Well, I doubt if any readers of these scribblings will be shocked. After all TIJABP. But this piece by the editor of PNAS wonders if the day of meaningful editing is over. I hope not. Looking backwards over my several hundred papers, the American Journal of Human Genetics was the most rigorous and did the most to improve our manuscript.

On a subject no one wants to read about (about which no one wants to read?) | PNAS

“Communication” remains in the vocabulary of scientific publishing—for example, as a category of manuscript (“Rapid Communications”) and as an element of a journal name (Nature Communications)—not as a vestigial remnant but as a vital part of the enterprise. The goal of communicating effectively is also why grammar, with its arcane, baffling, or even irritating “rules,” continues to matter. With the rise of digital publishing, attendant demands for economy and immediacy have diminished the role of copyeditor. The demands are particularly acute in journalism. As The New York Times editorial board member Lawrence Downs (4) lamented, “…in that world of the perpetual present tense—post it now, fix it later, update constantly—old-time, persnickety editing may be a luxury…. It will be an artisanal product, like monastery honey and wooden yachts.” Scientific publishing is catching up to journalism in this regard.

Being a renowned scientist doesn’t ensure success. On the same day that molecular biologist Carol Greider won a Nobel prize in 2009, she learnt that her recently submitted grant proposal had been rejected. “Even on the day when you win the Nobel prize,” she said in a 2017 graduation speech at Cold Spring Harbor Laboratory in New York, “sceptics may question whether you really know what you’re doing.”

Secrets to writing a winning grant

We are not of this world

This is from Larry Page of Google (quoted in “The Age of Surveillance Capitalism: The Fight for a Human Future at the New Frontier of Power” by Shoshana Zuboff)

CEO Page surprised a convocation of developers in 2013 by responding to questions from the audience, commenting on the “negativity” that hampered the firm’s freedom to “build really great things” and create “interoperable” technologies with other companies: “Old institutions like the law and so on aren’t keeping up with the rate of change that we’ve caused through technology. . . . The laws when we went public were 50 years old. A law can’t be right if it’s 50 years old, like it’s before the internet.” When asked his thoughts on how to limit “negativity” and increase “positivity,” Page reflected, “Maybe we should set aside a small part of the world . . . as technologists we should have some safe places where we can try out some new things and figure out what is the effect on society, what’s the effect on people, without having to deploy kind of into the normal world.

As for his comments on safe spaces, I agree. There are plenty of empty planets left.

I wish I had said that..

A comment on an article:

With reference to Janan Ganesh’s column (“What the US lost when the Berlin Wall fell”, November 7). This is such a clever line.

“It is as though hatred obeys the first law of thermodynamics. Like energy, it can be transferred but never destroyed.

This apropos the US right’s shifting from the Soviet Union to immigration and climate. I’m trying to figure out how to work it into my own stuff. Full credit, of course.

Link

I don’t like the work-life balance meme. I know what it means, but I never wanted it. Medicine was once talked of as a vocation, and when I was a medical student I can remember many doctors who clearly believed so as well. Neonatologists who appeared to live on the special care baby unit; surgeons whose idea of Christmas day was to do a ward round and bring their children with them; and ‘be a paediatrician and bring up other people’s children’. The job was not just any job. I remember the wife of one professor who appeared on the ward when I was a houseman very late one night. “Had I seem the professor, her husband?” I had: I saw him there most evenings when I was on call. On this night, for whatever reason, she had accompanied him. Sadly for her, he had forgotten, and gone home without her. Thales and the well.

For me being an academic was a ‘calling’. A grand phrase, I know. But it has for most of my career been a way of life beyond the paycheque. I believe in the academic ideal, but increasingly fear the institutions no longer do. For me, home and office were not distinct. I vaguely remember — and it is quite possible I am mistaken here — that my first Professorial contract at the University of Newcastle stated ‘that by the nature of the work no hours of work are stipulated’. As my children would testify, weekend mornings were spent in the (work) office, and the afternoon in the gym and pool with them.

I retire* in the near future, and I face a practical problem. Much of my ‘work’ is at home — books and papers of course, but also the high spec iMac Pro that I have used to produce videos, alongside video cameras and lights. On the other hand, my office is full of things that strictly speaking are personal, in that I bought them with my own money rather than with a univeristy purchase order. But my work space — measured in square metres if not mental capacity, I hope — is diminishing. A domestic negotiation is required.

*From paid employment, not from my work.

Diseases of Deans

Woodrow Wilson once remarked that it is easier to change the location of a cemetery than it is to change a curriculum.

Via Jon Talbot, commenting on an article on the failures of online learning. I would only add the comment made by Henry Miller (in the context of medicine):

Curriculum reform, a disease of Deans.

My earliest conscious memory of disease and doctors was in the management of my atopic dermatitis. Here is Sam Shuster writing poetically about atopic dermatitis in ‘World Medicine’ in 1983.

A dozen years of agony; years of sleeplessness for child and parents, years of weeping, itching, scaling skin, the look and feel of which is detested.

The poverty of our treatments is made all the worse by the unfair raising of expectations: I don’t mean by obvious folk remedies; I mean medical folk remedies like the recent pseudoscientific dietary treatments which eliminate irrelevant allergens. There neither is nor ever was good evidence for a dietary mechanism. And as for cows’ milk, I would willingly drown its proponents in it. We have nothing fundamental for the misery of atopic eczema and that’s why I would like to see a real treatment—not one of those media breakthroughs, and not another of those hope raising nonsenses like breast-feeding: I mean a real and monstrously effective treatment. Not one of your P<.05 drugs the effect of which can only be seen if you keep your eyes firmly double-blind, I mean a straightforward here today and gone tomorrow job, an Aladdin’s salve—put it on and you have a new skin for old.

Nothing would please me more in the practice of clinical dermatology than never again to see a child tearing its skin to shreds and not knowing how long it will be before it all stops, if indeed it does.

Things are indeed better now, but not as much we need: we still don’t understand the itch nor can we easily block the neural pathways involved. Nor has anything replaced the untimely murder of ‘World Medicine’. A glass of milk has never looked the same since, either.

There is an interesting review in the Economist of the ‘Great Pretender: The Undercover Mission that Changed out Understanding of Madness,’ written by Susan Cahalan. The book is the story of the American psychologist David Rosenhan who “recruited seven volunteers to join him in feigning mental illness, to expose what he called the ‘undoubtedly counter-therapeutic’ culture of his country’s psychiatry”.

Rosenthal’s studies are well known and were influential, and some might argue that may have had have a beneficial effect on subsequent patient care. The question is whether they were true. The review states:

in the end Rosenham emerges as an unpalatable symptom of a wider academic malaise”.

As for the ‘malaise’, the reviewer goes on:

Many of psychology’s most famous experiments have recently been discredited or devalued, the author notes. Immense significance has been attached to Stanley Milgram’s shock tests and Philip Zimbardo’s Stanford prison experiment, yet later re-runs have failed to reproduce their findings. As Ms Cahalan laments, the feverish reports on the undermining of such theories are a gift to people who would like to discredit science itself.

I have a few disjointed thoughts on this. There are plenty of other considered critiques of the excesses of modern medical psychiatry. Anthony Clare’s ‘Psychiatry in Dissent’ was for me the best introduction to psychiatry. And Stuart Sutherland’s “Breakdown’ was a blistering and highly readable attack on medical (in)competence as much as the subject itself (Sutherland was a leading experimental psychologist, and his account is autobiographical). And might the cross-country diagnostic criteria studies not have happened without Rosenham’s work?

As for undermining science (see the quote above), I think unreliable medical science is widespread, and possibly there is more of it than in many past periods. Simple repetition of experiments is important but not sufficient, and betrays a lack of of understanding of why some science is so powerful.

Science owes its success to its social organisation: conjectures and refutations, to use Popper’s terms, within a community. Just repeating an experiment under identical conditions is not sufficient. Rather you need to use the results of one experiment to inform the next, and with the accumulation of new results, you need to build a larger and larger edifice which whilst having greater explanatory power is more and more intolerant of errors at any level. Building large structures out of Lego only works because of the precision engineering of each of the component bricks. But any errors only become apparent when you add brick-on-brick. When a single investigator or group of investigators have skin in the game during this process — and where experimentation is possible — science is at its strongest (the critiques can of course come from anywhere).

An alternative process is when the results of a series of experiments are so precise and robust that everyday life confirms them: the lights go on when I click the switch. This harks back to the reporting of science as ‘demonstrations’.

By these two standards much medical science may be unreliable. First, because the fragmentation of enquiry discourages the creation of broad explanatory theories or tests of the underlying hypotheses. The ‘testing’ is more whether a publishable unit can be achieved rather than nature understood. Second, in many RCTs or technology assessments there is little theoretical framework on which to challenge nature. Nor can everyday practice act as the necessary feedback loop in the way the tight temporal relationship between flipping the switch and seeing the light turn on can.

Term of the day

Negative egalitarianism (also known as jealousy)

Richard Gombrich

Perhaps, perhaps not. But when and where is even more important.

Hailed as a maths prodigy at school, Shields accepted a junior position at Merrill Lynch after studying engineering, economics and management at Oxford University because the trading room floor offered him a thrilling, dynamic environment. He was not alone: of 120 engineers in his year group at university, Shields added, only five went into engineering.

I think we should be much more cautious in attempting to direct young people’s choices beyond providing them with an education. We should feel proud of their independence of mind, remembering that supply side factors will likely win out over central planning. It is the supply side that we need to deal with, not least Putts Law. The same applies to medicine.

This personal story is worth a read for other lessons, too.

‘The men who plundered Europe’: bankers on trial for siphoning €60bn | Business | The Guardian