This is a rant. It is witty and amusing and packed full of information but nevertheless it is a 16 chapter rant. Ben Goldacre is angry about nutritionists, homeopaths and assorted quacks but not because they are deluded crackpots who are making a fortune from deluding the public. Ben is angry because they bring Science and in particular evidence-based medicine into disrepute.
So as part of this rant Ben educates the reader about the placebo effect, regression to the mean, controls, double-blinds, cherry-picking, meta-analyses and funnel plots and a huge number of other tricks and techniques that make the difference between scientific evidence and wishful thinking. This book can be a little hard going at times but it is worth the effort.
There are gems of humour:
How does a water molecule know ... to treat my bruise with its memory of arnica, rather than a memory of Isaac Asimov's faeces? I wrote this in a newspaper once, and a homeopath complained to the Press Complaints Commission. It's not about the dilution, he said: it's the succussion. You have to bang the flask of water briskly ten times on a leather and horsehair surface, and that's what makes the water remember a molecule. Because I did not mention this, he explained, I had deliberately made homeopaths sound stupid. p36
He also attacks directly Dr Gillian McKeith PhD ("or, to give her her full medical title Gillian McKeith") who is a nutitionist who believes that dark leaved vegetables are good for you because the chloroplasts will oxygenate you (chloroplasts work in the presence of sunlight; "it's pretty dark in your bowels: in fact, if there's any light in there at all something's gone badly wrong" and even if there was, you don't want the methane in your gut to mix with oxygen unless you desire spontaneous human combustion). He attacks Professor Patrick Holford who says that there are now oranges containing no vitamin C (so buy my supplements) and he fiercely attacks Matthias Rath who has used advertising campaigns to persuade South Africans that AZT is bad for HIV sufferers and they should instead use his vitamin pills.
He also attacks big pharma for using distorted medical evidence to sell its products.
At the end he describes the MRSA hoax and the MMR vaccine scandal. Some time ago the press went to town about MRSA in British hospitals. Much of the evidence came from swabs that journalists sent to a single lab in Northamptonshire which turned out to be run by a man with a mail-order PhD who had set up his lab in a garden shed. The MMR scandal was based on a single, anecdotal paper; none of the controlled medical trials have found any evidence whatsoever to suggest that MMR causes autism.
So Ben perhaps reserves his greatest anger for journalists. When they "stood by" the MRSA lab analyst we had the scenario of "a tabloid journalist telling a department of world-class research microbiologists that they are mistaken about microbiology." p284.
This is what Ben believes: "the people who run the media are humanities graduates with little understanding of science, who wear their ignorance as a badge of honour. Secretly, deep down, perhaps they resent the fact that they have denied themselves access to the most significant developments in the history of Western thought from the past two hundred years; but there is an attack implicit in all media coverage of science: in their choice of stories, and the way they cover them, the media create a parody of science. On this template, science is portrayed as groundless, incomprehensible, didactic truth statements from scientists, who themselves are socially powerful, arbitrary, unelected authority figures. They are detached from reality; they do work that is either wacky or dangerous, but either way, everything in science is tenuous, contradictory, probably going to change soon and, most ridiculously 'hard to understand'." pp224-225
Ouch! This is scary stuff. How on earth do we counteract this? Scientists are used to being paid peanuts while arts graduates swan about doing sod all and earning much more. But this lazy journalistic parody is actually dangerous because it promotes quacks, cranks and crackpots which, in the end, kill people. Science is the only method of enquiry which has produced progression in our understanding of the world. We cannot afford to lose it.
At tne end Ben proposes a number of websites to look at to enthuse young people with the excitement and discipline of science: badscience.net would be a good place to start.
An important book.
August 2008, 339 pages
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