Doctor, columnist, blogger, and woo-chaser Ben Goldacre’s acclaimed book, Bad Science: Quacks, Hacks, and Big Pharma Flacks (2008), has just appeared in an American edition. I’ll be reading it for sure.
Bad Science sold 240,000 copies in the UK (that’s huge!) and reached #1 on the nonfiction charts. Reviews have been uniformly positive; there’s one in this week’s New York Times, and you can see older reviews in the Torygraph and The Independent.
And the book has a new chapter that didn’t appear in the two-year-old British edition. From the NYT review:
Sometimes bad science is downright harmful, and in the chapter titled “The Doctor Will Sue You Now,” the usually affable Dr. Goldacre is indeed angry, and rightly so. The chapter did not appear in the original British edition of the book because the doctor in question, Dr. Matthias Rath, a vitamin pill entrepreneur, was suing The Guardian and Dr. Goldacre personally on a libel complaint. He dropped the case (after the Guardian had amassed $770,000 in legal expenses) paying $365,000 in court costs. Dr. Rath, formerly head of cardiovascular research at the Linus Pauling Institute in Menlo Park, Calif., and founder of the nonprofit Dr. Rath Research Institute, is, according to his Web site, “the founder of Cellular Medicine, the groundbreaking new health concept that identifies nutritional deficiencies at the cellular level as the root cause of many chronic diseases.”
Dr. Rath’s ads in Britain for his high-dose vitamins have claimed that “90 percent of patients receiving chemotherapy for cancer die with months of starting treatment” and suggested that three million lives could be saved if people stopped being treated with “poisonous compounds.” He took his campaign to South Africa, where AIDS was killing 300,000 people a year, and in newspaper ads proclaimed that “the answer to the AIDS epidemic is here.” The ads asked, “Why should South Africans continue to be poisoned with AZT? There is a natural answer to AIDS.” That answer was multivitamin supplements, which he said “cut the risk of developing AIDS in half.”
“Tragically,” as Dr. Goldacre writes, Dr. Rath found a willing ear in Thabo Mbeki. Despite condemnation by the United Nations, the Harvard School of Public Health and numerous South African health organizations, Dr. Rath’s influence was pervasive. Various studies have estimated that had the South African government used antiretroviral drugs for prevention and treatment, more than 300,000 unnecessary deaths could have been prevented.
You don’t have to buy the book to read the whole sorry story, which is readily available online. Dr. Goldacre believes in the widest possible dissemination of information. But if you do buy the book, you’ll find it illustrated with lucid charts and graphs, footnoted (I’d have liked more of these), indexed and far more serious than it looks. Depending on your point of view, you’ll find it downright snarky or wittily readable.
If you’ve read it, weigh in. Inquiring Americans want to know.
It’s a great book. Should be required reading for all pre-Med students. Yes it’s snarky at moments, but above all he is angry – and about all the right things.
I read this book (British edition) and found it educational and amusing. It was a bit too British oriented from a US viewpoint. I rated it 4.5 out of 5.
I fail to understand how it is “too British” (except for the incorrect spelling of words). What’s happening in the UK is not unique to them; the same stuff (and more) goes on in the USA.
I had the same reaction as NEB. Goldacre devotes several chapters to individual quacks that infest UK news programs, talking about their history, their promotions and their wild claims. Because it was so specific, I didn’t think it was especially useful to people outside of the UK. If there are some general lessons to be learned, they were lost in the minutiae of their specific failings.
“(except for the correct spelling of words)” I corrected your spelling.
There’s some time since I read it, so I’m a bit fuzzy on the details, but I remember it as an excellent read.
For some perverse reason the chapter on cosmetics and a “make your own moisturiser”-howto is what I remember best.
I’m a faithful reader of his Bad Science columns, but I still haven’t read his book. I also got to hear him speak at the recent London “protest the pope” rally.
“has just appeared in an American edition”
I was wondering why the NY Times just reviewed it, since it’s been out here for 2 years.
Anyway, his columns are excellent, and I expect the book to be also.
Thanks for the web info. 😉
“The doctor will sue you now” is also in the later 2009 edition, which I have. It’s also available online for free.
“Bad Science” is an entertaining read that should be on any skeptic’s bookshelf.
As Matthew said, he sould be on the reading list for any trainee doctor/med student – & for any patient. Other have gone before in a similar vein but he specialises in exposing medical bullshit. In addition, a quick read but broader in its exposure of quackery, is Damian Thompson’s book “Counterknowledge” – website here –
http://counterknowledge.com/
I can’t find the column, but Goldacre said that one of the main things a doctor should learn in med school is how to distinguish actual evidence from pharmaceutical companies’ marketing spin.
That’s an age-old problem. Back in the days when the companies would hand out significant samples of various drugs, my father and grandfather would keep notes on how patients respond rather than simply lap up the marketing nonsense. Just look at what a cure-all drugs like Ritalin have become. Even somewhat recently (the past 20 years) some preparations which have been on the market for decades have been removed due to the lack of proof of efficacy.
“Should be required reading for all pre-Med students.”
More importantly, it it should be required reading for all Journalism students!
I enjoyed the British edition and would be interested to see what changes have been made to make it more relevant to a US audience.
On that (journalism) Flat Earth News by Nick Davies – on my long list & a journalist friend who works for Nature has praised it –
http://tiny.cc/7c6c7
plus the Brooks book (see 13. below).
It’s a brilliant book and I recommend it higly. I have given a number of copies as presents, good reaction from everyone concerned.
Should be taught in schools. Truly great book on the methods of science and how quacks, big pharma and the media abuse, misrepresent and misunderstand them!
Go Ben, tell it to the world!
A wonderfully entertaining, and educational book. This book really changed my outlook on certain things. It’s taken me a long time to think of myself as a sceptical person (though I tried, was just naturally gullible I guess), but this book helped change that for good.
Very enjoyable book and wonderfully snarky. I learned loads especially about medical trials.
The good chapters are great but I was a little turned off by the several chapters which seemed to deal with just individual British quacks. It felt parochial and uninteresting and I ended up just skimming over them. Disappointing because up until that point it was really engaging.
Someone else said it was a bit angry but I found the opposite. It had a lot of little jokes and the closest he comes to a rant is to make an aside saying that, were he not writing a light, popular book he would be compelled to make an impassioned rant. A single sentence here and there noting the absence of anger is as close as he gets to actual angry rants. I thought it worked to show his feeling while keeping things light and fun to read.
One thing I did find disappointing was that in his long discussions about placebos was that he never found the chance to quantify just how significant the effects really are. It comes across as positively Alt-Med in the passion with which he extols the body’s ability to heal itself using the power of our minds & the placebo but I suspect that the effect, while measurable and statistically significant, is actually much more minor than he implies. I could be wrong but there simply wasn’t any information given so how am I to know?
The end impression was that alt med, homeopathy and whatever are actually a good thing if they stimulate the enormous healing power of the placebo.
That’s my biggest problem with the book. People need to understand that there are many issues with pain management which scientists have not yet made great progress with, and that the placebo effect can help a bit with a small but significant percentage of people. However, rather than tout the quack I would encourage people to try to find activities which they find fun and interesting to help them get their mind off the pain – I would also make it clear that this may help some people but not all and activities should also be chosen to limit the chances of aggravating the problem.
I also don’t think that Ben made it clear that the placebo effect is most significant for pain management. In cases of diseases which pass on their own, placebo is absolutely worthless unless it helps ease a discomfort which cannot be ameliorated with drugs. Suggesting that a placebo may be worthwhile for just any old thing is wrong and dangerous. Diseases which do not generally pass on their own can never be ‘treated’ with placebo – only untreatable pain accompanying some illnesses or injuries may respond at times to a placebo.
You should also read Michael Brooks – 13 Things That Don’t Make Sense
http://tiny.cc/l2cgx
which has a chapter on Placebo effect along with many others on the frontiers of science.
The chapter that was left out of the original UK edition was included in the later paperback version.
Ben Goldacre has done a short (under 5 mins) video for the NHS Choices website on placebos. He has also embedded it on his website here.
I got the paperback edition without the chapter on Matthias Rath, but Ben and his publisher had made that chapter available as a free download from the book’s website.
It was a very interesting book to read and I would recommend it to the average person who knows virtually nothing of the pharmaceutical industry. I don’t always agree with Ben on some topics – for example tolerating purveyors of snakeoil solely for the possible benefit of the placebo effect (the snakeoil salesmen/women are *not* selling the stuff as a placebo and it is unethical to allow people to believe that snakeoil is anything but a placebo), but all in all it’s an excellent book.
But doesn’t the placebo effect work only if the patient thinks he’s getting something real? If you identify a placebo as a placebo, wouldn’t that negate the effect? In other words, if you call a placebo a placebo, it’s no longer a placebo.
Which is not to say that sellers of snake oil should be let off the hook, at least if there’s a more effective treatment available.
According to Goldacre, a study was performed where participants were told that they were given placebos and yet they still responded. Hawthorne effect possibly – medicine is complicated.
Interesting. As an aside, I remember a Doonesbury cartoon from years ago that anticipated this finding, with one of the characters (I forget who) going on about the great new drug his doctor prescribed, called “pla- pla- placebo”.
Sadly, I can’t find it online.
Yes, and there’s even mention of a test which had positive findings where even the colour and shape of the placebo were effective.
I was going to say that the placebo effect is far more complex than that, but Tyro’s done a better job. A placebo does not only work if the patient is not aware, it depends a lot on how you present it to them. If you say “this sugar pill does absolutely nothing, but sometimes people feel better if they take it” then you’re likely to tip the odds against the placebo having any notable effect. As I wrote before, you can tell a patient to think of diversions and that can actually work as a placebo – and yet you don’t tell the patient it’s a placebo and you do tell the patient that it may not work (well, you tell the patient it works for some people).
I ordered it from Amazon UK back when it was first released, but it’s still on my list of books to eventually get around to reading…
I enjoyed the book. I think part of his goal is to help people understand how to assess evidence.
If readers want even more detail on assessing evidence, doing trials properly and the like, they should try “Snake Oil Science” by Barker Bausell. It takes a bit more effort still than reading Goldacre’s book, but it is definitely accessible to non-scientists.
It’s one of the best non-fiction books I’ve read in a long time. It’s massively accessible for pretty much any reader (I even bought a copy for my mum, who is into reiki, and acupuncture, and all that nonsense, or rather was. :)). Even though each chapter tackles a different subject, scientific concepts are introduced throughout in an easy-to-understand (without being oversimplified) manner, which are then referred to again later on in the book.
It really is a great read for any sceptic. My mum went from being into reiki, acupuncture, homeopathy and all sorts of other nonsense before, to understanding the placebo effect, about how quacks often hide the results of their studies, about how pharmaceutical corporations attempt to influence doctors and patients directly (whilst noting that the direct-to-consumer marketing is far more of a problem in the US)
As others have said, it is rather UK-focussed at times, but that hasn’t stopped a couple of my online friends really enjoying it after I sent them a copy each, one in the US and one from Australia.
But in summary, it covers a hell of a lot of topics without being overwhelming. It is arguably aimed at a more general audience than us (a lot of the concepts will already be familiar and won’t need explaining), but that doesn’t stop it being informative and entertaining.
I can’t really recommend it enough
This is a fantastic read. He is particularly good at explainnig the rigorous testing that medicine has to go through before being approved for public use. A really good book, and one I’d recommend to anyone.
It’s a truly excellent book – I’ve bought two copies (one for me, one as a gift for a woo-loving relative). I found that it started out really good and got progressively better as he starts discussing more and more advanced forms of evidence-tampering.
Oh, and I didn’t have any issue with the specificity of the examples. But, then, I’m from Australia, so I’m used to America-specific examples.
I’ve read it only recently (with the new chapter included). There may be some personalities (such as Gillian McKeith [‘or to give her her full medical title, “Gillian McKeith’]) who may be estranged to the American audience, but by and large the same rules apply.
Of particular interest – and the book’s climax – is the measles, mumps and rubella (MMR) vaccination scare-campaign by the media that took place in Britain the early 00s, and the preceding chapter on media attitudes towards science.
Not particularily over-detailed on the scientific language, as it was designed for lay-people (thus its success), but a fantastic introduction nonetheless, and good fun too (irreverant British humour not necessary). You can also find much of the material on the badscience.net blog.
I loved that line! There are lots of great little jokes throughout making for a fun read despite the seriousness & underlying tragedies. Shows a skilled hand to make these accessible and light without diminishing or downplaying anything.
I highly recommend the book. It’s important to note that although a confirmed skeptic, Ben’s interests differ from those of many skeptics and he’s sometimes accused of being unskeptical because of this. It’s not true.
For example, as he says in the book and elsewhere, he’s not very interested in homeopathy because he doesn’t see it as a very big problem in practice. Personally, I have a big problem with people selling fake medicine, even if the instances of their doing real harm are pretty rare. Ben is less idealistic and more practical. It’s interesting to see this slightly different perspective. I suspect his views on placebos are another example: my first instinct is to shout “No! It’s not real!” But from the perspective of patient care, things – as Ben would be the first to point out – are a bit more complicated than that.
I’m not sure about the UK centric stuff. In my less charitable moments I might be tempted to think that only an American would say that 🙂 Randi’s books are full of US examples, but I’ve never heard anyone complain about that. He does have a go at specific people who happen to be from the UK, but the points he’s making around those people are universal.
For example, he spends some time on the awful Gillian McKeith, who is a nutritionist. However, his main point is about the duplicity of many nutritionists in general and I’m sure it’s not just the UK that suffers from this malady.
He also spends a lot of space on the Andrew Wakefield/media craziness. This is a UK phenomena, but the very same sort of thing is happening in the US right now (anti-vax, fuelled by media).
I’d be surprised if the stories only really work for people who are familiar with the protagonists, but I guess it could be true. Ben’s prose is chatty and perhaps I’m wrong.
The book is great though. The parts about how trials should be done are brilliant and the sensitive analysis of the anti-vax stuff is considered and excellently done.