Trusting Science, When It's Convenient

Every once in a bad while, I diagnose a child with a brain tumor.  Usually she's had some progressing coordination trouble, and worsening fussiness.  We do a CT scan, there it is, and I have to break bad news to the parents.  A common first parent reaction is denial.  "It can't be!" or, "Tell me you're wrong!" are some first things I've heard from parents when faced with such trauma.  To help them past this denial, I show them the CT scan. It's all there in black and white. It's easy to trust science when the facts are plain to see.  People also are glad to listen when it's good news.  A glass of red wine is good for you?  Drink away! There's going to be a cool eclipse?  Let's go see! But when the news is bad, believing is harder, especially when denial is a basic human response.  Denial is even stronger when you can't see the evidence for yourself, like on a CT scan. That's why denial is easy when it comes to issues like global warming or the benefits of vaccines. The evidence of these is wrapped up in reams of numbers and statistical analysis. Belief in vaccines or global warming comes down to trusting professionals who "live the data."  Like vaccine researchers, environmental scientists are university professors or government employees, earnest and sincere, whose career success depends on generating good data that survives the scrutiny of their peers. Science is a self-regulating profession.  If your data sucks, you'll hear it from your colleagues, as they publicly take apart your numbers, looking for faults. So I trust the environmental scientists just like I trust my colleagues in the vaccine field.  However, it's easier for me to trust the vaccine guys, since being in the profession I understand their data, and have actually met some of them.  Doctors are certain of vaccine benefits because part of our years of training and experience involve learning how to acquire data, interpret it, and use it.  We can be trusted to talk with authority on vaccines, because we also live the data. However, I know of at least one doctor who doesn't believe in global warming.  While doctors trust their own science, they may not trust others.  We're only humans ourselves, subject to the same denial response as anyone.  Recently one of my residents was printing out climate studies.  I asked if she didn't believe in global warming.  She did, but another of her professors didn't, and he wanted to see some proof.  My resident further explained that this professor thought environmental science was involved in a conspiracy. He believed that climate scientists were being secretly paid by renewable energy companies to generate data that supported their industry. As we discussed above, trusting science is hard when the news is bad and we just want to deny it.  It's also hard when the data is wrapped up in sheets of numbers and statistics that we don't understand.  It's even harder when we actively decide not to believe- to take an end-run around science with conspiracy theories. Trust in doctors, and in the medical profession, has taken a hit in the past few decades.  In 1966, 73% of Americans had great confidence in medicine as an institution.  In 2012, only 34% felt that way.  This follows erosion of public trust of other institutions like government, the church, the press, and other sciences.  This makes doctors have to work harder to keep individual patient's and parent's trust. Many older doctors lament the good ol' days when people took what they said as gospel and didn't question them.  However, I trained in an era where some patient skepticism was viewed as a healthy thing, that patients and parents should be engaged in decision-making.  After all, it's their bodies. To maintain their patient's and parent's trust, doctors now are being pro-active.  They're being more careful to be friendly and open-minded with patients and parents, to not deride their beliefs and denials, but work with them. After all, people rarely respond well when being told they're stupid.  Rather, doctors should be positive and understanding, gain trust, to then better explain the science when it's time.  This effort often works well for doctors, showing families that they care enough to meet them half-way, and the families become more inclined to trust when it counts.