The Skeptics Guide #1010 - Nov 16 2024

Interview with Michael Mann; Quickie with Evan: Banning Magic; News Items: Armed Police in Schools, Training Surgical Robots, New Imaging Technique, Physician Misinformation; Who's That Noisy; Your Questions and E-mails: Follow Up Mid-Atlantic Accent; Science or Fiction

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

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• 0:32Speaker 01

  You're listening to The Skeptic's Guide to the Universe, your escape to reality.

• 0:39Speaker 02

  Hello and welcome to The Skeptic's Guide to the Universe. Today is Wednesday, November 13th, 2024, and this is your host, Steven Novella. Joining me this week are Bob Novella.

• 0:48Jay Novella?

  Hey, everybody.

• 0:49Speaker 02

  Kara Santa Maria. Howdy. Jay Novella.

• 0:52Jay Novella?

  Hey, guys.

• 0:52Speaker 02

  And Evan Bernstein.

• 0:54Speaker 04

  Good evening, everyone.

• 0:56Speaker 02

  The year is going fast. It's almost the end of 2024.

• 1:00Speaker 04

  My gosh, we will be recording our year-end episode before you know it.

• 1:04Speaker 02

  That's right. It's always a good time of year to remind people that we have published two books, Skeptic's Guide to the Universe and The Skeptic's Guide to the Future. So if you have joined us recently and you're not aware of this fact, check us out. You could get to those books through our website or through Amazon. They make fantastic holiday gifts. You can spread the gift of skepticism to everyone in your life. So check them out if you haven't read them already. And some people have asked us, are they in digital form? Yes. Are they in audio form? Yes, you can get, they are read. Both are read by me, but you could also, if you'd like to read on Kindle, you can get them in digital form as well. So check that out.

• 1:47Jay Novella?

  We're working on a version of Darth Vader reading it, so I'll let you know when that comes out.

• 1:51Speaker 02

  Right. Have you guys seen any of the latest UAP congressional testimony today?

• 1:58Jay Novella?

  I have not.

• 1:58Bob Novella?

  I heard about it.

• 1:59Speaker 04

  I didn't get a chance to watch it.

• 2:01Speaker 02

  Yeah, Jay and I watched some of it and talked about it on the livestream today. It's as worthless as, you know, as it's been. Essentially, you know, UAP is the new, new name for UFOs, you know, unidentified anomalous phenomena. Okay.

• 2:16Bob Novella?

  Phenomena.

• 2:17Speaker 02

  Technically more, more accurate, more, more inclusive. But it's still the same thing. It's the same people talking about the same crappy evidence for the last 50 years. They had nothing new. There was just simply nothing going on. The, like, one of the bits that we saw today, the UFO proponent was saying, there is this, you know, it's the residue argument, what I call the residue argument. It's like, yes, you could explain 98% of whatever of these sightings of UAP reports, but there's that subset that you can't explain. As if, like, that's, that means there must be something interesting going on. But that's going to be true of anything. Anytime you have hundreds or thousands of whatever, you're not going to have enough information to necessarily definitively explain everything.

• 3:02Speaker 02

  There's always going to be some unusual cases. And then for people.

• 3:06Bob Novella?

  Without good evidence of it.

• 3:07Speaker 02

  Yeah, exactly. So the people who have reviewed this said that the reason you can't explain that 1% or 2% is not because they're fantastical, it's because the evidence is crappy. It's as if we don't have enough evidence to know what they were, which fits something else that we say all the time, which is like with UFOs, just like with Bigfoot and with everything else, the ambiguity, right? The fuzziness is the phenomenon. That is the phenomenon. It's, it is just the residue of low-quality evidence that, or cases that are going to be there for any phenomenon.

• 3:43Cara Santa Maria?

  Yeah, this is going to apply to, like, every field of every, I think about medicine, right? Like, there's a drug and you take the drug and you get better, but that percentage of people didn't get better. And you look at the autopsy and you can't figure out why. You're not going to assume they didn't get better because magic.

• 3:56Speaker 02

  Right, exactly.

• 3:57Cara Santa Maria?

  You're just going to assume you couldn't figure it out, but something biological was happening. That's so infuriating.

• 4:03Speaker 04

  I believe we call this logical fallacy.

• 4:05Bob Novella?

  Good analogy, Karen.

• 4:06Speaker 04

  God of the gaps fallacy.

• 4:07Cara Santa Maria?

  Yes, exactly.

• 4:08Bob Novella?

  Yeah.

• 4:09Cara Santa Maria?

  I can't explain it, therefore, magic.

• 4:11Speaker 04

  Right, therefore, something fantastic.

• 4:13Cara Santa Maria?

  Yeah.

• 4:14Speaker 04

  Fill in the blank. And that is where, but that is where all paranormal and all pseudoscience lives. It lives in that gap.

• 4:21Speaker 02

  Yeah, so nothing new. Same old crap.

• 4:23Speaker 04

  More of the same. Thank you, Congress. Waste our time, waste our money, once again.

• 4:27Speaker 02

  All right, Evan, you're gonna get us started with a, with a quickie about

• 4:30Speaker 04

  Yes.

• 4:31Speaker 02

  advertising magic in Kyrgyzstan.

• 4:34Speaker 04

  Kyrgyzstan.

• 4:35Speaker 02

  Kyrgyzstan.

• 4:36Speaker 04

  Good news, everyone. We're all moving to Kyrgyzstan.

• 4:40Cara Santa Maria?

  Ooh.

• 4:41Speaker 04

  And I think I'm gonna call these segments going forward, good news, everyone, because, you know, occasionally, there is some good news in the world of skepticism and, and rational thought to talk about, and this could be one of them. 2024, yes, Kyrgyzstan enacted earlier this year legislation prohibiting the advertising of services related to the occult and mysticism, which includes things like fortune telling, shamanism, divination, spiritualism, clairvoyance, and magic. What were we just talking about? Yep. And this ban extends across various media platforms, including the internet, outdoor advertising, radio, and television.

• 5:21Cara Santa Maria?

  Whoa, does that mean they can't advertise church?

• 5:25Speaker 04

  Well...

• 5:25Cara Santa Maria?

  That's interesting.

• 5:27Speaker 04

  I was gonna bring up that more towards the end here, but no, that's okay. Since you brought it up, I will mention it. So, um, this is a primarily Muslim country, and the banning of these kinds of practices is very much in accord with, with Muslim practices. You're not supposed to be doing this thing because it is in violation of the tenets of the religion. So it's as much a protective measure, probably, for the people of the country, which it is, as it is a, you know, further sort of solidification of the religious culture that permeates. So it's kind of a combination of both. But you know what? I'll

• 6:09Speaker 04

  take it, because I think other countries should also be doing this stuff. Do we know where Kyrgyzstan is?

• 6:15Cara Santa Maria?

  It's one of the stands.

• 6:17Speaker 02

  It's one of the stands in Asia.

• 6:18Speaker 04

  It is one of the stands and you've been to, um, which one? Kazakhstan, right?

• 6:22Cara Santa Maria?

  Kazakhstan, I've been to Kazakhstan, which is borders China.

• 6:26Speaker 04

  It does. Yep. Yep. So yeah, and this Kyrgyzstan does also border Kazakhstan, Uzbekistan, Tajikistan and China. And it's 90% covered by mountains, this country. So about 6 million people live there and they have a nomadic lifestyle traditionally in rural areas. Yurts, have you ever heard of yurts? Those are those tents. I actually saw a, I don't know, one of these decorate, decoration shows, uh, house decor shows and they talked about yurts. It was the whole show was all about yurts.

• 6:54Cara Santa Maria?

  I love a good yurt.

• 6:55Speaker 04

  It was pretty fascinating.

• 6:57Cara Santa Maria?

  I do. I've stayed in a yurt before. I like a yurt.

• 7:00Speaker 04

  And, uh, oh, they are the first country in the world to commit to protecting snow leopards, which is an endangered species found in their mountains. So good, good on them for that as well. Now, um, the ban extends to, yes, all the medias, broadcast media, social media. Uh, the measure is designed to prevent unscrupulous citizens from taking advantage of vulnerable segments of society, says Marlin Mametayalayev, who's one of the sponsors of the amendments. It aligns with similar actions in neighboring countries. Tajikistan, as I mentioned before, they have criminalized sorcery and fortune telling as well. They characterize these practices as being perpetrated by fraudsters and they implement strict measures against these activities.

• 7:43Speaker 04

  Uh, in fact, the fines, if you're fined for this activity, it's usually about like a half a year worth of your money that you would earn in a year. Right? So, so it's, that's pretty steep, um, relatively speaking. Here's one example of the kind of stuff that they've been doing with the fortune tellers. Right? So the fortune tellers will purport to offer anything from predicting the future to helping find suitable spouses and also to make your businesses flourish. So there was this woman, her name is Mavzuna, a housewife from the northern city of Kunjan. That's her first name, didn't know her last name. She paid $30 to help find appropriate husbands for her three daughters, who are aged 24 to 30.

• 8:27Speaker 04

  The fortune teller conducted separate sessions with the women, with these women in order to trigger their luck. Then, here's what she said. She gave me an egg to throw into the river, and now she's expecting eligible men to turn up to ask for her daughter's hands in marriage. All kinds of things, apparently. This is, this is, seems to be a common practice. And they'll take these eggs, or whatever, trinkets, mostly a lot of like talismans and metal jewelry and stuff, and they'll throw them into water bodies, into rivers, and into ponds and other things as part of this. But it's getting, the problem is getting so bad that authorities there are concerned that these metal pieces are lying at the bottom of these ponds, riverbeds, and other places where

• 9:11Speaker 04

  people go, or animals go, and it's injuring them. Right? They said authority, there's one example. Authorities recovered half a cart of locks from the bed of a, of one of the rivers that could have split the heads open of unsuspecting swimmers or people diving into the water. And the locks were actually discovered accidentally by police who were looking for evidence of some other crime that was going on. So, so many of these things that it's clogging, you know, that it's polluting their waterways and their water systems. That's how many of these charms and these fortune tellers are selling these people for total, total, you know, garbage, and things that just won't come true. So, that is the good news from Kyrgyzstan. And as I said, other countries, I think, should

• 9:54Speaker 04

  perhaps look to them as an example and try to help their citizens in any way they can from these fraudsters.

• 10:01Speaker 02

  So they're just banning the advertising? They're not banning the practices themselves?

• 10:05Speaker 04

  Correct. Yes, yes. Although they do, right. Although if you are caught, although if you are caught and determined to be fraudulent in some, in whatever capacity that these courts decide, you can be in big time trouble. So it is considered kind of mostly an underground practice. It's, it's, you know, the authorities have their eyes on you if you are doing these things to begin with. So it's, it's definitely frowned upon. Oh, and by the way, fun fact, there's a Kursig epic poem called "The Epic of Manas," M-A-N-A-S, which is one of the longest poems In the world, it has over 500,000 lines.

• 10:40Speaker 02

  Whoa.

• 10:41Speaker 04

  Yeah.

• 10:41Speaker 02

  This poem.

• 10:43Cara Santa Maria?

  That is an epic poem.

• 10:44Speaker 04

  It would be, it would take up three large volume books, basically. So imagine, it's kind of like, I envisioned it like memorized, if you know this poem, it's like memorizing the Lord of the Rings trilogy, basically, as a, as a poem, as one poem.

• 10:57Speaker 02

  Oh, boy. All right. Thanks, Evan.

• 10:59Speaker 04

  Yep.

• 10:59Speaker 02

  Kara, does having an armed police officer in school make kids safer?

• 11:05Cara Santa Maria?

  What do you guys think?

• 11:06Speaker 02

  No.

• 11:06Speaker 04

  Um.

• 11:08Speaker 02

  Think you probably wouldn't be talking about it if the answer were no.

• 11:11Speaker 04

  You're right.

• 11:12Cara Santa Maria?

  Bob says no. Evan says um.

• 11:15Speaker 04

  I, I have, I have no information to base, I have no stat, statistics to base that off.

• 11:20Speaker 02

  I mean.

• 11:21Speaker 04

  To base the decision.

• 11:22Speaker 02

  I would say it, it, that schools are, are benefit. I don't know what, to what degree.

• 11:27Cara Santa Maria?

  Hmm. Interesting. Okay. So according to Education Week's school shooting tracker, as of the last update, which was November 11th, 2024, so far, there have been 35 school shootings in the United States this year that have resulted in injuries or deaths. 217 total since 2018. There were 38 last year. So this year, again, up to two days ago, as of this recording, 35 school shootings with injuries or deaths, 65 people killed or injured. Um, so that's 16 people killed, seven students, nine employees, and 49 people injured. And they keep a map of all the school shootings. Um, very sad work.

• 12:10Cara Santa Maria?

  So this is, as we know, here in the States, a, a, a big problem, a scary problem, and a lot of parents are afraid. And a lot of people are clamoring to solve this problem. And there have been policy decisions, some of which are misguided, some of which are based in the evidence. But there, up to date, really hasn't been a lot of evidence to answer that question. You know, are schools with armed police officers actually safer? Does deploying officers in public schools deter criminal?

• 12:47Cara Santa Maria?

  Activity. And so I'm going to talk about a few studies today, which were compiled by Rod McMullum in Undark Magazine. He wrote kind of a long feature article about this. First, a little bit of Statisticles. More than 41,000 schools employ at least one law enforcement officer, or sometimes they're called school resource officers. And there have been big changes. During COVID, things got kind of interesting because of course, we saw the Black Lives Matter movement kind of take a big upswing after the murder of George Floyd.

• 13:28Cara Santa Maria?

  And we also saw a lot of schools, you know, closing or modifying their practices. And so during this time, many school districts decided to decrease funding or end school resource officer programs altogether. And others have gone in the opposite direction, increasing the presence of armed officers within their schools. But this article talks specifically about Chicago, which was one of the largest public school systems in the US. There are 325,000 students in Chicago schools that returned to classes this year

• 14:08Cara Santa Maria?

  without armed officers present. And this was the first time in Chicago since the year 1966. And so they have already started to collect some data on the outcomes of not having armed resource officers present. And in this model, they actually took the funding that they would have put towards paying these armed police officers. And they put it towards having social workers, trauma-informed mental health interventions, and social and emotional learning. So we're going to get to some of these Chicago studies, because it's really early, the information's really early. And we're going to turn to a couple

• 14:47Cara Santa Maria?

  of large studies, one of which is a systematic review that was published in November of 2023 called School-Based Law

• 14:57Cara Santa Maria?

  Enforcement strategies to reduce crime, increase perceptions of safety and improve learning outcomes in primary and secondary schools, a systematic review. This study looked at 32 different reports yielding 1,002 effect sizes to ask a number of different questions. But one of the big outcomes that they found was that there was no evidence that there is a safety, and I'm quoting them directly, no evidence that there is a safety promoting component of what they call SBL-E, school-based law enforcement. And the authors, based on this large study, come out in support of the criticism that

• 15:37Cara Santa Maria?

  school-based law enforcement actually criminalizes students and schools. So not only did they find that gun violence was not reduced, and actually, other forms of violence specifically in this study were not reduced, there was an increase in what is often referred to as the school-to-prison pipeline. So the types of disciplinary actions that were taken against students, which were especially high among Black and Hispanic boys, led to either suspension or, in some cases, incarceration.

• 16:20Cara Santa Maria?

  And there is a ton of evidence, and we won't get into like that whole body of literature, but there's a ton of evidence that sort of like punitive action at a young age leads to higher rates of incarceration later. And this is, there have been randomized controlled trials where students are assigned to middle schools where there's stricter punishment versus middle schools without that strict punishment. And they find that the kids who are assigned to those stricter middle schools, on average, are more likely to drop out of high school, less likely to attend a four-year college, and are more likely to be, come incarcerated as adults. So we know that these punitive practices have a detrimental effect on children's development and well-being, and studies are showing that having

• 17:07Cara Santa Maria?

  sworn law enforcement officers in the schools not only do not reduce gun violence, and in some cases, they don't even reduce violent crime. Another study showed that there was a small but significant decrease in fighting, probably because of just the physicality of the police presence, but that they do actually increase the number of infractions that are being reported against these children, which can have detrimental effects later in life. There's a couple of other things I want to point out. So one study showed that over 90% of schools that have a law enforcement officer present have an officer who's routinely armed. Although some of those officers have special training in violence prevention and youth

• 17:51Cara Santa Maria?

  mental health, requirements vary by state, and in many cases, there is no required special training in these areas. This article does a really interesting job of going back to the history. I didn't realize that resource officers started in 1953 in Flint, Michigan, and then efforts increased in the 60s in large cities like LA, Chicago, and Cincinnati. And then there's a dramatic increase after Columbine in April of 1999. And we saw that after this huge increase, by 2020, to about 48% of public schools has at least one school resource officer. And again, like I said, more than 90% of those schools have an armed officer.

• 18:31Cara Santa Maria?

  So that led to the 2019 to 2020 year, about 23,400 school resource officers being employed. Now, let's cut back to Chicago. In Chicago, they actually reduced that presence. They, you know, this year was the first year that students went back to school without school resource officers present, removing, okay, the U of Chicago Consortium on School Research put out a brief in June of this year, removing police officers from Chicago schools. And they call it SRO in this case, School Resource Officers. School resource officer removal was significantly related to having fewer high-level discipline infractions, and it was not related to changes over time in perception of

• 19:17Cara Santa Maria?

  Physical safety or student teacher trust either by students or teachers. So when school resource officers were removed, students did not say that they felt less safe and neither did teachers. They also found that schools that had resource officers, the ones that retained them, were more likely to serve predominantly black students. Black students became more than twice as likely as other students to have a resource officer. They tended to be smaller schools, but they tended to have higher suspension rates. And they tended to be schools where students who are eligible for free or reduced lunch, non-English learners or kids who were in special education.

• 19:59Cara Santa Maria?

  So these are schools where obviously populations are more vulnerable, are more likely to have these resource officers there. And those resource officers were not, over time, reducing or effective in reducing gun violence or gun crime, but they were effective in criminalization of students who were there to go to school because infractions were identified and magnified. So across the board, what we're starting to see, and there's not much literature on this subject, but it's gaining, across the board, we are starting to see that while some of the studies have cited kind of small benefits, most of them are showing very large detriments.

• 20:44Cara Santa Maria?

  And there is no detectable, there's no significant difference in outcomes when it comes to school safety. So the children are no safer, the children and the adults are no safer. And there is no detectable evidence saying that having police in schools is reducing gun violence at all.

• 21:01Speaker 02

  Yeah, that's interesting.

• 21:03Cara Santa Maria?

  There's a lot of good stuff here. It's not surprising to me, I think this is an area where I have dug a little bit deep into the research in the past, but I think for some people it is surprising and it is pretty counterintuitive that putting police officers in school leads to more arrests and more expulsions of students, very often disproportionately black and brown students, and very often student disproportionately- proportionally students with disabilities. But what it doesn't do is it doesn't make them safer from physical harm and violence, which was very often the whole argument, right? It's the whole reasoning behind having these police officers present.

• 21:41Speaker 02

  Yeah, I mean, it's easy to imagine for most schools, you know, there's probably not going to be events that require an armed officer present. And even if they are present, as we know, like from that, what was it, that Texas case, it doesn't always help, right?

• 21:56Cara Santa Maria?

  No, not only does it not always help, sometime, there is some evidence to show that when teachers are armed, it can actually lead to more detriment, not less. But we are seeing that there are laws that are being passed, like there's a law in Texas right now that requires schools to have armed guards. And the Florida law, I think, is even more intense. It requires that somebody in the school be armed. It doesn't even have to be a guard, it can be a teacher.

• 22:26Speaker 02

  Well, I mean, I think it's also a good area to continue to do research. I doubt this one study is going to change, or there are a few studies is going to change policy.

• 22:34Cara Santa Maria?

  There's about three, yeah.

• 22:35Speaker 02

  Yeah.

• 22:36Cara Santa Maria?

  And they are systematic reviews, by the way. So these are reviews of, you know, multiple studies.

• 22:42Speaker 02

  Right. Okay, thanks, Cara.

• 22:43Cara Santa Maria?

  Yep.

• 22:44Speaker 02

  Jay, tell us about training medical robots.

• 22:47Jay Novella?

  Yeah, I really like this one, guys. Johns Hopkins University researchers collaborated with Stanford University researchers, and they achieved something that's pretty significant. They're calling it a breakthrough in medical robots. So, you know, for the first time, they were, they were able to train a robot to perform surgical procedures by using video recordings of human surgeons. And this is definitely different than any other way this has been done in the past. This method is called imitation learning. And it essentially eliminates the need for manual programming of the robotic movements, right? This is like when a surgeon will, actually, you know, a surgeon's movements will be recorded as they go, right? Which is very difficult.

• 23:30Jay Novella?

  This moves robotic surgery a lot closer to full autonomy, like in the movies and stuff, like, you know, we've seen this. In different, different science fiction movies where you're seeing like, you know, some type of extensive type of surgery being done, you know, in outer space or whatever. What they now know can be done is robots can perform complex procedures without any human involvement. I know that sounds kind of outlandish, but it, they were able to do it. The researchers focused on an existing system called the DaVinci Surgical System. This is a widely used robotic platform. It's, you know, it's considered to be cutting-edge modern medicine. And to overcome that system's current limitations in precision, which is

• 24:10Jay Novella?

  a, you know, obviously a huge problem, they turned to video recordings captured by wrist cameras attached to the DaVinci robot's arm during surgeries, right? So what this means is these videos were originally created for post-operative analysis, where they document techniques and movements of experienced surgeons, right? With nearly 7,000 DaVinci robots today in use globally and more than 50,000 trained surgeons, the researchers had access to a massive archive of surgical footage. This was really the base of this whole achievement. That footage was absolutely significant. It proved to be an amazing amount

• 24:51Jay Novella?

  of data for them to incorporate into computer learning. So they used hundreds of these recordings. I guess they picked the absolute best ones. And the research team trained their robotic model to perform the basic surgical tasks, such as things like needle manipulation, something called tissue lifting, and surgery, surgery. So unlike traditional programming methods that which we have today, this, these require manually coding every step of a procedure. You know, think about that. They, in order for a robot to perform surgery the old way, they literally have to hand code in all those procedures and it takes an incredibly long time to do it. The new approach relies on machine learning,

• 25:33Jay Novella?

  which is incredible at this. It like, machine learning was, is so powerful when it comes to things like this. So the model combines imitation learning with advanced AI architecture that's similar to those powering ChatGPT, of course. Instead of processing language, the model speaks in something called kinematics. Have you guys ever heard of that?

• 25:54Cara Santa Maria?

  Yeah, it's like movement.

• 25:56Jay Novella?

  It's the mathematical representation of robotic movement. So think about that. A chat GPT like AI system was programmed to speak in mathematical robotic movements. That is so brilliant. I just love that. So historically, training the DaVinci robot to perform any single task was, like I said, incredibly labor intensive, and I want to give you more details about that. It required programs to code every single movement meticulously. And this took, you know, if you, if you want to pick one specific movement that would be involved in one procedure, modeling the steps involved in searching for particular types of surgery could take up to, guess how many years, guys?

• 26:35Bob Novella?

  I would guess a decade.

• 26:36Jay Novella?

  Right, a decade.

• 26:38Cara Santa Maria?

  Wow.

• 26:38Bob Novella?

  Yeah, I read the article. Yeah, that's, to program every discrete step and all the exceptions and stuff, yeah. A decade still seems like a little long to me, but yeah, it's, it's a hugely onerous process, especially compared to this, this little breakthrough they got here. This seems pretty sweet.

• 26:54Jay Novella?

  Yeah, so that decade-long process was incredibly restrictive in the flexibility and scalability of robotic surgery. It was one of the reasons why it didn't proliferate as, as much as we'd liked it to. So by contrast, the new imitation learning methods allow robots to learn these complex, complex tasks in just a few days, guys, a few days. Ten years to days.

• 27:19Bob Novella?

  That's incredible.

• 27:19Jay Novella?

  Unreal.

• 27:20Bob Novella?

  But don't forget, though, I think it said something that a hundred videos is a good sample for it to get a good handle on what's required. So a hundred videos, that's a hundred surgeries, essentially. That's, that's a lot.

• 27:33Cara Santa Maria?

  Yeah, but those surgeries are being done anyway.

• 27:35Jay Novella?

  Right, exactly. The fact is, we have those surgeries on video. We have them, you know?

• 27:40Bob Novella?

  Yeah, it's amazing.

• 27:42Jay Novella?

  You know, and as new, new, you know, new surgery methods come out, you know, of course, I'm sure that they, they would videotape them in the correct way to, to, you know, continue to let this happen, right? So one of the key advancements reported lies in the robot's ability To adapt its movements, right, which is really important because every human body isn't the same and every single situation isn't going to be exactly the same. So traditional robotic systems had to rely on this rigid, pre-programmed actions. And that's very error prone in the real world.

• 28:12Bob Novella?

  Oh, it sounds totally brittle. Yeah.

• 28:14Cara Santa Maria?

  Yeah, it's really scary, actually.

• 28:16Jay Novella?

  Training the models to use relative movements instead of fixed motions. The researchers enhanced the robot's precision and flexibility, right? This allows the robot to perform tasks with skill comparable to experienced human surgeons and even recover from mistakes like retrieving a dropped needle and then continuing on with the procedure. So the break.

• 28:36Bob Novella?

  That one, Jay, that one caught my, my attention because, yeah, that's cool that it's kind of like some emergent behavior where it knew just to pick it up and continue. But then I thought, well, wait a second, should that needle be sterilized now that it's fallen on the floor?

• 28:48Jay Novella?

  Well, I think it fell in the, in the, in the person being operated on. And I'm sure it would be an easy thing to fix if they'd said, you know, don't pick up anything that had hit the floor. Unless it's a heart or something, you gotta pick it up.

• 29:01Bob Novella?

  Yeah, well, those are the kinds of errors that I'd be afraid of, something that's, you know, that's unusual and rare. Something you wouldn't necessarily find even within a hundred surgeries. But still kind of like, oh, boy, don't do that. A human, any human would know not to do it.

• 29:15Speaker 04

  Do organs really fall on the floor?

• 29:17Cara Santa Maria?

  But would you actually be afraid of that, Bob? Because here's the thing. I think it's a little silly to have the standard be that there is no human involved at all. There will always be a human involved. But maybe they're just observing as opposed to actually.

• 29:31Bob Novella?

  Right.

• 29:32Cara Santa Maria?

  Operating.

• 29:32Bob Novella?

  Where even someone partially knowledgeable enough to know if something's really going off the rails.

• 29:37Cara Santa Maria?

  Yeah.

• 29:37Bob Novella?

  Would be nice to, but not necessarily a surgeon.

• 29:40Cara Santa Maria?

  Because that's the thing, you need to have a surgeon involved.

• 29:42Speaker 04

  Well, you still, right, yeah.

• 29:43Cara Santa Maria?

  If there is a bleed.

• 29:44Speaker 04

  You need a qualified.

• 29:45Cara Santa Maria?

  If somebody codes, like, and anesthesia is never going to be done this way. There's going to be an anesthesiologist there.

• 29:51Jay Novella?

  Well, I wouldn't say never. I mean, look, of course.

• 29:53Cara Santa Maria?

  Oof.

• 29:54Jay Novella?

  We'd be able to achieve all these things with enough time and

• 29:57Speaker 04

  Holy crow.

• 29:58Cara Santa Maria?

  I don't want that to happen. I want there to be a human being present.

• 30:01Jay Novella?

  You gotta think about it in a completely different way, right? Because, yeah, ideally, you feel better with a human doing it for, you know, all these implied reasons. But the point is, this will make surgeries probably cost less money and makes them much more readily available to people everywhere, including people in outer space or on, you know, ships that are crossing the ocean or whatever. I mean, I think, you know, the benefits here dramatically outweigh any of the negatives.

• 30:27Speaker 04

  That was the one good thing about Prometheus the movie, was that medical pod thing.

• 30:31Bob Novella?

  Oh, yeah, but dude, dude, dude. But still, still, they kind of blew it because, you know, this is like centuries in the future, there's an autodoc, which is, which is so cool, and then she has some, like, abdominal surgery, and then it staples her gut closed.

• 30:46Jay Novella?

  It was terrible.

• 30:46Bob Novella?

  Like, really, you're using staples in two centuries?

• 30:48Jay Novella?

  Just how about a foam that heals the flesh, you know?

• 30:51Bob Novella?

  Some bio glue or something. It was just like, oh, come on.

• 30:54Jay Novella?

  All right, but more importantly than that, Bob, Bob, which Star Wars robot would you want surgery, would you want to be your robotic surgeon?

• 31:02Bob Novella?

  I'd rather pick a Neil Asher Politi universe robot to do it.

• 31:05Jay Novella?

  I didn't give you that option. It's gotta be Star Wars, and you gotta answer in five seconds.

• 31:09Bob Novella?

  Whoever handled Luke's amputated hand, I'm sure would probably be pretty damn good.

• 31:14Jay Novella?

  Oh, I thought you'd want, you wanted IG, you know?

• 31:17Bob Novella?

  Oh, yeah, I don't know if he's, I don't know if he's signed off on surgery. If I go into combat?

• 31:22Jay Novella?

  He'd probably, he'd probably tear you apart, but...

• 31:25Bob Novella?

  Yeah, if I go into combat, I want egg, but for surgery, I'm not sure.

• 31:29Jay Novella?

  So, one last point here, guys. So what they were able to do was have the robot perform discrete pieces of surgery, and now they're, haha, they're stitching it all together, so they're working on making it be able to do the whole process from beginning to end. And again, you know, when you, when you're doing any kind of computer programming, you just break it down into smaller and smaller bits to make it easier, and apparently that's what they were doing here. But I'm, I'm excited about it. I mean, again, if, if people that can't afford expensive surgeries can have that be affordable to them.

• 32:03Speaker 02

  Them, I think this would be fantastic.

• 32:04Bob Novella?

  Oh, yeah, this I think this clearly has got a pretty bright future, especially after, you know, these robots seem to be doing better than than what would have been anticipated. Just after like 100 videos, it's got a solid handle on these complex surgical procedures. That's that's fantastic. Imagine, you know, when AI improves even more and you've got even more videos. Imagine if they got, you know, 1,000 or 5,000 videos from from like really high end surgeons and then maybe throw in some like biological context of a body and and what a body is and how it should behave like during surgeries and things like that. So that there's some more context. I think it would be even even better.

• 32:45Speaker 02

  All right. Thank you, Jay. Bob, tell us about these new imaging techniques. This is another sort of medical breakthrough kind of topic.

• 32:51Bob Novella?

  Yeah. Oh, don't get me started. All right. I'll say it anyway. So, yeah, this is a new imaging technology called HIPCT, which caught my attention this week. This technology uses fourth generation synchrotron radiation for medical and materials imaging far better in many ways than others like MRIs or CAT scans. This started when I was reading a news item recently about imaging silicate fossils. And the article kept going on and on about the silicates, but I kept thinking that they were kind of burying the lead with this revolutionary imaging technology that they just kind of mentioned almost as an aside. And then so I was looking at another article. This one was from a couple of months ago, but it was an interesting news item about

• 33:35Bob Novella?

  imaging human hearts with unprecedented detail. And they mentioned the same imaging technology and they did the same thing. It was just kind of like an aside. So I'm like, I want to learn about this thing. So I did some research where they weren't burying the lead and and I learned about HIPCT or hierarchical phase contrast tomography. And it was fascinating. So HIPCT was funded by Chan Zuckerberg Initiative. It's a multinational collaboration between scientists, mathematicians, clinicians and more. So these images, these imaging advances that they made are based on an upgrade. of the European synchrotron radiation facility to create brighter X-rays. And that's kind of the crux of this whole news item.

• 34:20Bob Novella?

  And about these X-rays, it's all about, it turns out, synchrotron radiation, which was fascinating to study. And I knew a little bit about it, but I really deepened my understanding. So synchrotron radiation is simply light. It's electromagnetic radiation that's been emitted by charged particles like electrons that are accelerating. But I'm not talking about accelerating like Steve's wife does in her high-torque Tesla, going faster and faster on the highway. In physics, that's called linear acceleration, right? You're going faster, or you're going slower. You're slowing down, which is, it's still called acceleration. It's just negative acceleration. We, of course, call it deceleration, but it's still acceleration. But there's another type of acceleration in physics called centripetal acceleration.

• 35:04Bob Novella?

  That means that essentially you're not going straight. You're on a curved path. So even if your velocity is the same, and you're not accelerating classically, colloquially, but you're on a curving path, technically, that's acceleration as well. And I remember first learning that years ago. And it's still hard for me to imagine that acceleration is moving on a curved path and having nothing to do with your velocity. But that's what it is in physics. Now, in electrons in the magnetic field, going around and around a circular facility, they're experiencing this centripetal acceleration, right? Because they're going around. They're not going straight. So this is centripetal acceleration.

• 35:44Bob Novella?

  And if they're also moving very, very fast at relativistic speeds, then they will emit significant amounts of synchrotron radiation, which can be anything from infrared to hard X-rays. So why does that happen? Why is that even happening? I was trying to figure out, why does it release energy like that? One reason is because that's what Maxwell's equations say will happen, and it does. So he was right. If you're not familiar with the Maxwell's equations, definitely check them out. But another common explanation that you'll find is that if you imagine this electron going around and around, a tiny bit of its kinetic energy is being converted into that radiation as its path changes. Okay? One way to think of what's happening, and that's why these electrons will slow down

• 36:27Bob Novella?

  over time, because if you're losing some energy, some kinetic energy that's being converted into radiation, you are going to slow down, and that's why these facilities that create synchrotron radiation, they have to continually pump more energy into the collider so that it will stay at the same linear velocity. So, okay, so it's these synchrotron X-rays that are changing many fields of science. They're millions to billions of times brighter than the X-rays that you got, Steve, when you broke both your arms playing Tarzan in that tree. I'm sure you got an X-ray.

• 36:59Speaker 02

  Oh, no. My wrists, not my arms.

• 37:02Bob Novella?

  Well, wrists, arms, lower arms, whatever. So the X-rays that you got were millions to billions of times dimmer than what they're creating here. These are the brightest X-rays on Earth that I could find, and the relatively new fourth generation synchrotrons are even better than the generation three that were around for years, kind of like going from ChatGPT three to four. These electrons are traveling at something like 99.99999% the speed of light. So these are like ultra-relativistic, hyper-relativistic. Now, this intense light can be focused to reveal super-high-resolution images. So it would be like using X-rays to not only see Steve's entire mangled wrist bone, but

• 37:46Bob Novella?

  also the individual bone cells anywhere in that bone. So that's kind of, we can't do that now. We can't use this radiation to look at living people yet, but that's kind of like what we're dealing with here, from seeing this one image of this one discrete object to being able to also zoom down into the cellular level. But it's not just the light intensity that's in changing. The X-ray beam itself can be tuned to specific wavelengths to analyze specific elements in the sample that you want to learn about. The common film X-rays that you use to image your broken bones would use a broad-spectrum X-rays. So these are using, it's kind of like, almost kind of like a laser where you're tuning to very specific wavelengths.

• 38:31Bob Novella?

  So the main benefit, the main benefit... Benefit of this imaging technology is if I had to distill it down to a few words is that it decouples the field of view from resolution. So that means that that a wide field of view, which historically would mean low resolution, no longer needs to be that way. You could have a wide, a wide field of view that gets the whole image, they'll say an entire human body can also be extremely high resolution. And that's, that's one of the major advances here. So how are they, how is this being used today? So I'll go back to the silicate story that they're using this technology to image silicate fossils. Now, do you remember that those silicate fish, they were

• 39:13Bob Novella?

  extinct, apparently, for millions of years until a fisherman caught one, like, what was that in the seventies, Steve? Something like sixties or seventies, somebody caught one. It's like, it's like pulling up a fossil that you thought that was long dead, that should not exist. The guy found one from the depths. So they, so they're using these sickatron, sickatron X-rays to image these, this, these new silicon, silicon fossils that were like 250 million years old that were still in the rock. They, they didn't excavate this fossil. It was still in the rock. So they imaged every bone in the fossil that was in the rock and they were able to create a full 3D model of the fossil bones with a level of detail that they've never seen with this type of fossil

• 39:58Bob Novella?

  before. They created a complete virtual skeleton with amazing detail. Basically, they discovered that this was a third species of silicate that they, that they've become aware of. The two that are, the two that they have found extant that are still living. And now this other fossil is a, is a third fossil that they're aware of. In this heart news item that I read about, the researchers were able to X-ray a heart with amazing detail. Senior author Peter Lee De Phil, he's a professor of material science, University College London. He said, "The atlas that we created in this study is like having Google Earth for the human heart. It allows us to view the whole organ at global scale, then zoom into street level to look at cardiovascular

• 40:43Bob Novella?

  In unprecedented detail, so that's a really cool analogy. He continues, "One of the major advantages of this technique is that it achieves a full 3D view of the organ that's around 25 times better than a clinical CT scanner. In addition, it could zoom into cellular level in selected areas, which is 250 times better, to achieve the same detail that we would get through a microscope, but without cutting the sample. Being able to image whole organs like this reveals details and connections that were previously unknown." Cool stuff. So, they say that the primary limiting factor was not even the image itself, but processing the huge amount of data that's created by this hip CT technology.

• 41:24Bob Novella?

  Now, so the future of hip CT looks even brighter than the X-rays it produces. So, I mean, medical imaging, material science, biological research, they are already benefiting from this tool, but going further in the future, as I love to do, of course, perhaps using a fifth generation radiation source, which probably will eventually arrive at some point. The resolution will likely go from the already awesome micron scale, which is a millionth of a meter, it could get even more awesome to the nano scale, of course, of course, a billionth of a meter, looking at molecular interactions and what's going on within cells. So, as this becomes more radiation efficient and safer, this could eventually allow for

• 42:07Bob Novella?

  cellular level detail on living humans without doing any nasty tissue sampling, because right now, it's ex vivo, which means that you could take a living sample, but you've got to remove it from whatever you're, you know, whatever living creature. So, if it were a human, you'd have to take a sample. So, that's, you can't do it on people yet. So, of course, typical hospitals don't have access to synchrotron facilities, so, in the future, accessibility for routine imaging is probably what's going to be one of the biggest hurdles. You know, they will make this smaller, more efficient, and cheaper, but I think there's probably going to be a limit to how small it can be, so, it's not going to be something that's going to like be at a local, small hospital, but who knows? Who knows what's going to happen?

• 42:50Bob Novella?

  And, but it's not just, this isn't just medical, we're also talking-

• 42:53Jay Novella?

  Material science as well will be able to use this to 3D image micro and nano structures of composites and that could lead to more advanced alloys, nanotubes and polymers and more. And like we've said on the show many times, material science is the shit. That's the stuff that that's the stuff if you make fundamental advances in material science that can impact society at such a huge level, so many industries, so many levels of society. Those are the those are the real big changes that can really make a difference. So I'll definitely be tracking this tech.

• 43:24Speaker 02

  All right. Thanks, Bob. All right, everyone. We're going to take a quick break from our show to talk about our sponsor this week, Rocket Money.

• 43:31Jay Novella?

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• 44:35Speaker 04

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• 44:50Speaker 02

  All right, guys, let's get back to the show. Let me ask you guys a question. You know, I like to start with those questions.

• 44:56Speaker 04

  Yes, you do. What?

• 44:58Speaker 02

  Should we police what physicians say in public on healthcare topics? Specifically, how should the regulatory agencies respond to physicians spreading medical misinformation?

• 45:12Bob Novella?

  I think they should be drawn and quartered.

• 45:15Cara Santa Maria?

  Well, I think.

• 45:16Bob Novella?

  I think they should follow it. They should track it and there should be ramifications for spreading misinformation or disinformation.

• 45:23Speaker 02

  So who gets to decide if it's misinformation?

• 45:25Cara Santa Maria?

  Well, how is that not already part of the ethical

• 45:28Bob Novella?

  Yeah, right.

• 45:28Cara Santa Maria?

  Code of the medical board?

• 45:30Speaker 02

  It is.

• 45:31Cara Santa Maria?

  Oh, okay.

• 45:31Bob Novella?

  Okay.

• 45:32Cara Santa Maria?

  Then, yeah, the medical board

• 45:33Speaker 04

  Well, who's policing?

• 45:34Cara Santa Maria?

  Should do something about it.

• 45:36Bob Novella?

  So who is policing?

• 45:37Speaker 02

  So in the US, in the US, there are state medical boards, right? They license physicians. They license all professionals at the state level. And the medical board also regulates those licenses. So if you're, yeah, if you're a physician in Connecticut, the Connecticut State Medical Board can hold you to the standard of care and also to a code of ethics. And they can take actions against your license.

• 46:02Cara Santa Maria?

  Yeah, they can fully revoke it if you do something bad enough.

• 46:05Speaker 02

  They can censor you. They could suspend your license. They could revoke your license. There's a range of things that they could do if there is a complaint that you've violated the standard of care or the code of ethics and they, and an investigation finds that to be true. So the question is, should, you know, a physician making anti-vaccine statements, for example, should that count? Should that be something that violates?

• 46:29Cara Santa Maria?

  Absolutely.

• 46:30Bob Novella?

  Absolutely, man.

• 46:31Cara Santa Maria?

  What you're saying to the public is no different than what you say to a patient.

• 46:35Speaker 02

  Yeah, so there's two, there's two contexts here. One is a physician giving misinformation to, directly to their patient. And then another context is, is giving it to the public, right? Not to like somebody that is actually their patient, but just like making statements in public.

• 46:50Speaker 04

  But this question was specifically about the public.

• 46:52Speaker 02

  Well, it's, it covers both.

• 46:54Cara Santa Maria?

  No, I'm saying both of those things should be violations.

• 46:57Bob Novella?

  Yeah, I mean, I, yeah, I think there'd be maybe a little bit more leeway for public, but not that much. And anything egregious should absolutely should be dealt with.

• 47:06Speaker 02

  Okay, so, you know, obviously I agree with you. So there's, you know, basically a discussion going on within like the medical profession as well as the legal profession about this issue. And there's also the question of are state medical boards enforcing any kind of?

• 47:25Speaker 02

  Of standard in terms of public information. Let me quote from you a couple of sources here. The Federation of State Medical Boards. This is the organization of state medical boards in the US. Their position is the following. Physicians who generate and spread COVID-19 vaccine misinformation or disinformation are risking disciplinary action by state medical boards, including suspension or revocation of their medical license. Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore have a powerful platform in society, whether they recognize it or not. They also have an ethical and professional responsibility to practice medicine in the best interests of their patients and must share information that is factual, scientifically grounded, and consensus driven for the betterment of public health.

• 48:10Speaker 02

  Spreading inaccurate COVID-19 vaccine information contradicts that responsibility, threatens to further erode public trust in the medical profession, and puts all patients at risk. The AMA basically agrees with them, right? That's they give the basically the same, different words, same opinion.

• 48:24Bob Novella?

  What's the problem?

• 48:25Speaker 02

  The problem is they're not doing it.

• 48:28Bob Novella?

  Oh, Jesus.

• 48:29Speaker 02

  So there was a recent study, which is what triggered this whole review, that asked the question, are state medical boards disciplining physicians for spreading misinformation? Now, this is a difficult question to get at, right? When you think about, how would you research? How would you answer this question? They basically looked where the light was available, right? So they got the information that they were able to get, and then we have to use that as a way to kind of infer how they're doing. So this is a JAMA article. They looked at 3,128 medical board disciplinary proceedings involving physicians, and they found that only 0.1% of them were for spreading misinformation to the community. That was the least common reason, 0.1%.

• 49:15Speaker 02

  Direct patient misinformation and inappropriate advertising were tied for the next two least common reasons at 0.3%.

• 49:25Speaker 02

  So these are way below all the other reasons that physicians get disciplined. Now, of course, we don't know.

• 49:32Cara Santa Maria?

  But is that representative?

• 49:33Speaker 02

  We don't know how many times physicians are violating this, or how many complaints there were, or what the percent. The thing is that complaints against physicians, if they are found to not be worth acting upon, right? If the physicians are essentially cleared, that information is not made public. That is.

• 49:52Cara Santa Maria?

  Yeah. And the complaints have to be filed in the first place.

• 49:55Speaker 02

  Yeah.

• 49:55Cara Santa Maria?

  Nobody is monitoring or policing physicians.

• 49:58Speaker 02

  Yeah, so we don't, there's no way to know how, how often physicians are spreading misinformation and how often complaints are being made and, and how they're being decided. All we know is of those complaints that are made public, it's a very teeny tiny slice, a point one percent, basically, for spreading public misinformation. So the, the authors of the study were saying, yeah, you know, this suggests that they're just not doing their job. That, they, they also say that we have some indirect information. So the, um, there is an increase in the number of complaints about physicians spreading misinformation.

• 50:37Cara Santa Maria?

  Okay, that's good.

• 50:38Speaker 02

  Um, so we know that while that's happening, the number of disciplinary actions is not increasing.

• 50:43Cara Santa Maria?

  That's not good.

• 50:44Speaker 02

  Yeah, so it doesn't appear, there does appear to be a disconnect, but yeah, so, but, you know, we don't have really perfect information here.

• 50:50Cara Santa Maria?

  Also, how many, I'm, I'm curious, how many physicians, and I know that that's a special division of doctors that you hear talking online, are actual medical doctors? How many of the COVID misinformation is being touted by people who never, who like, didn't maintain their license?

• 51:07Speaker 02

  Uh, I don't know what, what the percentage is, but I know a lot of the ones that I am aware of are M Ds.

• 51:12Cara Santa Maria?

  And they're, and they still.

• 51:13Speaker 02

  They have their M D and they're practicing, yeah, yes.

• 51:16Cara Santa Maria?

  Yeah, that's scary. That's really scary.

• 51:17Speaker 02

  Yeah, it is. The other side of the coin, though, is the question, if we think it's reasonable for medical boards to hold physicians accountable for spreading misinformation, are they the right people to do it?

• 51:31Cara Santa Maria?

  And. Yeah, probably not.

• 51:32Speaker 02

  Yeah, the, the consensus seems to be. That whether or not you think they should be doing it, they don't have the resources to do it. They're basically not in a position to do it. They don't have the the infrastructure of people who can, first of all, determine if something crosses over that line to, all right, this is demonstrable egregious misinformation, not something in the gray zone, not a matter of opinion, not something about which a ethical physician can have a minority, but reasonable opinion. This is demonstrably wrong, harming the public health, and is something that we could say is over the line.

• 52:10Cara Santa Maria?

  Well, and there's enough examples. I mean, there are famous examples like Dr. Death in Texas and like these different, but there are enough examples, yeah, of individuals who it took far too long for them to be stripped of their license. Like, they caused so much harm before enough evidence was amassed and a license was actually revoked. I don't think people are losing their licenses left and right for small things. Like, it has to be really egregious, and a lot of people have to be harmed first.

• 52:41Speaker 02

  Generally speaking, state board, state boards are very, very forgiving. Yeah, they, they.

• 52:46Cara Santa Maria?

  Yeah, and so, and so that's already worrisome that they would then be tasked with policing this public health issue. Because it really is, it's a public health issue.

• 52:56Speaker 02

  So I think the answer is that they need to reconfigure themselves to be able to do this. And there's the, the other way to think about this is that there are other resources out there that they could be availing themselves of. Skeptic groups. For example, no, actually, no. What I would say is that this is not something that we should be doing. We, we should be educating the public about this and maybe pointing the, the finger at individuals, but we can't be the ones to be deciding like whose license gets acted against. But there are other layers of state, of quality control within medicine, right? It's not just state medical boards. There's also specialty boards, right? So if you're an internal medicine doctor, you can get boards certified by the Board of Internal Medicine,

• 53:38Speaker 02

  which means they can withdraw your certification if you violate their standards.

• 53:45Cara Santa Maria?

  You also have to be credentialed at your hospital.

• 53:48Speaker 02

  You also have to be credentialed at your hospital. Of course, you could have your own private practice somewhere affiliated with no other institution. You don't have to be board certified. You can just have a license and do whatever you want. So then, there's always two layers. There's the state medical board and then there's the law. You could always be sued, right? There's the malpractice standard. Of course, that's not the one we want to rely upon because that only kicks in after harm has already been done, right?

• 54:13Cara Santa Maria?

  But is there, should there be like some sort of CDC, NIH, like some sort of like public?

• 54:19Speaker 02

  There's no federal level regulation of licenses. This would be a...

• 54:24Cara Santa Maria?

  No, I don't mean of licenses. I mean of taking some form of action against an individual who is causing a viable risk to public health.

• 54:35Speaker 02

  Yeah. So again, there's no legal infrastructure right now for this to happen at the federal level. So if we want to use the existing infrastructure, what we could have is say, for example, the specialty boards are in a great position. They're in the best position to determine what is misinformation because this is what they do all the time. They are the experts. They put together panels of experts to review the scientific evidence and come up with practice guidelines. And that could include communication guidelines as well. And then all the state has to do is says, yeah, whatever these guys say, right? All they have to do, we're going to utilize the recognized American board certification organizations and their practice guidelines.

• 55:16Speaker 02

  And they do this all the time. The state boards don't reinvent the wheel 50 times for every state. They use, you know, like the AMA ethical standards. They just say, yep, we'll adopt those, right? They will use, when you're sued for, or you know, there's an action, a complaint that you violated the standard of care, for example, they don't determine themselves what the standard of care is. They refer to published guidelines or experts or whatever, you know, other people. So it's not a stretch to say that, you know, that the specialty boards need to get way more involved with this and can be a resource for the state medical boards who then also need to be acting on these much more aggressively

• 56:00Speaker 02

  and availing themselves of the specialty boards to determine who is violating, who's spreading misinformation and disinformation.

• 56:09Cara Santa Maria?

  But then there's another layer here, a wrinkle, and I don't know if you want to get into it, Steve, but there is a wrinkle that comes down to straight up political pressure. And when the zeitgeist of the state, whether we're talking about the directives of the state attorney general or the directives of a surgeon general are explicitly saying, no, we promote these practices, we promote this misinformation, now things get really murky because there may be political pressure being leveraged onto that state medical board.

• 56:41Speaker 02

  Well, there shouldn't be, and by, and almost by definition, there really can't be any pressure by any federal person or agency.

• 56:49Cara Santa Maria?

  No, I'm talking about at the state level.

• 56:50Speaker 02

  Oh, yeah, at the state level. Yeah, it's all at the state level.

• 56:52Cara Santa Maria?

  But that's what I'm saying. There are states in which the zeitgeist is pro misinformation.

• 56:58Speaker 02

  But they should be independent. Who, is the governor going to put pressure on the professional board who licensed the professionals, that they should be independent?

• 57:03Cara Santa Maria?

  Yes. You see this, you see this in Florida all the time.

• 57:07Speaker 02

  Yeah. It should not, it should not happen.

• 57:10Cara Santa Maria?

  The state attorney, or the state surgeon general, or whoever it is, putting, do they have a surgeon general of each state?

• 57:16Speaker 02

  No, usually the attorney general handles that kind of stuff.

• 57:20Cara Santa Maria?

  Yeah, the AG. So, but, but, I mean, I saw this when I was living in Florida, these directives coming from state officials saying, don't get vaccinated.

• 57:28Speaker 02

  Oh, yeah, absolutely. But, but, but that does, that does not tie the hands of any professional organization. And I, I have been involved with professional organizations essentially fighting with the state over this. And also, the, like, the regular, like, the state medical board, you know, again, sort of relying upon professional organizations in order to act against somebody who was being protected politically, for example. So I think they are at cross purposes, which is the way it should be.

• 57:59Cara Santa Maria?

  Yeah, which is good, because it avoids that conflict of interest.

• 58:02Speaker 02

  Yeah, right. And then, and then the, the national board certification, you know, boards, they are completely independent, right? They are not even part of the government. They are just academic kind of professional organizations, whose purpose is really to just promote and certify high standards within their specialty. Again, I think they're optimally positioned to deal with these issues, and I think they just need to functionally connect with the state medical boards. Uh, right. So unfortunately, they've been gun shy, though, because they've been burned so often, but by both states and by individual quacks, right? So, for example, and all, and competing professional organizations, like the famously,

• 58:47Speaker 02

  like in the eighties, the chiropractor sued the AMA for practice infringement and won. And so the AMA has like been completely gun shy about dealing with pseudoscience in medicine ever since then. In Connecticut, for example, the, the state government went against the American Infectious Disease Society, right, on the, on the question of chronic Lyme disease. They sided with the quacks against the professional organization. So the states should absolutely not do that, but they absolutely do do that, right? The legislature, the legislature takes on the regulatory roles or supermans the regulatory

• 59:26Speaker 02

  role for purely political purposes, always causing mischief, never in a good way, in my experience. They should just basically let the professionals handle it and stay the freak out of it.

• 59:37Cara Santa Maria?

  Well, and that's what I'm so afraid of is deregulating and the increased distrust of these professional organizations, of institutional knowledge as a whole. What happens when you get to a scary place where in certain states, these types of licenses are no longer even regulated and anybody can call themselves a doctor?

• 1:00:02Speaker 02

  Yeah, well, if you have a complete erosion of expertise and professionalism and any kind of quality control, the game is over. But we're not there. We are not there yet.

• 1:00:10Cara Santa Maria?

  We're not there, but we have holes.

• 1:00:12Speaker 02

  Yeah, absolutely. Yeah. And they're mainly legislative. They are mainly legislative.

• 1:00:16Cara Santa Maria?

  They are.

• 1:00:17Speaker 02

  Yeah.

• 1:00:18Cara Santa Maria?

  But that's where a lot of power lies. And that's the part that scares me because the deregulation is happening at the legislative level.

• 1:00:23Speaker 02

  Yeah, and there's the healthcare freedom laws, which are all happening at the health, at the state legislative level. That's where all the mischief is happening. But while they still have the power to, you know, to protect the public with some level of ethical and quality control, they should do their job. And

• 1:00:40Cara Santa Maria?

  Absolutely.

• 1:00:40Speaker 02

  And right now, they're really not doing it. Because I just think they're not set up for it. You know, again, they have not adapted to this new world of misinformation, and they need to. That's the bottom line.

• 1:00:50Cara Santa Maria?

  100%, because otherwise, who is going to protect vulnerable individuals who literally do not know any better?

• 1:00:56Speaker 02

  Right.

• 1:00:57Cara Santa Maria?

  And are trying to listen to smart people giving them good advice.

• 1:01:01Speaker 02

  Yeah, you end up with the dueling experts, you know?

• 1:01:04Cara Santa Maria?

  Yeah.

• 1:01:05Speaker 02

  And everyone just thinks, ah, whatever, I can believe whatever I want, and I'll just go with my tribe, you know, because everyone has their own experts.

• 1:01:12Cara Santa Maria?

  Exactly, yeah. And their expert, it seems legitimate. They're licensed, they're practicing, they're credentialed, and nobody's taken that away yet.

• 1:01:18Speaker 02

  If you want the benefits of being licensed and credentialed and certified, you have to actually adhere to the standard. You can't have it both ways. You can't say, I'm a board certified physician, so you should, can trust me, and not be liable to those very certifying entities saying, nope, you can't say that, that's not true. That's misinformation. So the whole, there is no First Amendment defense here. There is it, because this is not personal speech or private speech, this is professional speech. Nobody deserves to be licensed, nobody deserves to be certified, and you're board certified. And so, yes, you can absolutely lose your board certification if you violate whatever standard the board decides to have.

• 1:02:02Speaker 02

  It's completely up to them, right? As long as it's being applied fairly and not selectively, you know? But if they say, this is the standard, you have to abide by our standards in order to be board certified, and that includes passing an exam and maintaining your continuing medical education and practicing within the standard of care, blah, blah, blah, and for any reason, they could say, nope, you no longer meet whatever we consider to be the requirements for certification, it can be removed. So, anyway, I think it's, I think it's pretty clear, but the, but the bottom line is, there needs to be pressure to, to take, to take a more active role in policing misinformation and disinformation coming from licensed and certified physicians.

• 1:02:45Speaker 02

  Jay, it's Who's That Noisy time.

• 1:02:48Jay Novella?

  Alright guys, last week I played this noisy.

• 1:03:04Jay Novella?

  You guys have any guesses?

• 1:03:05Speaker 04

  Yeah, shots of Ready Whip being passed around.

• 1:03:10Speaker 04

  Everyone open your mouth.

• 1:03:15Jay Novella?

  So, a listener named Matthew Morrison wrote in and said, "Hi Jay, my wife Nicole, daughter Neb, and I all agree this sounds like a fire extinguisher being used."

• 1:03:24Speaker 04

  I think it would be louder than that if it were a fire extinguisher. Those things can be loud.

• 1:03:27Jay Novella?

  Yeah, when you're right on there, sure, they're crazy loud. It's not a fire extinguisher, but that's a, that's a good guess. A listener named Joel Harding said, "Hi Skeptic's Guide, my six-year-old son Reed guesses that this Who's That Noisy for this week is an axolotl." And I, you know, I have, I didn't know that they made noise. Do they make noise? I mean, do they vocalize?

• 1:03:48Cara Santa Maria?

  I don't think they make noise like that. They're like teeny tiny.

• 1:03:50Jay Novella?

  I mean, if they did make a noise, I suppose it would be something like that with them like screaming, "My lungs are on the outside!" You know, it's a pretty scary thing that they got going on there. Another listener named Adam Russell wrote in and said, "This week's noisy is the mating call of a minok."

• 1:04:05Speaker 04

  Yeah, Adam.

• 1:04:07Jay Novella?

  Good job, right? I don't know if everybody got that. Anybody know what a minok is?

• 1:04:11Speaker 04

  I do.

• 1:04:11Speaker 02

  Yeah, from Star Wars.

• 1:04:12Speaker 04

  Star Wars, specifically.

• 1:04:14Speaker 02

  You like to chew on wire lines.

• 1:04:15Jay Novella?

  Yeah, the cables, you know?

• 1:04:17Speaker 04

  Specifically, the Empire Strikes Back.

• 1:04:19Jay Novella?

  Another listener named Nick wrote in. He said, "Hello, second time guesser. My guess this week is a brush-tailed possum letting you know you're in its territory. I recently had two of these cute-looking, monstrous, sound creatures move in under my house." They are not the brush-tailed possum, and I wouldn't be happy if I, if I met one of those. We have a winner from last week, guys. Are you prepared? You're all brimming with excitement, I can tell.

• 1:04:43Speaker 04

  I'm not ready.

• 1:04:43Jay Novella?

  Jesse Babonis wrote, "I think this noisy is the call of a kiwi bird." That is, that is the sound of a kiwi bird. Listen again.

• 1:05:00Jay Novella?

  Not a happy creature. Steve, I have to ask you.

• 1:05:03Speaker 02

  Yeah.

• 1:05:03Jay Novella?

  Did you have any idea that it was a bird?

• 1:05:06Speaker 02

  That was my, that was my, would have been my guess.

• 1:05:08Jay Novella?

  You did?

• 1:05:09Speaker 02

  Mm-hmm.

• 1:05:10Jay Novella?

  But you had no idea what the actual bird was?

• 1:05:12Speaker 02

  Yeah, I haven't heard that one before.

• 1:05:14Speaker 04

  Kiwi, huh?

• 1:05:15Jay Novella?

  Kiwi, huh?

• 1:05:16Speaker 04

  That little thing that we saw at night in, in, in New Zealand?

• 1:05:20Jay Novella?

  Well, yeah, we actually saw it during the day, didn't we?

• 1:05:22Speaker 04

  Did we? I thought it was night.

• 1:05:23Speaker 02

  Well, it was day to us, but it was in a night, every, I've switched.

• 1:05:27Speaker 04

  Enclosure.

• 1:05:27Speaker 02

  And the enclosure was flipped so that it's night was our day so that we could see it. Right? Remember that?

• 1:05:31Speaker 04

  Oh, it was like a trick.

• 1:05:33Jay Novella?

  Oh, yeah, yeah, yeah. Yeah, well, apparently they make that noise, so, um, not the most inviting noise, huh?

• 1:05:39Speaker 04

  No. Sounds terrifying.

• 1:05:42Jay Novella?

  All right, guys, I have a new noisy for you this week. I'm gonna play it for you right now.

• 1:06:05Jay Novella?

  Yes.

• 1:06:06Speaker 04

  It's not a bird.

• 1:06:07Jay Novella?

  That is most definitely not a bird. I will give everybody that unbelievable hint.

• 1:06:13Jay Novella?

  So, guys, if you think you know what this week's noisy is, or if you have a cool noisy that you heard, give me an email. Send me an email. The only place I want you to send me the email is [email protected]. A few quick things, Steve, so you could always become a patron of the SGU in these times where the world needs skepticism, I believe. Um, I wouldn't say now more than ever, but now is definitely inflection point where we really feel the need to help educate people on how to think and how to be reasonable and how to use reason to come to your conclusions. That's why we're here, guys. So if you would like to support the work that we do, go to patreon.com/skepticsguide, all one word.

• 1:06:56Jay Novella?

  You can also join our mailing list. Every week we send out an email. It gives you a summary of all the things that the SGU has done in the last week. And you could sign up going to the skepticsguy.org and on our homepage you'll see a button to join there. And we have three shows coming up. The DC, Washington DC, private show, which is a live recording of the SGU. And also we do an extra hour of fun and audience interaction. It's different every time. If you haven't been to one, go to one. There's only a certain number of these that we will ever do left, correct, guys?

• 1:07:27Bob Novella?

  Mm hmm.

• 1:07:28Jay Novella?

  It's an unknown number, but it is a limited number.

• 1:07:31Speaker 04

  It is finite. That is a correct, that is a correct statement.

• 1:07:34Jay Novella?

  We also, on the same day, this is happening all on December 7th of this year, we have a Skeptical Extravaganza. This is our stage show. This is a live performance that includes all of the SGU and George Robb. Ian is manning the tech table. And this is a show that we have been perfecting over the last 10 years. It's a ton of fun. I really do hope that you decide to come join us in DC. We will be, we also will be scheduling more of these around the country in 2025. We are happening, you know, the talks are happening right now. So this is a great show to grab. You can also go to the skepticsguy.org to buy tickets for that. And then, and the thing that I'm most excited for is Natacon 2025. This is

• 1:08:19Jay Novella?

  our conference. We started last year in 23. And it is a, it is an SGU celebration. That's the best way I could describe this. The conference is largely around socializing, but we do, of course, provide an incredible amount of content during the two days that the conference is going on. And there is going to be a lot of fun, new things that we do this year. If you're interested, you can go to nataconcon.com. Evan, what was that URL?

• 1:08:46Speaker 04

  Nataconcon.com.

• 1:08:50Jay Novella?

  Correct.

• 1:08:51Speaker 04

  Yes.

• 1:08:52Jay Novella?

  Please do join us. It's an awesome time. It's a great place to meet new people. We had such a blast last year that people are still talking about it. I know I am. And Sharon made us a ton of biscotti, right, guys?

• 1:09:04Bob Novella?

  Oh, boy. Oh, boy. That was just so good.

• 1:09:07Jay Novella?

  Yeah.

• 1:09:08Speaker 04

  Yeah, but, you know, we ate it all, so.

• 1:09:09Jay Novella?

  Yeah, that's why we're doing it again. It's the only way to get it. It's to do Natacon.

• 1:09:14Speaker 04

  Biscotti con.

• 1:09:15Jay Novella?

  Yeah.

• 1:09:16Speaker 02

  That's a wrap, Steve. All right, thanks, Jay. One quick email. We had a number of people write us to follow up with our mid-Atlantic accent discussion. Cool. I filed this under "it's always more complicated than you think."

• 1:09:31Speaker 04

  That's a big file.

• 1:09:32Speaker 02

  So mostly, they were referring to a video by a phonetics expert, Dr. Jeff Lindsay, who argues that the notion that the mid-Atlantic accent is fake is itself a myth. And then he sets about to debunk that myth citing a lot of evidence, you know, about the origins of the accent. I gotta say, I'm not convinced by his video. I mean, clearly, he understands a lot more about this than I do. But I looked up, just tried to research it as best as I could. And I could certainly find other experts that seemed to be as legitimate as this guy saying something extremely different.

• 1:10:15Speaker 02

  So at the very least, I think we need to say that this is a controversy, or it's contested. I don't know if this guy, this guy has a YouTube channel, right? Where he has a lot of videos about language. That doesn't necessarily mean that he's the definitive authority on everything just because he has a YouTube channel. But he certainly is an expert, and he has, you know, a reasoned argument to make. He's basically saying that the quote-unquote "mid-Atlantic" accent is a northeastern regional accent. And it's kind of what, you know, by the early 20th century, what was settled on as sort of a generic American accent. And he cites evidence from like, the aspects of the mid-Atlantic accent that were, that

• 1:10:59Speaker 02

  exist in the regional accents of the Northeast. Those features all pre-existed. So he said, "How could that be fake?" However, I also find references that say that not only was the mid-Atlantic accent manufactured, they named the guy who did it. They said this Australian phonetician, William Henry Till. Phonetician. Yeah, phonetician. Created the mid-Atlantic accent, basically for the purpose of saying, "There should be an English, like a, one accent that any educated person who speaks English anywhere in the world should speak." Right? And that's the quote-unquote "mid-Atlantic" accent. So I'm not sure how to square...

• 1:11:40Speaker 02

  The apparent history here that is being cited, you know, authoritatively by some experts with this guy's analysis, who's saying that, no, it was a northeastern American regional accent. So, I don't know. It's complicated. I do, there are some points which I think, some of which we made ourselves, and I've, actually, interestingly, I first learned that the mid-Atlantic accent was just a generic American. It was picked because it was a generic American accent. It was sort of the most neutral accent. I only later read that it was sort of an invented or crafted accent. And now this guy's saying, no, it actually

• 1:12:23Speaker 02

  is just sort of the regional accent that is the most neutral, and that's why it was kind of preferred by actors. Also, a lot of Hollywood actors were British, that's why they might sound like half-American, half-British, you know, etc. I also have, researching this, and I've read before, that a lot of the quote-unquote "regional" accents, laid on top of that is a socioeconomic accent. So, what we might be hearing is just a northeastern, upper-society accent, which sounds more similar across regions than do the lower socioeconomic-class accents, right? So, in other words, a upper-class person

• 1:13:08Speaker 02

  living in Boston, New York, and London would sound a lot more similar to each other than a lower socioeconomic-class person from those three cities.

• 1:13:18Cara Santa Maria?

  Yeah, it's also, it's interesting to think too, Steve, about like, when did, like, when we think of a neutral broadcast accent today, kind of a generic American accent today, when did that actually start?

• 1:13:32Speaker 02

  Yeah.

• 1:13:33Cara Santa Maria?

  Because in the 1600s and 1700s, we were all British.

• 1:13:36Speaker 02

  It was British.

• 1:13:36Cara Santa Maria?

  You know what I mean? Like, that's how people, or French, yeah, depends on where they were, but the English accent was probably a British accent.

• 1:13:46Speaker 02

  So.

• 1:13:46Cara Santa Maria?

  And that would have been regional as well.

• 1:13:48Speaker 02

  What do you mean by English?

• 1:13:50Cara Santa Maria?

  I mean, from England.

• 1:13:51Speaker 02

  Yeah, was a, yeah, of course it was a British accent.

• 1:13:54Speaker 04

  Anglo.

• 1:13:54Speaker 02

  That's what you're saying.

• 1:13:55Cara Santa Maria?

  I'm saying that early Americans, I'm not talking about indigenous Americans.

• 1:13:59Speaker 02

  Yeah.

• 1:13:59Cara Santa Maria?

  They were settlers.

• 1:14:01Speaker 02

  Oh, yeah.

• 1:14:01Cara Santa Maria?

  They were colonial.

• 1:14:02Speaker 02

  Well, we know that, for example, the New York accent is a Dutch accent.

• 1:14:06Cara Santa Maria?

  Right.

• 1:14:06Speaker 02

  And the southern accent is actually closer to a British accent than the northern accent.

• 1:14:12Cara Santa Maria?

  And the Appalachian accent is very Scottish. Like, at what point, though, did it become definitively American?

• 1:14:18Speaker 02

  Well, that's what this guy's saying. That around this time is when it sort of coalesced into a distinctive American accent. And this was just the northeastern version of that.

• 1:14:28Cara Santa Maria?

  That feels very late.

• 1:14:30Speaker 02

  Yeah, I don't know.

• 1:14:31Cara Santa Maria?

  Because it feels like we skipped the whole 1800s.

• 1:14:34Speaker 02

  I don't know.

• 1:14:34Cara Santa Maria?

  Yeah.

• 1:14:35Speaker 02

  So I don't, I don't, I have not come to a comfortable place where I think I've wrapped my head around this. I think it's complicated. I think there are a lot of moving parts here. I don't, it may not be so simple as this was a fake accent that was, you know, taught in finishing schools and affected by actors and actresses. I think there's multiple things going on, but I'm not convinced that it's entirely a natural regional accent either. I think there is an element of education and socioeconomic status in here as well.

• 1:15:04Cara Santa Maria?

  And it may be both. It may be that some people naturally spoke that way and other people go, I like the way that person is talking. I'm going to emulate that.

• 1:15:13Speaker 02

  Totally. And I know, you know, that if you go to, like, radio broadcast school right now, they will teach you how to talk in a very specific way. There is, there is a broadcast, quote unquote, accent today. We just take it for granted because it's normal for us, but it.

• 1:15:30Cara Santa Maria?

  Yeah, it's, it's the neutral American. And it's what, like, I have friends who are actors, right? But are from other countries. So they go to dialect coaches.

• 1:15:38Speaker 02

  Yeah.

• 1:15:38Cara Santa Maria?

  And they learn how to speak neutral American, like broadcast. They also learn how to speak in different accents.

• 1:15:44Speaker 02

  Right.

• 1:15:44Speaker 04

  Well, pilgrim.

• 1:15:45Speaker 02

  So that, that neutral American accent is not fake, but it's not natural either. It is affected, even though it is based upon regional accents. So I think it's complicated.

• 1:15:58Cara Santa Maria?

  Yeah, that's an interesting way to even look at it, Steve. Like, I speak with more of a neutral broadcast accent. I have never had a southern accent.

• 1:16:07Speaker 02

  Mm hmm.

• 1:16:08Cara Santa Maria?

  But my entire family does.

• 1:16:10Speaker 02

  Right.

• 1:16:11Cara Santa Maria?

  So like-

• 1:16:11Speaker 04

  Maybe you were adopted?

• 1:16:12Cara Santa Maria?

  But did I fake that? Did I choose that at a certain point in my life? Did I unconsciously choose that? Like, it's very interesting. Some people have thick accents and some people don't.

• 1:16:23Speaker 04

  Could be. Your peers may have influenced it.

• 1:16:25Cara Santa Maria?

  I'm sure a lot of things influenced it. I watched television growing up. I don't know.

• 1:16:29Speaker 02

  No, it's funny. I remember I had a conversation with somebody from the South, and we were talking about the accents on television, and it was their impression that people on TV spoke in a southern accent. Well, it was our impression, you know, coming from Connecticut, that they spoke in a northern accent that-

• 1:16:48Speaker 04

  Well, then they were using a-

• 1:16:49Speaker 02

  The southern accent is the exception, and they thought the northern accent was the exception. So we're like, "Yeah, whatever."

• 1:16:56Cara Santa Maria?

  And I think that both of those are really obvious.

• 1:16:59Speaker 02

  Yeah, right.

• 1:17:01Cara Santa Maria?

  I hear your Connecticut accents all the time on the show, but my parents, I'm from Texas. My parents sound southern. I definitely hear their accents as well.

• 1:17:09Speaker 02

  But it's funny, everyone thought their own accent was the rule and the other ones were the exception.

• 1:17:14Speaker 04

  Yeah.

• 1:17:15Speaker 02

  You know, it's like, "Oh, yeah, that show, yeah, that's because that, like Barney Miller, they're in New York, so of course they're speaking with a New York accent." That's not the TV accent, though. The TV accent is my accent. That's what everyone perceived. That's funny.

• 1:17:26Jay Novella?

  Hey, Steve.

• 1:17:27Speaker 02

  Yeah.

• 1:17:28Jay Novella?

  I forgot to mention something, and this one's pretty cool. So, we just turned on, on our Patreon, the ability to gift somebody a membership.

• 1:17:37Speaker 02

  Whoa.

• 1:17:38Jay Novella?

  Oh, neat. Yeah, I thought this would be a cool thing to do for the holiday season. So you just go to Patreon.com-

• 1:17:44Speaker 02

  You can buy them our books and give them a membership.

• 1:17:47Speaker 04

  No accent required.

• 1:17:48Jay Novella?

  So all you gotta do is go to Patreon.com/skepticsguide/gift, and that link will be on the STU homepage as well. And what you could do is you could do two things. One, you could give it to anybody you want as a gift in any parameters that you want, and it could be a cool Christmas present or whatever. The other thing you could do is you could donate a gift membership to someone in the skeptical community that we will find, you know, Ian and I are working on this right now, that it will be very easy to locate people that want a free membership. And then they'll know who you are if you want them to as the person, you know, giving the gift. So, check it out. I think it's a really cool thing to do and it also can support the SDU.

• 1:18:30Speaker 02

  All right. Thanks, Jay. Guys, we have a great interview coming up with Michael Mann. So let's go to that interview now.

• 1:18:47Speaker 02

  We are joined now by Michael Mann. Michael, welcome back to The Skeptic's Guide.

• 1:18:51Speaker 07

  Thanks, Steve. It's great to be with you.

• 1:18:52Speaker 02

  Yeah, always a pleasure to have you on the show. So you're obviously a famous climate scientist, and that's had both good and negative aspects in that you've been targeted because you have spoken publicly what the science says about climate change. So since we've talked to you last time, it's been a few years, actually, I think, since we spoke last time. How do you think things are going in terms of like parts of minds, climate change, et cetera?

• 1:19:16Speaker 07

  It's a great question. This is sort of the topic of my penultimate book, not the most recent one, or Fragile Moment, but The New Climate War. Back in 2020, sort of, there's this evolution away from denialism because it's difficult to deny something that people can see with their own two eyes. Literally being told to not believe what you're seeing with your eyes, what you're hearing with your ears. And so, I think polluters, other bad actors, sort of promoting the fossil fuel agenda, if you will, recognize that denialism doesn't really cut it anymore. So they've turned to other tactics. And among

• 1:19:57Speaker 07

  them, ironically, is doomism. So, I mean, and I mentioned this, you know, in my talk today. That's in some ways a greater threat today than denialism because you have people who would otherwise sort of be mobilizing, would be on the front lines demanding action, becoming convinced it's too late to do anything and it potentially leads them down this path of disengagement and you've got some bad actors who are sort of feeding the flames of doomism. It's a really

• 1:20:24Speaker 02

  It's diabolical.

• 1:20:25Speaker 07

  It's absolutely diabolical and Machiavellian.

• 1:20:29Speaker 02

  Yeah.

• 1:20:30Speaker 07

  And that's what we face today.

• 1:20:32Speaker 02

  Yeah, and it's incredibly effective and in fact, even like among ourselves, we've had to be vigilant about not falling for the doomism.

• 1:20:41Speaker 07

  Right.

• 1:20:42Speaker 02

  Because, and again, just to put it, my perspective on this is that, and this is the same thing with like anti-vaxers or whatever, like you can, the big tell is that they're a denialist, is that the answer is always do nothing.

• 1:20:55Speaker 07

  Right.

• 1:20:56Speaker 02

  Right? Or it's always the negative, or it's always the vaccines, or it's like with climate change, the answer is always, well, we just shouldn't do anything.

• 1:21:03Speaker 07

  Reverse engineer what the argument has to be to get there.

• 1:21:06Speaker 02

  Yes, reverse engineer. And it's different. The argument changes, but the conclusion's always the same. So at first it was like, it's not happening.

• 1:21:11Speaker 07

  Yeah.

• 1:21:12Speaker 02

  You know, then it's like, well, it's natural cycles, you know, and now it's like, well, there's nothing we can do about it anyway, so why bother? And unfortunately, we've kind of been playing into that. You know, the people like the

• 1:21:23Speaker 07

  That's right.

• 1:21:24Speaker 02

  Yeah, we're saying, hey, we gotta do something, it's gonna get too late, it's gonna be bad, blah, blah. And now they're saying, yeah, you're right. It's like, in fact, it's too late, so why bother doing anything? It's like, shit, like we've inadvertently been playing into that narrative.

• 1:21:34Speaker 07

  That's right.

• 1:21:35Speaker 02

  And as you say, it like undercuts the very people who are probably the most activist.

• 1:21:38Speaker 07

  That's right. Yeah, it is truly pernicious and, you know, the good news, I suppose, is in a sense, it's an evolution, you know, towards the stages, you know, evolving, you know, in terms of the stages of denialism or delay, you know, and towards something that we can hopefully, the point I make in terms of our messaging on climate, it's good that there's a sense of urgency. We can make use of that. People clearly understand the urgency. It's the agency that we have to convince them of. But we're sort of Halfway there.

• 1:22:14Speaker 02

  Yeah.

• 1:22:15Speaker 07

  Um, and we need to sort of deprogram them from the misinformation that they've been fed. And, and that's what again is so sort of um pernicious here is the way that misinformation has been used and weaponized to, to feed this sort of um agenda of despair and doomism. And, you know, so it's a matter of telling people, look, the science actually, look how, look what the models predicted and look what the observations show. The models done a really good job.

• 1:22:43Speaker 02

  Right.

• 1:22:43Speaker 07

  Those same models tell us that we can limit warming below catastrophic levels. The only obstacle is politics.

• 1:22:52Speaker 02

  Right.

• 1:22:53Speaker 07

  Action. It's not physics.

• 1:22:54Speaker 02

  Right.

• 1:22:55Speaker 07

  The physics doesn't tell us we can't do it. The technology.

• 1:22:57Speaker 02

  Right. We have the technology too. I make that point too. We actually don't need any technology that we don't already have.

• 1:23:02Speaker 07

  That's right.

• 1:23:03Speaker 02

  And it's only going to get better. Like even, but even if we flatlined our technology, we could still solve it and it's going to get better.

• 1:23:09Speaker 07

  Yeah, exactly. The economies of scale, there's learning, learning by doing, the new efficiencies that, you know, arise when you start deploying that new technology. So yeah, we will do better than sort of the, the, the, the baseline scenario. But even the baseline scenario of, you know, a, a shift towards these new energy options will get us there.

• 1:23:28Cara Santa Maria?

  But how do you, how do you, maybe convinced is the wrong word. How do you have a conversation with individuals who are, are despairing and are despairing for legitimate reasons, right? Because they look at the political will and they look at every global summit and we're constantly falling short of these arbitrary goals. And they go like, we're, yeah, we might have the technology, we might have whatever. We're not going to get there because they don't want to enough and I'm just a person and I can't control this.

• 1:23:56Speaker 07

  Yeah, no, absolutely. And that's, that's, that, this is often the, the first point I make. We have to sort of parse out the different sort of sources of despair and doomism. Because the doomism based on the idea that we've triggered runaway warming and, I mean, that's all just nonsense and we've got to debunk that nonsense. The, the argument that, well, look at how fraught our politics are. Look at the election that, you know, we're in right now. That's much more difficult to combat. Because it's understandable, young folks, especially I teach at the University of Pennsylvania. I interact with, you know, Gen Z, you know, folks every day and I understand that. And I understand where it comes from, the cynicism that we can ever rise to the challenge.

• 1:24:40Speaker 07

  What I would say is that, you know, I remain sort of a stubborn optimist, is the expression I would use. In that, you know, I see in those same students, a level of fortitude and just sort of Gen Z'ers. To me, they get it in a way that previous generations didn't. They understand that it's their future that's on the line. They are very savvy, they're very, when it comes to communication and me, because they grew up in this sort of social media world. And they have tools and abilities that my generation didn't have. And they're using those tools to make a real difference.

• 1:25:19Speaker 07

  So when I see the students that I teach, every day they sort of inspire me and they convince, they convince me that we can do it.

• 1:25:27Speaker 02

  Yeah, yeah, yeah. Yeah, I've described myself as a pragmatic optimist. Same way, I'm an optimist because that's the only thing that's gonna work. Right, because yeah, because being a doomsday is self-defeating.

• 1:25:38Cara Santa Maria?

  Yeah.

• 1:25:38Speaker 02

  Like, and the same thing with political, like, if, oh, there's nothing we can do about it, that's a self-fulfilling prophecy.

• 1:25:43Speaker 07

  That's exactly right. And that's the struggle here, right, is that as scientists and as critical thinkers, we understand that we've got to be truthful to what the science is. That's, we cannot violate that oath that we have to be truthful to the science. Which means that if the science really did tell us it was too late to prevent runaway warming, we'd have to come forward and say so. I mean, and so, you know, Steve Schneider referred to this as sort of an ethical double bind, that we have to be truthful to the science and we have to be effective at the same time. It's something the other side has never had to do.

• 1:26:20Cara Santa Maria?

  I often see a parallel, it's interesting, in my work, working with cancer patients. I see a big parallel and I learn a lot from my patients, that there's often a hope for the best, but prepare for the worst mentality. And understanding that there are some things that are that are written in stone and there are other things where when it comes to hope, I think this is the biggest thing that has kept me from diving into cynicism. Hope is a moving target. You can adjust and adapt your hope based on the available evidence.

• 1:26:51Speaker 02

  Right.

• 1:26:51Cara Santa Maria?

  And you, it doesn't have to be all the way over here.

• 1:26:54Speaker 02

  Right.

• 1:26:54Cara Santa Maria?

  You can have hope for something over here.

• 1:26:56Speaker 02

  That's achievable.

• 1:26:57Cara Santa Maria?

  Yeah, and when you, when you're constantly sort of allowing that, it can keep you looking at the next step and the next.

• 1:27:02Speaker 07

  Yeah, and we're sort of wired that way, aren't we?

• 1:27:05Speaker 02

  Yeah. And along those lines, because I was going to ask you this question too, because one of the attacks that we also take is, yes, there are tipping points, but climate change also is a spectrum. It's like, and yeah, even if you think it's going to get bad, it could get worse. So at this point, our, our goal is always to make it less bad, right?

• 1:27:23Speaker 07

  No, absolutely. And this is, I, I always try to disabuse folks from the notion that there's like this cliff, like this, this tipping point that we warm the planet to 1.5 Celsius and we go off the climate cliff. That's not how it works. I liken it to a, a highway. We're going down this dangerous highway and we want to get off at the earliest exit that we can.

• 1:27:46Speaker 02

  Right.

• 1:27:47Speaker 07

  If we miss the 1.5 exit, we don't drive all the way to Topeka.

• 1:27:51Speaker 02

  Right.

• 1:27:52Speaker 07

  We get off at the 1.6 exit.

• 1:27:54Bob Novella?

  But isn't there though, isn't there something though to the, to the idea though, that a tipping point could be achieved where the climate basically resets itself into a new stable configuration? I mean, isn't that a thing though?

• 1:28:07Speaker 07

  Yeah, so let me clarify. So there is no one tipping point. It's, there are many possible tipping points with various subsystems of the climate. There are certain tipping elements. There are aspects of the climate system that are, you know, that, that have tipping point dynamics.

• 1:28:23Speaker 02

  But no one tipping point is catastrophic.

• 1:28:25Speaker 07

  Yeah. So if you look at global temperature, for example, that behaves very linearly, at least as far as we can see with the observations and the models, it's, the amount of warming is linearly proportional to the carbon emissions. No obvious tipping point. There's no runaway methane feedback of the sort that. Some climate doomers argue the warming is a very linear function and the models have predicted it very well. Where there is the potential for tipping points is in the nonlinear components of the system. And the ice sheets are a good example. There are feedback processes that once you start the collapse of the ice shelves and the ice starts surging into the ocean, it sort of feeds back on itself. There's something called the ice cliff instability.

• 1:29:10Speaker 07

  There are these various positive feedback mechanisms and of course, positive feedback is not a good thing here. And so that there are elements of the climate system, ice sheet collapse is one of them. There's been a lot of press coverage over the last week or so about the ocean conveyor.

• 1:29:27Speaker 02

  AMOC?

• 1:29:28Speaker 07

  The AMOC, exactly. Atlantic meridional overturning circulation. You can see why we don't spell it out.

• 1:29:36Speaker 02

  You were a researcher on that, weren't you?

• 1:29:38Speaker 07

  I was, I signed my name to a, to a letter from a number of scientists. Stefan Romstorf, a friend of mine from Germany, leading climate scientist from the Potsdam Institute, was sort of the spearheaded this, but I signed my name to it and for some reason, in the States anyway, I got mentioned quite a bit in the coverage. I was sort of like a minor signatory of it and I agree with the overall tenor of what it said. And there's some fine print that didn't get much coverage in the.

• 1:30:10Speaker 02

  Tell us about it.

• 1:30:11Speaker 07

  That, you know, it's speculative that we don't know where the tipping point is. There are uncertainties in the models, the observations, you know, are incomplete and so it's more speculative than definitive.

• 1:30:25Speaker 02

  And this is about like the Atlantic conveyor belt turning off?

• 1:30:28Speaker 07

  Yeah, if you saw the movie The Day After Tomorrow. I mean, and what happens in that movie is unrealistic, right? You're not going to have tornadoes destroy Los Angeles. You're not going to have super cooled plumes of air killing people or an ice sheet forming, you know, within three days over the northern half of North America and you're certainly not going to have Jake Gyllenhaal winning an academic decathlon. There's just no way.

• 1:30:55Speaker 02

  Least believable of all of those.

• 1:30:58Speaker 07

  I mean, I could not suspend my disbelief at that point.

• 1:31:02Jay Novella?

  They did say, though, like, it could be, it could be within a few decades, or it could be, you know, by the end of the century.

• 1:31:10Speaker 07

  Yeah.

• 1:31:11Jay Novella?

  I mean, the time span is, is big, but...

• 1:31:13Speaker 07

  The models, there's a huge spread in the models that we use. Some of them, it collapses within a couple decades. Some of them, it goes along happily to the end of the century. The other thing is, if it happens, the consequences aren't quite as catastrophic as you might.

• 1:31:29Bob Novella?

  Okay, that's encouraging.

• 1:31:30Speaker 07

  Yeah, I mean, so what would happen is you'd get cooling in the North Atlantic, and we wrote an article in Nature back in 2015 showing that there's, there's, like, if you look at the global temperature pattern of the last century, there's warming just about everywhere, everywhere, but there's this little hole south of Greenland in the North Atlantic where temperatures have actually been cooling.

• 1:31:51Jay Novella?

  Is that, what do they call it, the cold blob?

• 1:31:52Speaker 07

  The cold blob, there you are.

• 1:31:53Cara Santa Maria?

  Is there Ireland in the cold blob? Because they complain a lot about this, that it's getting colder in Ireland.

• 1:31:58Speaker 07

  Well, it's, they're in the periphery of where, the area that could see, so, I mean, in reality, there's only a small area in the North Atlantic that would likely cool.

• 1:32:08Jay Novella?

  Really?

• 1:32:09Speaker 07

  You would, yeah, and maybe reaching in, you know, to like, England, Ireland, slightly, slight cooling that could happen, but it's competing against the overall warming, and so it's a battle against, and the further you get away from the bull's eye, the more the warming is likely to win out over the cooling.

• 1:32:28Jay Novella?

  It's like the heat miser and...

• 1:32:30Bob Novella?

  Freeze miser.

• 1:32:31Speaker 02

  Cold miser.

• 1:32:32Speaker 07

  Absolutely. In fact, I talk about cold miser and heat miser in our fragile moment.

• 1:32:38Jay Novella?

  As you should.

• 1:32:40Speaker 07

  Yeah. And you name it, we talk about it in the book.

• 1:32:45Cara Santa Maria?

  You mentioned this idea that you're, you're already starting to see some evidence of this, that you use the analogy of this really dangerous freeway and wanting to get off of it as soon as possible. And yes, there may be a couple of different identified cliffs.

• 1:33:00Speaker 07

  Tipping elements, right.

• 1:33:01Cara Santa Maria?

  Tipping points where there are cataclysmic, or maybe... Less cataclysmic events happening. But I think that an important point to reinforce there is that we are on the freeway now. And just because I am in a home with good air conditioning and I can wear a coat in the winter and I can wear a tank top in the summer and I have plenty of water at my disposal. There are people whose lives are already destroyed by this.

• 1:33:24Speaker 07

  That's right.

• 1:33:25Cara Santa Maria?

  And I think we often don't bring that. We keep talking about later on.

• 1:33:28Speaker 07

  Right.

• 1:33:29Cara Santa Maria?

  Instead of right now.

• 1:33:30Jay Novella?

  So the climate refugees you're talking about, right? Like, yeah, we, if you don't live, if you don't live near the equator, then not much has really changed.

• 1:33:39Cara Santa Maria?

  Or if you're deeply coastal, or if you're, you know, there are all of these areas.

• 1:33:42Jay Novella?

  But yeah, there's people that are already just massively displaced.

• 1:33:46Cara Santa Maria?

  I just covered, I just covered this famine that's happening across multiple countries where there's no, that high nutrition yield food available to these children. This is climate change.

• 1:33:56Speaker 07

  Absolutely.

• 1:33:57Cara Santa Maria?

  It's directly related.

• 1:33:59Speaker 07

  Absolutely. I mean, this is something that I try to convey when I, you know, talk about where we are, that dangerous climate change. There's this like false notion that, again, that cliff, like dangerous climate change is 1.5 Celsius. That's where dangerous climate change, you know, dangerous climate change is here. If you're, if you're, if you're in Puerto Rico, if you're California, if you're, I mean.

• 1:34:23Jay Novella?

  North Carolina.

• 1:34:24Speaker 07

  North Carolina, the.

• 1:34:26Jay Novella?

  As you said, we can't, we can't ever say that hurricane was due to climate change. But we know that there's way too many things happening.

• 1:34:32Speaker 07

  Well, we know that the rainfall, there's a study already, an attribution study that shows that there was a 50% increase in the rainfall associated with Helene. That can be attributed to the warming of the planet. And that's, that, that, that can be linked directly to human lives.

• 1:34:46Cara Santa Maria?

  Yeah, absolutely.

• 1:34:47Speaker 07

  Lives lost and huge amounts of property damage.

• 1:34:51Jay Novella?

  A friend of mine lives in Texas, right? And he's been telling me about the summers recently and, you know, and he's like, it's getting bad. You know, the, the grid down there sucks. It can't handle anything extreme that's going on. You know, it's going to be a long time. Yeah. Oh, no, he had, they were way above 110. They were way above 110 last year, right?

• 1:35:09Speaker 07

  That's okay. You can just fly off to Cancun if you're the center.

• 1:35:13Cara Santa Maria?

  Exactly.

• 1:35:13Jay Novella?

  But it's, so what was funny is I'm talking to him and in the conversation, we're like, what's happening with the people who live in Mexico or you keep going down to the equator? I mean, it's like, yeah, it's bad in Texas, but we're north.

• 1:35:25Speaker 07

  Well, and that's very real. I mean, and so like the, you know, this leads us to, so all of these calamities mean that there are areas of the planet that are becoming increasingly unlivable. And that means more people, eight point two billion people and growing, competing for less land, less food, less water.

• 1:35:45Jay Novella?

  Yep.

• 1:35:45Speaker 07

  And that is a prescription for, you know, a dystopian future.

• 1:35:50Jay Novella?

  You think we're having an immigrant problem now?

• 1:35:52Cara Santa Maria?

  Right.

• 1:35:52Jay Novella?

  Imagine what that's gonna be.

• 1:35:53Cara Santa Maria?

  Oh, my God. Keep them out.

• 1:35:55Jay Novella?

  Yeah, right.

• 1:35:55Cara Santa Maria?

  What does that even mean?

• 1:35:56Jay Novella?

  Yeah.

• 1:35:57Cara Santa Maria?

  Like, there are people who need a place to live.

• 1:35:59Jay Novella?

  Well, that's the thing. The thing that scares me the most is that, right? When we get to a point, like, let's say, you know, and I don't want to catastrophize, but this basically is a catastrophe. But the idea is at some point, there's something that, there's gonna be some point in time when a lot of people are gonna be displaced. And it can't be like, it's not gonna be a regional fix, like, oh, they just moved a little north here, whatever. It's gonna be like, we have to move people out. This is a global effort. It could be, it could be a thing where we have to save, we have to save a hundred million people from dying, you know?

• 1:36:29Cara Santa Maria?

  And the thing is, it is, we are in that.

• 1:36:32Jay Novella?

  Yeah, exactly.

• 1:36:33Cara Santa Maria?

  It's already happening.

• 1:36:34Jay Novella?

  Exactly.

• 1:36:35Cara Santa Maria?

  And it's causing massive geopolitical conflict.

• 1:36:37Jay Novella?

  But you know what they say, Kara? They say, well, we're not, the United States isn't the biggest greenhouse gas emitter, and if China's not doing it, why should we do it?

• 1:36:45Speaker 07

  So we are. We put more, so the climate only cares about the cumulative carbon pollution that's been added.

• 1:36:51Jay Novella?

  Doesn't care about the country at all, right?

• 1:36:54Speaker 07

  It doesn't care about the country and doesn't care about what year it was added. So the United States has put more carbon pollution into the atmosphere than any other country.

• 1:37:01Jay Novella?

  Yes, a cumulative, we are the big.

• 1:37:03Speaker 07

  Yeah.

• 1:37:03Cara Santa Maria?

  We're still leading.

• 1:37:04Jay Novella?

  Currently, per capita, we're also the biggest.

• 1:37:07Speaker 07

  Yep, exactly.

• 1:37:07Jay Novella?

  But China just has a big population. They're currently at the moment.

• 1:37:11Speaker 07

  And they're currently, exactly.

• 1:37:12Jay Novella?

  Yeah, but they're also kicking our ass on solar power and other things.

• 1:37:15Cara Santa Maria?

  So they may mitigate that long before they even reach us cumulatively.

• 1:37:18Speaker 07

  That's exactly right. They're ahead of us on renewable energy front. They are, yes, they may be emitting carbon, more carbon than us, but not on a per capita basis.

• 1:37:29Jay Novella?

  Not even close.

• 1:37:29Speaker 07

  And so it's a diversionary tactic, right? Whenever, when you hear that, oh, what about, it's what about is what we call it?

• 1:37:36Jay Novella?

  Of course, yeah. I know, it's frustrating because you're like, well, it's gotta start somewhere. You know, it's like, it's not like, okay, on three, we're all gonna start doing this.

• 1:37:43Speaker 02

  Well, it's the exact same thing as the doo-mism. It's like, well, unless everyone's doing it, what's the point? It's like, yeah, but every bit counts. It could always be worse, making it less bad. You know, we're doing our best, all that stuff. It's like, it's, I think it is part of the same, but counteracting the doo-mism.

• 1:37:58Cara Santa Maria?

  You heard the analogy of like being in a rowboat and there's holes in the floor of the rowboat. And you're not gonna plug your hole because that guy over there hasn't plugged his hole? Like, what are you doing? Of course I'm gonna plug my hole, then I'll go help you plug your hole once my hole is plugged.

• 1:38:10Jay Novella?

  And, you know, the governmental bureaucracy, it's, you know, it's maddening. Because like, you know, we're like, we see issues being discussed, like, yeah, I get it. Yeah, that's not a bad issue, that's not a bad issue. But can global warming please take a front seat at some point in some recent administration? Right?

• 1:38:25Speaker 02

  Well, what do you, I was gonna ask you next.

• 1:38:27Speaker 07

  I actually wanted to like piggyback on what you just said. Because I, I want to extend the analogy further. And then there are those who are telling us that, no, we don't need to plug the holes in the bottom of the boat. We just need spoons to spoon out the water.

• 1:38:41Cara Santa Maria?

  Right.

• 1:38:44Speaker 07

  That's the geoengineering.

• 1:38:45Cara Santa Maria?

  It's so obvious what we can do right now.

• 1:38:48Jay Novella?

  I had somebody email me going, what if everything stays the same and we just get really good at carbon capture? And I'm like, we will be very good at carbon capture in about 100 years. We'll have massive, awesome technology. But we can't wait till then.

• 1:39:01Speaker 07

  And that's exactly the point.

• 1:39:02Bob Novella?

  Speaking about that, speaking about that, some people I've read have a point of view where they say that at some point, some of these, maybe some of these nonlinear tipping points are, will be kind of imminent, apparently. And merely decreasing the warming isn't gonna be enough. And we need to actively cool the planet with some form of geoengineering. So what are your thoughts on geoengineering?

• 1:39:26Speaker 07

  Yeah, so I have a whole chapter in The New Climate War. I'll talk a little bit about it in our fragile moment. Geoengineering or what could possibly go wrong?

• 1:39:36Speaker 02

  Right. Like Snowpiercer, you ever see that movie?

• 1:39:38Speaker 07

  Right, yes, yeah, there was also...

• 1:39:43Speaker 07

  It was an, there was an episode of this climate series that ran on one of the streaming services where they had a geoengineering sort of.

• 1:39:54Bob Novella?

  Mishap.

• 1:39:55Speaker 07

  Mishap, exactly. Oops. I think it involved, the problem is that, you know, it's being used mostly as a crutch right now, as an excuse for business as usual. I mean, who's really, you know, who is really pushing geoengineering is, you know, Rex Tillerson, you know, former CEO of ExxonMobil. Climate change is just an engineering problem. This idea that we can engineer our way out of it is sort of, it's a license to continue to, you know, to pollute. And as, you know, as we've already sort of alluded to here, this is not proven technology at scale. Like, yeah, it's theoretical at this point. There's no demonstration that it can be done at scale on the timeframe necessary, like carbon capture.

• 1:40:40Speaker 07

  Now, geoengineering, other things like sulfate aerosol.

• 1:40:43Bob Novella?

  Yes, in the stratosphere. I mean, that's something that we have lots of, we've seen it happen with volcanic eruptions. We know what it can, the impact it could have to the earth's salvo and stuff. So those are, that seems more interesting to me because you put those up there and in some studies show that diamond dust would apparently would be really efficient. Put them up there, they last for a while and they slowly.

• 1:41:04Speaker 07

  That sounds cheap.

• 1:41:05Bob Novella?

  It was, it was.

• 1:41:06Speaker 02

  A hundred trillion dollars.

• 1:41:08Bob Novella?

  A hundred trillion or 200 trillion, over 40, over four years.

• 1:41:12Speaker 02

  Yeah, 200 trillion.

• 1:41:13Bob Novella?

  Over 40 years, but I mean, it could be, they said 1.6 degrees cooling in that time.

• 1:41:17Cara Santa Maria?

  But here's the part that's so infuriating. It's like, I think about these, like, almost like a medical analogy, right? Like, if you don't want cavities, brush your teeth. Don't just extract the tooth every time you get a cavity. Like, if you're allergic to shell, don't just eat a bunch of shellfish and keep giving yourself.

• 1:41:32Speaker 02

  The medicine.

• 1:41:33Speaker 07

  I actually use that, I use that framing in a piece I wrote for BBC once, that, you know, you know, as sort of planetary doctors, if you will, we have an oath to first do no harm. And, and this violates that oath potentially because what you're describing, like, yeah, it's like, like a volcano, we know how it's during a volcanic eruption.

• 1:41:53Bob Novella?

  Acid rain, acid rain.

• 1:41:54Speaker 07

  Well, there's acid rain and it's also the climate that you get. If you, so the global, if all we cared about was the global average temperature, you can calculate how much sulfate aerosol you would need to pump in to cool off. But the problem is the, if you look at the pattern of the climate response to a volcanic eruption, it's not the inverse of the global warming pattern.

• 1:42:15Bob Novella?

  Right.

• 1:42:15Speaker 07

  So some areas will warm even faster.

• 1:42:18Bob Novella?

  Yes.

• 1:42:18Speaker 07

  Some will cool. The hydrological cycle globally over the continents is likely to slow down. So you get drying over the continents.

• 1:42:27Bob Novella?

  Oh, yeah.

• 1:42:28Speaker 07

  And then ozone depletion and other potential unintended consequences. So sort of the, it's the principle of unintended.

• 1:42:35Bob Novella?

  Yeah.

• 1:42:36Speaker 07

  And there's uncertainty, and uncertainty isn't our friend here.

• 1:42:38Bob Novella?

  Right.

• 1:42:39Cara Santa Maria?

  This is the largest system.

• 1:42:40Speaker 07

  Yeah.

• 1:42:40Cara Santa Maria?

  We are in this system. It's a stochastic system.

• 1:42:43Speaker 07

  Yeah.

• 1:42:43Cara Santa Maria?

  Everything we do changes it. And we got into this mess because we geoengineered.

• 1:42:48Speaker 07

  Yeah.

• 1:42:48Cara Santa Maria?

  I think that's the thing we have to remember.

• 1:42:49Bob Novella?

  Right.

• 1:42:50Cara Santa Maria?

  The extractive practices, the utilization, the burning. This is geoengineering. And we think we're going to geoengineer our way out, when what we could do is stop geoengineering so much.

• 1:43:00Speaker 07

  Yeah. Well, this actually came up at the VIP luncheon. Were any of you at that?

• 1:43:04Bob Novella?

  No.

• 1:43:05Speaker 07

  Okay.

• 1:43:05Bob Novella?

  Nah, we're not VIPs.

• 1:43:07Speaker 07

  I had an extra ticket. I would have given somebody.

• 1:43:10Speaker 02

  We were interviewing people.

• 1:43:11Speaker 07

  Yeah, I know, exactly. Got it. Yeah. It, we had a good sort of panel discussion. And, and one of the things that came up was like, it was, we were asked a question about time travel.

• 1:43:23Cara Santa Maria?

  I was going to say that.

• 1:43:24Speaker 07

  Yeah.

• 1:43:24Cara Santa Maria?

  I was just going to say that.

• 1:43:25Speaker 07

  And Neil deGrasse Tyson, you know, had an answer. Brian Cox had an answer, sort of. And then the question was posed to the physicist. I said, oh, wait a second. I was all but disinterested in physics. So let me give an answer, like a story about time travel. And I, the story that I used is like, when people asked me, is there any techno fix to climate that would work? I said, yeah, time machine.

• 1:43:45Speaker 02

  Right.

• 1:43:46Speaker 07

  That's the only techno fix that would, you know.

• 1:43:51Speaker 02

  That would fully work.

• 1:43:52Bob Novella?

  I'm afraid, though, that thirty, say thirty years, when it's bad, really bad, because I'm not very, as you know, I'm not very optimistic that we're going to get our shit together enough to, to make this not even more disastrous. Thirty or forty years, I could see some countries getting together and say, we got to do something dramatic now. Let's try this geoengineering. Hail Mary.

• 1:44:12Speaker 07

  You raise a good point.

• 1:44:13Bob Novella?

  Right, that's scary.

• 1:44:14Speaker 07

  Yeah.

• 1:44:15Cara Santa Maria?

  We don't have a global Government.

• 1:44:16Speaker 07

  Yeah. Exactly.

• 1:44:17Cara Santa Maria?

  That's a problem, yeah.

• 1:44:19Speaker 07

  And so you have people, and so you have people now looking at global governance issues. Like if we're, and I, I support that. Like even if you don't support geoengineering, we should be thinking about what we do in the event like a rogue country, like China decides it's favorable for its interests to. And, and part of the problem here is like one place cools at the expense of another place warming more. And so it becomes this very fraught sort of game theory problem. If you have individual actors acting in a way to try to optimize their own climate in a way that may be destructive to the global climate. Yeah, I don't want to be the sunny optimist Pollyannaish about it. I, I don't think it's too late to solve the climate crisis for the reasons that we've

• 1:45:04Speaker 07

  talked about, but I think we have a monumental battle on our hands. And the, the larger battle here is the, the battle to preserve democracy, to preserve fact-based discourse and the, the notion of objective truth.

• 1:45:19Speaker 02

  Yep.

• 1:45:19Speaker 07

  You know, which, and you know, which you guys are all about.

• 1:45:23Speaker 02

  They're saying the solution is to become a patron of the SGU. That's what I'm, that's what I'm hearing.

• 1:45:27Speaker 07

  That's what I heard. That it is. That's my truth. And I'll be looking for the check in the mail. Thank you very much.

• 1:45:34Speaker 02

  Yeah, absolutely.

• 1:45:36Jay Novella?

  We pay in bubble gum now.

• 1:45:39Speaker 02

  Well, Michael, thank you so much for sitting down with us. This was great.

• 1:45:42Speaker 07

  It was a pleasure, guys. Thanks.

• 1:45:43Jay Novella?

  Thank you.

• 1:45:43Speaker 07

  Thank you. Thank you.

• 1:45:57Speaker 02

  Each week I come up with three science news items or facts, two real, one fake. And then I challenge my panel of statistics to tell me which one is the fake. Three regular news items. You guys ready this week?

• 1:46:08Jay Novella?

  Let's do it.

• 1:46:09Speaker 02

  All right, here we go. Item number one, analysis of a Martian meteorite indicates the presence of bodies of liquid water on the surface of Mars as late as 742 million years ago. All right, number two, a recent study finds that doctors using ChatGPT plus as an additional aid did no better at making diagnoses than those using only traditional methods. And all right, number three, in an animal study, researchers have demonstrated the ability to deliver functional mRNA through inhalation.

• 1:46:43Speaker 02

  Kara, go first.

• 1:46:44Cara Santa Maria?

  Okay, so scientists analyzed a Martian meteorite and found the presence, or found something indicative of the presence of bodies of liquid water on the surfaces of Mars as late, does that say 742?

• 1:47:00Speaker 02

  Yep.

• 1:47:00Cara Santa Maria?

  Million years ago. Yeah, I have no idea when the liquid dried up, but I do think there was liquid. A recent study finds that doctors using ChatGPT Plus, I don't really know, is that just like the most recent one?

• 1:47:12Speaker 02

  Basically.

• 1:47:13Cara Santa Maria?

  What's the difference? Okay. As an additional aid, did know better at making diagnoses than those using only traditional methods. Well, there's so much here. Like, what were they diagnosing? Like a strep throat? Or were these complex, complicated things? And then item number three, in an animal study, researchers have demonstrated the ability to deliver functional mRNA through inhalation.

• 1:47:34Speaker 02

  Meaning that it gets into the system and it functions. It does what it's supposed to do. It takes up shop, makes proteins.

• 1:47:41Cara Santa Maria?

  Right. So I could see them doing that with some sort of viral vector. You inhale the virus and then it, you know, inserts itself. I don't know, that one doesn't bother me that much. I have no idea the age of the water, though, so that's problematic. And then the ChatGPT Plus, no better at making di- There's just too many unknowns in this one. I believe that would be the case if they were diagnosing strep throat. I do not believe that would be the case if they were diagnosing some sort of kind of infectious disease that required understanding of tropical medicine or differentials that weren't common.

• 1:48:16Speaker 02

  I mean, I'll say, they were challenging diagnoses, otherwise-

• 1:48:19Cara Santa Maria?

  They were?

• 1:48:19Speaker 02

  It would have been a pointless study, yeah.

• 1:48:21Cara Santa Maria?

  Yeah, I agree. So I think, I think in that case, then the ChatGPT Plus one is the fiction. I think that probably it did help to be able to ask. Wait, real quick, though. When you say "traditional methods," does that mean they were still able to, like, look stuff up in books?

• 1:48:37Speaker 02

  Yeah.

• 1:48:37Cara Santa Maria?

  Oh, hmm. Yeah, so they were still following a standard differential model? And they still had access to all the same information? Ugh. Okay, then I'll go with Mars. Maybe the date's wrong. I don't know.

• 1:48:50Speaker 02

  Okay, that's your answer?

• 1:48:52Cara Santa Maria?

  Yeah, I don't know.

• 1:48:53Speaker 02

  Okay, Bob?

• 1:48:54Bob Novella?

  Yeah, Martian meteorite. Yeah, that kind of makes sense. I don't have a, see any problems with that.

• 1:49:00Cara Santa Maria?

  Oh shit.

• 1:49:01Bob Novella?

  Uh, let's see, go to, um, three, the MR, inhaling mRNA. Yeah, I agree with Kara. Uh, if there's a viral vector, that makes a lot of sense, but I mean viral vectors are scary. Would they use that route? And then if they had a viral vector, why, we'd necessarily even need to use it for inhalation. But it kind of makes sense. But, uh, ChatGPT, yeah, I mean, I think there might be, I don't know, maybe, unless you're using ChatGPT with a specific medical database. If you're just using, I'm not aware of the, uh, the ins and outs of ChatGPT plus. But I think there, there might be a lot of, um, you know, medical misinformation mixed in, in there.

• 1:49:44Bob Novella?

  So generic ChatGPT might not be a great source for that kind of stuff. But, uh, it wouldn't, it wouldn't surprise me either way, but I'd say ChatGPT is fiction.

• 1:49:51Speaker 02

  Okay, Evan?

• 1:49:52Speaker 04

  Yeah, so the Mars meteorite as late as 742 million years ago with, uh, with indications of liquid water. I, we know there has been liquid water on the surface of Mars, but when? And a meteorite revealing that seems, I don't really see anything wrong with this one. Nothing is, is saying, hey, red alert, this doesn't jive. I, I think that's in sync with, with what's understood about Mars. But that we found it is kind of cool. The ChatGPT one, this is the one I think lends itself the most being the fiction. Only because, and no, for, not for any technical reasons, just for a guess reason.

• 1:50:34Speaker 04

  Because it reads here, as an additional aide did no better at making diagnoses. So that means if it's, it would be fiction if it did better or worse. So you kind of have two directions you can go with this one. So I think that opens up the possibility that that one's fiction a little bit more. And the last one, I don't, I know nothing about, um, you know, mRNA through inhalation. And just by what I heard Kara and Bob say, yeah, I'll say that one's science. So ChatGPT, I'll go with Bob. Fiction.

• 1:51:06Speaker 02

  And Jay.

• 1:51:07Jay Novella?

  The Martian one, I mean, I have no reason to think that the 742 million years ago, water thing, like I just, there's no reason to not believe that. Like, there's just no information in here that you can contest other than the date. And it makes sense, you know? I mean, I can't contest it in any way, so I'm just gonna assume that one is science. The second one about the ChatGPT being used as a diagnostic tool, does it actually help physicians or not? You know, if they have access to the latest information, it would be no different than asking ChatGPT if it has the latest information. The thing that I wouldn't want ChatGPT to actually do, though, is give any kind of medical advice. So I just don't think that's

• 1:51:52Jay Novella?

  a good thing to do anyway. Now, if they specifically programmed ChatGPT with very specific information and instructions, it might, it might help. I mean, I think it would definitely speed things up at the very least. But I just don't think today that, that it's there. I don't think that that's it. So I'm definitely very suspicious about the, you know, breathing in an mRNA and have it function. It can, you know, I know that breathing certain things in is a vector, right? It does work for certain things. I just don't think it would work for this. So I'm gonna say that one's a fiction.

• 1:52:27Speaker 02

  Okay, so we're spread out.

• 1:52:29Cara Santa Maria?

  Ugh, I hate going first. I disagree with my answer.

• 1:52:32Speaker 02

  You wanna change your answer?

• 1:52:33Speaker 04

  Oh, no. You wanna change?

• 1:52:34Cara Santa Maria?

  I do, but I can't.

• 1:52:35Speaker 04

  Is that true?

• 1:52:36Speaker 02

  Well, you change your answer.

• 1:52:36Jay Novella?

  We don't do that.

• 1:52:37Speaker 04

  Whoa, I didn't think that was possible.

• 1:52:39Cara Santa Maria?

  He's never let people do that. I will stick with my answer, but I think the ChatGPT one is the fiction.

• 1:52:44Speaker 02

  Okay. Well, let's start with number three. We'll go backwards.

• 1:52:48Speaker 04

  Oh, fuck.

• 1:52:48Speaker 02

  In an animal's body, we should have demonstrated the ability to deliver functional mRNA.

• 1:52:52Speaker 04

  Can't say that.

• 1:52:53Speaker 02

  Through inhalation. Jay, you think this one is the fiction. Everyone else thinks this one is science.

• 1:52:56Speaker 04

  Not anymore, he doesn't.

• 1:52:57Speaker 02

  And this one is science. Yeah, sorry, Jay.

• 1:53:01Speaker 02

  What do you guys think? It's not a virus. And so if it's not a virus, what did they, what are they using as the carrier, as the carrier for the mRNA? Because it can't just be

• 1:53:08Cara Santa Maria?

  Fact.

• 1:53:09Speaker 02

  Naked mRNA.

• 1:53:10Bob Novella?

  Lipids. Crisper?

• 1:53:11Speaker 02

  Lipids, lipid what?

• 1:53:13Bob Novella?

  Oh.

• 1:53:13Cara Santa Maria?

  Nanoparticles.

• 1:53:14Speaker 02

  Lipid nanoparticles. Lipid nanoparticles.

• 1:53:17Cara Santa Maria?

  Didn't you just do a lipid nanoparticle story last week?

• 1:53:20Speaker 02

  Yeah, lipid nanoparticles are magic, man. No, they are, they are great. It's a great technology. So they, they use lipid nanoparticles to house the mRNA. So basically it becomes aerosolized or nebulized, then you breathe it in, it gets into the lungs, it sets up shop, and they, they, they tested it in mice, and it was just producing a marker. Um, and they, and it was, you know, it sustained production of the protein that it coded for, I think it made it light up or something. Now, this, this was also fixing an earlier problem, because they had tried to use lipid nanoparticles previously for this aerosolized or nebulized delivery of mRNA. The problem was that the nanoparticles clumped together, and then they got too big. And then that would provoke an immune response. And so,

• 1:54:05Speaker 02

  which remember, that was the problem with the other lipid nanoparticle news item that I talked about. So this study was figuring out how to keep the lipid nanoparticles from clumping, so that they could, they could remain individual, and they could deliver their mRNA to the lung cells. And it worked. Yay. So this could be, um, a way, you know, in the future, we may like be inhaling our mRNA vaccines. No more shots, right? Or inhaling mRNA drug deliveries, you know. So this is a...

• 1:54:32Cara Santa Maria?

  Yeah, that's cool. We're already inhaling, what, flu vaccine?

• 1:54:36Speaker 02

  Yeah, yeah, yeah, yeah.

• 1:54:37Bob Novella?

  Did that come back? I thought they stopped doing that.

• 1:54:40Cara Santa Maria?

  Oh, I don't know. But I mean, it has, it has been available.

• 1:54:42Speaker 02

  We have the technology to do that. Yeah. If it's a live virus.

• 1:54:45Bob Novella?

  We have the technology.

• 1:54:45Speaker 02

  Only for live viruses.

• 1:54:47Cara Santa Maria?

  Oh, I see.

• 1:54:47Speaker 02

  Yeah. And that's why they didn't want to necessarily, it was because it was a live virus, not because it was inhaled. Um, so yeah, this is an animal study, so it's got to go through, they're gonna, it was in mice, they gotta do bigger animals, and then people, and then, so you know, five to 10 years, whatever.

• 1:55:02Speaker 02

  I guess we'll keep going back. A recent study finds that doctors using ChatGPT Plus as an additional aid did no better at making diagnoses than those using only traditional methods. Bob and Evan think this one is the fiction. Cara thinks it's the fiction, although she didn't choose it officially. Jay thinks this one is science, and this one is

• 1:55:21Speaker 04

  Say it.

• 1:55:22Speaker 02

  Science.

• 1:55:23Speaker 04

  What?

• 1:55:23Cara Santa Maria?

  Oh, no.

• 1:55:25Speaker 04

  Bullshit.

• 1:55:26Cara Santa Maria?

  Shut up.

• 1:55:27Speaker 02

  Holy moly. What the hell? Cara, man, you managed to pull it out.

• 1:55:31Cara Santa Maria?

  Oh, my.

• 1:55:32Speaker 04

  Wow, awesome. That's exciting.

• 1:55:35Speaker 02

  Talk about being right despite being wrong.

• 1:55:37Cara Santa Maria?

  That is amazing.

• 1:55:39Speaker 02

  Yeah, so yeah, they did no better. Now, again, this is an additional aid, meaning that the doctors in the group using ChatGPT had access to everything the other group had, plus ChatGPT Plus.

• 1:55:52Cara Santa Maria?

  Right.

• 1:55:53Speaker 02

  And it did not help them make any more accurate diagnoses. But here's the interesting thing I didn't include in the science of fiction. When they compared those two groups to just ChatGPT by itself, ChatGPT outperformed both groups of physicians.

• 1:56:10Speaker 04

  You should have included that.

• 1:56:11Cara Santa Maria?

  Fascinating.

• 1:56:12Speaker 02

  Even the group of physicians using ChatGPT, which means that the introduction of a physician resulted in less accurate diagnoses.

• 1:56:21Speaker 04

  Goodbye, doctors. So much for all those boards and stuff.

• 1:56:25Cara Santa Maria?

  That is bananas.

• 1:56:27Speaker 02

  So, I know, it's crazy.

• 1:56:28Cara Santa Maria?

  So they were asking it more specific questions by then, as opposed to just blanket saying, what does this person have based on these symptoms?

• 1:56:35Speaker 02

  Well, what the authors concluded, they did not conclude that we should therefore be having ChatGPT make diagnoses. What they said was, clearly, we need to teach physicians how to optimally use these large language models as a diagnostic assistant, because they're not using it right. Whatever, they were just, they didn't help them get to a more accurate diagnosis, or clearly, they were not leveraging that technology, even though it is capable of making a more accurate diagnosis by itself, which is, I don't know, it's incredible. Which means that analysis of a Martian meteorite indicates the presence of bodies of liquid water. On the surface of Mars as late as 742 million years ago is the fiction.

• 1:57:16Bob Novella?

  So here I'm looking at here, I'm looking at a goddamn article that says meteorite contains evidence of liquid water on Mars 742.

• 1:57:23Speaker 02

  I know, I know. That's exactly that is the title of the article.

• 1:57:26Speaker 04

  Cool, then we were right.

• 1:57:28Speaker 02

  And I was hoping I was hoping that people who read that headline, but didn't read into the the article itself, especially the actual article.

• 1:57:38Speaker 04

  Oh, we need the headline.

• 1:57:39Speaker 02

  The press release would would not have picked up on the fact that they're not saying that there was liquid water on Mars because liquid mortar water on Mars dried up three billion years ago. And what they're saying was that there was probably still some geologic activity, like some some volcanic activity, which there still is in pockets on Mars, that that activity melted the permafrost, causing a pocket of liquid water and that that water affected the crystallization of the minerals in the meteorite that ultimately became a meteorite on Earth, you know, from Mars. Interesting. Yeah, so that was that was a deception. But yeah, if you've just read the headline,

• 1:58:21Speaker 02

  you might be, it was it was water, deep water interacting with rock, not water on the surface of Mars. Evan, give us a quote.

• 1:58:30Speaker 04

  Here it here it is. Steve, you requested this quote.

• 1:58:34Speaker 02

  Yes, I like this quote.

• 1:58:36Speaker 04

  I have a foreboding of an American my children's or grandchildren's time when the United States is a service and information economy, when nearly all the key manufacturing industries have slipped away to other countries, when awesome technological powers are in the hands of a very few, and no one representing the public interest can even grasp the issues, when the people have lost the ability to set their own agendas or knowledgeably question those in authority. When clutching our crystals and nervously consulting our horoscopes, our critical faculties in decline, unable to distinguish between what feels good and what's true, we slide, almost without noticing, back into superstition and darkness.

• 1:59:21Speaker 04

  The dumbing down of America is most evident in the slow decay of substantive content in the enormously influential media, the 30-second soundbites now down to 10 seconds or less, lowest common denominator programming, credulous presentations on pseudoscience and superstition, but especially a kind of celebration of ignorance. And we should all know that as Carl Sagan from his book, The Demon Haunted World, if you do not have a copy, you must, must go get a copy, along with a copy of our book, The Skeptic's Guide to the Universe.

• 1:59:57Speaker 02

  Written in the 90s and, you know, basically very prescient, you know?

• 2:00:01Speaker 04

  My gosh.

• 2:00:02Speaker 02

  In terms of, you basically nailed it.

• 2:00:04Cara Santa Maria?

  I may have shared that on my socials the day after the election.

• 2:00:08Speaker 02

  I know, this was very, a lot of people were sharing, it's like, yeah, we gotta read this, because this is unfortunately true. The idea that, this is my giant frustration with this year, is that the media does not meaningfully inform the electorate that people do not understand the issues well enough to make an informed decision, and basically the majority of people are susceptible to propaganda and manipulation and this kind of lowest common denominator kind of arguments, and it's very disappointing.

• 2:00:41Speaker 04

  Hugely. We're gonna have some choice things to say about it at our year-end review show in a few weeks.

• 2:00:49Cara Santa Maria?

  Oh, yeah.

• 2:00:50Speaker 02

  We have a lot of work to do. The information ecosystem of America is broken, in my opinion. And, we've been saying this for years, this is nothing new, you know, this is, it's just getting worse, you know, with social media and everything, the loss of good science journalism, the loss of good journalism, period, the, you know, rise of essentially propaganda media, it's just, you know, we've lost our ability to make informed decisions as voters in this country, at least in sufficient numbers that reality holds sway. You know, the, the influence of reality and facts on people's decisions is too small, you know, to be definitive like it should be. Unfortunate. Okay.

• 2:01:35Speaker 02

  That's the world we're living in. Thank you all for joining me this week.

• 2:01:39Speaker 04

  You're welcome. All right, Steve.

• 2:01:41Speaker 02

  And until next week, this is your Skeptic's Guide to the Universe.

• 2:01:48Speaker 02

  Skeptic's Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to [email protected]. And if you would like to support the show and all the work that we do, go to patreon.com/skepticsguide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.

• 2:02:25Speaker 02

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