Recent attacks on science are frightening. They are so cavalier and unfounded. They totally disregard the fact that our lives depend on science and its discoveries in our everyday lives, the lives of our children, and generations to come.
I have spent the overwhelming part of my post-high school lifetime studying about science. Biology, physics, chemistry, biochemistry and more in college; anatomy, physiology, pharmacology, psychology, microbiology, immunology and more in medical school; pathophysiology, infectious disease, development, radiology, psychiatry, genetics and more in pediatric and medical genetics training programs. And then ongoing continuing medical education, journal reading and conference attendance for my over 44-year clinical career.
Such activities are not unique to me but shared by those in the medical professions and by others in the other sciences. We embrace science. A straightforward definition for science reads – the pursuit and application of knowledge and an understanding of the natural and social world following a systematic methodology based on evidence.
Science is a basic element of so many actions in our lives. It encompasses almost every action and reaction in our lives. Yet some folks see it as just high-brow stuff for intellectuals or the immeasurable stuff of the oft-maligned social sciences. And some folks see it as just plain antithetical to their faith journey. I would argue that to ignore the past, present, and future contributions of science is to our peril. To develop new technologies, to make informed decisions, and to solve problems of importance to all of us, science and scientific knowledge must be at the forefront of our individual and collective decisions.
Trusting science can be real challenge in today’s environment. When sound scientific advice is questioned by those with no understanding of scientific principles, the ensuing noise can drown out the reasoned advice. Most folks seem to think that science is fixed and unwavering. While the analytic principles are such, the processes (receiving data, interpreting data, adapting responses to existing and new data, then repeat this cycle) can lead to changing advice that is misinterpreted as flip-flopping or, worse yet, the idea that the advice is not trustworthy. The COVID-19 pandemic has taught us that advice one week might pivot the next week based on the constant review of the data. In such situations, naysayers have a heyday, touting that the scientists do not know what they are talking about. Quite the contrary, the scientists (and in the case of the pandemic, the public health officials) are using information that can be fluid yet still analyzed with sound scientific principles to provide the best information in the moment for the benefit of society. Might that information change when more data is available? Absolutely! That is the benefit of science leading the way.
Scientists are taught to “listen” to the data and adapt accordingly. Sometimes that even means reversing course. For example, today’s anticipated cancer wonder drug might prove to have unacceptable toxic side effects. An appropriate and timely analysis of the drug and its early use can detect these effects and make sure that they are mitigated or even eliminated. That is why we have rigorous standards for drug trials in our country to assure patient safety.
A recent article by Stephen Hall1 makes a dramatic point about science and children by stating that “It’s a cliché to say children are the most vulnerable members of society, but over the past three decades, scientists have established this as a physiological fact. Children eat more food and drink more water per unit of body weight than adults. They breathe more rapidly (and tend to breathe that air close to the ground). Those facts alone make children particularly susceptible when they are exposed to chemicals and pollutants. But that is especially true in the prenatal period and during early childhood, when the brain undergoes tremendous development.”
Pediatricians are physicians…and scientists. We take Mr. Hall’s words seriously. Why? Pediatricians are staunch advocates for children and oftentimes, and we can be downright annoying in our persistence to make a positive difference for children and families.
Medical decisions are made with science in mind because science matters. And science matters more than ever now. Science instructs care and advances how we improve the lives of our most vulnerable citizens and their families. Let’s discuss some examples.
- Vaccines—one of the absolute joys in my medical career is the progress in the eradication of lethal infectious diseases. Fortunately, I have never seen a case of polio, and now some forms of meningitis where I signed death certificates have been eliminated thanks to vaccines. HPV vaccine can prevent cancer. COVID-19 vaccine was developed with amazing alacrity and shows similar effectiveness to other vaccines. And vaccines do not cause autism!
- Antibiotics—in the middle of the last century, antibiotics started to be used. Their use has made an incredible difference in the treatment of so many diseases. But in the spirit of advancing care and using science, the discovery was made that antibiotics can be overused. Antibiotic overuse can be detrimental to patients and equally important, it can be detrimental to mankind. These discoveries demonstrate that the constant surveillance of science and the changes that occur are crucial to medical care.
- Cancer therapy—Childhood cancer has gone from incurable to often very treatable during my medical career. Why? Because clinical trials using scientific investigations were able to try different drugs and determine which ones helped and what went right. Scientists in the labs learned about how cancer cells function, suggested what medicines might be beneficial, and then worked with pediatric cancer doctors to see how they work in patients. Not everything was successful, so constant monitoring of the results was necessary. Therapies then needed to be checked years later to make sure the effects were sustained or not detrimental.
- Early childhood development—the science involved with understanding how adverse events (from abuse, neglect and even household dysfunction) affect children’s brain development has led to remarkable discoveries. These discoveries help explain child behavior, adolescent behavior and even adult-manifest diseases like hypertension, diabetes, and heart disease. The wiring of early brains and the genes that will be expressed are molded by the early experiences. We now know that changes in early brain development can be corrected with a variety of interventions that are exquisitely simple yet socially difficult. Therein lies the rub—how to use this science to help children, families and communities.
- Environment—The problems (pollen, pollution, smoking exposure, lead, you name it) that children are exposed to are critical to their development and health as noted in the quote above from Stephen Hall. Science has shown us that these exposures adversely affect children and mandate how we should correct problems in the environment. There is now good evidence to suggest an association between pesticides in the environment and the rise of autism and ADHD.
For those that argue that science runs counter to religion and the will of God, I would argue that science and its benefits are the will of God. Faith and science are not opposites. They are logical, integrated partners. The power of the human mind and its mysteries as acknowledged by those of faith celebrate the great discoveries that have changed lives forever, and thank God, we are better for it.
Medical decisions are made with science in mind. I contend that social decisions should be made with science in mind. Science cannot be ignored. Every morning when people wake up and take their prescriptions or start their cars, they are living science. One cannot selectively accept science for an advantage and ignore it at other times. Science matters—it improves lives, it tells us when we need to make changes and it provides a blueprint how to help children and their families. To make a difference, we should embrace science and use it to our benefit and avoid the pitfalls of ignoring it. And it is a big deal for children.
- Hall S. The Lost Generation: Trump’s environmental policies are putting the health of American children at risk. New York Magazine February 2019.