Book Reviews - Winter 2010

Science Doubters

When healthy skepticism turns into unhealthy antagonism

By Natalie Angier | December 1, 2009


Denialism: How Irrational Thinking Hinders Scientific Progress, Harms The Planet, and Threatens Our Lives, by Michael Spector, Penguin Press, 294 pp., $27.95

In October of 2009, my 13-year-old daughter contracted swine flu. We’d been hoping to get her vaccinated, but H1N1 cunningly arrived at her school a week or so in advance of the shots. As a result, my husband and I had no choice but to watch our daughter suffer through days of feverish pain and nights of tympanic coughing jags, all the while remaining on parental red alert for signs of the secondary infections that have made swine flu particularly risky for the young. Luckily, her case proved comparatively mild, but I still wish we’d had the chance to prevent the misery altogether, just as by vaccinating her we’d prevented her from suffering many of the banes of my childhood—-measles, rubella, and my personal worst, the mumps, which I distinctly remember as giving me the sensation that something the size of a walrus had been stuffed inside my cheeks.

So when I read about people who are afraid to get themselves or their kids vaccinated against swine flu because they’ve heard that the new shots “might not be safe,” or when I read about the recent outbreak of measles in San Diego among the unvaccinated children of parents who are convinced that vaccines cause autism, I am flabbergasted. Knock, knock, people. What’s next? Opposition to the washing of one’s hands with soap and water after using the lavatory? The overwhelming weight of evidence is on the side of vaccination. Vaccines, as a class, are remarkably safe drugs, and adverse reactions to them rare. The “new” swine flu vaccine was made the same way that regular seasonal flu vaccines are always made, and flu vaccines are considered so safe that every year we offer them first to our most physically frail.

As for the more sustained iteration of vaccine phobia, when the idea was first proposed in the 1990s that there might be a link between thimerosal — a form of mercury sometimes used as a vaccine preservative — and rising rates of autism and related conditions among children, many doctors and researchers took the notion seriously. They combed through the epidemiological and clinical data. They compared autism rates among children who had their vaccinations early in life with those who had their shots later; they compared children in this country with those living elsewhere, who were subject to different vaccination protocols. Researchers found no evidence that vaccines cause autism. None. Vaccine manufacturers decided to stop using thimerosal anyway, just to placate the critics.

Yet despite the data, despite the absence of thimerosal in today’s vaccines, the anti-vaccine crowd remains vocal, visible, and unappeasable. They talk about a conspiracy of silence between the pharmaceutical industry that manufactures the vaccines and the doctors who deliver them. They distrust government agencies, health officials, local school boards. They have celebrities like the actor Jim Carrey and the activist Robert F. Kennedy Jr. on their side. How can they be appeased, really, when they are suspicious a priori of most of the experts who are in the best position to analyze the data?

Michael Specter rightly brands the anti-vaccine crowd “denialists,” defining them as those who “replace the rigorous and open-minded skepticism of science with the inflexible certainty of ideological commitment.” All of us have our moments when we are in denial and refuse to accept the truth – about the severity of a spouse’s drinking problem, for example, or the probable outcome of a brother’s metastatic cancer. We couldn’t bear life without regular applications of high-gloss emotional paint.

But when a lot of people get together and vow fealty to a particular fiction, says Mr. Specter, when delusional thinking moves from the private to the hive mind, then you have a problem. “Denialism is denial writ large,” he writes, “when an entire segment of society, often struggling with the trauma of change, turns away from reality in favor of a more comfortable lie.”

I don’t know whether the term the author has coined, and shows considerable fondness for, will ever catch on, but many of the issues raised in Denialism are real and important, never more so than now, in the age of what might be called, to paraphrase The Onion, the tyranny of the glowing rectangle. The Internet in all its accessorized fabulousness may be the product of advanced science and engineering, yet it paradoxically can feed some of our most unscientific, irrational, and overwrought impulses. Not only does the Web allow every crank and conspiracy theorist to instantly find a global community of like-minded indignati, its open-platform structure favors opinion over evidence, conviction over uncertainty, popularity over p-value. Have a question? See what Yahoo!Answers thinks, and see how people have voted, whether they “like” this answer or that one.  If enough people give their thumbs up to an answer, you know it must be true!  Do you believe in evolution? How about global warming, dark energy, tectonic plates, or DNA? Please take a few moments to fill out this survey and write a customer review. “Unless data fits neatly into an already formed theory, a denialist doesn’t really see it as data at all,” Mr. Specter writes. “That enables him to dismiss even the most compelling evidence as just another point of view.”

A staff writer for The New Yorker, Mr. Specter presents a half-dozen case studies to buttress his claim that we are experiencing a great “tide of denialism” and that “irrational thinking hinders scientific progress, harms the planet, and threatens our lives.” Particularly effective are his chapters on the anti-vaccine campaign and the rise of the alternative medicine industry, which generates scores of billions of dollars a year in the sale of vitamins, herbal remedies, and homeopathic rubdowns, visits to the acupuncturist and the chiropractor, “wellderly” clinics and the like. The author appealingly presents himself as a recovering naïf, who, on feeling “unfocused and lethargic” not long ago for reasons that his doctor failed to determine, decided to seek “salvation in vitamins.” He went to his local Health Nuts store, chatted with the proprietor about his problem, and quickly filled his shopping basket with items like glutamine supplements to alleviate “brain fog and cloudiness,” garlic pills for “lowering cholesterol and keeping arteries free of blood clots,” and BlueGranate vitamins, “a synergistic blend of powerful and potent phytonutrient antioxidants” with “wondrous health properties” too numerous to specify.

He also turned to the Vitamin Advisor Web site, founded by a source he thought he could trust: Dr. Andrew Weil, the beloved, bearded patron saint of alternative medicine. Mr. Specter filled out an online form that asked a few questions about his medical history. Two minutes later, “Dr. Weil“ responded with a long list of “evidence-based” dietary supplements, all recommended to address Mr. Specter’s “specific health concerns.’” At which point Mr. Specter’s brain fog began to cede primacy to his reportorial skepticism. He soon learned that, despite the good doctor’s assurances, almost none of the dozen pills on the suggested list had proved their mettle in controlled studies, and some might even be harmful. Last May, for example, German researchers showed that supplements of the antioxidant vitamins C and E actually reduced the benefits of exercise. Mr. Specter comes down hard on Dr. Weil for promoting the notion of a “both-and” mentality that combines the rigors of scientific evidence with a belief in “magic and mystery.” Sorry, says the author, you can’t have it “both-and” ways. “Either you believe evidence that can be tested, verified, and repeated…or you don’t,” he writes. “There’s nothing in between but the abyss.”

Mr. Specter is less effective in his argument that the field of human genetics is hamstrung by denialists who refuse to acknowledge the reality of race. As he sees it, something like academic political correctness makes otherwise sensible researchers reluctant to consider the possibility that there may be significant genetic differences between different racial and ethnic groups, and that such discrepancies may be medically relevant. Yet what many critics have raised concerns about is not the idea that ancestry matters – of course it does – but rather how broadly our racial categories are defined.  If you want to tailor therapies to suit the needs of different populations, how useful is it to talk about, say, Hispanic Americans? Would you see the same set of congenital risk factors in a person of Guatemalan descent as you’d see in someone from Cuba or Venezuela? And if we’re touchy about the deep meaning of being an African American, well, we should be. Just look at our nation’s First Family. Not only is Barack Obama half white, but Michelle Obama recently learned that her great-great grandfather, Jim Robinson, was the son of a white slave owner and a slave girl named Malvinia, a family, a heritage that is hardly unusual among black Americans. What is the significance, medical or otherwise, of such knots in the family tree, and is it really denialism to demand that our terms be carefully defined?

I agree with the author that irrational thinking surrounds us, but I’m not convinced there’s any more of it now than in the past. He claims that people have lately lost their faith in science, scientists, and the idea of scientific progress, but plenty of evidence suggests otherwise. In this country, for example, enrollment in high school physics classes is at an all-time high, magnet programs in math and science become more competitive every year, and universities generate twice as many Ph.D.’s in the sciences as they do in the humanities. According to the Harris Poll, Americans reliably express admiration for scientists and doctors, with close to 60 percent of respondents rating the two professions as being of “high or very high prestige.” If you want to know what scorn feels like, try being a journalist, with a prestige rating of only 18 percent, or a business executive, at an abysmal 11 percent. We might drown in self-pity, if not for the sweet waters of denial.

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