I do not think that word means what they think it means

I’ve discussed on many occasions over the years how antivaccine activists really, really don’t want to be known as «antivaccine.» Indeed, when they are called «antivaccine» (usually quite correctly, given their words and deeds), many of them will clutch their pearls in indignation, rear up in self-righteous anger, and retort that they are «not antivaccine» but rather «pro-vaccine safety,» «pro-health freedom,» «parental rights,» or some other antivaccine dog whistle that sounds superficially reasonable. In the meantime, they continue to do their best to demonize vaccines as dangerous, «toxin»-laden, immune-system destroying, brain-damaging causes of autism, autoimmune diseases, asthma, diabetes, and any number of other health issues. To them, vaccines are «disease matter» that will sap and contaminate their children’s precious bodily DNA. After all, as I like to say, that’s what it means to be «antivaccine.» Well, that combined with the arrogance of ignorance.

If there’s one thing that rivals how much antivaccinationists detest being called «antivaccine,» it’s being called antiscience. To try to deny that they are antiscience, they will frequently invoke ridiculous analogies such as claiming that being for better car safety does not make one «anti-car» and the like. It is here that the Dunning-Kruger effect comes to the fore, wherein antivaccine activists think that they understand as much or more than actual scientists because of their education and self-taught Google University courses on vaccines, that their pronouncements on vaccines should be taken seriously. If there are two antivaccine blogs that epitomize the Dunning-Kruger effect, they are Age of Autism and, of course, the most hilariously inappropriately named given her history, but nonetheless it’s worth taking a look at her latest post, Anti-science: “You Keep Using That Word. I Do Not Think It Means What You Think It Means.”

Actually, it does. And if The Professor is going to spend nearly 7,000 words riffing on a title derived from a famous The Princess Bride quote, my retort can only be: «Science. You keep using that word. I do not think it means what you think it means.»

Not surprisingly, «The Professor» feels compelled to begin by asserting her alleged science bona fides. Describing herself as a «geeky physics major» who nonetheless has the temerity to «question» vaccine science, she declares herself «irritated enough by this journalistic trend to rebut to the popular conception of those who question vaccine science as ‘anti-science.'» What appears to have particularly irritated her and sparked this screed is a rather good article by Joel Achenbach from the March issue of National Geographic entitled Why Do Many Reasonable People Doubt Science? «The Professor» is particularly incensed by a passage in the article in which Achenbach makes the case that people who «doubt science» are, as she puts it, «driven by emotion.» Of course, that’s not exactly the argument that Achenbach does make. His argument, as you will see if you read his article, is considerably more nuanced than that. Rather, Achenbach points out observations that have been discussed here time and time again, such as how the scientific method sometimes leads to findings that are «less than self-evident, often mind-blowing, and sometimes hard to swallow,» citing Galileo and Charles Darwin as two prominent examples of this phenomenon, as well as modern resistance to climate science that concludes that human beings are significantly changing the climate through our production of CO₂. Not surprisingly, Darwin’s theory is still doubted by many today based not on evidence but rather on its conflict with deeply held fundamentalist religious beliefs.

Achenbach also makes this point:

Even when we intellectually accept these precepts of science, we subconsciously cling to our intuitions—what researchers call our naive beliefs. A recent study by Andrew Shtulman of Occidental College showed that even students with an advanced science education had a hitch in their mental gait when asked to affirm or deny that humans are descended from sea animals or that Earth goes around the sun. Both truths are counterintuitive. The students, even those who correctly marked “true,” were slower to answer those questions than questions about whether humans are descended from tree-dwelling creatures (also true but easier to grasp) or whether the moon goes around the Earth (also true but intuitive). Shtulman’s research indicates that as we become scientifically literate, we repress our naive beliefs but never eliminate them entirely. They lurk in our brains, chirping at us as we try to make sense of the world.

Most of us do that by relying on personal experience and anecdotes, on stories rather than statistics. We might get a prostate-specific antigen test, even though it’s no longer generally recommended, because it caught a close friend’s cancer—and we pay less attention to statistical evidence, painstakingly compiled through multiple studies, showing that the test rarely saves lives but triggers many unnecessary surgeries. Or we hear about a cluster of cancer cases in a town with a hazardous waste dump, and we assume pollution caused the cancers. Yet just because two things happened together doesn’t mean one caused the other, and just because events are clustered doesn’t mean they’re not still random.

We have trouble digesting randomness; our brains crave pattern and meaning. Science warns us, however, that we can deceive ourselves. To be confident there’s a causal connection between the dump and the cancers, you need statistical analysis showing that there are many more cancers than would be expected randomly, evidence that the victims were exposed to chemicals from the dump, and evidence that the chemicals really can cause cancer.

This, of course, is an excellent description of antivaccinationists, except that they no longer accept the precepts of science with respect to vaccines but cling to their «naive beliefs.» They rely on personal experience and anecdotes rather than statistics with respect to the question of whether vaccines cause autism, and no amount of science, seemingly, can persuade them otherwise. The Professor herself is a perfect example of this. She believes herself to be «pro-science» and so she is when science tells her what she wants to believe. When it does not, as in the case of vaccines and autism, she rejects it, spreading her disdain from just vaccine science to all of science. Indeed, her entire post is in general a long diatribe, even more than Orac-ian in length, consisting mainly of three key arguments: the «science was wrong before» trope; the «peer review is shit» trope; and the «pharma shill» gambit.

Achenbach notes that even for scientists the scientific method is a «hard discipline.» And so it is, because, after all, scientists are no less human than any other human being. The only difference between us and the rest of humanity is that we are trained and have made a conscious effort to understand the issues discussed above. We know how easy it is to confuse correlation with causation, to exhibit confirmation bias wherein we tend to remember things that support our world view and forget things that do not, and to let wishful thinking bias us. Even knowing all of that, not infrequently we fall prey to the same errors in thinking that any other human being does. Nowhere is this more true than when we wander outside of our own field, as the inaptly named Professor does when she leaves the world of physics and discusses vaccines or when, for example, a climate scientist discusses vaccines.

The hilarity begins when The Professor cites philosopher Thomas Kuhn’s The Structure of Scientific Revolutions. Even more hilariously, The Professor quotes extensively from the Wikipedia entry on Kuhn’s book, rather than from Kuhn himself. Kuhn’s main idea was that science doesn’t progress by the gradual accretion of knowledge but tends to be episodic in nature. According to Kuhn, observations challenging the existing «paradigm» in a field gradually accumulate until the paradigm itself can no longer stand, at which point a new paradigm is formed that completely replaces the old. Kuhn’s view of science is a fascinating topic in and of itself and I haven’t read that book in many years. However, most scientists tend to dismiss many of Kuhn’s views for several reasons, in particular because Kuhn tends to vastly exaggerate the concept of «paradigm shift.» Particularly galling is his concept of «normal science,» where in the interregnum between scientific revolutions he portrays scientists doing «normal science» (science that is not paradigm-changing) as essentially dotting the i’s and crossing the t’s of the previous revolution. (It’s a very dismissive attitude toward what the vast majority of scientists do.) Indeed, Kuhn’s characterization of the history of science has been referred to as a caricature, and I tend to agree. Certainly, at the very least he exaggerates how completely new paradigms place the old, when in reality when new theories supplant old theories the new must completely encompass the old and explain everything the old did plus the new observations that the old theory cannot. As Cormac O’Rafferty puts it, «The new can only replace the old if it explains all the old did, plus a whole lot more (because as new evidence is uncovered, old evidence also remains).» The best example for this idea that I like to cite is Albert Einstein’s theory of relativity, which did not replace Newtonian physics, but rather expanded on Newtonian physics, which is what relativity simplifies down to when applied to velocities that are such a small fraction of the speed of light that relativistic contributions drop out of the equations because they are so close to zero that it is reasonable to approximate them as zero.

None of these nuances are for The Professor. She misuses and abuses Kuhn to construct a «science was wrong before» argument that is truly risible:

It would seem likely that a journalist writing a high-profile article on science for National Geographic would not only be aware of Kuhn’s work, but would also understand it well. Achenbach seems to understand the evolution of science as inherently provisional and subject to change when new information comes in, but then undercuts that understanding with the claim, “The media would also have you believe that science is full of shocking discoveries made by lone geniuses. Not so. The (boring) truth is that it usually advances incrementally, through the steady accretion of data and insights gathered by many people over many years.”

This statement is patently false. First off, the mainstream media tends to downplay, if not completely ignore, any contributions of “lone geniuses” to science, as exemplified by the 2014 Time magazine cover story proclaiming “Eat Butter! Scientists labeled fat the enemy. Why they were wrong.” Suddenly, everyone was reporting that consumption of fat, in general, and saturated fat, in particular, is not the cause of high serum cholesterol levels and is not in fact bad for you. “Lone geniuses” (also known as “quacks” in the parlance of the old paradigm) understood and accepted these facts 25-30 years ago and have been operating under a completely different paradigm ever since, but it wasn’t until 2014 that a tipping point occurred in mainstream medical circles and the mainstream media finally took note.

Um. No. This change, which arguably The Professor vastly overstates, came about through the very accretion of knowledge. Moreover, as much as I castigate David Katz for his nonsense on other issues (such as his embrace of homeopathy «for the good of the patient»), he did get it (mostly) right when he criticized this ridiculous TIME magazine article for many shortcomings and exaggerations, not the least of which is that there never was a «war on dietary fat» and the seeming attitude that it’s OK to eat all the fat you want now. In any case, this is not the «paradigm shift» that The Professor seems to think it is. Rather it was a correction, which is what science does. The process is often messy, but science does correct itself with time.

Next up, of course, is an attack on peer review, something without which no antivaccine article is complete. Of course, criticism of the peer review process is something many scientists engage in. As I like to paraphrase Winston Churchill quoting a saying about democracy, «It has been said that peer review is the worst way to decide which science is published and funded except all the others that have been tried.» Yes, the peer review process is flawed. However, as is the case with attacks on the very concept of a scientific consensus, when you see general attacks on the concept of peer review, it’s usually a pretty good indication that you’re dealing with a crank. There is little doubt that The Professor is a crank. Naturally, she can’t resist including a section that is nothing more than a big pharma shill argument claiming that the science showing that vaccines are safe and effective must be doubted because everyone’s in the pocket of big pharma. No antivaccine article is complete without a variant of that tired old trope.

Hilariously, The Professor ends by arguing that all that tired, boring, old «normal science» (to borrow Kuhn’s term) is wrong and that True Scientists who perform «Revolutionary Science» (quoting Martha Herbert in the introduction to Robert F. Kennedy, Jr.’s pseudoscientific new anti-thimerosal screed, of all things!) all have «intuition»:

The ability to “utilize this subtlety and context to make important distinctions” that Herbert describes constitutes the difference between the scientific revolutionaries and those who will continue defending an error until long past the point that it has been well and truly proven to be an error. It is an ability that Albert Einstein possessed to a larger degree than most. Einstein felt that “The true sign of intelligence is not knowledge but imagination.” And that “All great achievements of science must start from intuitive knowledge. I believe in intuition and inspiration . . . . At times I feel certain I am right while not knowing the reason.” Interestingly, another well-known scientist whom many consider to have been “revolutionary” was known to place a great deal of emphasis on intuition. Jonas Salk, the creator of the first inactivated polio vaccine to be licensed, even wrote a book called Anatomy of Reality: Merging Intuition and Reason.

Of course, the problem that The Professor overlooks is that in science intuition is nothing if it doesn’t lead to results that are supported by data. Moreover, I would argue that what we have here in those who fetishize «intuition» in science is a massive case of that most human of failures of reason: Confirmation bias. We as scientists remember the times when our intuition ended up being validated and forget the almost certainly much more numerous times when our intuition either led nowhere or even led us astray. Yes, even Albert Einstein and Jonas Salk. Indeed, when called out by a commenter for most likely exhibiting confirmation bias about intuition in science and having it pointed out to her that intuition must never trump data, The Professor proves me right:

Confirmation bias on my part, huh? I have to say that that is absolutely untrue. It took me quite a long time to honor and rely on my intuition, and despite the fact that it is proven right over and over again, I STILL sometimes let my conscious mind override it to my regret. I didn’t understand intuition at all when I was younger and thought “hunches” were silly. In all that time, I have virtually never heard anyone say that “I really regret following my intuition on that, while I have frequently heard the latter — often from parents who have lost their children.

No one is saying “I don’t care what the data says.” I have NEVER said that. I read the data. I analyze the data. And I know it DOESN’T say what the mainstream media says it says — ever noticed that you can’t watch a show on TV these days without a few ads for drugs? I’ve read many of those “studies that show vaccines are safe” and I know their limitations — and they are vast. So, nope. Sorry.

So, first The Professor paints herself as a reluctant convert to trusting her intuition. If we’re going to play a war of anecdotes, I could list quite a number of times when I «trusted my intuition» and later regretted it. Her argument here is the very essence of confirmation bias. She remembers the times her intuition led her where she wanted to go, as well as the times she didn’t listen to her intuition and things didn’t turn out well, and forgets the rest. Then, basically, The Professor foes on to rationalize her relying on her «intuition» over data with respect to vaccines and autism by eliminating that cognitive dissonance. She does that by convincing herself that she doesn’t let her «intuition» trump the data in the case of vaccines because she doesn’t think the data show what scientists think the data show, namely that vaccines are safe and effective, do not cause autism, do not harm the immune system, and do not cause all the evils that Dunning-Kruger poster children like The Professor think they do.

Demonstrating her even more inept understanding of epidemiology and medicine, The Professor then goes on to ask:

Anenbach makes the argument that our intuition will lead us astray, encouraging men to get a prostate-specific antigen test, for instance, even though it’s no longer recommended because studies have shown that on a population level the PSA doesn’t increase the overall number of positive outcomes. But there are people whose first indication of prostate cancer was a high PSA result, and those people’s lives may have been saved due to having that test. Who is to say that the person requesting the test will not be among them? In other words, intuition is not necessarily wrong just because it encourages you to do something that is statistically out of the norm or has yet to be “proven” by science.

And who is to say that the person requesting the PSA test won’t be one who is overdiagnosed, who has an indolent cancer that would never have done him any harm during the remainder of his lifespan, but is harmed by unnecessary surgery and/or radiation? That’s the whole point! The Professor picks the good outcomes and ignores the potential for the bad outcome. Confirmation bias! She then twists all this into a massive argument for the precautionary principle, going so far as to cite the discredited Andrew Wakefield and Robert F. Kennedy, Jr., both whose arguments I’ve deconstructed more times than I can remember. (Just enter their names in the search box of this blog and you’ll see.) She also mischaracterizes Achenbach as saying that the scientists most dedicated to truth are the ones who break with the «existing paradigm,» even going so far as to say that by Achenbach’s own words Andrew Wakefield must be more dedicated to the truth than most scientists. Yes, I laughed out loud when I read that part. I also reread his article and could find nowhere where he actually made that argument.

So basically, The Professor ends up arguing that we should be wary of vaccines based on the precautionary principle, ignoring all the many years of accumulated evidence that vaccines are safe and effective and do not cause autism, in favor of the «intuition» of antivaccine activists and the work of «lone geniuses» like Andrew Wakefield because, you know, all that boring epidemiology is «normal science» (to quote Kuhn) and what her antivaccine heros are doing is «revolutionary science.» It doesn’t matter that their «revolutionary science» is wrong, of course, because, you know, The People:

Science can serve corporate interests or it can serve the interests of humanity. There will certainly be places where the two will intersect, but there will always be places where they will be in opposition, and science cannot serve them both. It is most assuredly not “anti-science,” rather it is “pro-humanity” to insist that, where the interests of the two are opposed, science must serve humanity over corporations. We are nowhere near being able to say that is currently the case, however, and while it may be prudent for individual scientists to stick with the tribe in order to further their careers, it is not prudent for us as a human collective to let corporate interests govern what that tribe thinks and does. Until the day that we can say science always puts humanity’s interest first, not only is it prudent for us to question, analyze, and even scrutinize “scientific consensus” from a humanist viewpoint, it is also incumbent upon us to do so.

She even asks if it’s «antiscience» to condemn Josef Mengele’s atrocities and the Tuskegee syphilis experiment in a hilarious rhetorical flourish against a a straw man argument that no one—and I mean no one—has ever made. You know. The Professor is starting to sound a lot like a toned down version of Mike Adams. Also, instead of «I’m not antivaccine, I’m pro-vaccine safety,» we now have «I’m not antiscience, I’m pro-humanity.» It’s the perfect toxic combination of Dunning-Kruger married to an outsized ego that thinks that a bit of training in physics trumps the knowledge of people who have spent their lives studying vaccines, autism, and the immune system. In other words, it’s a perfect distillation of the antivaccine movement.

Throughout The Princess Bride, the evil Vizzini (Wallace Shawn) states that things are “INCONCEIVABLE!” Eventually, there’s this wonderful part (actually there are about a million wonderful parts to The Princess Bride but this is just one of them), when Inigo Montoya (Mandy Patinkin) says:

“You keep using that word. I do not think it means what you think it means.”

(image via)

Though it’s meant to poke fun at Vizzini, this sentence speaks volumes, and is an important reminder to researchers. Recently, Danah Boyd and her colleague Alice Marwick wrote an op-ed for the New York Times explaining that the rhetoric surrounding cyber bullying is missing the mark. After hundreds of interviews with high school students, she noticed that when she questioned them about bullying, they defined that as a very “middle school” issue and not something that happened at their school. Yet this “didn’t mesh with” the team’s observations of clear bullying, so they started to really dig into the way teens talked about their lives.

Boyd and Marwick came to the conclusion that teens were using the term “drama” as a defense mechanism against bullying. They write:

“While teenagers denounced bullying, they — especially girls — would describe a host of interpersonal conflicts playing out in their lives as “drama.””

At first, we thought drama was simply an umbrella term, referring to varying forms of bullying, joking around, minor skirmishes between friends, breakups and makeups, and gossip. We thought teenagers viewed bullying as a form of drama. But we realized the two are quite distinct. Drama was not a show for us, but rather a protective mechanism for them.

Understanding the linguistic choices of their subjects on their subjects’ terms was incredibly important to the researchers’ ethnographic objectivity. Even simple definitions could not be taken at face value — they needed to dig deeper in order to gain a grasp not only of what the respondents were saying, but why they were saying it in that way.

The same principle should be applied to good market research. As an example, during a recent interview I conducted, a woman stated:

“Well for me personally, I respond more to a more girly approach. Retro figures, colors and more striking visual images.”

Now, for me the use of the phrase “retro figures” conjured the image of a very “Mad Men” silhouette — either that or a pin up. Because I couldn’t make any assumptions, I had to ask what she meant by retro in that context to see if she could better define the image she wanted to see. She responded:

“Well maybe retro isn’t the right word, but more of a fashion girl silhouette, glamour girl with scarf blowing in wind…”

The conversation went on, and I was able to get a very distinct image of the kind of personality this woman associated with the concept. I could have just left the definition to my own devices, but asking for clarification meant understanding the respondent on her own terms, which not only means better, more objective research, but also shows the respondent that I care about accuracy, detail, and him or her.

And research without a focus on the respondent? Inconceivable! (I had to)