Nesse on Academia

Jan 18, 2008

Darwinian medicine pioneer Randolph Nesse answers this year’s Edge question:

I used to believe that you could find out what is true by finding the smartest people and finding out what they think. However, the most brilliant people keep turning out to be wrong. … A lot of the belief that smart people are right is an illusion caused by smart people being very convincing … even when they are wrong. I also used to believe that you could find out what is true by relying on smart experts who devote themselves to a topic. But most of us remember being told to eat margarine because it is safer than butter then it turned out that trans-fats are worse. … I shudder to think about all the false beliefs I have unknowingly but confidently passed on to my patients, thanks to my trust in experts. …
Finally, I used to believe that truth had a special home in universities. After all, universities are supposed to be devoted to finding out what is true, and teaching students what we know and how to find out for themselves. Universities may be best show in town for truth pursuers, but most stifle innovation and constructive engagement of real controversies, not just sometimes, but most of the time, systematically. … Faculty committees intervene to ensure that most positions go to people just about like themselves. … Where can we look to find what is true? … We could begin to design new social structures that would support real intellectual innovation and engagement.

This seems to me to be just about the right attitude – admitting that academia is the best we have but lamenting that it seems so inefficient, and looking for better ways. Perhaps Nesse is ready to consider Idea Futures.

Discussion about this post

Robin Hanson

May 15, 2023

Hi Randoph, thanks for commenting. You'd be welcome to join this blog as a contributor, able to make your own posts here. For example, we did cover the antidepressant publication selection bias news, but I'm sure you would have done a more expert job of it. You may recall that we both presented at Susanne Lohmann's May 2001 conference "Why We Get Sick."

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Overcoming Bias Commenter

May 15, 2023

Hi Everyone,

Thanks for those comments. They make me feel somewhat understood, and a bit less uncomfortable about posting a somewhat intemperate piece on EDGE. After all, I AM, or claim to be, an expert at a university, so…

Here is the back-story that may be of interest. I am spending this year writing a book about why depression exits, really about the evolutionary origins of low mood and the relatively fragile mechanisms that regulate mood. In the process of my research, I went looking for information on the state of evidence on stress hormones causing depression (a previous research topic of mine). As I read review after review, it quickly became clear that the reviewers were expert stress researchers and nearly every one emphasized the role of the HPA axis in causing depression. But when I went to look at the primary literature, I found reports showing no difference whatsoever in HPA activity between depressed and nondepressed people. I have more work to do on this, but it was quite frustrating to find I could not rely on the experts. Some are biased on purpose or for profit, but I think most, having devoted their lives to finding out how stress could cause depression, found all the positive evidence most salient, and the negative evidence uninteresting.

Then there was Turner’s Jan 20, 2008 publication in the NEJM showing that 37/38 studies showing antidepressants effective were published, while only 3/36 negative studies were published as a negative results. Those of us in psychiatry who try hard to use the evidence turn out to have had only a very biased selection of evidence available. I am afraid my suspicions about the opinions of experts turn out to not go nearly far enough. (Other fields may, of course, be profoundly different)

The other thing on my mind was the difficulty universities have in finding appropriate positions for researchers who are asking evolutionary questions about why bodies are vulnerable to disease. Even a university that wants to establish a program in Darwinian medicine must contend with established disciplines that, understandably, want to hire more of their own kind. It is hard for work in an entirely new area to get started. And as I thought about it, it also seemed clear that Departments tend to replicate and extend biases already present. So, for instance, Departments dominated by post-modernists will tend to exclude those who rely on numerical data. In biology, Departments with a tradition of studying adaptation tend to hire more people with those interests, while Departments dominated by anti-adaptationism would not consider such candidates. Such agreement make for congeniality, but not for engaging real issues. Again, there is no one to blame, this is just an emergent result of human tendencies. Nonetheless, it seems to me to result in insularity of the sort that makes it very hard to see, much less fight, bias.

Ideas futures is an interesting thought. I am spending this year in Berlin with a group working on Darwinian medicine and one of our main challenges is to find out some way assess which of a thousand evolutionary medicine hypotheses is true. I have a cookbook piece on my web to guide hypothesis testing, but it still takes days to really assess any one proposal. Just this week I decided to see if hunter gatherers really don’t get heart disease, as I and others have been saying for years—so far the evidence is looking thin indeed.

You site is interesting and the topic could not be more important. I have written a bit on how being objective is not good for one’s reproductive success, but that is whole different topic. I will read more on your site.