This week’s recommendations include: a thoroughly disturbing expose — written by a medical doctor — of the unsafe conditions in America’s hospitals that frequently lead to permanent injury, destruction of health, or even death; an examination of the possibly shaky foundations of medical science; a review essay on “the oldest self-help book,” a 19th-century grimoire that offered mainstream magical and quasi-magical advice to generations of Westerners about everything from cooking to health to life direction; a cogent calling-out of the hijacking of public discourse by ubiquitous chatter about money and finance; a criticism of the unconsidered claim that telepathy and other parapsychological phenomena stand in a position of inherent conflict with “real science”; and a thorough trashing of “popular neurobollocks,” that is, the new and trendy spate of books promising better living and an end to human problems via a faux “neural” explanation of absolutely everything.
Are Hospitals Less Safe Than We Think?
Marty Makary, Newsweek/The Daily Beast, September 17, 2012
[NOTE: The excerpts given below — from an article whose author is a medical doctor with firsthand knowledge of what he writes about — are longer and more extensive than what we’ve shared from any item in any previous Recommended Reading update. This is both because the subject at hand is so screamingly important and because the collective impact of the information in these excerpts drives that reality home. Then there’s the additional fact that your trusty Teeming Brain editor encountered a crisis earlier this year in which a very close family member was very nearly killed, and now suffers from permanent negative consequences, due to exactly the kinds of things talked about here.]
Teaser: Bad doctors. Prescription errors. Surgical slips. Medical mistakes injure or kill hundreds of thousands of Americans every year. Why patients are kept in the dark.
A host of new studies examining the current state of health care indicates that approximately one in every five medications, tests, and procedures is likely unnecessary. What other industry misses the mark that often? Others put that number even higher. Harvey Fineberg, M.D., president of the Institute of Medicine and former dean of the Harvard School of Public Health, has said that between 30 percent and 40 percent of our entire health-care expenditure is paying for fraud and unnecessary treatment. While patients are encouraged to think that the health-care system is competent and wise, it’s actually more like the Wild West. The shocking truth is that some prestigious hospitals participating in a national collaborative to measure surgical complications have four to five times more complications as other hospitals. And even within good hospitals, there are pockets of poorly performing services … [B]ecause a hospital’s outcomes are hidden from the public, neither consumers nor payers have any way of measuring whether the medicine they provide is good, adequate, or even safe. Much as the financial crisis was incubated when bank executives turned a blind eye to the ugly details about their mortgage-backed securities, so too does medicine’s lack of accountability create an institutional culture that results in overtreatment, increased risk, and runaway costs.
… Years ago, one of my favorite public-health professors, Harvard surgeon Dr. Lucian Leape, opened the keynote speech at a national surgeons’ conference by asking the thousands of doctors there to “raise your hand if you know of a physician you work with who should not be practicing because he or she is too dangerous.” Every hand went up. Doing the math, I figured that each one of these dangerous doctors probably sees hundreds of patients each year, which would put the total number of patients who encounter the dangerous doctors known to this audience alone in the hundreds of thousands.
… A 2010 New England Journal of Medicine study concluded that as many as 25 percent of all hospitalized patients will experience a preventable medical error of some kind, and 100,000 will die annually because of errors. If medical error were a disease, it would be the sixth-leading cause of death in the country. My research partner lost his father due to a medical error. My medical partner lost his younger sister due to a medication error. My best friend’s mom had her breast removed unnecessarily because she was mistakenly told she had stage-III breast cancer. My grandfather died at age 60 from a preventable infection following a surgery he didn’t need. Andy Warhol died prematurely of a mistreated gallstone at 54; Saturday Night Live’s Dana Carvey had open-heart bypass surgery on the wrong vessel; and the singer Kanye West’s mother recently went to a surgery center for a routine plastic surgery, developed a rare complication, and died.
Is medical science built on shaky foundations?
Elizabeth Iorns, New Scientist, September 17, 2012 (from magazine issue 2882)
[NOTE: The author of this article, as she herself explains in the piece (in passages not quoted below), is co-founder and CEO of an initiative that seeks to address the problem she identifies. This initiative, Science Exchange, offers to help scientists establish the reproducibility of their findings for a fee and is “supported by leading Silicon Valley venture capitalists, angel investor.” So the article should be read with this in mind, since the author has a vested financial interest in what she’s saying. But that doesn’t mean what she says is any less striking or significant.]
Teaser: More than half of biomedical findings cannot be reproduced — we urgently need a way to ensure that discoveries are properly checked.
Reproducibility is the cornerstone of science. What we hold as definitive scientific fact has been tested over and over again. Even when a fact has been tested in this way, it may still be superseded by new knowledge. Newtonian mechanics became a special case of Einstein’s general relativity; molecular biology’s mantra “one gene, one protein” became a special case of DNA transcription and translation. One goal of scientific publication is to share results in enough detail to allow other research teams to reproduce them and build on them. However, many recent reports have raised the alarm that a shocking amount of the published literature in fields ranging from cancer biology to psychology is not reproducible. Pharmaceuticals company Bayer, for example, recently revealed that it fails to replicate about two-thirds of published studies identifying possible drug targets. Bayer’s rival Amgen reported an even higher rate of failure – over the past decade its oncology and haematology researchers could not replicate 47 of 53 highly promising results they examined. Because drug companies scour the scientific literature for promising leads, this is a good way to estimate how much biomedical research cannot be replicated. The answer: the majority. Failed replications also quite often go unpublished, thereby leading others to repeat the same failed efforts. In the modern fast-paced world, the normal self-correcting process of science is too slow and too inefficient to continue unaided.
Our Oldest Self-Help Book
Stefany Anne Goldberg, The Smart Set, September 10, 2012
Via David Metcalfe on Facebook
[NOTE: The Daniel Harms who edited the book discussed by Goldberg below is of course the same Daniel Harms whose work as an author and editor in the Lovecraftian publishing world has been so very valuable for so many years.]
Teaser: When did we start choosing over-the-counter over DIY witchcraft?
Most of the early how-to guides of practical wisdom and useful magic have been absorbed and forgotten. But a couple of them still get reprinted now and again to provide clues about how America came to be the land of three hundred million sovereign individuals. One of these guides is The Long Lost Friend. Officially, The Long Lost Friend is a grimoire, a book of magic. According to Daniel Harms — who has meticulously edited and annotated a new edition for Llewellyn — The Long Lost Friend may well be the most influential and, at one time, most well known grimoire to have originated in the New World. First published in German in 1820 as Der lange verborgene Freund (‘The Long-Hidden Friend’) [it] is a “practical manual of spellcraft” (Harm composed from bits of Santeria, hoodoo, Catholic prayers, medieval European spells, Native American herbal treatments, and German folk medicine … At one time, says Harms, everyone either owned a copy of The Long Lost Friend or knew someone who did. Much like the Bible, just being near a copy of The Long Lost Friend was said to thwart malevolence. But The Long Lost Friend was not only popular. Some considered it powerful and potentially dangerous. The post-Enlightenment American medical establishment, for one, publicly denounced all claims of self-healing or any medical practice not overseen by a recognized authority … The Long Lost Friend was also disturbing to both the Protestant and Catholic clergy who believed its spells — which actively, and creatively, evoked the name of God — to be heretical … The Long Lost Friend could be read as a charming bit of old-time esoterica, except that something about it still feels alive. Maybe that’s because The Long Lost Friend is a progenitor of another important contribution to American scripture: the self-help book … The self-help book, via The Long Lost Friend, is an appeal to the American still wandering in the wilderness, curious about everything, needing nothing, wanting it all but not knowing how to get it, believing in the magic of utility, and the utility of magic.
Don’t Show Me the Money!
James Atlas, The New York Times, September 15, 2012
[NOTE: Amen, world without end.]
I find myself ruminating about the glut of financial data that daily clogs the news: Libor and MF Global Holdings; HSBC’s money-laundering of Mexican drug-cartel money; “the London Whale” whose huge trades cost J.P. Morgan Chase billions; leveraged buyouts and mortgage-backed securities and derivatives and stimulus packages, Bain Capital and the tottering euro and the Greek bailout. Saul Bellow referred to this quotidian fretting about world affairs as “crisis chatter.” Today’s crises are all about what is euphemistically called “the financial services industry” — that is to say, they’re all about money. Call it Wall Street porn. Not only do we know more than most of us wish to know about how the rich live — we even know, thanks to the deep-digging efforts of the business reporters over at Bloomberg, how much they have. But there is such a thing as knowing too much: Did Larry Ellison buy a Hawaiian island for $600 million? And did that include the hotels? Is George Soros’s net worth $18 billion? $20 billion? (Anyway, why begrudge him? He’s probably given half of it away.) And when we talk about the 99 percent who aren’t rich, shouldn’t that leave just 1 percent who are? Then why are we always hearing about the 0.1 percent and the .01 percent? Valiant fact-checkers are off the hook on this one: my point is that the exact numbers don’t matter. We’re all aware of the vast and still growing gap between the very rich and everyone else, we all know the global economy is a mess. But do we have to hear about it every waking minute of every day? We’re in trouble when the earnestly liberal NPR begins its morning broadcast with a program called “Planet Money.”
Does Telepathy Conflict with Science?
Chris Carter, Reality Sandwich, September 18, 2012
[Precious few of the scientists who dismiss parapsychology on a priori grounds] ever bother to explain how the claims of parapsychology “stand in defiance” of science, or how “physics and physiology say that ESP is not a fact.” Indeed, it is rare for a skeptic to ever back up this claim with specific examples. As I show in my new book Science and Psychic Phenomena, on those rare occasions they do, they invariably invoke the principles of classical physics, which have been known to be fundamentally incorrect for more than three quarters of a century. However, a number of leading physicists such as Henry Margenau, David Bohm, Brian Josephson, and Olivier Costra de Beauregard have repeatedly pointed out that nothing in quantum mechanics forbids psi phenomena. Costra de Beauregard even maintains that the theory of quantum physics virtually demands that psi phenomena exist. And physicist Evan Harris Walker has developed a theoretical model of psi based upon von Neumann’s formulation of quantum mechanics. Ray Hyman’s 1996 argument (in the Skeptical Inquirer) that the acceptance of psi would require that we “abandon relativity and quantum mechanics in their current formulations” is thereby shown to be nonsense. Contrast Hyman’s statement with that of theoretical physicist Costa de Beauregard, who has written “relativistic quantum mechanics is a conceptual scheme where phenomena such as psychokinesis or telepathy, far from being irrational, should, on the contrary, be expected as very rational” … The data from parapsychology will be almost certainly in harmony with general psychological principles and will be assimilated rather easily within the systematic framework of psychology as a science when once the imagined appropriateness of Newtonian physics is put aside, and modern physics replaces it.
Your brain on pseudoscience: The rise of popular neurobollocks
Steven Poole, New Statesman, September 6, 2012
Teaser: The “neuroscience” shelves in bookshops are groaning. But are the works of authors such as Malcolm Gladwell and Jonah Lehrer just self-help books dressed up in a lab coat?
An intellectual pestilence is upon us. Shop shelves groan with books purporting to explain, through snazzy brain-imaging studies, not only how thoughts and emotions function, but how politics and religion work, and what the correct answers are to age-old philosophical controversies. The dazzling real achievements of brain research are routinely pressed into service for questions they were never designed to answer. This is the plague of neuroscientism — aka neurobabble, neurobollocks, or neurotrash — and it’s everywhere … In general, the “neural” explanation has become a gold standard of non-fiction exegesis, adding its own brand of computer-assisted lab-coat bling to a whole new industry of intellectual quackery that affects to elucidate even complex sociocultural phenomena … How can I become more creative? How can I make better decisions? How can I be happier? Or thinner? Never fear: brain research has the answers. It is self-help armoured in hard science … The human brain, it is said, is the most complex object in the known universe. That a part of it “lights up” on an fMRI scan does not mean the rest is inactive; nor is it obvious what any such lighting-up indicates; nor is it straightforward to infer general lessons about life from experiments conducted under highly artificial conditions. Nor do we have the faintest clue about the biggest mystery of all — how does a lump of wet grey matter produce the conscious experience you are having right now, reading this paragraph? How come the brain gives rise to the mind? No one knows … [O]ne might humbly venture a preliminary diagnosis of the pop brain hacks’ chronic intellectual error. It is that they misleadingly assume we always know how to interpret such “hidden” information, and that it is always more reliably meaningful than what lies in plain view. The hucksters of neuroscientism are the conspiracy theorists of the human animal, the 9/11 Truthers of the life of the mind.