People arguing for various alternative medical approaches being valid, or at least possible, often use the example of Ignaz Semmelweis, either directly or by using the completely valid limitations of the real world execution of science that the Semmelweis case raises. Unfortunately they only do so in a limited way and as a rhetorical device. They already know what is true, much like Semmelweis’ opponents, and fail to see that their favourite theory, while ridiculed like Semmelweis’ hypothesis, lacks the solid scientific backing Semmelweis presented. In this post I’ll examine this in more detail and contrast the case of Semmelweis with that of Samuel Hahnemann, creator of homeopathy, since they have overlapping life spans and together allow for some interesting comparisons between science based medicine and alt.med.
For those unfamiliar with the story of Ignaz Semmelweis, he was a Hungarian physician and early pioneer in antiseptic procedures. (If you know the story, you can skip this paragraph, but anyone would benefit from reading the wikipedia entry Ignaz Semmelweis as a refresher) He noted the difference in mortality rates from puerperal fever between two maternity wards in the hospital in Vienna where he worked, examined the differences between the two wards and determined that the main factor distinguishing them was that one was used to train medical interns and one was used to train midwives. He then hypothesized that the medical interns were picking up some sort of cadaverous particles from the corpses in autopsy (an activity not included in midwife training) and that this was the cause of the fever. To prevent this and to test his hypothesis he instituted the practice of hand washing with cholorinated lime before touching patients. This reduced mortality significantly both in this hospital and in other hospitals where it was used.
To someone living today, Semmelweis’ discovery seems obvious, and its opposition ridiculous, but it’s important to try to realise that germ theory was yet to be formulated, that medical science was still in its infancy and that Semmelweis wasn’t the first to consider contagion and cleanliness. Still, some of the arguments directed against Semmelweis are easily recognisable to someone defending alt.med. “Correlation does not equal causation”, “Your suggested mechanism is incompatible with established science”, “suggesting a single mechanism here is ridiculous” and “Where is your peer reviewed paper published” are not uncommon when dismissing some alt.med.-approach. Okay, I don’t know that the last one was used against Semmelweis, and probably not, but part of the baffling resistance to Semmelweis methods may be ascribed to lack of efficient publication and emanation of the findings.
So far so good for alt.med. Scientists, and therefore the real world of science, is resistant to change, and, although true in general, arguments such as “Correlation does not equal causation” and “parts of what you’re saying are obviously wrong” can be used as rhetorical devices to supress and ignore new ideas. And if Semmelweis eventually was vindicated and recognised as a pioneer, despite his “corpse particle” idea beeing inaccurate, isn’t it possible some alt.med.-heroes might one day be vindicated too? Of course it’s possible! All that is necessary is for them to have the solid data Semmelweis had and wait for science to catch up. But here’s what Semmelweis had, and alt.med. keeps failing to bring to the table.
- Solid scientific data to base his hypothesis on. There was a clear difference between the two wards, and Semmeweis could also show that the increased mortality from puerperal fever coincided with the start of patholocical anatomy at the hospital in 1823.
- Solid scientific results from testing his hypothesis. Mortality decreased significantly everywhere handwashing was mandated.
- He was fighting an establishment built on barely scientific ideas.
Twenty years ago alt.med. had excuses for not living up to the ideal of Semmelweis. Little research had been done and resistance to alt.med. was largely based on resistance to new things that conflict with current knowledge, but even back then there was the important difference that “current knowledge” in 1993 was vastly more scientific than “current knowledge” in the 1840s and 50s. Still, “How can you dismiss homeopathy/acupuncture/healing without proper medical trials?”, was not a cry completely without merit. Today however we have 20 years of research showing little or no effect of most alt.med. approaches and increasing knowledge of the quirks of human psychology that keep the belief alive in face of this. Today it is the homeopaths who refuse to accept the scientific data because it goes against their established “knowledge”.
Now what about Samuel Hahnemann, why is he interesting? Well for one thing, he invented the treatment that currently has the highest combined ridiculousness-popularity-misunderstanding level. There are dafter ideas out there, there are more popular treatments out there and there are ideas people know less about, but none combine all three in the way homeopathy does.
Unlike his modern day fans Hahnemann had perfectly good excuses for coming up with this ridiculous idea and sticking with it. He was 63 years older than Semmelweis and the state of medical science was quite a lot worse. He correctly observed that popular treatments of the day did more harm than good and actually quit practising medicine for a while and worked as a writer and translator while trying to investigate medicine scientifically.
Skeptical of the newly suggested effects of cinchona-bark as a malaria remedy he tested it out on himself and experienced similar symptoms to those of malaria. From this he incorrectly concluded that “like cures like”, substances affecting the body will cure illnesses with similar symptoms. Unlike Semmelweis he did no rigorous scientific examination of this hypothesis, instead he introduced more principles without testing them properly, the most important that diluting the substance doesn’t reduce the curative effect. Although some modern homeopathic remedies uses low dilutions, most uses dilutions so extreme that it’s unlikely for the single pill or drop you take to contain a single molecule of the original substance.
Being less harmful than popular treatments of the day, homeopathy rose to be a significant player on the field of medicine, but it was always attacked as being scientifically ridiculous, and as directly harmful treatments were weeded out by maturing medical science, homeopathy went into decline.
With the increased focus on alternative medicine at the end of the 20th century homeopathy had a second chance to prove itself, and failed. What’s interesting is that this failure has done little to reduce homeopathy’s resurgence. Medicine’s great successes in the 20th century are forgotten by the fortunate with access to modern medicine, we move the goalposts and demand to be completely healthy all the time and will accept no uncertain diagnoses and limits to knowledge, and alt.med. offers that certainty, ufettered by reality and demands for documentation.
Homeopaths and other alt.med.-proponents still see themselves as Semmelweises, unfairly ignored, and uninformed patients and politicians are still propping them up, ignorant that what they’re dealing with are Hahnemanns, successful only because they rarely do direct harm. Openness to new, untested ideas, was a virtue lacking in Semmelweis’ opponents and important to strive for even today, since it doesn’t come naturally. Openness to old, disproven ideas, is asinine, and alt.med. proponents should stop asking for it.
Hva skal vi med pressen? (Eller: er jeg enig med Inga Marthe Thorkildsen? Jeg tror svaret er kanskje.)
Hva motiverer i vår dager den fjerde statsmakt? (eller den tredje statsmakt om du er i Sverige) Opplagstallene? Eller et ønske om å formidle viktig og nøktern informasjon om statens ve og vel og de andre maktenes gjøren og laden? Om det sistnevnte fortsatt har en betydning gjøres det i hvert fall en dårlig jobb. Alt journalister tar i ser ut til å bli, eller være, tabloidisert slagsordspolitik og stråmannsargumenter.
Ta kvinnedagens store snakkis i riksavisen Aftenposten, Inga Marthe Thorkildsens brannfakkel “— Man kan si det er like verdifullt å gå hjemme med barn som å jobbe – men det er det ikke“.
For det første: Er det virkelig nødvendig å bruke et milelangt sitat som overskrift? Ja, det er et blikkfang og trekker lesere, men det gjør også leseren forutinntatt og setter tonen for debatten mellom de som sjelden leser forbi overskriften.
For det andre: Hva er det Aftenpostens journalist Marie Melgård har produsert? Er det et intervju eller har hun tatt jobben som talerør for likestillingsministeren på kvinnedagen? Produktet bærer preg av det siste. Vi skal halvveis ned i … artikkelen (?) før journalisten gir seg til kjenne ved å sitere et spørsmål til ministeren og det går ikke klart fram om utvalget av bakgrunnsinformasjon er ministerens eller journalistens. Det er også det eneste spørsmålet som presenteres, så vi får aldri vite hvordan det kom til at likestillingsministerens hjertesukk, som artikkelen (?) presenterer seg som i første avsnitt, ble ført i pennen av Aftenpostens journalist.
For det tredje: Midt i presentasjonen av Thorkildsens utsagn med noe uklart opphav, og rett før det eneste refererte spørsmålet, siteres så et argument fra “forfatter og blogger” Karianne Gamkinn. «Jeg er ikke en dårlig feminist selv om jeg ikke velger karrière.» Sitatet er fra Aftenposten, men formodentlig fra noe som ikke ligger på nett, for det er ingen lenke til … artikkelen? Intervjuet? Bokanmeldelsen? Kronikken? For meg ser det ikke ut som Thorkildsen ble forelagt dette sitatet før hun svarer på spørsmålet «— Hva tenker du om dem som lengter etter å være hjemme, og ikke vil ha likestillingspekefingeren i ansiktet?» men det farger helt klart leserens oppfatning av svaret.
Så langt i denne journalistiske produksjonen er det Thorkildsen som har kommet til orde, om enn med ukjent mengde assistanse fra journalisten. Er jeg enig med henne? Vel, det er ikke godt å si, siden jeg ikke vet hvilken problemstilling Thorkildsen egentlig svarer på, og tolkningen min blir farget av rammene og responsen fra opposisjonspolitikerne som kommer etterpå (og som jeg kommer tilbake til), men jeg tror det. Jeg er generelt ingen fan av Thorkildsen eller SV, men det hun sier og eksemplene hun velger forteller, er at å stå utenfor arbeidslivet for å være hjemmeværende over tid har store økonomiske kostnader og gir reduserte valgmuligheter på sikt, både fordi valgfrihet er knyttet til økonomi og fordi man reduserer sin egen verdi i arbeidsmarkedet, noe som også delvis gjelder det å velge deltidsarbeid. Eksempelet hun trekker fram er en kvinne som valgte å være hjemme med et barn med funksjonsnedsettelse (antagelig i ganske mange år), for så å bli forlatt av mannen og sitte igjen med minstepensjon. Hun påpeker deretter at det generelt i Norge ikke er politisk vilje til å bruke penger for å øke andelen hjemmeværende. At jeg ikke er enig med henne i at sekstimersdagen er et ansvarlig tiltak for å gjøre det lettere å være familiemenneske er ikke så viktig, jeg har tross alt ikke satt meg så godt inn i problemstillingen, og det er det eneste dryppet i en lang artikkel som ikke handler om hvordan ting bør være, men om hvordan de er.
Men tilbake til det journalistiske arbeidet og mitt “for det fjerde”: Nå kommer opposisjonen til orde under deloverskriften “Thorkildsen er kvinners verste fiende“. At det var? Høyres Linda Hofstad Helleland tar raskt og brutalt fra meg de små Høyresympatiene jeg hadde igjen ved å tolke Thorkildsens argumenter som etiske verdivurderinger og ikke personøkonomiske. Jeg kan vanskelig se for meg at et intelligent menneske ikke ser at det å gå hjemme med barn, med mindre du har et halvt dusin eller så, er et valg av personlig glede framfor person- og samfunnsøkonomisk gevinst. Og når vi har kommet forbi den emosjonelle tordentalen er det da også velkjent Høyrepolitikk vi serveres og ikke en falsifisering av Thorkildsens uttalelser om de økonomiske tapene hjemmeværende mødre utsettes for. Det er valgfriheten til å bruke all permisjon på mor Helleland trekker fram i et harskt angrep på noe Torkhildsen nok står for, men som ikke en gang indirekte er relevant kritikk av det hun har uttalt seg om her.
Hakket bedre gjør KrFs Dagrunn Eriksen det, men også hun ignorerer at Thorkildsen sier svært lite om hvordan det bør være og mest om hvordan det er. Jeg har vondt for å forene «Å kjøre på som SV og Thorkildsen gjør med å kreve 100 prosent tilstedeværelse på jobb, og at man skal være en 100 prosent perfekt mor, tror jeg fører til at flere velger å stå helt utenfor arbeidslivet» med Thorkildsens eneste uttalelse i denne sammenhengen om hvordan ting “bør” være, nemlig en innføring av sekstimersdag.
Har jeg feiltolket Thorkildsen? Det er vanskelig å si, siden jeg ikke har funnet en klargjøring fra henne. Er det for mye forlangt at alle politikere begynner hver sin lille blogg der de kan fatte seg i langhet uten journalistisk innblanding?
Har jeg vært for kritisk til journalistens arbeid? Basert på mye av responsen jeg har sett mener jeg jeg har mitt på det tørre. Riktignok ser jeg ikke for meg at responsen hadde vært veldig mye mer rasjonell og relevant, men da hadde i det minste skylden ligget på alle de andre journalistene og politikernes manglende evne til å snakke i noe annet en tabloidformat.
Books are great! Sure, there are books that are horrible in content or style. But the general concept of a book is one of the greatest things there is. And one of the best things is sharing your favourites with others or calmly and rationally discussing how your favourite book is a literary masterpiece and anyone disagreeing or liking a book you find unimpressive is a dimwitted poo-poo-head.
One site facilitating such discourse is Goodreads. You can register the books you own, or read, or plan on reading. Rate them, comment on them or discuss them. My main use of the site is as the (lessee one, two, …) fourth incarnation of a system for keeping track of books I’ve read so I don’t get disappointed halfway through chapter three when I realise it’s not just that the author is predictable, I have actually read the book before.
It’s also good for showing off that I own well over a hundred books and have read more than 1500.
The image below, unless you have some sort of resizing of your screen or browser, represents one fifth of the current world population as 400 x 350 pixels. That means each pixel, each of the smallest dots in the image, the width of the black edge, the single black dot in the middle of the pale blue square in the upper left, is 10000 individual human beings. If you’re not a hive mind, an alien intelligence or a terrestrial species capable of reading blogs that’s not Homo sap. (if you are, please leave a comment), that makes you one ten thousandth of a pixel in this image of just one fifth of humanity today.
The pale blue square, mainly there to make it possible to find that single, 10000-person dot, is about the population of Norway, 5 million people. The smaller black square next to it is how many people are born on this planet, each day, about 37000. And the smaller dark blue square next to that again is how many die, about 16000.
What about the big pink area? That’s the population of China. Nearly a fifth of humanity all by themselves. India would fill up nearly as much, while Europe and the US together nearly get to play in the same league.
What this means is you’re a miniscule part of humanity. Your desires, hopes and fears may be the most important thing in the world to you, but you’re only one of 7 thousand million people that make up humanity. All your actions are, most likely, swamped by the actions of the rest of us, and if there was a vote between pleasing you, and pleasing everyone else, you’d lose.
On the other hand, so would everyone else. The doings of humanity are made up of the actions of every individual. And as you’re reading this, you’re likely to be one of the part of humanity with the most freedom to act, the largest share of humanity’s surplus, the biggest influence. Thus, by any reasonable system of ethics, you also have the most responsibility to consider the consequences of your actions.
This is why MadArtLab is a great blog and QI is the best program on television:
NRK har en ny serie. Om tall! Yay!
Første episode av Siffer gikk nå på søndag, går i reprise i kveld og et par ganger til i løpet av uka og var en herlig rundtur i sannsynlighetsberegningens verden. I den anledning viste programlederen et utrolig triks for å få det samme resultatet i mynt og kron ti ganger på rad. Jeg skal ikke avsløre dette trikset her, men ta opp et annet tema utløst av at programlederen konsekvent sa han fikk kron, når han egentlig fikk mynt.
Pedantisk begrepspirk, sier du kanskje? Det kalte i hvert fall jeg det spøkefullt i en facebook-status, men ble behørig satt på plass av min mer finansielt kompetente far, som motbeviste standpunktet med en elegant reductio ad absurdum. Definisjonen på mynt og kron er altså kjempeviktig og dermed verdig plass her på Hyperbolsk. (I Hyperbolsk? Hos Hyperbolsk? Hmmm…)
Tenk om amerikansk høyesterett hadde vært uenige om definisjonen på heads og tails når de slo mynt og kron om hvem som skulle bli president i USA i 2000? Hvilke konsekvenser kunne det fått?
Nå vet jeg riktignok ikke hva som er fram og bak på amerikanske mynter, men på norske mynter er det som følger:
Den siden som har verdien er mynt og den siden som ikke har verdien er da ved eliminasjonsmetoden kron. Min hovedreferanse til dette er norske ordbøker, som bokmålsordboka. “Sånn har jeg aldri gjort det / sett det gjort.” er dermed ikke gyldige motargumenter. Finn en bedre referanse eller innfinn deg med realitetene.
PS. Myntens fram- og bakside, det numismatikerne kaller advers og revers, er ikke definert kongruent med mynt og kron og ser for meg ikke ut til å være ordentlig definert i det hele tatt.
There are multiple ways to write a blog and multiple ways to read them. You can write meaningless trivia from your everyday life and have a blog that’s updated constantly, but unless you’re some sort of celebrity or get lucky acquiring a following of sheep that’s more suited for facebook these days. Or you can write rare and high quality posts like I do, in which case the blog won’t be updated constantly.
If you read the first kind of blog you can just check it every day, and possibly several times a day, and there will be something new and inane for you to waste your time with. Just be careful so you don’t get obsessed with reading new posts as soon as they’re posted and check it more often than you check your work email.
If you read the second kind of blog you also can check it every day, but you’ll have a high rate of unnecessary visits, which is a waste and an affront to the deities of efficiency. You can check it more rarely, which will reduce the number of unnecessary visits, but increase your risk of getting to a new post rather late, which is an affront to the deities of sharing cool stuff before any of your friends find it themselves.
Now you could be lucky and just have notifications about new posts appearing in your facebook feed or some other similar place, but that requires you to be “friendly” with the blogger or the blogger being internet-important enough to have a facebook page that you can connect to, and at the current rate of facebook notifications it might escape your notice or not appear in your feed due to facebook’s secret algorithm for deciding what’s a top news item, at least if you’re an important person like me and you have multiple friends.
The solution to this problem is the RSS-reader. RSS is a standard for publishing content or content summaries that most blog-software supports. This means you can get yourself an RSS-reader, set it up to check your favorite blogs, and it will tell you whether any of them have something new to offer, and even let you read all or part of those offerings in one easy to access location. RSS can also be used in other ways, but they’re not important right now. Of course, if you only read one, rarely updated, but incredibly high quality blog you have gained nothing, but that just means you need to find a couple more.
Personally I use google reader. Why? Because I already had a google account and found it convenient. It has improved my blog reading experience 2.5 fold and it could do so for you as well.
I know it’s actually more than two weeks since I wrote the first posts, but even under a mantle of hyperbole I wanted a little more heft before I started trumpeting my blog-horn. Unfortunately I’ve been busy (and not only with Bejeweled 3) and the heft’s been delayed. Until now! So here it is, the most important blog in the world.
One thing I’ve done is turn on the automatic pestering of people connected to me on facebook and twitter. Now since I’ve already turned on the automatic pestering of people connected to me on facebook with whatever I share on twitter, that might cause double pestering. If that’s the case I’ll fix it. No need to panic about it yet.
Now sit back. Read the backlog of very important posts. And try to survive while you wait for the next.
Surplus is an essential part of life. Imagine a gazelle on a plain of poor grass that barely offered enough nutrition as long as the gazelle ate constantly. It’d have no time to watch for predators, couldn’t afford to expend the time or energy to run from one even if it spotted one, and don’t even mention breeding and raring offspring. This applies to all life great and small, and it applies to humans and societies.
We humans have the ability, above and beyond that of other animals, to spend surplus time and energy on lasting improvements to ourselves, our tools and our societies, to the benefit of ourselves and our descendants. Sure, there are animals that can be said to do similar things, but we alone can chose and plan our efforts. That’s where the luxury of modern society comes from and it consists of. Our ancestors worked to improve their tools and their societies and we reap the fruits by having even more surplus time and energy.
But, again above and beyond that of the other animals, we have the freedom to chose to spend our surplus on ourselves, with no benefit to either or own or our society’s future. I’ll call that frivolities from now on in the text, biased as that choice of term may be. You may be thinking, if this post so far has made you think at all, that there are examples in the animal kingdom of this, but you’re probably wrong. Take for instance the lazy lions spending lots of time just laying about the savannah. Aren’t they just enjoying themselves and frivolously ignoring their future? I think not. What would a lion do if it wasn’t laying about? Go hunt? And then what? I suppose it’s theoretically possible for a lion shaped creature to butcher meat and make air dried jerky as a reserve in case of emergencies. But even if that wasn’t impossible for a lion brained creature, what would be the point beyond surviving lean times? What would a lion do next when it had a full belly and a good store of jerked gazelle?
Sorry! That might have been an unnecessarily long tangent on non-existent inventive lions and you might be thinking, “I never thought lions should make gazelle jerky, what kind of stupid straw man argument is that?” The point was, of course, that I think any example of animals being frivolous will be stupid, but if you have an example of animals that could, without ridiculously increased inventiveness and mental faculties, spend their time more wisely, I’ll be happy to learn of it, but I’m fairly sure none exist. Humans and human societies however, can spend an inordinate fraction of their surplus on frivolities. In fact individual societies and the global network of societies are currently set up so that individuals and whole societies have available, not only their own surplus, but that of other individuals or societies as well. Them that’s got shall get. Them that’s not shall lose.
Now some may not see that as a problem, but I can only assume such people are either ignorant of reality or selfish beasts. If you’re a selfish beast you can just fuck off right now. I’m not interested in discussing your rationalisations of your egotism. But if you agree that the problem exists, or you are open to the possibility that you’ve been ignorant of it and might agree once you’ve thought it through, you should feel free to stick around.
At this point I must admit I’m part of the privileged minority commanding more than my fair share of humanity’s surplus sense and that I’m no saint wisely spending all that surplus on righting the imbalances in the world. The hours I’ve played Bejeweled 3 (some of them only this weekend) for instance, could have been spent more wisely, and the monetary support I’ve given the Bejeweled 3 developers, insignificant thought it may be to me, would make a real difference to those at the other end of the privilege scale, but a very important step is acknowledging there’s a problem and identifying what it is. And if at this point you’ve not realised the problem consists of a) the uneven distribution of power over humanity’s surplus, combined with b) the irresponsible utilisation of that surplus, I’ll be happy to educate you further in future posts, or in devastatingly clever replies to any comment you may have.
NB! If you want to argue about having been told to fuck off, you’ll have to wait until a later post.
(English text follows below)
Nordahl Griegs Til ungdommen har alltid virket sterkt på meg. Det er ikke uten grunn at den er et fast innslag i humanistiske konfirmasjonsseremonier i Norge, med et sterkt og gjennomgående budskap om det ansvaret hver og en av oss har for å leve etter og styrke menneskerettighetene for alle. Og nettopp dette budskapet har gjort den til et element i flere minnemarkeringer for sommerens omkomne, nå sist som avslutning på den nasjonale minneseremonien. Den kommer ikke til å virke mindre sterkt på meg i framtida…
Nordahl Grieg’s poem Til ungdommen has always had a strong effect on me. You can find the original poem as well as several translations at the wikipedia article. I recommend the one labeled “Beautiful English translation” by translator unknown, or learning Norwegian and listening to Herborg Kråkevik through the youtube link above. It’s a poem with a strong message that each and every one of us have a responsibility to work and strive for the human rights of us all and is known to many in Norway as a fixture of humanist confirmation ceremonies. This message, in such an emotional package, made it a natural part of the several memorial ceremonies this summer, culminating in it being the finale in the national memorial ceremony today. I doubt I’ll ever be able to hear it through without getting teary eyed again.