Many of my German
high school teachers were intellectual remnants of the “68er” movement. They had either been part of the 1968
anti-authoritarian and left-wing student protests in Germany or they had been deeply
influenced by them. The movement gradually fizzled out and the students took on
seemingly bourgeois jobs in the 1970s as civil servants, bank accountants or
high school teachers, but their muted revolutionary spirit remained on the
whole intact. Some high school teachers used the flexibility of the German high
school curriculum to infuse us with the revolutionary ideals of the 68ers. For
example, instead of delving into Charles Dickens in our English classes, we
read excerpts of the book “The Feminine Mystique”
written by the American feminist Betty Friedan.
Our high school
level discussion of the book barely scratched the surface of the complex issues
related to women’s rights and their portrayal by the media, but it introduced
me to the concept of a “mystique”. The
book pointed out that seemingly positive labels such as “nurturing” were being
used to propagate an image of the ideal woman, who could fulfill her life’s
goals by being a subservient and loving housewife or mother. She might have
superior managerial skills, but they were best suited to run a household and
not a company, and she would need to be protected from the aggressive
male-dominated business world. Many women bought into this mystique, precisely
because it had elements of praise built into it, without realizing how limiting
it was to be placed on a pedestal. Even though the feminine mystique has
largely been eroded in Europe and North America, I continue to encounter women
who cling on to this mystique, particularly among Muslim women in North America who are prone to emphasize how they feel
that gender segregation and restrictive dress codes for women are a form of
“elevation” and honor. They claim these social and personal barriers make them
feel unique and precious.
Friedan’s book also
made me realize that we were surrounded by so many other similarly captivating mystiques.
The oriental mystique was dismantled by Edward Said in his book “Orientalism”, and I have to
admit that I myself was transiently trapped in this mystique. Being one of the
few visibly “oriental” individuals among my peers in Germany, I liked the idea of being
viewed as exotic, intuitive and emotional. After I started medical school, I learned
about the “doctor mystique”, which was already on its deathbed. Doctors had previously
been seen as infallible saviors who devoted all their time to heroically saving
lives and whose actions did not need to be questioned. There is a German
expression for doctors which is nowadays predominantly used in an ironic sense:
“Halbgötter in Weiß” – Demigods in
White. Through persistent
education, books, magazine and newspaper articles, TV shows and movies, many of
these mystiques have been gradually demolished.
It has become common knowledge
that women can be successful as ambitious CEOs or as brilliant engineers. We
now know that “Orientals” do not just indulge their intuitive mysticism but can
become analytical mathematicians. People readily accept the fact that doctors
are human, they make mistakes and their medical decisions can be influenced by pharmaceutical
marketing or by spurious squabbles with colleagues. One of my favorite TV shows
was the American medical comedy Scrubs, which gave a surprisingly accurate portrayal of
what it meant to work in a hospital. It was obviously fictional and contained
many exaggerations to increase its comedic impact, but I could relate to many
of the core themes presented in the show. The daily frustrations of being a
physician-in-training or a senior attending physician, the fact that physicians
make mistakes, the petty fights among physicians that can negatively impact
their patients, the immense stress of having to deal with patients who cannot
be helped, financial incentives for performing unnecessary medical procedures, physicians and nurses with substance abuse
problems – these were all challenges that either I or my friends and colleagues
had experienced.
One lone TV show
such as Scrubs cannot be credited for
taking down the “doctor mystique”, but it did provide a vehicle for us
physicians to talk about the “dark side of medicine”. Speaking about flawed
clinical decision-making and how personal emotions can affect our interactions
with patients is not easy for physicians, because this form of introspection
can lead to paralyzing guilt. All physicians know they make mistakes, and even
though we ourselves do not buy into the “doctor mystique”, we may still feel
the burden of having live up to it. I remember how I used to discuss some of
the Scrubs episodes with other
physicians and these light-hearted conversations about funny scenes in the TV
show sometimes led to deeper discussions about our own personal experiences and
the challenges we faced in our profession.
Being placed on a
pedestal is a form of confinement. Dismantling mystiques not only liberates the
individuals who are being mystified, but it can also benefit society as a
whole. In the case of the doctor mystique, patients are now more likely to
question the decisions of physicians, thus forcing doctors to explain why they
are prescribing certain medications or expensive procedures. The internet
enables patients to obtain information about their illnesses and treatment
options. Instead of blindly following doctors’ orders, they want to engage their
doctor in a discussion and become an integral part of the decision-making process.
The recognition that gifts, free dinners and honoraria paid by pharmaceutical
companies strongly influence what medications doctors prescribe has led to the
establishment of important new rules at universities and academic journals to
curb this influence. Many medical schools now strongly restrict interactions
between pharmaceutical company representatives and physicians-in-training.
Academic journals and presentations at universities or medical conferences require
a complete disclosure of all potential financial relationships that could
impact the objectivity of the presented data. Some physicians may find these
regulations cumbersome and long for the “mystique”
days when their intentions were not under such scrutiny, but many of us think
that these changes are making us better physicians and improving medical care.
As I watch many of
these mystiques crumble, one mystique continues to persist: The Science Mystique. As with other
mystiques, it consists of a collage of falsely idealized and idolized notions
of what science constitutes. This mystique has many different manifestations,
such as the firm belief that reported scientific findings are absolutely true
beyond any doubt, scientific results obtained today are likely to remain true
for all eternity and scientific research will be able to definitively solve all
the major problems facing humankind. This science mystique is often paired with
an over-simplified and reductionist view of science. Some popular science
books, press releases or newspaper articles refer to scientists having
discovered the gene or the molecule that is responsible for
highly complex phenomena, such as cancer or philosophical
constructs such as morality. When discussing a recent paper on wound
healing, I came across an intriguing comment in a public comment thread: “When I read an article related to science it
puts me in the mindset of perfection and credibility”. This is just one
anecdotal comment, but I think that it captures the Science Mystique of people who place science on a pedestal of perfection.
As flattering as it
may be, few scientists see science as encapsulating perfection. Even though I
am a physician, most of my time is devoted to working as a cell biologist. My
laboratory currently studies the biology of stem cells and the role of
mitochondrial metabolism in stem cells. In the rather antiquated division of
science into “hard” and “soft” sciences, where physics is considered a “hard”
science and psychology or sociology are considered “soft” sciences, my field of
work would be considered a middle-of-the-road, “firm” science. As cell
biologists, we are able to conduct well-defined experiments, falsify hypotheses
and directly test cause-effect relationships. Nevertheless, my experience with
scientific results is that they are far from perfect and most good scientific
work usually raises more questions than it provides answers. We scientists are
motivated by our passion for exploration, and we know that even when we are
able to successfully obtain definitive results, these findings usually point
out even greater deficiencies and uncertainties in our knowledge. Stuart
Firestein’s wonderful book “Ignorance: How It Drives Science”
is a sincere and eloquent testimony to the key role of ignorance in scientific
work. A thoughtful “I do not know the
answer to this” uttered by a scientist is typically seen as a sign of
scientific maturity, because it shows humility of the scientist and indicates a
potential new direction for scientific research. On the other hand, when a
scientist proudly proclaims to have found the most important gene or having defined
the
most important pathway for a certain biological process, it frequently
indicates a lack of understanding of the complexity of the matter at hand.
One key problem of
science is the issue of reproducibility. Psychology is currently undergoing a soul-searching process because
many questions have been raised about why published scientific findings have
such poor reproducibility when other psychologists perform the same
experiments. One might attribute this to the “soft” nature of psychology,
because it deals with variables such as emotions that are difficult to quantify
and with heterogeneous humans as their test subjects. However, even pre-clinical cancer research on cancer cells and animal models of tumors is plagued by problems of reproducibility. In my work
as a stem cell biologist, I have also encountered reproducibility issues when my laboratory has attempted to replicate published scientific findings. My experience in recent years
has been that roughly only half of the published findings in stem cell biology can be
reproduced when we attempt to conduct experiments according to the scientific methods and
protocols of the published paper.
This anecdotal estimate of
50% reproducibility is not a comprehensive analysis. Researchers only attempt to replicate
findings which are highly relevant to their work and which are published in a
select group of scientific journals. If we tried to replicate every single
paper in the field of stem cell biology, the success rate might be even lower.
On the other hand, we devote a limited amount of time and resources to
replicating results, because there is no funding available for replication
experiments. It is possible that if we devoted enough time and resources to
replicate a published study, tinkering with the different methods, trying out
different batches of stem cells and reagents, we might have a higher likelihood
of being able to replicate the results. Since negative studies are difficult to
publish, these failed attempts at replication are buried and the published
papers that cannot be replicated are rarely retracted. When scientists meet at
conferences, they often informally share their respective experiences regarding their attempts to replicate research findings. These casual exchanges can be very
helpful, because they help us ensure that we do not waste resources to build
new scientific work on the shaky foundations of scientific papers that cannot
be replicated.
In addition to knowing
that a significant proportion of published scientific findings cannot be
replicated, scientists are also aware of the fact that scientific knowledge is
dynamic. Technologies used to acquire scientific data are continuously changing
and the new scientific data amassed during any single year by far outpaces the
capacity of scientists to fully understand and analyze it. Most scientists are
currently struggling to keep up with the new scientific knowledge in their own
field, let alone put it in context with the existing literature. As I have previously pointed out,
more than 30-40 scientific papers are published on average on any given day in
the field of stem cell biology. This overwhelming wealth of scientific
information inevitably leads to a short half-life of scientific knowledge, as
Samuel Arbesman has expressed in his book “The Half-Life of Facts”. What
is considered a scientific fact today may be obsolete within five years. The
books by Firestein and Arbesman are shining examples among the plethora of
recent popular science books, because they explain why scientific knowledge is
so ephemeral and yet so important. Hopefully, these books will help deconstruct
the Science Mystique.
One aspect of
science that receives comparatively little attention in popular science
discussions is the human factor. Scientific experiments are conducted by
scientists who have human failings, and thus scientific fallibility is entwined
with human fallibility. Some degree of limited scientific replicability is
intrinsic to the subject matter itself. Researchers use many different chemicals and biological reagents for their experiments, and even if they are obtained from the same manufacturer, there is no guarantee that their potency will be the same over time. At other times,
researchers may make unintentional mistakes in interpreting their data or may
unknowingly use contaminated samples. One can hardly blame scientists for
heterogeneity of their tested samples or for making honest errors. However, there
are far more egregious errors made by scientists that can have a major impact on
how science is conducted. There are cases of outright fraud, where researchers just manufacture non-existent
data, but these tend to be rare. When colleagues and scientific
journals or organizations become aware of these cases of fraud, published
papers are retracted and scientists face punitive measures. Such overt fraud
tends to be unusual, and of the hundred or more scientific colleagues who I
have personally worked with, I do not know of any one that has committed such
fraud. However, what occurs far more frequently than overt fraud is the gentle
fudging of scientific data, consciously or subconsciously, so that desired
scientific results are obtained. Experimental outliers might be excluded using questionable justifications, especially
if excluding them helps direct the data in the desired direction. Like most
humans, scientists also have biases and would like to interpret their data in a
manner that fits with their existing concepts and ideas.
Human fallibility
not only affects how scientists interpret and present their data, but can also
have a far-reaching impact on which scientific projects receive research
funding or the publication of scientific results. When manuscripts are
submitted to scientific journals or when grant proposal are submitted to
funding agencies, they usually undergo a review by a panel of scientists who
work in the same field and can ultimately decide whether or not a paper should
be published or a grant funded. One would hope that these decisions are primarily
based on the scientific merit of the manuscripts or the grant proposals, but
anyone who has been involved in these forms of peer review knows that,
unfortunately, personal connections or personal grudges can often be decisive
factors.
Lack of scientific
replicability, knowing about the uncertainties that come with new scientific
knowledge, fraud and fudging, biases during peer review – these are all just
some of the reasons why scientists rarely believe in the mystique of science. When
I discuss this with acquaintances who are non-scientists, they sometimes ask me
how I can love science if I have encountered these “ugly” aspects of science.
My response is that I love science despite this “ugliness”, and perhaps even because
of its “ugliness”. The fact that scientific knowledge is dynamic and ephemeral,
the fact that we do not need to feel embarrassed about our ignorance and
uncertainties, the fact that science is conducted by humans and is infused with
human failings, these are all reasons to love science. When I think of science,
I am reminded of the painting “Basket of
Fruit” by Caravaggio, which is a still-life of a fruit bowl, but unlike
older still-life paintings of fruit, it showed discolored and decaying
leaves and fruit. The beauty and ingenuity of Caravaggio’s painting lies in its
ability to show fruit how it really is, not the idealized fruit baskets that
other painters would so often depict.
The challenge that
we scientists face is to share our love for science despite its imperfections
with those around us who do not actively work in the field of science. I
remember speaking to a colleague of mine in the context of a wonderful spoof of
a Lady Gaga song called “Bad Project”. We both agreed that the spoof was spot on,
showing frustrations of a PhD student not being able to get experiments to
work, having to base experiments on poorly documented lab note books and the
tedious nature of scientific work. My colleague was concerned that if such
spoofs ridiculing laboratory work became too common, it would embolden the
American anti-science movement that is already very strong. Anyone who closely
follows American science politics knows that creationists and global-warming
deniers are constantly looking for opportunities to find flaws in
scientific studies and that they use occasional errors as opportunities to
suggest that well-established and replicated scientific results or theories
should be discarded.
My response to
these concerns is that it is our job as scientists to convince fellow citizens
how important science is, despite its limitations and flaws. The uncertainties and limitations of scientific knowledge
are not weaknesses, but strengths of the scientific approach, highlighting why it is so well-suited to help us understand our world. Enabling a false mystique of
science being definitive and perfect is not going to benefit science or
society in the long run. Instead, recognizing our failings and limitations in
science and openly discussing them with our fellow citizens is going to help us
improve how we conduct science. Anyone who carefully looks at
Caravaggio’s “imperfect” painting can see its beauty and still fall in love
with it. I hope that we scientists will be able to share the Caravaggio view of
science with the general public.
Acknowledgement: An earlier version of this article was first published on 3quarksdaily.com.
Image Credits: Painting Basket of Fruit
by Caravaggio via Wikimedia Commons
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