The cage of ‘can’t be’

“This Zen in the heart of science is revealed when the practitioner sets aside arbitrary beliefs and cultural preconceptions, and approaches the nature of things with ‘beginner’s mind’…seeing with humility, curiosity and fresh eyes”
Dan Drasin

 

 

It began with a dinner party chat. The first of countless threads of conversations which weave together as one, for the sake of this story. The people differ but their presentations don’t. The tablecloth itself could be woven of words and arguments from one dinner and laid out for the next – and the same sceptical coughs, narrowed eyes, upwards inflection of the ‘really?’ from different throats, faces and voices would fall softly to the table and lodge in their familiar places among the threads. All saying the same thing – ‘don’t rock my world’.

Peter sits down across the table from me. I’ve known Peter for decades; he’s married to an old friend of mine. A lawyer and businessman, he’s always good for a lively debate.

It doesn’t take long for us to be disagreeing about science. Probably about – hmmm – half a second after I told him I was now working as an alternative health therapist. He almost spat soup at me as he spluttered “You can’t be serious. It doesn’t make sense. What about double blind trials, what about the placebo effect?”

Be reassured, I am not going to ask you to accept alternative therapies. That is another story. I won’t be dragging you there today.

* * *

I’m not sure how it happened. Despite having a degree in Biochemistry, one day I found myself experiencing a reality that seemingly didn’t obey the laws of science, and therefore, I inferred, could not be real. Thanks to the generosity of friends (and sometimes dinner guests) who were willing to discuss this experience with me, I began to see that something was separating my experience of reality from accepted mainstream views. I Caging me in. The cage of ‘can’t be’.

I can’t deny my experience (and believe me, my mind has tried). So I’ve come to wonder if it is the cage itself that needs examining. If a scientific law can’t describe experimental results, then maybe, but not necessarily, the law is wrong. At the very least, it is worth re-examining. First, I need to explore what it is that stands between my worldview and that of many other scientists.

Alternative health therapy is just one part of my life which does not fit with mainstream medical science and which challenges my and others’ ideas about science. For the sake of describing my experience, we could equally be talking about many other phenomena that are not accepted by mainstream science, even quantum biology (which has led perfectly reputable physicists down a rabbit hole as they followed their theoretical and experimental models). But it has led me into this mind-pickle. So perhaps it will help me find my way out.

My gradual departure from the mainstream medical view of health began as most journeys do, one step at a time, and in my case, with the stories of those around me. One day in the 1990s, when a friend told me she’d sought alternative health help for her eight-year-old’s behavioural issue. The next school day the teacher apparently asked what my friend had done – the child had been so settled and happy in class. I figured it was probably nothing, but the scientist in me was curious to see if this could be repeated. Over months and years, I sent a stream of friends and family members to the same alternative therapist. A sceptical friend of mine who experienced severe stomach pain after eating had two appointments; the first remedy did nothing; the second, a month later, stopped the pains – and, 20 years later, his pains have not returned. A woman who had a dry cough her whole life stopped coughing. Cold sores disappeared. Life-long asthma retreated. Hay fever – medicated for decades – disappeared with a single remedy.

Bizarre. The scientist in me, and the sceptic, tried to reason these results away in any way I could. I told myself that these were isolated examples, or coincidences. The placebo effect, perhaps.

But the curious experimenter in me still had questions. If it was the placebo effect, surely, then, it would have had some effect with the first remedy that each person was given? Why would an alternative health hay fever pill be more effective as a placebo than a well-researched hay fever medication, given with confidence by a medical professional? How could a placebo work for a very young child?

Ever more curious, I enrolled in a course to study this further. As a student, I learned of many more cases. An Alzheimer’s patient, retreating into himself and on medication, after a single remedy recognises his doctor and starts reading and discussing the news again. People with recurrent ailments, such as urinary tract infections, migraines, eczema and bronchitis, no longer suffer these complaints, even years later.

After studying for four years, I took tentative steps towards practising. This proved tricky for me to resolve internally. It’s one thing to study; another to do. My inner ‘Peter’ was loud and critical, and remains so. He found studies refuting this therapy and recounted these loudly inside my head, daily. It’s the placebo effect; it’s the consultation; it’s coincidence; the person might have been going to get better anyway.

But the cases continued. Children with asthma used their inhalers less, and then not at all. A one-year-old who had been hospitalised twice in one year for pneumonia responded within minutes of taking a single remedy; while he grizzled on the floor with his latest bout, his parents gave him the remedy and ten minutes later he climbed onto a chair and demanded food. Although he had been to the GP ten times already that year, after that one single remedy, he did not go to the doctor again in the following twelve months.

Tiny babies with eczema on 90% of their bodies were given a remedy and a month later, the eczema remained only on the elbows and knees, and they no longer needed to use steroid creams. A three-month-old baby screamed on each car trip. She was checked medically, but nothing out of the ordinary was found. An hour after the baby was given a single remedy, she cooed happily for the whole car ride. Four months later, the improvement was still in place

It would have been far easier for me if it had not been so effective in these and the countless other cases I saw. It would have been easier for my brain, easier for my internal dialogue.

Up to this point, I’d had one foot in a small boat, one foot on firm land. I sensed that the gap was widening and that I had to decide. I could clamber back out of the boat, back onto the shores of accepted medical knowledge, and bury my experiences. I could join Peter and others on the beach and look out at the sea and the small boat and say, no, there is no evidence, so let’s just leave it. The evidence that is there is conflicting. Better not to trust a small boat on this water.

This would be the easier choice.

But once you have seen something for yourself, it’s hard to turn back. C.S. Lewis wrote, ‘Really, a young Atheist cannot guard his faith too carefully.’ Once you have been encumbered with experience, only the horizon tantalises. What else is out there?

I decided to stay in the boat, and gently pushed off from the shore. I looked longingly back at the shore of seeming certainty, where randomised placebo controlled trials, published in esteemed peer-reviewed journals light the way forward. I looked back to where things seemed to make sense and fitted with mainstream medical ideas. That was a place in which I spoke only one ‘language’, and everybody understood.

Those on the shore seemed to see nothing out here. Just the edge of their world. Nothing more.

It’s important to differentiate between belief and experience. I don’t believe in any of this. I experience it.

We must do one of two things to do with our experiences: ignore them, or see if they can be repeated, investigated further, and ultimately explained.

With what I know now, I can’t stay. I am a displaced person.

It doesn’t take much for my inner ‘Peter’ to have a field day; he needs only to find a compelling medical author who argues that evidence-based medicine is the only reliable tool. Then I remember that I’m doing this only because of the results I have seen. One case at a time, this is my own personal evidence-based experience. Each case adds buoyancy to my little boat, causing the bow to rise a little higher. I hold on tight and see where it takes me.

Turns out it takes me into arguments, where the positions on both sides are entrenched. And over the years I have noticed common themes in the arguments: a perceived lack of robust evidence, and a sense of my therapy’s untrustworthiness.

For years I have been peering at it as if it were a creature in a zoo – something strange, foreign, unfathomable. It is now time for me to ask what it is about science that doesn’t allow my experience.

What are the bars of this cage?

* * *

I look across the table at Peter. It occurs to me that we don’t actually disagree about science itself. Both of us would say science must be objective, repeatable and independently verifiable. Science can and must provide us with a way of overcoming our biases and personal prejudice; results are true, regardless of whether you believe them or not. But perhaps there is something in the way in which science is perceived that is getting in the way.

Is it the way studies are carried out? As the soup is served, Peter questions – “Would this stand up to a double-blind trial?” It’s a good question. Randomised placebo controlled double blind trials are those where new drugs (or treatments) are tested. A subject may, for example, be given either a drug or a placebo. Only those running the trial know which patients get the drug, and which get the placebo.

Randomised controlled trials are a useful and simple way of ensuring that experiments are free from bias. And randomised double-blind and placebo controlled studies showing alternative therapies work have been published in some of the best of medical journals in the world, including the Lancet, the British Medical Journal, Rheumatology and the European Journal of Paediatrics. But randomised controlled trials are just not the only way. I recall a quote by Sir Michael Rawlins, the former Chair of the UK’s National Institute for Clinical Excellence who says “double blind trials have for too long been considered the ‘gold standard’ of evidence and should be replaced by a diversity of approaches that involve analysing the totality of the evidence base.

One way of analysing the totality of the evidence base is to look at outcomes research. Later an after-dinner online search will take me to the American Paediatric Surgical Association website where I learn that for clinicians and patients, ‘outcomes research provides evidence about benefits, risks, and results of treatments so they can make more informed decisions’. If studies are done on a large enough scale and looked at on mass (such as meta analyses of large scale clinical studies) then these can also be a useful way of looking at a method of treatment.

In the November 2014 Discover magazine, Maggie Koerth-Baker discusses a different approach to clinical trials – the ‘N of 1’ study, where there is only one participant. She says “most medical experiments involve hundreds or thousands of patients. But sometimes the right number is one”, and says large trials are about averages and “averages don’t necessarily tell you what will happen to an individual”. She says “at the end, what you get is a patient-specific, individualized answer. It’s a process shown — by controlled clinical trials, no less — to improve patient outcomes.”

The ‘N of 1’ approach has been used successfully to treat people with osteoarthritis, chronic pain and ADHD. And outcomes research is a mainstream approach to healthcare research, so it can’t be the way we run clinical studies which is separating Peter from my world.

But for now I’m at the party and, listening to Peter, I am wondering whether my cage is created partly because science is often portrayed by media as definitive, authoritative, all knowing. We hear that science gives us certainty. As public we demand this, and the media delivers. Scientific discoveries are dished out like a successful political message – sound-bite sized and simple.

I can’t blame Peter for thinking science provides us with certainty, especially given the media’s message. As humans we like security; emotional, physical, financial. It’s natural we gravitate to the dependable, sure and solid; to science. Science provides us with a structure on which we stand and examine the world; a solid rock of understanding based on sound research from which we can begin to make sense of the world around us. It just doesn’t end there.

Scientists themselves know that science isn’t certain at all. Researchers love uncertainty; it’s the exciting part. As the former New Zealand Chief Government Science Advisor Sir Peter Gluckman said, “It is wrong to assume science is about certainty, for in most of science certainty is not possible; it is largely about reducing uncertainty”.

So it can’t be the uncertainty angle that challenges scientists, although it may be bothering Peter.

As the soup bowls are cleared away, Peter (barely concealing his frustration) says there is no evidence-based science supporting something as crazy as this. Part of me is with Peter on this one. I delight in the Mitchell and Webb parody (where the comedians try to save an accident victim by making a remedy from the car that just hit him) https://www.youtube.com/watch?v=HMGIbOGu8q0. I’m almost swayed by Ben Goldacre’s ‘Bad Science’, where he says these things have been thoroughly researched, with innumerable trials, and have been found to perform no better than placebo. (Although when he says Samuel Hahnemann, ‘conjured’ up the concept of ‘like cures like’, Goldacre displays his bias. Both the Greek physician Hippocrates and the Renaissance physician Paracelsus wrote of this concept. And many current medical techniques including immunisation, fertility treatment, contraception and allergy desensitisation are based on this precept.)

Dana Ullman’s open letter to Wikipedia founder Jimmy Wales in the Huffington Post unpicks the accepted cloth of scepticism to reveal the bias behind seemingly scientific comment on these things. Ullman points out the irony in that only one of the many references in Wikipedia’s first paragraph on homeopathy was published in a peer-review medical journal, a standard they require for homeopathy trials. This reference, a 2005 meta-analysis by Shang et al, was co-written by a Professor Egger who, before carrying out the meta-analysis, wrote to the Lancet Medical Journal saying that ‘he expected to find that homeopathy had not effect other than that of placebo’. Ullman goes on to list a series of unrefuted randomised controlled trials showing efficacy of homeopathic treatment that are published in mainstream medical journals. https://www.huffpost.com/entry/dysfunction-at-wikipedia_n_5924226

Evidently those on each side of the debate have entrenched positions. Even the biggest review of homeopathy ever carried out, the 2011 report funded by the Swiss government which concluded homeopathy is effective and safe, is dismissed by some (as being compiled by those with bias).

Of course there will have been bias. There is bias on both sides, for all sorts of reasons. To try to look at all these studies, and whether they are properly done, is beyond the scope of this work. But neither the evidence for or against homeopathy convinces me of its respective position. The compelling evidence for me is my own experience. Although I could be expected to be pleased to hear research supporting what I do, it doesn’t move me. I am happy only that it may help others to understand or to try it. It does not affect my own experience of this world.

Weirdness

In the meantime, if we can have no agreement on the research, we can at least look for other bars of the cage. Is it the inherent weirdness of what I do? Many people (including me at times) find the high dilutions in homeopathy, where a remedy could be more dilute than one drop in all the oceans of the world, biologically implausible (although at least two Nobel science laureates have said their research shows something going on in these high dilutions). I guess this is closely related to the uncertainty angle but I’m wondering if it goes a little further. Some people find what I do too weird to entertain. As author Tom McFarlane has said, for many people, “if something is not rational, or verifiable through the physical senses, then it is not real”.

At times what we can see looks too strange to be true, potentially violating every understanding we have about our world. This has happened before – Einstein presided over the discovery of some of the weirdest science to date. Quantum mechanics predicted and showed both theoretically and experimentally that an electron can be in two places at the same time. Even Einstein , was not completely convinced by quantum mechanics.

For nearly a century physicists have managed to contain the weirdness to the quantum level; these weird behaviours only occurred at tiny dimensions and were no threat to our understanding of the world around us. Physicists still say it is hard to imagine quantum mechanics in the warm and wet environment of living cells. MIT Professor Seth Lloyd says ‘It’s hard to see how this could be coherent enough for quantum mechanics… but it seems lots of systems contain internal weirdness. Maybe this is how the world works?” He confesses – “I thought Quantum Biology was crazy, but now I’m hooked.”

Consciousness writer Tom McFarlane says that science doesn’t always see all of reality, and cannot always explain everything it sees, like the visually impaired man who knows textures but not colour. Einstein tells us – “if at first the idea is not absurd, then there is no hope for it”. And British scientist JBS Haldane said – “the universe is not only queerer than we suppose, but queerer than we can suppose”..

So as the main course is being served (appropriately the dish is one our hostess has adapted as an experiment ‘to see if it works’, she says), I consider how even the greatest scientists acknowledge that results can be both observed and absurd. And I wonder how would it be if research was dropped whenever the results were unexplainable? Watson and Crick may not have continued their research into DNA if they had not persisted with their early ideas and trusted their observations – based on the scientific method – against the accepted scientific understanding of the day.

And the tools of this observation are continually changing. Biomedical scientists can now see and extract DNA in the laboratory. Today we know there are ‘instruments’ as complicated as our human observer selves, who have been shown to affect the outcomes of experiments by the very act of watching. As Heisenberg cautions us, “we have to remember that what we observe is not nature in itself but nature exposed to our method of questioning”.

British neurosurgeon Wilfred Trotter said “The mind likes a strange idea as little as the body likes a strange protein. If we watch ourselves honestly we shall often find that we have begun to argue against a new idea even before it has been completely stated.” History is full of examples of ideas which seemed absurd at the time, but proved to be right. Crick and Watson were initially instructed to drop their research into DNA but continued it as bootleg research. Astrophysicist Subrahmanyan Chandrasekhar put forward his theory of black holes in the 1930s but criticism from another astrophysicist meant his work was nearly forgotten. He was eventually awarded the Nobel prize in physics in 1983. The doppler effect was proposed in 1842 but bitterly opposed for two decades because it didn’t fit with accepted physics at the time.

History is equally full of examples of high ranking scientists claiming we now know all there is to discover. In 1894 Albert Michelson, the first American physicist to win a Nobel Prize declared, ‘The more important fundamental laws and facts of physical science have all been discovered, and these are now so firmly established that the possibility of their ever being supplanted in consequence of new discoveries is exceedingly remote.”

It’s easy to laugh now, especially as the example is old. But our ideas about science can change quickly. It wasn’t long ago antibiotics were dispensed freely. They’ve certainly helped keep many alive (and if you have meningitis you will still need those drugs). But we now know if we use them freely we risk antibiotic-resistant bacteria. And Dr Martin Blaser, director of the Human Microbiome Program at New York University, is publishing research showing the long-term use of antibiotics has wiped out our natural microbiome, or bacterial colonies, in our gut. Blaser says this is contributing to the rise of what he calls our modern plagues: obesity, asthma, allergies, diabetes, and certain forms of cancer.

The comfort of science

Peter’s discomfort with my work is understandable: weirdness and uncertainty are not at all comfortable. Recently Oxford University psychologists suggested that a faith in the explanatory power of science increases in the face of stress or anxiety and that a “belief in science” may help non-religious people deal with adversity by offering comfort and reassurance, as had been reported previously for religious belief. “We found that being in a more stressful or anxiety-inducing situation increased participants’ ‘belief in science’,” Dr Miguel Farias, who led the study in the Department of Experimental Psychology at Oxford University, said.

“While most people accept science as a reliable source of knowledge about the world, some may hold science as a superior method for gathering knowledge, the only way to explain the world, or as having some unique and fundamental value in itself” Dr Farias said.

I understand that for Peter, my work seems weird, unproven, unfamiliar. Short of showing him what I do (and that won’t convince a sceptic), how can I help him understand? Who is actually being caged in here?

Film maker and writer Dan Drasin says that for some sceptics, accepted theory overrides any actual evidence that might challenge it. He describes how some sceptics portray science ‘not as an open-ended process of discovery but as a holy war against unruly hordes of quacks’.

To me science is an unravelling, an observing, an unpicking. It’s not fixed. We don’t arrive, park up, turn off the engine and release a satisfied sigh of completion. Other than momentarily that is.

It is as if an explorer having staked a flag at the south pole, – “this is science! – it rules!” (it does by the way) – climbed out of their tent after a well-earned rest only to find that overnight the south pole had moved, leaving the flag off-mark. Because science is the ground beneath the mark, the process not the place. It’s always moving.

How did I wind up in the middle of this dinner party debate? I trained as a scientist and yet I’ve ended up here – experiencing a world that, every day, appears to conflict with science.

In fact it doesn’t conflict with science. It is science which has led me, moment by moment, experience, bafflement, repeat, experience, bafflement, repeat, year after year, to this place. Everything I’ve come to understand has challenged me as much as I imagine it challenges Peter. I can understand his caution; if I hadn’t experienced this first-hand, I wouldn’t believe me either.

I’ll never convince Peter but it’s been good to see him, and to talk about these things. As we prepare to leave, I glance back at the table and see for the first time, what was always there. I am myself a cloth; the threads run both ways in my mind – the ‘scientific’ me and the seemingly unscientific ‘homeopathic’ me – weaving together to create the fabric of who I am.

Later I find online another article by Dan Drasin, about the ‘Zen of science’; “Like all systems of truth seeking,” he writes, “science, properly conducted, has a profoundly expansive, liberating impulse at its core. This Zen in the heart of science is revealed when the practitioner sets aside arbitrary beliefs and cultural preconceptions, and approaches the nature of things with ‘beginner’s mind’…seeing with humility, curiosity and fresh eyes”.

With all the fighting to keep ‘mainstream science’ clear and separate from that which does not fit its rules, it’s almost as if science is presented as a fragile structure, which we must tender carefully to prevent a return to another dark age. Yet science is not fragile; it can handle weirdness, discomfort and uncertainty. In fact it’s a wonderful beast – animal or machine, take your pick. And it’s ready to ride. As long as we remain open about where it may take us. If we follow a scientific method – that is, create useful experiments, observe what we see and try to repeat this – it can never be the science that is at fault. Only our understanding of it.

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