If any of you are regular readers of The Guardian (I am not), or spend a much reading about the politics of clinical trials (which I do), you have probably heard of Ben Goldacre. He writes well, has a quick wit, and while I find the rhetoric of his crusade against “bad science” sort of frustrating and tiresome, I can’t help feeling a sense of kinship with someone I see as a fellow complicator. He at times can come across as a typically smug scientific triumphalist, but he is nevertheless no stranger to the complexities of evidence-production. He is also a driving force behind the AllTrials Campaign, which has been advocating – with surprising success – for a research culture/infrastructure that would ensure that all clinical trials (studies on drugs, devices, other medical treatments) centrally register and fully report their methods and results, something which does not yet exist in any meaningful way, and is undeniably essential for medical-scientific research to become more transparent and accountable (In a nutshell, the prevailing tendency, when you are conducting multi-million-dollar clinical trial with hundreds or thousands of participants and you don’t get the results you were hoping for, is to mine the data for something usable and change the stated objectives of the trial accordingly, or, more commonly, to just not publish and never talk about it again. Although the evidence is mixed as to whether this is especially common for industry-sponsored studies, there is no question that pharmaceutical companies have a lot riding on the results of the studies on their own products that they conduct or pay for).
Anyway, he comes to mind because it is apparently “a new year” and so chatter about resolutions and getting healthy and the care of the self and all that has now risen to a fever pitch. As someone who has perpetually (perhaps cyclically?) miserable health and for whom nothing in particular in the way of diet or exercise or homeopathic hoozlewazzle has ever made any difference, and who has by profession become rather intimate with the maelstrom of contingencies, fine-tunings, and epistemically rationalized fudgings that undergird the production of scientific knowledge, I find the cycle of everything-bad-is-good-for-you / everything-good-is-bad-for-you that often provides the fodder for such resolutions pretty obnoxious. In respect to this, it was nice to stumble across this article of Goldacre’s from around Christmastime a few years back wherein he takes lightly to task the kind of research (and subsequent marketing) that supposes to justify such things as chocolate and red wine consumption:
Moderate red wine drinkers, we are specifically informed, come out better on all kinds of health measures, and nobody wants to ruin Christmas by mentioning confounding variables again (like how moderate red wine drinkers hang out at home with their friends eating salad and talking about their posh jobs and stable social support). A fairytale science story must be simple, reductionist, and mechanistic. Red wine is good for you because it contains lifegiving molecules, like antioxidants. And nobody wants to spoil Christmas—for the whole family—by mentioning that the antioxidants story is one of the great unspoken non-starters of 20th century medical research. . . . Only a malevolent Scrooge-like figure, mumbling over his glass of tap water in the corner, would dare to point out that if you are going to pore over a biochemistry textbook, and pick pathways out at random, then you can prove anything you like.
. . .
And that’s when you might start to think, well now, perhaps people who eat fresh fruit and vegetables are, just like the people who drink red wine in decorous moderation, living healthily in all kinds of ways. Much like the people who buy vitamin pills. Lusty walks around country mansions. Cycling to work. That kind of thing.
The piece is flippant and short on actual citations, but it is meant to be – most anyone who has a subscription to the BMJ can probably search out what they need – and it is a well-needed intervention, as much so in 2015 as it was in 2007 (One needs only look to this Christmas headline from L’Express: “Le vin rouge prévient du vieillissement, c’est scientifiquement prouvé,” which cites a recent paper in Nature that turns out to have nothing specifically to do with red wine, or even with human beings). While Goldacre’s piece is more about marketing and bad science journalism (or science-indifferent health journalism), by ending on an implied note of ‘Just drink it, goddammit’, it also hints at something that I find all the more noxious about the whole phenomenon.
That is, the normalization of a moral economy wherein such things as chocolate and wine need to be justified by their ostensible health benefits – guilty pleasures redeemed, while the structure of spiritual blackmail remains perfectly intact. It is an economy wherein our health and the maintaining thereof take on a personal moral valence – the individual sits at the centre of a constellation of ‘lifestyle choices’ and the story of their good works are believed to be writ on and in the body, like a modern day collapse of the portrait of Dorian Gray. If you will pardon my hyperbole, at its worst this facilitates the blaming of the disease-ridden poor for not exercising and eating too many Junior Bacon Cheeseburgers; at its less extreme it still constitutes the selling of our pleasures back to us as (health) virtues. That is a calculation I don’t much care for. If you are going to drink and gourmandize and gorge at least do so because it is the stuff of life, not because it is supposed to hold out the promise – not even the promise! only a probabilistic, anonymous, statistical implication – of some extension of your otherwise miserable existence. Or, if you are going to lard yourself and your drinking in quasi-medical justifications, at least have the good aesthetic sense to go grander; do so on the basis of old-wives’ tales, epigrams from doomed novelists, the doctrine of signatures or just to keep your damn skeleton in.