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Being Honest About Ignorance

Tuesday, May 22, 2007

The temptation to deny scientific truths is timeless—and dangerous.

Today we reach an anniversary of sorts, unremarked, but remarkable nonetheless. It was 260 years ago this week that a young Scottish naval surgeon by the name of James Lind did something truly revolutionary.

In those days of English naval supremacy Britannia ruled the waves, but the royal navy itself was ruled by scurvy. Only a few years earlier, Commodore George Anson had attempted the royal navy's first circumnavigation of the globe. He left the Portsmouth naval yards in command of seven ships and 2,000 men. He returned two years later in one ship with just 188 men remaining. Some of his ships and crew had been forced to turn back, but of those original 2,000 sailors and marines, 1,400 men died during the voyage. Four were killed by enemy action. Almost all of the rest died of scurvy.

Scurvy killed thousands of sailors every year for four centuries. Caused by a severe deficiency of vitamin C, scurvy occurs when the body becomes unable to produce collagen, the connective tissue that binds the body's muscles and other structures together. For every sailor killed, often three or four more were severely incapacitated. Scurvy was perhaps the greatest challenge England faced as the world's preeminent maritime power.

Truth be told, we human beings are very good at refusing to accept facts or scientific evidence we do not want to hear. There is a long history of our doing so.

And so on May 20, 1747, James Lind did something quite extraordinary. He took 12 sailors under his care for scurvy, divided them into six groups, and gave each a different treatment. The first group was given a quart of cider a day; the second a dose of a royal navy patent medicine; the third were treated with vinegar, the fourth with nutmeg and the fifth with ordinary saltwater—these all being commonplace and recommended treatments for scurvy. The last group he gave a daily ration of two oranges and a lemon, another suggested cure.

At sea, in the midst of the War of Austrian Succession, James Lind had invented the clinical trial. And the results were nothing less than spectacular. After six days the two men receiving citrus fruits were both fit for duty and returned to service; none of the others showed any marked improvement.

James Lind had discovered conclusive evidence that scurvy could be treated and cured. He resigned his naval commission to write the era's definitive study of the disease, A Treatise of the Scurvy, which gave the history, clinical description and cure for the greatest single threat to British naval supremacy.

And here is what happened next: absolutely nothing.

The British Admiralty did not order up huge stores of citrus, even on an experimental basis. Some people accepted Lind's ideas. Some rejected them. Many—especially those in power—simply paid no attention. Sailors continued to die of scurvy. Citrus juice did not become standard fare in the royal navy until 1795—more than four decades after the publication of Lind's treatise and a year after his death.

This is yet another instance of scientific evidence being officially denied, suppressed or ignored when it conflicts with preferred belief. We can all name other examples, from Galileo's astronomical evidence that the earth revolves around the sun, to the suppression of the study of genetics in the Soviet Union under Stalin, to the claims made for years by tobacco companies that cigarette smoking and cancer could not be linked. Truth be told, we human beings are very good at refusing to accept facts or scientific evidence we do not want to hear. There is a long history of our doing so. It is a history that continues to this day.

Ignorance is a word we don't like to use today. It feels too much like a value judgment. But perhaps we should consider reclaiming it. We need to name this tendency, which seems to be ever more common in recent years, of ignoring facts we do not like. Call it willful ignorance. In this case, the value judgment is intended. By reclaiming the word ignorance, we reclaim also the 19th century sense that there is something inherently dangerous in not knowing.

Charles Dickens understood this. Remember Ebenezer Scrooge? When visited by the second of three spirits, Scrooge notices that the Ghost of Christmas Present seems to be hiding something under his cloak. "What is it?" he inquires.

"Oh, Man! Look here," the Spirit commands, and brings forth two children. They are wretched, abject, frightful, hideous, miserable. "This boy is Ignorance," says the Spirit. "This girl is Want. Beware them both... but most of all beware this boy, for on his brow I see that written which is Doom."

Dickens and his contemporaries knew the dangers of ignorance, which they feared could bring about society's doom.

And so in that era began an organized effort—the first in history—to stamp out ignorance. Compulsory universal education was introduced, and literacy rates soared. Libraries were built and museums and galleries opened. Lecture halls were established and learned societies created.

We must all beware the very real and understandable human tendency to ignore or subvert facts, and findings of science, that discomfort us for reasons of ideology, politics, religion, or personal taste.

In the nineteenth century, the predominant theory of ignorance was grounded in the notion of information access. People were ignorant, went the belief, because they did not have access to information. They could not know what they needed to know. From that follows the natural supposition that simply by finding a way of providing access to information, ignorance will depart, and knowledge will emerge.

Here in Baltimore, the Peabody Institute, with its free library, art gallery and public lecture series, was a manifest reflection of this belief. So too was the public library movement of the 19th century, championed especially by Andrew Carnegie, who gave a fair share of his fortune to communities across the country and around the world to build public libraries. "A taste for reading drives out lower tastes," said Carnegie. "There is not such a cradle of democracy upon the earth as the Free Public Library."

Between 1883 and 1929 Carnegie built thousands of libraries in the United States and other countries. Behind these actions stood the optimistic belief that if learning was fostered and information in the form of books made widely available, ignorance would wither and disappear.

The same thinking prevailed a century later. In the 1990s government and philanthropists teamed up to make sure every school and classroom was wired to the Internet. There was, we were told, a 'digital divide' that separated the poor and disadvantaged from access to information. Bridge that divide with Internet access for all, and the achievement gaps that exist within our schools would soon dwindle and disappear. Today, thanks to those efforts, 99 percent of American schools have Internet access.

But does access for all bring knowledge to all? Does more information bring more understanding? The evidence suggests otherwise.

When asked to identify the three branches of government, one in five American adults responds with Republican, Democrat and Independent. Thirty- five percent of those polled think the United States Constitution makes English our official language. Nearly a third of Americans polled can't name the vice president of the United States.

But maybe these numbers are not quite as shocking as they first appear. In a free society, people can choose not to know. It is a luxury a wealthy and technologically advanced country affords its citizens. Yet we need to ask: how much 'not knowing' can the world afford?

This willful ignorance is not a simple matter of people just having the wrong facts

Consider for a moment the headlines and news stories of the past year alone. In December Iran held an "International Holocaust Conference" largely for the purpose of denying the Holocaust ever happened. In Japan the Prime Minister claimed there is "no evidence to prove coercion" of the women forced into sex slavery by the Japanese army during World War II. At the International AIDS conference in Toronto, South Africa's health minister questioned the science of AIDS treatment and promoted a diet of garlic, lemon and beetroot as a viable alternative to anti-retroviral drugs now in use. Here at home, the Environmental Protection Agency ignored the advice of its own scientists (and an expert advisory panel) that fine-particle soot in the air be reduced as a proven human health risk. In a few days, in Kentucky, the $25 million Creation Museum will open featuring a diorama of Adam and Eve in the Garden of Eden.... happily co-existing with dinosaurs, whose fossil remains must be accounted for in some manner. Meanwhile, a recent Newsweek poll found 39 percent of those surveyed believed the theory of evolution is "not well- supported" by evidence.

We must all beware the very real and understandable human tendency to ignore or subvert facts, and findings of science, that discomfort us for reasons of ideology, politics, religion, or personal taste.

This willful ignorance is not a simple matter of people just having the wrong facts. Science constantly gets it wrong, as for instance when I was in medical school, and was taught that peptic ulcers were the result of stress and too much stomach acid. Then in 1982 two Australian scientists announced peptic ulcers were really caused through infection by spiral-shaped bacteria. It was many years before the medical establishment fully accepted this theory—and if you had a peptic ulcer during this time, I'm sorry, you probably suffered needlessly until someone thought to give you antibiotics.

No serious scientist says that everything we know today will still be correct tomorrow. Far from it. I teach a class in which I tell my students that half of what they learn here may one day be proved wrong. If we could only figure out which 50 percent is wrong, we could cut their schooling time in half.

We are often wrong. But when we refute accepted beliefs, we do so on the basis of new data and logical conclusions. That's not ignorance. That's science.

Unfortunately, ignorance is still with us—and more and more of it is willful ignorance. Beware: it is still the herald of society's doom. A fact, even if we do not like it, is still a fact. We must not ignore truths just because they make us uncomfortable.

But keep your eyes open. Don't expect the applause of others when you insist uncomfortable truths be acknowledged.

Here at Johns Hopkins we have a motto, veritas vos liberabit, the truth shall make you free. Yet the truth will not necessarily make you successful. The truth may not make you influential. And most assuredly, the truth will not always make you popular.

But that does not make it any less true. And I hope that you will not in any way lessen your commitment to it.

Adapted from the address of  William R. Brody, President of Johns Hopkins University, at the University's 131st commencement this past Thursday.

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