Ben Goldacre - Bad Science lyrics

1 Matter I spend a lot of time talking to people who disagree with me—I would go so far as to say that it's my favourite leisure activity—and repeatedly I meet individuals who are eager to share their views on science despite the fact that they have never done an experiment. They have never tested an idea for themselves, using their own hands; or seen the results of that test, using their own eyes; and they have never thought carefully about what those results mean for the idea they are testing, using their own brain. To these people ‘science' is a monolith, a mystery, and an authority, rather than a method. Dismantling our early, more outrageous pseudoscientific claims is an excellent way to learn the basics of science, partly because science is largely about disproving theories, but also because the lack of scientific knowledge among miracle-cure artistes, marketers and journalists gives us some very simple ideas to test. Their knowledge of science is rudimentary, so as well as making basic errors of reasoning, they also rely on notions like magnetism, oxygen, water, ‘energy' and toxins: ideas from GCSE-level science, and all very much within the realm of kitchen chemistry. Detox and the theatre of goo Since you'll want your first experiment to be authentically messy, we'll start with detox. Aqua Detox is a detox footbath, one of many similar products. It has been promoted uncritically in some very embarra**ing articles in the Telegraph, the Mirror, the Sunday Times, GQ magazine and various TV shows. Here is a taster from the Mirror. We sent Alex for a new treatment called Aqua Detox which releases toxins before your eyes. Alex says: ‘I place my feet in a bowl of water, while therapist Mirka pours salt drops in an ionising unit, which will adjust the bio-energetic field of the water and encourage my body to discharge toxins. The water changes colour as the toxins are released. After half an hour, the water's turned red … she gets our photographer Karen to give it a go. She gets a bowl of brown bubbles. Mirka diagnoses an overloaded liver and lymph—Karen needs to drink less alcohol and more water. Wow, I feel virtuous!' The hypothesis from these companies is very clear: your body is full of ‘toxins', whatever those may be; your feet are filled with special ‘pores' (discovered by ancient Chinese scientists, no less); you put your feet in the bath, the toxins are extracted, and the water goes brown. Is the brown in the water because of the toxins? Or is that merely theatre? One way to test this is to go along and have an Aqua Detox treatment yourself at a health spa, beauty salon, or any of the thousands of places they are available online, and take your feet out of the bath when the therapist leaves the room. If the water goes brown without your feet in it, then it wasn't your feet or your toxins that did it. That is a controlled experiment: everything is the same in both conditions, except for the presence or absence of your feet. There are disadvantages with this experimental method (and there is an important lesson here, that we must often weigh up the benefits and practicalities of different forms of research, which will become important in later chapters). From a practical perspective, the ‘feet out' experiment involves subterfuge, which may make you uncomfortable. But it is also expensive: one session of Aqua Detox will cost more than the components to build your own detox device, a perfect model of the real one. You will need: • One car battery charger • Two large nails • Kitchen salt • Warm water • One Barbie doll • A full an*lytic laboratory (optional) This experiment involves electricity and water. In a world of hurricane hunters and volcanologists, we must accept that everyone sets their own level of risk tolerance. You might well give yourself a nasty electric shock if you perform this experiment at home, and it could easily blow the wiring in your house. It is not safe, but it is in some sense relevant to your understanding of MMR, homeopathy, post-modernist critiques of science and the evils of big pharma. Do not build it. When you switch your Barbie Detox machine on, you will see that the water goes brown, due to a very simple process called electrolysis: the iron electrodes rust, essentially, and the brown rust goes into the water. But there is something more happening in there, something you might half-remember from chemistry at school. There is salt in the water. The proper scientific term for household salt is ‘sodium chloride': in solution, this means that there are chloride ions floating around, which have a negative charge (and sodium ions, which have a positive charge). The red connector on your car battery charger is a ‘positive electrode', and here, negatively charged electrons are stolen away from the negatively charged chloride ions, resulting in the production of free chlorine gas. So chlorine gas is given off by the Barbie Detox bath, and indeed by the Aqua Detox footbath; and the people who use this product have elegantly woven that distinctive chlorine aroma into their story: it's the chemicals, they explain; it's the chlorine coming out of your body, from all the plastic packaging on your food, and all those years bathing in chemical swimming pools. ‘It has been interesting to see the colour of the water change and smell the chlorine leaving my body,' says one testimonial for the similar product Emerald Detox. At another sales site: ‘The first time she tried the Q2 [Energy Spa], her business partner said his eyes were burning from all the chlorine that was coming out of her, leftover from her childhood and early adulthood.' All that chemically chlorine gas that has accumulated in your body over the years. It's a frightening thought. But there is something else we need to check. Are there toxins in the water? Here we encounter a new problem: what do they mean by toxin? I've asked the manufacturers of many detox products this question time and again, but they demur. They wave their hands, they talk about stressful modern lifestyles, they talk about pollution, they talk about junk food, but they will not tell me the name of a single chemical which I can measure. ‘What toxins are being extracted from the body with your treatment?' I ask. ‘Tell me what is in the water, and I will look for it in a laboratory.' I have never been given an answer. After much of their hedging and fudging, I chose two chemicals pretty much at random: creatinine and urea. These are common breakdown products from your body's metabolism, and your kidneys get rid of them in urine. Through a friend, I went for a genuine Aqua Detox treatment, took a sample of brown water, and used the disproportionately state-of-the-art an*lytic facilities of St Mary's Hospital in London to hunt for these two chemical ‘toxins'. There were no toxins in the water. Just lots of brown, rusty iron. Now, with findings like these, scientists might take a step back, and revise their ideas about what is going on with the footbaths. We don't really expect the manufacturers to do that, but what they say in response to these findings is very interesting, at least to me, because it sets up a pattern that we will see repeated throughout the world of pseudoscience: instead of addressing the criticisms, or embracing the new findings in a new model, they seem to shift the goalposts and retreat, crucially, into untestable positions. Some of them now deny that toxins come out in the footbath (which would stop me measuring them): your body is somehow informed that it is time to release toxins in the normal way—whatever that is, and whatever the toxins are—only more so. Some of them now admit that the water goes a bit brown without your feet in it, but ‘not as much'. Many of them tell lengthy stories about the ‘bioenergetic field', which they say cannot be measured, except by how well you are feeling. All of them talk about how stressful modern life is. That may well be true. But it has nothing to do with their foot bath, which is all about theatre: and theatre is the common theme for all detox products, as we will see. On with the brown goo. Ear candles You might think that Hopi Ear Candles are an easy target. But their efficacy has still been cheerfully promoted by the Independent, the Observer and the BBC, to name just a few respected news outlets. Since these people are the authoritative purveyors of scientific information, I'll let the BBC explain how these hollow wax tubes will detox your body: The candles work by vaporising their ingredients once lit, causing convectional air flow towards the first chamber of the ear. The candle creates a mild suction which lets the vapours gently ma**age the eardrum and auditory can*l. Once the candle is placed in the ear it forms a seal which enables wax and other impurities to be drawn out of the ear. The proof comes when you open a candle up, and discover that it is filled with a familiar waxy orange substance, which must surely be earwax. If you'd like to test this yourself, you will need: an ear, a clothes peg, some Blu Tack, a dusty floor, some scissors, and two ear candles. I recommend OTOSAN because of their strapline (‘The ear is the gateway to the soul'). If you light one ear candle, and hold it over some dust, you will find little evidence of any suction. Before you rush to publish your finding in a peer-reviewed academic journal, someone has beaten you to it: a paper published in the medical journal Laryngoscope used expensive tympanometry equipment and found—as you have—that ear candles exert no suction. There is no truth to the claim that doctors dismiss alternative therapies out of hand. But what if the wax and toxins are being drawn into the candle by some other, more esoteric route, as is often claimed? For this you will need to do something called a controlled experiment, comparing the results of two different situations, where one is the experimental condition, the other is the ‘control' condition, and the only difference is the thing you're interested in testing. This is why you have two candles. Put one ear candle in someone's ear, as per the manufacturer's instructions, and leave it there until it burns down. Put the other candle in the clothes peg, and stand it upright using the Blu Tack: this is the ‘control arm' in your experiment. The point of a control is simple: we need to minimise the differences between the two set-ups, so that the only real difference between them is the single factor you're studying, which in this case must be: ‘Is it my ear that produces the orange goo?' Take your two candles back inside and cut them open. In the ‘ear' candle, you will find a waxy orange substance. In the ‘picnic table control', you will find a waxy orange substance. There is only one internationally recognised method for identifying something as earwax: pick some up on the end of your finger, and touch it with your tongue. If your experiment had the same results as mine, both of them taste a lot like candle wax. Does the ear candle remove earwax from your ears? You can't tell, but a published study followed patients during a full programme of ear candling, and found no reduction. For all that you might have learnt something useful here about the experimental method, there is something more significant you should have picked up: it is expensive, tedious and time-consuming to test every whim concocted out of thin air by therapists selling unlikely miracle cures. But it can be done, and it is done. Detox patches and the ‘ha**le barrier' Last in our brown-sludge detox triptych comes the detox foot patch. These are available in most high-street health-food stores, or from your local Avon lady (this is true). They look like teabags, with a foil backing which you stick onto your foot using an adhesive edging before you get into bed. When you wake up the next morning there is a strange-smelling, sticky brown sludge attached to the bottom of your foot, and inside the teabag. This sludge—you may spot a pattern here—is said to be ‘toxins'. Except it's not. By now you can probably come up with a quick experiment to show that. I'll give you one option in a footnote. An experiment is one way of determining whether an observable effect—sludge—is related to a given process. But you can also pull things apart on a more theoretical level. If you examine the list of ingredients in these patches, you will see that they have been very carefully designed. The first thing on the list is ‘pyroligneous acid', or wood vinegar. This is a brown powder which is highly ‘hygroscopic', a word which simply means that it attracts and absorbs water, like those little silica bags that come in electronic equipment packaging. If there is any moisture around, wood vinegar will absorb it, and make a brown mush which feels warm against your skin. What is the other major ingredient, impressively listed as ‘hydrolysed carbohydrate'? A carbohydrate is a long string of sugar molecules all stuck together. Starch is a carbohydrate, for example, and in your body this is broken down gradually into the individual sugar molecules by your digestive enzymes, so that you can absorb it. The process of breaking down a carbohydrate molecule into its individual sugars is called ‘hydrolysis'. So ‘hydrolysed carbohydrate', as you might have worked out by now, for all that it sounds sciencey, basically means ‘sugar'. Obviously sugar goes sticky in sweat. Is there anything more to these patches than that? Yes. There is a new device which we should call ‘the ha**le barrier', another recurring theme in the more advanced forms of foolishness which we shall be reviewing later. There are huge numbers of different brands, and many of them offer excellent and lengthy documents full of science to prove that they work: they have diagrams and graphs, and the appearance of scienciness; but the key elements are missing. There are experiments, they say, which prove that detox patches do something … but they don't tell you what these experiments consisted of, or what their ‘methods' were, they only offer decorous graphs of ‘results'. To focus on the methods is to miss the point of these apparent ‘experiments': they aren't about the methods, they're about the positive result, the graph, and the appearance of science. These are superficially plausible totems to frighten off a questioning journalist, a ha**le barrier, and this is another recurring theme which we will see—in more complex forms—around many of the more advanced areas of bad science. You will come to love the details. If it's not science, what is it? Find out if drinking urine, balancing on mountain ledges and genital weightlifting really did change their lives forever. Channel 4's Extreme Celebrity Detox These are the absurd extremes of detox, but they speak of the larger market, the antioxidant pills, the potions, the books, the juices, the five-day ‘programmes', the pipes up the bum and the dreary TV shows, all of which we will torpedo, mostly in a later chapter on nutritionism. But there is something important happening here, with detox, and I don't think it's enough just to say, ‘All this is nonsense.' The detox phenomenon is interesting because it represents one of the most grandiose innovations of marketers, lifestyle gurus, and alternative therapists: the invention of a whole new physiological process. In terms of basic human biochemistry, detox is a meaningless concept. It doesn't cleave nature at the joints. There is nothing on the ‘detox system' in a medical textbook. That burgers and beer can have negative effects on your body is certainly true, for a number of reasons; but the notion that they leave a specific residue, which can be extruded by a specific process, a physiological system called detox, is a marketing invention. If you look at a metabolic flow chart, the gigantic wall-sized maps of all the molecules in your body, detailing the way that food is broken down into its constituent parts, and then those components are converted between each other, and then those new building blocks are a**embled into muscle, and bone, and tongue, and bile, and sweat, and bogey, and hair, and skin, and s**m, and brain, and everything that makes you you, it's hard to pick out one thing that is the ‘detox system'. Because it has no scientific meaning, detox is much better understood as a cultural product. Like the best pseudoscientific inventions, it deliberately blends useful common sense with outlandish, medicalised fantasy. In some respects, how much you buy into this reflects how self-dramatising you want to be; or in less damning terms, how much you enjoy ritual in your daily life. When I go through busy periods of partying, drinking, sleep deprivation and convenience eating, I usually decide—eventually—that I need a bit of a rest. So I have a few nights in, reading at home, and eating more salad than usual. Models and celebrities, meanwhile, ‘detox'. On one thing we must be absolutely clear, because this is a recurring theme throughout the world of bad science. There is nothing wrong with the notion of eating healthily and abstaining from various risk factors for ill health like excessive alcohol use. But that is not what detox is about: these are quick-fix health drives, constructed from the outset as short-term, while lifestyle risk factors for ill health have their impact over a lifetime. But I am even willing to agree that some people might try a five-day detox and remember (or even learn) what it's like to eat vegetables, and that gets no criticism from me. What's wrong is to pretend that these rituals are based in science, or even that they are new. Almost every religion and culture has some form of purification or abstinence ritual, with fasting, a change in diet, bathing, or any number of other interventions, most of which are dressed up in mumbo jumbo. They're not presented as science, because they come from an era before scientific terms entered the lexicon: but still, Yom Kippur in Judaism, Ramadan in Islam, and all manner of other similar rituals in Christianity, Hinduism, the Baha'i faith, Buddhism, Jainism, are each about abstinence and purification (among other things). Such rituals, like detox regimes, are conspicuously and—to some believers too, I'm sure—spuriously precise. Hindu fasts, for example, if strictly observed, run from the previous day's sunset until forty-eight minutes after the next day's sunrise. Purification and redemption are such recurrent themes in ritual because there is a clear and ubiquitous need for them: we all do regrettable things as a result of our own circumstances, and new rituals are frequently invented in response to new circumstances. In Angola and Mozambique, purification and cleansing rituals have arisen for children affected by war, particularly former child soldiers. These are healing rituals, where the child is purged and purified of sin and guilt, of the ‘contamination' of war and d**h (contamination is a recurring metaphor in all cultures, for obvious reasons); the child is also protected from the consequences of his previous actions, which is to say, he is protected from retaliation by the avenging spirits of those he has k**ed. As a World Bank report put it in 1999: These cleansing and purification rituals for child soldiers have the appearance of what anthropologists call rites of transition. That is, the child undergoes a symbolic change of status from someone who has existed in a realm of sanctioned norm-violation or norm-suspension (i.e. k**ing, war) to someone who must now live in a realm of peaceful behavioural and social norms, and conform to these. I don't think I'm stretching this too far. In what we call the developed Western world, we seek redemption and purification from the more extreme forms of our material indulgence: we fill our faces with d**, drink, bad food and other indulgences, we know it's wrong, and we crave ritualistic protection from the consequences, a public ‘transitional ritual' commemorating our return to healthier behavioural norms. The presentation of these purification diets and rituals has always been a product of their time and place, and now that science is our dominant explanatory framework for the natural and moral world, for right or wrong, it's natural that we should bolt a ba*tardised pseudoscientific justification onto our redemption. Like so much of the nonsense in bad science, ‘detox' pseudoscience isn't something done to us, by venal and exploitative outsiders: it is a cultural product, a recurring theme, and we do it to ourselves.