A (rare) good news story

There isn’t so much good news around at the moment to want to pass by a piece that comes my way. And this one particularly attracted my attention because it linked to some local knowledge of mine. And, after just four years living in Spain, my local knowledge tends to be either extremely local or non-existent.

Up in the hills above and to the north of Madrid stands the village of Hoyo de Manzanares, lively, pleasant and welcoming. It’s where our grandkids, Matilda and Elliott live. Just for the avoidance of confusion, let me assure you, and this may come as a relief to you (since they're four and two and a half respectively), that their parents live there with them.

The next town eastward is Colmenar Viejo. I’ve always liked it for its name. It means ‘old beehive’. Whenever I see the name, usually on a signpost, I wonder whether honey’s better from an old hive, like wine from old vines. Alternatively, it might be a place that old bees retreat to. Or, again, it may mean that there never was a beehive there at all, rather like the community where we live, ‘Los Sauces’, the Willows, without a single willow anywhere within kilometres of the place.

The town hall and main square of Old Beehive

I most recently came across Colmenar Viejo’s name not on a signpost but in the headline of a newspaper article. The story was about a woman from the town. Her name is Eva Nogales and if you’ve never heard of her, well, neither had I.

It turns out that she’s shared this year’s Shaw Prize with a German scientist. What, you may be wondering, as I did, is the Shaw Prize? It turns out it’s an award for outstanding science set up by a businessman from Hong Kong. The prize is seen as a kind of ‘oriental Nobel prize’. Indeed, it appears that one in every seven recipients of the Shaw go on to win a Nobel too.

She won her share for the work of a team she leads in Berkeley, California, which mapped the structure, atom by atom, of proteins that play a vital role inside the human body. 

‘All life is chemistry,’ she points out, ‘ultimately, in biology, everything’s chemistry.’

She goes on to point out that everything comes down to 20 compounds called amino acids, which act like Lego pieces out of which complex proteins can form. 

‘With just twenty elements we have all the beauty of life, from a bacterium to an elephant, by way of a sea sponge.’

If you’ve read this far, you may be thinking, ‘well, OK, this is all very well and fine, but it’s not that extraordinary, is it? After all, there are winners of major scientific prizes every year, aren’t there?’

That’s true. But not that many of them are women. And even fewer are the daughters of a shepherd father and a seamstress mother, both of whom had to leave school to go to work when they were eleven or twelve. Eva Nogales grew up with parents that humble in their origins, but intensely committed to their daughter’s having the opportunity to study.

Eva Nogales, winner of an international science prize,
from Colmenar Viejo (Old Beehive)

She’s back in Colmenar Viejo at the moment. She returned to spend Christmas with her mother (her father died some years ago). While there, she met three teachers who were central in sending her towards a career in science, her teachers of biology, physics and mathematics. All three are women.

It’s a great story, isn’t it? Though the message is perhaps not quite as positive as it seems at first sight. That’s for precisely the reasons that make it so attractive.

Her recognition by the scientific establishment is lovely, but wouldn’t it be great if it were common for women? It’s wonderful to see someone from a humble background rise as far in international prominence as Eva Nogales, but whatever believers in the American Dream might suggest, that’s not common either, is it? And, though this is less important than the other two, wouldn’t many Europeans be pleased to see Europe rekindling the extraordinary dynamism in science it knew before World War 2, and offer as encouraging an environment to its top performers as Berkeley or other American universities?

Of course, if all those things were as normal as I’d like, the Eva Nogales story wouldn’t be so striking. Its very rarity makes it attractive. That rarity’s rather sad.

Still, let’s enjoy it anyway. Next time I’m in Hoyo, perhaps I can get across to Colmenar Viejo. And if I do, I’ll make a point of wandering down the street renamed ‘Avenida Evangelina Nogales de la Morena’, in honour of a local girl made good and a fine scientist.

Is Medicine really a Science?

“If your physician does not think it good for you to sleep, to drink wine, or to eat such and such meats, never trouble yourself; I will find you another that shall not be of his opinion; the diversity of medical arguments and opinions embraces all sorts and forms.”

So wrote Michel de Montaigne over four centuries ago.

Well, things have changed. Today, a growing body of information is attracting a consensus within the medical profession. However, the information is by no means stable. A journal of the Mayo Clinic in the US (its Proceedings) published a study in August 2013 of all the original research articles from the prestigious New England Journal of Medicine over a decade. It found that:

• 1344 articles examined a new or existing medical practice
• Over half of them (56.3%) suggested a new practice superior to an existing practice. This is known as ‘replacement’, where a new treatment is to be preferred to an old one
• Far more worrying, nearly one in nine (10.9%) found that a treatment in common use was inferior to what had preceded it and should be stopped. This is known as a ‘reversal’, where a new treatment is found to be inadequate and practice reverts to an older approach

That’s just one decade and just one journal, even if it is one of the publications with the most impact in medicine.

Maybe that means that Montaigne, if he were living today, would have to change his advice slightly: if you don’t like the advice your doctor’s giving you, you don’t so much have to find another doctor, just wait a bit – before long there’ll be some new advice coming along.

Of course, you do have to survive for as long as it takes to get that new advice.

Bloodletting: once one of the most common of medical practices
Now regarded as not generally beneficial...

What prompted me to think about all this? Why, the new advice from the Lancet, another of the most prestigious medical journals, that salt, against which we’ve been warned for so long and so loudly, for the harm it does to the heart, might actually be beneficial for cardiovascular disease if consumed in moderation.

Doesn’t this remind you of attitudes towards, say, aspirin? It was perceived as a panacea, a cure for practically any disease, when it was first discovered. Then the profession turned sharply against it, above all for its effect on the digestive system. But now the pendulum has swung back and aspirin, in moderation, is recommended for many conditions, and in particular as a preventative for certain heart problems.

As for red wine, I’ve lost track of where we stand now. Is it good for you? Is it bad for you? Maybe I should just take a leaf out of Montaigne’s book and just do what I like and, since I like red wine, keep drinking it.

In moderation, of course.

Naturally, all this progress is based on scientific work. Highly effective, intelligent research is slowly moving us forward. It’s causing us to question old remedies, and sometimes – maybe as often as one time in nine – even new remedies. Which means that medicine is becoming more scientific.

Gone are the days of bleeding patients, as in the eighteenth century, just because that’s what a physician does. After all a scientist might well come along and question the practice. But it seems that could also happen for many of the practices we still use, unlike bleeding. With so much of medicine subject to questioning, I’m not convinced that it’s reasonable to call it a science.

Perhaps it’s just a practice on the way to becoming more scientific…

There’s a great quote attributed to Mahatma Gandhi, though he probably never said it. Asked by a journalist what he thought of Western Civilisation, the story says Gandhi replied that he thought ‘it would be a good idea’.

Medical science? I don’t know what Gandhi would have thought. But to me it seems like it would be another good idea.

The scientific method: authoritative, impregnable. Even in the hands of humans

What gives science its authority is its ability to test ideas, in a way that can be repeated by other people, and based on prediction rather than on hindsight.

In a field like history, in which I worked for a while, one looks back on events and tries to come up with a plausible explanation for them. But plausibility isn’t proof, and there’s no clear way of distinguishing which of two or more plausible explanations is true (if any of them), which is why history is a subject of so much debate and revision.

For instance, today, on the 70th anniversary of the Dresden bombing, though we still feel horror at the number of deaths, we believe there were far fewer than Kurt Vonnegut mourned when he wrote Slaughterhouse Five. There are voices suggesting today that the bombing was even, perhaps, justified – including the voices of a number of survivors.

Dresden after the bombing of 13 February 1945

Science isn’t like that. A theory suggests that something must be a certain way, so we take a look – and it’s important that just anyone with the necessary skill and equipment can take a look – and if we find that things aren’t that way, the theory needs revising. If it is, we don’t necessarily accept the theory as true, but we feel we can perhaps keep using it as a helpful set of assumptions.

It’s true that there are some applications in the life sciences in particular, where we may be dealing with an individual’s reaction to a particular pathogen (or, to use a more technical term, a grubby little germ) and demanding that an observation be reproducible may be a tall order. However, generally, insisting on predictions that can be tested in reproducible experiments is a powerful methodology that has served us well.

One of the more famous such confirmations concerned Einstein’s General Theory of Relativity (not sure whether the capital letters are absolutely obligatory, but they somehow seem deserved). He predicted that light would be bent by gravity around really massive objects. So when light coming to us from a distant star has to travel close to the sun, it would be bent towards it, and the star would look further away from it than it should be.

In normal conditions, you can’t check that: the light from the sun completely drowns out any star shining behind it. But in a total eclipse, the sun’s light goes and stars apparently close to it can be seen. It ought therefore to be possible to see their apparent position.

Arthur Eddington
Confirmed Einstein's theory. Which he admired

In 1919, Arthur Eddington organised two expeditions to carry out the necessary observations during that year’s total eclipse, one in Brazil, the other in West Africa. Their measurement of the apparent displacement of the stars didn’t just to confirm that the phenomenon was happening, but that it was happening to the degree that Einstein’s calculations suggested.

Staggering proof of the power of Einstein’s theory, greeted with great acclaim around the world.

Except. The bending of visible light is slight. And during a total eclipse all sorts of strange currents get going in the atmosphere, creating all manner of problems seeing through it. Many people looking at Eddington’s photographs can only ask: how on Earth can you really assert anything from pictures as muddy and uncertain as these?

Eddington's picture of the 1919 total eclipse (negative and positive)
They support precise measurements, do they? Seriously? 

Interestingly, measurements carried out since by telescopes outside the Earth’s atmosphere, or on radio waves where the phenomenon is far greater, have all confirmed Eddington’s findings. So we can breathe easy (well, as easy as the weird picture of the universe that emerges from General Relativity allows). Still, it does leave a bit of a question, doesn’t it? Did Eddington really see what he claimed he’d seen? Or was it just too convenient?

The scientific method: rigorous, systematic, impartial. And authoritative as a result.

But it has to be applied by men and women. Who aren’t always quite as rigorous and systematic as one might hope. And who might, perhaps, be a little partial to one particular theory – such as Einstein’s.

Still, Eddington has ultimately been vindicated. So who cares whether his results were reliable or not? Doesn’t matter, does it? 

Or does it?