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Interview with Dr Steve Novella by Dr Rachael Dunlop
The Skeptic Zone
#6 - 21.Nov.2008


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Interview with Dr Steve Novella by Dr Rachael Dunlop for The Skeptic Zone Podcast.


This text may be reproduced in full or in part unaltered and with due credit to "The Skeptic Zone Podcast" and with mention and/or link to URL www.skepticzone.tv


Rachael Dunlop: Steve Novella is a clinical neurologist and academic at Yale University School of Medicine. He is the co-founder and president of the New England Skeptical Society, the associate editor of the Journal of the Scientific Review of Alternative Medicine, and a contributing editor to QuackWatch, which is a consumer advocacy website dealing with all types of health fraud. Steve also writes the monthly column Weird Science for the New Haven Advocate. But of course most of you would know him best as the host of the Skeptic's Guide to the Universe, which is one of the most popular skeptical podcasts in the world and currently has about 40,000 listeners each week. There's also a companion podcast called Skeptic's Guide 5x5, and on top of this Steve has several blogs, some of which he contributes to. His own is Neurologica. He also contributes to Science-Based Medicine and Skepticblog, which is the blog of the Skeptologists. So, welcome to the Skeptic Zone, Steve!

Steve Novella: Thanks for having me, it's great to be with you guys.

R: Well, based on what I've just summarized about what you do, let me start by asking you, how do you find the time?

S: It certainly is a lot of work, I mean, there's no way around that, writing a daily blog and producing two podcasts in addition to that medical career thing I got going as a sideline-

R: That's just a part time thing, right? *laughs*

S: Right, just part time. *laughs* But you know, part of it is the beauty of computers, I always, or pretty much always, have access to at least my laptop, so I can make productive time whenever possible. But also, in all honesty, it's, what I do, is not very different to my academic colleagues, you know, you have a pretty much nine-to-five either clinical or research schedule, and then nights and weekends you spend doing your academic writing or research, or editing a book or something-

R: Sure.

S: -I just choose to funnel my academic time primarily into promoting science education and science understanding.

R: Sure.

S: So, I'm not really any busier than my average academic colleague, to be honest with you.

R: Well, actually, Steve, we've got some breaking news to tell our listeners in the Southern Hemisphere, haven't we? We at the Skeptic Zone are very excited to announce that just a few hours ago, you and the rest of the SGU announced that you're finally coming to Australia, yay!

S: We are definitely planning on coming to Australia in 2010! Richard Saunders was kind enough to invite us down, and we jumped at the chance.

R: That's fantastic news. And that's going to be for the 2010 Australian Skeptics National Convention in Sydney.

S: Yeah, we are really, really looking forward to it.

R: Well, the whole team is going to come, right?

S: Yes, the whole SGU team.

R: Fantastic.

S: No-one would stand being left behind, so... *laughs*

R: *laughs*

S: We had to bring everybody.

R: That's going to be very exciting, we look forward to that. Now, one of my bugbears, Steve, and I think this is certainly one of yours as well, though I don't know if you'd call it a bugbear, but, it's alternative medicine, which is also known as CAM, or woo as some people call it. And of course, you've done a lot to educate people about some of the dangers of alternative medicine through your blogs and the websites you have. But one of the things you mentioned to me recently was that there aren't many doctors out there who are doing this, and I, like you, tend to go to psychic shows and well-being festivals, and I sat through almost every episode of the filming of "The One", which as you know Richard Saunders was the skeptical judge on-

S: Yes, that's right.

R: -and it was for education and research. But what I wanted to ask you was, why do you think more doctors and science professionals don't get out there and do this stuff, and make a fuss?

S: Yeah, there's a curious lack of outrage amongst rank-and-file academics and physicians as to what's happening. I speak quite a bit to other physicians about this issue. Those who see what's going on for what it is, which, to briefly summarize what I think the alternative medicine or CAM movement is about: it's basically an attack of the scientific basis of the standard of care. It's an attempt to create a double-standard, to carve out this separate standard where science and good science is not the standard of care-

R: Yes.

S: -in essence, so that anything can go, because obviously, you know, if you're a true believer or proponent of a treatment modality that does not meet the rigorous standards of science, or you're a charlatan or fraud who wants to make money off of a treatment that doesn't meet ethical or scientific standards, then you'd like to have this carved-out, special exception for you where you can pursue your trade without having to do things like research or-

R: *laughs*

S: -have basic science support your notions. So... And a lot of it is also inserting faith or spirituality into medicine-

R: Sure, yeah, yeah.

S: -as well, yeah, a lot of these belief systems are basically religions. Ah, so that's what's happening, yet I think just most of my colleagues don't understand that, they don't really see that. And part of the reason is because the CAM proponents have become very expert over the decades at couching what they're doing in very appealing terminology, they are masters of the language. In fact, the entire notion of complimentary and alternative medicine, or integrative medicine is another term that's being used, is an attempt to control the language, it's saying "It's an alternative" Well, it's an alternative to what? To science-based medicine?

R: To medicine that works, yeah.

S: Or it's complimentary or integrative, or in other words, you can integrate medicine that is based on science and we know is safe and effective with what, treatments that don't work, or that which we don't know is safe and effective? It's contradictory, kind of like saying we can integrate intelligent design and evolution education. Well, no, you can't teach students legitimate science and then confuse them with a bastardization of science at the same time. There's certain things that just can't be integrated together. So, they've done a really good job at controlling the language, they've couched what they're doing in terms of things like 'holistic medicine', saying we want to treat the whole person, you know - mind, body, spirit. It sounds really good superficially, but it's really all just a hand-waving distraction from the only issue that really matters, and that's getting away from science as the standard for healthcare.

R: Yeah.

S: So, part of it is just confusion to what's actually going on, the other part of it is misguided political correctness or notions of democracy, fairness or even academic freedom. In the US especially those kinds of themes play really, really well, and I hear that a lot from my colleagues, you know, when I say "Why aren't you outraged at this?" "Oh, we're just being fair and open and we're not going to repress someone else's ability to pursue what they believe in or claim what they what."

R: Which is dangerous, isn't it? Because a lot of this stuff is dangerous, in the sense that some of these practitioners will tell you to stop taking your conventional therapy and start taking theirs. And in that case, you're putting people's lives at risk, potentially.

S: Yeah, absolutely. I mean, that is the most obvious direct harm, diverting treatment away from treatments that are effective. There's a guy selling his supplements in Africa for AIDS telling his clients, "Stop taking your anti-retroviral drugs! Take my herbs instead.", directly telling them not to take the conventional medicine. So that happens a lot, sometimes even when it's not intentional, it's just diverting people's energy, time and attention away from more effective treatments. Sometimes patients cannot afford their prescription medications or their conventional treatment and the alternative treatment, therefore they have to choose between the two and, you know, often they'll choose the one that's offering the most hope, even though it's a false hope.

R: That's true, yeah.

S: There's many other kinds of harm, though too, while we're talking about that. Sometimes there's direct harm, direct physical harm from the treatment itself, not all of these treatments are safe. You know, chelation therapy has resulted in death, even a young child who was being treated with chelation therapy for autism, which is not an indicated treatment. This is based upon the mercury poisoning notion which is false. There's other harm, you know, if you inculcate a bizarre or anti-scientific notion of health and disease, there's lots of downstream harm from that: there's financial harm, and there's tremendous psychological harm, and I see that myself. Patients invest a great deal of emotion, and again, hope, into what turns out to be a false hope. It's like rubbing salt into the wounds, they, often times, have a desperate, even maybe terminal, illness, and then someone comes along, takes a huge chunk of money from them, wastes their time and energy with false hope for a period of time, and then they have that second letdown when it kind of dawns on them that "I've been hoodwinked" On top of having a terminal illness, now I'm a victim of fraud. It's a double-whammy.

R: I do have a friend in Australia who is currently undergoing chemotherapy, and she's got very virulent cancer, she's very sick, she's not long for this world, and of course she's desperate and vulnerable, and she recently fell victim to hair analysis. And these people have told her that she can't eat tomatoes, and she can eat macadamia nuts but not peanuts, and this woman is tragically going to die soon and her whole life is focused around "Well, I can't have a glass of wine because the hair analysis people said I shouldn't", and it's really compromising the last days that she has left.

S: That's an extremely good point, and I see that as well. I deal with often terminal neurological illness, such as ALS or motor neuron disease. You know, often times for some patients all we could really do for them, if it's an incurable illness, is try to make their remaining time as long, productive and high-quality as we can, and that has value: if you have a couple of years to live, you want to spend that with your family or your loved ones and be as active as you can and functional as you can be.

R: And let's face it, you want to have a glass of wine, don't you? *laughs*

S: Yeah, right. *laughs* That last time is taken away from them while they're pursuing these false hopes. I've had patients go to China to get fake stem-cell therapy, and they die over there, either of their disease or of complications of this treatment or infections or whatnot, but only after being bilked for $30,000 - $40,000 for the treatment, for the whole deal. And that's it, their last year of life was stolen from them just so somebody could make a fast buck.

R: And, in your opinion, that's fraudulent behaviour, not deluded behaviour, would you say? From the alternative medicine proponents, in that case?

S: Well, obviously, there's a whole spectrum, within the broad umbrella category of alternative medicine. It's hard to always say for sure with an individual, 'cause you can't read minds, how deluded are they versus fraudulent. There are some cases where you know they have to know they're committing fraud, like psychic surgery, with is popular in the Philippines.

R: Sure.

S: They're pretending to psychically put their hands inside somebody and remove tumours, or whatever they psychically diagnose. And they're palming chicken parts, and then revealing those to the people in order to deceive them. That's a level of deception that requires culpability, it requires knowledge of what you're doing, that's premeditated. Then you get to the gray areas, with these stem-cell clinics in China, and certainly by their behaviour, I think it's not so much that they necessarily feel that there's no potential value to what they're doing, I think they just don't care. They have some plausible deniability, they're doing something, they're get tons of money from desperate, wealthy Westerners, you know, from their point of view. Whether or not it works is kind of a secondary concern. So, it make not be that they know it's fraudulent, so much as they just don't care if it works or not. And then, definitely, at the other end of the spectrum, there's the true believers, to who this is a religious belief to them, or they're just so confused by the pseudoscience that they really think that it works or what they're doing is legitimate, they're just profoundly confused about the science.

R: Mmm. So that sort of leads me onto the next question, which is about the hijacking of scientific terminology by CAM proponents. Recently, I attended the Mind-Body-Spirit, or -Wallet, festival, as we affectionately call it in Australia-

S: Right. *laughs*

R: -and you'd be amazed, Steve, did you know quantum technology is working in alternative medicine? I don't know if you've heard about this-

S: Oh yeah!

R: *laughs*

S: Quantum technology is awesome, you know, throw the word "quantum" in there and it becomes instant pseudoscience.

R: Oh yeah, it's fantastic.

S: It's all about the marketing, which is one thing that the CAM industry does extremely well. It's all about the marketing. They also have an advantage in the fact that they're not constrained by things like facts and ethics.

R: Exactly.

S: If you're not so constrained, you can model your marketing purely for psychological impact. There are certain themes that they follow: one theme is the new gee-whiz technology, and this has been going on for a long, long time, ever since Western science has been institutionalized and in vogue in civilization. So, a hundred years ago, the cutting-edge, science-y kind of treatment was radiation, so there were radioactive tonics that people thought were the latest-greatest thing. A hundred years before that it was electromagnetism, so that's where Mesmer comes in with his animal magnetism, that you can use to cure just about anything. And now, it's quantum, Deepak Chopra's quantum healing, for example. It's a new way of justifying the vitalistic notions that are thousands of years old, you know, the notion that there's this life energy. So, now you just throw "quantum" in front of it, and you've got quantum life energy. But it's the same sort of spiritual, pre-scientific notions that were weeded out of scientific thinking over a hundred years ago. But yeah, extremely effective marketing.

R: It's funny, actually, because I had a conversation with a live blood analysis person at the previous Mind-Body-Spirit. I liken it, Steve, to someone who would place a whole lot of scientific words and jargon in a hat and just pull them out at random, and then pepper their spiel with these scientific words. So, to someone who doesn't have a lot of science education, it sounds like it kinda might be right, because it's science-y and it's technical. So, what you say about the marketing is true, it's what they do.

S: The point is to befuddle with technobabble, so people have this vague sense that it's science-y, but they don't understand enough to realise that it doesn't make any sense. I've seen that in product marketing as well, like in healthcare products. This one catalogue, I can't remember the name of the catalogue we examined at one point, but it had about a hundred different pseudoscientific products in there, health products. And I remember one, it had this cloth that had "the infrared spectrum woven into the fabric".

R: Oh, okay.

S: What? What does that mean?

R: *laughs*

S: Infrared woven into the fabric, what does that even mean? But it had the word "infrared" in it, it sounded good and made it, like you said, all science-y. But again, that is a deliberate attempt to deceive, that's what that is.

R: Another thing that they all do, a lot of them have "Dr." at the front of their names, and I was recently doing some research on this. But I wonder if you know much about how easy it for a layman, or anyone really, to find out if someone's "Dr." is legitimate, because, there're so many diploma mills around these days, it's not always easy to find out if someone actually does have a Ph.D.

S: Yeah, that's true. I mean, you can search for them on the web, and ask them for the details: if they can't provide you with a legitimate institution that provided their degree, then you should be suspicious. You should put the burden on them to prove that their degree is legitimate, not on you to prove that it's not legitimate. But if they can't provide a verifiable institution that provided the degree... Depending on how important this is to you, you could follow this up with the institution to see if they really got that degree, because they could lie about that as well. So, that vetting could be a few mouse-clicks or a phone call away for anybody, depending on how many layers of deception they are using to hide their trail. But certainly, when investigators or journalists write about an individual, you can find out if they're legitimate or not.

R: Yeah. It's kind of rubbing salt into the wound for me, for example, because I do have a Ph.D, and you can check on the University of Sydney website, people! It's there! And to see these people walking around saying "I'm Dr. This and I'm Dr. That", and in fact, we know of one person who not only has a Ph.D, but has a Doctor of Science as well, which I think he awarded himself from his own institution? *laughs*

S: Right.

R: My point is-

S: That's convenient.

R: It is convenient, isn't it? In fact, I checked the chronological order of his degrees, and he got the Doctor of Science before he got the Ph.D, which in academic circles is quite unusual. It's usually the other way around.

S: The problem is worse in that there are now recognized degrees that enable someone to call themselves a doctor, that have no external validity. For example, I'm sure how many of these translate over to Australia, but in the United States we have Doctors of Chiropractic, which call themselves "Dr." when they don't have a medical degree. And also now naturopaths, there are Doctors of Naturopathic Medicine. Naturopathy is just a collection of disparate, sometimes mutually exclusive pseudosciences: basically anything that's wrong, anything that gets discarded from mainstream or scientific science they pick up and weave into their practice. And reading their articles and texts, it's like reading a fantasy novel: it's jaw-dropping, the notions that they come out with, completely antithetical to even basic biology, forget about sophisticated medical research or whatnot, they're violating even basic biology. They weave all this into some vaguely thematic natural treatment. Now they can go to college, get a degree in naturopathic medicine, it's recognized in a number of states in the United States and they're slowly working their way through state legislatures, getting recognition. Do you have naturopaths in Australia?

R: Yes, we do, and it is a recognized degree, in fact it's about three years to do a degree in naturopathy. I'm not sure what they do with that amount of time, I haven't seen a curriculum structure, I've looked for one but I haven't found anything. But, yeah, we have them, unfortunately.

S: Look, that just confuses it even further, how is the public supposed to know, if the Government or State licenses somebody and they have a degree, it doesn't necessarily mean anything.

R: That's exactly right.

S: They're not doing their job of protecting the public from fraud or assuring at least a basic level of legitimacy in healthcare providers, so the public is left to fend for themselves.

R: yeah, well, I'm not sure what it's like with the FDA, Steve, but our Government body here is the Therapeutic Goods Administration, or TGA, and you can list a product with them, which then entitles it to go into pharmacies or drug stores, and Government will give it an official listing number and say it has been approved by the Australian Government, but things like, for example, ear candles, you can buy in drug stores here, homeopathy, you can buy in drug stores. From the perspective of someone in the public, it looks legitimate, because the Government has approved it, so it must work! And it's being sold in drug stores right next to conventional, science-based medicine.

S: Yeah, that's maleficence, in my opinion, that's just the Government completely failing the public. In the United States, we do have the FDA, but we also have, in 1994 Congress, under the auspices of a couple of true believers, passed the Supplement Health and Education Act of 1994, which basically removed all the things you're talking about, all sort of supplements and herbs and vitamins out of FDA control, so you could market it without having to provide any previous evidence of safety or effectiveness. And they created this new category of health claims, called Structure-Fuction claims. So, in the US, there's two worlds: diseases, and if you claim to treat a disease then that's regulated as a drug and the FDA has purview over that, but you can make these Structure-Function claims without any oversight or without any evidence to back up your claims. Those are things like "It boosts the immune system" or "It enhances a positive mood or well-being" or "nutritional support" or "detoxifies", you could use all these pseudo-health claims. And if you're careful with the wording and the marketing, you could make the claims you want to make, you just can't mention diseases. Also, you have to put a disclaimer, "These claims have not be reviewed by the FDA", but half the time they don't even do that minimal requirement. The bottom line is, unless you're pretty savvy about what's going on, to most of the public at large the companies are able to make the claims they wanna make and very easily cavort with the deliberately loose regulations. This has lead to an explosion of the supplement industry in this country. So know the public is having to wade through tremendously dubious claims, the few of which do get investigated almost always turn out to be incorrect or fraudulent, and it's a multi-billion dollar industry.

R: Yeah, we have the same thing here, where you can't make claims on the product, but you can say "may assist with..." or "may help...". You can't say it "cures" anything. But the other thing we have here, and I don't know if you have the same thing as we have, but in most of our pharmacies we have consulting iridologists and naturopaths! You can go see them for free, and they'll give you advice-

S: Not in pharmacies, I haven't seen them. There's certainly homeopathic remedies in drug stores and pharmacies and supermarkets, and then we have separate, boutique nutrition stores selling vitamins and minerals, they will often have the iridologist or whatever there. But pharmacies generally don't have these para-professionals, they're basically run by pharmacists.

R: One of the things with people who are not particularly science educated, is that if they try one of these CAM therapies, and they claim it works, they'll claim that "Well, it worked for my, therefore it works", they'll have a story, "Well, I had an ear infection, and I was taking conventional drugs and it didn't work, and I put an ear candle in my ear and it cleared up, so it worked." And the problem is, can you even explain to them that that's not the case? Is it even worth trying to explain to these people?

S: It's worth trying to explain it to people, I never give up on people ahead of time. It is very, very, very difficult. You have to explain some concepts of how we know what we know and how easy it is for people to be deceived by things. So, what you're talking about is the Post Hoc, Ergo Proptor Hoc logical fallacy, the "I was sick, I took this treatment, I got better, therefore the treatment made me better". Well, you don't know what would have happened if you didn't take the treatment, it's not a controlled situation. There's also the placebo effect, which is a very confusing concept. It's been extremely confused, especially by CAM proponents. Most people think of it as "the belief in the treatment leads to a real, physiological effect", and that, in fact, is not the case. The "Placebo Effect" is actually many, many different effects, anything other than a real, physiological response to an active treatment. So, that includes a host of psychological factors, misperception, biased memory, conformation bias, as well as the fact that there are other variables: if you're doing one thing to treat yourself, you're probably doing other things as well that may be helping. There's the need to justify your beliefs, or the fact that you've invested in the treatment, there's the hope that you want the treatment to work. So, there's a lot of factors at work that lead to a subjective sense that the treatment was effective, even when, by any objective measure, nothing has happened: the disease took its natural course, or the function of what is being measured did not improve in any way, survival did not improve. But people still say they "feel" better, and to them, it's very compelling. It's very difficult to convince people that their own experiences are misleading. It takes a certain level of skepticism to really appreciate that. It's probably the hardest thing that we deal with, convincing people that their own personal experience can be deceiving and that you can't rely upon it, that we have to trust these abstract numbers that were generated by a study, not your actual, own experience. History clearly demonstrates that personal experience is next to worthless in most cases, it's misleading. Again, you go back to a hundred years ago, when people were drinking radioactive tonics, well they thought they felt better for it too! they thought that that was the greatest thing, they thought they had more energy and vitality, all the while they were slowly killing themselves!

R: Yes. *laughs*

S: In fact, if radioactivity was discovered to be harmless, rather than actually harmful, it would probably still be around today as a tonic. You know, these things never go away entirely. In this country, the FDA has to step in and ban radioactive tonics, even as late as the 1940's people were still believing in it, they had to actually ban it. But Hiroshima, and the changing cultural perception of radiation, was what really killed radioactive tonics. But here you have countless people who absolutely believe that it was helping them. So they were totally wrong, they were profoundly, demonstratively wrong. So you have to extrapolate that to yourself and to everyone else. If they could be wrong, then anyone could be wrong about any subjective experience of their own treatment, but we have a psychological effect where we think that we're immune to psychological factors compared with everyone else in the world, everyone thinks that they're special in that regard. "Oh yeah, other people can be deceived by this, but not me!"

R: Not me.

S: Yeah. No, wrong, you're a human, you've got the same brain as everybody else. You could be deceived, we could all be deceived, I could be deceived. It's just all human nature.

R: It's the same concept as people saying "Oh, I know there are fraudulent psychics out there, but mine's real, mine's fine. All the rest are doing cold reading, but mine's not, it's spot on". You know.

S: Yeah, all those other psychics may be frauds, but not mine.

R: Not mine, yeah. You mentioned side effects just before, and I recently had an email exchange with someone about homeopathy, which is one of my favourite CAM's, and his point was, "Well, obviously homeopathy is safer, because there are no side effects, whereas conventional, orthodox medicine has side effects." Now, I'm wondering if you could explain to the listeners, why it is that there are no side effects with homeopathy, and what is means when you get side effects with conventional drugs, in other words, it means you're getting an effect.

S: Right, yeah, there's no side effects from homeopathy because there's no... effects!

R: Exactly! *laughs*

S: There's no physiological effects. The difference between a beneficial effect and a side effect is really just all context. What's the effect you're trying to get out of an intervention, and in the proper clinical context, some effects are desirable. For example, if you're taking a drug to help you fall asleep at night, it has a sedating effect. That sedating effect is the desired effect of that drug. But if you're taking a drug for pain, and you want to be functional at work, then the sedating effect is an unwanted side effect. it's just the context of what you're trying to get out of it. So, there's this concept of a therapeutic range: that, when we're developing drugs, we're looking for a chemical that has a dosing range where we will get the desired effect, but the unwanted side effects are minimal or tolerable, and the chance of any toxic effect is extremely minimal. There's testing that the drug must go through to ensure it stays within this safe, therapeutic range for treatments, because anything that has a physiological effect on the body is going to have a host of other effects. We're always trying to get the effects more and more specific, but there's no "silver bullet" or "magic bullet" that has just the precise effect that we want and no other effects. That's just a technological thing, we're just not at that level of technology. Sometimes it's just not possible, the body is a complex, evolved system, so we have, for example, one cell type or receptor type be evolutionarily closely related to another, that serves another purpose in the body, so when you make a drug to interact with one receptor, it's going to have an effect on the other one as well, even though that's not the effect that you're going for. So there may be some inherent biological limitations on how specific we can get in our effects as well. But homeopathy, you asked about, has no effects or side effects, because it's literally... nothing! There's nothing there!

R: It's water! *laughs* Or sugar pills.

S: Or sugar pills, it's water placed upon a sugar pill. One of the concepts of homeopathy is the so-called "Law of Infinitesimals". It's not really a law, it's just something that Samuel Hahnemann made up.

R: Made up! *laughs*

S: And it hasn't been validated in two hundred years, science has not found that it exists in nature, that it's describing anything real in the world. It's just this idea Hahnemann made up a couple of hundred years ago, that the more you dilute a substance, the more powerful it becomes. And that sounds counterintuitive, because it is! It's not correct, it's not an accurate description of reality!

R: Defies the laws of science.

S: Yeah, defies the laws of science, physics, chemistry, and common sense!

R: *laughs*

S: For a reason! Common sense does not always align with reality, but in this case it does. But, it's worse than just the notion that the more you dilute something the more powerful it becomes, even though the notion of Avogadro's number was known at the time, Hahnemann, either he personally didn't know about it or didn't think it was relevant to his scheme, that, when you dilute past a certain point, statistically, there's no active ingredient left, zero, not a single molecule of whatever you started out with is left. So, there's literally nothing left, nothing left behind. That can't possibly have any physiological effect. There's a couple of other magical beliefs woven into homeopathy, another is the "Law of Similars", that like cures like, and that's just sympathetic magic. That's just plain old superstitious sympathetic. You know, you grind up a rhinoceros horn and take that to enhance male sexuality because the horn looks like an erect penis. That's about the level of logic that we're dealing with, it looks like it, or it's similar to it, therefore it has some desired effect. And then the other component of it is that you have to shake the remedy with each dilution, like ten times in each of the three planes, and that's just ritual magic, that's just going through some non-sensical ritual. That's it, that's what homeopathy is.

R: Is the succussion though, is it to instill the memory of the active ingredient into the water, because the do talk about the water having a memory, don't they?

S: Yeah, but that's a very new or recent concept. Hahnemann never talked or wrote about water memory, that's a very recent rationalization to try and lend some scientific jargon to this non-sensical notion of homeopathy. And this is the equally absurd notion that water molecules can sustain the "memory" of more complex molecules that were previously diluted in it. But there's no known mechanism of physics or chemistry that can make that happen. Studies that homeopaths have tried to do have been unable to demonstrate this effect. Water's a liquid, it's a fluid, and even though there may be some transient relationships between the water molecules, they're extremely, extremely fleeting. They certainly will not survive for any long period of time, they wouldn't survive being dissolved on a sugar pill, eaten, absorbed into the blood stream, getting to the target in the body where they're supposedly having an effect. It's really just explaining one bit of nonsense with a more absurd bit of nonsense. There's zero science to it. But it's not about the science, to the homeopaths, it's about using non-sensical scientific jargon as plausible cover for the masses, that's what that's about.

R: Actually, it seems to me that water is the new buzz CAM. At the recent Mind-Body-Spirit I went to, everyone's selling alkaline water these days, or ionised water, telling you that it'll replace minerals in your body and you'll absorb it better. I tried to point out to one of these people that if you drink alkaline water it goes into your gut, which is pH 2, approximately, and it's no longer alkaline! They didn't want to hear about that.

S: Right. Don't confuse them with the facts, come on!

R: Sorry, sorry.

S: The whole acid-base thing is ridiculous, I mean, our bodies have very elaborate, controlling mechanisms for keeping our pH in our tissue and our blood in a very narrow, optimal range. You have to drink poison or do something extreme physiologically to overwhelm our body's mechanisms for maintaining body pH. So, drinking alkaline water, as you say, just mixes with the acid in your stomach and it doesn't have any effect on your body pH. But the water thing, that's been around for a very long time. The concept of water as a healing mechanism, that goes way back to the original spas where mineral water and later carbonated water was given as a healthy tonic. In fact, the soda pop that we drink today essentially evolved out of that tradition of mineral or carbonated water spas. That's why many of the popular soft drinks have herbal type names, like ginger ale, root beer, even Coca Cola. These all were initially health tonics, not beverages. They only became beverages after refrigeration was invented.

R: *laughs* And then they tasted better.

S: Right. *laughs*

R: So, just to change the subject a little bit, Steve, congratulations on your new President-elect. We're all very happy about that. And it looks like this might be good for science. The Democrats seem to be a bit more science friendly than the Republicans, and I believe that Barack Obama, in one of speeches said that he wants to double the funding to the NIH. Is this the case? Do you think it's going to be good for science?

S: Well, I think it will be better than the last administration. The one thing the Bush administration has done that has really aggravated the scientific community is subverting the integrity of science as a way of informing government. No-one thinks that scientists should be running the Government or should be setting policy and even policies that have a lot to do with science aren't decided entirely on scientific information itself, you still have to make value judgements, allocate resources etc. There are other issues that come into play that make it a political process. Everyone agrees, or most reasonable people agree, that accurate, unbiased science should inform government and policy decisions. You shouldn't go backwards: it seems that what the Bush administration was trying to do was start with policy they want, and then backfill the science or subvert the science to that ideology or to their policy agenda. They significantly downgraded the role that science advisors play in the creation of policy in both the executive branch and legislative branch over the last eight years.

R: Yeah.

S: And that was happening at a time, obviously, when the Republicans were in power and there were certain specific issues where they didn't like what the science was saying, so they had a separate agenda, like on global warming for example, so that earned them a reputation. Chris Mooney, in fact, wrote the book "The Republican War on Science" which pretty much says flat out that that's what they think is going on. Taking a broader view, I don't think that that is an issue that is unique to conservatives or to Republicans, I think that all ideologies tend to do that, certainly both sides of the political spectrum in this country have done it, to varying degrees. Both candidates, McCain and Obama, vowed in their responses to the Science Debate 2008 questions that were asked of them on the campaign trail to distance themselves from the Bush policy, they promised more funding for NASA, more funding for research, more support for science education, restoring the integrity of science. So they both were saying the same kind of things. I think we were going to be moving away from the Bush policy and the Bush sort of way of dealing with science regardless, but it is a swifter and cleaner breaker by switching to the other political party. Although, yesterday I was handed a letter written by Barack Obama to chiropractors in the United States, promising to integrate more chiropractic care into the veterans affairs system and into the healthcare system in general.

R: That's not good news!

S: That's not good news. Alternative medicine is one area of pseudoscience that has found bipartisan support in this country, they really know how to work both sides of the aisle extremely well. I haven't seen an advantage to one side or the other, you just deal with different issues.

R: Then again, you've got Oprah as well, and she's the most powerful person in the country, isn't she? I mean, when she endorses something like Jenny McCarthy everyone believes it?

S: She certainly is a media powerhouse and that gives her a tremendous amount of power, if your book in on Oprah's book club, it's an instant bestseller, that's the kind of power that she has. And unfortunately she has chosen to use that power for evil instead of good.

R: Yes, yes.

S: She has chosen to promote pseudoscience, quackery and nonsense at every chance she gets-

R: Like "The Secret".

S: Yeah. "The Secret", Jenny McCarthy, it's all bad. She's done more than probably any other individual to promote woo and pseudoscience.

R: And Tom Cruise as well, you can't forgive her for that. *laughs*

S: *laughs* That's true, though Tom Cruise's escapades probably hurt Scientology more than anything else. Anyone who thought that maybe Scientology was a little wonky, after seeing Tom Cruise was probably convinced of it and it removed all doubt.

R: *laughs* Yeah, you're probably right. Okay, Steve, so my final question is a tough one: is "skeptic" a dirtier word than "atheist", and what do you think will make the concept of being a skeptic more socially acceptable?

S: In terms of public perception, I think that "atheist" has a far more, at least in this country, negative connotation than "skeptic". In a lot of situations and contexts, you can call yourself a skeptic and that may provoke a positive response in some people, a confused or questioning response in others, and, I think, a negative response if it's confused with the word "cynic". That's one of the biggest problems we run into: people confuse skepticism with cynicism. And only really amongst true believers who have run afoul of the skeptical movement will people try to make "skeptic" into a bad word. But, at least in this country, the United States, atheism gets thrown around as a pejorative, as a way of branding a bad person. It would probably be impossible for an open atheist to get to any kind of national office in this country, probably even more difficult than someone who is openly homosexual, for example.

R: Wow.

S: It's bad, it's really bad. Our approach to skepticism is what's called scientific skepticism, we're about promoting science in education and critical thinking. We don't deal directly with religious faith, we deal with religion when it interferes with science, when it intrudes upon science, which they happily do all the time, so it's not really that much of a limitation. But if someone says "I have a personal faith in God, not based upon any evidence or logic or anything, I just reserve it for myself", I say "Congratulations, good for you!" What can I say about that?

R: *laughs*

S: There's nothing to say to address that. At best you're in the realm of philosophy, which I find interesting, but it's just not something we deal with directly. There is a bit of split in the skeptical movement, again on that issue, whether or not we should address pure faith issues as if they were any claim. Or do we make a distinction between science or evidence-based claims and personal faith. We've chosen, for a variety of reasons, mainly because it's what we're interested in and where our talents lie, to just focus on the science..

R: Yeah, yeah.

S: I kind of avoid even the word religion, because that creates a bit of a misconception. We actually do deal with religion, when religion intrudes upon science. Creationism is the most obvious example, yeah, that's a religion-based pseudoscience, and we will happily deal with all the claims of Intelligent Design proponents and creationists. But we don't deal with faith, because faith, by definition, it outside the realm of science. So it actually puts that into a much, much smaller box than us, I mean, we can't deal with anyone who makes any kind of claim in which logic or evidence can be brought up to bear. If you remove yourself entirely from any sort of logical or evidentiary basis, and it's just a personal statement of faith, then that's your freedom to believe whatever you want. We don't really care about what people believe, we want them to understand and think critically, but we don't concern ourselves about what people believe.

R: Alright, well thank you very much for your time, Steve!

S: Hey, it was a lot of fun!

R: Yeah, it was, it was great! We've got a little present for you which is currently on its way, probably on a plane right now: we've sent you the Great Skeptic CD 2, which is the Australian Skeptics Journal on searchable CD. We've also sent you a DVD called The Rhymekeeper, which is twenty-six original Australian poems, and Richard Saunders' fold along Origami DVD.

S: Excellent! Well thanks so much for having me, it's been a lot of fun!

R: Thanks Steve, and we can't wait to see you in 2010 in Australia! Finally! Very exciting news.

S: We're looking forward to it, that'll be great.


Thank you Jack Scanlan from http://www.youngausskeptics.com/ for transcribing this interview

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