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Tuesday, May 27, 2014

Rightly Wrong: Understanding the Autism-Vaccine Misbelief

The evidence is clear: vaccines are not linked to autism (American Academy of Pediatrics, Center for Disease Control, World Health Organization, Institute of Medicine). Yet, many people (Jenny McCarthy on Oprah, John McCain) and parents refuse to believe the science. Even after various pro-vaccinations campaigns - facts, science, emotions, stories - no kind of intervention is effective in making people change their minds. If you are thinking, "Why??," so am I.

A recent NY Times article, "I Don't Want to Be Right," provides some insight.  The article is about why people refuse to change false beliefs, even in the face of clear factual evidence and acknowledgement of the truth of such evidence. Take, for example, if someone says, "I know that the world is round, but I'm going to believe it is flat." Why would this happen? 

Consider this scenario:
...not all errors are created equal. Not all false information goes on to become a false belief—that is, a more lasting state of incorrect knowledge—and not all false beliefs are difficult to correct. Take astronomy. If someone asked you to explain the relationship between the Earth and the sun, you might say something wrong: perhaps that the sun rotates around the Earth, rising in the east and setting in the west. A friend who understands astronomy may correct you. It’s no big deal; you simply change your belief. 
But imagine living in the time of Galileo, when understandings of the Earth-sun relationship were completely different, and when that view was tied closely to ideas of the nature of the world, the self, and religion. What would happen if Galileo tried to correct your belief? The process isn’t nearly as simple. The crucial difference between then and now, of course, is the importance of the misperception. When there’s no immediate threat to our understanding of the world, we change our beliefs. It’s when that change contradicts something we’ve long held as important that problems occur (Maria Konnikova, NY Times, I Don't Want to Be Right).
Why would false belief happen? It'd happen if the belief tied in strongly with your sense of self, if that belief changes beliefs about a whole range of other things, if that belief threatens something you stood for with conviction. "A man with a conviction is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point." So wrote the celebrated Stanford University psychologist Leon Festinger" (See related article: Chris Mooney, Mother JonesThe Science of Why We Don't Believe Science).

What can scientists and physicians do about the vaccine and autism mis-belief, then? The answer is not clear, since the topic has become one of such conviction; one highly invested in emotion for parents and caregivers. But, at least it is not an inherently ideological one. The best we can do is try to prevent it from becoming more so - and that applies to all our politics and debates. 
And that, ultimately, is the final, big piece of the puzzle: the cross-party, cross-platform unification of the country’s √©lites, those we perceive as opinion leaders, can make it possible for messages to spread broadly. The campaign against smoking is one of the most successful public-interest fact-checking operations in history. But, if smoking were just for Republicans or Democrats, change would have been far more unlikely. It’s only after ideology is put to the side that a message itself can change, so that it becomes decoupled from notions of self-perception. 
Vaccines, fortunately, aren’t political. “They’re not inherently linked to ideology,” Nyhan said. “And that’s good. That means we can get to a consensus.” Ignoring vaccination, after all, can make people of every political party, and every religion, just as sick (Maria Konnikova, NY TimesI Don't Want to Be Right).

Friday, March 7, 2014

Calmness as Insight

Jeff Nunokawa is a Professor of English at Princeton University. He writes daily notes on facebook available to the public at, and is currently working on a book which puts together these notes. I can't recommend his notes enough for the insights he provides on everyday life, the struggles we all go through, the importance of connecting with others, and the way he speaks at once so personal and so general. His note (#5172!) this morning is beautiful. Just think, if we both read these each day, we're making daily connections, being a part of something greater, something shared. What a beautiful thought! Please join me? 

5172, Calmness as Insight

March 7, 2014 at 11:59amby Jeff Nunokawa
I do not think the craving for placidity is religious; I think a religious person regards placidity or peace as a gift from heaven, not as something you ought to hunt after. Look at you patients more closely as human beings in trouble and enjoy more the opportunity you have to say 'good night' to so many people (From M O'C Drury"Conversations With Wittgenstein").

You wake up angry and you remember why you're lonely. (You can't get too close to other people. No one can see that much of you: you're too easily annoyed.) And you go and read something calming that some wise man said in another century. (See above.) You're all set to open the far sighted gift that's come your way from far away. (The calming gift that lets you know that calmness is a gift. See above.) 

But then you notice that's something's off with your vision in one eye. Maybe you always have this problem and you're just noticing it now. Then you start to look around at what else you're just noticing now. Like the rest of what the wise man had to say (see above): Look at you patients more closely as human beings in trouble. Maybe say it twice for both eyes. (If you type it out, and don't just copy and paste it in, you might be able to see it better.) Look at your patients more closely as human beings in trouble. Look at the people around you as people in trouble. (You don't need 20/20 vision to enlist for that.) Look at yourself as a kind of First Responder. (You don't need a license to practice that.)

Look at good night and good morning as two aspects of the same greeting. Look at every greeting as a gift from something glowing. Look at every glowing as a gift from somethinggoing
Look at every going from the corner of one eye.
Note: As my two eyes make one in sight (Frost, "Two Tramps in Mud Time")

Wednesday, February 5, 2014

Arts and Humanities in Medicine

A talk presented to the Clare Dilletante Society which investigates the intersections between art and science, and likewise, humanities and medicine from my personal, narrative perspective.