Follow the Science.

but What is Science?

We have a big problem with the apparent fact that very few people seem to know what science is. I wanted to write about my thoughts on reading Moderna’s Data Package to the FDA’s VRBPAC meeting on June 14th and 15th 2022, but felt I needed to write this article first, to clear the ground so to speak. I did read all 119 pages of it and do have some thoughts but first:

We have a problem with the idea of science.

Right now it is very common for people to say stuff like follow the Science or I believe in science, or one of my favorites: Because Science.

If we loose track of what science actually is we can easily be led to talk about parts of science and then make a lot of mistakes about thinking scientifically, like the very common mistake of claiming that one experimental design is the whole of science: the elevated status of “Randomized double blinded studies” among some healthcare professionals. The focus on one study type cause these professionals to ignore what science is and the fact that there are experiments that are triple blind or even quadruple blind in which the authors and journals are also blinded as to the groups. Why is double Blinded thought to be a gold standard when there are triple and quadruple blind models?

This post is happening at a very specific time, and in case you are reading it a year from now I want to remind you that right now in June of 2022 there are a lot of politicians, private companies in media, social media, government agencies at state and federal levels, professional organizations caught up in the idea that anybody that questions the repeated scientific narrative is guilty of Misinformation, Disinformation, and Malformation, and worthy of contempt and persecution.

Flow of damaging COVID-19 disinformation must end now- American Medical Association

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Lots of people are politically responding by pointing out how this movement infringes on our Constitutional First Amendment Right to Free Speech.

I am concerned that everyone is loosing site on what science actually is and it is important to clarify, to the best of my ability this Saturday afternoon.

In my own words:

At a truly basic level, science is about questioning the world, questioning what others say about the world, and seeking to learn answers from what the world has to say. Science is when one looks and listens, tastes, smells and or touches with a goal of learning from your experience. The act of questioning and receiving response from and then adapting to the world is present in many many animals, but especially Homo Sapiens. We take it to the next level.

In this sense of Science, its pursuit is natural and innate. The word science comes from the Latin word Scientia which means: knowledge.

Science is Human in every sense of the word.

Think about toddlers and elementary school age children undergoing this process of exploring their worlds, sharing observations with others, and repeating the observations. Every Healthcare provider should be a scientist in this way, with specific rules that govern their ethical behaviors towards each other and most especially the people who enter into a patient relationship with them.

The Scientific Method is what we call the formal process of taking our innate skills at questioning and observing and place a structure on that exploration that can be shared with others in a more rational, and repeatable way.

We start by turning questions into statements called hypothesis. A hypothesis is a statement about the world (or pretty much anything really). Every scientific paper should have a hypothesis. I am not sure how a ‘Scientific’ paper can be called science if the author of the paper does not state the hypothesis is.

We then carefully and intentionally seek to find out whether a hypothesis is true by gathering data from observations and experiments and trying to disprove the hypothesis. There are lots of different types of experiments and they all have strengths and weaknesses.

Observations of what is happening is also a very very important part of science. Observations are gathered together and we call this data.

Scientists use math to show each other (and maybe themselves?) whether something is likely to be related to their experiments and observations or not.

If we can prove a hypothesis ( a statement about something) to be not true, we go back to the drawing board with what we have learned and ask another question or make another statement or conduct another observation or experiment. If we initially fail to prove a hypothesis to be false, we repeat the observations and see if we get the same results. The more times we repeat the same findings tells us that we might be on to something with that hypothesis.

There are lots of different science creators on youtube that really do a great job of helping you learn about stuff. Some channels I have seen that you should check out if you want to learn more about what science actually is:

Veritasium for teaching your stuff, Smarter Every Day for learning through the scientific method are some pretty great channels I watch with my kids.

If you podcast, I recommend Dark Horse Podcast by Heather Heying and Bret Weinstein. They are 2 evolutionary biologists scientists that LOVE to teach about science. Listening to them chat can help you understand how science is supposed to actually happen.

But remember how I said there’s a problem with science?

Just because people have PhDs and publish papers in science journals doesn’t actually mean that they are good scientists. There is a LOT of pressure to prove that your idea is CORRECT, rather than test to see if your hypothesis is false. Some people and organizations say things using science words, but don’t actual do the process of science. People do things like change the methods in the middle of the experiment, change the endpoints to be sooner or later because they like the results better one way or another, or state a conclusion that is not actually supported in the data in such a way that makes it sound credible.

The problem is that these people are trying to gather data to show something with math in a paper that proves something that they decided needed to be proved no matter what. If they don’t get the answer they wanted, instead of changing the hypothesis or performing a new experiment, they change the design and math while the experiment is still running to make it look like the thing they want to. I have read some studies where the conclusion is stated in a confusing way that makes it sound like the data supports what the authors wanted, even though the data really shows the opposite. Media publish conclusions of science papers and use those as talking points.

There are a LOT of tricks that people can do to distort science, especially when it comes to Pharmaceutical Industry. If you are interested about all the tricks that Pharmaceutical Companies use, check out Bad Pharma by Ben Goldacre.

But look y’all, I am a healthcare provider, and Science isn’t all bad either. So to leave on a positive note, I will end with what Science means to me in my work.

I was trained in the science of Nursing at Yale School of Nursing. True story: while in graduate school studying to be a Pediatric Nurse Practitioner I was privileged to have had included in my coursework lectures on Nursing Research given in person by Former YSN Dean Donna Diers before she died. Donna literally wrote the seminal textbook that defined what Nursing Research consisted: “Research in Nursing Practice.”

I am not a nurse researcher, but I do apply research in scientific ways to the population of patients I serve and add my specialized knowledge of my community to my practice and contribute in what ways I can to the Scientific Practice of Nursing. My work is called evidence based Nursing. Since I am a Nurse Practitioner there is a LOT of overlap with the similar practice performed by Medical Doctors called Evidence based Medicine.

As a Primary Care Pediatric Nurse Practitioner, its my job to be informed about how to help people and their children to be healthy, and apply that knowledge to my individual patients in a rational, scientific way, that is communicated meaningfully and respectfully, while learning from my patients and learning with my patients by listening to and observing them and their families. Part of my job is education (hence this substack), part of it is advocacy.

The art of Nursing Practice is balancing the Science and applying it in a accessible way alongside and with your patients. I will never, ever lie to one of my patients or their parents. I will always follow the code of ethics that focuses on the individual and inalienable dignity of each human being and the need to respect that person in their autonomy in healthcare.

Remember, real science is about forming hypothesis, learning from your experiences, reforming hypothesis. It is about questioning with a goal of learning. We all are scientists. Censorship is unscientific, as is the persecution of people for presenting information that questions things.

I recommend that you find a healthcare provider that is able to think critically, ask questions, be respectful, tell you the truth even if its hard, and learn with you about how to be healthy.

As far as how I incorporate prescription medications, for now I will leave it at this:

As a rule, I tend to be very distrustful of brand new to the market, fully approved pharmaceutical products for at least the first 5 years of their approval.

Check out Ben Goldacre’s book if you are surprised by this statement.

Thanks to my friend James Roguski for his awesome conversations (he brought up the problem with science and that really resonated with me) Check out his important substack:

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