Making Peace With The Decline Effect

In the light of this week’s controversy over whether or not coffee makes you smarter, Jonah Lehrer’s “The Truth Wears Off” in the New Yorker seems particularly well-timed. (Lehrer discussed this in-depth here last night.) His topic is the “decline effect,” in which the positive results of an experiment are less and less able to be replicated over time, and he paints a picture of the scientific community as a self-reenforcing echo chamber. Like FOX News, sort of. Not because they’re terrible people, scientists (or because they’re all Democrats!) but just because they are people. And people like to be proven right, not wrong. And also studies showing results that prove or bolster a groundbreaking discovery are much more likely to be published than those that show inconclusive results.

Australian biologist Michael Jennions tells Lehrer:

“This is a very sensitive issue for scientists. You know, we’re supposed to be dealing with hard facts, the stuff that’s supposed to stand the test of time. But when you see these trends, you become a little more skeptical of things.”

I’ll say. Who are we supposed to trust if we can’t trust science? Skepticism is healthy, for sure. But really, in some areas, we — or, I should say, I — don’t need any more of it. I’m not looking for a single over-arching theory of the universe. (Not that I’d mind it, I suppose, if it were to occur to me. Or if a more intelligent alien beamed it into my brain from space.) I don’t need hundred-percent, guaranteed answers to all the big questions. I’m just looking for some guidance in going about my day-to-day. I look to science, and people who know much more about it than I do, for that. The caffeine thing is a perfect example. I probably don’t need more than a single cup of coffee to wake myself up in the morning, and I don’t need to be any more jittery and nervous than I already am, but when it comes to being smarter, I could definitely use all the help I can get.

These days, though, the more science we get (and we sure get a lot of it these days, huh? Living as we do in the information age) the more fickle and shifty it seems. Trying to know what we’re supposed to eat or drink or not eat or drink or otherwise do or not do to keep ourselves healthy, this has seemed like a fool’s endeavor for years now. The accepted truth keeps changing so fast. Avocados, good or bad? How about eggs? What are the three different types of cholesterol again? I can’t keep up, but I try my best to do what my doctor tells me. (It was hard enough to find a doctor, which I finally did earlier this year, they way they move around and drop out of people’s more gainfully employed wives’ health plans and whatnot, and the way that people’s more gainfully employed wives’ companies switch health plans from time to time. This world.)

Of course, a doctors’ advice is usually based on what he or she has read or skimmed in the latest or slightly less latest medical journals (or what drug salespeople have most recently told him). And unfortunately, Lehrer writes, “In the field of medicine, the phenomenon seems extremely widespread, affecting not only antipsychotics, but also therapies ranging from cardiac stents to Vitamin E and antidepressants.”

Sure enough. My doctor prescribed me Vitamin D pills earlier this year, due to my having an apparently less-than-optimal amount of Vitamin D in my blood. Not three months later, the newspaper tells me to stop. Vitamin D pills have been proven unnecessary and might actually be harmful, it says. So I stop. For now, I guess. I haven’t called the doctor to see what she says about it. But, Jeez, I hadn’t gotten through half the bottle.

And I’d say that over a span of twenty years, I have been told the following by dental hygienists:

1) You should brush your teeth three times a day, once after every meal.
2) You should brush your teeth twice, once in the morning, once before going to bed.
3) You really should only brush your teeth once, before going to bed.
4) You should brush twice a day with an electric toothbrush
5) You should only brush once a day with an electric toothbrush, and use a regular tooth brush the other time.
6) You should brush your teeth in the little circle patterns where each tooth meets the gum.
7) The idea is to get the toothbrush bristles down underneath the gum, so you should hold the toothbrush at a 45-degree angle, to slide the Bristol in between.
8) No. You should just brush flat.
9) It’s not important to brush the tops of the back teeth.
10) You should brush the tops of the back teeth.
11) You should use the white mouth wash in the morning and the green mouthwash at night.
12) You should use the white mouthwash and the green mouth wash after every meal.
13) You should use the white mouthwash and the green mouthwash whenever you want, after anything you eat.
14) The pharmaceutical scientists are having so much success with the mouthwashes, that in twenty years, people aren’t going to have to even use toothbrushes regularly or go to the dentist as often. With its chemical advancements, the dental industry is basically making itself obsolete.

Who knows? I’m waiting for all my teeth to fall out at once, like I’ll leave them all in a crisp red apple in one unsuccessful bite, and then to go to the dentist’s office and have the dentist tell me, “Oh, you should never listen to anything a dental hygienist says.”

I used to not. For years, I didn’t go to the dentist or the doctor. When I was younger, I used to poo-poo science. I took a philosophy course in college with a professor who taught that much of the world’s problems could be traced back to the Cartesian split and the debasement of the physical world in favor of the intellectual one that followed, and how this gave license to man’s cutting everything he finds in half and then in half again, leading to science and Sir Francis Bacon’s desire to put nature on the rack and “torture her for her secrets” and all that. This violated the all-important oneness I had learned about in an Eastern philosophy class I had taken the semester before. (Being a philosophy major in college is a fine, ridiculous thing to do.)

So I was anti-science for a while, believing that it was all based on a lie that was keeping us from realizing a greater truth. “Maya,” we called it at the ashram, the “illusion” of the separateness of things. Just kidding. I never actually spent time in an ashram. Though I did stubbornly suffer too many headaches, refusing to take an aspirin. (The “natural” medicinal properties of marijuana only sometimes helped in this regard.)

I used to smoke cigarettes, too. A pack a day, for four years. I did this in full knowledge of the risk associated. My father died of lung cancer shortly after I started. It was part nihilism. (And in my most melodramatic internal analysis, an extended suicide attempt.) But also, it was what I saw as a life-affirming sort of hedonism that came from a healthy acceptance of the extent to which we don’t have any control over our fate. I could have an aneurism tomorrow; a piece of an airplane’s landing gear could fall off mid-flight and flatten me on my way to the store — smoke ’em if you got ’em. It was a way of dealing with fear, this thinking, an effective one, and I based (or excused) lots of behavior on it. I used to not wear seatbelts.

The biggest change in my thinking came, as it will, with the birth of my kid. It’s much less okay with me that I might die today, or tomorrow, or next week, than it used to be. (And let’s not even get into the matter of the kids’ health. That level of non-acceptance of the extent to which we don’t have any control over our fate isn’t good for anybody.)

But even before then, I’d come around on science, and empiricism in general. I’ve never believed in a god, and as I grew older, and came to a better understanding of Darwinism and the scientific method, it seemed more and more like the best guide to life. In the absence of faith, we amass the best information available, test it best we can and make our moves accordingly. Even if, considering Hume’s refutation of definitive causality, we can never be totally for sure that anything is going to work out the same way it has in the past.

In that way, seeing the embrace of uncertainty as science’s greatest selling point, I guess these ideas about decline effect don’t really change anything. Decline effect just demonstrates, as Lehrer puts it, “the slipperiness of empiricism.” And serves as a reminder that we should feel stupid and helpless and nervous and confused all the time. Or maybe I just drank too much coffee today. Or not enough?