Thank you for sharing this piece. This is exactly the kind of compassion and nuance we need in these discussions. And there’s a world of difference between choosing an approach that works for you (even if it lacks sufficient evidence) and telling everyone else to do the same, selling unregulated products, putting putting public health at risk, etc.
So when you’re coming down with a cold, you feel like you want to DO something. It’s human.
For what it’s worth, years and years ago, I heard Linus Pauling pontificating on the topic of vitamin C and the common cold. He first pointed out that it couldn’t HURT, because any excess vitamin C would be rapidly eliminated due to its water solubility. But does it help? I wasn’t convinced. (Nevertheless, as a young grad student, it was really cool to be actually talking to a Nobel prize winner, and a double one at that.)
And never underestimate the power of a placebo! If it does no harm, doesn’t cost the earth and makes you feel better and/pr restores your sense of control, why not?
Pretty much everyone is a hippocrit. So that does not make you stupid, a bad scientist or uncritical. It makes you human. As long as you don't communicate such things as effective without the evidence being there. There is no problem.
"May help support immune system." So the claim made by so many grifters and purveyors of snake oil, is good enough for you. Being human is why we need scientific methods in the first place, it's no excuse. You are ingesting a product that is typically unregulated and which can be mislabeled. The risk is not zero.
You serious, BillyJoe? Every. Single. Thing. that you do is evidence based? Maybe so (congrats!), but color me skeptical. You have to accept nuance at times, and you seem to be missing some valuable nuance in your assessment here.
Yes, I'm serious. The failure here is on three levels.
1) Failing to do what you teach others to do.
2) Failure to even hint that you will attempt to correct your failure.
3) Giving license for your readers to do likewise.
That is disheartening for me to hear coming from a respected science educator.
"Every. Single. Thing. that you do is evidence based?"
No, this is what I mean.
- Use only treatments for which there is reliable scientific evidence of benefit.
- Do not feel THE need to "take something".
- For the common cold all you need to do is keep warm, rest, take plenty of fluids, and eat according to your appetite. You do not need to pop a pill of any sort.
"you seem to be missing some valuable nuance in your assessment here"
I have no idea what you mean but perhaps you can explain.
I agree with you, and think that "...while I am a scientist, I am also a human." is a trivial statement.
Dr. Steier notes that supplements are unregulated and may be mislabeled, yet she thinks risks are minimal and worth it for something of "possible (if uncertain) benefit." How can one be sure that the risks associated with an unregulated supplement are minimal? Please Dr. Steier, share your favorite zinc's brand name with us so we all can be as sure as you are that it's risks are minimal.
Dr. Steier writes: "I was making an informed decision based on... and the recognition that sometimes the act of doing something when we feel unwell serves a psychological purpose that has value in itself." Well that is certainly scary thought coming from a public health scientist. An invitation to the land of woo if I've ever heard one.
Dr. Steier has written a number of articles I rank very high in terms of science and critical thinking values, but this is certainly not one of them. Great to show empathy and share the struggles of being human with others, but that can be done while at the same time challenging ourselves and others to do better.
Yes, I think the harm here was to essentially give license to readers to make non-science-based decisions by not saying that the non-evidence-based choices she made were mistaken and that she would attempt to correct them to align with the evidence. It's a relatively minor matter in the case of the common cold but some readers may think it is okay to extend it to other areas.
You and George seem to have missed the point of the article I am afraid, or at least had a wildly different interpretation of it than I did (can't figure out why, but you're entitled to that of course). Human beings are imperfect, including scientists. You seem to be equating taking a zinc pill when one has cold symptoms to pounding supplements on a daily basis (which is where we often see cases of toxicity, etc.) - this is just a hunch based on the "shame on you" tone of your comments, maybe you didn't mean it that way. And your 3 "levels of failure" are questionable as well. "Giving license for your readers..." come on. You are stretching that one beyond the scope of the point of this article. How is it giving license? Please explain. By being honest about something she did personally? You'd rather her be a hypocrite or just hide that fact? There were no recommendations made here. You also seem to be assuming with these opinions that the reader hasn't read anything else BUT this article. I think the main thing both of you seem to be missing here is the HUMAN ELEMENT. Scientists and doctors are humans too.
"Scientists and doctors are humans too." Again, a trivial statement.
It is because we are human that we have to try so hard to overcome the many tendencies that can lead to harm and obscure the truth. That struggle is constant, and it's the same, whether it's about zinc or mineral miracle solution.
There is very little daylight between zinc for colds and homeopathic remedies. What's the difference between thinking zinc is harmless and homeopathic remedies are harmless? A person may even know that there is probably no active ingredient in a homeopathic remedy and still take it because, you know, what's the harm? There are almost always harms to giving in on this point. Spending money unnecessarily, foregoing effective treatments, encouraging magical thinking, etc. Every time someone thinks "What's the harm, the critical thinking part of their brain should light up to say "No, wait a minute, I know better than that and will resist the temptation.
I got Dr Steier's point, but I think she sets a poor example as a science communicator, public health scientist, skeptic, and critical thinker in this specific case. By all means, show that you are human, that you have the same cognitive biases we all do, but also teach us how to overcome them rather than giving in to them.
I got a bad feeling while reading the article and it got progressively worse as I continued to read to the end. That prompted me to analyse why the article gave me such a bad feeling and why I felt the need to comment. My initial comment was deliberately short but, after getting a response, I decided to post my full analysis.
I have seen this attitude before, and I just don't see any way to justify it. Your outlook is either science-based, or it is not. There will be readers who take non-evidence-based treatments (yes, and supplements) who will feel they have been given license to continue. I mean, I get it, I am a fan as well, but this one was bad, sorry.
Thank you for this very nuanced and balanced piece. I am not a scientist, though a similar data based approach is required in my line of work, and I truly believe it helps everyone when leaders, people with privilege and/or authority and/or knowledge, acknowledge being human and share their thought process. It's basically what this world needs more of.
I laughed pretty hard at your “process” because I went through a similar experience Sunday morning - flu-like aches, low-grade fever, etc. and started the “differential” examination because I was having a minor surgical procedure I had waited a considerable time to have on Monday morning. What could it be? I broke out the Covid-19 test (I have yet to contract it), and negative. Seasonal flu didn’t seem to make sense… UTI? I had one home diagnostic test left and it was positive for leukocytes. How & why that day, for only the second time in my life? Who knows. My brother asked if I couldn’t just “pound the fluids,” get some cranberry juice,or “methenamine salts” (?) I told him I’d call him back when I got back from Urgent Care. The very nice young Dr. who saw me had never heard of “methenamine salts” either. It seems to me that, as you say, not every health decision in our lives requires a run through the NLM, but our common sense training should serve us in the very simple as well as the exceptionally complex decisions we will make professionally, and in our role as “patients” allow us to let go & let the providers we have entrusted with our health & wellbeing to ultimately guide us appropriately.
Thank you for sharing this piece. This is exactly the kind of compassion and nuance we need in these discussions. And there’s a world of difference between choosing an approach that works for you (even if it lacks sufficient evidence) and telling everyone else to do the same, selling unregulated products, putting putting public health at risk, etc.
"an approach that works for you"
In other words, a personal anecdote, that we warn other people is not evidence of anything.
So when you’re coming down with a cold, you feel like you want to DO something. It’s human.
For what it’s worth, years and years ago, I heard Linus Pauling pontificating on the topic of vitamin C and the common cold. He first pointed out that it couldn’t HURT, because any excess vitamin C would be rapidly eliminated due to its water solubility. But does it help? I wasn’t convinced. (Nevertheless, as a young grad student, it was really cool to be actually talking to a Nobel prize winner, and a double one at that.)
Thank you for your thoughtful reflections. We are all human and I’m so glad that you are bringing this to the forefront.
And never underestimate the power of a placebo! If it does no harm, doesn’t cost the earth and makes you feel better and/pr restores your sense of control, why not?
Can we clone you? Excellent article 👌
Pretty much everyone is a hippocrit. So that does not make you stupid, a bad scientist or uncritical. It makes you human. As long as you don't communicate such things as effective without the evidence being there. There is no problem.
"May help support immune system." So the claim made by so many grifters and purveyors of snake oil, is good enough for you. Being human is why we need scientific methods in the first place, it's no excuse. You are ingesting a product that is typically unregulated and which can be mislabeled. The risk is not zero.
I'm sorry but I find these tales disheartening.
What hope do have we have if we don't even follow our own evidence-based advice.
You serious, BillyJoe? Every. Single. Thing. that you do is evidence based? Maybe so (congrats!), but color me skeptical. You have to accept nuance at times, and you seem to be missing some valuable nuance in your assessment here.
"You serious?"
Yes, I'm serious. The failure here is on three levels.
1) Failing to do what you teach others to do.
2) Failure to even hint that you will attempt to correct your failure.
3) Giving license for your readers to do likewise.
That is disheartening for me to hear coming from a respected science educator.
"Every. Single. Thing. that you do is evidence based?"
No, this is what I mean.
- Use only treatments for which there is reliable scientific evidence of benefit.
- Do not feel THE need to "take something".
- For the common cold all you need to do is keep warm, rest, take plenty of fluids, and eat according to your appetite. You do not need to pop a pill of any sort.
"you seem to be missing some valuable nuance in your assessment here"
I have no idea what you mean but perhaps you can explain.
I agree with you, and think that "...while I am a scientist, I am also a human." is a trivial statement.
Dr. Steier notes that supplements are unregulated and may be mislabeled, yet she thinks risks are minimal and worth it for something of "possible (if uncertain) benefit." How can one be sure that the risks associated with an unregulated supplement are minimal? Please Dr. Steier, share your favorite zinc's brand name with us so we all can be as sure as you are that it's risks are minimal.
Dr. Steier writes: "I was making an informed decision based on... and the recognition that sometimes the act of doing something when we feel unwell serves a psychological purpose that has value in itself." Well that is certainly scary thought coming from a public health scientist. An invitation to the land of woo if I've ever heard one.
Dr. Steier has written a number of articles I rank very high in terms of science and critical thinking values, but this is certainly not one of them. Great to show empathy and share the struggles of being human with others, but that can be done while at the same time challenging ourselves and others to do better.
Yes, I think the harm here was to essentially give license to readers to make non-science-based decisions by not saying that the non-evidence-based choices she made were mistaken and that she would attempt to correct them to align with the evidence. It's a relatively minor matter in the case of the common cold but some readers may think it is okay to extend it to other areas.
You and George seem to have missed the point of the article I am afraid, or at least had a wildly different interpretation of it than I did (can't figure out why, but you're entitled to that of course). Human beings are imperfect, including scientists. You seem to be equating taking a zinc pill when one has cold symptoms to pounding supplements on a daily basis (which is where we often see cases of toxicity, etc.) - this is just a hunch based on the "shame on you" tone of your comments, maybe you didn't mean it that way. And your 3 "levels of failure" are questionable as well. "Giving license for your readers..." come on. You are stretching that one beyond the scope of the point of this article. How is it giving license? Please explain. By being honest about something she did personally? You'd rather her be a hypocrite or just hide that fact? There were no recommendations made here. You also seem to be assuming with these opinions that the reader hasn't read anything else BUT this article. I think the main thing both of you seem to be missing here is the HUMAN ELEMENT. Scientists and doctors are humans too.
"Scientists and doctors are humans too." Again, a trivial statement.
It is because we are human that we have to try so hard to overcome the many tendencies that can lead to harm and obscure the truth. That struggle is constant, and it's the same, whether it's about zinc or mineral miracle solution.
There is very little daylight between zinc for colds and homeopathic remedies. What's the difference between thinking zinc is harmless and homeopathic remedies are harmless? A person may even know that there is probably no active ingredient in a homeopathic remedy and still take it because, you know, what's the harm? There are almost always harms to giving in on this point. Spending money unnecessarily, foregoing effective treatments, encouraging magical thinking, etc. Every time someone thinks "What's the harm, the critical thinking part of their brain should light up to say "No, wait a minute, I know better than that and will resist the temptation.
I got Dr Steier's point, but I think she sets a poor example as a science communicator, public health scientist, skeptic, and critical thinker in this specific case. By all means, show that you are human, that you have the same cognitive biases we all do, but also teach us how to overcome them rather than giving in to them.
I got a bad feeling while reading the article and it got progressively worse as I continued to read to the end. That prompted me to analyse why the article gave me such a bad feeling and why I felt the need to comment. My initial comment was deliberately short but, after getting a response, I decided to post my full analysis.
I have seen this attitude before, and I just don't see any way to justify it. Your outlook is either science-based, or it is not. There will be readers who take non-evidence-based treatments (yes, and supplements) who will feel they have been given license to continue. I mean, I get it, I am a fan as well, but this one was bad, sorry.
Thank you for this very nuanced and balanced piece. I am not a scientist, though a similar data based approach is required in my line of work, and I truly believe it helps everyone when leaders, people with privilege and/or authority and/or knowledge, acknowledge being human and share their thought process. It's basically what this world needs more of.
Well. Then perhaps those tobacco enemas aren’t so silly after all…
I laughed pretty hard at your “process” because I went through a similar experience Sunday morning - flu-like aches, low-grade fever, etc. and started the “differential” examination because I was having a minor surgical procedure I had waited a considerable time to have on Monday morning. What could it be? I broke out the Covid-19 test (I have yet to contract it), and negative. Seasonal flu didn’t seem to make sense… UTI? I had one home diagnostic test left and it was positive for leukocytes. How & why that day, for only the second time in my life? Who knows. My brother asked if I couldn’t just “pound the fluids,” get some cranberry juice,or “methenamine salts” (?) I told him I’d call him back when I got back from Urgent Care. The very nice young Dr. who saw me had never heard of “methenamine salts” either. It seems to me that, as you say, not every health decision in our lives requires a run through the NLM, but our common sense training should serve us in the very simple as well as the exceptionally complex decisions we will make professionally, and in our role as “patients” allow us to let go & let the providers we have entrusted with our health & wellbeing to ultimately guide us appropriately.
In New Zealand, we use methenamine hippurate to prevent UTIs in those who have them recurrently and it does help some people, but not as treatment.
Thank you. I had never heard of it!