I went to the dentist this week for the first time in about three years. I was expecting that the doctor would give me that disappointed look, which as we’ve all learned from our parents, is far worse than the angry look. But it turned out that most everything looked just fine. I say most everything because in symmetric spots on my upper molars, two cavities were beginning to form. I thought that cavities could be spotted by simple visual or X-Ray inspection, but I was wrong. It actually requires that four or five equally frightening medieval tools be jabbed into the tooth repeatedly over the course of 15min. You learn something new every day.

I was going to use that last paragraph to segue into something else, but there’s really no connection, so that’s just manipulative. Now for a subject totally unrelated to dentistry:

While I’m reading nerdy articles, I often get excited by the rapid and accelerating pace of medical discovery. Phrases like “highly significant” and “as Fig 1 demonstrates” lull me into a daydream of technological wonders, until I’m imagining AIDS vaccines made into chocolate bars and curative malaria pills in restaurant mint baskets. This high will last until I walk outside and see someone in a wheelchair or sneezing. First I get mad at them for wrecking my daydream, then I wonder how it’s possible that we can know so much, but our ability to do seems to lag far behind.

For instance, on Duke’s online catalogue, there are 79 journals with the prefix “Neuro”, including my favorite: Neurourology and urodynamics. I would estimate on average that these journals come out once a month, with (again, a guess) an average of 15 articles per issue. Let’s see, carry the i, divide by pi…that’s almost 15,000 articles/year, excluding most foreign journals and those with “Neuro” somewhere else in the title. All this information, and yet a visit to any site related to a major neurological disease will reveal that we’re fairly clueless about their ultimate causes. Schizophrenia is one of the clearest examples, being tied to everything from genetics to maternal infection. Where’s the disconnect between our seemingly vast knowledge and limited abilities? I can think of two causes, one real and the other psychological.

I feel the “real” weak link is a direct result of how science progresses. In order to determine the impact of a specific factor, whether in medicine, physics etc., all other possibly interacting factors must be held constant. For example, if I’m trying to determine the effect of exercise on weight loss, I would have to make sure that everyone I was testing was eating roughly the same food, not taking diet aids, or getting liposuction. But reality is infinitely detailed, and every detail has a real impact. It would take a long time to find the effect of every variable on a given disease, so the best we can do is make educated guesses about the most likely contributors and hope we get lucky sooner or later. This leaves us where we are now, with exponentially growing reams of information but relatively slow progress on the practical end. There are people who think that our ability to understand/prevent/disease will catch up soon with our information gathering, but I’m skeptical*.

The other reason I get fooled into a false sense of progress is mostly in my head. Even though we can only study one case and one effect at a time, we can often study it with incredible accuracy. One my old college professors regularly publishes results with 7 significant digits, which is accuracy to about one part in 10 million. It’s easy to become so impressed with results that I forget I’m just reading about one experiment and not something indicative of scientific knowledge as a whole.

Well, that’s all I got for now. Plus, I’m sweating a lot and I can’t figure out why, so it’s probably a good time to stop.

P.S. I’ve sicced Google Analytics on this blog. I know the approximate geographic location or your Internet service provider. I’ve got you now.


*Ray Kurzweil, for example, who I mentioned in my last entry. His site is nuts. http://www.kurzweilai.net/