The end of ignorance

The folks at whoring for some link love sent me an interesting link. They had a talking heads session (“diavlog”—damn, that’s hard to say) between John Horgan and some other guy (sorry, “Some Other Guy”). Horgan is the guy who brought us The End of Science, a book which was more widely criticized than read. I haven’t read it either, but after watching him, I think I need to do a little reading. He’s a bright guy, and interesting to listen to, but as live chats often go, there were some errors that deserve parsing, not just because they are errors of fact, but because they reveal a certain disappointing line of thought.

In one segment, Horgan and Other Guy are discussing “the limits of medicine”. This bit was disappointing for a number of reasons. Horgan pointed out that medicine had discovered much about Lyme disease in the last few decades, but then said that there are “certain areas where they just seem to be…inadequate to the task.”

Some of this is Horgan’s same old theme of “science: been there, done that.” But there are some pretty important problems here.

First, he defined a problem incorrectly. The problem is not that doctors haven’t figured out how to treat “chronic Lyme disease“, it’s that we haven’t figured out how to deal with patients who think they have it. As Horgan points out, the evidence is clear that there is no role for long-term antibiotics in so-called “chronic Lyme”. The critical appraisal he left out is whether or not such a condition exists.

The second error he makes is in saying that medicine is somehow “not up to the task”. He praises science for discovering Borrelia, and a minute later says that we’ve hit an unsurmountable barrier. If we are at “the limits of medicine”, how do we know? What will replace it? This is a very troubling assertion.

Science-based medicine has ways of dealing with problems. Problems are defined and quantified. Operational definitions are developed, diagnostic tests evaluated, and interventions developed and tested. Is there a disease where this model can’t work? Does a negative answer (“treatment ‘x’ doesn’t work”) mean that our methodology is wrong?

In fact, negative results validate our methods. Negative results are perhaps even more important than positive ones. Science-based medicine is willing to abandon failed hypotheses, something you never see happen in “alternative” cult medicine.

Horgan eventually dives into the “limits” of psychiatric care. He bemoans “shock therapy” (sic) and speaks of psychiatry being a “shadow world” where there are “no good treatments…no cures”.

This is simply an argument from ignorance. The fact that he does not understand psychiatry does not mean that it is a failure. We have many good evidence-based interventions in psychiatry, and obviously a long way to go. Some of our problems are societal—psychiatric (brain) care and research is not funded as well as other treatment of other bits of the body. Illnesses of the mind are more difficult, but that doesn’t mean we should abandon science as a way of learning about and treating them. What is the alternative?

I wonder sometimes about folks who lack the imagination to see the way forward. It is curious how someone can, in one moment, praise the advances of science, and in the next say that science is no longer adequate for understanding reality.

Or is he saying we already know everything? In that case, it’s time to share.


  1. Being an undergraduate in Chemistry is frustrating for me. I love the subject well enough, but sometimes I find myself asking if there really is anything left to discover. We chemists aren’t even given mention in Horgan’s book.(I haven’t read it either, but so I hear)

    I see tons of new and interesting articles pop up in Nature and Science, and wonder if I’ll ever get a bite at the apple by the time I get to that stage in my education. So far what I hear about new chemical discoveries is not novel theory, but novel application of theory. Maybe I’m too naive in terms of my education to see it, but I can’t escape the feeling that the depths of my field have been effectively plumbed, much as I love it.

  2. llewelly

    First, he defined a problem incorrectly. The problem is not that doctors haven’t figured out how to treat “chronic Lyme disease”, it’s that we haven’t figured out how to deal with patients who think they have it.

    But ‘thinking they have chronic Lyme disease’ might be a medical disorder in its own right. To make an analogy, consider sleep paralysis. Some people think they’ve been abducted by aliens. This is potentially a symptom that they have suffered from sleep paralysis. It can also be a symptom of sleep deprivation. In this sense, alien abduction is not real in its own right, but it does represent one or more genuine medical disorders. The same could be true for ‘Morgellon’s disease’ as well.

  3. llewelly

    By the way, I recall Horgan’s famous book as having largely the same character as his words on this bloggingheads segment. Most of the problems you talk about here plague his book from beginning to end.

  4. Please arm yourself with the scientific data, your going to need it…
    Read The Dearborn Conference “How the Test was Spun” to see how and why we are being misdiagnosed with the 2-tiered testing the CDC has in place.
    They have committed scientific fraud at the Second
    National Conference on Serologic Diagnosis of Lyme
    Disease, a/k/a The Dearborn Conference, in 1994.
    You and your family deserve to know the truth, “Why we
    are all so sick and being misdiagnosed.”

  5. T. Bruce McNeely

    John Horgan has a bee in his bonnet about psychiatry. He gave a completely one-sided criticism of SSRIs in the course of a book review (Listening to Prozac) a couple of years ago. I responded here (about half way down the page).

    His example of psychoanalysis as a talk therapy at least as effective as SSRIs particularly bugged me. Your diagnosis of Argument From Ignorance is right on. Since I see no evidence that he has learned anything since this exchange, I think that he is willfully ignorant. The “limits of science” in his are those he set up himself.

  6. Anonymous

    the lyme trolls are rather predictable

  7. That ranting about psychiatry is eerily familiar. Is Horgan a scientologist by any chance?

  8. IIRC Horgan has spoken out rather strongly against scientology and other cults

  9. I think Horgan’s problem is the same one I see in a lot of journalists who talk about similar themes… “end of science”, “science 2.0”, and so on. None of them actually have a proper understanding of what the scientific method is. The “failures” they point to – when they are real – are simply failures of one particular policy or method or situation, and the alternatives they suggest are general just more science, which they’ve confused themselves into thinking is something different.

    @The Chemist:
    You’re an undergrad, so trust me, you have no idea how much you don’t know 😉 Once you get out of the boring stuff you do in your degree, there’s a whole world of research into all sorts of exotic things to explore.

  10. I read Horgan’s book some years ago.

    My main memory is that he was being self-consciously “post-modern” in bringing Thomas Kuhn’s paradigms to the limits where different theories are “incommensurable” and acceptance of a particular theory is more a socializing process, or even a power struggle.

    One of his main assaults was on String Theory. In fairness, he pre-figured a lot of more recent criticisms of the theory as being an elaborate “language game” in an arcane symbolism among priest-scientists that has not a hope in hell of ever being empirically verified.

    However, that was before I read Brian Greene’s “The Elegant Universe” which I thought was a brilliant defence of string theory.

    I think Horgan is a phenomenon of a period of uncertainty and indecisiveness about the future of science and the world. Now that the post-modernists seem to have lost the “science wars”, I am not sure if he has much that is useful to add. I even forget if the famous Alan Sokal hoax paper on “The Hermeneutics of Quantum Gravity” came before or after his book. I would like to hear his comments on it.

  11. I’m willing to come out and call him an idiot. Not only was his book badly conceived, argued, and written, he has clearly learned nothing in the interval. I mean really? shock treatments and chronic lyme? He thinks those are the things we do or are challenged by?

    He’s an ignorant twit.

  12. @Martin,

    Really, that’s all I want to hear. Thanks.

  13. @Martin,

    Really, that’s all I want to hear. Thanks.

  14. wackyvorlon

    When they speak of having reached the end of innovation, don’t forget that similar thoughts have been around for a very long time. People aren’t able to see the way forward, and assume that means that there isn’t one. The truth is, if we already knew what was coming, it would be here already.

    Regarding talking vs. SSRIs:

    I have problems with depression, and take celexa for it. No amount of talking was going to resolve the issue. He speaks from the position of one who does not, in fact, suffer from depression. Speaking as one who does, I respectfully submit that he should take his comments, drive them up his rectum and smoke them. That is all.

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