An Inconvenient Truth about the Left

For the last few years, Bush and others within the Republican Party have ignored and distorted scientific evidence because the evidence didn’t match their ideology. The latest example this weekend is the administration’s attitude on the Endangered Species Act, but of course the most glaring example is the pseudo-controversy they fan regarding global warming. I’ve said before, however, that having folks on the Left complain about the Bush administration is hardly a recipe for positive change. To achieve positive change, you have to be willing to criticize your own.

So this is a (harsh) criticism of some folks on the Left and their attitude towards Science. It’s about how Science can be inconvenient, not just to the oil companies, but also to the hippies, yuppies, to you, and to me. Science has an annoying tendency not to follow any ideology, and a true scientist is one who can accept a failed hypothesis when confronted with the facts. You don’t get to pick and choose your evidence.

Let’s start with Bill Maher, a fantastic comedian whom I watched regularly until an insane pseudo-medicine rant a few weeks ago that turned my stomach. Bill argued that the reason we get sick and need drugs is because of “the swamp” of bad food (i.e. meat) that we eat:

I would never get the flu on a plane
[…]
You all look at me like I’m crazy…

Yes, Bill, you are crazy. If you’re sitting next to someone with the flu on the plane, no matter how little meat and much tofu you’ve been eating over the last few years, you’re going to get the flu, and if it’s a bad case of the flu, you might die. That’s how biology and germs work. The idea that somehow we have evolved into perfect beings who never get sick, that germs wouldn’t themselves evolve and find ways to reproduce and survive, is preposterous. This truth, supported by hundreds of years of medical evidence, might be inconvenient to folks at PETA who like to exaggerate the factory farming issue (which is a real issue). But it’s true nevertheless.

Bill continues:

What about the idea of side-effects? We see ads about drugs all the time on the news.
[…]
If you’re taking these drugs and you get these side-effects, that’s not the cure.

Of course drugs have side effects. That’s why drugs are typically not prescribed without good cause, because there’s always a downside. Doctors will prescribe a drug to you when they believe the positive effect of the drug significantly outweighs the potential negatives. This is clear and obvious to anyone with medical training or to someone, like me, who just asks their primary care physician a few simple questions. Bill: couldn’t you at least ask a doctor about this before going on your rant?

Interestingly, Bill’s rant here indirectly makes a good point: non-doctors, like Bill Maher, are ill-equipped to understand these drug ads. The magazine-based drug ads seem even worse to me: have you read the 2, sometimes 4 pages of fine print that follow a drug ad? Does anyone, really? Isn’t this a sign that maybe we’re targeting these ads at the wrong audience? That’s an issue worth discussing, Bill. Stick to the policy, and please leave the science to the scientists.

Vaccines

In medical school, my wife was shown graphs of childhood diseases and resulting deaths over the years. The trend was unmistakable: Republican administrations de-fund vaccination programs, diseases rise sharply, Democrats re-fund them, diseases drop. But again, this is not a post about Republicans. This is about how Democrats can be just as bad. The latest hip thing is the belief that vaccines cause other problems, in particular that some mercury-based preservatives (thimerosal) in vaccines (the MMR vaccine especially) cause Autism.

This theory was pushed by an RFK Jr. piece in Salon and Rolling Stone a few years ago. Sadly, the piece is full of exaggerations and statements taken out of context. But the story is back in the news now, because of a recent ruling by the vaccine court, which agreed to pay the medical costs for the family of a little girl who developed autism-like symptoms after receiving a number of vaccination shots.

Except… here are the facts that her parents agree with: the little girl has an extremely rare underlying (and at the time, undiagnosed) disorder, 9 vaccine shots were administered at once because she had missed some earlier (a practice against which most doctors strongly warn), and her disease is “autism-like”, but it’s not autism. In other words, we know what happened to this little girl: she had an extremely rare condition which, when combined with the excessive vaccination shots, triggered a sequence of events which led to brain damage. Blaming the vaccine here is a bit like blaming an antibiotic because some people are allergic. Should you test for and monitor the possibility of an allergic reaction? Of course. Should you forgo antibiotics altogether, letting thousands of people die from TB, pneumonia, etc..? I hope not.

The evidence against the MMR-autism link is extremely strong. The most compelling is that, since the mercury-based preservative was removed from vaccines in 2001, the rate of autism diagnosis has continued to increase at the same “alarming” rate in the US and two other countries. Experts agree that the increase in autism diagnosis is not an actual increase in the disease, rather it is an increase in the medical community’s understanding of what constitutes autism-spectrum diseases. We’ve always had Autism, we just didn’t know how to diagnose it.

Unfortunately, like most negative evidence, this kind of result is particularly difficult for most people to process (even scientists, who can get very emotionally attached to their hypotheses). We still don’t have an actual explanation for Autism, and we’d like someone to blame. The idea that we know nothing about how this disease comes about is unsettling. We don’t know what causes Autism, and that’s extremely inconvenient. But we do know it’s not vaccines. That’s the harsh truth, as best as Science can tell.

And the vaccination situation is getting worse. The New York Times reports on a trend in California to not vaccinate kids at all. This is, in no uncertain terms, insane and irresponsible. These parents actually hold “measles parties” to have their kids infect one another so they gain disease resistance the “natural way.” Like Bill Maher, these parents are forgetting that “the natural way” means certain death for a sizeable chunk of the population. The purpose of vaccines is to get the natural immunity without that pesky “side-effect” of death.

In the case of vaccines, this insane reasoning finds comfort in the particular state of the world we’re in: most kids are vaccinated, which means the viral pool is low and even unvaccinated kids don’t get infected, so parents don’t see the downside. But with more unvaccinated kids, the pool will increase, and the damage will spread even to the vaccinated kids (because vaccines are not 100% reliable), and more dramatically to the kids too young to get vaccinated.

A number of pharmaceutical companies have misled and continue to mislead us. But that doesn’t mean that all drugs and medical interventions are bad. It just means one should be cautious. The danger of some of the new drugs is that there isn’t enough research to substantiate their benefit. The danger of not vaccinating is that there’s overwhelming research that proves the enormous benefits of vaccination, both individually and to the population at large.

It’s about the research. It’s about the science. It doesn’t always fit some nice consistent ideology. It’s inconvenient. But it’s the truth. And since we live in a world where the truth has real consequences, we have to learn to deal with the inconsistencies in our mental models and be good scientists. Otherwise, we have no leg to stand on when criticizing folks with different ideologies who twist science to their liking.