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Do You Believe in Magic? - by Paul Offit MD

Wednesday 26 September 2018

One of my pet peeves is homeopathy. I have nothing against natural medicine - many of the pharmaceuticals out there come from plants or are related to chemicals that come from plants - but homeopathic medicine just pisses me off. The reason is that it is based on two ridiculous assumptions: 1) that like cures like - this is based on the fact that quinine taken in large enough doses causes fever like symptoms which are similar to the malaria is also cures, 2) that diluting something until it is not even there still leaves energy traces or something in the water it once touched. This is the basis for homeopathy - that quinine, which cures malaria, causes symptoms somewhat similar to malaria in large doses. To me this is like saying that since I once had a headache and had a glass of water before the headache went away that water cures headaches.

I was expecting this book to be a debunking of "alternative" medicine and it largely was. But it also made some points in favor of alternative medicine which I had never really considered.

As a science-minded person I know that research shows that vitamin C does not cure colds, cancer or most illnesses besides scurvey. But still when I get a sore throat I want to take vitamin C. Even knowing that the myth that it boosts your immune system was largely created and promoted by one man, Linus Pauling, and is mostly an invention of the media, I still believe it. Even knowing better I still feel like it helps me when I get a cold. This is because of the placebo effect which is very real. This is why in clinical studies they test medications against placebos - because just believing that something will help tends to make it actually help.

While the benefits of most alternative medicine are not supported by science (if they were they would be regular medicine instead of alternative), the placebo effect makes this a somewhat murky area. When people go to the doctor for a cold there is generally not much the doctor can do. Antibiotics won't help with a cold (which is a virus) and will just promote antibiotic-resistant bacteria, but most patients expect the doctor to prescribe something. My father is a doctor and when I was a child he would tell me about some of his older patients who he would give a vitamin B12 shot to every time he saw them. He said they expected some kind of medication and they seemed to like the brightly colored vitamin B12 injections so he would give them one. Now with pharmaceuticals advertised on TV he doesn't have that option - the patients come in requesting a specific medication and he can either give it to them regardless of whether they need it or not or let them go away angry and dissatisfied. Of course this is why big pharma loves advertising direct to consumers, but it results in a lot of people taking a lot of medication they don't need, that probably won't help them, and that which may have negative side effects.

This is where alternative medicine comes in. There is a story at the end of the book about a doctor from England who moves to Africa in the 1800s. A visitor mentions about how backwards and primitive the witch doctors were, so the doctor takes him to see a witch doctor. The witch doctor at times chants, at times waves smoke around, at times gives the patients powder and sometimes points over to the English doctor. The doctor explains to his guest that when the witch doctor is chanting the patient has a psychological problem and the witch doctor is helping just by listening and doing something. The people who were given powder had minor ailments which would resolve on their own. For the people with serious medical problems which he could not treat, the witch doctor was sending them to the medical doctor. 

In this story the witch doctor is providing a valuable service - the people who don't need medical attention get to feel better because they talked to someone who listened and gave them something. Whether what they were given actually helps is irrelevant since their problems will resolve on their own. The people who actually need medical attention are referred to the medical doctor. The difference between this story and the reality of today is that the witch doctor knew what his limits were and when to refer patients to a level of care they need. Today most alternative healers do not believe in scientific western medicine and warn their patients away from it.

There is an entire field of medical research devoted to placebo medicine so placebos definitely have a place in medicine. However for them to work requires that the patient believe it will work and the patient is unlikely to believe that if the healer does not. There is a fine line between the need for alternative healers to believe in their remedies and also be aware of when their patients need actual scientific medical care. If they can manage this I think alternative medicine has a valuable place in medicine. Unfortunately it seems that most healers are not aware of their limits.

Labels: books, science, medicine
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Einstein's Intuition, by Thad Roberts. is one of the most amazing books I have read in a long time. I saw Thad giving a TED talk about visualizing nature in more than the four dimensions we normally experience, and then before it was even over I started trying to track down this book. 

I have always assumed that there are more dimensions than the three spatial and one time dimension we humans are familiar with. The biggest objection to this assumption is usually: "if they exist, why don't we see them?" As far as I'm concerned the answer is because perceiving them doesn't contribute to our survival, therefore there is no evolutionary advantage to perceiving them. More typical answers from the scientific community are along the lines of "they are very small" or "they are rolled up." 

When I read "A Brief History of Time" as a child, I became fascinated with cosmology and quantum mechanics. One of the key ideas of quantum mechanics is that we can't know where a particle is or where it is going. To represent them quantum mechanics uses a "wave function" which is essentially a probability wave that gives you the probability that the particle will be in a certain location at a certain time. As a child I thought this was unbelievably cool, but as I grew and I thought more about it I started to have trouble with the interpretation of this concept. The typical interpretation of quantum mechanics is that the particle is not actually in any one location until we measure it, at which point the wave function collapses and the particle solidifies to a specific location. This has two rather disturbing implications. The first is that we humans somehow control the universe by the act of observing it, (this idea is explored in the fantastic fiction book by Greg Egan "Quarantine.") In my opinion this idea is the height of hubris, giving humans near magical powers to change the universe with our minds. The second implication is that the universe is stochastic, meaning that it is essentially random - we can predict probabilities but it is impossible to predict anything for certain.

Over the years I had convinced myself that the wave function was in fact a probability wave, and that we humans just couldn't know for sure where particles are going to be because of the limits of our minds and our technology. I thought it was crazy for scientists to actually think that the universe is random, that "god plays dice with the universe" to paraphrase Einstein. In my mind, that thought contradicts the whole basis of science. I believe that if one had complete knowledge of the universe, of every single particle's position and energy at any given point in time, one would be able to know exactly where every particle would be at any point in the future. The problem with this is that to model the entire universe one would need a computer that is far bigger than the entire universe, the easiest way to model the universe would be with an exact copy of the universe, which is obviously rather impractical. 

The part of Thad's TED talk that grabbed me in was when he showed a simulation of what it would be like to be a two-dimensional being. He showed a line that had colors of different sizes flashing on it in different areas for different amounts of time. There was no discernible pattern. Then he widened the perspective by a dimension, showing that the line was in fact a line cut from a video of a pool table with balls bouncing around it. When we add the extra dimension in it is easy to find the patterns, from the two dimensional point of view it looks like splotches of color are just popping into and out of existence randomly - much in the way quantum mechanics models particles.

Mr. Roberts apparently has the same issues with quantum mechanics that I do, and he proposes a theory which pretty much offers a simple and intuitive explanation for not only quantum mechanics, but the nature of space time and even the four fundamental forces of physics. While there is really no way to prove or disprove his theory yet, I greatly admire his audacity at thinking outside the box and challenging ideas that are widely accepted even though they don't really make that much sense. His theory is that space is quantum - that spacetime, rather than being an unbroken continuum of empty space, is in fact composed of what he calls "quanta" - discrete, tiny units. When an object moves in space it moves from one quanta to another. This implies that nature is in fact, eleven dimensional - we have the four dimensions we normally experience, plus three additional spatial dimensions and one time dimension in which the quanta exist, and three more dimensions with the quanta. 

The genius of Roberts' theory is that it offers a single, unified, intuitive explanation for many physics issues. For example, the four fundamental forces - gravity, nuclear weak, nuclear strong, and electromagnetic - can now be reduced to a single phenomen of vortexes in the quanta. The Planck constants become measurements of the size of the quanta. Time becomes an attribute of the quanta. Why the speed of light is a universal constant is also explained. Quantum tunneling is just particles jumping from one quanta to another through empty spaces in between them, rather than particles vanishing and reappearing somewhere else for no obvious reason.

At it's base, this theory is a variation of Bohmian mechanics or pilot-wave theory, which is a deterministic interpretation of quantum mechanics which uses hidden variables - variables we are not aware of. Adherents of the traditional stochastic Copenhagen interpretation have written proofs that these hidden variables can not exist. While I have not read any of these, the fact that someone can even try to prove that something we don't know about does not exist seems to me to be the height of insanity. Quantum mechanics is often touted as the most successful theory in the history of physics. It is very successful at predicting probabilities, so if you accept that the universe is random that may be true. If however, you believe that things happen for a reason (on a subatomic level) and that those reasons can be understood, the theory becomes a heuristic for predicting what could happen, without really understanding what actually is happening. 

Mr. Roberts shares my deep skepticism about received truths. This basically means that nothing you are told or you hear should be accepted as true until you understand the reasoning and/or facts behind it. This book questions the "why" behind much of current physics theory, and realizes that much of it doesn't make sense, so he comes up with another theory that does make sense. While Thad gives no real direct evidence to support his quantum space theory, he does provide a great deal of circumstantial evidence, and he has obviously thought all of it through very carefully (I should note that I am not sure that direct evidence is really possible given our current technology.) However, the fact that he is willing to abandon all of the things that are generally accepted as being true and to think outside the box is just amazing to me. There is nothing I love more than a completely new way of looking at things, and this book definitely provides that

Labels: books, science
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