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

theatre2

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. . . .

CF, History, and Pork Chops

JacksonMSFlying to Mississippi in the next few days to talk about the world’s greatest invention. I’ll be speaking to technical side execs at CF Industries, America’s largest manufacturer of ammonia — which is to say, the biggest user of Haber-Bosch technology (the subject of The Alchemy of Air). CF started out as a little farmer’s cooperative in the 1940s and is now listed on the S&P 500. They run America’s biggest Haber-Bosch plant, in Donaldsonville, LA — a monster factory that pumps out fertilizer for millions of farmers. Looking forward to seeing Jackson, and maybe even getting the chance to try the pork chops at Lou’s Full-Serv Southern Restaurant.

Korean Alchemy

Just got word that The Alchemy of Air will be published in Korea. I’m always happy to have my work translated for other countries — the more readers, the better — and the issues in the book are especially important in Asia. Hint to Crown/Harmony (my US publisher): I’ve gotten several requests recently for a Spanish language version.

The Biofuel Boondoggle

Good op-ed in the New York Times online today, outlining the price we’re all paying to add ethanol to our gasoline.  But the hidden ethanol tax is only part of the problem. Paradoxically, adding a seemingly “green” biofuel to our gas is also bad for the planet.  When you factor in all the costs (both financial and environmental) of growing the corn and sugar cane to make the ethanol, burning the biofuel turns out to be worse than burning the gasoline it’s replacing. I know from my work on sustainable agriculture that the biofuel boondoggle is succeeding only in enriching some big farmers, while disproportionately taxing the poor, pulling needed land out of food production, and degrading the biosphere. It’s time to end a bad policy.