Regularly one can hear snarky and condescending remarks on so-called “airport literature”, but as said before I have found quite some worthwhile (and if not then in any case entertaining) stuff there filling many otherwise lost hours usefully (or at least pleasantly). Here’s another one from that series. A bestseller, no less, making the Amazon Top 10 and selling over half a million copies. Justly so for entertainment purposes alone.

The book is written with an enormous sense of humour (sometimes understated, sometimes taking things all the way, and beyond) and alone for the comedy factor worth reading. Some passages had me even laughing aloud, like when Goldacre gets the same accreditation as Gillian McKeith - for his dead cat. Or when discussing the miraculously increased potency of cannabis over the past decades ending up with a greater THC contents than the actual mass of the plants. Or Anton’s letter to Goldacre about possible water leakage… And many more!

Humorously delivered or not, the subjects discussed in the book are of course very serious, dealing with health and medicine (and thus in a major way with risk). But, once more, there are much, much worse ways of learning about sciencey stuff than reading this book!

At first the book is about a basic understanding of science (or rather the lack thereof) in which quickly ethics get interwoven (the most dramatic chapter around ethics may be “The doctor will see you now” which was omitted from previous versions of this book - it deals with the practices of Matthias Rath and the anti-HIV campaigns). There is a certain build-up from detox and brain-gym via skin-care products and homeopathy to the placebo effect (which, by the way, suggests that the theatrics and rituals around alternative healing may have an effect, but the pills and powders and potions do not). After this Goldacre effectively trashes nutritionists and makes the shift to the “pill solves problem” attitude that gives a nice transition to mainstream medicine. One sobering message from Goldacre is that “there are no real differences between the $600 billion pharmaceutical industry and the $50 billion food supplement pill industry”. It’s not only alternative quacks who practice bad science and play the media; also pharmaceutical firms know the tricks like cherry-picking or massaging statistics.

The last part of the book deals with media/health scares, taking the cases from MRSA (bacteria in hospitals) and the MMR vaccine (allegedly causing autism) as the main examples which tell a pretty sobering story: newspapers aren’t really interested in proper science and actively ignore scientific evidence if it doesn’t suit their agenda.

The dumbing down of science through all these incidents (like media presenting things on authority instead of based on evidence) is the greatest problem according to Goldacre, partly because this may have devastating effects in younger or future generations. Reasons for this are the medicalization of problems, the erosion of knowledge what science is about and the application of the scientific method and undermining of the public’s understanding of evidence. According to the author there is no need for media to cut out scientific evidence and replace it with “scientists have found xyz” type conclusions that are fashioned by journalists that lack proper knowledge. People are smart enough to understand the evidence provided it’s explained properly (e.g. by describing research methods and presenting numbers in natural frequencies). And of course the evidence must be transparent and accessible so that it can be reviewed and tested by other scientists

In-between all the entertaining, and sometimes enraging, subjects there are many lessons for people working in safety, and then I’m not only talking about chapters 13 and 14 (“Why clever people believe stupid things” and “Bad stats”) that deal with explanations and examples of frequently seen human misperceptions and mistakes. By the way, if you’ve read a couple of books discussed on this website (e.g. from Gigerenzer, Mlodinow or Kahnemann) quite a few of the examples will be familiar by now. Apart from these there are many more lessons to be learned. While most examples are taken from the medical world (alternative or mainstream) I think it’s fairly easy to come up with examples of safety quacks, safety charlatans, safety scares and we have to be wary of ineffective or unproven safety measures (programs) that are rather driven on belief than on solid science and facts. And there are of course many lessons how media, politics and communication work - or don’t work.

We also should keep the following quote in mind, since it stresses that we as advisors have a major responsibility: “when your advice is followed by a very large number of people, if you are wrong, even with the best of intentions, you can do a great deal of harm, because the effects of modest tweaks in risk are magnified by the size of the population changing its behaviour”.

A short overview of the book can be found on its Wikipedia page. A HUGE collection of bad science can be found on Goldacre’s website. This site is rather slow and lags/behaves jerky on my pc. I hope you don’t suffer the same problems because there is a trainload of interesting and fun stuff there. You might also want to see Goldacre's TED Talk.

I’ve read the 2009 pocket version (which includes the additional chapter previously left out as well as an index) published by Fourth Estate. (ISBN 978-0.00-728487-0)