larger puzzle – it’s the collection of questions, taken in context of one another, that leads to meaningful understanding. When we don’t understand the best path forward, it’s likely that we are early on in the game of 20 questions, with little information to guide us.  Occasionally we get lucky and ask the right question early – but more often than not we’re left to scratch our heads and ponder yet another question to help unlock the “mysteries” that face us.

That is the beauty and the pain of science – it’s slow, it’s methodical, it leaves the honest participant in a state of ambivalence with some degree of frequency, but in the end it yields real answers if we wait for the clarity that can come from careful analysis. Without it we are left with magical beliefs and misguided explanations… we’re left with Jenny McCarthyism.

Posted in: General, Science and Medicine

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7 thoughts on “Science And The Game Of 20 Questions

  1. daedalus2u says:

    excellent article which lays out the real scientific/skeptic way of thinking in clear and easily understood terms.

    You must have been a whiz at 20 questions, which is a great way to teach scientific thinking.

  2. Rogue Medic says:

    Great article.

    One of the other problems that people have is accepting that there is not always just one right answer. When it comes to medical care, the response to the first treatment might not be positive for this patient, although it is positive for 80+% of patients.

    The application of science at the individual level is the realization that although we are all members of the same species, we are not identical. That is part of the problem in explaining science to people.

  3. tmac57 says:

    What many people may be expecting from science is that ‘ah ha!’ moment that is so satisfying for even non-scientists. That may be why people are drawn to those that claim to have the ‘simple’ answer like “vaccines cause autism, and all manner of other medical problems”. One of the hallmarks of pseudo-science is the ‘magic bullet’ cure or explanation such as the “candidiasis hypersensitivity syndrome” . The layperson has very little appreciation for just how complex biological systems are, and they get frustrated by the sometimes fuzzy and ambiguous nature of research findings. This can lead to a distrust of the ability of mainstream science to give them the answers that they expect. When someone comes along and say ” I know what’s wrong with you, it’s the mercury in your fillings ” or similar such catchall diagnosis , that can be very seductive as opposed to the more honest “We just don’t know yet” response.
    By the way, I personally liked the “blurry camera lens at a farm” analogy the best.

  4. Thanks for this post! The 20 questions example is great – to gain knowledge, you have to keep refining the approach, and rule out competing ideas. And in the end it is the totality of the questions that provides the discovery of knowledge.

    Related to the autism problem: a challenge is that, sometimes, we do get ill from one specific, identifiable thing, if only we can figure it out: I adopted a dog with allergies. I had the A-Ha moment and figured out that it was a wheat allergy. Admittedly, while the culprit was not very difficult to identify, it took my background knowledge in allergies and rotation diets to isolate the culprit. This smoking gun/silver bullet resolved a lot of dog misery. If only everything were so easy and straightforward.

    I believe it is worthwhile to keep looking for simple, clear culprits in these clinical issues – but at the same time to keep in mind that the answer could just as well be very complicated – such as accepting the possibility that “autism” actually captures a range of disorders that resemble each other functionally, but might have greatly varied etiologies.

  5. weing says:

    “But far more worrisome than living with ambivalence is living with stagnation. I would argue that one of the greatest red flags in the scientific world is an unwillingness to learn – an unyielding commitment to a set of beliefs, despite increasing evidence that they are not accurate. I think of homeopathy and acupuncture as good examples of this phenomenon – since they have not evolved significantly since their inception, their proponents therefore must admit that they have learned almost nothing new since the dawn of their use.”

    But they have learned new ways of selling it to the gullible. Their market research is great and they have been successful in applying a double standard to science based medicine. You have to grant them that.

  6. Joe says:

    Those are two, good analogies for teachers.

    With respect to sCAM, you could observe that the more one focuses the telescope (i.e., the more rigorous the test), the less clear the result is. Concerning 20 questions and sCAM, the answer to the first question is always inadequate, requiring a “do over” of question one (i.e., more research is needed). The latter may be a bit of a stretch.

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