Category Archives: health

Uncertainty (again)

I’m blogging from the Science and Citizenship Conference. It’s being held partly to mark a ten year anniversary of the Lord’s report on Science and Society. Much of the programme was based on workshops considering key theme’s in the report. I took part on one about uncertainty and risk, and thought it was worth sharing my notes.

We started off with four key questions. Is it a new problem? To what extent are journalists to blame? To what extent are scientists to blame? What can we do to make it better? What can we all do to improve things?

We passed back and forth through various reasons why the issues of risk and uncertainty might be new, and then in turn why they are not. For example, I played the annoying “I once did a history of technology course” card that many of the fears about online media could be seen at the introduction of public libraries (the printing press, paperbacks…). Instead, I suggested maybe we have a growing intensification of activity and awareness around issues of rick and uncertainty.

In many ways, the things were were saying reflected ideas Ulrich Beck discussed in terms of ideas of the Risk Society, decades ago. As I grumbled a few months ago, the debate is an old one. That said, one of the reasons why Beck makes for an interesting example is his discussion of an increasing awareness not only of uncertainty, but the various contexts behind such uncertainty (which in turn can make us more uncertain as we seek new certainties, part of Beck’s notion that “modernity has become its own theme”).

We all seemed to agree that there was a lot of uncertainty in science and that this should be discussed openly with non scientists. We went through the various reasons why we might blame the media or scientists for not communicating such uncertainty, before critiquing ourselves to then defend both groups. For a while we seemed to pour blame on the education system, arguing that school science needs to think more about how to best prepare future-publics (rather than just training future-scientists). Though I agree school-science is important and could be improved, playing who’s to blame isn’t especially productive and  I’m not sure it’s realistic to pile too many expectations on the shoulders of an education system.

One participant mentioned a line from David Willetts – that in a society which is fragmented and uncertain, scientific evidence gives you something you can all agree on – and argued that this actually puts a huge pressure on science. It’s easy to say “yay, the science minister likes science”, but the scientific community should think about what they are are being offered here. When talking about who might be to blame, it was suggested that science holds some responsibility for being seduced into a political and media system where they are asked for certainty. That science from WW2 onwards might have seemed over-confident, but if so, it was because it sold a confidence back to people who (unfairly) asked it of them. It was also suggested that sensitivity over climate change denial is making things worse, with people defensive over the authority of science denying uncertainty. Again, it’s worth asking who’s hands are the scientific community playing to if they try to claim undeniable certainty?

(I don’t know, maybe climate change is another issue with it’s own context, and maybe working in a context with “merchants of doubt” means it’s necessary).

I’ve heard Willetts use that line too. As I argued at the time, in some respects this is a lovely thought. The big and scary postmodern world brought together with the warm glow of science. I just don’t think science tends to work like that. The very “scientific way of thinking” Willetts is prizing here is, itself, fractured and contestable. Indeed, the delivery of evidence can often be the beginning of a debate. I don’t think this is a criticism science, if anything it’s a celebration: the capacity for debate and sense that there is always a possible black swan around the corner is one of the things I like about science.

And solutions? There were the arguments about education. Perhaps predictably, “dialogue between journalists, scientists, members of the public and politicians” was mentioned, though, again predictably, we didn’t seem to have time to talk about how. Other suggestions included more standup maths shows, and citizen cyber-science. There was also some discussion of the advantages of citizen science projects in helping people feel ownership of science in some way – so science doesn’t seem like a project done by “those other people”. An interesting point was made with respect to work in Kenya; that science is sometimes seen as a Western thing and it’s been important to communicate that science can be African too. As one participant put it, this is perhaps “engagement through a sense of appropriation”.

For me this boiled down to another key word in that Lords report – trust. As Demos said back in 2004, an emphasis on risk and uncertainty is arguably a consequence of engagement happening too late in the process. If you want to build trust, you have to start early.

Miracle Mineral Solution

If you keep an eye on the UK skeptic media you will have probably already heard the story of 15 year old Rhys Morgan and Miracle Mineral Solution (“Bleachgate”). If not, let me share it with you.

Crohn’s disease is horrible. Being a teenager is horrible. Have a read through The National Association for Colitis and Crohn’s Disease pages for 16-29 year olds to get an idea of what it’s like when both happen at once. Welsh teenager Rhys Morgan was diagnosed with Crohn’s a few months ago. He did what a lot of people with similar conditions do and joined some online support groups.

It’s probably worth repeating that Crohn’s is horrible. I should also stress that it’s a complex and unpredictable condition, the details of which medical science is still unraveling. Such support groups are not only an emotional support, but can be great for sharing information, knowledge and experience. They can also be ways of spreading things that aren’t so helpful, and they can emotionally difficult places too (I can recommend this book for some discussion of issues surrounding this).

Rhys was sceptical of one of the treatment being pushed on a forum, something called “Miracle Mineral Solution”. Very sensibly he did a bit of digging, and sound found that the FDA describes it as industrial bleach. Rhys shared his concerns with the forum, and a whole story of internet community nastiness followed. Watch Rhys’ videoblog for the full story, as he tells it himself so well (or see transcript on his blog).

When the story first broke about a month ago, it was covered extensively by skeptics bloggers, but no where else much. This week, there was an overview of the story in the Guardian, via a column by skeptic-blogger Martin Robbins. It’s great that Martin’s connection there gets the story into such a high profile site (and, as Paul Bradshaw says, it’d be good if lots of people link to Robbins’ piece with the words Miracle Mineral Solution…). Still, I’d have loved to see it covered by, for example, reporters on education or health beats too. Not just for the extension of coverage, but because I think it’s worth reflecting on the story from more than just a skeptic perspective.

There has been a move in recent years to make UK science education more about public engagement, designing curricula that not only train the next generation of scientists, but equip young people to use and critique claims to scientific authority as part of their everyday lives (see this GCSE for example). However, a lot of this sort of work seems to see the process as preparation for later life, as if active engagement is something adults too whereas kids are simply passive. Similarly, I’ve heard activists in young peoples’ health complain that under 18s are too often seen as “human becomings” rather than “human beings” when it comes to medicine; that teens are simply taught how to prepare for a healthy adult lives as if they have little role in their current existence.

I can see why people have been celebrating and supporting Rhys on this issue, but he’s not the only teenager to take such a sensible and active role when it comes to their health (e.g. the trustee of Body and Soul featured in this podcast). I suspect a lot of young people hope to get the best possible information about health; that they will spend time looking for such information and will be sceptical about what they find. Also that the care that others get good information too, and so share it about, and that they will get into fights with other young people and adults while they do so.

That’s why, for me the tale of Rhys Morgan and Miracle Mineral Solution isn’t just a story for or about skeptics. It’s a genuinely interesting, concerning and illuminating story of inter-generational health communication in a digital age, and one I’d have love to see talked about more.

EDIT: 19/9/10 changed reference to Martin’s piece in Guardian which was initially down as a blogpost rather than a column. See my comment on Paul’s blogpost for context. Also, look – the story has been picked up by a Kenyan newspaper and on the PLoS blogs.

Mechanical metaphors in kid’s body books

This is the cover of Usborne’s classic kid’s book How Your Body Works. The book has been around in some form since 1975, so you might have seen it before. I’m interested in it for many reasons, but this blogpost is going to focus on the way it reflects an oft-used metaphor when it comes to explaining the human body, that of a machine.

Cover of How Your Body Works

Comparisons of the body to machine are sometimes seen in a negative light; endemic of a mechanistic worldview which is overly-reductive approach to something as complex and beautiful as the human body.

Yawn.

Ok, a “yawn” is over-trivialising the anti-mechanist critique, but I want to argue that kid’s body books employing robot metaphors are a bit more complicated than that (personally, I think you can say the same of Blake’s Newton, but that’s another story). My central point is that mechanical analogies provide a diverse set of cultural referents. Machines comes in a range of sizes, shapes and styles, and people use and think about them in a range of ways. Further, both machines and the way cultures have understood them has changed over time.

Perhaps a mechanical analogy allows some form of abstraction, providing some distance from specifics when handling issues like reproduction, infection and digestion. For example, the section outlining what happens when a blue robot loves an orange robot very much.

how (robot) babies are made
Such abstraction may also provide an expository role. Yes, the human body is a lot more than, for example, a set of bellows (below), but the image filtered down the multitude of things going on inside a person’s chest so we can learn about one thing at a time. Reduction for explanatory purposes isn’t (necessarily) to say the world really is that simple.

lungs

Mechanical analogies for specific systems (e.g. lungs as bellows) is one thing, but when it becomes a matter of depicting the whole body, we start moving towards associations with robots. The metallic skeleton on the cover of the Usborne book isn’t necessarily a robot, but there is something robot-like about him.

There are a wide range of cultural associations that might come with such allusions. Think of Dr Who, and robots are nearly always symbols of what is inhuman or a lost humanity (e.g. their nod-to-Metropolis Cybermen, or hide-behind-the-sofa Daleks). But think of Wall-E, or these smiling robot tshirts I spotted recently, or these robot cookies. Robots can be your friends. At the Science museum this week you can “meet Kaspar the friendly humanoid robot”.

There’s a nice study of robots in children’s literature by Margaret Esmonde in this 1982 collection of essays on machines in science fiction. According to this study, the robot or cyborg is generally a benevolent character in children’s stories, often acting in loco parentis or as a reasonably sympathetic step-brother. Even where there are “bad” robots, they tend to be destroyed with the aid of “good” ones. Her only example otherwise being Dr Who. Interestingly,  such child characters tend to be boys – a robo-brother, not sister – though she does mention one, it is very much an exception to the rule. I also wonder if there is something to be said about the childlike representation of robots in not only fiction, but news stories (even research projects) too; that we take the sometimes limited abilities of robots as a reason to pat them on the head and go “aww”.

The gender and generational points are just as an aside though, my main reason for mentioning Esmonde’s study is that the robot of children’s popular culture may well be a very sympathetic, even empathetic, character. Just because it is not human, doesn’t mean it is inhuman. Esmonde describes a few fascinating case studies. For example, a picture book produced to illustrate the UN declaration on rights of the child: a little boy lives a secure and caring life under the love and protection provided by his robot guardian. ‘Nosey’ people intervene and separate them, so the robot returns, disguised as a human and takes the boy back and they live happily ever after.

Esmonde traces mechanical characters in children’s fiction back to  L. Frank Baum’s Oz series. There is Tik-Tok, pictured, who you might know from the 1985 movie (see also this io9 piece on Pre-Golden Age SF Robots), and possibly the most straightforwardly mechanical man, the Tin Woodman, who everyone knows from the musical (“if I only had a heart”). Esmonde also discusses the lesser-known Chopfyt, a fascinating character made from cast-off “meat” parts of the two other men. She stresses these characters were all relatively ambiguous in their humanity, there isn’t the humans vs robots distinction which is so often played out in Dr Who. She also argues that Baum is content to leave these questions unanswered.

In my introduction I stressed that technologies and our cultural ideas about them have changed over time.  With this in mind, it’s interesting to see a very Tik-Tok style robot re-used in Phillip Reeve’s steampunk-ish Larklight books which self consciously re-uses old futuristic tropes of the robot to play with hopes, fears and other aesthetics surrounding them. Reeve is an extremely complex writer when it comes to images of technology, I haven’t space to discuss it here, but there are some brief notes on him buried in this paper. Or just read his books (the Mortal Engines series too, and do it before they are all movies).

Getting back to non-fiction, let me introduce you to The Body Owner’s Handbook (Nick Arnold & Tony De Saulles, 2002). This is part of Scholastic’s Horrible Science series, and structured out under the narrative conceit an instruction manual for the human body. In some respects, this is quite straightforward body as machine stuff. As are later points in the text which refer to the digestive system as a ‘fuel storage tank and conveyor belt’ and a ‘body repair shop’ is used to discuss cell replacement (The Body Owner’s Handbook, 2002: 22, 28). It is quite self-aware about this, and seem to expect the audience to be as well. As mentioned in my post about poo books, in some respects make fun of the distance provided by the mechanistic imagery (whilst also applying the convenience of it).

However, I think The Body Owner’s Handbook is slightly different from How Your Body Works in the way it conceives of its technological metaphor. For a start, it combines it with a loose narrative of a childlike Frankenstein monster. I’m drawing a line under the Shelly comparisons now. It is fascinating and arguably key to understanding the book, but a whole other blogpost. Suffice to say this is a slightly more “meaty” approach to (bio)technology and a (post)modern critique.

Monsters aside, The Body Owner’s Handbook seems to be applying a machine metaphor rooted in consumer technology. As with a lot of the books in Horrible Science, the language and imagery is heavily influenced by advertising styles (though, it should be noted with their tongue firmly in cheek):

Looking for a new body? Why not choose the real McCoy – the one and only Human Body. It’s Planet Earth’s most advanced living machine! It’s built of the finest material to a tried and tested design that’s over two hundred thousand years old! (The Body Owner’s Handbook, 2002: 8 )

This is a technology you would buy. It is not one that powers the “dark satanic mills”. Neither is it one you’d build yourself. It is ready made, just for you. This is not a Fordist form of mass production where the mechanical body is available in any colour as long as it’s black. This body is available in a variety of colours; “light brown, dark brown, pink, beige and yellow” (The Body Owner’s Handbook, 2002: 9).

In some respects such a contemporary consumer-tech model of the body allows for a connection with a sense of individualism: note the location of the apostrophe in the book’s title, it is body-owner singular. Yet, this note on race is emphasised by arguing that bodies are all the same underneath; the sense that everybody’s body is the same is very important to the scientific stories of the book. Perhaps this is the curtailed (and occasionally illusionary) individualism of interaction with branded technology. To some extent such identities come, to some degree, pre-packaged. Pink microscope anyone?

Moreover, such pre-packaged advanced tech comes with a greater degree of ineviable black-boxing. There are right and wrong ways of interacting with its surface, but its internal workings are a relative mystery to users. As many writers on technology have argued – indeed many writers on post/ late modernity have argued – the quantity of specialisation that goes into producing much contemporary means they come with greater mystery. Personal computers make one of the nicest examples of this. In the early 1980s, many personal computer users not only programmed but actually made their own kit. By the early 1990s, even the professionals could only produce one small aspects. Perhaps then, mechanical metaphors no longer provide simplicity? (if they ever really did)

Significantly, The Body Owner’s Handbook warns: “The body isn’t designed to be opened by non-experts and this can result in serious body breakdowns” (p12). In some respects this is in some contrast to a line in one of the first Horrible Science books, also about the body:

[science] belongs to everybody, because everybody’s got a body – and you’ve got every right to know what’s going on in yours (Blood, Bones & Body Bits, 1996: 5).

That said, perhaps back in those golden years of hobbyist tech and meccano collections, when kids built their own crystal radios (grew their own computers, spewed out their own difference engine, etc etc), no one told them to “tinker” with their physiology. Or maybe they did (um, maybe let’s not go too far with this tinkering analogy…). As The Body Owner’s Handbook‘s use of Frankenstein reflects, biotech has always been a slightly different matter.

Perhaps the most important thing to keep in mind is that they are only interesting as examples of what adults choose to produce for children. Personally, I think this is fascinating in itself, but it isn’t necessarily a sign of what children themselves think. In the light of a spate of “wrong superheroes” stories last week, this is something to keep in mind. If you want to know what children think, ask them. Musing about the media presented to young people is interesting and worthwhile when understood on it’s on terms, but it doesn’t tell us what is going on in the heads of actual children.

My main point, however is that if we do want to think through some of the symbols involved in technologically informed explanations of bodies, is pays not be reductive/ simplistic about machines.

Poo Books

I have a small collection of “poo books”. For research reasons, obviously. Fancy a tour? Of course you would. Let the poo commence.

pile of poo

By “poo books” I mean books for children about either digestion processes of going to the toilet. Such books often use the word “poo”. It is largely their term, not mine. These are not books about “shit”, “crap”, “faeces”, “defecatory materials” or “excretionary waste products”, but slightly less direct ways of talking about the same topic. Though equally we might call shit or faeces equally euphemistic (either because they choose to swear or because they rely on disinterested-sounding terminology). Indeed, in many ways poo books embrace the whole topic of what comes out of our bottoms with reasonable enthusiasm. This enthusaism is often self-consciously and proudly childish. As such, the “poo” in question is some respects half euphemism and half an expressive avoidance of euphemism.

Poo books for under 5′s are often designed to provide information and reassurance about this stuff that comes out of our bottoms (whatever we want to call that). One of the most internationally famous of the poo-book genre is Everybody Poos (Frances Lincoln, 2002), or Everybody Poops in America. There is a sort of sequel on farting called The Gas We Pass. First published in Japan in the late 1970s, this is typical of the poo-book genre in that aims to normalise by treating it as something fun, even jokey.

different poo

In his 1992 book, Language and Ideology in Children’s Fiction, John Stephens refers to Maurice Sendak’s Where the Wild Things Are as a case study in the presentation of “safe monsters” in children’s literature. By giving comically grotesque forms to inner fears, Stephens argues, Sendak’s illusions work to defeat the image of that fear (Stephens, 1992: 136). The 2001 Pixar movie Monsters Inc is probably a better example of this; arguably its whole plot is based around this idea.

I think we can apply Stephens’ analysis to a lot of poo-books (indeed, many comic health books in general); an aim to turn young people’s fears about the workings of their body into “safe monsters”. This bottom stuff can, after all, can be both painful and socially embarrassing. For all that we think of scatological humour as childish entertainment, like most children’s literature, these books have a pedagogical and/ or moral aim of some sort. They aim to teach and to help their audience in some way. See also It Hurts When I Poop or, one of my personal favourites, the Moose with the Loose Poops (Hippocractic Press, 2009, pictured). Part of a “Dr Hippo” series (Hippo-cratic, see what they did…), it even comes with a pull-out medical guide for parents tucked into the back cover. Here we have mummy-moose comforting the ill protagonist:

moose with loose poops

Poo books for primary school age (i.e. those passed the toilet training stage) often utalise the apparent comedic value of poo as a hook talk about wider scientific processes. The Horrible Science series is one of the best examples of this approach. We can also see it in some of the medical titles of the larger and more famous parent-series Horrible Histories too, though do note these have different author/ illustrator teams and slightly different take on what “Horrible” might mean. Snot, puke, pus and blood are equally popular subject matter here, it’s not all about the shit. I think the “safe monsters” analysis is still applicable here though, and although there aren’t many poo-books for teenagers, there are perhaps comparisons to be made with titles like Diary of a Teenage Healthfreak.

Horrible Science are keen to show off the use of knowledge, alongside humour, as a way of defeating fears around health issues. At the same time, they continue to draw immense delight from references to poo etc, as well as lightly spoofing the same scientific approaches to studying it which they draw power from (complex beasts, the Horrible Science books). For example, Painful Poisons (2004) starts by stating that “lots of people think poison is a scary subject”. It then goes through a goading, pantomime device of implying you don’t really want this, do you, parodying a patronising adult voice and playing to the idea that this is the secret stuff kids love to read about (pages 5-6), before concluding by emphasising that poisons are everywhere and although it is “easy to be scared” the best way to deal with poisons is with knowledge rather than fear (pages 143-4). You can see similar shifts – from fears “some people” hold and towards knowledge and a delight in the horrible nature of the scientific object – in Angry Animals (2005) and Chemical Chaos (1997).

In the example below (The Body Owners Handbook, Scholastic, 2002, page 23) is possibly my favourite: a cartoon rendering of the sorts of diagrams of the digestive system frequently reproduced in school textbooks and exam papers. There is the sound of “plop” (in a friendly, handwritten-style font) along with the childish, slightly twee “poo”. This is juxtaposed with comical language which pokes fun at whilst simultaneously applying the conventions of talking indirectly about excretory matter in a scientific manner; “solid waste ejection pipe”, “fuel storage tank” and “conveyor belt for waste processing”.

Plop!

American readers might be more familiar with the Grossology series; it similarly celebrates the gruesome in a sense of appealing to childishness, and applies this with scientific information to help liberate children from fears of their bodies. For example, the cover of Naked Grossology (the title on the body) promises: “Really gross things about your body, It’s stinky, it’s lumpy, its squishy, but hey, it’s your body”. I’m also a fan of Gooey, Chewy, Rumble, Plop, available on both sides of the Atlantic, which includes a beautifully realistic tongue on the cover as well as pop-up technology to give you a view down the gut.

Possibly my favourite of the poo books is Poo: A Natural History of the Unmentionable (Walker, 2005). I think it typifies the “half euphemistic” approach to poo in many of these books. It clearly relishes poo, and yet maintains some distance from the actual object (partly by cartoon illustration, partly through dry humour). The back cover is especially nice. I hippo declares “I like to spray it all over the place”, a bird sitting on it’s back: “I make houses out of it”. The book contains a lot of detail, and it is worth knowing that the author, Nicola Davies is a zoologist who used to present the Really Wild Show. Note the “natural history” in the title (and white-coated characters on cover). Like Horrible Science, this is a step along from toilet training and seems to self-consciously play with the humour of the serious and detached way science might deal with “poo” just as much as any other humour in the subject.

Wale

Maybe it’s not surprising I like this book. As with a lot of poo books, it seems to appeal to grown ups as well as children. I have a copy because it was a birthday present (a birthday in my mid-20s). Indeed, this article from the New York Times about the US publishers of Everybody Poos notes the books are popular with adults buying for other adults.

Arguably, this is true of a lot of children’s books (see also point on the “impossiblity” of children’s media and “generational drag” in latter half of this blogpost). The idea that children will like the yuk of poo and snot and pus is just an adult’s idea of childishness, one that it is interesting to have seen shift slightly in the last century. As I argue in my PhD on Horrible Science, they seem to have roots in a rather Beano idea of childhood. In his 1989 book about working at the Beano, On Comedy: The “Beano” and Ideology, Leo Baxendale, creator of the Bash Street Kids and Minnie the Minx, talks of a desire to depict what he felt was a truer, “scruffier” and more anarchic image of children, in contrast to “soft” fairytale images he felt the Beano applied up until the 1950s. For Horrible Histories author Terry Deary, the social acceptability of the Horribles is largely due to the legacy of Roald Dahl who, according to Deary, made the use of horror and black comedy in children’s books acceptable (Deary, 1999: 97). Considering that historical background I thought it was interesting that the NYT article referenced criticisms that poo-books aren’t very American. I’ve noticed that Grossology is a lot milder than Horrible Science (and the Horrible books have never really made it in the USA). Maybe, despite the various efforts of Warner Brothers, Nickleodeon and the Simpsons, the more anarchic image of childhood is still less acceptable in the USA.

A final point prompted by the Horrible Science books: we live in a multi-media age, and kids science books are, generally, a rather interactive form of “dead-tree” publishing. So, yes, finally, we have the mini-sub-genre of “hands-on” poo books. Obviously, such hands-on interaction is heavily mediated. They don’t actively ask their readers to handle their faeces. For example, Horrible Science’s Disgusting Digestion sticker book (Scholastic, 1998) includes a set of stickers of partially (and not so partially) digested food for you to place along their cross-section diagram of the gut.

Have you the stomach to read on?

It is worth noting that this is true of most so-called hands on interaction in kids science. Whatever their appeal to immediacy, most so-called “experiments” are mock-ups of demonstrations. It isn’t just shit which science books for kids feel a need to fabricate. This is often for quite sensible educational and practical reasons, but worth baring in mind. I think I’ve saved the best till last. Because the book Farley Farts (2003) does actually fart, albeit annoying softly. Play this little video to hear it.

This post has been largely descriptive. If you’re interested in slightly more academic analysis, I can recommend Mills, Alice (2006) ‘Harry Potter and the Terrors of the Toilet’, Children’s Literature in Education, vol 37(1), 1-13. I think Mills nails the differences between boys and girls toilets as dramatic sites in children’s books: Girls toilets, she argues, are relatively private and thus places of solace, where characters go to escape on their own; Boy’s bogs are more um, ‘communal’ and full of fighting, pain and suffering. The rest is a bit too psychoanalytic for my personal taste, but if you like a serving of Kristeva’s idea of the abject with your literacy analysis (and/ or the odd bit of Harry Potter studies), it’s a peach of a paper.

I’ll leave you with a tip for anyone reading this post on the toilet, from the charming Liam goes Poo in the Toilet (2008, subtitle: A Story about Trouble with Toilet Training). Sage advice at any age, I’d say.

relax and push