The good doctor
Ben Goldacre’s newspaper column skewered quack scientists and unmasked dodgy pharma companies. It was, he tells Adam Dudding, all just for fun.
It was 2003. Ben Goldacre, a bright young medical doctor and researcher, was sitting in Luton airport, just north of London. He’d missed his flight to see his girlfriend in Germany.
He was also annoyed because he’d been reading a newspaper and encountered, for the umpteenth time, a piece of sloppy, unscientific reporting of a health story. Normally he’d bottle up his irritation and uncork it at some gathering in a sanctimonious, socially inappropriate way, but today he was feeling reckless.
‘‘I thought, ‘I’m going to write something about how stupid that is’.’’
He found a payphone, called the switchboard of the Guardian (seeing as that was the newspaper he was holding) and asked for the health editor, but was instead put through to science editor Emily Wilson (currently the editor of Guardian Australia).
He told her what he wanted to write ‘‘and she said OK, get me 600 words by Thursday 5pm, and if you can’t do it by then don’t call me – in fact, if you can’t do it by then don’t ever call me again.’’
Thus began Bad Science, Goldacre’s hugely popular
Guardian column that ran for eight years and spawned a 2008 book of the same name.
He pointed a finger at pseudoscientists and anti-vaccination lobbyists, at homeopaths and pushers of unproven vitamins. He mocked the Daily Mail’s obsession with reporting on spurious causes of and cures for cancer, and generally gave journalists hell. In 2012, he published another book, Bad
Pharma, which excoriated the deceitful practices of major drug manufacturers. The two books have sold half a million copies.
He, meanwhile, continued to build up a ferocious CV as an epidemiologist – someone who studies the statistics of medicine – and he leads a large research team at Oxford University. But he’s still telling the wider public how to spot bad science, and what to do about it. In September he’ll be in Auckland for a night on stage where ‘‘I’m going to get up and tell a lot of stories about how science has been manipulated by quacks, by drug companies, by academics, by regulators, and by politicians’’.
Skyping last week from London, Goldacre said his concerns are hardly unusual. Almost all scientists and doctors find reading newspaper coverage of science frustrating and are inclined to rant about it, ‘‘but I have become a kind of mouthpiece for disenfranchised nerds’’.
He’s not just an excellent explainer; his writing is also often funny. For years he waged war on the unwarranted reputation of the UK nutrition guru Gillian McKeith, unmasking her mailorder PhD then demonstrating the rigour of her registration with the ‘‘American Association of Nutritional Consultants’’ by registering his dead cat for the same certificate. His stage presentation style, as showcased in a Ted Talk from 2011, treads a little-trodden line between science lecture and comedy.
Mixing stats with stand-up is unusual, agrees Goldacre, but perhaps it was inevitable. His father Michael is an epidemiologist at Oxford, and his mother Susan Traynor was a pop star – lead singer of the 1970s band Fox, when she went by the name Noosha Fox.
‘‘I have basically put one word from each of my parents’ job descriptions together and become a stage epidemiologist – I think the first. That’s the real story of why anyone does anything, isn’t it: you see something up close and can see that it’s fun, then you want to go and do it.’’
As much as a scientist-cumentertainer, though, Goldacre is a campaigner.
‘‘Campaigning has been on my mind since I was young. I did some work in a very junior way at Liberty, the civil rights campaigning group, in my 20s. I did lots of stuff around road protests and squatters’ rights.’’
He’s in his early 40s now, and teasing quacks has given way to loftier projects. His recent projects include compare-trials.org which is devoted to the systematic naming and shaming of journals that publish shonky research findings, and another website, openprescribing.net, which allows doctors, patients, and researchers to dig into the prescription habits of every doctor in the UK.
In Big Pharma, Goldacre said data manipulation was rife in the pharmaceutical industry, including sneaky non-publication of unfavourable trial results; now he’s doing something about it – spearheading a campaign called All Trials, which calls for compulsory reporting of all results.
Yet even the mockery of quacks like Gillian McKeith always had a serious goal.
‘‘I’ve never cared about quacks ripping off the general public. It’s only ever really been a gimmick to me – a colourful story around the opportunity to explain to people the really important and interesting science of how do you know if something is good for you or bad for you?’’
What he really wanted readers to take away was an understanding of how to tell if a study has been properly designed, how to tell if someone’s exaggerating the benefits of a treatment; how to tell if somebody is just seeing faces in the clouds of statistical noise in their data.
So sure, he might have written a column debunking a story in the
Times that falsely claimed huge numbers of children in British playgrounds were using cocaine, but what he was really doing was exploiting ‘‘the opportunity to explain how you correct for clustering in survey data and how you do a Bonferroni correction for multiple comparisons’’.
Time and again, says Goldacre, you come across some difficult technical regulatory shortcoming that has been left unfixed because it’s too hard for policy makers or the general public to understand.
‘‘An important first step to fixing that problem is to communicate effectively on it – to share an accessible account of the problem and why it matters.’’
The maddening thing, says Goldacre, is that there are widespread structural problems throughout society in the way we use evidence and statistics to make informed choices – whether it’s about a pill, or an exercise treatment, or a policy to reduce unemployment – when, in fact, this stuff isn’t especially hard to grasp.
‘‘We’re all of us about three days’ reading away from being able to make competent, informed judgements.’’
He feels a bit ashamed whenever he says ‘‘read my books and then you’ll understand’’, but really, that was the reason he wrote them in the first place.
‘‘They were only written so I didn’t have to pin down each individual person I met, and talk at them for three days in an increasingly fractious state of mind.’’
In 2012, Goldacre advised the UK government on how randomised control trials, which are often thought of as the preserve of medical researchers, can be used to compare the effectiveness of different policy interventions, from teaching methods to crime-
‘I used to feel very sad that there wasn’t an accessible, engaging, funny description of how medical statistics works or relates to a particular news story ...’ Ben Goldacre
prevention strategies. It’s all very grown-up stuff.
Yet from a reckless phonecall at Luton airport to teaching the government how to choose policies, the Goldacre project has all been of a piece: ‘‘There are a bunch of data tools, a bunch of academic papers, a bunch of courses, and the books and the talk, that are all about exactly the same thing: the better use of everyday data in healthcare.’’
He’s happy to see that the market for exposing bad science is more crowded than when he started out.
‘‘I used to feel very sad that there wasn’t an accessible, engaging, funny description of how medical statistics works or relates to a particular news story, because not only were people getting the stories wrong, but anyone who wanted to understand this stuff would have nowhere to go.’’
Now, anyone who’s interested can go online and find a thousand blogs aimed at every level of understanding, and crucially, ‘‘with every kind of imaginable posture’’. Some people like their bulls***-busting serious, others prefer it funny. Some like sanctimonious, others like flippant. Some are detail-freaks while others want a quick read. You’ll sometimes even find good science coverage on the trashiest of websites.
‘‘I’ve written 3000 words on some really difficult methodological issue, in f***ing Buzzfeed! You know.
‘‘The world we live in today is glorious’’, says Goldacre. ‘‘Anyone who wants to, anyone who is sufficiently clueful and motivated that they want to learn about stuff – they can. All they need is access to the internet, and I don’t think I will ever stop finding that amazing and fantastic.’’