SGU Episode 381
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| SGU Episode 381 |
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| 3rd November 2012 |
 |
| (brief caption for the episode icon) |
| Skeptical Rogues |
| S: Steven Novella |
B: Bob Novella |
R: Rebecca Watson |
J: Jay Novella |
E: Evan Bernstein |
| Quote of the Week |
Skepticism is essential to the quest for knowledge, for it is in the seedbed of puzzlement that genuine inquiry takes root. Without skepticism, we may remain mired in unexamined belief systems that are accepted as sacrosanct yet have no factual basis in reality. |
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| Forum Discussion |
Introduction
You're listening to the Skeptics' Guide to the Universe, your escape to reality.
This Day in Skepticism (1:28)
November 3, 1957 Sputnik 2 launched
In Memorium
Paul Kurtz (3:45)
- 1925-2012
S: Well, we are going to start the new segment of the show with an in memoriam. We do like to, on the Skeptic's Guide, pause to remember those members of the skeptical community who have passed, and Paul Kurtz died several days ago, just the day before the organizers were coming down to the conference. He died on Sunday. He was 85 years old. It was 1925 to 2012, so that is 86. I can do math. (audience laughter) You'll know why i was confused in a moment.
R: 'Cause you're terrible at math?
S: Yes. So, before we get the show started, Ron Lindsay and Kendrick Frazier talked about Paul Kurtz. You know, he was one of the giants of the skeptical movement, of the skeptical community. You know, he was largely responsible for organizing the Committee for the Scientific Investigation of Claims of the Paranormal, founding Prometheus Books, CFI, Secular Humanism. He was an academic, a philosopher. He really gave a lot of weight to the movement early on. He made it to that – he broke it to that next level. It wasn't that, you know, before he came on board. So he has to be remembered for that. We did have some interactions with Paul along the years. The first year that we started – (audience cooing)
R: Baby Steve!
E: Aww.
S: I was a little younger back then.
R: He's three years old there.
B: He's only half-grey there.
S: (laughing) I'm only half-grey!
E: A little less grey, yep.
S: You can mark my age by my greyness up until about ten years ago, when i went totally grey. Right when we got started, in 1996, you know, CSICOP, now CSI, you know, they were the big national skeptical organization. They'd definitely – They took us under their wing, you know, gave us their support, their local membership list, so that we could get our movement going. And i remember meeting Paul at the first World Skeptics Conference, and he was immediately—like, you know, your grandfather—like, you know, very, very comfortably took on that air of being a mentor. It's like, "Yeah, this is great. You're welcome to the skeptical movement." So i definitely remember him fondly in that way. A few years later, Paul organized a meeting of the local skeptical groups. In the picture here you can see me again with Bob, Perry, and Evan. The four of us came up together –
J: Now, if i remember correctly, Rebecca, you and i were off being badass somewhere else, right?
R: I think that's what was happening, yeah.
S: – and, i think, in the foreground, that's Colonel Joe Nickell, isn't it?
E: Colonel.
S: Yeah, he had broke his leg in Spain, or something?
R: Round of applause for Colonel Joe Nickell!
E: I remember that.
(applause)
S: Joe actually is going to come up, and he's going to read a poem that he wrote, i believe, about Paul.
JN: Paul was a great supporter of the arts, and i hope he would have liked this. The poem is called "Book of Seasons: An elegy". (Uncertain re: permission to reproduce poem)
S: Thank you, Joe.
Leon Jaroff (7:34)
- 1926-2012
S: This same weekend, Saturday before the show, Leon Jaroff also died. He was 85, hence my confusion. So, Leon Jariff—not a big name in the skeptical community recently, and if you ask, you know, people at conventions like this if they knew who he was – I mean, in fact, right before the show Rebecca said to me, "Who's Leon Jaroff?"
R: (indignant gasp)
S: Sorry, Rebecca.
(audience laughter)
S: But he was perhaps one of the most skeptical journalists that we have had.
B: Yeah.
S: He was the science columnist for Time Magazine. It was he who said, "You know, popularizing science is important, you know, we should start a science-dedicated magazine." And that was Discover Magazine. That was him. He was not afraid to be a hard-nosed skeptic when writing about scientific issues. So, for example, when writing about chiropractors, he wrote,
Chiropractors also employ a bewildering variety of weird practices to diagnose their patients. Some use applied kinesiology, a muscle test that supposedly can diagnose allergies and diseased organs. Hair analysis and iris readings are commonplace in the profession. Even sillier are many of the treatments that chiropractors use and recommend: homeopathic potions, colon irrigation, magnetic therapy, enzyme pills, colored-light therapy, and something called "balancing body energy," among other mystical procedures with undocumented effects.
S: That's from a mainstream journalist writing in Time Magazine. Do we see this kind of thing today? I don't think so.
B: Nope.
(audience applause)
S: So, you know, we do have to, I think, also note the support that Jaroff gave to such a good science journalism, and that kind of hard-nosed, skeptical science journalism is definitely something we miss. That's a void that, I think, that we in the skeptical community have to fill, but, unfortunately, it is a void.
News Items
Big Bang Conference at CERN (9:31)
S: Rebecca –
R: Yes!
S: – this is a different quote. It's not as good a quote.
Science in isolation is great for producing stuff, but not so good for producing ideas.
R: Mm-hmm.
S: Who said that?
R: That was said by Andrew Pinsent at the Ramsey Center for Science and Religion. What I particularly liked about this quote is that it is completely reversed – it is the exact opposite of what I would have suggested.
S: Mm-hmm.
R: I would say that science is actually really good at ideas, but, in order to produce stuff, you have to add something else. You know, like, they might be able to figure out lasers, but to make a CD player you need a marketing executive.
S: Or death ray.
R: Thank you. Yeah, of course. Why didn't I go there first?
(laughter)
R: Yeah, so, this quote comes from a recent article that the BBC produced: "Big Bang and religion mixed in CERN debates". Apparently, there was a conference recently that CERN held—you remember CERN, you know, the guys who, apparently, may have found –
J: Higgs!
R: – the Higgs boson.
S: A boson with Higgs-like properties.
R: A Higgs-like thing.
S: Boson, yeah.
R: A Higgish. I like "Higgish" –
B: "Higgish"?
R: – a little bit.
J: (laughing) "A little bit!"
S: "Higgy"?
B: (singing, inaudible) Higgy again."
R: So, yes. Apparently, I don't know the purpose – I don't know what, who dreamt this up, but what I'm thinking is that someone was concerned that they may have found a particle that many people know as the "God particle", and, so, they're concerned that they're going to be excommunicated or, you know, that people will rebel—religious people will rebel—against science. Basically, we'll have some sort of Dark Ages–esque thing happening, and, so, maybe somebody at CERN thought, "Well, we should have this conference where we talk about how religious people should be OK with the Higgs boson."
B: Mm-hmm.
R: So, those are the good intentions that I'm assuming are behind this conference that has speakers such as this. The quotes in here are pretty fun, and none of them have any amount of intelligence to them. Steve, you're the one who brought this one to my attention here –
S: Yes.
R: I'm interested in what – we've talked a little bit before about things like the Templeton Foundation, which is an organization that gives out a prize – gives out prizes to people who can explore science in a religious context, basically. And I'm a bit opposed to it. I feel like it's muddying the waters. I think we don't need to bring religion into what people are doing at CERN.
S: Mm-hmm.
R: I think those two things are happily separated, but I'm interested in knowing your feelings on this.
S: Oh, absolutely. I mean, I think trying to introduce theology into science is misguided. You know, this conference was specifically about the origin of the universe. So, it's not just about scientific issues in particular. I think the thinking, at least on the part of the theologians who were quoted about this conference, is that, well, you're talking about the origin of the universe. That's a really big question, and religion is about answering the really big questions—not science. Science is narrow and reductionist, and makes stuff, but can't really grapple with the big questions of our origins. And that's exactly incorrect, as you were saying. That's a complete knock to science. I mean, science is, in fact, the only human intellectual endeavor that can answer any empirical question about the origin of the universe.
R: Yeah.
J: So, was the conference, though, the scientists trying to appease religious people? The saying that –
R: Well, you know, apparently, this was – the conference was done on the part of CERN, according to BBC, and that's what I find troubling. I'm totally OK with a conference that religious people host, you know, and the topic might be "How do we –" you know, "How do we consider our theology now that we know X, Y, and Z—now that science has discovered this? What does that mean for our belief system?" And I think that's fine, but, you know, apparently, the theologians who were there seem to think that this was a chance to debate the scientists –
J: Yeah.
E: Yeah.
R: – and, no! Why would you do that? Debate is completely the opposite direction of where you want to go.
S: It also – I mean, the quotes seem to me like a desperate grasp at relevance, trying to make it seem like they're – you know, that theology is still relevant to questions about origins of the universe, when, in fact, science has completely displaced it from that endeavor.
J: So, did it end up with, like, a fistfight? Like, what happened?
(laughter)
E: Science won.
R: I haven't found any evidence of any arrests, so, apparently –
S: There were no fisticuffs?
J: That really must've been awkward as hell, though, right? Like, they're like, sitting there, like, after a whole day, and they're like, "Uh, OK, it's over now."
E: Something tells me they're not going to be doing this again. They're going to learn from this.
S: I don't know.
R: Well, I mean, it's actually not even – like, I wish it had been that exciting. But, instead, it just seems like it was really boring –
E: Yeah.
R: – and nobody came to any conclusions. Because you can't, you know?
S: Yeah.
R: You're just having a discussion of, like, well, you know, "But what don't we know?"
Italian Earthquake Scientists Convicted (14:57)
S: Now, we're trying to keep – we like to keep our live shows really light –
(laughter)
E: So far, so good.
S: So, we thought we'd talk about a horrible earthquake that killed over three hundred people.
E: Yeah, let's go there.
R: Good intro. Good intro there.
S: But there's actually a better story embedded in that. There were six Italian scientists, who were recently convicted of manslaughter –
B: Yeah.
S: – for failure to properly communicate the warnings about the upcoming L'Aquila earthquake in 2009. Yeah, we've been following this story, you know, since it happened. The quick version is that there were a number of small tremors in this very earthquake-prone part of Italy, and the geologists—the local geologists—you know, were following it. And their opinion was that, well, these tremors are very common. Most such tremors are not followed by major quakes. Most major quakes are not preceded by these kinds of tremors. So, the probability of a major quake occurring is not particularly higher, you know, now, just because of these tremors, than at any time, and, therefore, there's no cause for alarm. Now, they were specifically asked during a press conference, "Should we panic?" You know, "Should we evacuate?" And they said "No. There's no reason to evacuate. Stay at home and drink a glass of wine."
B: Steve, was this about a year ago that we covered this?
S: 2009. 2009 –
B: Oh, wow. (inaudible)
S: – so, was the quake, and then the court trial started about a year ago, and now the decision came down that the six scientists were convicted to six years – I think six years in prison and something like, you know, millions of dollars in damages for manslaughter—for the deaths of the people who didn't evacuate because they – of their reassurances that there was nothing to be worried about.
R: That's horrific.
J: Well, i, you know, to play devil's advocate real quick, if there was true negligence—like, if they didn't follow through with things that they needed to do, if they did a terrible job at analyzing the data, in a fashion that – where the data could have been analyzed better, or they actually weren't asking their peers for the information—i can understand if there was extreme negligence.
S: Right.
J: But, even still, like, that's very hard to prove, and I just don't understand –
S: Well, I mean, not really. The question is, was their opinion within the standard for their profession? That's—in my opinion—that's the only real question here. You can't be blamed for being wrong, right? You can't be blamed for a bad outcome if you were following the standard. Now, of course, scientists can't predict earthquakes. You can't predict when an earthquake is going to occur. That's the bottom line. What – every statement they said was truthful, you know, every factual statement. "These tremors do not necessarily mean that there's an earthquake coming, and they are not a reason to evacuate. We don't evacuate every city where there's tremors because there might be a major quake, because it's not that predictive." So, that was not negligent. No, and they weren't really being accused of negligence. They were basically being accused of poorly communicating to the public. It seems to be based on a lot of false premises about what scientists can know—what an expert about, you know, an earthquake, a geologist, expert can know.
R: Yeah, they've been convicted for not using a magical power they don't have.
S: Yeah.
R: They might as well have convicted all the psychics in Italy for not accurately predicting this earthquake.
J: I think we need to be careful—i don't disagree, of course. I don't think that these men should be going to jail for this at all—but it is an important thing to state that, I think, people should go to prison, or get in trouble legally, if they are misrepresenting science or – right? So you see where I'm going with this.
S: Well, yeah. If you are –
J: If you're setting that premise—you're saying, "Hey, these guys screwed up, they didn't do what they were supposed to do, they didn't communicate to us the real possible outcomes here", whatever—and, like –
S: Yeah.
J: – I'll reiterate, I don't think that they should be going to jail—
B: Well, I don't agree –
J: —but, I do think, though, that that standard that that court set needs to be applied all the way down the ladder.
B: Yeah, but, Jay, like, someone saying that "I have a cure for cancer and it's scientifically proven" but it's a sham?
J: Exactly, right? So, if they're going to actually take those scientists out and say "You're done. You're not performing science anymore and you're going to jail for that bad decision or information you gave", well, hello! Then, you know, all of a sudden, a million lawsuits need to be filed.
S: But, it wasn't – to clarify, though, it wasn't bad, it was just unlucky. I mean, doctors encounter this all the time, you know. You are asked to decide, you know, what tests to order, what diagnoses a patient might have. There's a whole lot of liability involved with that. You can't be convicted of malpractice just because of a bad outcome if what you did was within the standard of care.
B: Right.
S: So, was the information they were giving to the public within the standard for the profession? If the answer is "yes", the fact that there was a low-probability earthquake the next week is not their fault.
E: Right.
S: It doesn't change the fact – you know, if they're saying there's a 99% chance that there's not going to be an earthquake, and then the 1% thing happens, they were still right –
J: Yeah.
S: – in saying that it was unlikely.
R: Yeah.
E: Didn't the evidence show, basically, that they performed correctly, essentially? They did not –
S: That's the consensus. I mean, so, there's worldwide outrage, especially among the scientific community (inaudible) –
B: This has got to be shot down in a higher court.
S: Yeah.
B: This can't – can't possibly stand.
E: I hope so.
S: Well, there's two appeals left. There's two appeals, and they will stay out of prison before those appeals. So, the United States National Academy of Science, the Royal Academy of Science—the Royal Society, rather—issued a joint statement saying that "that is why we must protest the verdict in Italy. If it becomes a precedent in law, it could lead to a situation in which scientists will be afraid to give expert opinion."
J: Yeah, that's devastating.
E: Mm-hmm.
S: So, it would have a chilling effect. What – you know, what geologist is going to, you know, talk to the public in Italy now, if you could wind up in jail and, you know, financially devastated, and your career devastated, because you can't predict the future, you know, because you don't have a crystal ball? It's insane. It's insane.
J: Yeah. To think that they're going after these scientists, and they're not going after the rampant quackery throughout –
S: Well, there's that, too.
E: I wonder how much pressure they came under from, like, the families, the survivors, of this terrible, terrible devastation –
J: Oh yeah, they had to hang someone.
E: – and I imagine they put a lot of pressure on politicians and other people in order to hold somebody accountable.
J: They have to. They had to send someone down the river for that.
B: Did they have a trial?
S: Yeah.
B: Did they have witnesses and experts coming in?
S: Yeah. Yep.
B: I'd love to know the details of what exactly happened, because how could –
(laughter)
S: So, we'll see if the worldwide backlash has an effect. I mean, again, they do have two appeals left, so we'll definitely follow it.
Whale Makes Human Sounds (21:35)
S: All right, Rebecca, so, we have a cute animal –
R: Thank you.
S: – we're going to talk about now.
J: This is a happy one!
R: Just tell me this narwhal or whatever is alive.
S: It's a whale.
E: It's alive and well.
S: It's a beluga whale.
B: It sort of looks like a narwhal.
R: Tell me this beluga is alive!
E: That's NOC the beluga. They're very much alive.
R: It's not a beluga?
E: "NOC". N-O-C.
S: "NOC". NOC the beluga.
R: Oh! "That's NOC."
(laughter)
R: I was about to say, "No, that is a beluga."
S: Sounds like a children's song.
E: It does sound like a children's –
S: Evan, sing it.
E: No.
S: OK.
J: Don't change it! Please don't –
E: If my daughter was here, maybe. But, no. So, what's important about NOC the beluga? Well, OK, so, picture this: You are part of the National Marine Mammal Foundation, OK, and you're in the tank, swimming around with the whales and stuff, and, all of a sudden, you hear somebody—you hear a voice—call your name. Something to the effect that – "Get out of the water! Get out of the water!" So, you're in the tank and you come up and you say, "OK, who told me to get out of the water? Who told me to get out of the water?" And the other scientists and people are looking around you like, "Nobody? What the heck are you talking about?" And, he's like, "Well, I definitely heard that!" Well, what did he actually hear? Well, apparently, NOC the beluga made some noises very reminiscent of human noises. Beluga whales are, you know, incredible creatures. Their calls – They're known as the canaries of the sea. They have a very high-frequency, high-pitched tone to their noises that they make, but they make lots of different kinds of noises. They can emit up to eleven different kinds of sounds—crackles, whistles, trills, squawks—all sorts of things. But, it's been rumored that these whales can emit noises that sound like humans talking. And, for the first time, they've actually recorded NOC the whale making these noises, and they have it on tape. And we have it on tape.
R: Nah.
(NOC makes unnervingly human-sounding noises)
R: Did he maybe just swallow a kazoo?
(laughter)
J: Everybody has a drunk neighbor that makes those noises.
(laughter)
E: Oh, gosh. Who knows what the heck he was saying? You know, dolphins have been taught to mimic noises that kind of sound like human voices, but, before this, there's been no record of an animal spontaneously coming up and making these kinds of noises. This is the first evidence, the first hard evidence we have of it.
R: Here's – I have a theory. I have a theory. I have a theory that – so, whales, in general, are incredibly intelligent –
E: Oh yeah.
R: – possibly as smart as us, but they don't want thumbs, or any way to talk to us –
E: Or fire.
R: – and I feel like they do, basically – That's true. No, I saw Spongebob once. There was fire under the sea. I think it can be done.
S: Yep, but they don't have nanotechnology, though.
R: They don't. So, my theory is that whales are basically, like – they have – it's like they have locked-in syndrome, you know? Where they're just –
J: Oh, no.
R: – super-intelligent, and there's all these people around them, and they're just messing with them –
J: So, he was screaming, actually –
R: Yeah! And, so, he's been like, his whole life, he's been in this stupid little – like, he's in captivity, right? So, he's been in this stupid little aquarium, and he's just, like, "I hate all of you! And I'm going to will myself to tell you, because you're too stupid to understand!"
E: So, basically, what's going on here is, the whale has learned to change – rapidly change pressure within its naval cavity in order to create these sounds. And, it hasn't – the whale is able to over-inflate what's known as its vestibular sac in its blowhole, which is normally acts to stop water from basically coming in. So, the whale is going through a lot of, you know, effort, essentially, to try to make these noises. And I'm sure they're going to be trying to figure out exactly, you know, basically, why is the whale doing this?
S: Well, he just – this whale was – did spend his life in captivity –
E: Yeah.
S: – so, he did hear human speech a lot, and maybe he's just, to some extent, mimicking the sounds that he grew up hearing his whole life.
J: It's definitely – it definitely has a human sound to it, in the cadence and everything.
S: Yeah.
J: I mean, he's intelligent enough to mimic a human, which is really cool.
R: Yeah.
J: And, then, you always think, you know, if he can mimic a human—if his brain is advanced that much—you know, maybe he –
B: Mm-hmm.
S: But, is he mimicking humans or making fun of humans? You know, like people make fun of other languages?
R: Yeah, he's just like "Weh! Weh! Weh! This is what you sound like!"
E: Yeah. You stupid bald monkey and (inaudible)! Get out of here!
B: Sounds like a false dichotomy.
PANDAS Controversy (26:18)
S: So, we're going to talk about – going from talking about beluga whales to talking about PANDAS! Except, we're not talking about pandas, because we're talking about –
E: Wait.
R: Stop toying with my emotions, Steve!
S: I had to put a cute picture of a panda up there for you, Rebecca. We are talking about pediatric autoimmune –
R: It makes sense.
S: – neuropsychiatric disorder associated with –
E: I didn't know PANDA was an acronym. Cool!
R: Steve, I miss the panda.
S: – streptococcal infection—or, PANDAS. See? There's a panda.
(laughter, cooing)
E: Aww!
R: Yay.
S: We're talking about PANDAS –
E: Aww.
R: Boo.
J: Oh.
E: That's worse.
S: – which is a legitimately controversial medical diagnosis! So, essentially, what happens is, children suddenly develop ticks—like Tourette syndrome—and psychiatric disorders—obsessive–compulsive disorder—and it is thought that, in some cases, that it is actually – the inciting event is an infection—bacteria—streptococcal infection. Now, of course, it's always difficult to establish the reality of a new disease. Unless you get all your ducks in a row, and all the, you know, pathology all adds up, it's sometimes difficult to identify a legitimate new syndrome and to prove that – cause and effect. So, correlation is one thing. As we know, correlation is not necessarily causation. And, so, the syndrome exists. There are – the number of physicians who have identified the sudden onset psychiatric – neuropsychiatric disorder, and in some cases it is temporally associated with a streptococcal infection. But that's not the same thing as saying that the strep infection caused the neuropsychiatric syndrome. So, that's – and there's the controversy. Now, of course, we live in the modern Internet age. So, as soon as a scientist says, "I think that there's this syndrome—I want to call it PANDAS—and – sort of, you know, a psychiatric syndrome provoked by a bacterial infection", of course, there are now support groups, and there's groups on the Internet, and there's patient groups supporting this diagnosis before the science is even settled. And, then, of course, once that happens, when you try to do more science, or have any kind of discussion about whether or not this is a real syndrome, you have parents and patient groups and advocacy groups, you know, calling you all kinds of nasty names and saying there's a conspiracy against people with PANDAS, it's all the insurance companies and Big Pharma and evil doctors or whatever. So, that's the situation that we're in the middle of right now, unfortunately, is that, before the science is settled, you know, there's the scientific controversy, then there's the public controversy. This came to the media attention recently because of a 16-year-old girl called Elizabeth Wray. She developed, you know, a syndrome like PANDAS with ticks and psychological disorders, was diagnosed by a physician with PANDAS, and then was transferred to Boston's Children's Hospital for – presumably for further treatment of PANDAS. Now, the story that is going around the PANDAS community is that once she got to Boston University—or Boston Children's Hospital—she was told – the parents were told, "We don't believe that PANDAS is real – that it exists", and then they essentially admitted their daughter to the psychiatric unit and started treating her with psychiatric medications. Now, I don't know if that's true, because the doctors and the hospital are not telling their side of the story because of patient confidentiality. So, we don't know what their side of the story is. We only know the parents' side of the story, filtered through the PANDAS community. Unfortunately, now there's – this story has taken on a life of its own. There's a Free Elizabeth Wray movement going on within the PANDAS community, they're telling all kinds of horror stories about Boston Children's Hospital, and, you know, we can't verify any of it. What's interesting in reading about it is that each side has their narrative—and I wrote about this on Science-Based Medicine—because one of the things that – the ideas that we're wrestling with in the skeptical community is that—well, all right, we have, I think, a good approach to critical thinking, we understand a lot about self-deception, about the nature of science and pseudoscience—but we don't always have a good story to tell the public, or we have a hard time convincing mainstream outlets that we have – that our story is an interesting and good one. You know, we have to really market our narrative—the skeptical narrative. When you read about stories like this, the PANDAS proponents have a really compelling emotional narrative. It may be total B.S.—i don't know—but it's very compelling. They have a story of a child suffering from an unusual disease, parents who just want to do what's right for her—I believe all those things are correct—and then they are, essentially, being abused by a dismissive and skeptical medical establishment who doesn't believe in this disease, and that is treating their child with perhaps harmful, you know, psychiatric medications. They even – this went to court. Apparently, the hospital thought that the parents were being negligent in not allowing them to give proper standard of care—psychiatric treatment—to their child, and they wanted to have custody taken away from the parents, and they wanted to admit Elizabeth to a locked psychiatric ward—again, not sure – I can't verify those from the hospital's side of things. A judge – a Massachusetts judge essentially made her a ward of the state while they sorted out what was going on, but they did not grant the hospital their request to treat her in the way that they wanted to. So, they essentially just – the state took her out of everybody's hands for a moment – for the moment. So, it's interesting. Of course, the PANDAS community, again, is up in arms, you know. The court essentially took custody away from these parents that are only trying to do what's right for their daughter. But, of course, you could see the other narrative—you know, let's assume that the physicians think that—even if you think – whether or not you think PANDAS really exists—they think that she has a psychiatric illness, the parents are in denial, they're pursuing this false diagnosis, and they're, you know, refusing standard medical care. That's a story, too.
B: What if you just pulled out the whole strep association, and just treat it like a "pandisorder"? Is their beef that it's associated with strep, and they don't think there's any association? Why don't they just treat it like a neuropsychiatric disorder –
S: Yeah.
B: – and forget about the whole strep association?
S: Well, because the strep association would lead you to treat with things like antibiotics. So, that's the question: Should you treat it with antibiotics, or should you treat her like a psychiatric (inaudible) patient?
J: Why not both? I mean, why wouldn't you –
S: Well, she has had at least one round of antibiotics. You can also treat it like an autoimmune disease, with, like, intravenous globulin, for example. So, I mean, these are real medical questions. Do we treat it like an infection, do we treat it like a post-infectious auto-immune disease, or do we treat it like a psychiatric disorder? Those are real questions.
J: Steve, are you saying pandas don't exist? Let me just get this straight.
(laughter)
S: So, well, I did – to give a serious answer to your sarcastic question, I did –
R: My favorite kind.
S: – take the opportunity – I'm good that way. I'm good that way. I did take the opportunity just to familiarize myself with the PANDAS literature—again, I always emphasize, I'm no an expert in this, but I can read the literature and give my opinion like a science journalist—i think it's genuinely controversial. When I read the research, there's lots of – the ducks are not in a row. So, when you do things like treat kids who apparently have PANDAS with antibiotics in a double-blind, placebo-controlled trial, they don't necessarily improve. And, if you look for the antibodies that are supposed to be there, they don't necessarily correlate with the disease onset or with the existence of strep. So –
B: So, this is clearly not like autism and vaccines. It's just more complicated than that.
S: So, no. So, right. So, autism and vaccines, like, I would say, that's been studied enough to say that autism's – that autism is not caused by vaccines. We can say that. We can make the negative statement. I cannot make the negative statement that PANDAS does not exist, only that the research so far has not reached the threshold where we can agree that it does exist and that there is some actual negative data—there's some positive data, too—so it's legitimately controversial. It did remind me, though, of the chronic Lyme disease controversy—
R: Yeah.
S: —which is very common in New England—again, where they think that a number of symptoms, including neurological symptoms, can be caused by a bacterial infection and treated with antibiotics. And the same – there's a lot of overlap in those two communities, you know.
J: Steve, are you saying that the public has unrealistic expectations?
S: Well, I think – it's partly that. I mean, I think the public is uncomfortable with the uncertainty, and they like this sort of hero–villain narrative, so they paint the medical community as the villains, and—except for those maverick physicians who understand. They're Lyme-literate, or they understand PANDAS, so they're the heroes—and, then, the insurance companies don't want to pay for, you know, over-and-over recurrent courses of IV antibiotics, so they're the villains, you know. They're not—I'm not defending insurance companies, but sometimes they actually – sometimes they're right. They don't want to pay for things that are not science-based or evidence-based. So, it's complicated. And, you know, how do we – so, how do we deal with a child with this disorder when we don't know what the best scientific answer is—we don't know if it's autoimmune, infectious, or psychiatric? We just have to, you know, do the best we can—and there may be different physicians who would take different approaches—but to portray it as "PANDAS definitely exists. If you don't believe in it, you're dismissive and you're mean and evil, or you're protecting some kind of Big Pharma grant that you're getting"—they always bring that up—rather than saying, "You know, we really want to know the right answer, but we just haven't found it yet. It's still – it's legitimately controversial."
J: Yeah, I think what you're saying does confirm what I was thinking, is that the public wants an answer, science is not yet done figuring this one out, and –
S: Yeah. Like the earthquake one, right?
J: Yeah.
S: Sometimes the answer is, "We don't know yet", you know. "We need to do more research". In medicine, we have to make decisions with imperfect, you know, information, so, you know.
J: Wouldn't it be typical, too – like, let's say that this is happening over and over again –
S: Yeah.
J: – like, at some point, some doctors are going to come up with different ideas, they're going to try it out, you know. The trial-and-error process happens, and—i hate to say it, but—this girl is probably going to be one of the people that gets tested on with new ideas.
S: Well, I mean – well, if you're really testing then you should be doing a research protocol. If you're just applying the best knowledge that we have to an individual patient, that's – a certain amount of trial and error with that that's not really experimentation. So, there is a difference there. So, I don't know. The other interesting question that I'm kind of alluding to is, what role do the patient or the advocacy groups play? I think, a lot of times, that they are helpful in raising awareness for a disease or a disorder and raising funding, and advocating for patients. You know, I've seen, I think, there's a lot of very effective, very good patient advocacy groups out there. But, sometimes, they put their nickel down on a specific scientific answer, and that's not their job.
J: Yeah.
S: It's not their job to predict or demand that science give them the answer they want. And, you know, unfortunately, some people want the answer to be "an infection"—not "genes", not, you know, "We don't know".
J: Yeah. It's curable. That's the one they want.
S: Of course, who – that's the answer I would want to have! "It's something outside that is, you know, foreign, that can be cured, and that can reverse my child to the way that they were". Who – every parent wants that to be the answer, but sometimes you – you know, you have to step back from what you want and listen to the evidence. That's the – that's the scientist's, that's the physician's job, you know. You should just let them do their job, you know.
J: All right, so, I want to bring up a quick side point on this.
S: Yeah.
J: So, as an example, let's say, fifty years ago, let's say this was happening. What stance do you think the public would have differently than what we're seeing today?
S: It's the same, and this did happen fifty years ago. Fifty years ago, you know, she would be diagnosed with neurosyphilis—maybe not somebody who was sixteen, but that was the stand-in for what we now would, you know, the same subculture would diagnose with chronic Lyme. There were believers in that. There were physicians who believed in treatments like chelation therapy, you know, and science proved it wrong, and they said, "Well, we don't care, we're going to still do it. We're going to come up with – We're just going to keep coming up with special pleading and alternate theories, and form our own societies and our own – and just keep doing it, and say that it's all a conspiracy."
J: Mm-hmm.
S: So, but, I think that it's just the turnaround time is so much faster because of the Internet. Like, another example: CCSVI, right? The alleged blockage in the veins that drained blood from the brain, causing multiple sclerosis. It's that – that whole process—of Dr. Zamboni proposing this entity and a treatment, to it being researched, to it being refuted, to, you know, patient advocacy groups springing up and calling for conspiracies and calling for research and demanding that science give them the answer that they want—all has taken place within a few years. We've seen that cycle happen right before our eyes. So, the Internet is just making it happen a lot quicker and a lot bigger, I think. But it's always been this way.
J: So do you have any ideas on what we could do? Could the skeptical community do anything to help this (inaudible)?
S: Well, I think what we do is, we discuss the issue from a science, logical, critical thinking point of view, you know. We point out the role of science in this, and we, I think, we try to bring the public discourse to a level that can deal with it in a more productive way, rather than the conspiracy mongering, sort of lowest-common-denominator that it would otherwise sink to.
J: Yeah.
Reporting Ghost Stories (39:44)
- pnd
Live Q&A (51:06)
- Questions from the CSICon audience
Science or Fiction (55:19)
S: Item number one. A new study finds that astronauts who spent more than one month in microgravity have a 35% increased risk of heart attacks and strokes. Item number two. Scientists have discovered the first feathered dinosaur in the western hemisphere, and also adds another dinosaur group known to have feathers. And item number three. Researchers find that, at the molecular level, evolutionary changes can be highly predictable.
Skeptical Quote of the Week (1:08:11)
Skepticism is essential to the quest for knowledge, for it is in the seedbed of puzzlement that genuine inquiry takes root. Without skepticism, we may remain mired in unexamined belief systems that are accepted as sacrosanct yet have no factual basis in reality.
J: Paul Kurtz!
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