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Understanding science means realizing that science doesn’t always have all of the answers

Cory Michael, MD
Conditions
April 12, 2020
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The impact of science on the well-being on our planet has never been more important than it is now. We are all looking to science and technology in a search for answers and resources. We keep watching television in search of these answers, but we are left unsatisfied because we don’t understand medical science.

A great deal of what we know as doctors comes from other doctors. A group of people taught me what I know; several others taught them, and so on. We are so focused on the misguided concept of mentoring that we hardly teach people to think for themselves. We are rarely taught to think like scientists in medicine.

I used to think that dissemination of knowledge was part of the continuing education requirements incumbent upon medical professionals. At one of the first medical conferences I attended as a resident, I recall a highly energetic speaker, Dr. L., who was so charismatic that I borrowed heavily from his style and cited much of his content for my first scientific meeting presentation one month later. Several years later, my resident colleague presented before Dr. L. and I. After the talk, Dr. L. congratulated the resident on a great presentation. When I told him that I still draw from his inspirational talk many years later, he neither remembered me nor the talk. We remember our mentors, but they often do not remember us.

Dr. L. was a great speaker, but this does not make him a great scientist. This is where we get caught up in bias and stray from science, instead relying on charisma. As for scientific conferences, too many of them are held for the purpose of profit only, knowing that physicians will use tax-deferred compensation to spend on a de facto vacation. Sometimes speakers and presentations are selected for the sole purpose of increasing conference attendance. This is how “junk science” gets disseminated.

So much of learning in medicine is at the textbook level. A textbook is mainly the interpretation of a primary or many secondary authors, whereas new discovery in medical science requires review by expert peers. This level of study is not included in medical or most health care professional schools. Ideally, good science occurs with multi-institutional collaboration, which is very difficult to come by in medicine because science is ego-driven in which an individual seeking primary credit for a discovery.

In the early stages of the coronavirus pandemic, much has been rapidly published in journals that is anecdotal and not necessarily generalizable. It is understandable why journals seek to publish so quickly, but for valuable conclusions to be drawn, we must accumulate and study before we develop meaningful conclusions. When 100 different people send in 100 different case reports, we are chasing our tails. News media are latching on to some of these publications and drawing incomplete suppositions. These include reporting errors with respect to vaccine development and poorly evaluated treatments.

As for the greater role of the media, too much of this has become partisan. We should be reporting on the virus and how to get ahead of it, but many news articles are politically targeted. Even health care leaders have latched on to some of the bad science reported by suggesting dates at which we may see peak incidence. In a climate of fear and doubt, unfounded rumors have been spread regarding the solvency of some of our facilities and physician groups. What I would like the media to report more on is the number of coronavirus survivors rather than the number of deaths. Some positivity is needed. We also need to be made more aware of the consequences of never cleaning your disposable mask after multiple uses.

Regarding the science of this virus, we know that you can stop the spread of coronavirus through your own actions. Maintain physical distancing and shelter in place. What we are seeing is unprecedented, and trying to guess when this will be over is just beyond the realm of our science right now because it all depends on human behavior. Trying to make unfounded predictions at this point is not helpful. I had to listen to a radiologist drone on for an hour this week describing curves and talking about the limitations of testing that he has no expertise in.

It also seems that with what we knew several months ago, it looked very much like our country was willing to let the virus sweep through and kill whoever it was going to kill. Our leaders were clearly asleep at the wheel. I had just assumed that they were willing to let thousands die in exchange for questionably improving job security for millions.

The primary expert opinion we have has been conveyed to us through Anthony Fauci, a medical scientist who has learned public health on the job over decades. I would like to see a much more comprehensive scientific front from a larger array of experts.

After this current pandemic has been dealt with, there are many lessons that will be learned, the greatest of which will probably be related to economics and the utilization of resources. I hope that we engage in rational thinking when we elect our next set of leaders and let reason take the place of personal ideology. Charisma is no substitute for expertise.

Perhaps the coronavirus will inspire people to want to learn science. The social sciences are just as important as the biological sciences. In this case, we need to ask ourselves why minorities are disproportionately affected. We will need new inquisitive learners. As I have said before, what we see now is just an audition for something deadlier and more impactful.

Often what science tells us is that there is no certain answer to a question. To quote the professional basketball commissioner, we know less today than we did a month ago. The sooner we understand that, the sooner we can accept that the comforts we normally enjoy are indefinitely on hold. Grasping the virtue of patience should be our primary focus.

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Cory Michael is a radiologist.

Image credit: Shutterstock.com

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