—
Nothing in life is to be feared, it is only to be understood.
Now is the time to understand more, so that we may fear less.
Maria Skłodowska Curie
—
WELCOME TO Never Mind The B#ll*cks, Here’s The Science. The title captures exactly what this book is about. It’s about the science behind the biggest issues that confront our species today. These issues intrigue me, and hopefully you: control over your life; vaccination; dieting; mental health; addiction; legalising drugs; racism; men and women; bullshit jobs; climate change; euthanasia; the future. Using my scientific training, I’ve examined the science in each of these topics. I have, in the inimitable words of Matt Damon in the The Martian, literally ‘scienced the shit’ out of them. B#ll*cks and shit? There’s two rude words already, and in a science book!
Science is so great because it’s based on information that comes from experiments and data that have been independently checked and ultimately reproduced by different scientists. Scientists are competitive and love scientific combat and, when they work together, they are unbeatable. The best want the truth. Science is the antidote to fake news, so we need it now more than ever. We are all astounded by what’s happened with COVID-19, the disease caused by the virus SARS-CoV-2. That pandemic has revealed how we need science more than ever, and I discuss several of the topics through the lens of that particular malicious virus. My goal is to get as close to the truth as I can on all of these topics, using science as my only guide.
A SAMPLE TAKEN FROM THE FIRST PATIENT INFECTED WITH SARSCOV-2 IN THE US. THE YELLOW SPHERES ARE EACH A SINGLE VIRUS.
To be a scientist is to be a sceptic. This is why they argue with each other. I read a great quote recently from a 1924 issue of the Massachusetts Institute of Technology’s Tech Engineering News magazine (that’s how much of a sceptic I am – checking back issues of MIT newsletters). It said, ‘The predominant feature of the scientifically trained mind is the ability to associate cause with effect. It is not content with the knowledge and application of facts, but it seeks the reason therefore. It is continually in a state of unrest, turmoil, irritation. Moreover, it manifests a natural inclination and willingness to know the reason “why”.’ Unrest, turmoil and irritation? Sounds great, doesn’t it? But it makes an important point. Scientists obsess about associating cause with effect. Or to put it another way, determining the link between correlation and causation. Vaccines correlating with, but being responsible for protection against, an illness. A diet correlating with, and hopefully causing, weight loss. An antidepressant correlating with, but being the reason for, improved mental health. A genetic variant correlating with, and causing criminal activity. Being female correlating with, and being the reason for, increased empathy. Human activity correlating with, and causing, global warming.
The correlation/causation issue is critical in science: you might well correlate one thing with something else, but that doesn’t mean that what is being correlated is the cause of something else. For example, there is a correlation between smoking and cancer. For a long time, tobacco companies claimed that this was just a correlation. But then the science became irrefutable – smoking causes cancer. This can be proven with rigorous statistics and by coming up with a mechanism, which proves the link. In the case of smoking, the mechanism is chemicals in the cigarette smoke: these cause mutations in the genes that produce proteins which, when mutated, cause cancer. The case that smoking causes cancer took off when in 1953 scientists showed that mice painted with tobacco tar developed tumours. Study after study confirmed this observation and extended it, providing the mechanistic link. Game over. This led to panic at tobacco companies who met secretly in New York’s Plaza Hotel to start their campaign to counter the bad publicity, dubbed ‘the most astonishing corporate deceit of all time’.1
Another example of how correlation and causation can become entangled is a study which showed a correlation between the number of babies being born and numbers of storks nesting nearby.2 This was done to illustrate how we shouldn’t jump to conclusions. The investigators found that there was a correlation, and the correlation passed a stringent statistical test. This indicated that storks deliver babies, right? Not so fast. Close inspection revealed that the reason for the correlation was that storks were nesting near larger villages (which had more chimneys for them to build nests on), where the number of newborn babies was greater. So even though there was a correlation, it wasn’t occurring because the storks were delivering the babies. The correlation was actually with village size. The bigger the village, the more chimneys; the more chimneys, the more storks but also the more babies being born. The final proof of the claim that storks deliver babies would have been a mechanism, which means showing how it would work: stork scientists observing storks actually delivering babies. You never know – and, as a scientist, I must remain open-minded (and slightly crazy) to even countenance the possibility. And the most important scientists were often crazy because they could think laterally. There’s even a study that correlated the places where mad cow disease occurred in the UK with where Brexit voters lived.3 This one was satirical. We scientists laughed and laughed. But for a split second, we all wondered …
People don’t really want to know that scientists are sceptical. What they want is for scientists to nail their colours to the mast, based on the evidence at hand. Anecdote and snap decisions are the enemy of science – what is needed are experiments, data, statistics and a considered response. Sadly, these criteria can be inconsistent with what politicians or media editors and sometimes even editors of scientific journals want, which is where the problems can begin. Donald Trump’s championing of the drug hydroxychloroquine for COVID-19 gives us another egregious example of what can happen when politics and science meet. For political reasons, Trump wanted a rapid treatment for COVID-19. He said the evidence behind hydroxychloroquine as a treatment for COVID-19 was ‘great’ and ‘powerful’. He also asked, ‘What do you have to lose?’ The president of the American Medical Association, Dr Patricia Harris, answered, ‘Your life’. Hydroxychloroquine can damage the heart, and had never been tested against COVID-19, a disease that can involve heart damage. This made doctors very cautious in its use against COVID-19, although it can be used safely for diseases such as rheumatoid arthritis. Dr Anthony Fauci, eminent immunologist and lead member of the Trump administration’s White House Coronavirus Task Force, said, ‘The data are really just, at best suggestive. In terms of science, I don’t think we could definitively say it works.’ Who do you agree with? If you’re a scientist only one thing matters: data must trump politics.
Deliberation is key to science: it helps us see where the truth lies, as opposed to responding with our intuition. Susceptibility to fake news is due to lazy thinking (you can just hear your old teacher saying that, can’t you?) as opposed to inherent bias.
Most of the topics I cover are serious. If we make a wrong decision, we end up destroying the earth. Or killing people on a clinical trial. How does science inform our decisions when it comes to these issues? Each chapter is a question that I address with data and/or experiments to help us (science loves both of these). I’ve done my best to give you the best evidence to support conclusions drawn. You might want to check the facts yourself, and that’s fine. I may have gotten some things wrong. You should correct me – with evidence. That’s how it’s supposed to work. Now, more than ever, people need to believe in science and scientists, as opposed to what you might read on the side of a bus.
At the start of each chapter, I include a quote to inform the topic from artists, writers or comedians that I love. At the end of each chapter, I give my own bottom line. You could be lazy and just read these, because they capture the essence of each chapter. Or you could do the right thing and delve deeper to find out the science that led me to my conclusions.
I hope the book helps and informs you in your deliberations on these weighty matters. I hope you come away positive about your own life if the topics are especially relevant to you. I hope you will feel more comfortable about these topics: not wholly, of course, because we are built to be uneasy. It’s part of our innate nature. Hopefully, you will achieve enlightenment through science. It’s only through dialogue and challenges that we make progress. And I hope you feel more positive about the future – a future where we are all headed, with science as our one true friend.
So, with your glass half full, join me on this mission to reaffirm your vows as a scientist if you are one already, or if you’ve lapsed (no shame in that) to remind you why science is great. And if you’re neither of these, I welcome you most warmly. Together we can navigate our way through enormously important questions. And you will see why we should all be scientists: always questioning, always trying to work things out, but ultimately turning darkness into light.