Essay:Skeptics in the Pub, Janurary 2012

Well, it's Friday morning and the mild hangover, caused by red wine and shouting about politics at someone's house for two straight hours, is already subsiding. Last night, I had the pleasure of being in the same room as well-known skeptical speaker and author Simon Singh, and the even greater pleasure so of being so close to that hair. The title of the Skeptics in the Pub talk was Trick or Treatment; Alternative Medicine on Trial, discussing an overview of evidence and mechanisms of various alternative medicines based on the 2008 book of the same name by Singh and Edzard Ernst.

We begin with an illustration of how the mind works. Playing Led Zepplin's Stairway to Heaven backwards has long been a candidate for backward masking, but in this case we were able to induce the effect in a sizable chunk of the 50-strong audience. Simply by reading aloud the words people were meant to hear, and then displaying them on screen karaoke style, you can make people think that not only is the word "Satan" mentioned, but there's an entirely coherent (for a certain value of coherent) passage "about Satan and his tool shed" too. Including a mention of "666" that would in no way be recognised without being pointed out first. Such a demonstration of priming and audio pareidolia, live to an audience, illustrates how we can't simply trust what we think and experience, but need to put controls and tests on it.

The rest of Singh's presentation itself was fairly straightforward. There's certainly very little you can teach me about how absolutely mental homeopathy is, unless you've discovered a new mind-blower to add to this list. But acupuncture is something I'm far less familiar with, and I've actually learned how you can create a placebo control group for acupuncture. Three methods, in fact; firstly you can just do acupuncture as stated but intentionally miss the meridian lines of the body, and so very easily test whether Chi is bullshit or not; or you can insert the needles only part way into the skin, rather than deep; or even better, you can actually create sham needles that don't even puncture the skin, but do give you enough of a prick to think you have been needled. And now I'm going to stop talking about jamming needles into my skin because I'm starting to squirm.

Where Singh's experience shines is in libel and journalism, and the question and answer sessions covering this topic were fascinating. Of course, being sued by the British Chiropractic Association, ostensibly over the word "bogus" (and there was an interesting discussion of the semantics of other terms in the relevant article, such as "happily promotes"), gives him one of those unique perspectives. In light of the News of the World phone-hacking scandal, breaking only a few months ago, there's a potential for libel reform to be somewhat derailed. Basically, how can someone both support libel reform, that seeks to lift restrictions on journalists from doing their job and be for the regulation, under scrutiny at the Leveson Inquiry, proposed by groups such as Hacked Off? It's a tough call for skeptics and those valuing freedom of speech, caught in the middle of both wanting to say what they need to say without giving shoddy journalists free reign to do as they like. The answer to this is simple, and seems to be agreed on by all skeptics, Evan Harris for instance, at the centre of libel reform; encourage good journalism and discourage bad journalism by getting a good definition of "public interest" laid down. Sham medicines and exploitative treatments that don't work should be highlighted as such because that very much is a public interest. If people can be mislead by claims, even those on the alternative medicine documentary on the BBC from a few years back, then that is very much in the public interest to be corrected.

Anyway, the question and answer session in the second half was by far the most productive. As I sat, pint in hand, close to a group that were scribbling notes and reacting in certain ways, one thought ran through my head: "shit, I'm sat next to some homeopaths." This could get interesting. Given that a hand shot up quickly over some back-pain evidence, I refined this to "shit, I'm sat next to some chiropractors, they fucking sued him!!" So, questions from that part of the room were where the thought-provoking, albeit not world-shattering, ideas came from. I'll summarise what I can remember with some bullet points.


 * Alternative practitioners aren't that rich, and earn about £18,000 per year (woo, that's £18,000 more than me at the moment), and many aren't in work or haven't had a job in 5 years.
 * They would like the research to be done, but can't afford to pay for research out of their own pocket.
 * It's unfair that practitioners should be asked to pay for clinical trials, it's very one-sided in favour of Big Pharma ("Repeat after me: pharma being shit does not mean magic beans cure cancer.").

Though there were perhaps half a dozen in that camp, this seemed to be the main points they were trying to get across. Singh took them on board well, and I have to admit he's far more open minded than I am on the subject. While I agree with him that yes, if the evidence shows it, then great, let's use that treatment, I firmly believe that what research has been done pretty much proves that these treatments have no effect, nor any plausible mechanism for working. If the treatments worked as miraculously as claimed then it would be utterly trivial to prove it, and the "more research is needed" line is just wasting our time. Anyway, that's just me.

Two points on this seemed to come out of discussions afterwards. Firstly, if your treatment would overturn biology, chemistry and/or physics in order to be right, then indeed the onus will be on the practitioners to prove it works. And yes, they can pay for it given this, if it works consider it quite an investment. Secondly, the comparison with Big Pharma almost shoots them in the foot as it's effectively admitting that they're treating people despite having absolutely no evidence for their treatment. If I remember rightly, Simon Singh did bring this point up, and it was certainly echoed by the skeptics present: Big Pharma being caught doing this, distributing a treatment without evidence, it would be a scandal.

Anyway, a decent enough talk and discussion all round, if cut short a little by Singh having to jet, or at least train, off at 9pm. It was a packed and productive two hours, and I'm sure I've missed or forgotten something (in fact I know I have, like the chiropractic v osteopathy thing, but this is getting too long already), so perhaps another time.