Monthly Archives: November 2004

trust and reliability online

I recently published an article in which I described the following “troubling example”:

In June 2004, if you went online to learn about ?cholesterol,? you might have typed that word into Google, the world?s most heavily used search engine. Google would have quickly returned a list of more than five million websites containing the word ?cholesterol.?

The first ten websites would appear immediately before you; the remaining five million would take progressively more time and patience to find. The eighth result would be a page within MedlinePlus. This is an elaborate website created by the National Library of Medicine, a department of the United States government that has an annual budget of US $250 million, a mandate from Congress to inform the public about medical issues, more than a century of experience, and a highly professional staff of scientists and librarians. …

Somewhat higher up on the Google listing, at number five, was a site written by Uffe Ravnskov , MD and PhD, who described himself as the ?spokesman of THINCS, The International Network of Cholesterol Skeptics.? His site announced: ?The idea that too much animal fat and high cholesterol are dangerous to your heart and vessels is nothing but a myth. ? If you think this is written by another internet crackpot, take a look at Dr. Ravnskov?s credentials and the reviews of his book??which was for sale on the site.

I am not competent to judge whether Dr. Ravnskov?s claims about cholesterol or his own credentials are accurate. However, it is remarkable that an individual with a low-budget website?registered to the ?.nu? domain, which belongs to the New Zealand protectorate of Niue in the South Pacific?should be able to beat the National Library of Medicine of the United States in the competition for prominence on Google.

Dr Ravsnkov has, understandably, sent me an email complaining of his treatment in my article. I went back to his personal page and the Thincs website. To me, they raise interesting, complex, and ambiguous issues. Indeed, I meant to explore those issues in my article, although I confess that my tone was disparaging toward Dr. Ravnskov. These are the points that “trouble” me:

1) None of us can tell directly whether “animal fat and high cholesterol are dangerous to your heart and vessels.” We all rely on trusted authorities. People like me are completely dependent on others’ expertise. But even a scientific specialist in this field would have to trust the instruments he or she used and the reliability of past research. So the issue is not whether Dr. Ravnskov’s argument is right (I’m not qualified to judge that), but rather whether we should trust him or the medical orthodoxy that he is challenging.

2) In general, there are some good reasons to trust medical orthodoxy. Scientific method makes sense. Randomized, double-blind, clinical trials really are the “gold standard” of research. Not only that, but academic and government-paid researchers are supposed to work for institutions with integrity that reward truth and not profit. It worries me that anyone can create a website and say anything at odds with the medical establishment, and potentially convince lots of people to ignore the standard advice.

3) On the other hand, it is perfectly plausible that all those white-coated folks at NIH could be wrong about a particular topic. “Group-think” could have set in. Worse, they could have been more or less corrupted by the pharmaceutical companies that are making huge amounts of money from anti-cholesterol drugs. Newspapers and medical journals are full of distressing stories about distorted medical research.

4) Dr. Ravnskov’s websites look a little amateurish, and they advertise a book that he is selling. They list articles and other books in support of his position; but many are not peer-reviewed. Facts like these are sometimes taken as signs that a website is untrustworthy. However, some of the articles he cites are peer-reviewed. More importantly, the conventional signs could be misleading. Maybe Dr. Ravnskov’s sites look amateurish because they are low-budget; and they are low-budget because he has integrity. Maybe MedlinePlus isn’t more reliable, just more slick.

4) I feel that if I were worried about cholesterol (which I’m not, especially), then I could look into the issue and decide which sources are really credible. I could take the time to read the links on Medline and on Dr. Ravnskov’s page, and I believe I could make decent judgments. However, I (arrogantly) assume that I have better-than-average skills in the interpretation of research. How should we tell a 9th-grader to sort out reliable and unreliable claims?

All of this underlines the deep importance of ethics in medical research. I would quickly dismiss a critic of medical orthodoxy if it weren’t for all those stories about financial conflicts-of-interest.

“The Storm”

Here is a great, if difficult, war poem. It’s from the first page of La Bufera e altro (The Storm and Other Things), a book that Eugenio Montale began in fascist and Nazi-occupied Italy during the Second World War and published in 1956. My amateurish English translation follows. Click for some commentary and the magnificent Italian text.

The Tempest

Princes have no eyes to see these great marvels

Their hands now serve only to persecute us

–Agrippa D’Aubigne, à Dieu

The storm that drums on the hard

leaves of the magnolia its long March

thunder and hail,

(the sounds of crystal in your nocturnal

nest surprise you, of the gold

squandered on the mahogany, on the gilt edge

of the bound books, a sugar grain

still burns in the shell

of your eyelids)

the flash that candies

trees and walls and surprises them in this

eternity of an instant–marble manna

and destruction–that you carry

carved in you by decree and that binds you

more than love to me, strange sister,–

and then the rough crash, the sistri, the shudder

of the tambourines above the ditch of thieves,

the tramp of the fandango, and above

some gesture that gropes. —

just like when

you turned around and with your hand, cleared

your brow of its cloud of hair,

waved at me–and went into the darkness

Continue reading →

a story about universities and communities

I thought the following was the most interesting story told at the Penn State conference last weekend. (I’ll relate it in an anonymous paraphrase, since I don’t have the speaker’s permission to name her or her institution.) The story takes place at a major research university that’s near a deeply impoverished city. Don’t try to guess which one–there are lots. An administrator gathered a group of socially engaged, committed professors to meet with representatives of the community. The community members listed a set of pressing concerns, one of which was the huge trucks that rumble through their city. It came time for the professors to respond, and one by one, they all said that they knew nothing about trucks. The community members replied (in effect), “Well, it looks like we’ll have to deal with this on our own. But what good does it do us to have a world-class research university here?”

Like all good stories, this one prompts many thoughts, not all mutually consistent. My colleagues at the meeting made some interesting points, and then I came up with other ideas on my way home. In particular …

  • It wasn’t necessarily wrong for the professors to disclaim expertise about trucks. There’s nothing worse than false pretentions to knowledge, and these people really didn’t know about urban planning, traffic control, or related issues.
  • Possibly, the university should hire different people if it can’t field experts on the topics that concern the neighboring community. But possibly not. It all depends on mission. The university in question sees itself in service to the whole world, so it’s understandable that they don’t hire truck experts.
  • It might have been a good thing for the community to realize that they had to solve the problem on their own. There is nevertheless a question about the purpose of universities, especially ones that are supposed to serve their neighbors.
  • There could be a role for the university as a knowledge-broker. A staff member could be charged with putting community members in touch with experts–either at the campus or elsewhere. (Although no one at Penn State said so, this is a traditional role for librarians.)
  • Perhaps the professors who said they knew nothing about trucks were missing the point. Trucks are easy to understand; and urban planning (while complex) may not be the issue here. The real problem may not be trucks or roads but power: who wields it, how to confront it, how to get it. Professors, specifically political scientists, are supposed to understand power. But you can’t just transfer information or expertise about power to community members. Something much closer to real education would be required. By the way, the education could be mutual, since the best political scientists learn from observing or participating in political struggles.

“gay in a red state”

Since the election, I have repeatedly heard sophisticated liberals make extraordinary statements about conservative America, statements that verge on hatred and panic. One senior colleague, for instance, thinks that the election was basically about race; according to him, a hard-core 30% of Americans are fundamentalist Christians who regularly hear KKK-like speeches in their churches. I’m sure that there are equally extreme stereotypes on the other side of the Red State/Blue State divide. That doesn’t make it OK for liberals to lash out; nor are massive misinterpretations a good basis for rebuilding the Democratic Party. Even when stung by a bitter defeat, liberals, of all people, need to keep their minds and ears open. Anne Hull’s Washington Post article, “Gay in a Red State,” is a good place to go for some nuance.

Several weeks ago, I argued that the New York Review of Books should not have illustrated an article about American conservatism with a photo of Fred Phelps, an elderly reverand holding a “God Hates Fags” sign. I wrote that Phelps was essentially a cult-leader whose doctrines contradicted the mainstream teachings of evangelical Christianity. I said that using his face to illustrate an article about conservatism was like putting Castro’s picture next to a critical piece about liberalism.

Today, Anne Hull tells what happened when Phelps arrived in Sand Springs, OK, home of the 17-year old Michael Shackleford. Shackelford was previously the subject of Hull’s article about being gay in small-town Middle America. After reading this earlier story, Fred Phelps and his coterie came to Sand Springs to demonstrate, armed with signs saying, “Fags are Worthy of Death,” “Fags Doom Nation,” and other charming slogans.

Shackleford’s mother and pastor, convinced that homosexuality is a sin, were intent on “saving” him. His church’s sign said, “I hate the sin but love the sinner–God.” If this message was directed at Michael Shackleford, it suggested a lack of tolerance. Michael Shackelford’s community fundamentally disagrees with me and my community about the young man’s nature and its moral significance. They think his soul needs “saving”; I think he’s fine just as he is. There is a cultural divide in America.

However, Phelps was enraged by the church’s sign and told the Post, “It’s a play on words, the sin and the sinner. You can’t separate the two. There are some people in this world who are made to be destroyed.” Michael Shackleford’s neighbors knew that this was wrong. They knew it instinctively and passionately–not because they are liberal (although they are actually very liberal, by global and historical standards), but because they are Christian.

A truck driver shouted at Phelps, “Let he who cast the first stone …” A “burly man with a crew-cut” approached Shackleford in church and gave him a thumbs-up. Another congregant (holding his Bible) told Shackleford, “Man, you be who you are. We got your back.” His mother let him go to Washington for a Human Rights Campaign dinner. There, he visited a gay bookstore to buy a book for her, a book “on being a Christian parent of a gay child.”

There is deep moral disagreement in America. I passionately believe that the other side is wrong and doing harm, maybe even contributing to the suicide and murder of gay kids. However, there is also a great deal of commonality–and flexibility. Michael Shackelford’s mom, for instance, hopes that her son will be “saved” from homosexuality, but supports his educational journey to the alien big city. She is a better citizen than a liberal who forms hostile opinions of American fundamentalist Protestantism without actually listening to any fundamentalists.

to Penn State

I’m on my way to Penn State University this morning for a “National Public Scholarship Conversation.” We’ll be talking about ways to conduct what Harry Boyte would call “public work” in a land-grant, state university. When scholars do public work they somehow collaborate with fellow citizens to generate ideas and information of public value. We’ll also consider “the university’s role in the development of democratic principle and practice” among students. I know and admire many of the participants, and the moderator will be NPR’s David Brancaccio. So this should be fun.