Bad Science: Quacks, Hacks, and Big Pharma Flacks

The aim of this book is that you should be future-proofed against new variants of bullshit. Since producing bullshit requires no conviction, but protection against it does.” – Ben Goldacre
The annals of human history are littered with accounts of charming and suave con-men endowed with a knack of coaxing gullible fellow humans into parting with their hard-earned money. Not only are these smooth operators hard to detect but their trickeries also fly under our skeptical radars. They sashay around in the veneer of knowledge and savvy, lead people down the paths of fantasy garden and eventually, swindle them without an iota of resistance. It’s this type of grifters that Ben Goldacre – author of ‘Bad Science’ – wants us to guard against. Goldacre’s key targets are the impostors operating under the hood of medicine: the savvy crooks that perpetrate a vast pseudo-scientific deception on the often naive populace. He goes all-guns-blazing at these false gods who profit from the lack of skepticism and grave misunderstanding of science shared by a large majority of citizens.

As a man of science, Goldacre harbors a rightful grudge against those who willfully concoct spurious scientific theories and dupe general public. Homeopathy, Big pharma, alternative therapy peddlers and cosmetics firms are some of the miscreants that Goldacre dresses down in his book.

Goldacre is unambiguous in his criticism of homeopathy. He fumes at the way homeopathy continues to thrive despite the absence of sufficient scrutinies from the scientific community. Blatant omission of legit procedures such as randomization and blinding in homeopathic clinical trials only accentuates its ‘pseudoscience’ tag. Worse, weird rituals such as the banging of water flasks against horsehair cushions do not exactly evoke feelings of confidence in homeopathy either. So why do people choose homeopathy over mainstream medicine? Goldacre says that a disappointing experience with the mainstream medicine is the leading reason why people choose to go the other way.
Goldacre also fulminates against the newfangled educational kinesiology organization called Brain Gym. Brain Gym notoriously runs a curriculum of physical drills – ranging from weird to downright preposterous – across schools in the UK. These physical drills allegedly improve the cognitive faculties of children. The only problem is that these workout sessions lack the apt scientific research to back them up. No wonder Goldacre is categorical in his criticism of Brain Gym. Out of curiosity, I decided to browse the official UK Brain Gym website. While browsing the site, I stumbled upon a subsection called ‘Response to Criticism’ where I found one of the most bizarre responses to criticism. It reads, “The majority of the Brain Gym studies are anecdotal. There is some peer-reviewed research of our program. As a non-profit organization with limited personnel and financial resources, facilitating research at this time is not an option for us.”To steal an analogy from wrestling entertainment, this sounds more like a squeal of someone squirming into submission as the opponent tightens the choke-hold than a brave response to criticism. Much to my horror, Brain Gym are on an expansion spree and have spread their tentacles in India as well.
When he is not picking apart the charlatans, Goldacre wrecks the devious methods these hucksters regularly employ to rig the research outcomes. He instructs the reader to not read too much into an observational study over a proper intervention study. Pseudoscience experts usually rely on small-sized observational studies – littered with confounding variables that they don’t have the expertise to detect – to flaunt their bogus savvy. Other times, these half-experts count on surrogate endpoints such as blood tests and cherry-pick the studies that fit in with their hypotheses and leave out all the incriminating evidence to arrive at customized but flawed, procrustean conclusions.
“…out of its $550 billion global annual revenue, the pharmaceutical industry spends twice as much on promotion and admin as it does on R&D” – Ben Goldacre
The endless barrage of marketing salvos and PR rhetoric from the pharma and the FMCG firms is another contentious bone for the author. He is resentful because people have deserted good-old green veggies in favor of vitamin pills and antioxidants, all in the name of vibrant well-being. Much to my sadistic delight, Goldacre tears into the antioxidant fad. He cites a Cochrane systematic review that covers all the placebo-controlled randomized trials of antioxidant supplements ever performed. In a chilling confirmation, the study establishes a positive correlation between consumption of antioxidants and a slight increase in mortality. More antioxidants, huh?
After disrobing the alternate therapy quacks and vitamin pill salesmen, Goldacre turns his guns to big-bad-pharma. In the chapter called ‘Is Mainstream Medicine Evil?’, he takes the wraps off a host of unethical, wicked practices that pharma companies indulge in to get their drugs to market quickly. For instance, a majority of clinical trials – an expensive proposition – are conducted or commissioned by pharma industry itself. Consequently, the drug companies get to wield an enormous influence over what gets researched and what gets published. Most trials are conducted on healthy young people – even if the medication is meant for older people – in order to get suitable results. Further, only positive trials make it to the academic papers and journals whereas those with negative outcomes are often banished to the back-burner. And to top it all, trials of diseases with concentration in developing world or frontier countries are often declared a failed proposition straight away due to a perceived lack of monetary adequacy and hence, never pursued. It is shameful, but apparently true!

Our increasing reliance on what we read in the paper and watch on TV is a clear indictment of our increasingly fading skeptic faculties. Media’s inability to make heads and tails of ‘Science’ irks the author. In Goldacre’s words, “Everything in media is robbed of any scientific meat, in a desperate bid to seduce an imaginary mass who aren’t interested.” A crucial highlight of the book is the author’s postmortem of the media-engineered MMR hoax in the UK. An excruciating trial of media frenzy that led the unaware citizens into believing that MMR vaccination was linked with autism. Cloaked in melodrama, British media made one cardinal sin after another to fuel the anti-MMR spiel for nine long years. Such was the hyperbole surrounding the hoax that British media snugly ignored all the dissenting evidence and pulled out all stops to confirm its own stance, affirming what behavioral scientists calls confirmation bias.

It’s true that journalists are word-checkers not fact-checkers. Nassim Nicholas Taleb, author of bestselling books ‘The Black Swan’ and ‘Antifragile ‘ blatantly declares,” The business of journalism is pure entertainment, not the search for truth.” In the MMR case, several experienced authors and columnists so astonishingly ignored the fact that the study that made them roll all over had in fact never been published in a single academic journal – a major benchmark for most scientific findings. Media often dumb down the science part of the news bit and doggedly report the-epic-breakthrough or the-whopping-failure parts that are in line with their sensational-reporting mandate.

Bad Science is an explosive book. It’s full of eye-opening takeaways and scary revelations. I like the no-holds-barred approach of the author. He enlightens the reader and also, subtly induces a sense of healthy skepticism with respect to the baffling world of fancy pills and alternative therapies. In conclusion, you don’t need a white-coat clad, jargon-spouting pseudo-expert telling you to consume vitamin pills and antioxidant supplements to stay fit. Good, old-fashioned healthy-eating practices have more impact and are easy to follow. But then as Goldacre sarcastically remarks, “…where is the spectacle in that?”