Tag Archives: epidemiology

Reality: a hard sell

I can’t help but wonder if doggedly debunking all spewings from the purveyors of woo is somewhat a fool’s errand.

There are a number of pseudo-scientific disciplines whose concepts are inherently highly attractive and contagious to the average Joe, saying things that make him feel good and making him want to pass on the good news. Think of how easy to sell these messages are:

  • organic food – frolicking chickens, steaming compost, happy farmers, healthy food – a return to basics, back to a purer time when humans actually had roots in the earth and cared for it; you too can go organic!
  • complimentary medicine – age-old wisdom, so long suppressed by big pharma is unlocked just for those open-minded enough to look. Are you open-minded! Yes? Here are your keys to healthy prosperity!
  • astrology – our fates, entwined with the universe, form a beautiful unity; enigmatic scholars have acted custodian to its cipher through the ages. Are you a spiritual soul? You too can share time’s secrets!
  • parapsychology – our minds are more powerful than science knows, and we all have potential beyond our wildest dreams! But hold on! Only those willing to break free from the trappings of conventional science will ever see the light…
  • and of course the big kahuna, religion – imagine for a minute the greatest most wonderful thing in all the world, and that is but nothing compared with the joys that await the believer, and for all eternity too!

It is little wonder the bible I had as a kid said “Good News” on the cover.

The issue is that the logical shredding of these pieces is often a sobering dose of reality that fills most people with instant sleepiness:

  • organic food is not always kinder to the planet and claimed health benefits are of the ‘hard to verify’ sort
  • alternative medicine actually does work, but only the level one would expect from getting time, care, attention and the placebo effect
  • the laws of physics do allow marvellous things (x-rays, computers, holograms) but it takes serious study to understand why they don’t allow for the positions of stars and planets to have predictable effects of the day-to-day ongoings in suburbia.
  • the mind is indeed fabulously clever and poorly understood, but those tedious laws of physics, and indeed dry, cold logic, are annoyingly sticky when it comes to clairvoyance, ESP, psychokinesis and precognition.

So YAWN! Boring!! Logic and analysis mean effort, work, thinking things through, totting up totals, cross-checking claims, testing, questioning and doubting. Pretty much the opposite of nice & easy. Accepting we are not all-powerful, we are not immortal and that we will all be forgotten someday is just no fun. These are not messages that will go viral, that will breed missionaries, that would generate a manic fervour. More like manic depression.

—–

So the deck is stacked. Pseudo-scientific ideas persist because they are tenacious memes, and they are almost impossible to kill. They are contagious and sticky, and lovely and easy, and fighting them off requires not just the will, but also the ammunition.

And that is why it worthwhile to continue to fight the good fight – to keep trying to debunk poor thinking – to provide the ammunition to that small number, those that may be on their own, surrounded by superstition, but with that gift in their heart that is that first inkling of doubt.

I will do it for those that think they are alone as I once did.

We live in a time of unprecedented opportunity – people have better access than ever to the tools to arm themselves to achieve a new sort of ideal: to make life choices with full access to all the facts. We are after all free to choose to believe anything, the problem only comes when we are not given the choice. No information, no balance, no choice.

Medical Trends: The Holistic View

There is clearly a lot to be learned about medicine from history.

Indeed many effective treatments can (and have) been identified not by close examination of the human body, but but the close observation of patterns in statistics.

Thus is is possible with good data, a good eye, and quite a bit of spare time, to see many of the contributing factors to disease or accidents. The famous cases include the realisation that the plague was carried by rats and that cholera was in the water. Thus was born the science of epidemiology.

I think if I was starting university again right now, there is a good chance I would have steered towards that as a profession – for it has saved countless lives, and can be done from the safety of a nice desk, replete with good coffee and a supply of biscuits. I have never been drawn to a life of tending to the ill or injured, so this would have been a nicer way to get my benevolence ‘hit’.

Alas, I studied engineering, and though perhaps I could use epidemiological methods to predict metal fatigue or bridge collapses, I am not sure that would be very useful. We engineers seem to spend much more time looking at the costs of making something, and then the price you can sell it for.

Anyway, time for the science bit…

Epidemiologists looks for patterns relating illnesses to other things: other illnesses, location, professions, exposure to animals, and many more.

There are some pretty major trends in health happening right now. For a good example, look at Hans Rosling’s presentation at TED recently. He shows, among other things, that people are living longer than ever before. Despite all the talk of the world going to pot, it seems there is an untold story – the story of how life expectancy in the developing world has been climbing beautifully for several decades. The stats tell a story of a golden age in humanity.

To go off on a slight tangent, I have to say what a pity it is that the media focus so much on the wars and tragedies. Of course, they sell sensation, so they will continue, but we humans are not used to getting news from the whole planet – we have barely got out of the trees and only left our small villages for cities an eye-blink ago. Evolutionarily speaking, our fears were programmed in a much smaller environment where news did not travel very far – the story of a death would be significant because you didn’t know very many people. Nowadays we get more news and we also know far more people because of the world of celebrity (blame the media again), and because we are so ‘networked’ (its the ‘new’ media this time) we also know a huge number of people by association. Thus we receive bad news far more often and tend to overvalue its direct threat to us.

Now let me get back on track. We are living in a golden age – better nutrition, cleaner water, the understanding of the theory of germs, and of course, advances in medicine (think vaccines, think penicillin, think surgical methods). We have benefited hugely from a better understanding of how the body works and of how fungi, bacteria and viruses work.

The activity is higher than ever on countless fronts: dementia,  HIV/AIDS, epilepsy, stroke, heart disease, and so on… but what about the big kahuna? I refer of course to cancer.

Well it has not been cured. The ‘cure for cancer’ has long been held up as the iconic challenge to medical science. Only trouble is, the challenge is flawed. There is no one ‘cancer’ – there are many different cancers  – and the little bastards are all subtle and complex – and even if you can kill one, killing it will often kill off something else, because cancers are not as alien as say viruses – they are in fact our own cells turning on us.

So rather than looking at cellular function and cunning ideas like rna interference, what can we do with epidemiology?

Cancer death rates are not independent of the death rates from other causes...

Yes, cancer is not an ‘epidemic’ – we are not studying its spread, but we can certainly study correlations and seek causation (think smoking tobacco or working with asbestos). Smarter people than I are already poring over this sort of data, and there is much hand-wringing nowadays because the ‘easy’ causes have most been found and now we are looking at the weaker correlations, where the link is not certain, or where the sacrifice to benefit ratio is unclear. Think barbecue meat, think E numbers and so on.

But I don’t want to talk about that sort of cause. What I am wondering is relates more to age…

Cancer is somewhat a statistical process – it may arise as a random mutation, which, as fate would have it, is also bad for one’s health. Many mutations result in no effect or perhaps cell death or perhaps just reduced function of the cell.  There are very few mutations that actually allow for continued (and sometimes rampant) growth and macro level harm. As the mutation is a random event, the chance of occurrence will depend on the number of ‘cellular events’ that occur in a lifetime – this is determined by two factors, the frequency of the events – and the length of the lifetime.

Now add to that randomness the fact that many cancers are slow growing – they may take too long to harm or kill you and something else gets you first.

These two factors together go to show you that the longer you live, the greater the risk of cancer development. Add to this the probable third factor that older cells are more likely to go haywire, and you can easily see why cancer is more commonly suffered by older people.

Does this mean that you risk of ‘catching’ cancer ‘today’ is less if you are younger? Well yes, if your cells (or immune system) are in better shape, mutations may be rarer and you may fend off some that do occur – however, your chance of ‘having’ cancer (rather than ‘getting’ it) are accumulative with age, so this is a very strong factor when looking at screening (looking for cancers that already exist). It is often only worthwhile screening for cancer in older people where the ‘hit rate’ makes the costs (false positives) justifiable.

This age affect is well known, but I am wondering if another factor may be throwing a curve ball into the stats – the longer lifespan of people generally.

As some types of cancers are being treated more effectively (prevented/slowed/cured), and as death from other causes (heart disease, pneumonia, tuberculosis, etc.) drops, does that not give cancer more fertile ground to wreak its havoc?

In other words, will curing other ailments, to some extent, tend to push us into the waiting arms of cancer?

And if this is already happening, perhaps the cancer death rates, hiding underneath the massive advances there may actually be an  underlying increase in death from cancer due to the increased survival of everything else.

———————

So! We all die of something eventually. I guess the question medical science now needs to ask is:  what is the best way to die? Should we be saved from one death only to have another? Will cancer rates start to creep up again as advances against cancer slow and lifespan continues upward? Time will tell!

Skepticism: religion’s cancer

Religion has been described as a virus. This is not because it’s ‘bad for you’ necessarily, but rather due to the way it spreads.

It’s not hard to see the parallel: like viruses (and bacteria), religions exist within a population and spread from person to person.

But what about atheism? Is it a viral idea (meme) too?

I will argue that it isn’t. Perhaps it’s more like a cancer, a ‘mutation’ that kills off religious infections.

Cancers are sneaky, because they can occur spontaneously, almost by chance, and are therefore a very statistical phenomenon: your chance of getting cancer is affected by a), your exposure (to carcinogens causing mutation events), and b), your predisposition (genes affecting your ability to cope with the these mutations). 

Your chance of becoming an atheist is likewise affected by a), your exposure (to information about how the world works) and b), your predisposition (intelligence, or ability to apply logic to the information).

I.e. atheism differs from religion in the same way that carcinogens differ from viruses.

Can we develop this idea? I think so.

Let’s look at how you ‘get’ atheism…

Picture it: you’ve been brought up in a good god-fearing, church-going family. You went to Sunday school, you know which of Cain and Abel was the baddy and you can explain to people about how there is good evidence for The Flood. You also have a healthy fear of  sex and the other sins.

But you go to school and you learn about plate tectonics and see how well South America slots into Africa, and then you learn how European bees are not quite the same as African ones, just like Toyota Corollas aren’t, and one day, while looking at the grille of your step-mother’s 1.3GL, and daydreaming about the A-team, a thought strikes you, like a shot of cancer-causing sunshine on that patch of skin on the back of your right shoulder, that cars evolve differently in different counties and maybe that explains all the animals and perhaps God didn’t make a women out of Adam’s rib after all, cos’ that never did make much sense, because a rib is a pretty silly thing to make a women out of anyway.

Catching a dose of Christianity on the other hand, does not come from inside, as the result of reasoning, it comes from outside, from other people.

Most often you will be born into a house absolutely soaked in the infection, you will be infected soon enough, prayers will be said at mealtimes, the church is so big and grand, and the hymns are so catchy, and then they wheel out Christmas and baby Jesus (or baby ‘cheeses’ as my son says)…

But even if you’re not so lucky, there’s hope. You can drop in at a church any time (though Sundays are best I’m told) and the chances are, even if you are down on your luck, short of friends, and even if you aren’t very nice, the sweet people there are quite likely to help you. That feeling of family, of unquestioning acceptance – brings a special warmth to the cockles of the heart.

Once you’re in the door, religion, having evolved pretty niftily, can now play you like a violin. Your emotions, developed to help promote clan solidarity, are hi-jacked and kick in nicely. Did you know, that if you really listen to what these folks say, and really try to feel God’s love, you will indeed feel something! Now that’s a clever infection…