My piano was tuned the other day. It’s been a while. We’ve been in our current house for almost twenty three years, and it hasn’t been tuned all the time that we’ve been here. Before that it was in our house in Glasgow, and before that a flat in Edinburgh. It had been moved there down several spiral flights of stairs from a third floor tenement flat in Edinburgh. So it has travelled around throughout my adult life, since the days when I would daydream rather than practice in the front room of my Granny’s tenement flat in Glasgow’s east end. And that, it turns out, is only a small part of the story of this particular piano.

As far as I had known, it was bought from a shop in Duke Street, Glasgow, some time in the 1950’s by my “auntie” Mary (actually a great aunt). It was later, in the 1960’s, that it was moved to my Granny’s front room, where I encountered it most weeknights. I’m sure I started piano lessons with the best of intentions; they lasted barely a fortnight, the lessons lasted much longer. I went to lessons for about eight years – poor Mrs Stephenson (my long-suffering piano teacher). I didn’t know if Auntie Mary had bought the piano new, but I do now. When the piano tuner removed the front of the piano, both top and bottom, to get at the mechanism, in addition to some mould and a broken dampener, the most significant thing to be seen was a label that I assume was affixed when the piano was new. It listed the dates of the first few tunings along with the initials of the tuners. The date of the earliest tuning was in 1903 - my piano is about 120 years old. It is in fairly good nick for its age, especially now that it is approaching being in tune for the first time in a while. Gets you thinking though.

I met all four of my grandparents, although my paternal grandparent both died when I was a small boy. It is worth noting that it is only relatively recently that knowing your grandparents became common. When my piano was first tuned, average male life expectancy in the UK was only about 45 years. According to the latest ONS figures, average life expectancy is now around 80 (and greatly improved from the 68.1 for my birth cohort). These numbers are population averages and hide vast variation. The 20^th century was a tough one for many. After all, there were two world wars and the privations that came with them. Disease for many was an ever present, potentially fatal threat. The pandemic has reminded us of how modern medicine has improved our lot. In the mid 20^th century, infectious diseases like TB were still killing large numbers of those infected (the pre-WW2 case fatality rate was about 50%), and childhood diseases like measles still killed hundreds every year. Polio, in the news recently, was a major scourge. I remember, as a child, visiting a family friend who was in an “iron lung”, the result of a polio infection. The antibiotics that became widely available after the war, and the childhood vaccines that were gradually introduced, fundamentally transformed this health landscape. The net result of this, plus other innovations like the NHS, improved diet, improvement in air quality because of the clean air acts, is that my children have known all four of their grandparents, and I (maybe/probably) might get to know mine.

Back on the subject of old age and music, we had the sight and sound last week at Glastonbury of the 80-year-old Paul McCartney introducing those two young whippersnappers Dave Grohl (a mere 53) and Bruce Springsteen (72) to the crowd during an acclaimed set lasting almost three hours. It was a reminder that by and large we are not only living longer lives, but we’re remaining healthy into old age. All things being equal, I might have quite a long time to enjoy my newly in-tune(ish) piano. And I get to enjoy other things too. I celebrated my own 60^th birthday this week (hence all this meditating on age). So the other day (as a special treat) we made our way into town and I obtained my Merseytravel over-60s travel-pass. The (Merseyside) world is now my free oyster, although only after 9.30am and at weekends. I have no idea if I will actually avail myself much of this new-found freedom of buses, trains and yes, the famous Mersey ferry. But it’s the principle that counts. I don’t have quite the same life to reflect on as Macca; he has been a cultural icon for at least sixty of his eighty years. But my life, the only one I have to ruminate on, has been truly blessed, and by much more that even living in Liverpool.

Many things have changed over my sixty years, and many things will change should I have twenty or so more. But for fifty of my sixty years there has been one constant. One of the things I was blessed with was parents who know and love Jesus, and so introduced me to Him. This was about example, not coercion. For reasons we needn’t go into, at the age of ten I asked Him (as it seemed to me) to keep me safe (I had something pretty specific in mind that I wanted to be kept safe from). I had no deep understanding of what I was doing, or its implications, but something fundamentally changed at that point which has shaped my life since, and indeed my eternal destiny. My understanding has grown. I am surer now of the basis on which I made my commitment to Him, and I am clearer about His commitment to me. This is not a symmetrical relationship; how could it be? But it is a relationship that goes both ways. The basis of that transaction (for that’s how I saw it) was all to do with who He is, and what He accomplished in His death two millennia ago. That basis is unchanged and unchanging – it is His grace through which His benefits have continued to flow to me.

There have of course been bumps along the way. There always are in real life. And there will be more. But when knocked of out of tune, He always has the skill to set me right; He has perfect pitch.

Life in the Pandemic X: Exacerbating uncertainty

 Many things in life are uncertain (apart from death and taxes obviously). And many things are uncertain in science. Indeed identifying, controlling and quantifying uncertainty is a key aspect of the practice of science. We’re so keenly aware of uncertainty that we try to dissuade students of talking about science “proving” things, as though in any given situation absolutely all uncertainty can be removed. We don’t think that it can be, and we can therefore never be “certain”. What we seek to do is accumulate evidence supporting a particular explanation for a given phenomenon so that it moves from being highly provisional (a hypothesis), to being fairly probably the correct explanation (a supported hypothesis), to being the best and most highly supported explanation we have (at which point it’s  usually elevated to the status of a theory). This takes time and effort. Even so, we also accept that the most accepted theory, with apparently lots of supporting evidence, can always be superseded by a new theory. This might be an extension of the original theory, or indeed a contradiction of it. But this whole approach raises  problems. It is tricky to explain (as you may have noticed), and it’s not the way most people think or speak most of the time. These problems (and why they matter) have been amply exposed by the pandemic.

Let’s start with the language problem. There are situations where certainty is conflated with clarity. In a startling reversal of form for the particular bunch of politicians currently running the UK, the pandemic mantra has been “We’re following the science, therefore….”. This is a reversal because it suited them in a previous situation (ie the Brexit debate), to downplay the view of “experts”. But as I’ve noted before, in the pandemic, this has changed. Experts are in; but uncertainty is not out.

Politicians and the media, are very keen on what they call clarity. But COVID19 is a virus new to  humans, and therefore new to science. Nothing was known, indeed could be known, about it (although things could be inferred). Early in the pandemic, at the time when many key decisions were being taken, the science was more than usually uncertain, and therefore the scientific advice to politicians had to be highly caveated (this is an assumption on my part, I wasn’t privy to it). But this doesn’t make for snappy press conferences. And it almost certainly guaranteed that the advice would change, and therefore the instructions issued by politicians would have to change (example: face masks). The media don’t particularly help in such situations. Their stock in trade is the language of u-turn and climb-down. It might have been wise to clearly communicate from the start that the course of action being embarked upon was based on a consensus of what, given the evidence at the time, was reasonable. Not certain, but reasonable. Problem is, would any of us reacted as we need to if the politicians had spoken this way?

To be fair to them, there have been some sceptics and deniers who have been happy to jump up and down and accuse them of exaggerating the danger of the situation for nefarious political ends. They have pointed out that for all the talk of half a million UK dead and the NHS overwhelmed, this was not the disaster that developed. But this is to miss the point. The one experiment that could not be done was the one that involved doing nothing and essentially letting COVID19 run its course. So on the basis of (suitably caveated) advice, we had our lockdown. And while we can’t be certain (that is, after all, the point I’m making), the difference in case and death curves (eg see here) between most EU countries (including the UK) and others like the US and Brazil, suggests that this was indeed a sensible course of action. As an aside, we have to now hope that we don’t blow it, and revert to the earlier trajectory that could lead to disaster. However, at least some of the critics seem to suggest that with all the uncertainty involved, essentially nothing should have been done. Action should only have been taken once all doubt had been removed. But then that would have meant nothing would have been done. And many thousands more would have died, deaths that we have almost certainly avoided. It will perhaps be possible to demonstrate this statistically, once more  evidence has accumulated. But at the point the big political and economic decisions had to be taken, actual evidence was scarce.

We have heard this sort of call to wait for certainty before, both in another contemporary context and historically. And it’s here that the language problem, and the complexity problem intersect. Climate change, its cause, effects and what we should do about it (if we can do anything about it), is undoubtedly complex. The idea that it is caused by human activity (primarily the burning of fossil fuels from the industrial revolution on, increasing atmospheric CO₂) has been a matter of overwhelming scientific consensus for decades ie we’ve gone beyond hypothesis, supported hypothesis, and theory to consensus. Even still, scientists in this area will probably be unwilling to say they have no doubts, that the relevant theory/theories have been “proved” in some absolute sense. That’s just not the appropriate language of science. But that allows others to come along and say that the science is uncertain, there are alternative explanations or the whole thing is just a hoax. Here, a legal analogy might help.

I served on a murder jury some years ago. We were faced with the weighty decision of whether the prosecution had proved its case beyond reasonable doubt. Notice that you can still convict and have doubt. The question is whether the case is proved beyond reasonable doubt. One can always come up with lots of “could be’s” and “might have beens”. But if they fly in the face of the evidence, or are not supported by evidence, then they are not reasonable. And if they are not reasonable, they is no reason to pronounce the defendant “not guilty”. If the scientific consensus around climate change were a defendant in the dock, although there are doubts and uncertainties, they would be ruled out by the evidence as unreasonable, a guilty verdict handed down, and the jury would go away and sleep soundly, their duty done. And yet the uncertainty, complexity, and the language of science conspire to provide a space for those who say we should do nothing because we are not 100% certain, precisely at the time when action has to be taken.

At least some who operate in this space are following in a fairly inglorious tradition that has been exposed several times. They seek to foment doubt and increase complexity, obfuscate evidence and exacerbate uncertainty. They explicitly seek to sow doubt, of the unreasonable sort. The approach was famously summarised by a cigarette company executive in the 1960’s in a now infamous memo which stated “Doubt is our product since it is the best means of competing with the ‘body of fact’ that exists in the mind of the general public.”(1). What followed was essentially a well funded disinformation campaign of epic proportions. Meanwhile, cigarettes continued to be manufactured, sold and consumed and contributed to the early deaths of millions. The story of this and similar campaigns is expertly revealed in its gory detail by David Michaels in his books (2,3). And there’s evidence that there are commercial and other interests playing the same game with climate change. Stir up doubt, exacerbate the uncertainty, and the public will conclude that either the issues are so complicated and unclear that it would be premature to take action (like ban smoking or increase tax on gas guzzlers), or that the inconvenience of action is not worth uncertain benefits.

This kind of thing is happening in the pandemic. Reasonable people are not taking reasonable actions because, particularly in the US, misinformation is being spread and uncertainty is being exacerbated. The scary bit is that when the much hoped-for vaccine becomes available, we all know it’s likely to start over vaccination against COVID19. But, to resort to some unscientific language, you can be sure that wearing a mask and washing your hands frequently at the moment, and getting vaccinated once one or more vaccines have passed through the requisite trials, is a really good idea. I don’t doubt it.

 1. Michaels D (2005) Doubt is their product. Scientific American 292(6):96-101 (available on Research Gate: https://www.researchgate.net/publication/7806937_Doubt_Is_Their_Product)

 2. Michaels D (2008) Doubt is Their Product. Oxford Univ. Press

 3. Michaels D (2020 )The Triumph of Doubt: Dark Money and the Science of Deception Oxford Univ. Press

Don’t be duped (or even gooped….)

I may have invented a new word. As far as I can tell there is currently no verb “to goop”. However, goop does exist as both a common and proper noun. In the dictionary “goop” is defined as a sludge or slimy concoction. “Goop” (capital G) is a completely different box of frogs. It started off as a newsletter, authored by the actress Gwyneth Paltrow. It has since become a money-spinning “lifestyle brand”, and most recently, in the form of “The Goop Lab”, a 6-part Netflix “documentary” series. There is of course the obligatory website, a cursory look at which suggests that Goop is primarily a shop window for expensive cardigans and handbags, quack remedies and lifestyle hacks. To be fair, you’ll find various disclaimers on the website, and in Netflix series, that those behind Goop are not making medical claims. However, if people don’t buy their stuff they don’t make any money, so I suspect the hope is that the disclaimers will be quickly passed over and forgotten as you move on to various opportunities to part with your cash. I confess I’m not fashionable and I’m tight with my cash, so Goop wasn’t really on my radar. That is until the boss of the NHS mentioned it in a recent speech.  

Sir Simon Stevens is the Chief Executive of the National Health Service in England. He is clearly frustrated by health “fake news” and more importantly its effects. Political fake news is bad enough. And you could argue that it has led to a number of alarming consequences in recent years. But health fake news can have fatal consequences. Essentially his charge was that Goop, particularly with the reach given it by Netflix, was spreading health fake news widely and quickly.  In his remarks he grouped Goop with snake oil salesmen and anti-vaxers. It was, in his view, not a source of useful, health-related information. Nor was it providing health-related but basically harmless entertainment.

In response, beyond the widely reported and relatively anodyne statements put out by Goop directly, Gwyneth herself went on the record to reject this criticism. She feels it is unfair primarily because she claims that Goop doesn’t give health advice at all. And it might be that that the professionals are just over-reacting to bit of entertaining fluff, with the expected sniffiness of professionals and “experts”. One Guardian columnist while agreeing with what Stevens had said, reckoned there wasn’t too much to be concerned about. The public were smart enough to work out that Goop was an over-priced, modern snake oil operation. “It’s just a wellness brand – expecting it to hold toscientific/medical criteria is like expecting a lip gloss to do a handstand.” I’m not sure I get the allusion, but you get the idea.

So what about Gwyneth’s claims that advice isn’t being issued and scientific claims are not being made? On the Goop UK site, under the “About” tab, it’s not too difficult to find language that at least drops heavy hints that both scientific and medical thinking are central to Goop’s operations. Under “Wellness” we read “We have a tightly edited wellness shop of products vetted for efficacy by our in-house research scientists, and we’ve also created five vitamin and supplement protocols with doctors to cover all the bases.” (emphasis mine). And as for the Netflix series, it is called the Goop lab. I accept that on one level this all falls short of clinical advice and scientific claims. But at the very least there is a particular kind of signalling going on. It strikes me that they want a veneer of intelectual respectability, and think this comes from signalling the involvement of a degree of scientific and medical competence.

This isn’t just me being over sensitive (I am after all a scientist, and I do clinical research). Or if it is, I’m not alone. Dominic Pimenta, a cardiologist writing in the Independent put it this way:  “The problem is that the Goop“lab”  gives itself the appearance of scientific rigour, while in fact offering pseudoscientific laziness: they cite“trials and experiments” without evaluating them, and talk to “practitioners and doctors” without critiquing their conflicts of interest (of course the largest conflict of interest on the show is Goop's, a billion-dollar brand selling, among other things, alternative health products).” It appears Gwyneth and her chums want the respectability that comes from hinting that they are taking a scientific and responsible approach, without doing any of the hard (and expensive) work that this entails. This would after all impact on the bottom line.

Of course part of the problem is that we don’t really need Goop to tell us how to be well at all. We know what leads to wellness, and it is not expensively packaged supplements, coffee enemas, and various beads and balls stuck in unmentionable places. It’s simple, boring stuff like a diet with plenty of fresh fruit and veg, a reasonable amount of exercise and as much sleep as you need. Accompany these with a degree of intellectual stimulation (analogue or digital) and engagement, and a network of meaningful human relationships and psychologically you’ll probably be the right side of fine. None of this costs a fortune or need involve Goop or any other website.

Mind you, this will only keep you in temporal (and therefore temporary) good nick. Without wanting to sound deliberately preachy (which of course means I am about to), while these simple measures will keep us in good physical and psychological health, they won’t ultimately satisfy our most basic need. At the beginning of his “Confessions” Augustine of Hippo pointed out that “..our heart is restless until it finds its rest in you.” It’s that restlessness that Goop and much else in modern life seeks to address or at least distract us from. Inevitably it fails.

Don’t be duped. To quote the Psalmist: “For he satisfies the longing soul.” (Psalm 107:9). The "he" in this case is of course the God who created and sustains us (whether we recognise it or not).