I have become very discouraged lately.  We appear to be fighting a war on science even as we enjoy the tools and the improved health science has given us.  Without doubt, I would be dead if it were not for science.  I had strep throats when I was younger, and without penicillin, I likely would have had rheumatic fever and rheumatic heart disease, the surgical treatment of which back then was far less effective than it is today.  In 20 years of practice, I never once saw rheumatic fever.

We have a vaccine rate that in Arizona is scary.  About 85% of public school students are vaccinated; 50% in charter schools.  There are many who are convinced vaccines cause autism, because of the Thimerosal in the vaccine.  This has been disproven.  Indeed, some of the research stating such was shown to be fabricated.  A recent guest on Science Friday said she did not vaccinate her children, in part because they get a third more vaccines than people like me did.  Is this wrong?  If so, do we have good data and a good analysis of those data?

Let me talk about the past…60 years ago.  Back then, we had iron lungs for polio victims (my brother had polio), and kids didn’t spend summers in crowds, because we were convinced we would get polio, we were so scared.  Today, at a clinical pathological conference in the United States, asymmetric paralysis of a limb might well be misdiagnosed, for polio is so rare.  The Salk Vaccine trial was stopped early, because it was so effective.

We don’t need vaccines, some say, because these diseases are no longer present.  They are not present because we vaccinated against them.

“UCD”–usual childhood diseases–used to be on a patient’s chart.  What are the usual childhood diseases?  I had rubella.  When was the last time somebody saw a deaf child, because the mother had rubella during pregnancy?  My wife has a cousin, who lives with his mother as an adult, because his mother had rubella during pregnancy.  Today, if we vaccinate against rubella, we will never see this happen.  Rubella is a very mild disease, and it is possible not to know one is ill.  I had rubeola (measles), and I can still remember the dark room and the sickest I have ever been.  Measles kills 1 in a 1000 people and is extremely contagious.  It is now news when there is a small epidemic.  When I grew up, everybody had measles.

Varicella, or chickenpox, was a rite of passage, a time one had to stay home from school but felt perfectly fine.  Mumps caused orchitis, or testicular swelling.  When was the last time one saw a person who had mumps?  My other brother had mumps meningitis.

Hemophilus influenzae meningitis was a common disease in young children.  What happened to it?

Diphtheria killed thousands in my parents’ generation.  In 1972, Native Americans on the Crow Reservation were still getting it.  I know.  I was there.  When was the last time anybody heard of a case in the US?

Pertussis affected my mother.  This disease has lately come back, often in adults, and has caused deaths. That scares me, because this disease may be eliminated, as we have done with smallpox.  I have a smallpox vaccination scar; most Americans do not have one.  I saw one case of tetanus in my life….in Malaysia, when I was in the Navy.

Do we really want to take the chance these diseases will come back?  Maybe I am wrong, so I will make a prediction.  In Arizona, there will be a major epidemic of a preventable childhood disease in the next 10 years.

Science gave us safer automobiles.  We have a death rate from motor vehicle accidents half of what it was in 1980.  This is due to several factors, but seat belts and airbags have been the major ones, along with a push to decrease drunken driving, better highways, and better automotive design.

Science has given us better food safety, too.  We don’t see brucellosis from unpasteurized milk, although there are many who drink it and want the right to do so, as espoused by Ron Paul, during his campaign.  Prediction #2:  we will see at outbreak of brucellosis or milk-caused tuberculosis in the next 10 years.  I can be wrong, so I think it is only fair I make predictions….and hope I am wrong.

Science gave us better aviation safety.  When I grew up, airliner crashes were frequent.  We have often gone years without a major commercial aviation accident.  There are many factors:  Doppler radar, knowledge of windshear (change in wind direction with altitude), and the ability of pilots to safely report mistakes without retribution are among them.  Doctors would do well to learn from pilots; my medical safety reporting system was drawn up 11 years ago and went nowhere.  We don’t know how many people die from medical errors, but four members of my small family have suffered from their consequences.  The crash on Mt. Weather in the 1970s occurred, because pilots did not realize where the summit was on the approach to Washington, D.C.  Six weeks earlier, pilots on another airline noted that the summit was a potential danger point.  Because there was no safe way to report that fact, nearly 100 people died.  That issue is no longer present–in aviation.

Science has given us the ability to look up things we want to know about.  I remember encyclopedia salesmen and still have Bartlett’s book of quotations.  Why do I need it?  If I want to know something, I go to the Internet.  The problem with the Internet is that one can find any counterargument to any topic, because there is no peer review.  All technology has a downside.

Science has given us evolutionary theory, which has been politicized (court cases as to whether it should be taught in school would to me qualify as politicized), which over time has better–not worse–explained how we arrived on the Earth.  Our DNA is nearly 99% in common with some primates, and yet we still have a large number of people who disagree that we evolved.  For the record, we did not descend from monkeys; we descended, the evidence shows, which to me appears sound, from a common ancestor to both of us, that no longer exists.

The vast majority of climate scientists have concluded, with high confidence, that man has caused climate change and warming of the Earth, both terms must be used.  Instead of a fair discussion of the data, this issue has become one of the most polarizing topics I can think of, and it is sad.  I wrote a column on the subject for the Medical Society, when I was an invited writer, and I got absolutely hammered in the letters column.  I did my best to argue from facts, and try not to get caught up in the personalization of the arguments, which is so easy to do.

Here are some of the facts that I have looked at that helped me make my decision.

The Earth is clearly warming, we know that from long term trend analysis and we know that from the fact that nearly all (there are exceptions) glaciers are retreating, and the ocean is rising 3.2 mm a year (from satellite measurements, which is astounding that we can do that).  A recent downturn was explained by flooding in Australia and Amazonia.  The Earth goes through cycles of warming and cooling, so there have been questions raised as to whether this is cyclical.

Carbon dioxide levels have risen since the Industrial Revolution.  We know this from ice core analysis, and we are dealing with CO2 levels that have never been this high in the history of mankind.  In addition, the oceans are acidifying at a rate not seen in the past several million years.  The oceans are buffering CO2, but nobody knows for how long they will do so, or what the current 30% increase in hydrogen ion concentration will do to shellfish, coral, and a million other species in the ocean.  CO2 is a potent greenhouse gas, although water vapor is more common, and it would seem reasonable to think that this is the cause.

Correlation is not always causation, but it can be.  Tobacco correlated highly with lung cancer, and this was enough to remove advertising from TV (yes, that once occurred).  When carcinogens were discovered in tobacco smoke, then the correlation became causal.  The high correlation of [CO2] with global temperature rise to me is strong evidence, given that CO2 is a greenhouse gas.

Around the world, people are seeing climate changes they have never before have  seen, especially in the high latitudes and high altitudes, where the changes are much greater.  If the permafrost melts, methane, an extremely potent greenhouse gas, will  become a factor.

Is this a certainty?  No.  But there is high confidence such is occurring.  Do we assume it is wrong?  We have to balance the risks of changing our lifestyles with the risk that climate change is truly occurring.  If we are wrong on the front end, we have spent money we didn’t need to spend to change how we get our energy.  On the other hand, an oil or coal driven economy cannot continue indefinitely.

If we are wrong on the other end, we have changed the planet, perhaps irrevocably.  I think Americans who argue climate change should use Fahrenheit and not Celsius, so as to honestly keep the numbers fair.  Celsius is 55% of Fahrenheit, and 3 C. does not sound as bad as 5.4 F.  Warming of 1.4 F. of the Earth, which has occurred in the past 130 years, is not insignificant.  A month 1.4 F. warmer than normal is quite noticeable to people.  A month 6 F. warmer is a record.

What I do not understand is why Americans, almost alone in the world, have such low percentages of belief that climate change/global warming is occurring.  Only 12% are “alarmists,” to quote a poll, and roughly the same number are at the opposite end.  Most of the middle is concerned, but think we have a lot of time.  Interestingly, about 90% of  Europeans believe in global climate change.  Are we smarter?  Educational results wouldn’t seem to agree.  Is it because we live in a temperate climate, where we don’t see the changes, and many Europeans live at a Canadian latitude?  Why has this issue become politicized?  I simply don’t know, but on Facebook and among people I am around,  the issue is incredibly polarizing.

In part, I wonder whether it is because science education has become poorer in this country.  More people believe in astrology, which has been soundly shown not to be the true, then know why we have seasons.  My late father edited two high school science books 60 years ago, and his explanation of seasons is still the best I have ever seen.  Many of us cannot find Polaris, although uneducated slaves on the Underground Railroad knew it well, as they fled north 150 years ago.  Only a minority know what a year represents.  Many do not know how to compute the doubling time of money (72/interest rate), feet per second a car goes at 60 mph (88), number of feet in a mile (5280), or the weight of water (8.3 pounds per gallon), the latter of which perhaps explaining why so many people get in trouble, when they try to cross running water in an automobile.  All of the above have everyday applications.  Science works, and its predictions in many instances may be verified.  Perhaps that is why there is so much resentment of science; it predicts things–bad things–accurately.  Carl Sagan called science a “candle in the darkness,” a statement I particularly like.

I was asked to debate this issue in the medical society and declined to debate. Doctors would do well to debate how we are going to improve health care access and quality, not climate science.  Yet many of my colleagues do not believe in evolution, which I have to admit I find astounding, given the evidence.  Then again, many believed surgery on asymptomatic carotid artery stenosis was beneficial, even when the data overwhelmingly showed it was harmful where I practiced.  I was unable to change something where we had clear, easy to understandable data; I don’t expect I am going to change something where the data are less understandable.

Lately, the hot button issue has been calling the issue climate change and not global warming.  That puzzles me.  Climate change occurs when our cities absorb so much heat that the nighttime temperatures rise and rainfall patterns change.  Climate change occurs when dust from Chinese coal plants lands in the Rockies, and the absorption of sunlight causes an early melting of snow and a change in runoff.  Climate change has occurred when 3/5 ths of the bird species in the Christmas Bird Count have the center of their range at least 160 km (100 miles) further north.   Climate change occurs when there are major changes in rainfall patterns.  Climate change occurs when a long standing lake in Gates of the Arctic National Park can no longer be used as a landing strip, because it is too shallow, from melting of the permafrost.  Many, many Alaskans are well aware of climate change.

The fact that nearly every climate scientist believes we are changing the climate does not, of course, mean they are right.  Science moves in fits and starts and is not based on what the majority believe.  It would appear, however, that the science behind the discussion is, if anything, under-predicting the severity of the issue.  A recent article I reviewed on Facebook used regression to show the Earth had cooled since 2002.  The regression line was not significantly different from zero, and the assumptions underlying the regression were not met.  That alone did not disprove climate change, of course, but all data used have to be subject to scrutiny by both sides, and poor data needs to be removed from the discussion.

Could my mind be changed?  Yes.  If my own city had 2 years in a row with normal temperatures–even 1 degree above normal would be acceptable–I might rethink my position.  If the Arctic Ice Cap increases in size every year for the next decade, the global temperature falls every year for the next decade, and the ocean rise stops, I would rethink my position.  I would have to.

The questions I do have are these:

Can you argue your position without personalizing it?  This is extremely difficult, but the subject is climate, not Al Gore, cap and trade, big government, conspiracy theorists or environmentalists.  It is about science.  I don’t think it is fair to state the numbers of scientists who believe there is no climate change when the vast majority do believe.  But again, science is not about majority rule; it is about facts and interpretation of facts.

Can you offer statistical evidence that shows confidence intervals that include zero (no change) or fail to include zero (a change), a p-value >0.05 (or any other value you think is worthwhile).

Can you state what it would take for you to change your mind, so that you are offering predictions as to what is going to happen to the climate?  This way, we can test your predictions versus other predictions.  If nothing will change your mind, then it is senseless to discuss the subject.

Can you state fairly what will happen to the Earth should you be wrong?  If you reply you cannot be wrong, then you are saying you can predict completely accurately the future of a complex system that we do not completely understand.  Nobody I know can do that.

It is high time we approached this issue sensibly, using the science that brought us vaccines that saved my life, transportation and food safety that keep us alive, moving and comfortable, and technology that makes our lives so much easier.  Science was at its best with Hurricane Irene last year.  With time, the models were revised and revised, so that the predictions were better and better.  If instead, we choose a path that Governor Rick Perry chose with Hurricane Rita, to pray that it stop and turn around, we are going to kill a lot of people.  We can choose to have an honest look at the science behind global climate, and look at the models, or we can choose a path that Congress did, passing a resolution, which denied climate change.  Resolutions don’t affect the climate; many factors do affect it, and we know many of them.  Right now, most scientists believe the factors are significant.  If they are wrong, we should know fairly soon.  The problem is that if they are right, then by the time there is convincing evidence for every person, it is going to be too late.  I guess that puts me in the “alarmist” camp, and I really want to be  in the “I was wrong” camp, hearing, rather than saying, “I told you so.”


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