SGU Episode 921

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SGU Episode 921
March 4th 2023
Hidden Hydrogen: Does Earth hold vast stores of renewable, carbon-free fuel?
SGU 920                      SGU 922
Skeptical Rogues
S: Steven Novella
B: Bob Novella
J: Jay Novella
E: Evan Bernstein
Guest
PW: Perry Wilson, Yale nephrologist
Quote of the Week
I think knowing what you can't do is more important than knowing what you can.
Lucille Ball, American actress
Links
Download Podcast
Show Notes
Forum Discussion

Introduction, Guest Rogue Perry's new book

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 Wednesday, March 1^st, 2023, and this is your host, Steven Novella. Joining me this week are Bob Novella...

B: Hey, everybody!

S: Jay Novella...

J: Hey guys.

S: Evan Bernstein.

E: Good evening folks!

S: And we have a guest rogue this week Dr F. Perry Wilson. Perry, welcome to the Skeptics Guide.

PW: Thanks, great to be here.

S: Now Perry your first name is actually Francis but you go by Perry and I'm just wondering, have you ever seen the movie Stripes by the way?

PW: Yeah of course.

E: Oh no.

S: Do you ever pull a Nobody calls me Francis. If you call me Francis I'll kill you. You ever tell that to anybody?

PW: You know I have tried and it only elicits scales of laughter so I just can't pull it off.

S: You can't pull of I'll kill you if you call me Francis.

PW: Doesn't work.

B: You got to get that look in your eye.

S: A thousand yards stare?

E: Oh my gosh.

S: So Perry we're having you on the show partly because Cara's away this week. She's out of the country so it's a good week to have a guest rogue. But you published a book recently. How Medicine Works and When It Doesn't which I've been helping to promote. Excellent book, really. It's a good way of introducing people to just some of the inner workings of medicine so they could think about it a little bit more critically. So how is the, how the book promotion going?

PW: It's been going great. This is a book that I think is very much in line with what you guys talk about every week. It's about why people are susceptible to medical misinformation. The cognitive biases, the motivated reasoning that leads people to make bad choices. But I tried to be fair and I think one of the things that people are really responding to about the book is that I acknowledge that part of the reason that people go to alternative practitioners and engage with sort of hokum is because they're not getting something from the medical establishment that we're failing in some fundamental ways to provide the best possible care for our patients. So I think it's important to take a kind of holistic view here and see what's going on.

S: Yeah I mean obviously we can always do better in science communication. We could always do better in just the delivery of medicine and the regulation of medicine. I like your chapter on the pharmaceutical industry because it's not like we can give a full-throated glowing defense of the industry because they do shady stuff all the time. But there's a far cry from that to the wild conspiracy theories that people come up with. And so it's hard to have to be advocating for a nuanced position in the middle.

PW: It is and we're kind of in a world where nuance is really unpopular. In social media it's like the way you get engagement is by taking very extreme positions. And of course in medicine and I think in most things in science the extreme positions are rarely correct usually there is some gray area and I think pharmaceutical companies is a perfect example. Yeah, they're for profit. That is their motivation. At the same time there are some drugs that are essentially medical miracles. Cures for Hepatitis C. Obviously these are big big things that are life-changing for people.

S: It's like every institution humanity has ever developed. It may be help in some ways and it's flawed in other ways. There's no perfect institution whether it's democracy or science itself or education or whatever. And we have to learn how to maximize the good stuff and mitigate the bad stuff, right?

PW: Yeah. And keep improving.

S: And keep improving. That's the self corrective, yeah, self-correction has got to be built in. Which also means transparency and honesty and all that stuff but yes people want their clean morality play where there's villains and heroes and we just default to that simplistic narrative.

PW: Exactly. It does generate a lot of clicks but nothing is like that. There's no medication without side effects. There's no, there's no perfect, there's only good enough.

S: Right, there's only good enough. And we could do, and maybe hopefully doing a little bit better.

PW: Right.

S: Yeah. But and that's the other- so we talk about black and white thinking etc., but the other sort of way that people want their purity, their moral purity is what we call the Nirvana fallacy. It's like oh this isn't perfect therefore it's useless. It's like there's nothing less than perfect that's good enough like the anti-vaxx are like prove to us that these are 100% safe. It's like no, there's no such thing in the world. Life doesn't work that way.

PW: Exactly.

S: That's an unreasonable standard. So how do you confront that sort of thing in the book?

PW: I mean we, be honest about it. And part of the way I describe medicine is in contrast to some of the more absolute sciences, physics and mathematics where there are proofs and you can you know prove that the square root of two is an irrational number and through logic and a little bit of arithmetic and that's just it. There's no argument there. Medicine isn't like that. Medicine is a science of hedging your bets that's how I describe it in the book. It's about making the best choices with the evidence and there's no guarantees but it's like investing in a stock portfolio or something. You're just picking the health behaviors and interventions that have the best chance of leading you to a healthy life. And we can't promise you what one of those things that will be. All we can do as doctors is sort of advise on what the data shows and my hope and you can tell me if I'm being naive here, you guys are deep in this. My hope is that if we're just honest about that we say, look we can't promise you that this vaccine for example is going to prevent you you from ever getting covid in the future however what we can tell you is that chances are you'll be better off if you take it than if you don't because the data is pretty clear that the downstream effects of covid are worse than any of the downstream effects of the vaccine. And maybe if we are sort of framed things in that way, that we are, it's a science of hedging your bets. People will appreciate the honesty.

S: You're right, you are being naive. I mean that's obviously a good starting point but we know from research and experience that it's not the end point because if you're confronting a deliberate machine of misinformation just giving people facts isn't enough. You have to understand their narrative, you have to confront their narrative, you have to replace their narrative with a better one. One that's more evidence-based, more logical, etc. And you can just, here's a bunch of facts and being honest and transparent with you. That's great, that's a minimum requirement but by itself- and with some patients it's probably enough, I think with a lot of patients it probably is enough but with people who have already been programmed with misinformation, we know that it isn't enough. We know that.

PW: Of course. It's very hard in that situation. And part of what doctors need to do and what's great about listening to your show is we need to know what those elements of misinformation are. A lot of doctors, patients will come in and they'll say I heard about what's going on with the vaccine from QAnon and doctor will be like what the heck is QAnon. And to some extent if our patients are bringing this to us it is our responsibility, not to necessarily go deep on [inaudible] or whatever but we need to be aware of the counter narratives that are out there just so that we're prepared. So that we can say okay yes, this I've heard of. Here's why I need to move you away from this or that it's dangerous.

S: So we should tell the listeners that you are a doctor at Yale, right?

PW: Right.

S: Internal medicine and kidney specialist, correct?

PW: Correct.

S: Yeah and however our connection is ironically completely independent of the fact that we both work at Yale, right? We've sort of connected over this stuff.

PW: Yeah.

S: Not really our work at Yale although I'm sure we have some patient overlap because everybody who works at Yale probable does. But that's not it's interestingly not how we met but in any case we are going to have you talk to us about some other medical stuff later in the episode. There's a story that's blowing up that you suggested a couple days ago that we definitely have to get deep into the weeds on. But first we're going to start with a quickie with Bob.

News Items

S:

B:

C:

J:

E:

(laughs) (laughter) (applause) [inaudible]

Mining Hydrogen (13:38)

• Hidden Hydrogen  

ChatGPT Update (31:30)

• What is Bing with ChatGPT? Here's everything we know 

Erythritol and Heart Disease (57:10)

• Common sweetener erythritol tied to higher risk of stroke and heart attack 

Growing Brain Electrodes (1:13:54)

• Electrodes grown in the brain -- paving the way for future therapies for neurological disorders 

legion

Woodland Elves (1:22:57)

• Mexican president claims he has proof of mythical woodland elf 

Who's That Noisy? (1:33:41)

Answer to previous Noisy:

North American porcupines

_text_about_moisture_vaporators_SW_reference_

New Noisy (1:37:08)

[_short_vague_description_of_Noisy]

short_text_from_transcript

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Science or Fiction (1:37:37)

Theme: Ancient bizarre medical treatments Item #1: In order to treat the black death, thought to be caused by deadly vapors, medieval physicians recommended sniffing farts that had been stored in a jar. Item #2: A medieval treatment for stuttering was a hemiglossectomy – to surgically remove half the tongue, without anesthesia. Item #3: Of the many ancient treatments for hemorrhoids, the most aggressive involved placing a live rat in the anus until it died.

Answer	Item
Fiction	Rat into anus
Science	Sniff farts from jar
Science	Remove half the tongue

Host	Result
Steve	clever

Rogue	Guess
Evan	Sniff farts from jar
Bob	Remove half the tongue
Jay	Rat into anus
Perry	Remove half the tongue

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

Skeptical Quote of the Week (1:51:04)

I think knowing what you cannot do is more important than knowing what you can.  – Lucille Ball (1911-1989), American actress, comedian, and producer

Signoff/Announcements (1:53:52)

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
• Fact/Description
• Fact/Description

References

Vocabulary