(Cross-posted at Science-Based Medicine.)

Labels are a cognitive double-edged sword. We need to categorize the world in order to mentally capture it – labels help us organize our mental maps of the overwhelming complexity of things and to communicate with each other. But labels can also be mental prisons, when they substitute for a thorough, nuanced, or individualized assessment – when categorization becomes pigeon-holing.

We use many labels in our writings here, out of necessity, and we try to be consistent and thoughtful in how we define the labels that we use, recognizing that any sufficiently complex category will be necessarily fuzzy around the edges. We have certainly used a great deal of electrons discussing what exactly is science-based medicine, and that the label of so-called alternative medicine is really a false category, used mainly for marketing and lobbying (hence the caveat of “so-called”).

We get accused of using some labels for propaganda purposes, particularly “antivaccinationist” (often shortened to “antivaxer”). Also “denier” or “denialist”, as in germ-theory denier. Even though we often apply labels to ourselves, no one likes having an unflattering label applied to them, and so we have frequent push-back against our use of the above terms.

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I fly a few times a year, mostly to conferences. There is a certain amount of tedious routine to flying now – at check-in you have to bring your own bag over to the security scanner, then you have to make your way through the gauntlet of security and hope that you are not randomly selected for further screening, or that you forgot about that tube of toothpaste in your carry-on. Once you make your way to the gate you have to listen for your zone, and once on the plane there is the struggle to find good overhead space to stow your stuff. If traveling in a group there is often the game of musical chairs to see who will sit next to whom, and if traveling alone there is the minor anxiety about the personal characteristics of the people sitting next to you. Add a couple of children to the experience and the complexity of the whole operation increases significantly.

Once I settle into my seat all I want to do is lose myself in some activity, inevitably involving a personal electronic device, and let the hours of airline captivity pass as quickly as possible. I read books on an e-reader, play games, listen to podcasts or music, or watch movies on my iPad or iPod, or even my Android cell phone. Occasionally (depending on how long the flight is) I might even whip out my laptop, expanding my electronic options further.

It is therefore highly annoying and inconvenient when the flight attendant makes their rounds prior to liftoff to tell me to turn off all electronic devices – all the way off. Airline mode is not sufficient. My annoyance is increased by the fact that I seriously doubt this is truly necessary. Sure – it’s only 5-10 minutes on takeoff, and the last 10-15 prior to landing, but it is an unwelcome interruption to my electronic distractions. I can only flip through Sky Mall so many times as an alternate.

So a recent Scientific American article on the topic caught my interest. They outline what we know and don’t know about the use of personal electronic devices (PED) on airplanes. I did some digging and found the same information everywhere I looked. It seems everyone is getting their information from the FAA. Here is a summary of what I found:

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The BBC reports on a field trial of LED light (light emitting diodes) that is, pardon the pun, glowing. I agree with many of the points made, but there is a distinct lack of pointing out the current downsides to LEDs.

LEDs have many advantages. The bulbs can now be made to produce white light. The study reports that generally the reaction to the kind of light put out by the LED fixtures was positive – more like daylight. I don’t think this is a function of LED technology, however. Incandescent bulbs come in several varieties, such as soft light or harsher light, and you can generally find one that you like. Compact fluorescent bulbs do not have as much variety in the color or softness of the light they produce, and some people find them a bit harsh.

It seems that the LED fixtures that were put into place were brighter than the bulbs they replaced, so people could have been responding to the increase in brightness rather than the color of the light. I purchased a few LED bulbs to see what they were like. I find the color of the white light to be acceptable, certainly not a barrier to use.

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Joe Nickell has been a working skeptic for a long time, and I am very happy to call him a friend. In writing this post I am reminded of something he said to me that struck me as particularly insightful – (paraphrasing) cynicism is a cheap form of skeptical one-upsmanship. In other words, it’s easy to seem more skeptical than the next guy just by being more cynical. True skepticism, however, is hard intellectual work.

This resonated with me, and brought into sharp focus what has bothered me about many encounters I have had in which someone was chiding me for not being skeptical enough. Sometimes this was coming from a perspective that I would now consider denialism, the specific denial of a generally accepted scientific or historical fact for ideological reasons. At other times the cynical pseudoskepticism was really just paranoid conspiracy mongering. For example, I recently received the following e-mail:

I sort of lost interest in you folks way back when OBL was “killed'” and his body disposed of at sea and photographs withheld, all inviting skepticism but instead skeptics earning nothing but ridicule from your team. I decided you weren’t really skeptical enough about some things, just others. Something about the behavior of otherwise excellent minds in the shadow of a powerful military state with an excellent propaganda apparatus. Except that in this case the propaganda was clumsy, the lies flagrant and out there to see …

The e-mailer is referring to our discussion on the SGU of the killing of Osama bin Laden by US forces. At the time we received many e-mails from those who thought we should taken a more “skeptical” perspective – the position that the US government was lying about the killing of OBL to some extent, and perhaps even entirely. Skepticism regarding the government is a typical context for this sort of response.

This can serve as an excellent example, in my opinion, of the difference between true skepticism and the cheap imitation – cynicism.

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News of the death of Christopher Hitchens has by now worked its way around the internet and around the world. I first heard of it from a fellow skeptic in Australia. Hitchens was a great intellectual light in this world and it is always sad to see such a light go out.

I have been reading his column for years. Every Monday I eagerly read his take on world news or modern culture. He was an exceptional investigative journalist. You did not have to agree with his point of view to gain insight into the issues he covered. In fact he was one of those rare writers who was more useful and provocative when you did disagree with him – because he challenged your views with overlooked facts and interesting analysis. I am really not aware of anyone writing today who will fill the niche he occupied in my weekly reading.

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A recent New York Times article discusses the interesting phenomenon that some people in a persistent vegetative state (PVS) or minimally conscious state will have a temporary improvement in consciousness after being treated with the sleep-aid drug zolpidem (brand name Ambien). The journalist, Jeneen Interlandi, does a fair job, although the scientific discussion is shrouded in personal emotional stories   – the kind of tales that make for good storytelling but I think may give the reader the wrong overall impression of the science.

I have written here often about coma, and mentioned the zolpidem issue before, but an update is in order. Zolpidem is a sedative given to help with sleep onset (there is also an extended release version that can help with sleep maintenance). In 1999 it was first observed that a person in a coma appeared to respond to zolpidem with increased consciousness.  Since that time there have been a few further case reports and small case series, and even a small placebo-controlled trial. The overall result of these cases is that a small percentage of comatose patients appear to have a paradoxical response to the sedative in that it increases their brain activity. In one study only one patient in 15 responded. In another study of three children, none responded.

Is such a response plausible? Zolpidem is a GABA agonist, which means it activates the neurotransmitter GABA (gamma-aminobutyric acid). GABA is the primary inhibitory neurotransmitter in the brain, which means it decreases or inhibits neuronal firing. For this reason it is commonly use to treat seizures or abnormal nerve pain, by decreasing the activity of hyperactive or hyperexcitable neurons. How, then, could it increase brain activity?

Well – if you inhibit a part of the brain that is itself inhibitory, then the net result will be activation (two negatives make a positive). It is therefore possible that in some patients in a coma one part of the brain that is still functioning is having a net inhibitory effect on other parts of the brain that might be contributing to consciousness. The introduction of zolpidem then disinhibits brain function resulting in a net increase in brain activity.

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The bright light in the center of this NASA photo is the planet Mercury. But what is the smaller light off to the right? This is from a video available to the public on the SECCHI website (Sun Centered Imaging package and Heliosphere Imager). This is an array of imagers studying the space around the sun – the heliosphere. This still is taken from a video showing a coronal mass ejection. Mercury happens to be moving through the field of view.

A short clip from the video was uploaded to YouTube and now has over 4 million hits. The person who uploaded it (pseudonym sinXster) does a voiceover in which he says:

“That is definitely some sort of manufactured object. It’s cylindrical on either side and has a shape in the middle. It definitely looks like a ship to me, and very obviously, it’s cloaked… There’s really absolutely no explanation for that other than it’s some sort of ship.”

I always worry with things like this that it’s a Poe – that it was created as satire. But because we have voiceover we can at least make a judgement about the sincerity of sinXster – he sounds sincere to me, and there are no red flags of a Poe. So – I acknowledge the possibility that it’s not serious, but will comment further as if it is.

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One thing that I notice when the issue of so-called complementary and alternative medicine (CAM, although some of my colleagues add the “s” from “so-called” to make is SCAM) is brought up in the media is that many misconceptions will be cited as fact, often by both sides, although far more by the pro-CAM side. CAM advocates seem to rely almost entirely on misconceptions and factual errors.

In Australia recently an ABC program aired that was highly critical of CAM, and now CAM advocates are firing back. The latest exchange was initiated by a group of 34 Australian physicians who are campaigning against pseudoscience in medicine. This is something that should not be controversial, but amazingly there is a large number of practitioners (although a minority) that stand  up to defend pseudoscience in medicine. They report:

Emeritus Professor of Medicine at the University of New South Wales John Dwyer says some courses previously offered at Southern Cross were more “magic” than science.
“We were off to a bad start with Southern Cross University when their founding Professor of Health and Nursing was teaching for years Healing Touch therapy; quite extraordinary nonsense.”

Good for him and his colleagues – we need more professionals who are not afraid to point out that the CAM emperor has no clothes.

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This is an interesting science story – the fairly recent discovery that there is a potential link between low Vitamin D levels and the risk of multiple sclerosis (MS).  It is a good example of how the process of science works to incorporate new ideas.

MS is a complex set of diseases that involve chronic inflammation causing damage to myelin in the central nervous system. There are various types of MS, distinguished by the pattern of outbreaks over time – such as relapsing remitting or chronic progressive. There appears to be meaningful differences between the various types of MS, as they tend to respond differently to treatment.

Ignoring that for now, MS as a disease type is autoimmune in etiology – the immune system is attacking the host itself and causing damage. The trigger for MS is still somewhat mysterious, but there is evidence to suggest that it is a combination of genetic predisposition with an environmental trigger.

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We all do it. In fact, we are generally very good at it. Smart and educated people are better at it.

Rationalizing is a daily practice, part of the “default mode” of human thinking. We make up reasons to justify believing what we want to believe. Often we are only dimly aware of why we want to believe something, the calculus largely occurring in the subconscious depths of our brains.

We defend beliefs because they are pleasing to our egos, because they minimize cognitive dissonance, and just because they are our beliefs. They resonate with our world-view, our internal model of reality.

We have at our disposal a long list of logical fallacies that we can marshal to the defense of our beliefs. Notions that are based on solid evidence and logic do not require such vigorous defense. Those beliefs that cannot be defended by logic and evidence require that bad logic and bad data be invoked to defend them. Luckily we have no problem distorting and cherry picking facts and twisting logic into pretzels.

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