Friday, January 11, 2019

Letter from a reader: “We get trapped doing the same unproductive things over and over and over”

Dear Dr. Hossenfelder,

I read with great interest your book “Lost in Math: How Beauty Leads Physics Astray”. I would like to communicate regarding several points you touch upon in the book. The issues you raise are far more important and far-reaching than you may realize.

First, allow me to introduce myself. I am a U.S. practicing physician and researcher, and my clinical work is in Infectious Diseases. I also possess a substantial philosophy background (graduate student at Tufts University). My research career tracks a pathway you may relate to, given what you state in your book. At one time I was a basic scientist, and worked in the area of host defense against HIV, the virus that causes AIDS. My overall training, however, was in a different area, namely SEPSIS.

SEPSIS is infection sufficient to cause death, and it is a leading cause of mortality worldwide. One concept has driven research and clinical practice in this area (SEPSIS), and that is the idea that infection (usually bacterial) is followed by an exuberant host-derived inflammation that is sufficient to kill the host (patient). In a sense, the bacteria do not kill you, they make you kill yourself.

A fascinating development has emerged in the field of SEPSIS research. More than 250 clinical trials have failed to cure SEPSIS using anti-inflammatory drugs (at a cost of billions of US dollars). The response of the bioscience community to repeated failure has been to double-down…over and over and over again!!!

In your book you describe proliferation of theories in particle physics that do not have empirical implications that can be tested (what philosophers would call a lack of empirical adequacy), and so these become unfalsifiable in principle and function more like religion than science. They drain precious resources and have little, if any chance, to generate empirically testable results (this is the opposite of science). As you touch upon, the concept of theory falsification in science (Popper) is exaggerated, and contradictory data are not just tolerated, they are often ignored.

In my field (Medicine or bioscience) we have a similar crisis, but it is somewhat different from the situation in physics. In our case, there is simply NO THEORY whatever to guide experiment. Have you ever heard of a theory in medicine? I do not believe there is such a thing. In the absence of theoretical guidance, we perform endless experiments and get trapped doing the same unproductive things over and over and over (like 250 failed SEPSIS clinical trials).

The stakes here are higher than one might think, since the idea that inflammation is the cause of disease in general has spread to almost everything else in medicine (inflammation causes cancer... Alzheimer disease... heart attack... stroke... depression... etc, etc, etc). That is why we are told to take aspirin, fish oil, anti-oxidants, vitamin E, CoQ, curcumin, etc. Interestingly, all these applications of the hyperinflammation concept are wrong.

My response? I gave up my laboratory and decided to attempt to explore a novel direction of bioscience research. I work to generate a novel medical theory, and I believe I am currently the world’s only funded medical theoretician (as far as I know). I am attempting to overhaul the hyperinflammation concept of disease and replace it with a different approach beginning with a comprehensive novel theory of SEPSIS.

To conclude, I point out that the crisis you call attention to in physics is present elsewhere in science. In the case of physics, the problem is bad theory, in the case of biomedicine the problem is an absence of theory. The role of theory in science is absolutely pivotal, and really facilitates progress in all scientific fields (imagine physics without Newton).

I think the root of many current problems that block scientific progress is a lack of understanding of what is going on in science (as opposed to the ability to DO science). As a physicist, you are on the front lines of a special kind of science that impinges upon what underlies reality, and this is not the case in other kinds of science like bioscience. You may want to delve into the relationship between Platonism and Scientific Realism... I believe you will find much to consider that will answer your questions about what, exactly, has gone wrong with physics.

Lee Shapiro, M.D., F.A.C.P.

University of Colorado Anschutz Medical Center and Denver Veterans Affairs Medical Center


Greg Feild said...

For years, economists treated human beings as "rational actors" in their theories. I'm not sure economics is a science, but they claim to be doing better now that they realize people don't always act in their own self interest.
In psychology, behaviorism was a great insight until it was " taken too far."
It seems to happen in every field of endeavor. People take a decent idea for truth and often forget the origins altogether.

Greg Feild said...

I would not say medicine is without theory. "We" know antibiotics work by breaking down the cell wall of bacteria and this drives research for new antibiotics.
We know how the immune system works and can create vaccines against polio, smallpox, etc.
There is still much to learn, of course.

Greg Feild said...

On the other hand, the recent discovery that the bacteria in your gut talks to your brain is already spawning a lot of junk science imho.

naivetheorist said...


what does the 267 on the envelope represent?

naive theorist

panais said...

I just wonder what is the purpose of repeatedly using CAPITALS for a condition that has long be used as a normal term in MEDICINE. My experience of people using capitals on the internet portends "bad things" for the users, but I did not put this post up, so I will just believe that there was some (cursory) research about the claims contained in it.

Valdis said...

IMHO "proper science" should describe existing situation well and make reliable (falsifiable) predictions for future. Economy can't do properly neither...

naivetheorist said...

Dr. Shapiro:

a google search shows that there has long been a call for 'theoretical medicine' ( In fact, the greatest physical chemist of the 20th century Linus Pauling (who interestingly, insisted that he was a 'theoretical chemist', not a theoretical physicist) called for the establishment of professorships in theoretical medicine in academia. One reason to do this is that perhaps physicians would realize that they need to continue educating themselves after they leave medical school and become practicing physicians. my own extensive interactions with doctors in dealing with my debilitating illness indicates that there is an urgent need for this - there is nothing more distressing than knowing more than your doctor. It's difficult enough to deal with your illness without having to teach your doctor about it (this applies to your auto-mechanic or plumber as well).

naive theorist

Unknown said...

You're right of course - many medical treatments are based on an understanding of the causes and this comes from the theoretical basis of the underlying bio sciences.

That said I don't read Les Shapiro's letter as 'no theory, no where'. Rather I think he is saying that in some areas (specifically in his experience Sepsis) there is no underlying theory to describe the cause, forcing his colleagues to design experiments focused on visible symptoms (hyper immune response). Without a basic theory or understanding of the illness this makes sense - treat the symptom , cure the patient. But as Dr Shapiro points out this 'suck it and see' approach has, to date, had little success. And in that respect Dr Shapiro's experience is closely aligned with the thesis set out in 'Lost in Math'.

Sadly, in medicine the consequences of a failure to consider the wider picture, alternatives and underlying theory of an illness are far worse than theoretical physicists becoming fixated on a specific but apparently unproductive idea.

Cra-cra said...

In the past I entertained ideas in medical theory. For example if one takes differential equations they can model biological growth numbers. The Lotka Volterra Equations. If one takes Cancer Incidence rates, if it has a biological origin, then the causation should have a flux in population levels. That flux should then cause a possible noticeable shift in incidence rates. So maybe there are Market driven artifacts as well that could show up in the data. And the point was, statistics can't find causation, but maybe a hybrid theory that mixes statistics and differential equations could. And a method such as this could really help direct funding to the causation.

Other medical theory is just simple science. Science is about taking measurements. Collecting data. The invention of machines and apps that help people collect data on their diet, their habits, even to the point that there was lime juice added to the margarita, would bring Data Science into medicine. Which medicine is about 40% objective reasoning. The field of psychiatry is woefully underfunded in obtaining big data machines. Instead they should be apply research funds to collect a massive amount of data from diet, to personal habits for a very large sample space. Then they maybe able to finally spot like Caffeine interacting with the A2A receptor to cause a dopamine imbalance. But instead of data centric, they are forced to follow a manual. If they don't follow the manual they are fired. If they do follow the Manual they end up putting patients on all these expensive medicines, which then the government ends up paying for.

Its really really sad, and I'm glad there at least one person being funded to work on theories in medicine. One of the core theories is going to be objective data collection science. ASU has a program moving in that direction, so I'm sure there has to be some sort of awareness of the pitfalls of Subjective based medicine. Objective based medicine could vastly reduce the medical error rate in the US which is at least the 3rd leading cause of death. A lot of it is probably not reported or covered up due to legal issue and a culture of destructive behavior towards mistakes.

Sabine Hossenfelder said...


It's supposed to illustrate a full inbox. I didn't realize it's difficult to comprehend.

I am adding at least one image to every post just because the share widgets won't work properly without. They don't always mean a terrible lot.

Steve Pells said...

In my field (Medicine or bioscience) we have a similar crisis, but it is somewhat different from the situation in physics. In our case, there is simply NO THEORY whatever to guide experiment. Have you ever heard of a theory in medicine? I do not believe there is such a thing

This is nonsense. A couple of obvious examples of true theories that are testable and have been productive in biomedicine are the Germ Theory of Disease (Pasteur, Koch, infectious disease) and Stanley Prusiner's Prion Theory explaining transmission of neurodegenerative diseases such as Creutzfeldt-Jakob disease and the various spongiform encephalopathies. Going a little wider, the theory of evolution by natural selection is effectively the grand unified theory for the life sciences, and has many applications in medicine specifically, including making testable predictions. Obvious examples are the appearance of antibiotic resistance in bacterial species partly due to their irresponsible use in livestock farming, or the escape of chemotherapeutic-resistant variant cells in cancer.

The difference is that in biomedicine, large amounts of data often drive the development of theory, rather than the other way around as in physics (at least as it appears to me from the articles of our hostess here). Theories in biomedicine always need to be modified in the light of new data.

In biology, if you want a law, here is mine: "In Biology, it's always more complicated than you think".

So for example, 10 or 20 years ago there was much interest in treating conditions caused by acute or chronic cell loss with stem cells. There still is, and hopeful data are appearing, but it looks like the classical model of "inject stem cells into lesion, they will see damage and differentiate into the cell type that has been lost" is either not the case, or at least vastly oversimplified. Theory needs to develop, but there is theory.


Bradley Sherman said...

I'm not sure I agree there are no theories in medicine. Humors (black bile, yellow bile, phlegm, and blood) were a theory. Today we have Germ Theory. But I agree with the gist of the essay. I worked for a company which began investigating sepsis and gave that up for sequencing DNA. Much of medicine is based on received wisdom and trial and error. No one can explain how anesthetics work (e.g. the inert gas Xenon is an anesthetic!), but they are one of the great discoveries in medical science. Erlich gave us salvarsan (arsenic-based!) to treat syphillis, but its exact mode of action remains unknown; even the exact structure of the molecule was not revealed until 2005, almost 100 years after its introduction:

Greg Feild said...

I thought it was an acronym, something I never knew! Turns out it is a word.

Greg Feild said...

One last comment: People never die of old age anymore!
They always die "of something".

Paul Linsay said...

Dr. Shapiro,

Medicine has a problem that physics doesn’t, it is much more heirarchical than physics. In physics no one gets by making decrees, you have to be right. If someone thinks you’re wrong they can and will challenge you no matter how great your contributions have been. Just look up the debates between Einstein and the rest of the community about quantum mechanics. When I was at Caltech none of the theorists hesitated to debate Feynman, who was wrong now and then just like everyone else.

In medicine there are notable examples of the opposite even with the evidence staring them in the face. There is the famous case in the 1840s of Semmelweiss showing that by simply having the doctors wash their hands the death rate among women who had just given birth dropped precipitously. He was hounded out of the hospital because it didn’t fit current dogma. More recently, two Australian doctors showed that stomach ulcers were caused by a bacterial infection and could be cured quickly with an antibiotic. No one would give them the time of day. Right after WWII the New York hospitals were curing ulcers with the then new penicillin. It was shutdown because everyone knew ulcers were caused by stomach acid.

The problem in medicine is much more of a culture problem than lack of a theory. How do you keep the researchers from being sheep?

Greg Feild said...

The "other sciences" seem to have a weird math envy, and inferiority complex regarding physics.
Evolution is probably the best theory/model of all the sciences with many converging lines of proof. As was said, it is now the foundation of biology.
Evolution is more compelling than the SM and easier to understand and believe.

QM is an excellent mathematical apparatus, but _currently_, with no underlying physical model.

Verdict: Biology is the new Queen of the Sciences ! For now...

Greg Feild said...

Leland Shapiro. I found a page listing all his patent applications.

Seems he can cure every disease known to humankind with enzymes, or by destroying enzymes. It wasn't quite clear.

Lawrence Crowell said...

There is the germ theory of Pasteur, which I guess stands as a theory in medicine. Biology in general is not a very theoretical science. Darwin proposed the theory of evolution and Crick & Watson the DNA code for polypeptides.

Bill said...

Bee - Excellent letter from Dr. Shapiro. Thank you both for sharing it.

sean s. said...


No one ever died of "old age"; it was always due to something (pneumonia mostly). Old age does not kill, it weakens and then something banal comes along and kills you. That ain't new.

sean s.

Greg Feild said...

Here's the gist.

A certain enzyme causes sepsis.
If you eat a certain protein that breaks down this enzyme, you're cured!

This same magic protein cures AIDS, usw.


Michael McCracken said...

I have had several shocking conversations with colleagues in biology who have strange interpretations of what theory is/does. Some of these colleagues are of the opinion that theories are "things that have been proven true," such as evolution by natural selection. Though I have no doubt in evolution, this position, or just this use of the term "theory" in this way, seems shaky and could even suggest that there's not much guiding biological research. This is no slight on biology as a scientific endeavor -- my perspective is that, in general, biological sciences are more immediately relevant than, say, HEP -- but it does suggest that the preparation of biologists is lacking in some fundamental way. I've also talked to (experimental) chemists who have only a weak grasp of what theoretical chemists do (or even that they exist), as well as chem theory grad students who are pissed that their work is not taken seriously.

These issues came to light a few years back when my institution was trying to codify its general-education goals for lab science courses. I suggested that an important part of doing science was working with theories and testing theories/models by experimentation. Biologists pushed back claiming that one does not "work with" theories, theories are true.

I feel bad for a science student that has never had the opportunity to predict (quantitatively) how a phenomenon should pan out, and then have their predictions confirmed by experiment, and worse for the student who never had the opportunity for a simple model to fail and teach them something new.

Michael McCracken said...

I also respectfully disagree with the first paragraph of Dr. Shapiro's comment. In an ideal world, it would be the case that physical theories live and die by their ability to predict phenomena or explain results. Several authors argue that this process has gone somewhat off the rails in the last 20-ish years of HEP, and I would add that it seems that a hierarchy has formed.

Bruce Rout said...

Excellent letter and extremely potent. Thanks Dr H.

Steven Mason said...

Steve Pells wrote: the Germ Theory of Disease

That's a great example. If we can have killer apps, the germ theory is a killer theory, so to speak. I'll go back further to Hippocrates who came up with the theory that diseases had natural causes and were not punishments from gods, evil spirits or spells. Like you, I'm puzzled about what Dr. Shapiro means.

Let's take a look at what Dr. Shapiro stated:

Dr. Shapiro wrote: the idea that inflammation is the cause of disease in general has spread to almost everything else in medicine (inflammation causes cancer... Alzheimer disease... heart attack... stroke... depression

First, inflammation is a defensive response. When our body thinks it's being attacked, it initiates an inflammatory response - fevers, swelling, congestion, aches and pains. In this context, we don't think of inflammation as a cause of disease; it's a cure for disease.

That being said, things can go wrong with the body's defensive responses. Sepsis is a general term for when the body's defensive responses are massive enough to be harmful and potentially deadly. When someone has sepsis, the body is harmed by both the infectious agent and the massive defensive response. It's a tough slog; sepsis is a war of attrition.

There are autoimmune diseases when the body launches an inflammatory response against itself (e.g. arthritis, psoriasis). Another problem is inflammatory responses to transplanted tissues. Yet another problem is chronic inflammatory responses, which brings us to diseases like cancer and Alzheimer's.

There is a hypothesis that chronic inflammatory diseases, such as pancreatitis and Crohn's, can increase a person's cancer risk. There's good evidence that chronic inflammation can cause disease. Dr. Shapiro seems to be saying that the mainstream medical community is putting too much emphasis on inflammation. I don't know about that. Doctors still say that diseases are caused by bacteria, viruses, toxic substances, radiation, prions, etc. Inflammation - especially chronic inflammation - has been getting more attention recently because we want to determine if, in fact, it might be a contributing factor in some diseases like cancer.

Maybe Dr. Shapiro's point is that inflammatory disease research is wasting too many research dollars just like particle colliders are wasting too many research dollars. But there's no evidence that chronic inflammation is a medical dead end. And unlike new particle colliders, treating sepsis is actually saving lives. If Dr. Shapiro has discovered a breakthrough approach that will save even more lives, that's great.

A more accurate analogy would be this: Old and new particle colliders are giving us useful data and we are making progress in theoretical physics. Then someone like Dr. Shapiro finds a way that gives us even more useful data. That would be great, but it wouldn't make sense for Dr. Shapiro to claim that the old approach was failing. After all, Newton's equations are still useful even though they "fail" in some cases. Even if Dr. Shapiro has found a breakthrough, that doesn't necessarily mean that chronic inflammation isn't a factor in disease.

I'll conclude by saying I'm just as puzzled as panais as to why Dr. Shapiro uses caps for an ordinary term like sepsis. He also caps NO THEORY even though everyone knows that medicine does have theories. More puzzling still is Dr. Shapiro's implication that taking an anti-inflammatory approach to treating sepsis hasn't had any success. That simply isn't true. It might be the case that some of the new anti-inflammatory protocols being tested haven't been successful for certain things, but that's the nature of research. Don't throw the anti-inflammation baby out with the feverish bathwater.

Steven Mason said...

Greg wrote: Verdict: Biology is the new Queen of the Sciences

My hierarchy is based on foundations: Physics is king, chemistry is queen, and biology is jack, I suppose. But since they say "If you don't know jack, you don't know anything," maybe biology is king after all.

Greg wrote: Seems he can cure every disease known to humankind with enzymes

I've been hearing about the miraculous benefits of enzymes for decades. Enzymes are a foundation for the raw food and raw milk movements. A person can spend enormous amounts of money at vitamin shops buying nutritional supplements containing enzymes. The vast majority of these supplements have not been properly tested for efficacy.

Back in the 1970's I used to take chewable papaya enzyme pills because some doctor wrote a book claiming that it helped digestion and would therefore significantly increase energy levels. I was already healthy and energetic, but who doesn't want to be even more healthy and energetic?

When I completed my experiment I concluded that the pills tasted good. In fact, I found them to be so tasty I became addicted, eating them like candy between meals. Because of my addiction I was forced to stop the experiment. I don't know if my results have been replicated by larger studies. :-)

Steven Mason said...

naivetheorist wrote: the greatest physical chemist of the 20th century Linus Pauling

Pauling was a great scientist, but it seems he was as enamored with vitamin C as Newton was with alchemy. I know plenty of smart people who are absolutely certain that megavitamin therapy is extremely beneficial for healthy people. I'm on the "it makes expensive urine" side - not to mention the fact that megadoses of vitamins and minerals can cause problems.

If Linus Pauling was the captain of a British ship in the 19th century, he'd make all of his sailors drink a gallon of lime juice each day to get their minimum dose of vitamin C. That would leave very little room for rum.

Steven Mason said...

Lawrence wrote: Biology in general is not a very theoretical science

The field and subfields of biology have plenty of theories (medicine - medical biology - is a subfield). Do a quick internet search.

Some of us are puzzled about Dr. Shapiro's claim that medicine has no theories. Ordinarily I would take such a statement as a red flag, but since he's a physician I'm reserving judgment. It's a statement that's begging for clarification.

Steven Mason said...

Unknown wrote: I don't read Les Shapiro's letter as 'no theory, no where'.

Here's what he wrote:

"In my field (Medicine or bioscience) we have a similar crisis, but it is somewhat different from the situation in physics. In our case, there is simply NO THEORY whatever to guide experiment. Have you ever heard of a theory in medicine? I do not believe there is such a thing."

It seems pretty clear to me. In the context of medicine, if you don't read "no theory, nowhere" in that statement, you are putting words in Shapiro's mouth.

It may be a case of faulty writing. We've all done that and it's no big deal. But as the statement stands, your interpretation is not reasonable.

Unknown wrote: I think he is saying that in some areas (specifically in his experience Sepsis) there is no underlying theory to describe the cause.

No on two counts. First, his statement makes it clear he's talking about medicine and bioscience, not just sepsis (note that sepsis is not capitalized). He *might* have meant sepsis, but the statement is what it is and you can't just wish it away.

Second, even with your gracious correction of Shapiro's presumed mistake, the statement still has problems. In fact, there *are* theories that describe the causes and treatments for sepsis. Doctors have, in fact, saved countless lives.

I'm all for giving Dr. Shapiro the benefit of the doubt, but some of his statements are begging for clarification. It's not particularly helpful for you to interpret them in ways that completely change what's written. If someone says the Earth is flat, it wouldn't help if you say he meant it's spherical.

Unknown wrote: But as Dr Shapiro points out this 'suck it and see' approach has, to date, had little success.

It may have escaped your attention, but it didn't escape mine. Dr. Shapiro mentions some kind of repeated failure in 250 clinical trials for sepsis. He provided no hints as to what the clinical trials were attempting to do and how they failed. You're accepting what he says at face value and that's very unscientific.

Steven Mason said...

Valdis wrote: IMHO, "proper science" should describe existing situation well and make reliable (falsifiable) predictions for future. Economy can't do properly neither

Essentially, you're saying economics is not a science because it can't make reliable predictions about complex systems.

If meteorologists can't make reliable predictions about weather beyond a week or two, does that mean it isn't a proper science? If doctors can't make reliable predictions about who will survive cancer treatment, does that mean medicine isn't a proper science?

Economic models are better than you might think at describing existing conditions and making predictions. But there is complexity and there is a lack of information.

Consider the Great Depression and the 2008 economic crisis. Huge bubbles, huge debts, huge leverage, meager capital reserves, insecure employment, living beyond one's means, millions of people one paycheck or one major illness away from bankruptcy, speculation, greed, fraud, public and private corruption, crony capitalism, complex dependencies, etc. Even a layperson with moderate knowledge of economic principles could see the potential for problems.

An economist can tell you that if you play Russian roulette you might get a bullet in your head. You say economics is not a proper science because it can't predict with certainty when you'll get a bullet in the head.

I won't quibble if you want to say there are hard and soft sciences. But saying economics is not a proper science crosses a line. Science is a method. Proper science means following the method. Proper science involves principles such as looking for natural explanations for observable phenomena, forming and testing hypotheses, using objective evidence, etc.

Economics is the study of how society allocates scarce resources. This is not a trivial pursuit. Economists can either use the scientific method to do this vitally important work, or they can use some non-scientific method. IMHO, it would not be proper for economists to use a non-scientific approach.

Leland Shapiro said...

I am grateful for all the comments above. A few points to consider:
1. Medicine is not science. If I had to label it (medicine) as anything it seems to best resembles engineering. The hallmark of engineering is the existence of a bottom line or practical goal: build the bridge, make the cellphone, get the patient better. This explains why medicine, like many engineering fields, uses an amalgam of some science, some precedent, some word-of-mouth, some anecdotal precedent...anything and everything to improve patient health (good observation Bradley Sherman).
2. I am reasonably certain there are no broadly applicable legitimate theories in medicine. Some people refer to the "germ theory" and other such things, but these seem best described as observed associations (albeit important ones). Mature theories do more than describe associations between data, and this explains why theories often possess unobservable entities like elementary particles/waves, gravity, information, or genes. "Germ theory" per se tells us nothing about how disease occurs and fails to answer important questions. If one calls this a theory, it is a very limited one indeed. Does anyone really want to compare the empirical success of "germ theory" or "prion concept” with relativity? Quantum Mechanics? Thermodynamics? I do not. some points emphasize the lack of interest in theory development in medicine. Is there anyone who will fund a theoretical medicine grant application (not the NIH)? Who is the Einstein of medicine, The Planck of medicine? Do journals publish articles on theoretical medicine (a handful at best)? These observations underscore the near absence of interest in theoretical medicine (does such a discipline exist?)
3. Steve Pells voices criticism, for which I am grateful. Calling something a theory does not make it a theory. "Germ theory" does not, I believe make the grade (see above comments). One really needs principled reasons (criteria) to differentiate observation or association descriptions from theory (perhaps to be discussed later). I will concede that "prion theory" may qualify, but the scope here is limited to a single disease...I would add H. pylori as the cause of ulcers as a theoretical accomplishment in medicine (Marshall + Warren, Nobel Prize winners), but here again the scope is very limited. Glad you mention evolution. I will throw down a controversial gauntlet and state that this a very weak theory that receives far more credit ("grand unified theory") than it deserves. Evolution predicts very little (if anything), explains some things in a peculiar way, and leaves open the truly interesting questions (if there is interest, I can explain in more detail). Finally, evolutionary biology is not the same as medicine. Thank you for mentioning "in biology it's always more complicated than you think". The truth of this statement reflects a lack of theory that simplifies a field (a pivotal role of theory). Newton's mechanics unified falling apples and moving planets into 3 tiny laws of motion- simplification! Saying things are complicated is giving up on an explanation. I prefer not to do this but call for theories that simplify the data and uncomplicated the situation.

I appreciate above comments,
Lee Shapiro

Leland Shapiro said...

Continuing from prior responses...
4. Role of data in medicine is fascinating and problematic...mostly because the relationship is got backwards by many scientists/doctors. There is a badly misguided movement (in my opinion) in medicine now that assumes that data acquisition is the pathway to discovery and disease cures. This has produced the "big data" disaster. Theory directs data acquisition, not the other way around (see Sabine's book...this is shown repeatedly). Since medicine has little interest in theory development (apologies to opposing comments above), big data rules the day. The motivation for big data? Well, we have the technology, and new toys will always be played with, especially when combined with millions of dollars. These projects are based on a faulty understanding of science. Did big data assist Einstein? Schrodinger? Heisenberg? Pauli? Dirac? Feynman? (the answer is no). Still not sure about this? Look again at the history of the human genome project. Number of cures=0, number of diagnostic tests= 0, insight into disease causation=0, cost to taxpayers= $3 billion. if big data were a pathway to discovery and cures in medicine, the cures should be piling up by now...the silence is deafening..
5. Some good news: game-changers in medicine include anti-HIV drugs and anti-hepatitis C drugs. Other than that, there has been less progress than you might think. But these drugs were derived from biochemistry and molecular biology, not theoretical medicine. Their discovery advanced or established no theory I am aware of, and there are no clear implications that extend beyond treating these specific infections.
6. Stem cells- be aware that much of the hype about this area derived from fraudulent research. Since then little has been accomplished.
7. I thank all those who commented above.
Lee Shapiro

Ian Miller said...

Lee wrote that problem is: "a lack of understanding of what is going on in science (as opposed to the ability to DO science)"

In my opinion, that is essentially it. We do not know what we know because if it does not fit into what everyone expects, and there is no immediately perceived option to fix it, it is forgotten. As Enrico Fermi once said, "Never underestimate the joy people derive from hearing something they already know." Or think they know. The corollary appears to be, never underestimate the desire to put something that does not fit with current thinking to one side. We need more analysis of what we know, and more analysis in terms of what else could fit.

Medicine is particularly hard done by because it is almost impossible to separate the variables, nevertheless things like diet studies are often presented to the public as if it has been done perfectly. I have noted "A is good for you", followed by "Oops, A is bad for you and should be eliminated", followed by, "Hold on, A is not so bad after all, and B that was used to replace A is worse". I doubt the physical sciences are free of asserted conclusions that really were leaped to, and on a personal level, I believe there are theoretical aspects that need at best clarification, and maybe significant modification.

Leland Shapiro said...

To Greg Field...yes I hold many patent positions (mostly controlled by my university). Before becoming a medical theoretician, I was a basic science medical researcher and directed an active laboratory at University of Colorado. My group discovered a remarkable inhibitor of HIV (AIDS virus) in human blood and solved the molecular mechanism by which this occurred. We proceeded to discover that this molecule in blood, alpha-1-antitrypsin (AAT), an abundant serine protease inhibitor, suppressed many other pathogens as well. We presented the concept that AAT is an innate immune substance with powerful and broad-ranging anti-pathogen activities in several publications. Not sure such things exist? Consider the fact that every minute of your life you are exposed to millions of viruses and bacteria that you have NEVER encountered before...yet people rarely get sick. This is the research focus of a large medical field called innate immunity, or immunity that does not require prior exposure to a pathogen. In this context, AAT broad antimicrobial activity is not as far-fetched as you may think. Besides, a german company independently verified our results and designed a synthetic AAT-like molecule that inhibited HIV replication in infected patients by >90%. if interested, I can provide references. A lot of this information is on Google and papers can be searched on PubMed.

Lee Shapiro

Paul Titze said...

Hi Bee,

Finished reading your book, got a few comments/questions, hope you don't mind:

p93 "And for that we necessarily need to compare predictions with observation to select useful assumptions for our theories. Which is what we did before we got carried away by ideals like naturalness."

Personally I don't care about naturalness, beauty, unification etc, I don't think Nature cares either and all these assumptions are a hindrance to finding a model that works. I hope your book is widely read among physicists in this area and it will make them rethink their assumptions so real progress can be made.

p108 "Theoretical physicists used to explain what was observed. Now they try to explain why they can't explain what was not observed."

Is there a good argument why taxpayers should be paying theoretical physicists for this?

p248 "You will find that for almost all reasearch in the foundations of physics the answer to at least one of these questions is no. This means you can't trust these scientists' conclusions. Sad but true."

Can you cite 3 papers available on arXiv on the foundations of physics that answers Yes to all your questions in Appendix C?

Cheers, Paul Titze.

Sabine Hossenfelder said...

Hi Paul,

No, there is no good reason why taxpayers should be paying theoretical physicists for producing useless theories by employing flawed methods that have not worked for decades. Hence the book.

I cannot answer the question in the appendix for other people. How am I supposed to know?

I can merely tell you that no one presently takes any means to address social and cognitive biases. You can address cognitive biases to some extent yourself. Addressing social biases as an individual is pretty much impossible. Try as I might I am still part of a community and I am still a human being who wants to fit in as much as everybody else.

Gregory said...

"In my field (Medicine or bioscience) we have a similar crisis, but it is somewhat different from the situation in physics. In our case, there is simply NO THEORY whatever to guide experiment."
Not so. The theory of evolution has led to artificial evolution, and then to useful medical approaches. I've spent 13 years doing just this with a company I founded, Genescient. Further, the genetic info gained by selecting for longevity in animals has produced real findings, especially knowing some human repair genes and how to improve their actions. For further, see, which sells a product that works, derived from this approach. Evolution works!

Greg Feild said...

My best friend died of a cancer cure she found on the internet. This cure said enzymes were the cure not the cause!
She also had to neutralize her blood because it was "too acidic".

marten said...
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naivetheorist said...


you said

"there is no good reason why taxpayers should be paying theoretical physicists for producing useless theories by employing flawed methods that have not worked for decades."

is there a reason taxpayers should be paying theoretical physicists for doing any research at all (other than in hope of the eventual development of something 'useful' - like a nuclear bomb')? i suppose that if you support taxation (which i don't) it's okay to pay them for teaching and it's certainly better than using the money to build a wall to keep out foreigners, but if the government is going to rob its citizens (which it must in order to survive), wouldn't it be more reasonable to spend the $ on biomedical research or AI research? and in those areas, private companies seem to be doing far better work than government funded researchers.

maybe, we should admit that we are scamming the public or just stop taking $ from the government (which what i did). it would at least be honest.

naive theorist