Elk Grove Village, IL – The American Academy of Pediatrics (AAP), the primary professional organization responsible for establishing pediatric healthcare standards, has finally released updated recommendations on dosing of infantile spanking (IS) and corporal punishment (CP) in children.
“This represents a huge step forward for pediatricians and parents,” Head of Disciplinary Pediatrics at Children’s Hospital of Philadelphia Dr. Mort Fishman explains. “Until now, parents have had to call the pediatrician, make an appointment and travel to the office sometimes hours to days after the undesired behavior has occurred. Or they visit urgent care facilities and emergency departments. Sometimes they wing it.”
It is this “winging it” by many parents that has concerned pediatric medical professionals for decades. Since the discovery of CP almost accidentally in the 1930s when a Harvard researcher inadvertently dropped a heavy glass beaker on the head of a stubborn lab assistant, a number of children have overdosed. Some have suffered permanent injury. A few have even died. Researchers have long blamed the lack of pediatric guidelines and inappropriate extrapolation of adult dosing, shouting out the oft repeated axiom that kids are not just little adults. Recent studies have even revealed an alarming upward trend in the inappropriate use of home corporal punishment.
The usual suspects are frequently mentioned by pediatricians, researchers and public officials. “Anybody can publish anything on the internet,” Fishman, who co-authored the AAP paper, adds. “There are literally thousands of websites offering up unproven techniques, inconsistent dosing, and pseudoscientific mechanisms of action.”
Parent groups have also become a loud voice in the discussion of pediatric corporal punishment over the past several years, calling for more research and for guidelines for home use. Members of such organizations as Mother’s Against Time Out and the more influential National Spanking Society have raised awareness and millions of dollars with 5K running races, bake sales and van-based mobile spank clinics. Many pediatricians are giving credit to these groups for speaking out for those who cannot speak for themselves and for pushing the AAP into action.
Dr. Fishman and the AAP hope that the new guidelines will help pediatric healthcare professionals to not only appropriately dose corporal punishment, but to better educate parents and other caregivers such as teachers, daycare workers and babysitters. As stated in the paper’s conclusion, “Empowered and educated caregivers can now confidently dole out safe and effective corporal punishment in a timely fashion without the need to clog up overburdened medical system.”
So are the new infantile spanking and corporal punishment guidelines useful for parents as well as pediatricians? They couldn’t be simpler according to Matt Stevens, a mechanical engineer and parent of 3 young children, one of which is kind of a jerk. “When one of my kids talks back or forgets to do a chore, usually Matty Jr., we have a handy flow chart taped to the wall by the fridgerator. After a few calculations, I know just how hard to smack him.”
But the responses to the new guidelines are not all positive. A vocal minority of pediatricians are raising concerns over the ability for caregivers without medical training to decipher the recommendations. Dr. Percival Boudreaux, academic pediatric hospitalist and discipline researcher, is one of the more prominent voices of opposition. “Is Timmy just being sassy or is he exhibiting stage 3 lollygagging? Is he a smart aleck or a wisenheimer? I trained in pediatrics for almost ten years and sometimes I can’t tell the difference!”
Dannon, the makers of Activia yogurt and DanActive drinks, has been fined $21 million dollars by the FTC for deceptive advertisements involving specific health claims. Specifically, they claim that their products can make you poop and keep you from catching a cold or the flu. Not smart. Really not smart. But it doesn’t matter because they will still come out on top.
The FTC has been trying (bless their little hearts) to crack down on misleading claims in advertisements, and I appreciate the effort. Thanks to the emasculation of the FDA by the 1994 Dietary Supplement and Health Education Act (DSHEA), the FTC is the only governmental regulatory body that can put a stop to them. In this case, as the linked article explains, it is likely too little and too late. Dannon has been pushing their products with these bogus claims for years and they are widely accepted by the public. $21 million dollars is a minor slap on the wrist and just the cost of doing business these days.
To catch any readers not familiar with DSHEA up to speed, it fundamentally changed the way that supplements and herbal remedies are regulated, making us all a lot less safe as a result. Post-DSHEA, regulation of the supplement industry, and even the more mainstream over-the-counter medicine industry (they are actually pretty much all the same thing these days), essentially works like old wild west law enforcement. Manufacturers can pretty much do as they please as long as they don’t make specific disease claims, such as that their product cures asthma, and as long as they don’t kill anybody. Well, as long as they don’t kill too many people.
Under DSHEA, the burden of proof for safety, efficacy and label accuracy belongs to the FDA. That may not sound bad but trust me, it is. There are hundreds of new products in this category that come out yearly and the FDA does not have the resources to investigate all of them. So there has to be some kind of triage system in place. A company can package a product, such as a so-called herbal remedy, and as long as they stick to what have come to be known as structure and function claims (“immune support” or “cardiac health”) they won’t be noticed by the FDA. They don’t need any evidence that their product is safe or that it is effective in any way. They don’t have to be honest about what is on the label in regards to ingredients. Nobody is checking on these things. It is an honor system and it has killed people.
Take ephedra for example. Ephedra is an herb that has been used traditionally for things like colds and asthma, as well as for increasing energy and for weight loss. It is understandable that pre-scientific cultures came to associate ephedra with these conditions because it is a potent stimulant. It constricts blood vessels, increases the heart rate and blood pressure, and it opens up airways in the lungs. Because of this effect it was investigated as a potentially beneficial medicine but the side effect profile was rough and better medications were developed. Science-based medical practice had no place for ephedra but it became an increasingly popular component in supplements taken by people desiring improved athletic performance or weight loss. It still isn’t clear whether or not it actually has much of an effect, if any, in regards to those desired outcomes, but it quickly became very clear that it was dangerous.
For years, thousands reports of adverse events came in to the manufacturers of products containing ephedra. These reports included deaths from strokes and heart attacks. These adverse events, including deaths, occurred not only in unhealthy people with risk factors for such outcomes but also in healthy young adults. Finally the FDA decided to step in, and in the late 90’s proposed label warnings. This was met with a campaign by the supplement industry and their lobbyists, as well as the two senators (Hatch and Harkin) responsible for DSHEA in the first place, to put a stop to this. They succeeded and unsuspecting consumers continued to suffer.
Then the tide turned. Additional evidence supporting the FDA concerns about ephedra came along, and public awareness of these concerns and calls for action increased. But it wasn’t until 2004 that the sale of ephedra was made illegal, after many thousands of serious adverse events were uncovered that had been purposefully kept from the FDA by a supplement manufacturer and after a large and expensive meta-analysis was conducted that clearly showed just how dangerous ephedra was. Even this was bitterly contested by the supplement industry but appeals were denied and ephedra remains banned in America.
DSHEA allowed this to happen. If supplements and herbal remedies were regulated like the sloppy drugs that they are, manufacturers of products with ephedra would have needed to provide appropriate evidence that they were safe. The tale of ephedra puts the lie to the fallacy that natural equals safe and should have served as a cautionary tale and impetus to improve the system. It didn’t, so you the consumer must be weary.
This came out today. I’ve read about many cases of adulterated herbs and supplements, usually Viagra spiked male “enhancement” pills, but things are much worse than I thought. Warfarin? Benzos? Damn. And that’s here in America folks.
In The Most Precious Thing, the opening chapter of Sagan’s masterpiece The Demon-Haunted World: Science as a Candle in the Dark, he discusses the appeal of pseudoscience and the various belief systems held by humans throughout history. All of us try out different belief systems at one point or another as we progress through life, generally because they fulfill our emotional needs. Many of these are encountered during childhood and adolescence, but most adults try out new beliefs as well, whether it is a new religion, astrology, psychic powers, the charismatic story of a self-help guru or even an alternative medical practice like chiropractic or acupuncture.
Sagan describes how these beliefs fulfill our desires for personal powers, our hunger for spirituality and our desperate yearning for cures for diseases. They can calm our fears and reassure us that death is not the end. They can buttress our feelings of importance in creation and ensure that we are tied to the universe, if not the center of it. They can serve as a gateway to the feelings of wonder and majesty that we crave while going about seemingly mundane existences.
Sagan, as he so often does, perfectly encapsulates the feelings of folks like myself, who look to science rather than the supernatural or pseudoscientific to satisfy that aspect of human nature that has come to be known as spirituality or to provide a sense of wonder in our lives. As a counterpoint to Sagan’s approach, I always think of Yann Martel, who in his otherwise excellent book The Life of Pi takes a different tack. In the story, the main character tells two versions of his travails on the high seas on a lifeboat accompanied by an unsavory cast of characters such as a Bengal tiger and a vicious hyena. Or was it simply himself and a deranged cook? He asks which is the better story and I certainly agree with the characters in the book that are posed this question when they say that the story with the animals is. Martel then writes, “and so it goes with God.”
Martel implies that the supernatural or pseudoscientific, in this particular case the existence of one particular version of a higher power, is the better story and is therefore more worthy of belief. To be fair, some in the religious community have not taken kindly to this assumption, equating it with postmodern claptrap, but it speaks to what the vast majority of believers, if not virtually all of humanity, is heavily influenced by. We all are emotionally impacted by a “better story” when it comes to spirituality and our connection to the natural world. Unfortunately, as countless polls over the past few decades continue to reveal our decreasing understanding of basic scientific concepts, the question is likely being begged by Martel and many others that the average person in America knows enough about science to make a fair comparison.
Sagan responds to the reality of the supernatural and pseudoscientific appealing to our human nature in typical and illuminating fashion:
“Although it’s hard for me to see a more profound cosmic connection than the astonishing findings of modern nuclear astrophysics: Except for hydrogen, all the atoms that make each of us up – the iron in our blood, the calcium in our bones, the carbon in our brains – were manufactured in red giant stars thousands of light-years away in space and billions of years ago in time. We are, as I like to say, starstuff.”
Although it helps to reveal the astonishing and awe-inspiring reality behind our existence, Sagan’s astrophysics inspired sentiment is far from enough to fully grasp the grandeur of human existence as revealed by scientific inquiry. Evolutionary theory, the linchpin of our understanding of life on Earth, describes the next phase of how we came to be here on Earth. But when Darwin published his own masterpiece in 1859, he didn’t just set in motion the means to which we might understand why modern humans are what they are. Evolutionary theory explains, simply and elegantly, how we are related in fundamental ways to all life from the bonobo and chimpanzee to the sea cucumber and even to unicellular bacteria. It reveals how, bit by bit over billions of years, life has struggled to survive in varying environments. How it has evolved countless mechanisms to improve its reproductive success via a sloppy process with no specific goal in mind. And yet here we are. No claws. Weak. Naked and soft. Flightless. Completely incapable of survival for years after we are born. Yet here we are. Social. Communicative. Resourceful. Masters of a variety of environments through our ingenuity, drive and a thin rim of neural tissue built upon a forebrain shared by all other vertebrates. Not by magic or divine whim. Not because of a universal directive or a undetectable vibrational field. Evolution, properly understood, is by far the better story and science is the key to that understanding.
I often discuss so-called “big picture” concepts such as this with my oldest daughter who has only just made six years of age. My goal is for her to grow up having a firm grasp of the beauty and majesty of science, even if she does not come to care about the specific details as much as her daddy. A few weeks ago, while watching a television program about the human body, I explained to her how we are all starstuff, born in the hearts of enormous balls of plasma held together by one of the fundamental forces of nature, and how one day our individual components will return whence they came. How in a few billion years, when the star at the center of our solar system burns up the last of its hydrogen and enters its own red giant phase, the Earth will be engulfed. Showing no signs of fear, she sat quietly for a moment. I could almost hear her brain working its way around the information.
Children are born scientists because they innately know to perform the most basic and most vital of the components of the scientific method, and they are better at it than most adults. They ask questions. A question is a celebrated occurrence in my house and it is always met with an honest answer, even if it is “I don’t know.” It is okay for children to learn that their parents are not the repositories of all human knowledge. It does them a disservice to make things up or to suppress their curiosity by dismissing their inquisitiveness. But it is only truly valuable if the “I don’t know.” Is quickly followed up by “But let’s find out.” My daughter didn’t have a question this time, although they would come over the days and weeks that followed. She thought deeply for a while, smiled and replied, “That’s really nice.”
Zoo Knudsen / Knudsen’s News
Jandine Odenkirk sits patiently in a room at a clinic located just blocks from her downtown Baton Rouge Apartment, waiting for her doctor. Only instead of the typical sterile treatment room, uncomfortable examination gown and nervous pacing, Odenkirk is nestled in a warm bed and surrounded by soft lights and music. A doctor walks in, places a metallic band around her head and plugs the attached array of wires into a sleek black machine in the corner of the room. It immediately comes to life and within seconds a slow but steady stream of paper emerges which the doctor examines closely for irregularities or, as is usually the case, signs of improvement. The doctor smiles. Her brain waves look much better.
As you may have already gathered, this isn’t your usual medical practice. In fact, it is much more than that. Odenkirk is one of a growing number of patients whose lives are being changed for the better by the Baton Rouge Sleep Bank™, which is owned and operated by Dr. Mort Fishman, DS. Fishman, a Doctor of Sleepology™ certified by the Certification Division of the Correspondence College of Tampa, a subsidiary of Sleep Bank™, saw a great need for sleep banking in Baton Rouge. “I’m proud, not only to call such a fine city as Baton Rouge home, but also to be able to provide such a life-changing service,” Fishman explains while Odenkirk undergoes her hour-long treatment process. “Before I came here people literally didn’t even know that sleep banking existed!”
Fishman has seen it all during his 5 years as a certified Sleepologist™. He says that fatigue is the number one cause of most medical complaints (See Table 1). Luckily, despite being ignored by more conventional doctors who only treat the symptoms of fatigue rather than the whole tired person, maverick scientists have been investigating treatment options for fatigue without the benefit of billions of dollars from the pharmaceutical industry because alternative treatments can’t be patented. Their tireless efforts eventually led to the discovery of sleep banking and ultimately to the patented process of Sleeptivation™, where banked sleep is transfered into the brain of a sleep deprived patient.
“It’s simple really,” Explains Dr. Fishman. “Most people are familiar with regular banks, where humans deposit and withdraw money. Many people may even be familiar with milk banks or even cord blood banks. This is exactly like that except instead of breast milk for micropremies or stem cells for cancer patients, we bank sleep.”
Here’s how it works. Just like with blood or plasma donation, healthy volunteers take anywhere from thirty minutes to an hour of their time, usually on a weekend or day off, to come to the Sleep Bank™ and donate sleep. The process couldn’t be more easy. Volunteers are hooked up to the same machine as Jandine Odenkirk only the large black knob on the front is turned to “In” instead of “Out”. Volunteers are not monetarily compensated for their donation for a very important reason. “Studies performed at Sleep Bank™ regional headquarters in Boulder were troublesome,” Fishman reveals. “They discovered that non-altruistic sleep donation increased the risk of sleep rejection by over a quartile! It wouldn’t be right to take that kind of chance.”
When a fatigued patient, like Jandine Odenkirk, comes in for a Sleeptivation™ session, they are treated as well as they would be at any expensive spa, conventional or medical. Aromatherapy and Music Therapy are integral to the process, which also includes a 5-minute light massage and a glass of wine. The knob on the machine is then turned to “Out” and the patient typically enters a relaxed state almost immediately, with most actually falling asleep. “Several studies have shown that the process of Sleeptivation™ is more effective if the patient is asleep during it, but that is where our understanding of this complex science becomes less clear.”
Odenkirk, a 45-year-old executive with a history of stress and anxiety disorders, isn’t concerned about the science. She reveals, “I’m glad that top minds are looking into these questions, but what really matters is if it works. And, in general, I can usually say that I feel somewhat more relaxed after the treatment.”
Sessions can last anywhere from thirty to forty-five minutes, but Dr. Fishman has on occasion allowed them to go longer. “We don’t practice cookbook Sleepology™ at the Sleep Bank™. Sometimes a patient just needs a few more minutes.”
But I didn’t just take Dr. Fishman’s word for it, although he is one of only ten certified Sleepologists™ in Louisiana. I asked noted local skeptical blogger, The Red Stick Skeptic, his thoughts on sleep banking and Sleeptivation™. “It sounds like a typical set up for being fooled into thinking that a treatment works, when all that is going on is the customer is getting a nap and a healthy dose of placebo,” Red Stick Skeptic bellowed curmudgeonly. “And I’m sure it isn’t free either!”
To answer the question once and for all, I underwent a Sleeptivation™ session and couldn’t have been more impressed. As a dedicated investigative journalist who is lucky to get 2 to 3 hours of sleep each night, I know that sleep deprivation is a big problem, and sure enough I suffer from just about every symptom on Dr. Fishman’s list. After my hour of treatment, I felt relaxed and ready to face the rest of the day. I’d recommend it to anyone and everyone. Sleeptivation™ is the real deal.
(Sleeptivation™ costs $200 per half hour but there are less expensive rates when sessions are bought in bulk packages of 10, 20, or 50. The Baton Rouge Sleep Bank™ also offers an unlimited lifetime membership for $15,000. There is also an at-home system which can be rented for $500 per day or $2,000 per week. These fees do not include consultation with a certified Sleepologist™. High quality cotton tee-shirts, with the slogans “You Ain’t Been Vated, Till You Been Sleeptivated™!” or “Perfect Health is 1% Perspiration and 99% Sleeptivation™!” are available for $20.)
Table 1: Symptoms proven to be treated by Sleeptivation™*
-difficulty maintaining homeostasis
-persistant production of saliva
-difficulty abstaining from cocaine use
-continued regrowth of body hair despite repeated attempts at shaving it off
-difficulty holding more than 5 to 9 objects in working memory
-difficulty reading without one’s glasses or contacts
*According to the International Sleepology Institute™
Baton Rouge, LA-Zombie scientists working out of the Zombie Division of Louisiana State University’s Department of Neurosciences announced today during a press conference held in the basement of Hodges Hall that the results of a year-long study of zombie behavior refute the widely held belief that zombies only eat 10% of your brain.
“These results will come as a shock to the millions of tasty humans that believe zombies only eat 10% of their victims’ brains,” Lead researcher and lumbering type zombie Greg Stinson explained while chained to the podium. “Even large percentages of zombies believe it. But this exhaustive examination reveals that we actually eat 30-40% of delicious life-sustaining human neural tissue when time allows, and that any uneaten portions usually are consumed by various animal zombies. And Native American zombies are known to eat all parts of the brain.”
Dr. Mort Fishman, a fast-running zombie neurologist, has questioned the 10% myth for years. He revealed from his containment structure in the Department of Neurosciences’ underground facility that the new study is a nice confirmation of the skeptical stance but that it is unlikely to change many of the superstitious beliefs about zombies that are so prevelant amongst humans. “Undead cranks and charlatans will likely continue to push zombie self-help books and unproven herbal remedies with pseudoscientific claims of boosting a zombie’s brain eating potential. I’ve learned over my many years as a zombie that anecdotes are more powerful than any scientific study. Also I’ve learned that brains are delicious and I would very much like to eat your brain.”
I’ve been thinking about Carl Sagan a lot lately. This isn’t surprising considering what would have been his 76th birthday recently passed (November 9th), and a number of skeptical blogs and podcasts have covered this fact. Sagan passed away in 1996, a good 7 years before I stumbled into awareness of the skeptical community, but his impact on myself and countless others since has been significant. He was, and is, a beloved icon of the skeptical movement, and deservedly so. Sagan championed reason and popularized science like none before or since.
While Sagan’s classic 1995 ode to critical thinking, The Demon-Haunted World: Science as a Candle in the Dark, wasn’t my first book focusing on science and skepticism, it certainly had the greatest impact. My personal introduction to skepticism, after watching an interview of him on the DVD extras for Penn and Teller’s television program Bullshit, was James Randi’s Flim-Flam, another classic that finds a home on many top ten lists. That book, along with the writings of Michael Shermer, Bob Park, Stephen Jay Gould and many others have influenced my approach to life greatly, but none like Sagan’s. It wasn’t just his ability to debunk pseudoscience, which I am especially fond of, or his ability to discuss complicated scientific topics in a way that those of us with lower intelligence quotients could grasp. Sagan’s gift was his ability to communicate the wonder of it all, the overarching beauty of a natural world with intimate connection between the tiniest elementary particles and galaxy clusters 85 million light years from Earth, or strands of nucleotide molecules and elephants.
I’ve decided to pick up my copy of The Demon Haunted World and read it for the second time. My plan is to share what is meaningful to me as I progress through it, and to hopefully inspire others to read the book themselves.
In the first few pages of the book, Sagan wastes no time in describing one of the fundamental frustrations in skepticism. While being driven to a speaking engagement, he engages in conversation with the driver, an intelligent man with many questions about topics ranging from the supposed lost continent of Atlantis to the shroud of Turin. As Sagan politely shoots down each and every claim brought forth by the gentleman, he is struck with the notion that here is a man, curious about the natural world and motivated to learn, with a misplaced sense of awe. Rather than the wonders of scientific discovery, he is captivated by the unproven and implausible claims of pseudoscience.
“And yet there’s so much in real science that’s equally exciting, more mysterious, a greater intellectual challenge-as well as being a lot closer to the truth. Did he know about the molecular building blocks of life sitting out there in the cold, tenuous gas between the stars? Had he heard of the footprints of our ancestors found in 4-million-year-old volcanic ash? What about the raising of the Himalayas when India went crashing into Asia? Or how viruses, built like hypodermic syringes, slip their DNA past the host organism’s defenses and subvert the reproductive machinery of cells; or the radio search for extraterrestrial intelligence; or the newly discovered ancient civilization of Elba that advertised the virtues of Elba beer? No, he hadn’t heard. Nor did he know, even vaguely, about quantum indeterminacy, and he recognized DNA only as three frequently linked capital letters.”
Admittedly, the siren’s call of pseudoscience can be quite enticing. I speak from a certain degree of experience having been caught up in the world of paranormal research in my younger days. Like the driver in Sagan’s anecdote, I have always had a keen interest in understanding how things work. Not quite like my brother, who used to take apart mechanical devices so that he could put them back together, learning what makes them tick in the process, but on a more fundamental level. And I have always experienced an intellectual rush, so to speak, from learning about new scientific advances. M problem was differentiating science from baloney.
I yearned for insight into the mysteries of life but faced a number of hurdles, like cultural influences, the educational system itself and the way science is presented by the media and entertainment industries. I knew quite a few scientific facts, such as how to define a mammal, how fossils are formed or the order of the planets but I didn’t realize, hadn’t an inkling of in fact, how much there was that I didn’t know. And when I did attempt to piece together these random tidbits into a larger picture, I filled in the gaps of my understanding with what was available for easy digestion. I credulously watched television specials on alien visitors and the paranormal or read the Time Life series on ghosts and psychic powers uncritically. I even remember learning some medical “facts” from the commercials for a local chiropractor. Later, when I told my friends about it, I thought I was discussing legitimate science. I thought that these were the real mysteries of life. I didn’t have a clue what real science was or how it works.
The frustration that so many skeptics share, and certainly those involved in skeptical outreach, is that such a large impetus for belief in pseudoscience is that it fulfills the human desire for awe and wonder. But it is a meager gruel. One of the reasons why so many people look elsewhere for their wonder fix is that science is typically not presented in a flattering light to the public. Scientists are portrayed as nerds, or weird old men in white jackets with wild hair. Science is the butt of jokes and shown as boring, or overly complicated, or as just another way of understanding the universe, equal to any other. But good science, properly explained in the right context, is more awe-inspiring, more satisfying than anything that could ever be invented by the human brain.
Sagan discusses the general state of scientific illiteracy but more importantly why it matters:
“It’s perilous and foolhardy for the average citizen to remain ignorant about global warming, say, or ozone depletion, air pollution, toxic and radioactive wastes, acid rain, topsoil erosion, tropical deforestation, exponential population growth. Jobs and wages depend on science and technology…..Consider the social ramifications of fission and fusion power, supercomputers, data “highways”, abortion, radon, massive reductions in strategic weapons, addiction, government eavesdropping on the lives of its citizens, high-resolution TV, airline and airport safety, fetal tissue transplants, health costs, food additives, drugs to ameliorate mania or depression or schizophrenia, animal rights, superconductivity, morning-after pills, alleged hereditary antisocial dispositions, space stations, going to Mars, finding cures for AIDS and cancer.
How can we affect national policy-or even make intelligent decisions in our own lives-if we don’t grasp the underlying issues?”
Despite the negative stereotype of skeptics, debunking is only a small part of what we do. Despite being much maligned, debunking is an extremely important role, but that is a topic for another post. Many of us consider the most vital role of the skeptic, however, to be that of the science popularizer. Unfortunately, very few actual scientists have proven to be any good at this. Besides Sagan, there is a very short list of people who have been able to achieve any significant mind share. Bill Nye and Neil deGrasse Tyson are two very excellent examples. A number of non-scientist skeptics have answered the call as well, but it is an uphill battle. Still there is hope. The popularity of shows like The Big Bang Theory and Mythbusters is very encouraging.
More to come.
Carl Sagan supposedly once said that randomness is clumpy. It is my new favorite thing to say because it is so simple and it so effortlessly explains so much about our experience with the natural world. Sagan’s ability to offer up life-changing nuggets of rational thought like this was unmatched and his efforts to bring science and reason to the public have been sorely missed since his passing in December of ’96. If you haven’t read any of Sagan’s works, I highly recommend The Demon-Haunted World: Science as a Candle in the Dark.
If you have a coin, and an hour to kill, record the results of a few hundred flips and you’ll see what Sagan meant about the nature of randomness. You will inevitably record clusters of heads or tails that seem improbable. Runs of heads or tails five, six, even seven straight times wouldn’t surprise me at all. But eventually, the outcomes will average out to about half of the flips being heads and half resulting in tails. The more trials that you perform, the closer the outcomes will approach exactly 50% for each possible result. I’m assuming you aren’t using a trick coin of course.
I don’t think that very many people would argue with the fact that on average a coin flip is random chance, although there are still people out there who think that the Earth is flat and that Miley Cyrus isn’t a robot. But because of a deeply rooted cognitive bias, we tend to forget that randomness is clumpy. We accept the established odds overall, but not in short runs of randomness whether it is a series of coin flips or, for a more “real world” example from my line of work, the incidence of bacterial meningitis in neonates with fever. We do this despite the many cold doses of reality experienced over a lifetime of allowing the past results of a random process to influence our expectations of future results of that random process. This is the essence of the Gambler’s fallacy, an error in logic that can lead to the belief, for instance, that after five heads in a row there is a higher than 50% chance that the next flip will land on tails. There isn’t.
The cognitive bias which results in this commonly employed logical fallacy is, as is often the case, the result of an inappropriately employed mental shortcut. These shortcuts, known as heuristics, can be very helpful but sacrifice accuracy for efficiency of thought. In the case of the Gambler’s fallacy, the representative heuristic is to blame. If someone is aware of the fact that a result has a known frequency of occurring, such as the flip of a coin or the spin of a roulette wheel, they often mistakenly make the assumption that short runs will be representative of long runs. This means that a run of ten or twenty should be equally split between heads and tails, or red and black in the case of roulette (1), in the same way that a run of a million would be. But, once again, randomness is clumpy and short runs often have surprisingly unbalanced results.
I recently had a somewhat heated exchange on the comment section of a Facebook friend’s status update. My friend, a mother of three boys, was expecting her fourth child and had not found out yet whether this baby was a boy or a girl. She expressed her desire for a girl and a relative of my friend commented that the new baby would almost certainly be female because the odds were so highly in favor of such an outcome. It is true that the odds of having 4 boys in a row is very low, about 6%, but this was a classic example of the Gambler’s fallacy. I responded and an argument ensued.
Now I am the first to admit that I am somewhat of a drive by skeptic when it comes to Facebook. I rarely allow an opportunity for chiming in when I disagree with a comment to pass by. And I further admit that I recognize that this is probably a character flaw of mine, and that I have made more than a few people rather angry or at the very least somewhat uncomfortable when their comment section is hijacked. My wife thinks I’m as ass, and as with most things, she is almost certainly correct in her assessment. I’m working on it, but I just couldn’t pass up such a beautiful hanging curveball.
So what were the odds of my friend’s child being a girl? There are two ways to approach this problem with one of them being right and one possibly seeming right because of the representative heuristic. Readers of this blog should know that what feels right on a gut level is often completely wrong. First though, some basics on the determination of sex in humans (2).
Human infants are generally born as either male or female and the determination of sex is based on genetics. Most mammals, humans included, select gender using an XY system that most of you are probably fairly familiar with even if you don’t remember the specifics. Modern humans, individuals with genetic syndromes aside, have a genome which consists of 23 paired chromosomes. The pair that determines an individual’s sex are, not suprisingly, called sex chromosomes. Females generally have two X chromosomes (XX) and males have both an X and a Y chromosome (XY). It is widely considered, although there is some controversy, that human zygotes are inherently on the path towards being female at conception and that, if present, a single gene located on the Y chromosome alters this course resulting in male offspring (3).
Most cells in the human body are identified as diploid, which means that they contain the above mentioned 23 pairs of chromosomes (4). Reproductive cells like sperm and ova, known as gametes, are haploid in that they only contain one set of the 23 human chromosomes. This make sense because they will combine to form a diploid zygote at conception. The female ovum always contains an X chromosome. It is the male sperm which ultimately will determine sex because an individual sperm can carry an X or a Y chromosome. Which sperm fertilizes the impatiently waiting ovum is a crapshoot and it works out to a roughly 50/50 split between male and female embryos (5). Studies looking at large numbers of families have shown conclusively that even in the case of families with long runs of male or female children, the chance that a subsequent child will be male or female remains pretty close to 50/50.
So in the case of my friend with 3 boys and a bun in the oven, the likelihood of having another boy was 50%, not 6.25%. And the chance of finally having a girl was 50%. But let’s further explore the notion so strongly argued by my friend’s relative, that the sex of previous children impacts the sex of future children. As I’ve already explained, there is a perfectly reasonable cognitive bias to blame for this fallacious logic, the misuse of the representative heuristic. But for argument’s sake let’s assume that he was right. What would the mechanism for this be? How would past results impact future results of a seemingly random process like sex determination? Somehow the male sperm would have to be cognizant of the sex of prior children and to intentionally select an X or a Y chromosome carrying champion to breach the defenses of the female genital tract and fertilize the ovum, perhaps in an effort to maintain the appearance of randomness over multiple pregnancies. These diabolical sperm must apparently act to prevent our awareness of a grand conspiracy which hinges on there being a roughly equal number of male and female offspring. Are they psychic and able to probe the inner recesses of the male mind? We may never know the answer but there is something I do know: don’t anthropomorphize sperm, they hate that!
(1) I realize that the odds of that little white ball landing in a red or black slot isn’t exactly 50/50. The 0 and 00 green slots give the house a little edge. So does the booze.
(2) As opposed to alligators, for instance, the sex of which are impacted by temperature variations rather than genetics.
(3) Usually. Sex determination is very complex. There are certainly instance where the genotype (XX or XY) doesn’t match with the phenotype (outward appearance) but these are quite rare and beyond the scope of this post.
(4) This isn’t entirely accurate. Most cells in the human body are bacterial.
(5) There is some nuance to this naturally. There is the possibility of a minor influence by environmental factors or factors inherent to sperm carrying X versus Y chromosomes which may lead to a slightly increased chance of male versus female offspring in some women, or a slightly higher rate of male births than female across populations, but these differences are not meaningful. And unless you are making use of gender selection via technology, such as with IVF, any environmental changes made by families to encourage the birth of a prefered sex will not alter the outcome.
I recently received the following response on the “About Red Stick Skeptic” section of my blog:
“I totally understand the need for skeptism and critical thinking in this day and age. We have become much more focused on the almighty $ than anything else. However, to lump all alternative medicine practioners/practices into the category of pseudoscience is not only shortsighted but misleading. Some of these therapies have been around longer than medicine and have stood the test of time.
I know that we are all essentially wired the same, however, how we respond to certain things can be completely different. So just because one person does not respond favorably to a particular therapy does not mean the next person won’t.
Skepticism is healthy, denial is not. Millions of people have been helped in some way, shape, or form from alternative therapies. Have an open mind and ask questions, but try things for yourself and let your body determine what’s right for you.”
This may seem like a reasonable criticism at first glance. Skepticism, the commentor remarks, is healthy while denial(ism) is not. That is probably very true, although I have a feeling that we disagree on just what defines these terms. I doubt that the commentor understands the practice of skepticism, which is more than just having and open mind and asking questions, although both are important. He is a pseudoskeptic. Like the pseudoscientist who makes use of the trappings of science to give the appearance that legitimate investigation is taking place, he uses skeptical terminology and professes his appreciation for critical thinking. He knows some of the lingo, but this is merely subterfuge.
Psuedoskepticism is sometimes an intentional act employed to fool others by giving claims an air of undeserved legitimacy. “Hey, I’m a skeptic and I really believe in this stuff!” Many people intuitively know to be wary of obvious salesman, although they do tend to leave this inherent skepticism at home when they seek relief for what ails them. Or it occurs as a mechanism to avoid cognitive dissonance, to better convince oneself that the bunk they are spouting is the real deal. I suspect that the commentor falls into the latter category and is himself denying the robust evidence that exists refuting the personal belief in alternative medicine that he is so invested in emotionally, and likely economically. But I’m an optimist.
Skepticism calls for the provisional acceptance of claims based on scientific evidence and plausibility. The greater the evidence, the less plausible a claim must be to be accepted. Some seemingly outlandish hypotheses have come to be accepted because the evidence is clear and powerful. (An expanding universe? My ancestors were apes? What the heck?) The greater the plausibility, the less robust the evidence needs to be for the skeptic to tentatively accept the claim. But there must still be evidence, however, and that evidence must still be scientifically sound.
We place greater or lesser importance on evidence based upon its type. Trying things for oneself and letting one’s body determine what is right, as was recommended in the above comment, is anecdotal and subject to being impacted by countless biases and confounding factors. Not suprisingly, it is the weakest form of evidence when it comes to figuring out whether or not a treatment works. Calling for me or my readers to base acceptance on this is a huge red flag indicating that we are dealing with a believer rather than a skeptic. Regardless, there is always the risk of improperly including individuals or practices in one classification if you overgeneralize or make straw man arguments. We should always remain open-minded to new ideas. We shouldn’t ignore evidence because of an idealistic or dogmatic set of beliefs. All of these are valid points, all true sentiments. And all are clearly empty words when read in the context of the entire comment.
It is implied that I am unfairly claiming that all alternative medicine modalities are pseudoscience and their practitioners frauds. He claims this is shortsighted because some of these therapies have been around for hundreds of years and have stood up to the test of time. Millions of people, he reveals, have been helped in “some way, shape, or form” by alternative therapies. That is rather nebulous but that many people can’t be wrong. Right? Well, how have they been helped exactly? Make a specific claim and I’ll address it. There are many examples throughout history of lots of people being fooled and the bottom line can be summed up with the well worn skeptical axiom, “The plural of anecdote is anecdotes, not evidence.”
It is ironic, and just plain wrong, for a skeptic to use an argument from antiquity or an argument from popularity as support for my being shortsighted. These supposedly ancient therapies, acupuncture often coming up in this context, have had centuries or longer to prove themselves and continued existence is a poor marker for true efficacy. Physicians and other healers bled patients for more than a thousand years, all claiming just as vehemently that the benefit was clear. They did so in pre-scientific times and thus have somewhat of an excuse for killing their patients in an earnest attempt to save their lives. But times have changed and the age of science has brought a better understanding of the natural world. Bloodletting was a casuality of this advanced ability to lift the veil of ignorance, along with the humoral system of medicine that birthed it.
A healing therapy can survive and manitain popularity for a variety of reasons, even when it is ineffective. The only way to root out therapies that work from the countless examples of those that at best serve as placebos, or at worst cause harm, is the scientific method properly applied. Good science has been used to investigate these therapies and the verdict is in: There are no alternative medical therapies that have proven benefit for any human ailment beyond that of placebo. A great deal of bad science has unfortunately been used to propel these modalities further into public awareness and even into hallowed halls of many academic institutions. This is a trend that has worsened over the past few years and shows no signs of slowing down. It is quite accurate to refer to therapies as pseudoscientific that are bolstered with bogus and meaningless scientific jargon (human energy fields, cellular vibrational frequencies, etc) and badly designed studies (no placebo control, anomaly hunting, etc).
It would be quite unfair, however, for me to lump all practitioners of pseudoscientific therapies into the category of fraudulent hucksters and snake-oil salesman. I don’t know what is truly in the hearts of these folk. I have no doubt that some of them are dishonest and know that they are selling lies but I am equally sure that some honestly believe in their practice or product. It is easy to be fooled into thinking that something works when it doesn’t. I don’t attack the person, I focus on the idea, and in the world of alternative medicine the idea is rotten and needs to be thrown out with yesterday’s copy of Fortean Times.
There is good science taking place every day that focuses on areas considered, wrongly, to be alternative medicine, and there have been many great successes. Many of the effective components of our pharmaceutical armamentarium originated from the plant world, for instance. Study in this area continues and will likely yield future advances in medicine. Proponents of alternative medicine are quick to hold these successes up as evidence for the worth of alternative medicine in general but this is absurd and highlights the risk inherent in having a category of medicine which includes modalities as disparate as medicinal herbs and reiki. Imagine if I decided to treat a patient’s abdominal pain with an antihypertensive agent because penicillin is an effective treatment for strep throat. It is equally ridiculous to imply that because aspirin was derived from the willow that iridology is a legitimate modality for diagnosing lung cancer, or that echinacea is effective in treating the common cold. But this kind of reasoning takes place every day and my critic’s comment is saturated with it. Using the sucess of one treatment labeled as alternative medicine, especially when it shouldn’t even be included in the group, to give legitimacy to another may be effective if your objective is widespread acceptance, but it is a dangerous double standard.
Herbs, even if touted as safe and natural alternatives to conventional medicines, are merely drugs. Crude, unrefined and sloppy drugs. Of course there are likely to be herbs that have the ability to effect the physiology of the human body, and the low hanging fruit have been collected over the past couple of hundred years. The overwhelming majority of what is left over will have no effect, or will have a deleterious one. But there may be a supplement on a GNC store shelf somewhere that might hlep with a particular condition. The reality is that those who take that supplement are just as subject to the potential risk as they would be taking amoxicillin for an ear infection. Ephedra comes to mind quite easily. Without proper scientific investigation, it is a roll of the dice and that is assuming the contents actually match what is on the label. Many supplements have been found to contain pharmaceuticals. Viagra in male enhancers, for instance. There is nothing alternative about studying the natural world scientifically for possible benefit to mankind. It is alternative, however, when herbs or supplements are touted as natural and risk free cures when evidence is lacking or, as in many cases, after scientific evidence is clearly unsupportive.
The commentor agrees with me, and others who are decidedly smarter than me, that humans share some hardwiring. I don’t think he quite understands what we mean, however, but he certainly provides a fantastic example of it. When I say that the human brain is hardwired to respond to certain situations in fairly reproducible ways, I am talking about mental behaviors. We all employ certain heuristics, or rules of thumb applied to thinking, that help us efficiently make sense of our environment. This is an advantage in many instances, and helps set us apart from the rest of the animal kingdom, but it has its downside. We often sacrifice accuracy for efficiency. We jump to conclusions when we apply these mental shortcuts too broadly or place more importance on our gut conclusions than on scientific evidence. Logical fallacies, such as the appeal to antiquity and the argument from popularity, are examples of hardwiring that hinders our ability to correctly assign cause and effect relationships.
We are also similarly hardwired, although I don’t typically use that term in this setting, in the sense that we share a physiology that responds in a very predictable pattern to changes in our environment, to injury and illness and to foreign substances such as toxins or medications. This is one of the foundations upon which the scientific investigation of medical therapies relies upon to determine safety and efficacy. It all comes down to the basics of our physiology, which we have an impressive, although admittedly incomplete, grasp of. One of the findings of proper scientific inquiry into the treatment of human illness is that the more we treat every patient the same, the better the outcomes tend to be.
Naturally we must take into account a number of psychosocial factors in addition to the biological ones, and there are ranges of variable response to our interventions. But much of this is due to factors that we have discovered and understand through the use of science. To claim that humans respond to treatments completely differently, however, is misleading. And to use that claim as impetus to seek out implausible and unproven remedies is risky. Where does one draw the line? How do we measure response and decide if it is favorable? How would we decide that any one treatment is not effective? If science is to be ignored, how would we decide what treatments should be attempted first, or which are too dangerous? Pseudoskeptics tend to avoid following this kind of thinking out to its logical conclusion, an approach to healthcare which would be a nightmare for patients and would quickly fail because of enormous expense and increases in morbidity and mortality.
How is a doctor like a psychic? The answer is surprisingly simple. Despite sounding like the introduction for a bad joke, along the lines of “What is the difference between a doctor and a chiropractor?”, the comparison of physicians to those individuals claiming to call upon supernatural powers to gain access to previously unknown information holds true……sort of.
Like psychics, doctors make use of a particular set of unique skills to extract personal information from their patients. This is often done in such a way that patients are unaware of just how much they have revealed about themselves. This always involves simple and direct questioning, such as when the doctor asks a patient about their symptoms or whether they have had any surgeries in the past. But many of the questions asked by physicians do not intuitively have any connection to a patient’s concerns, such as when I recently asked the parent of a child with bloody diarrhea if they owned any turtles. Or when I asked the parent of a jaundiced infant if gallstones run in their family. A good doctor often must read between the lines and connect seemingly disparate lines of evidence to arrive at a conclusion which may not be obvious to the patient or family. And though the doctor is able to figure things out that they didn’t directly ask about, and had no foreknowledge of, no psychic powers are necessary.
The psychic, when performing a reading for a client, also probes or fishes for information. Sometimes they ask obvious questions, such as if the client has been having problems at work. Sometimes they make statements, such as when a psychic senses a problem in client’s chest or feels that someone from beyond the grave, whose name starts with an M, is present. Both physicians and psychics also make use of a visual examination to add to their impression about the patient or client, with hopefully only the doctor putting any physical examination skills into use. They both play the odds, making assumptions based on how likely something is to be true. A physician, for example, may look at a 5-day-old severely jaundiced infant at their newborn follow-up visit and, with a fair amount of confidence, focus the initial discussion on interventions for breastfeeding difficulty. Similarly, a psychic may look at a tearful young woman with no wedding ring on and bags under her eyes from a lack of sleep and make a high-yield assumption that she is having a relationship problem. But such indirect techniques are not necessary to be a highly successful psychic.
I’ll go ahead and reveal, not that it will come as a surprise to regular readers, that the evidence supporting the existence of psychic abilities is weak and doesn’t support acceptance. But it is accepted by large percentages of the American public despite a lack of both plausibility and of supporting research. It is easy to understand why, once reason has been set aside and a belief in psychic powers initiated, this belief is resistant to the assault of rational explanations. As with other similarly implausible notions, such as the proposed impact of the full moon on psychiatric symptoms or birth rates, confirmation bias serves as a powerful means of protection. Because of confirmation bias, we only seek out or remember information that confirms our beliefs. And we selectively interpret new information in such a way that our beliefs are not negatively impacted, thus avoiding the dreaded entity known as cognitive dissonance. When confronted, believers will generally offer up anecdotes and, in some instances, poorly designed pseudo-research but these primarily serve as means to prevent loss of belief. The big question is why do we believe in the first place?
It would be easy for me to chalk belief in psychic powers up to mental illness, or to gullibility. I could assume that all psychics are frauds and that they use trickery to convince us (1). I’m sure that many believers are nuts, and that many psychics are intentionally manipulating people for potential fame and fortune, but I’d wager these are in the minority. Most folks, psychic are psychic friend, are simply deluded, having fallen victim to what essentially are glitches in the otherwise pretty effective functionality of the human brain.
The human brain, magnificent though it may be, is perfectly suited for belief in the supernatural. Among the many traits that make humans successful as a species is our ability, if not our uncontrollable drive, to connect the dots. Our ability and urge to put two and two together, or however else you want to describe this uniquely human(2) capability, is a direct result of the evolutionary path we have stumbled onto. And it has always been at the heart of humanity wide improvement projects. But having a plump neocortex isn’t all vaccines and moon landings, unfortunately. With great brainpower comes an equally great ability to fool ourselves, and it has led to a vast array of irrational convictions and superstitious beliefs.
The reason for this is that, as good as we are finding meaning where it exists, we are equally adept at finding meaning where it doesn’t. We force patterns in random stimuli. We strive to piece together unrelated data points. Only humans, for example, can look at the pattern in a pine door and see the face of Jesus or hear discernible and meaningful words amongst the gibberish of a Beatles’ song played in reverse. And, because we just can’t help it, we absolutely love to make everything about us. The entire universe was created with us in mind, after all. At least it was according to the majority of humans alive today. But we are even better at this when it comes to making sense out of the world on a personal level. This is the very essence of superstition, isn’t it? The absurd belief that not only my life can be negatively or positively effected by meaningless actions such as walking under a ladder or carrying around a lucky rabbit’s foot, but the lives of others as well. The egotism involved in believing that forgetting to wear a pair of lucky socks might result in a football team losing a game is staggering. It is the assignment of personal significance to meaningless information that sets us up to fall for the primary means of being fooled, or fooling ourselves, into believing that some people, including ourselves, have psychic abilities. This fundamental method of deception is known as cold reading.
Cold reading is a method of manipulation that can be purposefully put into use by a trained charlatan to give the impression that they possess abilities beyond the natural world. It involves a variety of techniques that lead to the offering up of information, not by the psychic but by the person who has sought out the psychic(3) for guidance, or that take advantage of the human drive to find personal meaning in vague or random data. The general approach of the psychic is to throw out vague statements or questions and allow the client to either give visual cues that they have found meaning in something, perhaps with a slight smile or a change in body positioning, or to give verbal feedback which helps guide the reading down a certain path.
The following is an example of how a typical cold reading session might go:
Psychic Jim (PJ): I’m sensing a disturbance in your chest. Have you had problems with your heart, or your lungs, or anything in the chest?
Subject Sally (SS): Well, I cracked a rib once during a fight.
PJ: The spirits are telling me there has been conflict in your past, but no resolution. You should find this person and seek to make peace in order to find true happiness.
SS: It was during a kickboxing class and my partner accidentally kicked me in the side too hard. There weren’t any hard feelings.
PJ: Great! The spirits were unclear whether this conflict was in the past or if it was a current issue in your life. They are telling me that you have an easy-going nature. You are capable of forgiveness when others might become bound up in negativity. That shows great strength as a person!
Or like this:
Psychic Jim (PJ): There is someone here with us today Sally. The mist is heavy around them but I’m sensing a male figure who passed on recently.
Subject Sally (SS): One of the guys at the office died last week. A heart attack. We weren’t close. He was a hard worker though, and a nice guy. His name was Tim.
PJ: I’m sensing regret. Tim is telling me that he didn’t feel close to you and he wished he would have made an effort to get to know you. He’s saying that you were always such a positive presence at work. He says that you deserve a promotion!
SS: It’s my company. How could I be promoted?
PJ: The mist is heavy around Tim, I’m barely sensing him. He says that you were wonderful to work for.
Do you think that Psychic Jim demonstrated mysterious supernatural abilities? Subject Sally most likely does. Psychic Jim knows he doesn’t have to be right every time, or even very often. Or at all. He just had to make vague statements or questions and she filled in the details. He also skillfully was able to change directions when a path hit a dead-end, as it did when Sally revealed that Tim was an employee of hers and not a co-worker. Sally will very likely misremember that the information she gave, the cracked rib and the deceased man at work, was provided by the psychic. She will remember those pseudohits and forget the blatant misses. People want to believe, they want there to be meaning in the psychics statements, so they will force it and their brain will warp the memory. The positive nature of the psychics claims, that Tim was telling him how wonderful she is, only increases the likelihood of this happening. Psychics know that telling clients what they want to hear is the surest way to insure repeat business (4). This is why their readings consist of vague yet positive statements, along the lines of newspaper astrology sections, that almost anyone would feel fit them well. After all, don’t we all wish to be strong, capable of forgiveness and a positive presence at work!
Cold reading isn’t just a tool of charlatans, however. These techniques come into play unintentionally all the time. Some so-called psychics hone the skill over time with study and practice but many people are also naturally good at them. They are the people who consider themselves intuitive and really good at reading people. Rarely do these people believe that they are using psychic powers though but they also rarely understand that their ability isn’t all that special. Anyone can learn to convincingly cold read. Anyone can be a psychic. So it is easy to see how some professional mediums may actually believe that they have a special gift unexplainable by science, and that they are truly helping people. I disagree. Regardless of the intention, deception is very rarely justified.
So is your doctor a psychic? He or she is no more or no less psychic than that Tarot card reader in the local strip mall or even famous psychics like Sylvia Brown. As a doctor, I can promise you that if I were truly psychic it would make my job and my life much easier.
For a more humorous (in my opinion) take on the subject of cold reading, check out this satirical news story.
(1). They do use trickery in many instances of course. This post is about the practice of cold reading but there also exists what is known as hot reading. If you visit a psychic, or see one on television, who makes very specific claims be skeptical. There are innumerable cases of psychics and faith healers being busted using a variety of techniques to obtain information from a client or audience member without their knowledge. Infamous faith healer Peter Popov’s wife would mingle with a crowd before a show and then relay information she picked up to him via a hidden earpiece microphone. An episode of Penn and Teller’s Bullshit showed how a famous psychic invited friends of her publicist to a showing which was to be filmed for the program, and visited with the group prior to the reading. The episode showed how she clearly regurgitated information she had acquired during the informal pre-show chat as if she had obtained it using her psychic intuition. Also, use of the internet has made life much easier for so-called psychics looking for info on future clients.
(2). I know, I know. Simmer down all you animal lovers. I fully realize that there are myriad examples of problem solving in other species, even perhaps a limited grasp of the concept of time. I argue, however, that it is uniquely human to have a true understanding of cause and effect and an ability to make sense out of our environment to the degree that we do, for better or for worse. Although sometimes I think my cat Molly might be smarter than she looks. My dog Sock is just plain dumb though.
(3). I don’t mean to just pick on psychics here. Cold reading is a technique that is put into use by astrologers, faith healers, salesman, psychologists, and yes even well-meaning physicians.
(4). A psychic who likes to tell clients that their dead uncle thinks they were a douchebag will have short sessions.
How does a dedicated and highly intelligent physician practice quality evidence-based medicine and recommend homeopathy? How do they approach the decision to initiate antibiotics or to order a heparin drip scientifically, while at the same time they uncritically accept claims that magical memory water can impact the course of skin disorders like psoriasis or “boost” the immune system? The answer is compartment syndrome.
Medically speaking, compartment syndrome occurs when there is increased pressure within an enclosed space in the body. This pathologically increased pressure can lead to compression of vital structures such as nerves and blood vessels, and can ultimately lead to tissue death due to a lack of oxygenation. I deal with this every now and then in my line of work as a pediatric hospitalist, usually when a patient has suffered some kind of musculoskeletal injury or has a serious bacterial infection involving muscle or other deep tissues, but it is fairly rare. What I encounter much more frequently, however, is more of a mental compartment syndrome. Like medical compartment syndrome, the psychological equivalent leads to the obstruction of reason which can result in a false understanding of reality and the subsequent acquiring of new and often increasingly untenable beliefs. And while those that suffer from it tend to incur less risk of direct physical harm compared to medical compartment syndrome, it is still something which should be taken seriously because there is the potential for disastrous results such as loss of money, relationships, or even one’s health.
All of us, even the most hardcore of skeptics*, has at least one superstition or one implausible belief that doesn’t hold up to scrutiny. This is because nobody is immune to the hardwired flaws in our ability to interpret the natural world. We see patterns where none exist. We assign undeserved causation based on our inherent susceptibility to anecdotal evidence. Our memories are imprecise and malleable with time and retellings. And we are capable of erecting these seemingly impenetrable walls around our beliefs that protect them from disconfirming information.
Why do we do this? Why do we take certain aspects of ourselves and separate them from other aspects of ourselves that are diametric, as exemplified by our fictional physician, who holds a firm belief in an absurd pseudoscience while actively supporting science-based medicine in all other areas of her practice? It all boils down to the avoidance of mental anxiety. This feeling of unease, or cognitive dissonance as it has come to be known in psychology, motivates us to take action to avoid it. This action typically comes in the form of defense mechanisms like confirmation bias and a variety of rationalizations. The fictional homeopathy-supporting medical doctor might simply ignore studies that don’t support her belief, or chalk negative studies up to undisclosed bias or the inability of “western science to study homeopathy”, all without realizing how this is a significant departure from her usual approach to the evaluation of evidence for or against a scientific claim.
Another example, and one that I’ve experienced on a number of occasions, is the defense mechanism that occurs when a parent is confronted with dissonance inducing information that calls into question choices they have made in the care of their child that have led to a poor medical outcome. I have experienced this most often with the parents of unimmunized children who have developed a vaccine preventable illness, but I have also had similar interactions with parents who have refused appropriate medical care for their ill child. The response is often one of demonizing the authority figure presenting the information, in this case me, or the medical establishment in general. The cognitive dissonance resulting from the acceptance that an irrational decision led to the suffering of one’s own child would be staggering and recovery from it would be difficult. Casting the physician as the bad guy, perhaps in the pocket of “Big Pharma”, serves as a convenient means of disregarding that information and avoiding the dissonance. The sad fact is that most people, when confronted with information such as this, dig in their heels and become further entrenched in the belief system, be it anti-vaccine paranoia or medical conspiracy theories, and the compartment walls become further reinforced.
I don’t pretend that writing posts such as this, or speaking at conferences about the benefits of practicing skeptical science-based medicine, will tear down or even weaken a solidly built mental compartment. But not every belief is as absurd, not every wall as sturdy. We all have these compartments protecting our beliefs and some of them, even in the most hardcore of believers, are just asking to be demolished. There are many people who are simply unaware of these concepts and knowledge of them might help some avoid a logical fallacy or two in the future. My goal is to help provide the dynamite to those who want to use it, and to perhaps stop construction of a wall before plans are even drawn up.
*For the longest time, when discussing this concept with others, I’ve thought myself an exception. I’m not. While watching television recently, I began turning down the volume to better hear something my daughter was saying to my wife. I watched as the volume counter descended. My television is very imprecise in this endeavor, the volume counter coasting sometimes several increments after removing pressure from the button on my remote. On this occasion it settled on the number 13. I immediately felt uncomfortable and dropped it down a little further. I then felt rather silly. Did I really believe that some calamity would befall myself or my family because of the television volume being left on the dreaded number 13? Of course not. But, then again, if something bad did happen how would I know it wasn’t because of it? Thankfully my volume counter doesn’t go up to 2012.