Saturday, December 10, 2016

Anything but the Facts, Ma’am.

In dementia care, we are looking to science for the cure.  We are hoping that someone will study the facts about dementia, come up with that epic hypothesis for what’s going on, test it with an equally epic experiment and present us with a little white pill that will save the day.  Yeah, keep writing those care plans.

Actually, to do science, you have to cultivate your inner ignorance.  Ignorance: How It Drives Science is the title of biologist Stuart Firestein’s 2012 book.  He has surprising advice for his college students and readers, “Forget the answers, work on the questions.” (p.16)  He documents how knowledge is piling up at a very disconcerting speed and how, based on the experience most of us had in school, laypeople think science is all about this pile of facts.  However, Firestein claims that real scientists select facts “for the questions they create, for the ignorance they point to.” (p. 12) That is, scientists aim their research at what they wish they knew.  He compares it to looking for a black cat in a dark room when there might not be any cat after all.

Firestein goes on to discuss the problems with facts.  Not only are there are way too many of them to digest, but they tend to, um …, change with time.   “No datum is safe from the next generation of scientists with the next generation of tools,” he points out on p. 21.  He also states that it’s ridiculous to think that the facts that we are presented with are untainted by biased observation or interpretation.  He agrees that the more widely accepted a fact is, the more of a risk there is that it will become too entrenched and resist needed revision.

All of this aside, Firestein has another purpose in writing this book.  He wants to encourage non-scientists to peek in more often on what’s happening.  So what if you can’t follow the details of current research?  He cajoles, “You can enjoy a painting or a symphony without possessing any of the know-how of an artist or a musician.  Why not science?” (p. 125)

This sounds good, to a point.  Still, if I go to a concert or look at a painting, I can think about it.  I can form my own opinion.  That’s part of the deal.  Saying the emperor has no clothes is not just a fashion opinion, it is an assessment of a “fact.”  Laypeople might not follow the calculations that a physicist uses, but we are often pretty good at spotting bias and politicalization.  You can look for the black cat that might or might not be in the dark room, but we see the elephant that definitely is in the room, namely that the “facts” are not as dependable as we are told and that it does matter.

As part of a case history, Firestein explains on p. 120, “The universe is not so much expanding; rather space is being created and the universe, the things in it, galaxies and the like, are simply filling up the expanded space.”  Then he adds “… No sense asking what’s on the other side of that expanding edge of the universe.  It isn’t there; it hasn’t been created yet.  Just because a question can be asked doesn’t make it a meaningful question.”

Really?!?  I’d be ‘lacking sense’ if ask a question?  Oh, sorry, my question isn’t “meaningful.”  Well, history is full of examples where scientists said there was “nothing else there,” when there really was something else on the other side.   Firestein blithely goes on to document how, in this case, they had to tweak the original theory to fit some new data.  Yes, that happens. Theories get changed.  Regularly.

To me, the main time when science has credibility issues is when scientists are the only ones who get to ask the questions.  Don’t tell me to just enjoy what science dishes out today, without any comment other than “Bravo!” I’m not going to be an uncritical consumer.  What we call “science” is constantly upgrading itself like your average cell phone.  Science has always been politicized, funding-driven, and pock marked with cover-ups and in-fighting.  When science gets it wrong, it affects my life, my residents’ lives, our future, our children’s future.  I do enjoy science – but I like to add a grain of salt myself.

© Donna Stuart, ADC                 December 10, 2016


Firestein, Stuart. Ignorance: How It Drives Science. New York: Oxford University Press, 2012.



Saturday, February 27, 2016

Conscience and Compliance


Anyone who has worked with children, served in the military or managed a healthcare institution knows how important it is to achieve compliance (or obedience) to rules and expectations.  Yet, compliance has also led to some of the most egregious atrocities ever perpetrated against humanity.  We all know the testimonies of war criminals who were “just following orders.”  Unfortunately, studies show that most normal, decent people (like you and me) will still do bad or stupid things under the influence of our cultural training to comply with the authority system where we find ourselves.  Kind of scary.

Ira Chaleff, in Intelligent Disobedience, Doing Right When What You’re Told To Do Is Wrong, describes the types of situations where compliance can obviously be detrimental, even career-ending or deadly.  Airplanes have crashed because a co-pilot didn’t stand up to the pilot who was making a mistake.  The WorldCom accountant, who was asked by management to move funds around illegally, thought about refusing, but that wasn’t enough to keep her out of jail.  A guide dog that sees an oncoming car, but obeys his blind master’s signal to cross the street, is going to get them both killed.  A teacher witnesses bullying by another teacher, does nothing about it because it wasn’t her classroom, and gets fired.

Chaleff noticed several red flags to watch for:  conflict between orders you’ve been given and a higher set of values you hold, technical answers given to smooth over moral questions, unwillingness of an authority figure to put orders in writing, noticing that you are avoiding implementing an order unless the authority figure is physically present.

He points to items which can help people intelligently disobey:  voicing problems sooner, withdrawing your support if you are also an authority figure, having bystander support, and training your subordinates to feel comfortable questioning unreasonable orders (you’d want them to, wouldn’t you?).

It is easy to complain about the problems created by the authority structures around us.  Listen in on any break room discussion.  It is harder to identify when to take a stand and how to take a stand.  We’re really talking freedom of conscience here.  Problems can arise suddenly.  The costs can be high.  There are no guarantees you’ll win.  It pays to be prepared.

© Donna Stuart, ADPC                     February 27, 2016


Chaleff, Ira. Intelligent Disobedience. Oakland: Berrett-Koehler Publishers, Inc., 2015.