Continuing from The Difference Between Doubt and Post Modernist Insanity – Part I. More on what firetender wrote.
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I will paraphrase Richard Feynman. I think that, based on the repeated evidence that alternative medicine is not any better than a placebo, it is much more likely that the reports of alternative medicine cures are the result of the known irrational characteristics of terrestrial intelligence than the unknown rational efforts of some mystical intelligence.
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But when the next set of experts determines that what they did really didn’t help that much in the long-term, and, in fact interfered in some way with progress that they now have shown essential to recovery, then where does that put you?
Why do you believe that this will be the case?
There is no valid reason for your argument.
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The changes that happen in science are almost never the complete reversals that you suggest. The changes in science are similar to someone driving a car and using the steering wheel to adjust the direction, but making progress toward their destination. You would have us believe that this is made up of a bunch of sudden reversals and the occasional transformation into a whale and a bowl of petunias.
The more we learn, the more we realize that we don’t know.
We are still learning.
We are still increasing what we know and understand.
Learning more about what we don’t know does not mean that we are decreasing what we know or decreasing what we understand.
You appear to be looking at this as if you are describing a person who is making more money, but is having inflation devalue the money the person is making. If the rate of inflation is greater than the rate of income (or increase in income), then the person is losing ground. But science is not finance. Knowing more is knowing more, even the awareness of more unknown material is a part of knowing more.
The changes in science almost always buttress the previous science. The changes in science almost never reverse, or overturn, the previous science.
Einsteinian physics did not invalidate Newtonian physics. Gravity still works, but it has been also applied to things that Newton was not able to observe. Newton was not able to figure out the properties of light. Light has paradoxically both particle and wave properties. As have become able to observe more, we have realized that this is not solved by a distinction, but by accepting that this paradox best reflects reality. Light is made up of both particles and waves. We should not expect to find out that light is neither particle, nor wave, even though we will learn a lot more about the way light works.
Einstein showed that even light is affected by gravity. Gravity still works. Our understanding of gravity is improved by new science, not overturned. Will massive objects fail to behave according to the laws of gravity because of science being overturned?
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Did Newtonian physics remain unchanged?
No.
Was Newtonian physics overturned?
No.
Will Einsteinian physics remain unchanged?
Probably not.
Will Einsteinian physics be overturned?
There is no good reason to believe that this will happen.
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Are you claiming that we will find out that morphine and fentanyl are not effective for pain management?
Are you claiming that we will find out that lorazepam and midazolam are not effective for sedation?
Are you claiming that we will find out that CPAP (Continuous Positive Airway Pressure) and high-dose nitrates are not effective for hypertensive acute pulmonary edema?
Are you claiming that we will find out that high quality chest compressions and defibrillation are not effective for cardiac arrest?
Are you really that crazy?
Well, Rogue, to be honest with you, I might very well be, but I’ll embrace it based on your Feynman quote!
It’s quite possible a lot of the therapies and drugs you mention will be shown to do what they were advertised to do.
Go to a hospital and observe the use of sedation. You may be able to talk someone into allowing you to observe procedures if you agree to sign a bunch of confidentiality paperwork.
The morphine and fentanyl will consistently be effective for pain management.
The lorazepam and midazolam will consistently be effective for sedation.
The CPAP (Continuous Positive Airway Pressure) and high-dose nitrates will consistently be effective for hypertensive acute pulmonary edema.
The high quality chest compressions and defibrillation will consistently be effective for cardiac arrest.
Science means that we will be able to predict what will happen and at what rate it will happen that way.
The morphine and fentanyl will consistently be much more effective than placebo for pain management.
The lorazepam and midazolam will consistently be much more effective than placebo for sedation.
The CPAP (Continuous Positive Airway Pressure) and high-dose nitrates will consistently be much more effective than placebo for hypertensive acute pulmonary edema.
The high quality chest compressions and defibrillation will consistently be much more effective than placebo for cardiac arrest.
That is something that alternative medicine cannot do.
That is science-based medicine.
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To be continued in The Difference Between Doubt and Post Modernist Insanity – Part III.
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Footnotes:
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Curiously the only thing that went through the mind of the bowl of petunias, as it fell, was, ‘Oh no, not again.’ Many people have speculated that if we knew exactly *why* the bowl of petunias had thought that we would know a lot more about the nature of the universe than we do now.
akroeze,
Precisely.
Perhaps I’m not giving science enough credit, in quite the right way.
Each and every one of the individual interventions you note, Rogue, do and likely will continue to do what they are supposed to. I have no qualms with that at all.
But science is progressing SO rapidly the CORE CONCEPTS are being overturned or reversed, and in our lifetimes!
We seem to be running into disagreement about this. It’s NOT the elements of the individual approaches that are being overturned, although in my case, some have been. They are still scientifically valid for what we’ve observed them to do. I’m saying the GUIDING CONCEPTS that make us use the elements as we do, however, will soon be changed.
Classic example, “A” and “B” were essential components of CPR. Without breaths, compressions were considered useless is what I was taught. Same thing with BiCarb, Epi and ZAP! over and over. Individually, those guys perform as advertised but the Core Concept of using them in conjunction with each other has been proven to be flawed.
CPR has been completely overturned, NOT modified because these well-defined APPROACHES were once thought to work and now have been shown to be marginal, at best. Elimination of 2 of 3 essential components says that was simply a flawed CONCEPT, unable to ATTAIN A RETURN TO LIFE AND TO VITALITY.
I wouldn’t be harping on this except both my experience and logic tell me that what Gupta (as illustration, NOT Bible) is claiming to be the next approach rings true. I can remember that patients I “saved” had to deal with the backlash of my interventions long after I got them breathing again, and many never recovered.
It makes sense that buying time tomorrow will mean slowing physiology down and allowing us to do the repairs necessary and then gradually bringing the patient back up again into a body that functions rather than aggressively trying to snap it back into life. I’m saying prepare yourself for another such reversal, just “fighting” the acid of Ulcers has fallen to “managing” the causative bacteria.
Science is telling us there’s a Whiplash Effect we hadn’t been able to see before. Scientifically, it has been revealed, so now what?
WE STOP DOING WHAT WE’RE DOING AND TRY TO FIND SOMETHING ELSE MORE SCIENTIFICALLY VIABLE.
I recognize this as how science works. Am I wrong?
Gupta’s saying the CORE CONCEPT I used back then is flawed. He’s saying (essentially) that the stuff you’re using is a MODIFICATION of what I used, but still a CONTINUATION of the Core Concept.
I’m saying it is HIGHLY LIKELY that 20 years from now the Core Concepts WE BOTH used to bring back the dead will be outmoded, overturned or eliminated.
Many of the individual interventions I used in the 1980’s HAVE been shown to be counter-productive WITHIN their Core Concepts. My projection is that SCIENCE will find SOME BETTER CORE CONCEPT is right around the corner. We all will have to adjust.
I am NOT dissing our science. If anything, I’m reflecting how fast it’s moving. Fifty years ago it was house calls followed by funerals at home. 25 years after that it was paramedics and aggressive intervention. 25 years after that? You’re the one that will be managing the transition.
firetender,
You are not giving science enough credit.
Yes.
No.
You refer to treatments that were not based on good science.
How is that a criticism of science?
Where is the survival research that has been overturned?
There have not been survival studies that demonstrated a benefit from ventilation.
There have not been survival studies that demonstrated a benefit from bicarb.
There have not been survival studies that demonstrated a benefit from epinephrine.
If you are referring to defibrillation, when you write ZAP!, then that has been shown to improve survival. We continue to use defibrillation, although we just shock once the first time, rather than with escalating doses.
The only part of CPR that had evidence supporting improved survival was the chest compressions. Resuscitation has only 2 things that have been shown to clearly improve outcomes. Excellent continuous compressions and prompt defibrillation. Everything else is a guess. We still need more evidence on therapeutic hypothermia.
Why do you blame science for the opinions of the experts creating the guidelines?
Feynman makes it clear that experts are enemies of science.
Everything else you were taught by experts made sense, too.
Explanations exist; they have existed for all time; there is always a well-known solution to every human problem — neat, plausible, and wrong. – H. L. Mencken.
No. There isn’t.
You are pointing out the flaws of the experts Feynman warns about. You blame science, rather than the true culprit – experts.
Stop paying attention to experts, such as Dr. Gupta.
You are wrong.
Your problem is with the experts, who claimed they were using science.
Dr. Gupta is just another expert.
Dr. Gupta is an anecdotalist, so Dr. Gupta will only continue exactly what you have been criticizing.
If Dr. Gupta gets anything right, it will only be a coincidence, because Dr. Gupta does not understand the way to scientifically examine medicine.
According to the AHA –
2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science
Part 1: Executive Summary
Introduction
Free Full Text Article with links to Free Full Text PDF download
2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science
Part 8: Adult Advanced Cardiovascular Life Support
Free Full Text Article with links to Free Full Text PDF download
I don’t see any scientific core concepts beyond excellent, minimally interrupted compressions and defibrillation.
Everything else is expert opinion/interpretation.
If we are not using compressions in 20 years, it will be because we have found a more effective means of providing artificial circulation. It is extremely unlikely that we will do this because of evidence that compressions are not effective. That much appears to be settled. Ditto for defibrillation.
The rest is expert opinion/interpretation.
Maybe the quotes I supplied are only with the latest guidelines –
2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Part 7.2: Management of Cardiac Arrest
Introduction
Free Full Text Article with links to Free Full Text PDF download
No. They have been pretty consistent in explaining that there is not evidence of improved survival with all of the toys you claim were based on evidence.
Just because we have been doing something, directed by doctors, does not mean that it has been based on good science.
…and since you brought up the subject of flying saucers…
I’ve SEEN flying saucers. I know that’s a HUGE SURPRISE to you, Rogue!
AND, I happen to believe that we are the ONLY form of intelligent life (like this) in the Universe.
The “flying saucers” I saw were in the night sky over Long Island in around 1966. I have no doubt that they were literally technologically light years ahead of us because during the watching, (presumably) Military aircraft were sent in pursuit. And it WAS a pursuit of about 5 jets pushing to their limits to catch up to these blinking lights in the sky.
And you know what those lights were doing? They were playing with those jets; letting them catch up and then STREAKING away at speeds exponentially greater than the jets could attain and then returning to pace them precisely JUST OVER THEIR COCKPITS; fling in formation in twos and threes and then one breaking rank to get behind a jet and then exactly match its speed, probably and literally only feet from the jet’s tail. This went on for about 20 minutes, and then, presumably bored, the blinking lights left.
I came to the conclusion that what I witnessed was incredibly human behavior! So I’ll go against Feynman’s explanation and say this:
Not too long after we, as a species, have cracked Einstein’s code, I’m certain we WILL be coming back to fuck with our forebears!!
firetender,
Eye witness testimony is probably the least reliable form of evidence available to us.
I don’t know what you saw. When observation has been studied, the reports of people have had only a weak correlation with what they were shown.
We put too much faith in our untrustworthy powers of observation, rather than in our more consistent powers of imagination.
Thank you so much Rogue, I figured out what our core conflict is; you think this is all real!
Your Buddy understood this:
“Science is a way of trying not to fool yourself. The first principle is that you must not fool yourself, and you are the easiest person to fool.” – Richard Feynman.
I think I could sit down with this guy and we’d see eye-to-eye, because 100 years from now, ALL of us will have been fooled. He understands this and you refuse to grant him his brilliance.
“Learn from science that you must doubt the experts.”
You, right now, ARE the expert.
…and “you are the easiest person to fool.”
Science is the belief in the ignorance of experts.
Of course it is, because they, like you, are the easiest ones to fool. And…
“science is the belief in the ignorance of experts.” Let’s try it another way:
and that means you who are the experts of TODAY, by Feynman’s definition of science, MUST BE IGNORANT.
Anxiously awaiting your reply!
russ reina,
Maybe you are correct. Reality isn’t real. That must feel very satisfying for you. Really.