Wednesday, July 15, 2009

I wrote this up after noticing that critical thinking, which is pretty much all you do in grad school (and sometimes do in medical school) pretty much ruins your ability to take any arguments from laypeople seriously. Our culture has a thinking problem. More specifically, our culture has a lack-of-thinking problem. The scientific thought process, which will become your life in the grad years, makes you painfully aware of this.


I want to briefly ramble about a bane of the first two years of medical school which, as I have emerged from my cocoon of WUSM II, I have also noticed a great deal in popular media:

The scourge of plausibility

In med school (especially 2nd year), you go through some pretty specific and complex physiology and pathophysiology. You often find yourself trying to reason through complicated questions imposed by other students trying to figure things out, especially in topics like cardiology, nephrology, and neurology. Instead of wading through pages of text, you might find yourself coming up with an answer and justifying it with a plausible mechanism that you derive from other knowledge that serves as “common sense.” One example I remember is as follows (skip if you don’t care):

A friend and I knew from lecture that acidemia causes hyperkalemia, but we didn’t understand why. We thought that the increased acid secretion by the kidney would go hand in hand with potassium secretion… but this wasn’t the case. So, we tried to back-reason mechanisms for this apparent paradox. Here’s the scourge:

We had some pretty interesting solutions, all sounding “plausible” with our medical knowledge at the time, and all totally wrong. Once we got it straightened out, I felt a little silly. This happened other times with problems that were much more difficult to resolve.

Here’s a real world example: I am going to make a pair of contradictory statements, and back them up using stereotypes that you probably have. If you read only the first or only the second, you might believe either.

1. Heavy online video game players (think World of Warcraft addicts) are generally overweight. Their constant grazing on high calorie foods and soft drinks, in addition to their sedentary lifestyle, shifts their average BMI well into the overweight range.

2. Heavy online video game players (think World of Warcraft addicts) are generally underweight. Their constant inactivity, nutrient-poor diet, and low sun-induced vitamin D synthesis leads to muscle and skeletal atrophy and shifts their average BMI well into the underweight range.

These statements might invoke images from your memory ( from South Park, the mac guy/ hacker from Live Free or Die Hard), enforcing your belief in the “truth” of each statement. But which is right? I don't know, but a really fast pubmed search found this which seems to suggest that neither is (clinically) true.

The popular media, I’ve been noticing, is HORRIBLE with this. Anything sounding plausible is reported as fact, especially under the pretense of stereotypes/generalizations. It’s gotten to the point where I just stopped believing anything vaguely “scientific” that I haven't read in a true scientific publication*. This is especially true when it comes to health, psych, or behavioral research. If you hear anything, and I mean ANYTHING, in the health/news/tech newsmedia, don’t believe it. Don’t even regurgitate in bar chatter with friends unless you’ve looked into it further.

If you want to know if it’s true or not:

- go to the article/news story

- find the researcher mentioned or interviewed

- go to their lab page or do a lit search

- find their most recent article pertaining to that topic

- skim the abstract and conclusions or, better yet, read the whole thing

If you don’t care enough to at least glance at it like this, it isn't interesting enough for conversation fodder anyway.

And I swear, the next person that says something like “I heard about a neurological study that shows that facebook and myspace are actually making kids stupid” is going to get chewed out.

*: Journal, review, textbook, book, or (with caution) science reporting outlet.