‘Living Medical Traditions’

Another update to the Science Wooseum story.

I took some time to document more of the exhibit, which is indeed tucked away on the top floor, sandwiched between two very good (and bigger) displays relating to the development of modern medicine. Some really amazing pieces in there. I’ve made a web album of the photos.

Mm, appeal to tradition.

The Living Medical Traditions section is definitely worrying. It has a completely different feel.

In contrast to the display just around the corner, Living Medical Traditions are presented as credible practices simply because they are old and lots of people still subscribe to them.

There’s no educational value in this, and some of it is just wrong. Simon Singh and Edzard Ernst did a better job of researching the origins of alternative medicines (e.g. the possibility that acupuncture actually originated in central Europe) – why was Ernst not consulted*?

In the Before Modern Medicine exhibit, the practices of ‘Western’ physicians that are now discredited (such as blood-letting) are openly mocked, complete with caricatures and categorical statements that people were frauds making money out of the vulnerable. We still see plenty of that going on today.

Renaissance practices that don’t fit in with the scientific knowledge we’ve gained since (such as alchemy, astrology – which plenty of people still believe in – blood-letting and so on) are presented as ‘magic‘ and folklore. There are also some beautiful artefacts chronicling some of the medical advances borne out of closer studies of human anatomy and disease.

The tone is very detached; people used to do these things. Wasn’t that silly! Look how absurd and how far we’ve come. But then when you turn a corner, it’s completely different – everything is addressed to you, telling you what you could try and what the practitioners of these traditions could use based on your needs. It all reads like one big advert.

The advertising is far more blatant in some instances though. The whole of the ‘personal stories’ interactive panel, for example (apologies for the snide comments and shrieks of horror at the cupping – not for the faint-hearted!):

To look at a couple of the main offenders (ignoring for now the Geri DVD that had us laughing):

An e-mail address to contact the seller. Excellent.

No discussion of the conflict between hospitals and alternative practitioners, how politics, corruption and various other factors can come into these ‘choices’, the problems of herbal medicine; even if it does work, do we know why? Is it safe? Drugs that have been derived from plants and are widely-used e.g. aspirin and those that are deadly – no mention.

I can’t see this as anything other than a promotion. A commentary on how some traditions are clawing their way foil-clad into the ‘modern age’? I don’t buy it.

David Colquhoun already mentioned one of the most obvious free advertising elements; Parkbury House Surgery in St Albans probably gets a fair bit of custom out of this.

It seems Professor Shi Zaixiang wrote or at least heavily contributed to his own exhibit.

It explains that he ‘treated’ people who seemed to have Ménière’s disease, which can be serious in some cases and there is not currently a cure – though this is not mentioned on the display.

There are other concerning claims dotted around the board.

It seems that the Living Medical Traditions  gallery goes against some of the Wellcome Trust’s own proposals for how an exhibit should be put together:

1. Exhibitions should be research-led, not a form of dissemination

Research into alt med effectiveness – both the negative and positive results – is not discussed here. I overheard one girl at the acupuncture ‘interactive display’ saying “yeah this actually works doesn’t it, because these bits are sort of connected…” and later “You could probably do it at home if you had needles thin enough, right?!” – worrying.

2. A scientist should always be involved in the exhibition, a technologist if it is about technology

It doesn’t seem that any scientists were consulted here. *Professor Ernst would have been the obvious choice.

5. Never show ready-made science

Focus on the processes of science: science in the making; the triumph of discovery; the frustration and blind alleys explored along the way. Also, look at the social and cultural processes of scientific ideas becoming accepted and embedded.

For me, the exhibit doesn’t do that. It shows ideas people have just because… well, they’ve had them for a long time. It doesn’t tie in at all with the generation of evidence-based medicine or why people are questioning the ethical acceptability of these practices.

That brings me neatly to the comments from John Beddington, the government’s chief scientific adviser. Obviously it’s probably not that sensible to compare pseudoscience to racism or sexism – so it’s better to read his comments in New Scientist for a more considered piece.

It is time the scientific community became proactive in challenging misuse of scientific evidence. We must make evidence, and associated uncertainties, accessible and explicable… We must also be confident in challenging the misrepresentation or exaggeration of evidence and the conclusions it leads to. Where significant consensus exists, it must be made obvious.

He is essentially issuing a rallying cry to challenge pseudoscience, from misplaced scepticism to deliberately misleading and fraudulent claims.

the serious public debate required to drive progress is being undermined by individuals or groups who cherry-pick facts to drive their own agenda

I believe the Science Museum’s tactic here is contrary to this; of course, my view is distorted by the circles I move in and we’re all more concerned about it than Joe Public, but I’d almost see that as another symptom of widespread ignorance of what evidence-based medicine and the scientific method actually are.

Once again, I have no issue with examining alternative medicine in a museum setting, I simply have a problem with the way this is presented; more interesting avenues have been shirked in favour of what mainly comes across as promotion largely due to the language employed.

I’m not sure what the next step is, if anything – hopefully the post and the photos give a better idea of our particular objections to this exhibit.

Links:

Zeno’s blog on the MHRA and homeopathy. Relevant, seeing as the Museum can’t even get it right when it comes to homeopathy. It’s not minute quantities, it’s nothing at all. Even the New Zealand Institute of Chemistry are joining in now.

https://picasaweb.google.com/noodlemaz/ScienceMuseum#5575163246467307730

A “Media Tart” Case Study

I recently went to a course run by some ex-BBC journalists, Media Players International, on how to engage with the media regarding your research. They encouraged us to become the Media Tarts of the future, so here I (vaguely…) recall some of Dr Armand Leroi‘s lecture to my fellow postgrads and I from way back in the Summer, which was on that very topic.

I’ve enjoyed Armand’s telly programmes and was fortunate to have a pint and a chat with him at the very first London Skeptics in the Pub I went to (having been apprehensive about knowing no-one beforehand!).

Probably most famous for his science best-seller, Mutants, Armand has a great passion for his subject – evolutionary biology – which I very nearly pursued after university myself (and still sometimes wish I had!).

My Life As A Media Tart

Guest lecture to School of Medicine & Dentistry, Queen Mary University of London, Postgradute Day.

How I became one and how you can too!

The OMIM database* shows that we are all mutants. This gives us information on development.

[*I love OMIM; Online Mendelian Inheritance in Man, and have done since it was introduced to us at university. You can search any gene you can think of and see if it's been linked to a heritable disease in people, with links to the original papers, follow-up studies, details of other-organism models, big clinical studies, drugs and so on. Very useful & interesting.]

Armand recalled dealings with the “innocent of knowledge” TV people in Soho(!) when Channel 4 had commissioned a series of programmes that should cover science in the form of:

Sex, death and deformity

The Sex was provided by Olivia Judson, the Death by Gunther von Hagens [oh how I did enjoy the Body Worlds exhibition!!], and the Deformity by Armand!

He showed us a timeline of the deadlines set (and missed!) during the writing of Mutants, and its movement to TV serialisation.

Filming is wonderful! But draining.

Having worked on the flatworm C. elegans (one of biology’s favourite genetic models) for many years, Armand noted how human compassion affected the projects – studying mutants can mean ‘treating real people as flies’, with respect to their genes;

I was comfortable with worms!

We scientists are sometimes resistant to being taken out of our comfort zones!

TV is a crass medium

Apparently the BBC even has a ‘walking & talking’ school! They’ll teach you how to move and talk at the same time. Amazing.

Is it worth it?

A common question with regard to any sort of science communication endeavour, especially ones such as writing and presenting that can take a lot of time and effort. Armand replies:

There is a need for science. Lots of TV science!

The situation isn’t quite as dire as many of us tend to think. SciComms is flourishing in many ways; this is the first time in my life, at least, that it’s been cool to be nerdy! Perhaps I’ve just restricted my social bubble so much that that’s inevitable, who knows.

We need scientist-driven content.

Rather than producer-driven; otherwise you fall into the sensationalist traps, don’t actually inform anyone of anything and maintain useless stereotypes.

Prof. Kathy Sykes and notable others have started to take on alternative medicine (close to the skeptics’ hearts of course) and pseudo-skepticism such as the ‘global warming swindle’ (see below).

Science Matters.

There has been a war of sorts, going for >2300 years; if one is going to be overly-dramatic about it, involving (un)truth, light/dark and (un)reason. Perhaps embodied by Aristotle’s movement away from his teacher, Plato, saying

Plato is my friend, but the truth is more my friend.

Something with which I identify very much, in fact.

The value of Scientists in engagement

It needs to be about more than just saying “trust me, I’m a scientist”

TV is run by humanities graduates!

That may well be so, in which case the narrative tends to rank above substance.

Is it true? It is news?

It is of course important that you have a good narrative, though, otherwise people will get bored and wander off! So I wouldn’t be too quick to dismiss their skills or be particularly mean (have loads of humanities grad friends and they’re no less brilliant for it – am a firm believer in the importance of diversity. Hey, all the geneticists should agree with that!) – but it’s probably worth trying to give some input, to steer things in a more fact-based direction.

The example given was of a Channel 4 ‘documentary’ called The Great Global Warming Swindle. It was investigated by Steve Connor who said it:

was based on graphs that were distorted, mislabelled, or just plain wrong…

To which the producer Martin Durkin replied:

The original NASA data was very wiggly and we wanted the simplest line we could find

Given the audience and subject matter this is hugely irresponsible and, understandably, people made various statements against it.

Prof. Carl Wunsch at MIT, who participated in the documentary, said The Great Global Warming Swindle was ‘grossly distorted’ and ‘as close to pure propaganda as anything since World War Two’.

One of Armand’s comments during correspondence with Durkin, that ended up involving Ben Goldacre and Simon Singh as well, was affectionately dubbed the ‘Leroi Conjecture’

Left to their own devices, TV producers simply cannot be trusted to tell the truth

He finished with some advice:

Editing is unavoidable. Seriously engage and keep control. Say ‘It’s this or I walk’

Don’t be pressured into presenting something you don’t agree with or something that’s wrong. Don’t let your message be twisted.

Going back to the journalists I met on the course; apparently there’s no such thing as ‘off the record’. Get your message clear in your mind before you begin, do your best to stick to it. You can learn to direct questions yourself and maintain the agenda – they’re already skilled at doing it.

Use the Press office of your universities – fortunately at Queen Mary we have a very good one. Don’t forget that they exist.

Mythbusting

I’ve talked of it before as a potentially important role for scientists (and anyone, really) and it seems to be a growing phenomenon – that or I’m just more aware of it. All perhaps catalysed somewhat by Nick Davies.

For example, the lovely Mr Marshall, not a scientist by training, has moved into covering Bad PR (or Bad News, as a more pun-tastic title for SitP talks and wotnot) – that includes opinion polls and general PR screw-ups.

These go along the lines of:

Determine the outcome, and then run the study to find it.

It’s rather like Creation ‘science’, if you like. Here’s the conclusion, now let’s go cherry-pick that evidence.
What doesn’t fit, it’s fine – we’ll ignore it, or we’ll design a study that irons that wrinkle out.

If you venture into comms/outreach, as a media tart or otherwise, you can do your own bit in this ‘war’, if you want to call it that – science would probably appreciate it.

Armand gave us a whirlwind tour of his programmes to date:

Alien Worlds

This 2005 programme was seemingly dismissed as a bit silly; indeed we had a bit of a giggle at a screen-grab of some computer-generated space whales.

What Makes Us Human

Armand in his shades there

The programme examined the differences between the chimp (our closest relative, genetically) and human genomes and the idea of a genomic recipe.

He expanded upon one example of how genetic research has used human examples to glean information about the functions of our genes and why we develop the way we do.

In Gujarat, Pakistan, there are shrines to the Rat People;  they have unusually small heads and the mental ability of 2-3 year-old children. The local presumption is that they are cursed (or they believe that beggars or gypsies put pots on their heads to deliberately create a source of income in the family). Infertile people go to the shrine and must ‘donate’ their first child to the shrine, or all their future offspring will be doomed to this fate.

The condition is called microcephaly – a recessive genetic disorder, involving several genes, including microcephalin (involved in brain cell proliferation).

It’s fascinating because when we consider chimps vs. humans, our genes have evolved very fast; one major distinguishing feature being our ‘huge’ brains. One gene important in this feature of ours is clearly microcephalin.

He also recounted attending a very surreal dwarf conference in Reno, US., called Little People of America. Dwarfism is caused by varied bone disorders, achondroplasia being the most common, and there many people come together from all over the world to share their experiences, access support networks, meet up and make friends.

We got an amusing image of the evo bio lab’s shrine to ditto the pig (as a good luck mascot!) – animals with two faces are a striking example of mutants helping our understanding of genes; with this condition being particularly ‘entertaining’, given the gene involved (a favourite amongst us biologist/gamer types) – Sonic Hedgehog (or Shh).

Darwin’s secret notebooks

A National Geographic piece on the formation of Darwin’s thoughts. Tenuous links here being that Darwin was British and bald! They got to go on the National Geographic ship Polaris, I’m insanely jealous of this.

What Darwin Did Not Know

A programme designed to explain the development of evolutionary understanding since the publication of the Origin of Species (in just 90 minutes!! Hardly a simple task).

Armand’s favourite example from this is the Lake Malawi cichlid fish. An absolutely astounding variety of fish species have evolved in that lake and a lot of work is still going on to characterise them.

Aristotle’s Lagoon

Armand’s pet project to date, the title referring to a Lesvos Lagooon visited by “the father of biologists”, Aristotle, who wrote the Historia Animalium as a result – the first in-depth zoological study.

Interesting as the recording of the Infinite Monkey Cage I went to recently involved the question of “Is philosophy dead?” and the seemingly age-old rivalry of scientific vs. philosophical study (not that I separate them that much, personally) – here Aristotle was considered only a philosophical figure, and I thought it was a shame they’d clearly not watched this programme!

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Finally I should probably plug my first foray into the world of scientific telly, brought to you by the excellent Wellcome Trust – have a look at tissue culture in our lab, here!

One Year On: Libel Reform Update

December 2nd 2010 at the Free Word Centre: an update on the progress of the Libel Reform

all-important refreshments

campaign.

Hosted by Jonathan Haewood of English Pen, John Kampfner of Index on Censorship and Tracey Brown of Sense About Science.

English pen have their photos from the evening on Flickr; I managed to avoid being in any of them this time!

From the literature distributed at the event:

The One Year On event follows weeks of further revelations of the impacts of the libel laws:

- Plastic surgeon Dr Dalia Nield was threatened with libel action by the manufacturer of a ‘Boob Job’ cream for saying she was concerned the product was potentially dangerous*

- A survey of bloggers and online forum hosts found that bloggers are particularly affected by the libel laws as they work without the support of a large company so suffer an inequality of arms, particularly where they are writing about companies, institutions and products.

- Yahoo!, AOL (UK), Mumsnet and the Internet Service Providers Association told Prime Minister David Cameron that the current laws make ISPs liable for content hosted by them and means material can get taken down in response to a threat when there may benothing defamatory about it.

* This is in reference to Rodial’s product, a cream called “Boob Job” – covered by Ben Goldacre, and we also mention it in Episode 7 of Super-Duper Woo-Fighting Duo!

Introduction

We were first assured that people’s counter-arguments have led to modification of positions and proposals within the campaign – differing interpretations have been taken on board and the aims of the campaign modified accordingly (in true skeptical fashion!).

It has sparked the first serious public discussion on libel in the UK; no insignificant achievement.

More MPs signed the libel reform EDM than any other in parliament. All parties made a commitment in their manifesto. A Libel reform bill has also come through the lords.

And, of course, Simon Singh won his appeal! Leading to the “Fair comment should be strengthened and clarified” resolution.

In addition, Jonathan has written:

In a year’s hard campaigning we’ve seen a lot of activity – but nothing has actually changed. We are now looking to the Government to produce a Bill that protects the public interest and recognises our changed media environment. We are commmitted to upholding free speech, reputation and access to justice – we just hope that the Government is too.

However, there have also been worrying trends. Scientists, publishers and bloggers are still  regularly being threatened with libel writs.

At the very least we can probably accept that everyone wants to:

- protect free speech

- recognise the importance of reputation

- maintain access to justice

—

Richard Allan

(Director of European policy, Facebook)

He states the importance of being able to talking with people as freely as possible, then mentioned the “Twitter bomb threat” (which prompted me to tut loudly; people need to stop calling it a ‘bomb hoax/threat’ because it wasn’t) – speech issues are on the agenda in both the public and political spheres.

In his view, the objective is: legal support for speech (as long as that speech isn’t illegal; i.e. recognise the existence and [lack of] implications of casual talk or ‘the Pub vs. the public) – let’s have a better environment.

They don’t want to have to respond to solicitors’ casual threats of libel. Instead:

- The complainant should go to the author first

- Obtain documents from court to say it’s a genuine complaint

Internet companies take content down first and ask questions later! (Once bitten…)

There needs to be a single publisher rule; a limitation of 1 year; long enough for someone to take action if it is in fact actionable.

Facebook is globally accessible but libel tourism isn’t acceptable.

We need to respect that people have views on things – they do and will continue to discuss them in public fora, including online.

Unless this is understood, it is simply “an accident waiting to happen” – will it take a few solicitors to pick it up and run action to have dramatic chill, before things change? Let’s get legislation now rather than fix it after the fact.

—

Emily Cleevely

(Head of Policy, Publishers’ Association)

Emily started by asserting the value of publishing and why it’s in the government’s interest to protect it, having generated £4bn revenue in the UK in 2009; up 2.6% in 2010 – in the current market. If we’re to get out of the recession, surely we should be supporting growing industries?

Is publishing the key? It also aids with social mobility e.g.  in the form public libraries.

Creativity should be protected – authors must have freedom of expression without great fear of libel action. Not just trials but also the threat of libel, the chill, that convinces too many that silence is a safer option.

Emily gave the example of Wayne Rooney’s book, which apparently had a lot of things taken out/changed. Not sure anyone was too impressed with this point, particularly Matt…

The PA will continue to be active in politics and media regarding Libel Reform.

Most interestingly, Emily gave some stats from a survey conducted in October this year regarding the effects of libel on PA members (which will be published in a January 2011 report): 100% (of the 65% total membership that participated in the study) said they had modified content or language in a book prior to publication to avoid the risks presented by current UK libel laws.

Richard Mollet, CEO of the PA, said:

The Publishers Association has been campaigning for libel reform for many years and is concerned about the chilling effect which the current law has on freedom of expression. The results from our survey demonstrate that libel law as it currently stands is a huge burden to many publishers in the UK and may act as an obstacle to growth, innovation and freedom of expression within the sector.

—

Tom McNally

(Minister of State, Minister of Justice)

[Most of the time he was speaking, I kept wondering what he was fiddling with in his jacket pocket. Anyone else??]

Having only been a minister for 6 months, McNally wanted to quote the ‘Dick’ Crossman diary (1964) on ministerial duties [roughly, as I couldn't quite write fast enough!]:

One of the curious features is that one cannot distinguish day from day or night from night

[I think that's the case with plenty of jobs, to be honest!]

He did say we “should have a Draft Bill in Spring” (which means sometime before June 1st 2011)

Going from the Lords to legislation is a slow process and the importance of “future-proofing” whatever we do was emphasised.

In my notes I then have something about ‘the next parliament March 2012′ – even after reading some Wiki on our parliament, I don’t know what he/I meant by this (please comment if your memory and political/legal understanding is better! This is not difficult to achieve, mind).

McNally implored us to continue:

Don’t stop! … This is the end of the beginning for your campaign

The Draft Bill is a rough outline of what the government will commit to. When it comes out, we may not like phrasing and bits might be missing..!

He then addressed Simon Singh:

My son is 17 and doing Maths, Physics and Chemistry in St. Albans – your ordeal was very rough but you’re a hero to young scientists and have inspired a lot of young people in science

Which, I think, we all very much agree with.

Having read Douglas Hurd‘s paper on communications, focussing on “Quality, Diversity and Choice” – he wants to ensure we have that in our media, unrestricted by the libel laws.

—

Questions

Q (DAG): Do the activists only come in after bill publication – can’t we input now? [Tom A: wait a bit!] You said ‘hopefully’ there will be a slot in 2011/2012 – does that mean there might not be one? [Tom A: No minister can commit to anything in the preceeding financial year]

Q: Have you considered vulnerable writers (like the disabled) and the use of sensitive/offensive terms – legislating on which are acceptable, and how does one defend one’s reputation? [Tom A: regarding hate crimes, the issue hasn't come into libel reform yet] – I think the general opinion here was that this was a bit of an irrelevant/off-the-mark question.

Q: (Simon) – Interview in Aus with Questions: regarding homeopathy – threat of London libel. Someone blogged anyway. People someone quoted have asked to be anonymous for fear of libel. [Tom A: Contrasting legal advice: is the Master of Rolls looking?] From the audience: “At every stage…” – some ramble that didn’t mean a lot, from where I was sitting!

Comment: (Síle Lane) – from a Sense About Science survey, of the editors of scientific journals (in all subject areas):

- 32% have been threatened with libel action

- 44% have asked authors to modify articles

- 38% have refused to publish due to fear.

Tom A: We’ll try! We can’t go into detail; we need laws to protect science discussion and criticism. Legislation needs to be right, not flawed and open to criticism. Then a comment about public opinion/support that I missed – perhaps, the public generally supports making sure scientific claims & criticisms can’t be silenced by legal threats? I don’t know if there have been any surveys on this.

Q (Evan Harris): A claimant lawyer can make their case (and have it rejected!) -  we need to create a public interest defence; incorporating a ‘threshhold’ of damage caused to reputation (in this country), given what is published abroad. [Tom A: Something about the Lester bill and 2 sides interacting, that I missed. Plus, there's another chill for people with 'media intrusion', who are met with "don't like it? See you in court"]

Response (Evan): Individuals need to be able to sue. Companies, less so. [A: this must be looked at.]

Comment (Nigel Tait – Carter Ruck (!) ): ‘Please don’t worry about us lawyers!’ – because they’ll keep making money regardless, basically. Which is true.

Q: (Tracey Brown) – Is it a good thing (economically) that London is a litigation centre? There are other ways though;  so that we would not be blocking world discussion, but leading it.

Q: (Matt Flaherty) – The recent Supreme Court case that replaced “fair comment” with “honest comment” – how big a deal is that?

- we didn’t get an answer to Matt’s question, sadly, even though it was arguably the best one (but perhaps we’re just biased ‘cos we love Matt. Still, it’s a shame no one offered a response).

Q: I want to bring up the elephant in the room, or perhaps the country; I’m sympathetic to PA and Facebook but what about people exposing military abuse; will you allow Assange to stay in the UK? – people chuckled at this a bit.

Richard makes a joke and someone says “Assange is not a subject for mirth”.

(Richard): Sorry, World insanity causes me to resort to black humour! When you hear of people ordering assassinations for something the person has said, that’s just insane.

A (Tom): I Can’t answer this! Ask the attorney general. Q: What’s your view of the leaks? Patience! – is all I’ve got in response to that, but I can’t remember if any more was said.

Comment: The burden of proof is not actually biased to the claimant (I had a semi-drunk argument/discussion about this – the unfairness of the law re: the accused who makes the libellous comment – in the old London SitP pub, then about 2 weeks later I bumped into the guy at Westminster Skeptics and he said I was right and he’d been talking rubbish. Always nice to know!).

Q: One of the main reasons for libel tourism is that our lawyers charge 40-50x fees! No one can afford this! Would the lawyers really want to remove this source of income?

A (Joanne Cash): – Yes we will go against our paychecks! “If you need any help, you know where I am!”

Comment (Emily): People ask about the value of science vs. creative works and biographies. Science must be critiqued. Perhaps there should be a seperate – legal, if I recall -category for science?

Hey, Audacity! We use that for SDWFD(wc)

Personally I don’t think I agree with that. If you start treating science as a really special case, this could potentially damage an already shaky relationship with the layperson. Though evidence-driven criticism is especially vital in science and particularly medicine, I don’t see why such criticism should be actively discouraged (with such great effect as the current libel law has) in any field.

—

Closing comments

Tracey: When we started, we heard “don’t bother” because: it’s too complicated; you’re small; the government is uninterested.

Remember this is as much about the public right to read as for people to speak. Uncertainty leads to debate and often uncovering the truth.

For example, take the case of Peter Wilmshurst as one that gives a simple perspective (we  want the public to be made aware of things that might be dangerous, rather than people deciding not to speak out to protect others, for fear of losing their house, their job, their livelihood).

When small people say things to power sometimes things happen

—

I’m sure many of us still like to think that could be true.