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=== Facilitated Communication Still Pseudoscience <small>(41:30)</small> ===
=== Facilitated Communication Still Pseudoscience <small>(41:30)</small> ===
* [https://sciencebasedmedicine.org/facilitated-communication-is-still-pseudoscience/ Facilitated Communication Is Still Pseudoscience]<ref>[https://sciencebasedmedicine.org/facilitated-communication-is-still-pseudoscience/ {{sbm}}: Facilitated Communication Is Still Pseudoscience]</ref>
* [https://sciencebasedmedicine.org/facilitated-communication-is-still-pseudoscience/ Facilitated Communication Is Still Pseudoscience]<ref>[https://sciencebasedmedicine.org/facilitated-communication-is-still-pseudoscience/ {{sbm}}: Facilitated Communication Is Still Pseudoscience]</ref>
'''S:''' You guys remember facilitated communication.
'''J:''' Oh yeah.
'''B:''' I don't wanna talk about it.
'''C:''' Yep.
'''E:''' Horrible.
'''S:''' First introduced in the 1980s. It was all the rage for a while. So, the idea of facilitated communication is that some people who have cognitive problems, either like some types of autism or other types of developmental difficulty. That they can't communicate, now it may be that they can't communicate because they don't have the ability to communicate, meaning that they don't their brain that can't process language in words and they can't understand it. But the but the thinking is that there may be some people who have more ability to communicate than we can see because they have other things that are keeping them from using words, from speaking.
'''C:''' Right so there may be psychological or other types of development or whatever they have but their language centers are intact.
'''S:''' Or if not intact, they're good enough that they have─
'''C:''' Right.
'''S:''' ─they have an inner, like a hidden inner intellectual life. They can understand words but for whatever reason they're physically not able to speak and or or type or whatever. And so the idea of facilitated communication was that we're going to break through their physical limitations in order to communicate with them, right? So classically the way I've seen works is that you would hold the hand of your client and you would help them point to letters on a letterboard. And spell it out.
'''C:''' Yeah, is an {{w|Ouija}}.
'''S:''' Exactly, it's like a Ouija board.
'''E:''' Not even.
'''S:''' Unfortunately this became popular in the late 80s and early 90s before it was really studied. And when people started studying it appropriately, meaning that they were putting the proper controls in place, it became very quickly obvious that the facilitators were the authors of the communication, not the clients, right? That they were pointing the finger at the letters through the {{w|ideomotor effect}}, you know, subconsciously. And the client who they were allegedly communicating with was not doing any of the communicating. And that was it was really scandalous at the time. They were like sincere speech therapists and people involved who were who genuinely believed that it worked and they were devastated that it was all self-deception.
'''C:''' Yeah it reminds me a lot of the whole like memory regression hypnosis phenomenon.
'''S:''' Totally, false memory syndrome, absolutely.
'''C:''' False memory syndrome and like the court cases.
'''E:''' Around the same time.
'''C:''' Yeah, and there were you know relatively legitimate practitioners who just hadn't done their research sadly. They wanted to believe it.
'''S:''' Yep yep  They didn't do their due diligence and horrible things happened, people were sent to prison based upon facilitated communication testimony.
'''B:''' Accusations.
'''S:''' One, one famous, yeah. one famous case of a facilitator who basically fell in love with her client and had sex with him.
'''J:''' Oh my god.
'''S:''' And she was essentially seducing herself through her own subconscious.
'''C:''' Saying oh but they consented.
'''S:''' They consented, they consented through FC. So it's dangerous, it's dangerous. It actually steals the voice of of the client. And it's, and so since it was proven, you know, that there were issues with authorship, the professional organizations have really warned against it, they're they're very hard against the [https://www.asha.org/ American Speech-Language-Hearing Association] for example has a very clear position paper. They are against FC in all of its forms. Now you would think after all of that that it would have faded away or at least gone to the fringe. And it's sort of on the fringe but it's actually a lot more mainstream than you might think.
'''B:''' Oh, come on.
'''S:''' It's never really gone away. I, I've brought it up a couple of times over the years. The one time, remember the the the Hoben case or the the, I believe it was a dutch person who was in a in as an adult, was in an accident and and was now is now non-communicative, non-verbal. Not persistent vegetative but pretty close. And and the neurologist thought that oh this, you know, person actually has much more intellectual capability than we than we thought. And that was all based upon a facilitated communication, you know, specialist. The video there is extremely enlightening, if you and and, I linked to this when I wrote about it, I linked to it again on science based medicine.
'''B:''' Steve is that the one where you is that the one where you could actually see that the person that was being facilitated wasn't even looking at the keys.
'''S:''' Yes, yeah.
'''B:''' Not even looking.
'''S:''' Yeah so that, which is also, was, you know, that's also the classic you know FC that that was one of the case, that was a lot of the cases were like that. Where they're, they're not looking at the board, which makes it impossible. But even if they were, this person, so that the idea is that he's subtly cueing the facilitator to tell them which letter he wants to point to.
'''C:''' He was minimally conscious?
'''S:''' Yes exactly.
'''C:''' Yikes, yeah, yikes.
'''S:''' Which I, which a neurologically intact person could not do, the way, and on the video you see the facilitator like rapidly typing on the board, like super fast and they're intently looking at the board, the other the client is just barely looking at it, or not looking at it at all. It's just absolutely, it's impossible, it's physically impossible for that to be happening, right?
'''B:''' Right.
'''S:''' So anyway, so there are cases like that where like it's a 100% that client is not doing the communication. And then of course the simple thing you do is you blind it. You give information only to the client, you give different information to the facilitator, and you say which information gets communicated. It's always the information you give to the facilitator. All right.
'''B:''' It's trivially easy, I mean it's really like a joke how easy it is.
'''C:''' It's almost like James Randi's test, like it's that simple.
'''S:''' It's a simple test, it doesn't have to be a complicated study. All right, but, there is essentially a cult of FC that exists within the medical, speech therapy, you know, and psychology world, right? And so how do they keep alive the idea of facilitated communication? Well they've morphed it, they've morphed it into different forms. They they do a few things. So one is simple rebranding─
'''B:''' Classic.
'''S:''' ─they've rebranded, rebranded it into something called Rapid Prompting Method or RPM, right? Rapid Prompting Method. It's FC, that's just what it is. So the, here's the big difference. They don't hold the client's hand, they hold the board in front of the client, right? So now, instead of moving the client's hand, they move the board!
'''E:''' Oh my gosh.
'''C:''' ''(laughs)'' I love how you just said that.
'''E:''' It's like the Ouija board you're moving the board instead of the [inaudible].
'''S:''' They could say, we're not touching the client, so we're not doing FC. It's like yeah but you're still. ''(Cara laughs)'' So the thing is if the client is doing the pointing, if they're the author, why isn't the board on a stand? Why are you holding it at all?
'''C:''' Yeah why isn't everything stationary.
'''S:''' Yeah so anyway, so professionals call that facilitator dependent communication, right, so they essentially, any method where it's possible that the communication is facilitator dependent is not real. And it's not valid and it should be looked at with extreme caution. Now I watched a lot of videos of this, of RPM, one of them was just apps, it was so bad. And it's a mother working with a daughter so it's obviously very sad. And the daughter's very alert and interactive and smiling and everything and emotionally, you know, there's definitely some interaction going on. But they, they're you know they're they look non-verbal or non-communicative, and it's so obvious watching this video that the mother is forcing what the output that she's looking for. But let me give you the most blatant example. She asks her daughter a 50:50 question, right? Is it A or B? And the correct answer is A. She clearly points to B, like insistently points to B. The mother doesn't react it just look just keeps looking at her and then she gives her another nudge, like you tell me and then she switched, the daughter switches her answer to a which is like that's correct you are correct─
'''E:''' Oh my gosh.
'''S:''' ─she whisks away the board to the next task.
'''C:''' I mean this is like the age old.
'''E:''' That's ridiculous.
'''C:''' Ugh it's like.
'''E:''' Clever Hans.
'''S:''' It's clever Hans, that's it.
'''C:''' It's clever Hans, it's every police interrogation that ends up getting thrown out later.
'''S:''' It was the clever Hans effect, right? She just kept, she just didn't react until she got the answer she was looking for and then she reacted and gave the the positive feedback.
'''B:''' I think with Hans was easier.
'''S:''' That's what we're talking about, that's what we're talking about here. It's a completely invalid method we had recently written about this on Science Based Medicine, we got a flood of angry emails─
'''B:''' Angry?
'''S:''' ─from from supporters of FC, and you know you know like really and they were all using the same kind of language. I think somebody must have posted a link on their on their message board or something yeah so we got this flood you know of these angry emails. Which prompted me to like update my research on it and write about it again. So one of the things that they pointed to was a study that used eye tracking to show that the clients were looking at the letters before they pointed to them. But it, so there's two problems with that. The methodology of that study has been, you know, highly criticized because it's still facilitator dependent. But the the thing is, this is another method they use. So the rebranding is one, the sort of hiding and plain sight or hiding in the herd is the other way. And this is very clear, it was good to get these emails because like, I like to hear what the true believers are saying. Like how they're justifying their own beliefs. So one of the things that they did was, they didn't talk about FC or even RPM, the Rapid Prompting Method, they talked about augmentative and alternative communications. And you guys are against AAC, right, augmentative and alternative communication.
'''C:''' Wait, what? Like adaptive technology, of course not.
'''S:''' Exactly, of course, I know. Yeah so AAC is basically an umbrella term for a host of legitimate communication methods with people who have impaired communication.
'''E:''' And they're elevating themselves into that class?
'''S:''' Exactly. They're slipping themselves into this broader category and then they say you guys are against all of this. It's like no, we never even mentioned it. We were talking only about, I think in this case it was the RPM. There's also this speech to communicate, S2C so that was another one that we might have mentioned. But we we're not talking about AAC at all. So there it's complete bait and switch, a complete bait and switch.
'''E:''' That's like a, it's like a homeopath saying oh well you're against all pharmaceuticals.
'''S:''' Yes, exactly, that's exactly what it is.
'''C:''' The thing about that specifically is that if it's coming from providers─
'''S:''' Yeah.
'''C:''' ─it's especially insidious.
'''S:''' Yeah.
'''C:''' There is a part of me that really can't help but empathize with a parent─
'''S:''' Oh totally.
'''C:''' ─who wants to believe that this is how they're connecting and communicating.
'''E:''' Oh gosh, of course.
'''C:''' And of course in their mind this is just another adaptive technology because they have been hoodwinked into thinking it's evidence-based. And that's the sad thing is that it would be an easy narrative for them to follow that you just want to take away this technology that's allowing me to communicate with my daughter. That's not the problem.
'''S:''' Here's the other way they hide, yeah absolutely. Here's another way they hide, so one is by trying to pretend like is this part of this this wonderful breakfast, right, part of this complete breakfast. But it's also, they use evidence of non-facilitator dependent communication. So you take a relatively high functioning individual who can communicate entirely on their own by pointing to a letter board or typing. And say there that's evidence that it works. It's like no but that's not, that's not facilitator dependent. If you can show me facilitator independent communication where the authorship is verified, that that person is the author, that's great. But that doesn't prove that facilitator dependent communication, where you can't prove authorship is real. So they miss the actual point that we're making.
'''C:''' They miss the active ingredient there.
'''S:''' Yeah exactly, yeah.
'''J:''' I'm curious have you ever thought about this before but wouldn't this be unbelievably easy to disprove if they.
'''B:''' Oh yeah, it is.
'''J:''' Just ask. Okay, so who is, who is the person that is being facilitated it's my brother you know five years ago he got in a horrible car accident. Okay but you're communicating with him, okay, what did he call me as a nickname when we were kids?
'''S:''' They've done that, and they can't and that always fails, right?
'''J:''' Well there you go.
'''S:''' If it's facilitator dependent.
'''J:''' I've just disproven the whole thing.
'''S:''' But this is, they have an answer for that because again it's a cult and no amount─
'''C:''' They have motivated reasoning.
'''S:''' ─yeah the motivated reasoning is profound, so this is what they say about that, which again is why I love to get these these emails. They say, you can't expect somebody with autism to communicate in the same way that we all communicate─
'''E:''' Special pleading.
'''S:''' ─and you're actually, you're asking, it's a total special pleading, you're asking them to understand what you know and what you don't know and to give you the information you're looking for and you can't reasonably expect them to do that. So all of those studies are flawed.
'''E:''' Untestable!
'''C:''' That's what physic would say.
'''S:''' So it's untestable. But here's the thing, but then they point to studies where that's exactly what's happening when it gives them the results that they want of course that's that's facilitator independent communication. So they're not even internally consistent in the criteria they use they are just dismissing the negative evidence out of hand and it doesn't even make sense.
'''C:''' I feel like there should be an informal logical fallacy, maybe there is when somebody uses science in their argument when it benefits them and then rejects science and their argument when it doesn't benefit them.
'''S:''' Well it's internal inconsistency, so that's, it does make the list. All right the final thing they do which is really gets you, this one's really distasteful. Is they take the moral high ground, so they say you're denying that these people are people and you're denying that they have you know a meaningful existence or that they have any potential you know to have an inner intellectual life, you're, so you're you're erasing them. Like they're using─
'''C:''' That's disgusting.
'''S:''' That's disgusting.
'''E:''' It's like a human shield.
'''S:''' They're using all of that language.
'''C:''' It's like no, you're erasing them by giving them your voice.
'''S:''' Yes, exactly.
'''B:''' Exactly.
'''E:''' Yes, you're hiding your pseudiscience behind these human beings.
'''S:''' Exactly. But then they get all high and mighty about how terrible we are and but that's the cult, right, that's it. So anyway, that's what I learned recently about what the current state of FC is. It really is disgusting. It's still a pseudoscience as I say, FC is still pseudoscience but the the professional organizations that were all over it. And they really have, this is that's the good news in all of this. They understand what it is they really understand the nub of what's wrong with it and they are they are dead set against it, they call it out by name they are not having, there's no shruggy problem, there's no wishy-washiness. Like this is bad, it's pseudoscience, it's hurting our clients, you should absolutely not do it, this is harmful.
'''B:''' That's encouraging.
'''S:''' Similar to the approach to the false memory syndrome.
'''C:''' False memory syndrome, conversion, remember conversion therapy? Very similar to that too, past life regression, primal scream therapy. All of these things that are they're detrimental.
'''S:''' Yeah they're actively harmful, they're actively harmful, absolutely.
'''E:''' FU FC. ''(laughter)''
'''S:''' Okay.
'''B:''' Nice.
'''S:''' But it's so disappointing that, I mean this is something that should have gone away 30 years ago.
'''B:''' I mean you were ripping that apart in the 90s.
'''E:''' Oh I remember Steve you wrote articles in our newsletter.
'''S:''' This is old school.
'''B:''' This is one of the first big things you really took on.
'''E:''' Yes. I remember that too.
'
''C:''' And it's just another example of the vulnerable being taken advantage. And then there being a difficulty extricating the practitioners and the people who have an agenda from the, I guess the people who are victims of this. Mash together.
'''S:''' It's not enough to mean well, I'll even buy that these people all mean well. It's not enough. When you're a professional you have to do due diligence. If you're a cop who's investigating a crime, I don't care if you want to catch the bad guy. You have got to follow protocol, you have got to make absolutely sure that you are not eliciting a false confession. Or, whatever, you're doing a bad investigation. If you're a physician, you have to do due diligence to make sure that it's evidence-based. If you are doing this you have to make sure that you are not the author of the communication. If you don't do that that's on you, that is a violation of your professionalism.
'''C:''' It's a violation of your ethics code and all of these fields have an ethics code that says that they have to uphold what is it beneficence and reduce maleficence. Like that's fundamental to the ethical ethics code.
'''S:''' Absolutely.
'''B:''' I love that movie.
'''E:''' Sleeping beauty?


=== Gamma Rays and Gravitational Waves <small>(58:56)</small> ===
=== Gamma Rays and Gravitational Waves <small>(58:56)</small> ===

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SGU Episode 876
April 23rd 2022
876 projectile fusion.jpg
(brief caption for the episode icon)

SGU 875                      SGU 877

Skeptical Rogues
S: Steven Novella

B: Bob Novella

C: Cara Santa Maria

J: Jay Novella

E: Evan Bernstein

Quote of the Week

Stupid entropy ruins everything.

Jennifer Ouellette, American writer

Links
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Show Notes
Forum Discussion

Introduction, Bermuda Vacation

Voice-over: You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello and welcome to the Skeptics' Guide to the Universe. Today is Tuesday, April 19th, 2022, and this is your host, Steven Novella. Joining me this week are Bob Novella...

B: Hey, everybody!

S: Cara Santa Maria...

C: Howdy.

S: Jay Novella...

J: Hey guys.

S: ...and Evan Bernstein.

E: Good evening everyone!

S: So I am back from Bermuda, I had a little vacation last week. It was my 30th anniversary 3-0.

C: Oh yay.

E: Wedding anniversary?

S: Yes my wedding anniversary.

J: So you you what, you flew out to Bermuda?

J: Yeah.

E: You called how long Jocelyn, you said, hey, I'm here. (laughter)

S: We got a direct flight from JFK, it was 90 minutes.

E: Oh beautiful.

J: That's really close.

S: A little faster than average but less than two hours basically from New York to Bermuda. It's a lot further north than people think. It's actually not in the Caribbean, it's not a Caribbean island.

C: No it's the, it's the outermost point of the "triangle".

S: Well yeah, by definition.

C: It's far up.

E: You said the magic word.

C: I mean the triangle is made up of what? Like it's Miami or the Keys, Puerto Rico and Bermuda. So it's like really far away from those two places.

J: Steve did you see any planes like actively being sucked into the ocean?

S: I didn't see, I saw very few planes. So the planes land on the east side of the island, that very tip, like very end of it. And they don't fly over the island. So when you're on the island, you're not really seeing a lot of planes. I don't know if you guys are familiar with it, it's shaped like a J but tilted like 45 degrees on this side. So it's a very very long skinny island.

C: What's the water temperature out there in the middle of the Atlantic?

S: So it's in the jet, it's in the gulf stream, right? So that's why it is semi-tropical, right, because even though it's so far north, it's basically like equal to the Carolinas but it's subtropical because, it's because of the gulf stream. So it gets a lot of warm water. However at the end of the winter is when the water is at its coldest and then it warms up in the spring. So when we were there actually the water was warming up while we were there. We go from day to day it was a little bit warmer. But when we first got there it was fairly cold. The locals tell us that they start swimming in the ocean in May. So by then it's swimmable. And then through through the summer of course it'll be swimmable.

C: Nice. Yeah, Atlantic waters can be, well I guess it all depends on where you are, but so warm. I remember going to Puerto Rico and being like oh my gosh the ocean feels like bath water.

S: Yeah.

C: And I'm so used to the ocean out here in California it's like frigid, you can't get in it unless you're in a wetsuit.

S: Yeah I think it's just all the gulfstream.

J: So did you ride scooters?

S: We didn't, you know, so it, it's again, getting around the island was interesting. So here's my quick skinny on Bermuda especially if you're in the northeast of the United States, it's actually a it's the closest, you know, like tropical paradise you can get to. It's beautiful, you know, we had a great time there. On the plus side it's, you know, they definitely, like tourism is one of their major industries, the whole place is set up to be tourist friendly. They make it very easy to even though it's a foreign country, you know, it's very easy to get in and out of. And they accept the American dollar one-to-one with the Bermuda dollar. I think they must just fix the Bermuda dollar to the American dollar, so everyone just accepted the American currency one to one. And everyone is super friendly, like everyone is incredibly friendly.

E:' That's their, that's their industry.

S: And not just like at the hotel like I mean we were, we were at one point we walked up like the middle of the island on the old railroad trail, there used to be a railroad that goes there, and, but that's gone, there wasn't even any railroad ties or anything, it's just a path now, it's just a trail. But it's basically going mostly through residential areas and we would walk by people in their backyard and they would be super friendly to us. Also like like when you ride in a taxi like the taxi driver like beeps and points and waves at every other driver. Because, you know, obviously there's like 60 000 or something people who are─

C: A small town.

E: Oh everyone knows them.

S: ─yeah live permanently in Bermuda, yeah, residents. And yeah but they say, all the taxi drivers chatted with us while we were you know getting a ride and they said yeah it's a small small place. And not that everyone knows everyone but, you know, especially if you're like I guess all the taxi drivers know each other. Sometimes they were shout out by name. But it was just like a super friendly environment and culture. Very, very nice. The downside is it's kind of expensive.

B: Oh really?

S: Yeah.

C: Well you when you said that they fixed their dollar to the dollar one to one that definitely right there tells you, and plus you're going to be paying a, well hey it's it's a remote island, so shipping is expensive, just getting supplies there.

J: You can't drive anything there it's like all imported.

E: Yeah for example, do you have a for example Steve on that?

S: On the, on the expensive thing?

E: Yes.

S: Well yeah, just everything, the restaurants were the worst. They were like twice as much as what you would pay for the same food here.

B: Oof.

S: I don't think that's a shipping, think about it─

C: There's also a tourist situation there too.

S: ─all of our food is shipped in too. Like even in Connecticut, we're not, we're mostly eating food that is shipped a lot farther away than getting to Bermuda, so I don't really think that's the issue.

C: Well there, I do think there are some like if you think about Hawaii that is a real, supply chain issues are real.

S: That's different yeah, that's different Bermuda is close.

C: Yeah it's further away, that's true.

S: It's not that big a deal you think about it, you buying, you're eating your potatoes from Idaho, does it matter? It's closer to Bermuda than probably to some parts of the United States.

B: What about fish dinners?

S: A lot of seafood, of course, it's an island.

B: You'd think that would be cheaper.

C: No but you're also paying for tourist prices.

S: So here's the thing, it's not, it's actually not tourism is part of it but here's the big reason and─

B: Aliens right?

S: ─no it's in the 90s I think finance eclipsed tourism as the number one industry in Bermuda. And the guy, so one of the taxi drivers who's been born and raised or lived there his whole life he gave us the whole history like financially at Bermuda is like. It was great in that it brought a lot of money into the island. But he said but that was the inflection point where everything became expensive. Because now you have a bunch of millionaires buying up 10 million dollar homes and willing to pay lots of money for everything and so everything became expensive. So that was, that was the point at which it really got out of control. And to the point, to the point where like a lot of younger Bermudans had to leave. They couldn't make a living there. Just became too expensive to live there.

C: So even when you like leave the the hotel kind of areas─

S: Oh yeah, everywhere.

C: ─yeah unlike when I was, I was just in Puerto Vallarta and it's like you know the peso is is weak compared to the dollar, I think it's 120th. And when you're out in the city everything's really cheap. But of course when you go to like tourist trap areas, thing were more expensive.

S: It wasn't just a tourist trap. Although that that did add a yet another layer to the expense. But it was it was basically just an expensive cost of living is expensive there, that's the problem.

C: That's unfortunate.

S: Yeah, yeah it is. So it's kind of a double-edged sword, you know, that the finance coming in because it did, it did bring money to the island but it raised, raised the cost of living there. The, so getting around the island so if, you're if you're not a permanent resident you cannot rent a car, right, it's not an option.

B: Wow.

S: So there was a bus system we used that a few times, it was fine, you know, the bus system is fine. They have, the taxis are fine. We were happy to, to give money to the locals who were driving the taxi, so we didn't really care about that. If you really, if you want to rent something to get around, you could rent scooters or twizzies. You guys ever heard of twizzy?

B: Nope, never.

S: That was I think the most popular thing for visitors to do, so it's basically an all-electric vehicle, it's one person wide so you're basically sitting in the middle of it and it only sits one person across. But it's it's two people front to back. But it like barely fits two people. It is small.

J: It's kind of like a quad, right? It's like a quad that has a cabin.

S: Yeah, kind of, it's four four wheel but it's two people─

C: But not big crazy off-road tires.

S: ─the person would have to squeeze into the back. And the thing is the traffic, there's there's no highways, right? I mean the traffic is all slow everywhere. And it's, you know, it's a it's a British colony so everyone drives on the left. You know you wouldn't, I wouldn't feel like the traffic is not dangerous but here's one thing about it. It's not very pedestrian friendly because, you know, it's a volcanic island, right? And the, you know, geologically it's basically all volcanic rock and it's not a huge cliff or a mountain but it's very hilly and so the roads are essentially cut out of the volcanic rock. And they made them just wide enough for the two lanes of traffic, there's no shoulder there is no place to walk.

E: Nowhere to walk.

S: And some of the bus stations are literally a pole on the side of the road. Like I don't even know where you're supposed to stand.

B: Jesus, wow.

S: No so you really, so a couple of times, now some of the more residential areas did have shoulders and did have there were a couple of sidewalks here and there, but you couldn't really walk the main roads. I mean you could but you have to just count on cars driving around you, because you're walking in the road you know you there is no side of the road and sometimes it's literally a wall, you know, on the side of the road. So it's not very pedestrian friendly, so that's why we generally either took a taxi or took a bus. We did do a little bit of walking then it was a little bit scary at times. We would look both ways for traffic and then run to the next sidewalk, you know, before too many cars had to go by. But very very nice, I definitely think we'll be going back. It's, you know, just a very close, quick. You could, you could take a long weekend there, you know what I mean? Like it's so close.

C: Did you get a tan?

S: I did. I got a little bit of a tan, more than I wanted to but yeah.

B: UV sucks.

S: Yeah, I just don't, I don't like to expose my skin to UV light.

J: So what was your absolute favorite thing about the experience?

S: I probably, there was, there was some birding there, you know, so we went to this, is called Spittle's Pond and it was, that was, that was a fun day. So it was yeah, there was lots of good pictures, just good nature walks. We went to the, we were there on Good Friday and Good Friday apparently is Kite Flying Day on the island. They flight─

C: Kites? Fun.

S: kites on other times but that's like the big day. And there's a traditional Bermuda kite. It's like round or octagonal and it's called a hummer because it has a thing in the middle that spins it makes a humming noise when you─

E: Cool.

S: ─when you fly it.

C: I haven't flown a kite since I was a child. I don't think.

S: Yeah.

C: How fun.

S: Yeah it was a lot of fun.

B: Last time I saw a kite it was on Reddit and it was lifting a little kid up in the air. I mean.

E: Okay.

B: I mean it was crazy. And I think it was real.

E: Right. 70% chance of it being real.

News Items

Vaping and Brain Inflammation (10:55)

S: All right let's move on to our news items. We haven't spoken about vaping on the show, I don't think. Cara, you're going to tell us about the effects of vaping on brain inflammation.

B: What?

C: Right, so, you know there's a lot of literature out there on vaping but when you read most articles about vaping one of the main things they say is there's not a lot of literature out there on vaping. And I think it's it's because it's new and because very often we're comparing it to the bananas huge body of literature on cigarettes, right, and on the the detriments of cigarettes. So there's a study that was published in a journal, I didn't know this journal before but I have to admit I really like it, it's an open access journal called eLife and so anybody can read this study and this, I'm gonna take a quick aside because this was my favorite part of this, reading this study. It's got all these different sections right like most scientific articles have the abstract, they have the introduction, the results or the materials and methods, the results, the discussion, the different appendices with all the data. They also have all of the raw data available to you. But, they fully, openly publish their editor's notes. So basically when scientists submit there's always like something that the editors don't like. So they say hey we'd like for you to do like this much further investigation or can you explain this better or we think your language was strong here. And then the scientists reply and say thank you for that, this is how we think about it and here's a change that we made and there's a back and forth. This journal publishes that entire back and forth.

B: Wow.

C: I know, it's really cool.

B: That's cool, I like that.

C: Yeah, so you can really see like what, they maybe were a little too, their language was too strong at the beginning or where they needed to clean up and add a little bit to make the study more robust.

B: Remove curse words, you know.

C: (laughs) Yeah, you know, some of some of the f-bombs we should take out. So this was a a study with a lot of authors it looks like from like VA San Diego, UCSD, so University of California San Diego. In this study they said okay we would like to know how one very specific type of vape affects the whole body. And so they, you know, they say in their introduction, a lot of studies look at specific organ systems but they were like we want to see what happens if we expose mice to vape. And we want to do both an acute model and a chronic model so they do this, it's a twice a day paradigm in one group for one month. Oh sorry, it's a three time a day paradigm, I apologize, three times a day daily. In one group they do it for one month and then they also do it for three months. Because they want to see the difference. And they look at not just the brain, because you did mention neuroinflammation, but they also look at the lungs, the heart and the colon. Mostly what they were looking at were inflammatory markers. So although they didn't often see direct evidence of inflammation, they saw upregulation of genes or proteins that are responsible for inflammation. And that's, that's mostly what they reported on. There were some examples where they actually saw. And there were some examples where they actually saw a reduction, which is why very often the, the authors use the word in their, in their discussion immunomodulation. As opposed to just inflammation or upregulation because there are some places where they actually saw down regulation. If I could kind of generally summarize, oh and there's another really interesting thing about the study but we'll get there, they looked at two different flavors and they saw different outcomes. So that's kind of weird. But there's a possible explanation here. So, the thing that they were really interested in. It was, they wanted to look at one of the most famous products on the market, JUUL, and they wanted to look at their sort of fourth gen, their most recent style of vape which is these pods. And these pods are interesting because most studies a, are done with like the older version of the vape pens. But these pods actually have more nicotine than basically anything on the market. I think at one point they described it as a single pod, because you both, I guess you basically just vape off of the pod until it's empty. A single pod has more nicotine than a whole pack of cigarettes.

J: What? Wait, how long would it take to use a single pod, like is it?

C: It probably completely varies based on the person. But you know given that there's no marker, the way that, with cigarettes there's a marker. Like people can say I smoke a pack a day or I smoke a half a pack a day or I only have two cigarettes a day. But with this it's like they just smoke it until it's empty. And I wonder if there is a psychological difficulty there in in being able to modulate your own use. If you don't have any of those, you know, I'm not lighting a new cigarette. And so you know I think we very often hear conversations about e-cigarettes as smoking cessation tools. And although sometimes the literature I think kind of poo-poos on that a little bit more strongly than they could, I think the concern is that if we really think about this in a binary way. Either they're good for you or they're bad for you, this becomes really dangerous. Because of course there are e-cigarettes on the market that don't have nicotine. And of course there are some good papers that show that people who slowly but surely drop their nicotine level until they're no longer smoking nicotine at all and then quit, but it helps them quit. But what these researchers were looking at were pod-based e-cigarettes. These JUUL devices that only came out in the last five years or so, that have high levels of nicotine in them. And there are a lot of users of these and sadly the, I think it's 12 million adults that use e-cigarettes totally, and the highest rates are among 18 to 24 year olds. And they're flavored, right? And so that's that's a whole other conversation, a regulatory conversation. So here they looked at mint flavor and mango flavor. But get this, at the time they were the most popular choices, that's why they chose them. I know. Now they're no longer made these two specific pods that they were doing the research on. And so they modeled the use, like I said by exposing young adult mice three times a day for three months. But they also looked at changes after a single month and then they looked at the aggregate changes after three months. And they did see neuro inflammation after three months. They specifically saw it in in the nucleus accumbens, both in the core and in the shell. And they saw it in the hippocampus. And the reason that these two regions are important and the reason that the researchers talk a bit about these two regions being important with this gene expression of inflammatory markers, is that uh they're involved in behavior modification and and heavily in, you know, reward, drug reward, drug seeking behaviors, addiction behaviors. And even some, I mean they call it like anxious or depressive behaviors. I think they're more referring to mood in the nucleus accumbens but there is a concern here that that if there is inflammation in this area that that could have some bearing behaviorally on addiction levels and on mood which can sort of be associated with addiction. They also did find some changes to cardiac tissue and the weird thing is these alterations to the inflammatory state were not very easy to point to. There was actually some down regulation at the three-month part in the cardiac tissue. And so you might think sort of on the surface maybe that mean, you know, it's reducing inflammation, maybe that's heart healthy. But what they found or what they're concerned about is no maybe that actually means that it's it's depressing an immune response in the heart. And that's, you know, disconcerting as well. So we don't know how these things translate to actual health in human subjects. Because we're looking at gene expression in adult mice. But what they found again was that the nucleus accumbens both the core, accumbens, both the core and the shell and the hippocampus saw some neuromodulation. They saw changes in these inflammatory markers in the in the heart. They saw changes to inflammatory markers in the colon and they also saw some changes in the lung. But they were not what they expected, they expected pathophysiologic changes in the lung and they actually didn't see them. So they didn't see alteration to airway response. They didn't see some of the expected alterations that they, that they thought that they might see. And I think that's an interesting outcome in and of itself. They didn't see emphysema and they didn't see overt inflammation. But of course there are massive limitations to this study. Number one, three months is their chronic condition, that's not really that long. So you know it's like there's always going to be limitations when you're doing laboratory work because it doesn't directly translate to people. And then lastly there was this interesting effect that they saw, where the mint pods seem to have a stronger inflammatory effect, especially in cardiac and colonic tissue. Compared to the mango pods. And when they looked they recognized that the nicotine concentrations were the same, but the flavoring compounds the chemicals that actually make the flavorings were different. One of them was based on something called ethyl maltol, that's how they made the mango flavors. And then they actually used menthol concentration to make the mint flavor. And there is a concern here that there is a negative outcome simply from the flavor ends not specifically due to the nicotine.

E: And is that consistent with tobacco.

C: I was gonna say, it kind of jives with the idea of all those different carcinogens that you would see in tobacco. When you would burn the paper and the glue and there was like so many different compounds that were discovered over the years. And so yeah it's an interesting study because it's not as clean as you would think. You know, they had some hypotheses and not all of them were confirmed. Their, their sample size was small and that was one of the concerns from the editors. But they also replied that they did do a power analysis in advance and they didn't want to collect more data beyond what their power analysis told them to collect, you know, because they didn't want to alter those outcomes.

B: What's the power analysis?

C: Oh power analysis is is, there's different software programs that you can use but it's a statistical way to in advance to say okay, I'm going to do this type of statistic. Like I'm going to do a chi-square or I'm going to do an ANOVA or an ANCOVA and I want to make sure that if I'm looking for a difference between groups that the difference is large enough to recognize. Right? Like it's going to be 25% difference or 5% difference. And you set all those parameters and then you calculate how many samples you need to collect in order to achieve that power in your study. Because if you're doing let's say 20 contrasts, you're going to need way more, a much higher n than if you're going to do one contrast.

B: Right.

C: And so a power analysis allows you to set your statistics in advance so that you don't end up inadvertently p-hacking for example.

B: I was going to ask about that. I like that, if it's trying to deal with that, even indirectly.

C: Yeah that's one of the things that I thought it's funny, because this study is interesting and of course the write-ups around it are interesting like hey, vaping is not great you guys. Like look at these things that we're seeing, we're seeing inflammation in the brain, we're seeing changes to cardiac immuno response, we're seeing changes in the colon, we're seeing changes, you know, across the the body of these mice. This is not, this is worrisome at minimum. But the other thing that I thought was interesting was this study is a very cool explanation of how science is done. Because the curtain is completely peeled back. And so for those of you who are interested in reading more about the process of doing science, this this allows you to kind of peep into that in a cool way.

E: eLife.

C: eLife, yeah. Very cool.

S: Yeah so it's, it is complicated, the whole vaping thing. It may be helpful in some situations but it's not entirely benign itself. And there's been a lot of hand-wringing in terms of like public health policy should be before it or against it.

C: Right and in some ways it may be, it may be worse, you know, in some ways it may be better, like we said, helping people quit smoking if they follow these protocols and they do it appropriately. But for some people, you know, I think they make a false dichotomy. They go, well at least I'm not smoking cigarettes and it's like or maybe you should not be smoking at all.

S: Yeah, right.

C: Because a lot you know vaping is attractive to younger people, it doesn't make you cough as much it does it's not as aggressive like it doesn't feel as aggressive so it probably feels safer there are these psychological issues that come into play.

S: And it does lead some people to to smoking tobacco.

C: Oh for sure, for sure. And also like one of the, the mint ones that I was telling you that they had different effects in the lungs specifically. They found that some of the changes, the gene expression changes, actually are correlated with sensitivity to downstream infection. So for example the changes after they used the mint vape as opposed to the mango vape made those mice more sensitive to catching and becoming sicker from bacterial pneumonia. So so it's it's it's even more complicated than just is it or isn't it bad for you in and of itself.

J: You know, I think a good rule of thumb is breathe in air only.

S: Yeah.

E: Yeah you kind of wonder if there were no tobacco or no none of those products, would would vaping have ever come into existence, would they've ever stumbled upon.

C: Right, like it's just the, the faster horse, right, is this the car. And I think there was one other thing that I didn't mention because it wasn't directly studied in this study but they did mention it in the introduction, so it has been studied before. Apparently the size of the actual molecules when you vape are smaller so they get deeper into the lungs.

S: And of course you have to you know emphasize that because of the way they did this research these results should be considered preliminary and need to be confirmed. Because they were kind of shotgunning like looking for everything and just to see what was out there. So until these results get replicated we really can't say you know if they're real let alone what the implications are.

All right but thanks for going over all of that Cara

C: Yep.

Projectile Fusion (25:20)

S: Jay, tell us about projectile vomiting, I mean projectile fusion. (laughter)

C: Oh man.

S: Projectile fusion. What is this?

C: I love projectile vomiting.

E: No, stop Cara. (Cara laughs)

J: Okay guys this is awesome. Only if this is true though but you know this is this seems to be legitimate. (laughter) Scientists have now crafted a new way to achieve nuclear fusion. Guys, a brand new way to do it.

B: What the hell man?

J: Today yo let's give a quick description here. So today's concept of a fusion reactor is you have a a very very powerful magnetic field that's shaped in this very odd shape it's called a taurus.

B: Doughnut.

J: Doughnut, right, right it's, doughnut's close enough. It's like a bent doughnut. And then they, that is containing plasma which is fantastically hot and it's very complicated. It's an, it's a feat of engineering in a bigger and more complicated than probably anything other than maybe the hadron collider. I don't know, probably more complicated than that.

B: So yeah Jay so that's the tokamak method and but there's also another way using inertial confinement that's also showing some promising success so there's definitely more ways to skin that cat. But now you've got another way to skin the cat.

J: Here's another way, you're ready Bob?

B: Yeah.

J: Just to give more info, so this company originally came from the University of Oxford. I guess a team that was working there branched off and started this company. So they have a new approach and it's called, like Steve said, projectile fusion not vomiting.

C: (laughs) Damn.

J: Although if vomiting could help the world I would, I would encourage it. And this idea guys, the original idea here came from the pistol shrimp. Remember that dude? They can punch your socks off─

B: Yes.

J: ─that shrimp that could break the glass. It can shoot its arm so fast that it's like a bullet.

S: Yeah this is the pistol shrimp, it's similar. It's like snapping its claw, right, then and that it moves so fast, it's the fastest moving I think animal appendage in the world.

B: Right, that was science or fiction.

S: And it causes like a cavitation in the water with a little mini boom there.

J: Cara let me put it to you like this, he could punch your mouth loose.

C: I don't wanna loose mouth.

J: Yeah, all right, so anyway, so this procedure is less complicated than than the fusion reactors that they're building today. And you know everyone is scrambling to build these things and who's going to you know figure out all the engineering first. Well according to First Light Fusion their reactor is not only less complicated but it's less expensive. And it's more energy efficient. Now let me get into some details here. They believe that their technique is going to be the fastest way to commercial fusion which essentially means, you know, selling electricity to the world. So how does it work? They shoot a hundred gram projectile. 200 times the speed of sound from a two-stage, get this, hyper velocity gas gun, right? So they're shooting this little projectile only, only 100 grams. And they're shooting it at a pellet that contains the fusion fuel. You follow me so far?

B: Yeah.

E: Yes.

J: Now we're talking about to get back to the speed here. 200 times the speed of sound. 14 540 miles per hour or 23 399 kilometers per hour. That is fast. I think we all agree on that. When the projectile hits the fuel target it accelerates the fuel to 156 586 miles per hour or 252 000 kilometers per hour. That's fast.

E: Pretty fast.

B: Wait, wait, how could it something going, what, 11 or 12 000 miles an hour accelerates something to go and 10 times that speed?

S: From what I understand to explain that Bob, so you have the target that the projectile is being shot into. That target contains the pellet of fuel like deuterium. And but also it's designed in such a way that when it gets hit, again, like the pistol shrimp, it causes this shock wave from the cavitation of the material, right? Just like the pistol shrimp causes cavitation in the water. Then you get these overlapping shock waves bearing down on the pellet of fuel compressing it even further and accelerating it to these crazy speeds. You know, 10 times the speed of the projectile itself and causing the fusion.

J: And this, and that, and what the company says is this brings about a pulse of fusion. Fusion energy. So let me give now more details. This new method absolutely does it does sound much safer and simpler than traditional fusion reactors that have to create the how is powerful magnetic field, you know, that's holding in the super hot plasma. So when this technique is used in a large scale fusion reactor. And what I mean by that is when it goes commercial, when they build the big one that's going to really do it, they will first drop the pellet that contains the nuclear fusion fuel into the reaction chamber, right? So they're just dropping it down, it goes down into the reaction chamber, then the projectile is shot down the same hole, that that the the fuel pellet was dropped into. And it'll be timed perfectly, so it hits the fuel at the exact moment it needs to. And this will create a pulse of fusion energy, because the energy from the projectile is transferred to the pellet which ignites the fuel. The reactor chamber is filled with liquid lithium, that's there to absorb the heat that's created by the reaction. And then of course it goes through the same process as any other reactor goes, right? So the chamber, this giant release of energy happens. So the lithium actually protects the chamber from the gigantic release of energy. And this is important because in the other fusion reactor designs this stage actually is very difficult to engineer to make everything work and to make it safe. So, you know, collecting the energy from the magnet based reactors, they haven't even fully figured it out yet. They then transfer the heat from the lithium to water and then what happens guys? Water generates steam, the stem turns the turbine, the turbine generates electricity and there you have it, that's how every single, you know, power plant ends up just turning water into steam. So this process would repeat every 30 seconds. Even though the pellet of fuel is super small, only a few millimeters. Like I said that energy that's released could generate enough power to, all right guys, let me ask you this. So we have this tiny little millimeter size pellet of fuel that gets hit by the the projectile, it ignites, creates fusion and releases enough energy to do what? I'm curious to know what your guess would be?

S: Light a light bulb?

E: You mean what can we power with this?

J: Yeah, how much power does it generate.

S: About a hundred?

J: A hundred. A little bit more than a hundred. So it could power a UK, an average UK sized home for over two years.

E: Whoo.

B: Wait a second man.

J: So every 30, every 30 seconds.

B: Are you sure?

J: That's what they said.

B: Millimeters, a millimeter sized amount of fuel.

J: Every 30 seconds.

B: For two years?

E: That's a lot of energy.

J: It sounds like a lot, I know, I'm that, but look, we're a skeptical podcast. Your skepticism is appreciated. (laughter) People need to read further into this, this is what is being said. I'm, I'm just a messenger here, don't get angry with me. Bob, I thought that was a lot too.

B: The energy density of nuclear fuel is too far higher than chemical energy that's one of the benefits of fusion.

J: They've proven that the physics works and that the thing can function the way that they've designed it. The company is saying other things like, every time that they hit a wall like like an engineering wall, they quickly figure out how to get past it. The engineering that they have to come up with isn't, isn't that bad and it's achievable. They're saying, you know, they think that by the 2030, let me give you the quote from the company just to say in their words. First, they, they've only spent 45 million pounds on their, on their design and that's not a lot of money. And they've gotten a very long way in the process here. They're saying, and I quote First Light is "working towards a pilot plant producing ~150 MW of electricity and costing less than $1 billion in the 2030s." So, you know, this is a decade. Decade plus away, that's not that far. And, you know I think that if they haven't thought of the things that are going to stop them from getting to the finish line it's it's unlikely according to everything I read that they haven't been able to forecast everything. That's the beauty of this this simpler design.

E: And no replication yet?

J: I don't think so Ev, I mean this is one company that you know this is their idea. They came out of a legitimate institution, you know, the idea was so good that they, you know, that they're pushing it to go to market you know they're trying to get there as quick as they can. I'm excited, you know, I like hearing stuff like this because it sounds promising. Until I, you know hear and read more you know it just right now it seems really great. Just a really cool thing that that was discovered.

S: So Jay it sounds like each time they drop the fuel and then they they hit the target and it fuses, it's like a pulse of energy.

J: Yeah, it's like this big pshh, right there's a huge explosion.

S: It's a putt, yeah so they're not creating sustained fusion.

J: No, that's that.

S: They're just getting a, that's that's probably where the simplicity comes in. Because creating sustained fusion is why it's really hard. Every 30 seconds. So what's happening is they that the, you know, so there is more more complicated physics here than I described. But it is essentially what I said. And you know they do it, they do it after 30 seconds and you know Steve, maybe they have 10 000 of these things, you know, happening all at the same time.

S: All right but here so, the thing is, what all I'm reading so far is that they made fusion happen, which is nice, you know, because that's a prerequisite for all this working. But you know, when did the first like tokamak or─

B: Yesterday.

S: ─get any fusion at all, it was like 40 years ago yeah. And and we're still 20 years away I would say at least from, if the other, you know, methods, any of the other methods working. So just the fact that they made fusion happen is actually not that big a deal. So the questions that I have that I'm not seeing answered in any of those, I still think we're at the like press release level in terms of the information that we're getting, is, are they generating more energy than it takes to make this happen in the first place. So until they get to that point this is not a useful process. And I didn't see them say that which makes me suspicious, right, why would you not say that, if, unless you, did you read that anywhere, that it produces excess energy.

J: No it's not, you know, you're right Steve, it's not producing excess energy yet.

S: That's a big bragging point if you get to that point and and the absence of saying that─

B: That's telling.

S: ─that they're not there yet.

J: Yeah, I agree, like they're, they they're not there yet because they haven't built the facility to to handle that yet, right? But who knows, you know, how this goes, right, we hear lots of stuff like this. I mean we're skeptical, I'm skeptical of it too but the, you know, that's part of the exercise here.

S: It's an interesting idea it's an interesting idea because, you know, obviously the hard part with fusion is getting the pressure and temperature necessary to make it happen. And it's it's real, that's what's really hard to do that. So here they said okay, we're just going to make it happen for a moment and make it produce fusion, get the energy out of that to produce electricity and then move on, rather than trying to have sustained fusion. And that, that's a very interesting idea. So we'll see if it works out. But you know, this whole all we have to do is scale it up thing we know how that goes.

J: In five to ten years Steve, five to ten years.

S: Yeah, five to ten years. So I'm not hearing anything that tells me this can't possibly work. I think it's a great idea. I'm glad that they're researching it and they seem to be making progress, but we can't pop the champagne quirks yet.

J: Correct.

S: Until they actually are producing excess energy it's still theoretical.

J: Cara what, what do you got Cara? (laughter)

C: I just wanna know, this is probably the most naive question but like, is this dangerous? Are there ethical considerations around doing this?

S: There's only 10% chance that the world will blow up. (laughter)

E: Oh yeah and 1% chance of a black hole.

J: No, I mean Cara, from my understanding, the second that a fusion reactor like the ones that we've been reading about for the last 20 years, you know, if their magnetic field fails the whole thing just shuts down and it's like you know it's not going to like do anything like it's not going to have a gigantic explosion or anything.

S: It's, it's hard to make fusion happen, so it's not like you're going to get runaway fusion.

C: Right, right. But when you do make it happen, is it like, you know, is it perfectly contained? Is it like, are there concerns around that?

S: Absolutely.

B: Fusion classically has as much much much lesser of a you know radiation, radioactivity footprint than than classical than fission.

S: Than fission yeah.

B: Fission is dirty as hell, fusion is is much better in that regard. Not perfect but it's much much better in that regard. And, I do wanna say that this is a form of inertial confinement. So if you've got tokamak and then there's inertial confinement and inertial confinement has been done by many, by some labs where they basically shoot like dozens of lasers at a pellet and they make it all heat and compress into into a tiny little, you know, into a tiny dot that causes the fusion. So this is a variation on the inertial fusion technique. Which is, it sounds cool to me, I love how simple it is and I definitely want to read more about it.

J: And Cara, jazz fusion is perfectly safe, don't even think about it.

C: I don't know that, that shit is dangerous.

J: Thank shit will know you out.

E: There's this fusion restaurant down the street, oh my god, it's so good.

S: What about Asian fusion?

J: I love it. Now I'm hungry.

S: All right. Thanks Jay. Hopefully we'll be reporting on this in the future and it just made our book obsolete, okay.

J: Steve, I know, right? Curses.

S: We're gonna be, one of our plans is literally, because like it's painful, because you have the book like the, actually today I sent them my final approval of the final edits of whatever.

E: Oh it's so outdated.

S: It's like it's slowly becoming outdated as every new things come in, I'm like oh I want to add that to the book.

C: Steve.

E: The book medium is though.

C: I'm just finishing an, an academic book, like I'm co-editing so I didn't write the whole thing right, but we're editing and bringing in all these chapters so it's put so much work into it. And I'm pretty sure the new DSM like just came out or it's about to come out. I'm like, oh god, we have to change every single chapter.

S: Yeah, I know.

E: And then finally in 2014.

J: It's the only thing, it's the only time that progress in the world hurts a little bit.

C: Right.

S: But we're gonna maintain a website where we keep updating the stuff in the book though.

C: Yeah that's smart.

E: Smart.

J: That's easy for you to say Steve.

S: It's easier, that's the plan.

E: He's not doing it.

[commercial brake]

Facilitated Communication Still Pseudoscience (41:30)

S: You guys remember facilitated communication.

J: Oh yeah.

B: I don't wanna talk about it.

C: Yep.

E: Horrible.

S: First introduced in the 1980s. It was all the rage for a while. So, the idea of facilitated communication is that some people who have cognitive problems, either like some types of autism or other types of developmental difficulty. That they can't communicate, now it may be that they can't communicate because they don't have the ability to communicate, meaning that they don't their brain that can't process language in words and they can't understand it. But the but the thinking is that there may be some people who have more ability to communicate than we can see because they have other things that are keeping them from using words, from speaking.

C: Right so there may be psychological or other types of development or whatever they have but their language centers are intact.

S: Or if not intact, they're good enough that they have─

C: Right.

S: ─they have an inner, like a hidden inner intellectual life. They can understand words but for whatever reason they're physically not able to speak and or or type or whatever. And so the idea of facilitated communication was that we're going to break through their physical limitations in order to communicate with them, right? So classically the way I've seen works is that you would hold the hand of your client and you would help them point to letters on a letterboard. And spell it out.

C: Yeah, is an Ouija.

S: Exactly, it's like a Ouija board.

E: Not even.

S: Unfortunately this became popular in the late 80s and early 90s before it was really studied. And when people started studying it appropriately, meaning that they were putting the proper controls in place, it became very quickly obvious that the facilitators were the authors of the communication, not the clients, right? That they were pointing the finger at the letters through the ideomotor effect, you know, subconsciously. And the client who they were allegedly communicating with was not doing any of the communicating. And that was it was really scandalous at the time. They were like sincere speech therapists and people involved who were who genuinely believed that it worked and they were devastated that it was all self-deception.

C: Yeah it reminds me a lot of the whole like memory regression hypnosis phenomenon.

S: Totally, false memory syndrome, absolutely.

C: False memory syndrome and like the court cases.

E: Around the same time.

C: Yeah, and there were you know relatively legitimate practitioners who just hadn't done their research sadly. They wanted to believe it.

S: Yep yep They didn't do their due diligence and horrible things happened, people were sent to prison based upon facilitated communication testimony.

B: Accusations.

S: One, one famous, yeah. one famous case of a facilitator who basically fell in love with her client and had sex with him.

J: Oh my god.

S: And she was essentially seducing herself through her own subconscious.

C: Saying oh but they consented.

S: They consented, they consented through FC. So it's dangerous, it's dangerous. It actually steals the voice of of the client. And it's, and so since it was proven, you know, that there were issues with authorship, the professional organizations have really warned against it, they're they're very hard against the American Speech-Language-Hearing Association for example has a very clear position paper. They are against FC in all of its forms. Now you would think after all of that that it would have faded away or at least gone to the fringe. And it's sort of on the fringe but it's actually a lot more mainstream than you might think.

B: Oh, come on.

S: It's never really gone away. I, I've brought it up a couple of times over the years. The one time, remember the the the Hoben case or the the, I believe it was a dutch person who was in a in as an adult, was in an accident and and was now is now non-communicative, non-verbal. Not persistent vegetative but pretty close. And and the neurologist thought that oh this, you know, person actually has much more intellectual capability than we than we thought. And that was all based upon a facilitated communication, you know, specialist. The video there is extremely enlightening, if you and and, I linked to this when I wrote about it, I linked to it again on science based medicine.

B: Steve is that the one where you is that the one where you could actually see that the person that was being facilitated wasn't even looking at the keys.

S: Yes, yeah.

B: Not even looking.

S: Yeah so that, which is also, was, you know, that's also the classic you know FC that that was one of the case, that was a lot of the cases were like that. Where they're, they're not looking at the board, which makes it impossible. But even if they were, this person, so that the idea is that he's subtly cueing the facilitator to tell them which letter he wants to point to.

C: He was minimally conscious?

S: Yes exactly.

C: Yikes, yeah, yikes.

S: Which I, which a neurologically intact person could not do, the way, and on the video you see the facilitator like rapidly typing on the board, like super fast and they're intently looking at the board, the other the client is just barely looking at it, or not looking at it at all. It's just absolutely, it's impossible, it's physically impossible for that to be happening, right?

B: Right.

S: So anyway, so there are cases like that where like it's a 100% that client is not doing the communication. And then of course the simple thing you do is you blind it. You give information only to the client, you give different information to the facilitator, and you say which information gets communicated. It's always the information you give to the facilitator. All right.

B: It's trivially easy, I mean it's really like a joke how easy it is.

C: It's almost like James Randi's test, like it's that simple.

S: It's a simple test, it doesn't have to be a complicated study. All right, but, there is essentially a cult of FC that exists within the medical, speech therapy, you know, and psychology world, right? And so how do they keep alive the idea of facilitated communication? Well they've morphed it, they've morphed it into different forms. They they do a few things. So one is simple rebranding─

B: Classic.

S: ─they've rebranded, rebranded it into something called Rapid Prompting Method or RPM, right? Rapid Prompting Method. It's FC, that's just what it is. So the, here's the big difference. They don't hold the client's hand, they hold the board in front of the client, right? So now, instead of moving the client's hand, they move the board!

E: Oh my gosh.

C: (laughs) I love how you just said that.

E: It's like the Ouija board you're moving the board instead of the [inaudible].

S: They could say, we're not touching the client, so we're not doing FC. It's like yeah but you're still. (Cara laughs) So the thing is if the client is doing the pointing, if they're the author, why isn't the board on a stand? Why are you holding it at all?

C: Yeah why isn't everything stationary.

S: Yeah so anyway, so professionals call that facilitator dependent communication, right, so they essentially, any method where it's possible that the communication is facilitator dependent is not real. And it's not valid and it should be looked at with extreme caution. Now I watched a lot of videos of this, of RPM, one of them was just apps, it was so bad. And it's a mother working with a daughter so it's obviously very sad. And the daughter's very alert and interactive and smiling and everything and emotionally, you know, there's definitely some interaction going on. But they, they're you know they're they look non-verbal or non-communicative, and it's so obvious watching this video that the mother is forcing what the output that she's looking for. But let me give you the most blatant example. She asks her daughter a 50:50 question, right? Is it A or B? And the correct answer is A. She clearly points to B, like insistently points to B. The mother doesn't react it just look just keeps looking at her and then she gives her another nudge, like you tell me and then she switched, the daughter switches her answer to a which is like that's correct you are correct─

E: Oh my gosh.

S: ─she whisks away the board to the next task.

C: I mean this is like the age old.

E: That's ridiculous.

C: Ugh it's like.

E: Clever Hans.

S: It's clever Hans, that's it.

C: It's clever Hans, it's every police interrogation that ends up getting thrown out later.

S: It was the clever Hans effect, right? She just kept, she just didn't react until she got the answer she was looking for and then she reacted and gave the the positive feedback.

B: I think with Hans was easier.

S: That's what we're talking about, that's what we're talking about here. It's a completely invalid method we had recently written about this on Science Based Medicine, we got a flood of angry emails─

B: Angry?

S: ─from from supporters of FC, and you know you know like really and they were all using the same kind of language. I think somebody must have posted a link on their on their message board or something yeah so we got this flood you know of these angry emails. Which prompted me to like update my research on it and write about it again. So one of the things that they pointed to was a study that used eye tracking to show that the clients were looking at the letters before they pointed to them. But it, so there's two problems with that. The methodology of that study has been, you know, highly criticized because it's still facilitator dependent. But the the thing is, this is another method they use. So the rebranding is one, the sort of hiding and plain sight or hiding in the herd is the other way. And this is very clear, it was good to get these emails because like, I like to hear what the true believers are saying. Like how they're justifying their own beliefs. So one of the things that they did was, they didn't talk about FC or even RPM, the Rapid Prompting Method, they talked about augmentative and alternative communications. And you guys are against AAC, right, augmentative and alternative communication.

C: Wait, what? Like adaptive technology, of course not.

S: Exactly, of course, I know. Yeah so AAC is basically an umbrella term for a host of legitimate communication methods with people who have impaired communication.

E: And they're elevating themselves into that class?

S: Exactly. They're slipping themselves into this broader category and then they say you guys are against all of this. It's like no, we never even mentioned it. We were talking only about, I think in this case it was the RPM. There's also this speech to communicate, S2C so that was another one that we might have mentioned. But we we're not talking about AAC at all. So there it's complete bait and switch, a complete bait and switch.

E: That's like a, it's like a homeopath saying oh well you're against all pharmaceuticals.

S: Yes, exactly, that's exactly what it is.

C: The thing about that specifically is that if it's coming from providers─

S: Yeah.

C: ─it's especially insidious.

S: Yeah.

C: There is a part of me that really can't help but empathize with a parent─

S: Oh totally.

C: ─who wants to believe that this is how they're connecting and communicating.

E: Oh gosh, of course.

C: And of course in their mind this is just another adaptive technology because they have been hoodwinked into thinking it's evidence-based. And that's the sad thing is that it would be an easy narrative for them to follow that you just want to take away this technology that's allowing me to communicate with my daughter. That's not the problem.

S: Here's the other way they hide, yeah absolutely. Here's another way they hide, so one is by trying to pretend like is this part of this this wonderful breakfast, right, part of this complete breakfast. But it's also, they use evidence of non-facilitator dependent communication. So you take a relatively high functioning individual who can communicate entirely on their own by pointing to a letter board or typing. And say there that's evidence that it works. It's like no but that's not, that's not facilitator dependent. If you can show me facilitator independent communication where the authorship is verified, that that person is the author, that's great. But that doesn't prove that facilitator dependent communication, where you can't prove authorship is real. So they miss the actual point that we're making.

C: They miss the active ingredient there.

S: Yeah exactly, yeah.

J: I'm curious have you ever thought about this before but wouldn't this be unbelievably easy to disprove if they.

B: Oh yeah, it is.

J: Just ask. Okay, so who is, who is the person that is being facilitated it's my brother you know five years ago he got in a horrible car accident. Okay but you're communicating with him, okay, what did he call me as a nickname when we were kids?

S: They've done that, and they can't and that always fails, right?

J: Well there you go.

S: If it's facilitator dependent.

J: I've just disproven the whole thing.

S: But this is, they have an answer for that because again it's a cult and no amount─

C: They have motivated reasoning.

S: ─yeah the motivated reasoning is profound, so this is what they say about that, which again is why I love to get these these emails. They say, you can't expect somebody with autism to communicate in the same way that we all communicate─

E: Special pleading.

S: ─and you're actually, you're asking, it's a total special pleading, you're asking them to understand what you know and what you don't know and to give you the information you're looking for and you can't reasonably expect them to do that. So all of those studies are flawed.

E: Untestable!

C: That's what physic would say.

S: So it's untestable. But here's the thing, but then they point to studies where that's exactly what's happening when it gives them the results that they want of course that's that's facilitator independent communication. So they're not even internally consistent in the criteria they use they are just dismissing the negative evidence out of hand and it doesn't even make sense.

C: I feel like there should be an informal logical fallacy, maybe there is when somebody uses science in their argument when it benefits them and then rejects science and their argument when it doesn't benefit them.

S: Well it's internal inconsistency, so that's, it does make the list. All right the final thing they do which is really gets you, this one's really distasteful. Is they take the moral high ground, so they say you're denying that these people are people and you're denying that they have you know a meaningful existence or that they have any potential you know to have an inner intellectual life, you're, so you're you're erasing them. Like they're using─

C: That's disgusting.

S: That's disgusting.

E: It's like a human shield.

S: They're using all of that language.

C: It's like no, you're erasing them by giving them your voice.

S: Yes, exactly.

B: Exactly.

E: Yes, you're hiding your pseudiscience behind these human beings.

S: Exactly. But then they get all high and mighty about how terrible we are and but that's the cult, right, that's it. So anyway, that's what I learned recently about what the current state of FC is. It really is disgusting. It's still a pseudoscience as I say, FC is still pseudoscience but the the professional organizations that were all over it. And they really have, this is that's the good news in all of this. They understand what it is they really understand the nub of what's wrong with it and they are they are dead set against it, they call it out by name they are not having, there's no shruggy problem, there's no wishy-washiness. Like this is bad, it's pseudoscience, it's hurting our clients, you should absolutely not do it, this is harmful.

B: That's encouraging.

S: Similar to the approach to the false memory syndrome.

C: False memory syndrome, conversion, remember conversion therapy? Very similar to that too, past life regression, primal scream therapy. All of these things that are they're detrimental.

S: Yeah they're actively harmful, they're actively harmful, absolutely.

E: FU FC. (laughter)

S: Okay.

B: Nice.

S: But it's so disappointing that, I mean this is something that should have gone away 30 years ago.

B: I mean you were ripping that apart in the 90s.

E: Oh I remember Steve you wrote articles in our newsletter.

S: This is old school.

B: This is one of the first big things you really took on.

E: Yes. I remember that too. ' C:' And it's just another example of the vulnerable being taken advantage. And then there being a difficulty extricating the practitioners and the people who have an agenda from the, I guess the people who are victims of this. Mash together.

S: It's not enough to mean well, I'll even buy that these people all mean well. It's not enough. When you're a professional you have to do due diligence. If you're a cop who's investigating a crime, I don't care if you want to catch the bad guy. You have got to follow protocol, you have got to make absolutely sure that you are not eliciting a false confession. Or, whatever, you're doing a bad investigation. If you're a physician, you have to do due diligence to make sure that it's evidence-based. If you are doing this you have to make sure that you are not the author of the communication. If you don't do that that's on you, that is a violation of your professionalism.

C: It's a violation of your ethics code and all of these fields have an ethics code that says that they have to uphold what is it beneficence and reduce maleficence. Like that's fundamental to the ethical ethics code.

S: Absolutely.

B: I love that movie.

E: Sleeping beauty?

Gamma Rays and Gravitational Waves (58:56)

AI Emotion Detection (1:10:32)

Who's That Noisy? (1:21:05)


New Noisy (1:24:37)

[in and out puffing sounds similar to heavy breathing]

J: ... If you think you know what this week's Noisy is, or if you heard something cool like the sound that you just heard, then you should just email me very quietly and very sincerely to Who's That Noisy, WTN@theskepticsguide.org. That's all you have to do.

Announcements (1:25:12)

Questions/Emails/Corrections/Follow-ups (1:26:10)

Email #1: Communicating Skepticism

I work at a not-for-profit (https://www.digitalpublicsquare.org/) and one of things we try to create are interventions when it comes to things like public health. In terms of vaccine misinformation, we have a site that offers information in a quiz-like format (https://knowitornot.com/). Now, I know you all have discussed the efficacy of these types of interventions and wanted to know your thoughts. I've heard that sometimes these types of true/false paradigms might not be the best and don’t do well to "vaccinate" folks against mis/disinformation. Personally, I can see how such a paradigm talks down to someone who's deep in the hole, and it might not communicate the "skeptical" mindset. I'm wondering what the Skeptics think of strategies like these, and if there are any particular insights you could offer based on your experiences. Love the show, thanks!

– Wahid Shafique, Toronto


Science or Fiction (1:33:44)

Theme: Bermuda

Item #1: There are no native mammals in Bermuda, only introduced species such as mice, rats, and feral cats.[6]
Item #2: There are more than 300 shipwrecks in the waters off Bermuda, making it the shipwreck capital of the world.[7]
Item #3: When Bermuda was first discovered in the 1500s and later settled by Europeans, it had no native or indigenous population.[8]

Answer Item
Fiction No native mammals
Science Shipwreck capital
Science
No native population
Host Result
Steve clever
Rogue Guess
Evan
Shipwreck capital
Jay
No native population
Cara
No native mammals
Bob
No native mammals

Voice-over: It's time for Science or Fiction.

Evan's Response

Jay's Response

Cara's Response

Bob's Response

Steve Explains Item #3

Steve Explains Item #2

Steve Explains Item #1

Skeptical Quote of the Week (1:54:41)

Stupid entropy ruins everything.
Jennifer Ouellette, American writer

Signoff

S: —and until next week, this is your Skeptics' Guide to the Universe.

S: Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to info@theskepticsguide.org. And, if you would like to support the show and all the work that we do, go to patreon.com/SkepticsGuide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.

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Today I Learned

  • Fact/Description, possibly with an article reference[9]
  • Fact/Description
  • Fact/Description

Notes

References

Vocabulary


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