4^th estate, 2008

Conclusion Ben Goldacre is on a mission to teach us about how scientific evidence is systematically ignored, manipulated, misinterpreted, fabricated, and otherwise molested. “Bad Science” is both funny and alarming. It's a recommended read for … anybody, really.

Ben Goldacre is a man on a mission. He wants to teach the general public about science. About what it is: Careful interpretation of results from properly conducted experiments. But most of all, Goldacre wants to teach us what science is not about: Unquestioningly accepting unsubstantiated claims from authoritative figures.

Cover of "Bad Science", by Ben GoldacreThe book starts out lightly, describing fairly innocuous cases of bad science. For example, Aqua Detox is a treatment for getting rid of all the toxins that accumulate in your body throughout your life (or something along those lines). Essentially, the treatment consists of putting your feet into a bath of salt water, through which a small electrical current flows. The effectiveness of the treatment is obvious: The water turns brown and a foul smell is released—clear evidence of toxins leaving your body, right? In actuality, the brown color is due to rusting electrodes and the smell is the result of chlorine being released from the water. Both are the result of electrolysis and occur regardless of whether you have put your feet in the bath or not (if you are interested you can work out the details for yourself with a little high-school level chemistry). I think this is pretty funny, because a) you're an ass if you believe this stuff and b) you won't get hurt even if you do.

From these obvious forms of quackery, Goldacre moves on to homeopaths, nutritionists and alternative medicine practitioners. Clearly, some diets are better than others (you can see this, for example, in the amusing documentary “Super Size Me”) and, in some cases, you may benefit from particular food supplements. But Goldacre reminds us of a few facts: Homeopathy is utter nonsense and most of the things that nutritionists say are nonsense as well: Eating spinach does not directly oxygenate your blood and oranges without vitamin C do not exist. Goldacre suggests that nutritionists (which, by the way, is a meaningless and unprotected term in most countries, unlike, for example, “dietist”) devise elaborate and pseudo-scientific diets, because the simple advise to eat healthy and varied doesn't make any money. Essentially, nutrionists use bad science to prevent people from discovering that they are redundant.

Although alternative medicine does not, as a rule, cause much harm, there are some gruesome exceptions. Here in the Netherlands, for example, a national celebrity stopped (or never started in the first place, I'm not sure) her treatment for cancer after a “spiritual medium” convinced her that she was suffering from a bacterial infection which should be treated using alternative medicine. She died. It would be unfair to say that the medium killed her, since she might have died even if she had received proper treatment, but her chances of survival were definitely greatly reduced. Right now you may be thinking that people have their own responsibility: Even if someone (who is not your doctor) tells you to stop chemotherapy, you can and should know better, because reliable information about cancer is readily accessible. And I would agree. Which is why I found the following example particularly disturbing.

In South Africa, under the reign of Mbeki, there were many “AIDS dissidents” who denied the link between HIV and AIDS. This is tragic, but not always and necessarily due to malevolence. Many poor Africans understandably hold a grudge against the wealthy western world (perhaps particularly in South Africa, where memory of “apartheid” is still fresh) and they have cultivated the belief that AIDS is actively spread by western pharmaceutical corporations to make money by selling antiretroviral drugs. And, of course, pharmaceutical companies do make money by selling these drugs. I wouldn't even necessarily put it beyond them to infect people with AIDS (although I doubt it), but this is beside the point: If you are infected with HIV you need antiretroviral drugs or you will develop AIDS and die. So, if you know better, you should try to convince AIDS dissidents that they are wrong. What you should not do, is post full-page adverts in South African newspapers saying things like “Stop AIDS genocide by the drug cartel”. Why would someone do that, you ask? Well, they might be selling a multivitamin food supplement, which is “the natural solution to AIDS”. Which is exactly what Matthias Rath has done. By promoting his vitamin pills as the treatment for AIDS (not a complementary treatment, mind you, the treatment) he has caused indescribable damage to the South African society and unbelievable personal suffering. You can say the same of former president Mbeki, but he may plead ignorance (I honestly don't know what he must have been thinking). Matthias Rath, who has a medical degree, can not.

Rath has sued Ben Goldacre for libel, to prevent him from publishing his chapter on the multivitamin natural solution to AIDS. Fortunately, Goldacre has won this case and he has made the chapter, which was not part of the first edition of "Bad Science", freely available. You can read the full chapter here.

Well, it's time to wrap up this book review, before it escalates into a full blown political statement. As you will have guessed by now, I really liked the book. It was amusing (e.g., the Aqua Detox hoax), sometimes exasperating (e.g., the chapter on Matthias Rath) and frequently enlightening. Although a mission is a dangerous thing for a writer to have, Goldacre does not fall into the trap of becoming a zealot. He simply examines experimental results, provides the relevant references, and points out weaknesses in the overstated claims of others.

On a slightly less positive note, some parts of the book lack a clear structure and are somewhat repetitive. His staccato and personal writing reads a bit like a series of blogs or columns, which is not terribly surprising, since Goldacre is a columnist for the Guardian. Another of point of criticism is that the book frequently, and without introduction, refers to typically British terms and personalities. For example, if you are not from the UK you may not immediately understand a passing reference to the MMR scare, and you may not be familiar with the delicious (and healthy!) recipes of Gillian McKeith.

But these are small gripes. Overall, “Bad Science” is one of the most riveting books I've read in some time. Also, and I hate to say these types of patronizing things, it's important that people are made aware of these issues. Because, as pseudo-scientists say pseudo-mathematically: Science_Bad → Happen(Bad_Things)

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Conclusion In “The Grand Design”, Hawking and Mlodinow discuss the big questions of modern physics. The subject matter is engrossing, but the hurried presentation leaves the reader unsatisfied.

“All science is either physics or stamp collecting.”

Cover of "The Grand Design", by Stephen Hawking & Leonard MlodinovThere is a definite ring of truth to this famous statement, but because my chances of becoming a physicist are slim, the best I can do is occasionally pick up a popular science book. And, of course, no one has popularized physics like Stephen Hawking, the enigmatic disabled genius.

A great deal has been made of Hawking's newest book, “The Grand Design”, which he has written together with Leonard Mlodinow. Especially the superfluous statement that there is no God (or something to that effect) caused a small stir in the press, even in our not particularly pious country.

Unfortunately, “The Grand Design” does not live up to the hype. The book is entertaining, but there is little to set it apart from the competition. Hawking and Mlodinow start out with a very brief introduction to the philosophy of science. From there they fly by quantum mechanics, glance over string theory, and, a mere 150 pages later (large font, lots of pictures), they arrive at the grand conclusion. In this conclusion they appear to say something important, perhaps even brilliant, about how the total energy of the universe is zero, which would allow the universe to appear out of nothing (or something along those lines). But the problem with the conclusion, and the book in general, is that the ideas are presented too hurriedly. The reader is left unsatisfied, not being given the time to come to grips with the complex ideas. Also, “The Grand Design” is filled with little jokes. None of them are very funny and they quickly become annoying.

Of course, you must admire that Hawking is still able and motivated to write books at all. This is undoubtedly a huge undertaking and, I suspect, his disability is part of the reason why the book is so short. But nevertheless I am forced to conclude that there are better books out there, which deal with essentially the same subject matter. You may want to consider books by Lee Smolin or Leonard Susskind. One of Susskind's best books, "The Black Hole War", actually deals with his personal battle of minds with Hawking. Their "war" had to do with whether or not black holes destroy information. In the process of explaining the technicalities of their dispute in layman's terms, Susskind gives a personal, and at times moving, account of his encounters with Stephen Hawking. But I digress.

In conclusion, “The Grand Design” is a reasonably entertaining book about modern physics. If you are seeking the “new answers to the ultimate questions of life” that are promised by the subtitle you will be disappointed. If you have a specific interest in Stephen Hawking you may find the book worthwhile.

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Pantheon Books, 2010

Conclusion In “Self Comes to Mind”, Damasio provides a neuroscientific account of consciousness. Despite being occasionally somewhat opaque, the book is a worthwhile read for anyone interested in consciousness.

In his latest book, “Self Comes to Mind”, Antonio Damasio outlines his ideas about the neural basis of consciousness. This is not the first time (and probably not the last) that Damasio has dealt with this subject matter, but “Self Comes to Mind” is different from his previous books. First, the role of emotion is not quite as prominent. Second, “Self Comes to Mind” appears to be oriented towards people with some knowledge of neuroscience. The book is also perfectly suited for the interested layman, but those who are looking for light-weight popular science entertainment may be better off with, for example, recent books by Oliver Sacks or Victor Lamme.

Cover of "Self Comes to Mind", by Antonio DamasioAccording to Damasio, consciousness is all about neural maps. In order for an object to be consciously perceived, it needs to be represented in brain areas that are crucial for consciousness. This statement is a tad trivial when it comes to sensory perception (vision, hearing, etc.), but Damasio emphasizes that this principle extends to emotions as well, with one difference: Emotions are the result of maps of the body itself, rather than maps of the outside world.

Damasio already expressed these ideas about neural map-making before, but in “Self Comes to Mind” he goes a step further and provides a detailed account of how he thinks consciousness emerges from the brain. He makes a distinction between three levels of “self”, which build on each other to construct the type of full blown consciousness that we humans are privileged to experience. As I understand it, the most basic form of self, the “protoself”, is a neural map of an organism's internal status: It reflects whether an organism is hungry, etc. The “core self” extends the protoself by incorporating interactions between an organism and its environment: An organism eats something and as a result its sense of hunger disappears. At the highest level, the “autobiographical self” adds information about an organism's past and its expectations about the future.

Although Damasio's description of the layered self is interesting and mostly quite convincing, I was also left confused at times. Does he mean that there really are three qualitatively different levels of self? Or does he make this strict distinction only for the sake of clarity, while he really envisions a continuum? As another example, in the final chapter, which deals with the contribution of culture to consciousness, he sympathizes with the notion that “something of great import may have happened to the human mind between the events narrated in the Iliad and those that make up the Odyssey.” Again, I was confused, because as far as I know the Iliad and the Odyssey span a few decades? This seems like too brief a time (an evolutionary blink of the eye, really) for any real changes to occur. Nitpicking aside, I'm sure Damasio doesn't mean to say that humans were substantially less conscious a few thousand years ago, but this section left an awful lot of room for interpretation.

In summary, there is a lot to like about “Self Comes to Mind”. Damasio is an excellent writer and his ideas are interesting. On a slightly less positive note, his writing is occasionally ambiguous, leaving the reader “not quite getting it”. Nevertheless, I recommend “Self Comes to Mind” to anyone who is interested in the neuroscience of consciousness, especially if you like to be challenged rather than entertained.

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Picador, 2010

Conclusion With “The Mind's Eye” Oliver Sacks reaffirms his reputation as one of the most eloquent chroniclers of the human brain.

More than anything else, Oliver Sacks is a storyteller. In “The Mind's Eye” he tells about people who have lost some aspect of their perceptive (mostly vision) or expressive (mostly speech) abilities. The book opens with a woman who suffers from severe difficulties in reading. Over the course of years her condition deteriorates, until her visual agnosia is so bad that she is effectively blind. Sacks gives a very personal and compassionate account of her story (as he does of the other cases described in the book), and focuses on the womans personality and the way she tries to cope with her condition, as much as he does on the neurological aspects. Sacks is also very eloquent; Almost unrivaled in this respect, I would say.

Cover of "The Mind's Eye", by Oliver Sacks

Nevertheless, after the first three chapters I was getting a little worried that the entire book would consist of case studies. Not that the stories aren't interesting, just not sufficiently so to fill 250 pages, especially since similar stories have been told before. Luckily, my worries were unfounded and about halfway the book switches from case studies to Sacks' personal quirks, hobbies and experiences. Apparently, he suffers from congenital prosopagnosia, which means that he has a very hard time recognizing faces. He describes how this mild deficit has led to some embarrassing situations (quite amusing) and goes a little bit into the neuroscience of face perception. Sacks is also a member of the New York stereoscopic society, a society for people who enjoy creating 3d images. In this context he provides an interesting account of stereo vision and associated deficits. In one of the last chapters, Sacks describes his own encounter with ocular cancer. Especially the quotations from Sacks' own journal from that time are quite intense.

You could criticize Sacks for relying too much on anecdotal evidence. For example, he discusses the extent to which blind people rely on visual imagery (mental visual images) based on a number of autobiographies. I am not convinced that autobiographies are a very reliable source of information, but Sacks uses these autobiographies (and other anecdotes) as food for thought and they are certainly interesting in that respect.

In summary, “The Mind's Eye” is an excellent book. Oliver Sacks' style of writing is very pleasant. An exception to the overall pleasantness of the book is the chapter that deals with Sacks' own struggle with cancer. But even here Sacks shines as a superb writer.

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