Sunday, March 24, 2019

ABOVE ALL QUESTION!


We know that Iron does not turn to gold. We do, don’t we? And that Stone cannot be converted to plastic. No disrespect to either the stone or plastic. Both are held in equal regard. After all billions of pounds of stone is the fundamental foundation of the Pyramids and plastic is the modern-day ubiquity, hailed and maligned simultaneously.

But if you did believe in alchemy and magic then this is the right place for you to come and be exorcised. 

From John Ford’s movie, “The Man who shot Liberty Valance” comes the age-old quote “when the legend becomes fact, print the legend." There is so much truth oozing out in those words, especially in these modern days in this age of highly evolved civilization. Snarky as that might sound to some and others, it is the elemental truth of the day, these days.

Manipulating someone takes a calm shrewdness and calculated but persistent endeavor. It happens in everyday life, be it in science, politics or even and perhaps especially in medicine. We will deal with the two bookends around politics and you are free to draw your conclusions on the politics of today. I will not lurk there to ruin anyone’s day.

Science is real. It is based on empiricism. It is also based on trial by error. In that solemn enterprise it also is fleeting. The empirical methods change, and a more robust mechanism is realized. Take the Wright Brother Flyer for instance. A trial by error by ingenious bicycle makers that cost at least one life in the process of powering the first flight, today, we have arrived at behemoth aircraft weighing millions of pounds, capable of carrying hundreds of passengers far, far away from their homes and back. Each step of the way to here, there were errors and each error made for a more robust innovation. Learning from errors is how science advances. Science changes as new tools of empiricism emerge. Thus, emergence is nothing more than gaining a new solution to a tired old problem. In the case of the Wright Brothers, it was that man can fly on powered aircraft. But they also stood on the shoulders of Otto Lilienthal, the German aviator who soared several times on non-powered gliders. And innovation is nothing more than building on the past.

The alter ego of science is pseudoscience. Even joining the two words is blasphemous at best. Science is purported to be reality based on the current assessment of available information seen through the lens of expectation. The term pseudo is the forced evil twin who imposes restrictions on science by creating false legends and then printing them as science. Let me give you a few short examples;

1. The Food Plate was boasted as the nutritional equivalent harbinger for good health and endorsed by none other than the largest of the medical societies. Turns out that 60% carbohydrate base in that pyramid created an untold calamity of obesity and chronic illness such as diabetes, hypertension, stroke, heart attacks and cancer. So much for Nutritional guidelines. Given the green light, breakfast became a sugar haven for children via colorful sugary cereals and other delights. Adults meanwhile pursued the sugar through cans full of colas to meet their Average Daily Requirement. The Legend had been printed and it took many a year to realize the damage done.

2. Blood Letting was the manifest therapy of most maladies, when a doctor was faced with an insurmountable illness and no known therapeutic modality was available and few were other than poltices. Sometime the first and last resort of action was “blood-letting.” But let us not judge too harshly, “blood-letting” started by the Egyptians in 1000BC and continued on till the setting sun of the 19thcentury. A lot of harm there was done, except for those with undiagnosed and in those times possibly unknown, patints with polycythemia or those with Hemochromatosis, those few might have been helped. This treatment might also have been the proximate cause of death for some Presidents of the United States, including George Washington.

True Science is about questioning. It is about the wrong questions not about the right answers that knowledge is furthered. It is about skepticism. It is about advancing the knowledge and not about prostrate obedience. Today, some crafty individuals have taken the mantle of establishing organizations for the sake of minting large sums of money from various segments of society using the art of pseudoscience. These carpetbaggers have a unique mechanism of action. They create a product in vacuum and then become the arbiters of expertise. They decide another’s aptitude based on false empiricism. These few have grafted themselves into positions of power and have merged with larger powers, by convincing others that they alone hold the right and might to determine what’s right. In so doing they have amassed large sums of money for themselves and used that accumulated wealth to further their plans through lobbying for more control. They cite their false legends (self-created body of information lacking scrutiny or veracity) and print them as fast as they can to parade them as evidence. They are indeed a body of falsehood and evil. One such example in the medical field is the false promise of continuous certification and the maintenance of such certification. These organizations are folded under the umbrella of the American Board of Medical Specialties and they are under fire for falsehoods, coercion and other bad acts against physicians in general. The ugly truth of their large sums of monies held in places offshore and the large salaries commanded by the few that work in this organization to keep this false enterprise going, is the premise of the multiple legal actions against them.

Then there is the influence of statistics in medicine, which has been of equal harm in patient care. Medicine is practiced mostly under the best known and available evidence. That evidence is both of scientifically validated in nature, as well as intuitively known to those practicing the art and science of medicine in caring for the patients on a daily basis. Unfortunately, as the tools of statistical rigors were massaged over time, and means of means became the means to determine benefit of certain medicines, intuition has atrophied under guide of guidelines and wisdom has become a shell of its former self.

Many if not most, bowed to the gods of statistics as more and more massaging of a poor result in empiricism was heralded as the Second Coming against disease. But as all things are shaped by time, this one too has lost favor under tighter scrutiny. More physicians are trying to dig into the roots of the given answer and not just the colored leaf shown. Meanwhile the creators of this logic continue to march and berate those that defy their “Evidence.” Unfortunately, the emergence of truth is never timely, yet it always raises itself in the face of unseemly and irreverent acts.

Science is meant to be questioned at every step of the way, not swallowed as a pill of satisfaction. It is to be teased, pulled apart piece by piece to unearth that which will hold verification and can then be validated until newer tools and information emerge. We as humans advance by standing on the shoulders of giants to see that which cannot be seen. And each giant of the field learned his or her wisdom peering at what others were doing or had done. Watson and Crick advanced the DNA helix, not through the force of epiphany but on the crystallographic radiograph by Rosalind Franklin. Marie Curie had Antoine Henri Becquerel to rely upon as her muse. There is passion and persistence in remarkable discoveries as there is passion and persistence in great art too. It took Leonardo Da Vinci 13 years to finish the “Mona Lisa” painting and get the face to smile and smirk at the same time.

The quick fix methodology of the pseudoscientist, who are forever in a hurry, because charlatans do not want to be exposed nor do they want to lose the prize, do not care for the truth. Their aim is the financial prize.

Indeed, above all question! No one has said it better than this wonderful physicist Richard Feynman, “I would rather have questions that can't be answered than answers that can't be questioned.”

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