Contrary to what some of my detractors think, I don’t mind criticism of my viewpoints. After all, if I never encounter criticism, how will I ever improve? On the other hand, there are forms of criticism that are what I would call less than constructive. One form this sort of criticism takes is obsessive repetition of points that have already been addressed and failure to pay attention to how they were addressed. This is the sort of criticism that will eventually provoke an exasperated shrug of the shoulders or even an angry—dare I say Insolent?—retort.
Another way criticism can get on one’s nerves is when it takes the form of what I’ve been dealing with the last month or so from a certain famous crank, which has reached the point that I now refer to him as “He Who Shall Not Be Named” and do not link to him anymore, even with the “nofollow” tag or “donotlink.” Of course, everyone who’s a regular reader probably knows to whom I’m referring. In any case, those who’ve paid attention probably remembers that HWSNBN has been talking a lot of smack about me. None of this would be a big deal if it weren’t for the fact that he’s been lying in a most despicable fashion, accusing me of things I don’t believe or do. For instance, he’s tried to link me with Farid Fata, the local oncologist who was busted last year for bilking Medicare out of tens of millions of dollars for administering chemotherapy to people who didn’t need it, when in fact I despise Fata and all the evil he’s done. Similarly, he’s tried to paint me as a “psychological terrorist” who uses fear to push women to do mammograms, the better to profit off of them. In particular, what was hilarious about this was that he used a recent book by H. Gilbert Welch as the jumping-off point to attack me, apparently not knowing that last year Dr. Welch and I co-authored an article skeptical of mammography for the New England Journal of Medicine and have written more posts than I care to remember looking in detail at the pros and cons of mammography.
You get the idea.
Of course, HWSNBN lies; so of course one would expect that he wouldn’t care about the the truth of his criticisms, and he doesn’t. Skeptics expect that of him. What’s more disappointing is when one who claims to be on the side of science and even a “small-s skeptic” himself(and who should presumably know better) accuses a group with whom you associate with of things it doesn’t do and doesn’t believe not out of dishonesty, but rather out of ignorance of what your group believes and does combined with laziness that apparently led him not to bother to find out. I’m referring, of course, to an article written by contrarian Scientific American science journalist and blogger John Horgan with the clearly intentionally inflammatory title Dear “Skeptics,” Bash Homeopathy and Bigfoot Less, Mammograms and War More: A science journalist takes a skeptical look at capital-S Skepticism. Note the scare quotes. Note the sarcastic reference to “capital-S Skepticism.” Moreover, Horgan’s article is basically the transcript of a talk he gave at NECSS last weekend in which he proclaims himself “skeptical of skeptics” (what a tired cliche) and basically tells us we’re wasting our time with all that homeopathy and bigfoot stuff.
Heat but little light
Seeing what Horgan said, all I can say is that, although I’m still really unhappy that I couldn’t go to NECSS this year thanks to the demands of my day job, there was one good thing about not going and that was missing Horgan’s talk. As Steve Novella put it, Horgan’s talk was disappointing not because it was critical but rather because of his utter cluelessness about skepticism. (OK, Steve didn’t use the word “clueless”; I did. Steve’s always been a lot less “Insolent” than I have.)
I knew that Horgan’s purpose was to rile up the audience rather than to try to illuminate right from the very beginning of his talk. His purpose is to shed light, but he only sheds heat:
I hate preaching to the converted. If you were Buddhists, I’d bash Buddhism. But you’re skeptics, so I have to bash skepticism.
When someone starts out a talk telling his audience that he plans on bashing what they are there to celebrate, you know with a high degree of probability that what you’re likely dealing with is either an asshole, a contrarian, or both, not someone who is there to challenge the audience in a meaningful way. This is particularly true if that same person entitles his talk as an insulting instruction, an edict. To be fair, there’s a small chance that that won’t be the case, and the insulting title and proclamation that he’s here to bash you are just a ruse. After all, an argument can be made that stirring the pot this way can push the audience out of its comfort zone and challenge its deepest held assumptions. That can be a good thing. However, pulling that off is a high wire act that takes skill and, above all, a strong understanding of just what it is that the speaker is criticizing, in this case, organized skepticism (“big-S Skepticism”) and even “small-s skepticism.” In other words, you have to know what the hell you’re talking about. Horgan clearly does not and clearly lacks the skill to pull off that high wire act even if he did know what the hell he was talking about. Basically, Horgan starts out with a germ of a good point, namely that skepticism should be applied to more difficult targets as zealously as we apply it to “easier” targets. It’s a point that no serious skeptic would dispute. Unfortunately, Horgan proceeds to drive this point straight off the road into a cesspool of bad examples and arguments coupled with straw man versions of skepticism.
Before I look at some individual points where Horgan goes off the rails, I can’t help but note that there is one thing that permeates every word of his talk, and that’s an overbearing smugness, a moral superiority. I wasn’t there; so I don’t know if that’s how it came across during his actual talk, but it’s there in the written word. Horgan doesn’t try to appeal to the audience to do better through positive example, but rather by trying his hardest to make its members feel as dumb as possible, by preaching to them from a very high pulpit that he portrays as being made of science but I see as being constructed of BS. Unfortunately, whether he intends it or not, by “bashing” what he calls “big-S Skepticism,” Horgan by contrast paints himself as oh-so-much more of a better skeptic (small-s) than his audience. Basically, he was skepticsplaining to some of the most prominent and motivated skeptics around and failing miserably because he seems to think he’s the first person who ever thought of the issues he brought up when in fact these sorts of issues have been discussed by the actual skeptic movement ever since I started identifying with it many years ago, sometimes to the point where I can’t stand seeing another discussion of them again. Horgan reminds me of some of the newbie antivaccinationists who sometimes show up here at RI and start proudly trotting out long debunked antivaccine talking points as though they were the first ones who had ever thought of them and we’d never considered them before, only to run into a buzzsaw of exasperated debunking by those who’ve studied the issues and explained why the antivaccine viewpoint is incorrect more times than they can remember.
“Tribalism”: The perfect shield
Perhaps most annoyingly, Horgan pre-emptively inoculates himself against criticism by invoking tribalism:
So I’m a skeptic, but with a small S, not capital S. I don’t belong to skeptical societies. I don’t hang out with people who self-identify as capital-S Skeptics. Or Atheists. Or Rationalists.
When people like this get together, they become tribal. They pat each other on the back and tell each other how smart they are compared to those outside the tribe. But belonging to a tribe often makes you dumber.
Now, if anyone offers criticism to Horgan’s bad arguments, he can simply dismiss it as “defending one’s tribe” without actually addressing the actual criticism, whatever it might be. For example:
@MrMMarsh No, just makes you a run-of-the-mill Skeptic defending his tribe.
— John Horgan (@Horganism) May 16, 2016
Which reminds me:
Which is exactly what Horgan seems to have been doing.
“The Science Delusion”
Let’s look at Horgan’s talk to see if there are any decent points there. In a way, after Steve’s epic deconstruction of Horgan’s self-congratulatory wank, there doesn’t seem to be much left for me, but that never stopped me before. Besides, Horgan particularly annoyed me with a couple of passages. First, there was this:
“The Science Delusion” is common among Capital-S Skeptics. You don’t apply your skepticism equally. You are extremely critical of belief in God, ghosts, heaven, ESP, astrology, homeopathy and Bigfoot. You also attack disbelief in global warming, vaccines and genetically modified food.
These beliefs and disbeliefs deserve criticism, but they are what I call “soft targets.” That’s because, for the most part, you’re bashing people outside your tribe, who ignore you. You end up preaching to the converted.
You can see how utterly clueless Horgan is about skepticism just from this passage. For one thing, he seems to view “big-S Skeptics” as a homogeneous group with similar beliefs on the topics he lists. Horgan’s obviously never heard of the libertarian wing of the skeptic movement, which has a tendency to doubt human-caused global climate change and chalk it up to skepticism. Penn Jillette was notorious for this until I saw him a few years ago at TAM respond to a question about global warming with the ultimate dodge of, “I JUST DON’T KNOW.” Indeed, back in 2009, James Randi himself fell into the trap of repeating anthropogenic global warming denialist talking points. Did skeptics let him off the hook because he was Randi, and not just part of our “tribe” but a high ranking member of the “tribe”? Hell no! Skeptics did their best to educate Randi and explain to him where he went wrong.
I also can’t help but note that Horgan also seems ignorant of the whole “militant atheist” versus “accommodationist” schism, or the disagreements between skeptics over how critical we should be of religion. I’ve lost track of the number of times I’ve seen skeptics who are more “militant” atheists criticize skeptics more wedded to scientific skepticism for going easy on religion. It’s an argument that has raged since long before I ever started blogging, self-identifying as a skeptic, or going to skeptical conferences. It still bubbles up all too frequently. Good bud and skeptical physician John Byrne makes a similar and related point:
Horgan seems to be of the opinion that skeptics at NECSS dogmatically follow the decree of voices such as Richard Dawkins, Lawrence Krause and Michael Shermer (he named them specifically). Ironically, Professor Dawkins was (at one point) disinvited to this very conference for making — in some people’s opinion — offensive insinuations about feminists. Massimo Pigliucci has been very critical of Dawkins over the years. Lawrence Krause was not there this year either, but attended a couple of years ago. He was interviewed on stage by Massimo Pigliucci, who has been among Lawrence Krause’s most vocal critics, challenging him for being scientistic rather than scientific. Pigliucci has also debated Michael Shermer (at NECSS) about scientism and morality. Shermer’s views on science and morality have also been questioned by Dr. Steven Novella –also a NECSS board member– during a December 2015 discussion with Dr. Shermer on The Skeptic’s Guide to the Universe podcast. I cannot think of three names in the community that have received as much internal criticism.
But, no. If you believe Horgan’s take on NECSS and “big-S Skepticism,” we all worship at the altar of the “really big-S Skeptics,” like Richard Dawkins, Michael Shermer, James Randi, and the like.
“Soft targets” = What you care about. “Hard targets” = what I care about.
Particularly galling (and arrogant) is the “soft targets” versus “hard targets” gambit that Horgan launches into right after his “tribalism” gambit:
Meanwhile, you neglect what I call hard targets. These are dubious and even harmful claims promoted by major scientists and institutions. In the rest of this talk, I’ll give you examples of hard targets from physics, medicine and biology. I’ll wrap up with a rant about war, the hardest target of all.
I can’t help but conclude from the totality of his talk is that, to Horgan, “hard targets” are topics he cares about and his “soft targets” are targets you care about that he doesn’t care about (or at least cares about a lot less). His dichotomy is nothing more than “bashing” (Horgan’s words) skeptics because they don’t all care about what he cares about, including political views. From my perspective, a very appropriate response to such a criticism involves the F-word followed by “you” or “off.” (As I said, I’m much more “insolent” than Steve.) Horgan’s argument is no more than telling skeptics that they should care about what he cares about. Of course, that would be all well and good if he had included a positive appeal to entice his audience to care what he cares about and left out the contempt for caring about things he doesn’t care about. You know what I do whenever a commenter shows up in the comments of this blog telling me I shouldn’t pay so much attention to, say, vaccines and should pay more attention to the depredations of big pharma? OK, it usually doesn’t involve the F-word (usually), simply because I don’t like to use the F-word on this blog, but does involve the same sentiment, sometimes somewhat politely stated, sometimes not. No doubt Horgan will view such an attitude as “defending my tribe,” but in reality it just represents a general cussedness in not liking being told what to do by someone who doesn’t know what he’s talking about coupled with a very human irritation at being told that what I care about is not important.
A more polite characterization comes from Daniel Loxton, who describes Horgan’s bizarre argument as:
I’ve spent much of my career confronting the common argument that skeptics should not perform the service skeptics do best, but instead tackle other subjects we may not be qualified to address. It’s a head scratcher, honestly. “You have specialized expertise in X, but I think X is trivial. Why don’t you specialize in Y, because I think Y is important?” Nobody ever says this to Shakespeare scholars or doctors or plumbers. (“Dear ‘fire fighters,’ fight fires less and solve more murders”?) Seemingly everyone says it to skeptics.
Indeed. If someone came up to me and said, “Why don’t you stop writing about mammography, cancer, and homeopathy and look at Bigfoot instead?” I’d laugh dismissively. Yet, all too frequently I see the opposite argument being made uncritically by people like Horgan about skepticism.
Why don’t you criticize cancer screening? Oh, wait…
Be that as it may, since Steve handled so much of the other science Horgan mangled so well, I’m going to stick to what I know best, medicine, specifically cancer. I could go on and repeat the points Steve made about Horgan’s mischaracterization of skeptics’ reactions to ideas like string theory, whether we live within a simulation, and multiverses (hint: these issues have been batted about and criticized within the skeptical movement ad nauseam) or Horgan’s attacks on psychiatry and psychotropic medications, but I won’t. Well, not quite. I can’t help but note that Horgan approvingly invokes Robert Whitaker’s claim that psychiatric medications only help in the short term but make people sicker in the long term. As Steve points out, Whitaker mangles his science, but from my perspective I can’t help but note that he is also a favorite of the likes of quacks like Joe Mercola, who has interviewed him several times, and has received approving coverage by the likes of HWSNBN.
On to medicine, though. Horgan is very concerned that we are overtested and overtreated for cancer:
Now let’s take a look at medicine, not the soft target of alternative medicine but the hard target of mainstream medicine. During the debate over Obamacare, we often heard that American medicine is the best in the world. That’s a lie.
Can Mr. Horgan name a single “big-S Skeptic,” big name or or little name, who’s argued that American medicine is the best in the world? I’ve never seen this phenomenon. That’s what’s so irritating about Horgan’s speech. He keeps conflating pop culture and political claims with claims that skeptics make, just as he seems to conflate sloppy science journalism hyping new findings with what skeptics say about them. A recurring theme here and at my not-so-super-secret other blog is to take on how journalists cover science when they do it badly. It’s the same with Steve and many, many other skeptics. To hear Horgan say it, you’d get the impression that we just swallow whatever we’re told. Also, I can’t help but note that “alternative medicine” is anything but a “soft target.” Through the emerging specialty of “integrative medicine,” alternative medicine is becoming part of “conventional” medicine.
Echoing a point that would make Joe Mercola proud, namely that American medicine is supposedly more interested in “profits than health,” Horgan then gets to overdiagnosis:
Over the past half-century, physicians and hospitals have introduced increasingly sophisticated, expensive tests. They assure us that early detection of disease will lead to better health.
But tests often do more harm than good. For every woman whose life is extended because a mammogram detected a tumor, up to 33 receive unnecessary treatment, including biopsies, surgery, radiation and chemotherapy. For men diagnosed with prostate cancer after a PSA test, the ratio is 47 to one. Similar data are emerging on colonoscopies and other tests.
Europeans have lower cancer morality rates than Americans even though they smoke more and spend less on cancer care. Americans are over-tested, over-treated and over-charged.
Of course, this is one of the other passages that made me as a bona fide cancer expert cringe and grind my teeth. It’s a painfully simplistic description of the true situation, particularly if you look at how cancer mortality rates have been declining in industrialized countries. It turns out that mortality rates in the US actually compare reasonably well to Europe for most cancers, with the exception of lung cancer. Basically, we do well with some cancers compared to Europe, not so well with others, and overall our mortality rate from all cancers is pretty similar to major European countries and decreasing at about the same rate. As I’ve pointed out, if you look at our mortality from all cancer, you’ll see the US is in the middle of the pack, our line almost superimposed on the lines from France and Germany (and Canada, which I mention because, even though it is non-European, it spends a lot less on health care), with the UK having a noticeably higher rate of cancer mortality. Horgan has a point in asking whether the US is getting its money worth, given how much we spend relative to Europe or Canada for results that are more or less the same, but he is, quite simply, incorrect to make the blanket assertion that Europeans have lower cancer mortality rates than Americans. To cap off his simplistic analysis, in doing so, Horgan also conflates the problem of overdiagnosis with our higher mortality rate from lung cancer, but guess what? Only recently have we begun to screen for lung cancer and then only in very high risk individuals. He’s comparing apples and oranges.
As for cancer screening, need I repeat yet again that skeptics such as Harriet Hall, myself, and others over at my not-so-super-secret other blog have been writing about overdiagnosis and overtreatment at least since 2008? Steve says there are at least 40 posts there over the eight years the blog has been in existence, and I have no reason to doubt him. Then there’s the aforementioned NEJM article by yours truly. (Sorry, I couldn’t resist mentioning that again. After all, it’s not every day I get published in such a high profile journal.) Of course, Horgan’s treatment of overdiagnosis and overtreatment is as painfully simplistic as his comparison of cancer mortality statistics between the US and Europe, as he castigates skeptics for doing things we’ve been doing for years now, along with suggesting ways forward.
There will always be something “more important”
Horgan ends with a hilarious non sequitur that illustrates why his misunderstanding of organized skepticism is so epic:
In the last century, prominent scientists spoke out against U.S. militarism and called for the end of war. Scientists like Einstein, Linus Pauling, and the great skeptic Carl Sagan. Where are their successors? Noam Chomsky is still bashing U.S. imperialism, but he’s almost 90. He needs help!
Far from criticizing militarism, some scholars, like economist Tyler Cowen, claim war is beneficial, because it spurs innovation. That’s like arguing for the economic benefits of slavery.
So, just to recap. I’m asking you skeptics to spend less time bashing soft targets like homeopathy and Bigfoot and more time bashing hard targets like multiverses, cancer tests, psychiatric drugs and war, the hardest target of all.
I don’t expect you to agree with my framing of these issues. All I ask is that you examine your own views skeptically. And ask yourself this: Shouldn’t ending war be a moral imperative, like ending slavery or the subjugation of women? How can we not end war?
Of course ending war is important, but so what? As Loxton puts it, almost everything skeptics do is less important than ending war, which is “obvious to the point of silliness.” That includes Horgan as a “small-s skeptic.” In fact, I’d go beyond Loxton. Why isn’t Horgan out there curing cancer? A half a million people die of cancer every year in the US alone, after all! Or what about malaria? Over 200 million people a year suffer from malaria, and 415,000 die. Or what about environmental pollution? Or racism? Or sexism? Or ending totalitarian regimes? Why is Horgan wasting his precious time bashing skeptics when he should be bashing the “hard targets” like cancer screening, multiverses, psychiatric drugs, and war? Inquiring minds want to know!
Obviously—painfully so—there will always be issues more important or more impactful than what any of us does, with rare exceptions. Pointing to them and using them to denigrate someone’s efforts as pointless, which, make no mistake, is what Hogan comes across as doing, is not constructive. Rather, it is a very old strategy to denigrate that which you consider unimportant. A much better question is this: Is what one is doing worthwhile? Coming back to the episode of homeopathy, I say yes: Getting rid of homeopathy, if skeptics could accomplish it, would be worthwhile. Pushing for the FDA to regulate homeopathy the way it regulates real drugs would be worthwhile. Getting the FTC to regulate claims about homeopathy would be worthwhile. Keeping people from being defrauded by psychics is worthwhile. Countering antivaccine misinformation is worthwhile and saves lives. It’s also a direct outgrowth of skeptical activism against alternative medicine, as many antivaccine views derive from pseudoscientific health beliefs.
The bottom line is that, contrary to what Horgan implies, the skeptic movement, be it big-S or little-S, does not dogmatically worship at the altars of Richard Dawkins, Michael Shermer, James Randi, or anyone else, and it can walk and chew gum at the same time. Horgan would know that if he weren’t so clueless about just what skepticism is and what skeptics do. Yes, we can be tribal at times. We’re human beings, after all. However, I haven’t seen any evidence that skeptics are detectably more prone to “tribalism” than any other large group of humans, and it’s not as though we haven’t discussed this tendency ourselves. Basically, after all this time, the kids are all right. Horgan’s talk illustrates a very important principal. Honest criticism can be a very good thing (and I do think Horgan was sincere). However, even the most honest criticism can rapidly devolve into a string of self-righteous, distorted, and downright wrong characterizations like the ones in Horgan’s speech if the critic doesn’t take the time to understand his audience and learn about just what the heck he is talking about. Skeptics can take criticism just fine, but you’ll excuse us if we don’t react that well to uninformed criticism that betrays a lack of understanding about just what it is we are and do.