1/2 ‘Galen’s writings were the indisputable source of medical authority for more than a thousand years. “It is I, and I alone, who has revealed the true path of medicine,” Galen wrote with his usual modesty. And yet Galen never conducted anything resembling a modern experiment. Why should he? Experiments are what people do when they aren’t sure what the truth is. … Each outcome confirmed he was right, no matter how equivocal the evidence might look…’
—Tetlock/Gardner, *Superforecasting
2/2 “… Galen is an extreme example but he is the sort of figure who pops up repeatedly in the history of medicine. They are men (always men) of strong conviction and a profound trust in their own judgment. They embrace treatments, develop bold theories for why they work, denounce rivals as quacks and charlatans, and spread their insights with evangelical passion.” —Tetlock/Gardner.
I love that:
“Why should he? Experiments are what people do when they aren’t sure what the truth is.”
@WNYmathGuy I’d guess the Royal Society made that their motto because they were fed up of fifteen hundred years of Galen 😝
@22
America still has plenty of Galen'ish medicine going on. The new catch phrase of skeptics to combat it is, "evidence based medicine not eminence based medicine."
Our whole opoid crisis was promoted in a Galen way by an extremely wealthy American Midwestern family who is now trying to export that lie around the globe.
Maybe Galen was more honorable because he believed it to be true.
@WNYmathGuy Funnily enough, Tetlock talks about Galen because it was medicine that first was dragged kicking and screaming to randomized controlled trials (soon after WW2—so not that long ago), and it's medicine today that has most embraced it. Tetlock compares geopolitical forecasting today to the dark ages of medicine & how his Good Judgement Project is part of forecasting's scientific renaissance.
As you say though, Galen is still alive and kicking. Any reading you recommend on the opioids?
@22 I'm kind-of a non-reader; it's my least preferred method of getting information in my head. I think the first place I heard about it was the "Reveal" podcast episode "Too Many Pills" from 1/27/2018. Searching "Exposing opioid crisis" on the Internet gives me an assortment of published news.
http://www.latimes.com/projects/la-me-oxycontin-part3/
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
https://www.esquire.com/news-politics/a12775932/sackler-family-oxycontin/
http://www.latimes.com/projects/oxycontin-part1/
http://www.latimes.com/projects/la-me-oxycontin-full-coverage/
@WNYmathGuy Many thanks. I've spent many a charmed hour in the Freer and Sackler Galleries of Asian Art in DC, and it's sad to read this. Randomized controlled trials certainly can be defeated by good old-fashioned conflicts of interest and researcher dishonesty and greed—the oxycodone story isn't so much an indictment against Galen as against Satan.
@WNYmathGuy But whenever I think of researcher dishonesty, I think about Feynman's gentle rebuke to those physicists replicating Millikan's experiment: "Why didn't they discover the new number was higher right away? … When they got a number that was too high above Millikan's, they thought something must be wrong—and they would look for and find a reason why something might be wrong. When they got a number close to Millikan's value they didn't look so hard…" https://en.wikipedia.org/wiki/Oil_drop_experiment#Millikan's_experiment_as_an_example_of_psychological_effects_in_scientific_methodology
@WNYmathGuy So even without conflicts of interest and motivated funding sources, there are these pernicious sources of error that Feynman warns against. "They didn't look so hard", i.e., *they stopped looking*. I always try to ask myself, what have I just stopped looking for errors in, wrongly satisfied that I've gotten to the bottom of everything, that the New Yorker will write an exposé about in a few years? :P
@22
It's a part of the evolutionary process though, right? Think theirs a tiger in the dark = run, don't test the evidence for zebras.
Also, with a finite amount of thought hours per person per day, and potentially infinite ways of look for evidence to reject the desired hypothesis, we don't look at all.
A massive change of cultural norms would have to happen before society acted different than it is now.
@22 The latest episode of Shankar Vedantam's podcast called Hidden Brain took a look at America's dark history of forced sterilizations. So much bad science and filthy-dirty politics went into this embarrassing episode of our past. It made me think about your thread about Galen.
@WNYmathGuy
“What people didn’t grasp is that the only alternative to a controlled experiment that delivers real insight is an uncontrolled experiment that produces merely the illusion of insight … [the government] had just assumed that its policy would work as expected. This was the same toxic brew of ignorance and confidence that had kept medicine in the dark ages for millennia.” —Tetlock/Gardner.
Illusion of insight → suffering+oppression. Full paragraph for reference https://gist.github.com/fasiha/447258e2d26eeb8f9405f5a2f989ec1f
@WNYmathGuy and yet it’s so hard to be not Galen—“When hospitals created cardiac care units to treat patients recovering from heart attacks, Cochrane proposed a randomized trial to determine whether the new units delivered better results than the old treatment, which was to send the patient home for monitoring and bed rest. Physicians balked. It was obvious the cardiac care units were superior, they said, and denying patients the best care would be unethical…” —Tetlock. Who could blame them?!?
@22
So Galen wasn't in the Nullis In Verba club?