During the pandemic, various politicians stood in front of the television cameras and told us they were only following the science. But whose science? As Einstein noted, it is theory that determines what we observe. And different scientists subscribe to different theories.
Number 1 on the current Sunday Times general paperback book listing is Roy Taylor’s Reversing Type 2 Diabetes, and Taylor is a physician who subscribed to a very different theory from everyone else. Taylor, who recently retired as professor of medicine at the University of Newcastle (though he is still researching), noticed years ago, as a young doctor, that the standard story about type 2 diabetes had to be wrong. Like everyone else, he had been taught that type 2 diabetes was a progressive disease, but unlike everybody else, he realised that was not true.
Type 2, for those who do not know, is now epidemic in the west, and it generally strikes the overweight. It is characterized by high blood levels of sugar, which in turn cause heart disease, renal failure, and other life-shortening pathologies. In its initial phases, it can be treated by drugs taken orally, but (as the conventional story ran) it inevitably progresses to type 1, which is the type that has to be treated with injections of insulin. And type 1 is most certainly associated with a range of pathologies including blindness.
But along came an odd fact. During the 1990s a group of surgeons thought to reverse obesity in certain patients by removing large chunks of their stomachs. And to everybody’s surprise, those obese patients who also happened to have type 2 diabetes experienced an almost-immediate remission of their diabetes: within two days of their operation, their diabetes was cured.
Enter Taylor the contrarian. The mythology is that science is fact-driven, but science is actually theory-driven, and inconvenient facts are too often consigned to the intellectual oubliette. So after the surgeons discovered they had reversed type 2 diabetes by stopping their patients from over-eating, the physicians simply ignored the observation as being too difficult to understand.
The physicians ‘knew’ that diabetes was best treated by (i) very frequent eating, especially at breakfast, by (ii) consuming vast amounts of complex carbohydrates, and by (iii) avoiding fat. So they continued advising their patients to follow those three regimens.
But Taylor had internalised the lesson of the surgical excisions of large people’s stomachs, and he proposed treating type 2 diabetics by calorie restriction (aka weight loss dieting.) Which he did. Successfully. Thus reversing their diabetes.
Consequently, it transpired that type 2 had been progressive only because patients had dutifully obeyed their doctors by eating frequently, especially at breakfast (which was a disaster); by consuming vast amounts of complex carbohydrates (which was a disaster); and by avoiding fat (which was a disaster). Let us be grateful that diabetic physicians had, by the 1990s, at least forsaken leaches, cupping and bleeding, or we’d also have been told that progressive anaemia was integral to type 2 diabetes.
Having shown that type 2 diabetes is reversible, Taylor has since gone all David Attenborough, writing Life Without Diabetes in 2019, co-authoring Eat to Beat Type 2 Diabetes in 2020, and now publishing Reversing Type 2 Diabetes. And jolly good all three books are. But, thankfully, Taylor is not the only contrarian in science.
In 2005 Professor John Ioannidis of Stanford University published a now-famous paper with the worrying title of ‘Why most published research findings are false.’ And it transpires that most published research findings are indeed false because scientists are procrustean in their approach to facts: they pick their theories first and they then distort the facts to fit them.
Which is why Max Plank noted that science advances funeral by funeral, because only after the old guard (who will not surrender their theories) finally die can a new generation of researchers acknowledge inconvenient facts. And which is why Thomas Kuhn noted in his 1962 book The Structure of Scientific Revolutions that scientists—regardless of facts—change their theories so rarely and so painfully and so reluctantly that he coined a special term for it, ‘paradigm shifting.’
Nonetheless, we’ve all recently witnessed such a shift. A month ago 99 per cent of respectable scientists believed SARS-CoV-2 emerged naturally from a bat or perhaps a pangolin in China. Now as many scientists assume it escaped from a lab in Wuhan.
Yet few biological facts have emerged to justify such as a volte face — rather, it transpires that the person who last year wrote in the Lancet that a lab escape was unthinkable was, discreetly, himself involved in the lab’s experiments. So we theorise he was biased. And because theory determines what we observe, we now observe the same facts very differently. And we’ve shifted that paradigm double-quick because Covid matters.
Which leaves the rest of us adrift: who in science to trust? To which the answer is: the technologists. Science cannot be trusted because it’s theory-driven, but technology is the arena where theories are tested against reality. So we should place our trust in science only after it has been translated into technology and only after that technology has been tested against reality.
A scientific paper, even in the Lancet, is just that. A paper. But a vaccine or a low-calorie diet is an empirical test, and only if it works is the science from which it arises validated. But until a scientific paper has been tested empirically, we should view it only conditionally.