Seth's Blog

In December, the Los Angeles Times reported — very briefly — that from 2007 to 2008, life expectancy in the United States declined by 0.1 year. It should have been the lead story of every newspaper in the country with the largest possible headlines (“LESS LIFE“). Did 9/11 reduce life expectancy this much? Of course not. Did World War II? Not in a visible way — American life expectancy rose during World War II. I can’t think any event in the last 100 years that made such a difference to Americans. The decline is even more newsworthy when you realize: 1. It is the continuation of trends. The yearly increase in life expectancy has been dropping for about the last 40 years. 2. Americans spend far more on health care than any other country. Meaning vast resources have been available to translate new discoveries into practice. 3. Americans spend far more on health research than any other country and should be the first to benefit from new discoveries.

Maybe I’m biased (because my research is health-related) but I think this is the biggest event of our time. It is the Industrial Revolution in reverse — progress grinding to a halt. For no obvious reason, just as the Industrial Revolution had no obvious reason. Health researchers have been given billions of dollars to improve our health, the whole system has been given tens of billions of dollars, and the result is … nothing. Worse than nothing.

No journalist, with the exception of Gary Taubes, seems the least bit aware of this. It is a difficult story to cover, true. But several journalists, such as health writers for The New Yorker (Atul Gawande, Michael Specter, and Jerome Groopman) are perfectly capable of covering it. They haven’t. With a few exceptions, they write about progress (e.g., Peter Provonost’s checklists). It is like only reporting instances when Dirk Nowitzki missed a free throw. Each instance is true but the big picture they create — he misses all free throws — is profoundly false.

Among academics, the stagnation has received a tiny amount of attention. In a recent paper (gated), two University of Southern California professors, considering a wider time period, point out that there has been some improvement in how long you live after you get sick, but no improvement in how long you live before getting sick. Here is how the discussion section of their article begins:

There is substantial evidence that we have done little to date [meaning: from the 1960s to the 1990s] to eliminate or delay disease or the physiological changes that are linked to age. For example, the incidence of a first heart attack has remained relatively stable between the 1960s and 1990s and the incidence of some of the most important cancers has been increasing until very recently. Similarly, there have been substantial increases in the incidence of diabetes in the last decades.

Here is my explanation of the paradox of: 1. Enormous and increasing health care costs. 2. Vast amounts spent on research. 3. No better health. Health researchers, such as medical school professors, shape their research to favor expensive treatments, such as expensive drugs. In fact, the best treatments would cost nothing (e.g., the Shangri-La Diet). To make the expensive treatments seem worth studying, they invent utterly false theories and claim to believe them. For an example (research about depression), see The Emperor’s New Drugs by Irving Kirsch. Because health researchers are forced to worship absurd theories, they are incapable of good research. Absence of good research is why there is no progress. The health care supply chain — everyone between you and the research, such as doctors, nurses, drug company employees, hospital employees, alternative medicine practitioners, medical device makers, and so on — is happy with the situation (useless research) because it ensures that little will change and they will continue to get paid. They are the supposed experts — and remain silent.

It is human nature that everyone in the supply chain remains silent. They are protecting their jobs. But the silence of the journalists is The Emperor’s New Clothes writ large. To explain why smart journalists fail to notice the stagnation, I think you have to go back to studies of conformity. When everyone you talk to — people in the supply chain  — says black = white (i.e., that progress is being made), you say the same thing.

Why is personal science, the main subject of this blog, important? Because it is a way out of this stagnation.

In August 2010, John Farber, a reporter at the Milwaukee Journal Sentinel, wrote an article about how a medical device called Infuse, used for spinal surgeries, “went from revolutionary advance [2002] to public health alert [2008].” Bad side effects were common when Infuse was used, far more common than when it wasn’t used. Infuse is a hugely profitable product of Medtronic, the largest medical device company in the United States.

How did the high rate of bad side effects go unnoticed? Farber went on to find that there were unreported conflicts of interest in the journal articles about Infuse. The authors of the articles had received (before and after publication of the articles) large payments from Medtronic, on the order of $5 million per person. The articles themselves greatly underreported side effects. Moreover,

Evidence has accumulated suggesting that the superior clinical results reported by doctors with financial ties to Medtronic have not been replicated when the device was used by doctors who receive no payments from Medtronic.

A whole issue of The Spine Journal has been devoted to the problem and a Senate committee is investigating.

Thanks to Zachary Hamaker.

For several years I have been doing simple daily tests to measure my brain function. I got the idea when I noticed that a few capsules of flaxseed oil improved my balance. Flaxseed oil also improved other measures of brain function, such as digit span. I wasn’t surprised I could do better; what was surprising was how easy it was. It revealed a big gap in our understanding of nutrition. I do the daily tests not only to improve brain function but also to improve the rest of my body. I think the brain is like a canary in a coal mine — especially sensitive to bad environments. Learning what environment was best for the brain would suggest what environment is best for the rest of the body. When I started taking an optimal amount of flaxseed oil, my gums turned from red (inflamed) to pink (not inflamed), supporting this assumption.

I tried six or seven mental tests and eventually settled on a test of arithmetic (how fast I could do simple problems such as 5-3). I hoped that now and then my score would change (in either direction, faster or slower) and that these changes would point to new things that control brain function. No one had/has done such a thing. I had no idea if unexpected changes would show up or, if they did, how often. I didn’t know what the score changes would look like (their size and shape) nor, of course, what would cause them. Would all of them involve diet? Would all of them make sense in terms of what we already know? (Flaxseed oil makes sense because the brain contains lots of omega-3.)

The first two surprises were these: 1. My score suddenly improved a few days after switching from Chinese flaxseed oil to American flaxseed oil. This made sense: It is easy to destroy omega-3 if flaxseed oil is kept at room temperature. 2. My score suddenly improved when I switched from pig fat to butter. This was counter-intuitive: pig fat is more paleo than butter.

Last fall, there was another surprise: My score greatly improved since the summer. I was much faster than ever before. At first I thought the improvement was due to moving to Beijing. I had moved from Berkeley to Beijing in early September.  My Beijing life differed in a thousand ways from my Berkeley life. I had three ideas about which differences might matter. 1. Walnuts. Perhaps I ate more walnuts in Beijing. Walnuts are supposed to be good for brain function. 2. Heat. It was much hotter in Beijing than Berkeley. Maybe that improved brain function. 3. Vitamins. I took less vitamin supplements in Beijing. Maybe they harmed brain function.

I tested these possibilities. 1. I stopped eating walnuts. My arithmetic score did not clearly change. 2. Winter came, it got much colder. The improvement did not go away. 3. I took the same amount of vitamins I’d taken in Berkeley. My arithmetic score didn’t change. So all of these ideas were wrong.

Because they were wrong, I considered a fourth possibility: The improvement was due to removal of two mercury amalgam fillings on July 28, 2010. They were replaced with non-amalgam fillings. I’d had them removed for precautionary reasons. I wasn’t suffering from any signs of mercury poisoning. Hair tests had repeatedly shown mildly high amounts of mercury in my hair (75th percentile of an unspecified sample). Measurements of the mercury in my breath had come out higher than usual but it was hard to be sure the machine was working correctly.

I looked again at my data. It showed something I hadn’t noticed: the improvement started before I went to Beijing. It started very close to July 28. That was good evidence that the mercury explanation was correct. Now the evidence is even stronger. I’ve returned to Berkeley and thereby made my life quite similar to the situation when my scores were much higher than now. The improvement has remained.

The evidence for causality — removal of mercury amalgam fillings improved my arithmetic score — rests on three things: 1. Four other explanations made incorrect predictions. 2. The improvement, which lasted months, started within a few days of the removal. Long-term improvements (not due to practice) are rare — this is the only one I’ve noticed. 3. Mercury is known to harm neural function (“mad as a hatter”). As far as I’m concerned, that’s plenty.

A long Wikipedia article describes evidence on both sides of the question of whether mercury amalgam fillings cause damage. In 2009, the American Dental Association stated in a press release “the overwhelming weight of scientific evidence supports the safety and efficacy of dental [mercury-containing] amalgam.”  As recently as 1991, Consumer Reports told readers “if a dentist wants to remove your fillings because they contain mercury, watch your wallet.” (Dental insurance will pay most of the cost of removing my remaining amalgam fillings.) In an essay last revised in 2006, Stephen “Quackwatch” Barrett explained at length why mercury toxicity is a “scam”. According to Barrett, “there is overwhelming evidence that amalgam fillings are safe.”

Ask your dentist some pointed questions.

• trouble at the American Meteorological Society
• the power of mood-sharing by Alexandra Carmichael
• crash diet reverses Type 2 diabetes in a week
• archeology of fermentation
• American capitalism with Chinese characteristics: James Stewart’s first column for the New York Times. Stewart is one of my favorite writers.

Thanks to Anne Weiss.

Martin Wolf relays what passes for wisdom:

Albert Einstein is reported to have said that insanity consists of doing the same thing over and over again and expecting different results.

Which, if true, shows that Einstein was a theorist.

Call me insane. Based on many years of data collection, I believe scientific progress has a power-law distribution. You sample from this distribution when you collect data. You collect data again and again — “doing the same thing over and over again”. Almost all the data you collect produces little progress; a tiny fraction produces great progress. The secret to scientific progress is doing the same thing over and over — and being wise enough to grasp that the results will vary greatly. (Nassim Taleb understands this.) In the short term, it seems like you are getting nowhere.

I learned this lesson from my sleep research. For ten years I tried various solutions to my problem of early awakening. Nothing worked. All my ideas were wrong. Eventually I got “lucky” but actually I made my own luck by persisting so long.

Once you realize the distribution of progress, you grasp that the secret of success is making the cost per sample as low as possible. Few scientists, in my experience, have figured this out. They prefer expensive experiments because larger grants signal higher status. Won’t fancy equipment tell me more? they rationalize. Grant givers, also failing to understand the basic point, are happy to oblige the status-seekers: Much easier to administer one $200,000 grant than 10 $20,000 grants. And progress slows to a crawl.

More Rita Mae Brown is a more likely source of this saying than Albert Einstein.