I learned a new word today:
Polemic: ‘The art or practice of aggressive debate, attack on or refutation of the opinions or principles of another’.
This is the best way to describe Goldacre's work most recently brought together in the book Bad Science. According to Sir Iain Chalmers, quoted on the cover, it arms readers with ‘basic scientific principles to help everyone become a more effective bullshit detector’. Right on.
As a popular science text it is a breath of fresh, objective air written with style. Starting with cosmetics and the ‘detox’ industry, he then moves onto easy targets like Gillian McKeith. He tells a beautifully ironic anecdote about how he bought the same dubious doctorate as McKeith for his dead cat Hettie.
For those not familiar with Goldacre, he is a clinical fellow in psychiatry in London. He writes the column ‘Bad Science’ in the Guardian. He complements this work with his website, http://www.badscience.net, dedicated to his mission: the fight against pseudoscience. As the book progresses, the science becomes more complex, and the examples become more serious. He covers the more chilling topical medical and educational controversies of recent times. The MMR scandal, hysteria over MRSA, ‘Brain Gym®’. He covers study structure, bias, cherry-picking; the list is comprehensive, if a little chaotic. He never claims to be an authority on the issues he examines; instead, he critically appraises the evidence behind statements and persistently challenges incorrect information — an honourable attribute in a psychiatrist. He speculates on the reasons behind our society's current preoccupation with health, and the trend towards alternative therapies. His musings regarding alternative therapies are amusing but also direct our attention to services that need improvement. Waiting lists and the narrow biomedical approach discouraged in medical education can make patients dissatisfied leading them to seek alternatives.
An angry polemical approach is often required to make positive changes in a world where journalists are obsessed with quick fixes and miracle cures. However, every sentient being has the capacity for sensible thought if approached in the right way. Ranting is what blogs are made for and I wonder whether the tetchy tone of the book will alienate the people for whom it could be most useful. Regardless, I will be sure to recommend this book to friends, family, and patients as well as suggesting people keep badscience.net on their favourites. The only other criticism is that it could do with an index to find the statistics section when required. (This will be very useful for the AKT, those fellow trainees out there.)
As a young woman this book has empowered me to remain impartial to the bewildering array of quick fixes advertised by the cosmetic industry. As a young doctor the book has reinforced my distrust of drug reps. It has given me refreshed confidence to challenge their claims, and refined my critical appraisal skills. Most importantly, it has given me accessible evidence-based language to help me enlighten my patients, offering a hand of guidance in a world full of confusing promises. For me, this is part of what being a good GP is all about.