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Always Think for Yourself


Linus Pauling

I love it when a story has a happy ending. And this one does. Sort of.

Farrar, Straus & Giroux put out a new book a few weeks ago, Pandemic, by a good science/medical writer, Sonia Shah. To promote the book, they pulled some startling facts from Shah’s introduction and used them on the back cover and in other marketing material. Here are the “facts” as Shah presented them in her book: “90 percent of epidemiologists said that a pandemic that will sicken 1 billion, kill up to 165 million, and trigger a global recession that could cost up to $3 trillion would occur sometime in the next two generations.”

Startling numbers. Also very precise and factual sounding, and, well, science-y. Shah even footnoted her statement, citing a study done some years ago.

But turns out these are not “facts” at all. Ninety percent of epidemiologists have never said any such thing; there don’t appear to be any published studies at all to back up the statement. Turns out these “facts” are nothing more than guesses, extrapolations of  worst-case scenarios floated by a small group of attendees at a private meeting more than a decade ago. They were mentioned in a TED talk in 2006. And Shah picked them up from there.

I spent a little time trying to get to the source of the statement, only to find smoke. In other words, as Gertrude Stein said, “There is no there there.”

But now to the happy part(s):

  1. I got to indulge in detective work. I love that.
  2. I got to communicate with several bright, interesting people, from Larry Brilliant to Jennifer Senior. I like that.
  3. I got to explode some fake facts used to scare people into buying a book. Great.
  4. And Sonia Shah graciously acknowledged the error and pledged to correct it. This is the best of all.

There is also a not-so-happy part: I found out that fact-checking is not done, or is not done well, by most major book publishers.  This, to me, is even more startling than Shah’s statement. I have been writing books for three decades. I love the industry. I trust that books from major publishers will be accurate.  I assume that they have been checked for accuracy. But my assumptions, it turns out, are wrong.

Most book publishers don’t fact check books. They don’t. They really don’t.

Instead, most standard book contracts (mine included) shuffle the responsibility for accuracy onto authors. Editors focus on voice and flow and grammar. Publishers focus on sales. The only ones who have to take responsibility for factual accuracy, it seems, are writers.

Another illusion shattered. And a lesson learned.

What does this mean for readers? Well, caveat emptor, I suppose. As Linus Pauling said, “When an old and distinguished person speaks to you, listen to him carefully and with respect — but do not believe him. Never put your trust in anything but your own intellect. . . .  Always think for yourself.”



Chasing Smoke

imageMy simple question – where did the author of a recent science/medical book get her startling facts? – ended up with a deep dive into sources, a very enjoyable phone conversation, and a resolution of sorts.

Readers are directed to earlier posts here and here, which spell out how it all started.

Story begins with this startling line from Sonia Shah’s new book Pandemic: “90 percent of epidemiologists said that a pandemic that will sicken 1 billion, kill up to 165 million, and trigger a global recession that could cost up to $3 trillion would occur sometime in the next two generations.”

Pretty scary. So where did her numbers come from? All signs pointed to a guy named Larry Brilliant, coauthor of the paper Shah mistakenly cited, and a man with one of the best CVs ever, including stints as Ken Kesey’s traveling companion, Jerry Garcia’s personal doctor, world traveler, smallpox eradication pioneer, Google executive director, and head of various global health initiatives. A fascinating career.

I expect that Brilliant is very busy. So I was mildly surprised a few days ago when I got a phone message and an email from the man himself. He wanted to talk about the numbers that I had questioned.

We spoke yesterday. And I really enjoyed our talk, which ranged from the question at hand to digressions on everything from movies to think tanks to rock. Larry Brilliant seems like a great person.

But when it came to the source of Shah’s numbers, well . . .

Turns out that the figures she used were floated first at a private meeting ten years ago, during a time when bird flu (H5N1) was just starting to hit, jumping from poultry to humans and looking like something that might become the next Spanish Influenza, killer of millions. The meeting Brilliant convened in 2005, called Pandefense 1.0, was a private gathering of around 50 thinkers from various fields who wanted to get their hands around the potential scope of the threat. Among them was a investment expert from Canada who was among the first to project the economic impact of a pandemic. Her rough numbers for the U.S. and Canada were back-of-the-envelope projected to global levels to get to the $3 trillion figure. None of this was ever published in a professional journal.

As for the other numbers? They also came from Pandefense 1.0, via a survey of participants. The only published paper from the survey (the one cited by Shah as her source) does not include the numbers she used. Brilliant agrees her citation was wrong. Instead, he said, she should have cited a TED talk he gave in 2006. And — now we’re getting down to it — the numbers he used in that talk came from discussions at Pandefense. They were nothing more than educated guesses thrown around at a private meeting. They were never peer-reviewed. They never appeared in a published paper.

They might turn out to be right, but they are not science. (And they might turn out to be wrong: After years of frightening bird flu headlines and disaster scenarios, I was more than slightly surprised to find out that the actual global death toll from H5N1, to date, is 440.)

Brilliant plans to ask for a new survey that might really assess what epidemiologists think of the risk of a pandemic. I agree that one is needed. And until that’s done, the statement made in Shah’s book should be corrected.

(you can read the followup to this post here)

The Pandemic Problem, Part II

Yeah, this is not the book cover, but it's cool

Yeah, this is not the book cover, but it’s cool

Okay, continuing my little saga about looking for the facts behind the Startling Statement made by Sonia Shah in her new book, Pandemic. Please start by reading my first post about it, below.

And our story continues:

The problem starts when Shah makes this Startling Statement in the introduction to her new book: “90 percent of epidemiologists said that a pandemic that will sicken 1 billion, kill up to 165 million, and trigger a global recession that could cost up to $3 trillion would occur sometime in the next two generations.” Her cited source is a survey by epidemiologist Larry Brilliant. I read Brilliant’s paper and can’t find Shah’s numbers.

What does a curious science writer like me do? Write a bunch of emails, of course. I write all four authors of the original paper (Brilliant is third author among four) asking how that work can serve as the source of Shah’s numbers. I write Sonia Shah. I write the book reviewer at the New York Times who repeated the Startling Statement in her positive review of the book. When I don’t get a fast response from Shah (understandable, she’s on book tour)  I write her agent and  her editor at Farrar, Straus, and Giroux (tip for sleuths: you get these names from the Acknowledgments in Shah’s book).

Why do I spend all this time? Because I hate it when writers scare people with unsupported facts. There are probably a million facts in Shah’s book, and 99.999% of them are undoubtedly correct. But the Startling Statement is the big one, the nugget repeated in conversations, the elevator pitch that sells books. That one needs to be right.

Within a day or so I get a response from the original paper’s lead author, Wandi Bruine de Bruin, who confirms that the paper does not include the numbers in the Startling Statement, nor does she know of any other place where Larry Brilliant has published such numbers.

Which leads back to Brilliant himself. And here’s where we finally get to something like an answer. Brilliant gave a TED talk in 2009, halfway through which he mentioned the numbers in the Startling Statement. He said 1 billion sick, he said 165 million dead, he said it all. Shah appears to have picked it up from there, and the rest is history.

In other words, the Startling Statement is not from any scientific study (at least not one that anyone can point to yet; still haven’t heard from Brilliant), but sources to an unsupported couple of lines that a guy said in the middle of a TED talk. And that would be okay if Shah simply said where she got her numbers. But then the Startling Statement becomes something much less startling. More like, “Six years ago Larry Brilliant said in a speech that most epidemiologists probably believe that a pandemic will likely happen some time in the next five or six decades. . . ” Not exactly the stuff that book contracts are made of.

I hope this is not the end of the story. I hope Larry Brilliant can offer some real science to back up his statement. I hope Shah is a little more careful about her citations. I hope her publisher is a little more careful about fact-checking. But most of all, I hope that readers will demand real proof when they read stories about science.

(story continues here)


The Pandemic Problem

Naked Facts bannerOver at Naked Facts we’ve been posting a series of seven questions to ask when you read the science news. #1 on the list: Where’s the proof?

“This seems almost too simple. But many people reading the news don’t pay attention to the one thing that really matters: Where’s the evidence that this ‘discovery’ is real? Never accept anything just because a reporter says so. Demand proof.”

Okay, I have to walk it like I talk it. And chance, as Pasteur said, favors the prepared mind. Two days after I posted the above, I read a review of a new book called Pandemic by  Sonia Shaw, who has done a lot of good work writing about contagious diseases. In it, the New York Times reviewer, Jennifer Senior, did a good thing: She repeated a claim Shaw made in her introduction, then live-linked to the scientific study Shaw cited to support it. Here’s what Senior wrote:

“…she cites a study in which 90 percent of epidemiologists say they believe a global pandemic will sicken one billion and kill up to 165 million within the next two generations. Looking closely at the source of this statistic — a paper by the epidemiologist Larry Brilliant and three colleagues — I’m not convinced that things are quite so dire. (The number of epidemiologists he surveyed is actually quite small.) But…”

Then Senior goes on to the rest of the review. What hit me was Shaw’s Startling Claim: 1 billion sick! 165 million dead! Within two generations! So say 90% of epidemiologists! I track the medical news a little and had never before heard anything like these numbers. They were so specific, and they took such pride of place in the book, and they were from such a good writer, that they seemed instantly credible.

But they aren’t. At least not as far as I can tell.

The book reviewer’s caveat about the small sample size made me wonder about where those numbers came from, and the live link made it easy to check. Kudos to Jennifer Senior and the great grey Times.

So I read the paper. And guess what? No matter how many times I read it, I couldn’t find the numbers in Shaw’s Startling Claim. The study itself was sort of, well, minor. It was a bit long in the tooth for starters, based on data gathered in 2005 and published ten years ago (I think that’s like 60 in epidemiology years). As Senior noted, it was pretty small-scale — the entire study was based on an email survey of 19 “medical experts” and about the same number of non-experts. No telling how many of the “experts” were actually epidemiologists. Another red flag was the purpose of the study, which was designed to compare expert to non-expert opinions about bird flu, not to predict the chances of a pandemic. But the most important thing was this: The numbers Shaw used were not there. Not that I could see.

One more fishy thing: Shaw and Senior both referred to Larry Brilliant as the source of the Startling Statement. But he was only third of four authors on the paper. Usually the first author gets the credit. So why was Brilliant given top billing by Shaw? Turns out it’s not only because he has such a great name. I mean, really, Brilliant? No, turns out it’s because he’s a BIG DEAL in the world of science. Check him out: head of this, leader of that, TED speaker, Google ties, big government experience, big foundation backing, etc. etc. When Larry speaks, people listen.

So I did the next logical thing: I wrote Larry, Larry, what’s the source of those numbers? Haven’t heard back yet. But I also wrote the other three authors on the study, asking them if they could make the published data match Shaw’s Startling Statement.

And here’s where things get weird. . . .

(You can read Part II of the story here)

This One Graphic Says It All

One thing Twitter is good at is — yes, I’m tweeting more now that we’re trying to draw attention to the Naked Facts books — is the juxtaposition of otherwise random bits of information, allowing factoids to brush up against each other as if they were guests at a noisy, crowded cocktail party. Today’s example: Notice from the NYT and a link to the very first Science Times articles from 1978. That was the year I decided to become a science writer, enthused about raising the bar, bringing people better quality news. Yay! And right below it, from another source, was a tweet linking to a story about why science writers have so few friends (tongue in cheek, but still . . . ). Within that story was this great graphic:Medical_studies-05.0nicely illustrating the confusing overall message from today’s standard news coverage of health issues.  Nothing has changed, it seems. Final irony, there’s nothing better than Twitter itself at illustrating why people aren’t reading newspapers (thus killing many science writing positions) while adding to the noise, confusion, and attention-grabbing-at-the-expense-of-context attitude of most of today’s science coverage.

Naked Facts #2

abilify-cover-kdpThis is the second in a series of short books Monroe Press is doing on specific topics in science and medicine.  Our idea is to act as translators for the general public, deciphering and balancing the flood of science research and activist response so that non-scientist readers can quickly get the essentials.

The larger theme for the first titles is mind medicine, specifically antipsychotics — some of the most misunderstood, misprescribed, and profitable drugs ever made.

First in a Series

Seroquel coverI’ve been fascinated for three years by a simple question: How did a family of medicines I’d never heard of become the world’s best-selling prescription drugs?  Once I started looking into it, I got hooked, and I’ve been reading everything I could get my hands on ever since. They’re called antipsychotics. They did not exist before 1950, were found pretty much by accident, and were originally used only for treating schizophrenia. In the early days they were already amazing, almost single-handedly causing the emptying of the old giant mental asylums and turning them into little more than props for horror movies. Between 1955 and 1975 millions of patients were returned to their families — or the streets — because they were taking these drugs. By 2008 they had somehow broken out of the world of severe mental illness and been turned into blockbusters because they were being used to treat everything from insomnia and addiction to dementia in the elderly and behavior problems in children.

It looked like a great story. Unfortunately, as I researched it, two things happened, both bad for putting together a salable book proposal: First, the story ramified and effloresced into many others, intertwining with the discoveries of antidepressants, tranquilizers, and hallucinogens, the growth of neurochemistry and neurobiology, and on and on. It was all interesting, but it was too much. The material got so big it became unwieldy. The second problem was that the antipsychotic story had a lot of players, most of whom lacked the strong, colorful personalities needed for the kind of narrative history I write. There was no Haber and Bosch.

At the same time, I learned just how bad most of the information on the web could be when it referred to these drugs. So instead of a single book, I’m working my research into something quite different: A series of short, informative user’s guides that cut through all the pro- and anti-drug misinformation out there and offer a simple set of solid, science-based facts for users, their families, and caregivers. The first one, on Seroquel (quetiapine) is just out in print and ebook.

The Monroe Press

Years ago I started my own little publishing company, Monroe Press. Monroe Press weblogoNow my son Jackson and have started to revive and refocus it, with an eye toward offering top-quality, easy-to-read science writing for the general public. Our first series of short books will focus on psychopharmaceuticals — prescription mind drugs like antipsychotics and antidepressants — a field in which there is way too much slanted and mis-information. So we’re going to publish a series of very short, inexpensive, clearly written books, one per drug, describing what each medication does and and how it does it, along with a summary of controversies and recommendations for further reading. We’re hoping that some simple, solid science will be useful to patients and their loved ones, as well as the healthcare community.

Henry’s Utopia

Ford and Edison

Thomas Edison and Henry Ford

In 1921 Henry Ford and Thomas Edison announced plans to create a city ten times the size of Manhattan, built in America’s heartland, powered by clean, renewable energy, employing a million workers, with each one given five acres on which to grow their own food. They were going to invent a new kind of money based on energy units, and revive the economy of the South. This model, they thought, would end global hunger and war. Sounds a lot like utopia. And they almost pulled it off — until the government stopped them. The rise and fall of the Ford/Edison utopia is a strange, hopeful, tragic story that resonates with today’s issues around energy, technology, labor, and the economy.

Ancient healing


The theater at Epidaurus

Back from a few weeks in Greece, where I had a great time with Lauren on Crete and visited friends on the beautiful island of Lesvos (home of Aristotle’s biology and Sappho’s ecstasy). Also took a quick day tour of Epidaurus, for 800 years the greatest healing center of the Western world. What a place. It was the legendary home of Asclepios, the healing god. The medicine practiced here was more holistic than anything we have today: the priests of Asclepios used diet, exercise, singing, herbs, poetry, theater (the amphitheater at Epidaurus is still used today), surgery, ritual, water therapy, clean air, natural beauty, whatever it took to heal patients. But at the center was a therapy we don’t use much any more: Dream healing. Patients were counseled, cleansed, and prepared for a night or three in the abaton, a special underground dormitory where they would meet the god of healing directly, one-on-one, in their dreams. Properly interpreted by a priest of Asclepios, their healing dream would point the way to a cure. Today we would call it the power of suggestion, or placebo, or faith. Maybe an interesting example of the mind-body connection. But the ancient practice of dream healing was not tangential to medicine: It was central. And after centuries of successful use (they’ve discovered more than a hundred engraved stone thank-you plaques from cured patients), you’ve got to figure there was something to it. Maybe something we could learn from today. . . .