Analog Science Fiction and Fact 04/01/11

by Dell Magazines

  “Yes, that’s exactly what homeopathy—indeed, all of the so-called ‘alternative’ methods, need. We know so li—”

  “Oh, no you don’t,” Dustin said. “I’m not going to get drawn into some kooky attempt to legitimize fringe medicine by waving the chicken entrails of science over it.”

  That type of statement usually tipped a true believer over the edge, provoking a righteous rant that Dustin could refute point-by-point for the rest of the hour, but LeTourneau merely nodded as if Dustin had agreed with him and said, “Without someone of your stature taking an active role in the study, chicken entrails are all it will ever be. If I, as a practitioner of this miserably misunderstood art, performed the most perfect double-blind study in the history of medicine, my results would still be suspect. But if you join me in designing the experiments, and in collecting the data, and in interpreting the data we collect, perhaps we can truly understand what is—or is not—actually happening.”

  Dustin sat back in his chair, stunned by the sudden reversal of roles. How had this . . . this charlatan . . . outflanked him?

  Shelly leaped on the freshly wounded with the instincts of a broadcast journalist. “That’s an incredible offer,” she said. “How about it, Dr. Wegner? Are you game to put your money where your mouth is, as the saying goes?”

  Thank you, Jesus, Dustin thought. Aloud, he said, “Speaking of money, how do you propose to fund this study of yours? Real science takes money.”

  LeTourneau nodded. “Indeed it does, which is why studies of homeopathy and other naturopathic remedies have been so poorly executed, if you will pardon the pun. And which is why I propose that the producers of this very program, The Second Opinion, fund our joint venture. You can make medical history, Ms. Nguyen. You can either prove or disprove the value of an entire branch of alternative medicine once and for all.”

  Shelly turned white. “You want us to pay for the study?”

  Dustin couldn’t help himself. He said, “That sounds like a challenge. Are you game to put your money where your mouth is? As the saying goes?”

  Shelly looked at him as if he’d just suggested she take her clothes off on camera. Then she burst out laughing. “Do you have any idea how much money this show makes? Or doesn’t make, I should say.”

  “It takes in two point three million dollars in advertising revenue per installment,” LeTourneau said. “I took the liberty of looking it up. And your salary is seventy-six thousand per episode, somewhat over a thousand dollars a minute. The study I propose should—”

  “Cut!” Shelly shouted. She stood up from her chair. Her microphone cord snagged on the chair’s arm and tugged her blouse downward, momentarily exposing a great deal more of her breast than she had intended. “Cut the feed. Go to commercial.”

  The technician at the control board slapped switches and turned to face Shelly. “I cut it at ‘minute.’ Sorry; we’ve been on short delay since the space station snafu.”

  She scowled at him, then at LeTourneau. “Who the hell do you think you are, giving out my salary on the air?”

  “I’m a medical practitioner who needs your help. And yours,” he added, nodding toward Dustin.

  “You’ve got a damned strange way of asking for it,” said Dustin.

  LeTourneau shrugged. “Would either of you have helped me any other way?”

  “You’re not getting any help, buster, except out the door. Sammy, show this kook to his car.”

  One of the camera operators stepped forward, but the tech at the control bench said, “Uh, Shel? Phones are lighting up. We’ve got all eight lines stacked. I don’t think you want to come back to an empty set and take these phone calls for forty more minutes.”

  Shelly considered that. “You’re right, I don’t.” She unplugged her microphone and stepped down off the set, but the tech said, “Ninety seconds,” and she paused, thinking. Dustin did the math in his head: two point three mil in advertising revenue, call it two-thirds of that that wouldn’t run if the show went dark for the rest of the hour; she was looking at a potential loss of over a million and a half dollars if she threw a tantrum. Even at seventy-six thou per episode, she’d be working off that debt for the rest of the year.

  “Use the phone callers,” LeTourneau said. “Take the challenge to them.”

  Two and a half minutes later, after an additional minute of public service announcements while Shelly and the show’s producer argued over the phone, they were back on the air.

  “Live in fifteen, ten, five,” and the silent countdown.

  Shelly was seated in her chair, once again perfect. A big red prop phone rested on the glass table in front of her.

  “Welcome back to round two of The Second Opinion,” she said. “For those of you who might have just joined us, this is Dr. Dustin Wegner on my right and Dr. Nathan LeTourneau on my left. Dr. LeTourneau has laid down an interesting challenge, to say the least: He has challenged Dr. Wegner to assist him in a scientific study of homeopathic medicine, to be conducted under the rigorous standards of the Centers for Disease Control—and funded by The Second Opinion. While I’m not exactly happy with his announcing my salary over the air, I have to admit he’s made his point: I can afford to put my money where my mouth is. So I hereby agree to donate my earnings from today’s entire program to Dr. LeTourneau’s project.”

  She grinned and looked directly into the camera again. “But only if you do the same. So now I issue the challenge to each and every one of our listeners: Are you willing to put your money where your mouth is? How about it? There are hundreds of you on the phone right now, calling in to tell me we should fund this study. Dr. Wegner has agreed to do it if the funding is adequate to do the job right. So it’s up to you. Are you willing to put a day’s wages into science to clear up one of the biggest mysteries in medical history?”

  When, exactly had Dustin agreed to this cockamamie scheme? He didn’t recall saying he would, but then he supposed his challenge to Shelly could easily count as such. And to be honest, he was starting to like the idea of proving homeopathy wrong once and for all. If Shelly could swing the bucks, he’d happily run the double-blind tests.

  Shelly picked up the phone. “Hello, you’re on the air,” she said. “Are you willing to support our effort to answer this question once and for all? We’re asking one day’s salary from every caller. One day for science. Are you with us?”

  There was a long silence. Dustin wondered if the caller had hung up, or if the phone patch to the studio monitor had been switched off, but then the caller’s hesitant voice said, “Well, I don’t make much at McDonald’s, but, sure, I guess I could do that.”

  They took two million dollars in pledges by the end of the show. Money up front, largely paid by credit card. When the technician waved his four-three-two-one and zero-fingered hand at them, Shelly leaned over and kissed LeTourneau full on the lips.

  “You have no idea how much you just helped this network,” she told him. “Viewership will double when news of this gets out.” Then, to Dustin, she said, “I want you to squash homeopathy like a bug. You’re back on in three months with your report.”

  “Three months isn’t enough time to investigate a stubbed toe,” Dustin said.

  “It should be enough time to put the final nail in the homeopathy coffin,” she replied.

  “Not scientifically,” said LeTourneau. “We’re talking more like a year to determine how it works. Maybe two. If it can be done at all.”

  Shelly unplugged her microphone and stood up. “Six months, then. And a sixty-second progress report once a week suitable for airing on the show. Otherwise the audience will forget who you are.”

  Dustin nodded. He could do that. Compared to some grant conditions he had worked under, this was a free lunch.

  He walked with LeTourneau to the parking lot. “No offense, he said, “but I feel like I’ve just been conned into voting Republican. How the hell did you do that?”

  LeTourneau grinned. “Voodoo puppetry. I have a lit
tle doll of you on strings in my office.”

  “Yeah, right.” But as he drove home, he had to wonder.

  They met in that office three days later. If there was a voodoo doll, it was nowhere in evidence. In fact, the entire clinic in which LeTourneau worked looked like any legitimate outpatient facility might: two receptionists out front, nurses and PAs ushering patients in and out and taking vital signs, other doctors bustling from appointment to appointment. As he watched LeTourneau in action, though, Dustin noticed one significant difference between him and his mainstream counterparts: He took more time to talk with his patients about the treatments they were receiving.

  “You’ve got tension in your muscles,” he told one woman who complained of jaw pain after a dental visit over a month ago. “So I’m going to make you an infusion of a substance called Nux Vomica, which is a powerful muscle constrictor. At full strength it can make muscles tighten so hard and so quickly that it can break bones. But I’m going to dilute it by a factor of millions. In fact, by the time I’m done there won’t be any of the Nux left in the solution at all. But the water I dilute it with will retain the memory of the compound’s ability, and when I inject it into your jaw muscles, it will seek out whatever is making your jaw muscles clench and it will dilute that agent as well.”

  Dustin snorted. LeTourneau shot him a pained look, and Dustin said, “Sorry. Must be my allergies.”

  “I could help you with that,” LeTourneau said. He turned back to his patient. “The important thing to remember is that the medicine I’ll be giving you will relax your jaw muscles, and you’ll feel better by morning.”

  He’s counting on the placebo effect, Dustin thought. If a patient with a subjective ailment believed that they were being treated, their symptoms often disappeared. He said as much to LeTourneau when they were alone. He expected LeTourneau to deny it, but the homeopath simply nodded and said, “That’s the only logical explanation for what’s happening. What I want to know is whether that’s the only actual explanation, and if so, how to make it more reliable. Because this only works about seventy percent of the time.”

  “How often?”

  “Seventy percent.”

  “You mean 20 percent over random chance, not to 70 percent of your patients.”

  “No, I mean 70 percent of my patients get better. Random chance would give me something like a 5 or 10 percent success rate.”

  “I can’t believe you have that kind of success.”

  LeTourneau smiled. “I would be as skeptical as you if I hadn’t seen it demonstrated over and over again. So let’s design a study that will convince you, or reveal me as a self-deluded quack.”

  Designing a double-blind study—a study in which neither the experimenter nor the subjects knew whether they were in the control group—was a simple process. Implementing it was considerably tougher. Human ailments didn’t come in standardized units, nor were there an infinite supply of similar complaints to compare against one another. Dustin finally decided on a simple qualitative analysis of pain: Patients either felt that they’d been relieved of their pain or they didn’t. Half the participants in the study would get real homeopathic remedies, while half would get normal saline solution that had been nowhere near Dr. LeTourneau or any of his colleagues until LeTourneau gave it to them. Half of each group would be told that the remedies were genuine, and half would be told that they were getting saline. They would be asked several other questions to mask the ones Dustin and LeTourneau were most interested in, so they would be less likely to give the answers they thought the doctors wanted to hear.

  Dustin expected the results to be in perfect harmony with established placebo trials, in which about thirty percent of the patients perceived an improvement in their symptoms even when not given any real medication, but right from the start he was proven wrong. Wildly wrong. If anything, Dr. LeTourneau’s estimate of a 70 percent success rate was low. The number was closer to seventy-seven, just over three-quarters of the time. Intensity of pain didn’t correlate with the success rate, either: The most intractable conditions responded as well as the simplest.

  They wouldn’t open the records and learn which patients had received what until after the data were all collected. But just the overall success rate was enough to astound both doctors.

  “Something’s not right here,” Dustin said when the data became irrefutable.

  “My thought exactly,” said LeTourneau. “It should be more like 90 percent if there’s something real going on. Or 30, like normal placebo studies, if there’s not.”

  “Three-quarters. That’s significant. What are we doing three-quarters of the time?”

  They sifted through the data yet again, but until they opened up the records and discovered who received what, and who had been told what, they were stuck scratching their heads.

  So they shot a sixty-second video of themselves scratching their heads and gave it to Shelly to air at the tail end of her program. Ratings went up by 30 percent.

  The more Dustin watched the homeopath in action, the less he understood. With some of his concoctions, LeTourneau would rap the flask against the table during one or another of the intermediate dilution steps, explaining that the process was called “succussion.” Supposedly the water would remember its infinitely diluted solute better that way.

  “This makes no sense, you know,” Dustin said. “Less than no sense.”

  “I know,” LeTourneau said. “But I also know that I have more positive results when I do this than when I don’t. Only with some preparations, however.”

  “You need another double-blind test to see if that’s really true.”

  “Of course. Once this study is done, I’d love to try it. Of course I’d have to try it for every preparation I make, and vary the procedure at each stage of the dilution. The combinations are almost infinite.” He held a yellowish tincture up to the light, then tapped it on the table half a dozen more times. “Which explains why this field is basically a hand-me-down series of processes that have worked for other people at some time in the past. It’s so difficult to isolate all the variables, most practitioners just go with what’s been shown to work.”

  “Provided you trust the source,” Dustin said.

  “There’s always that factor to consider,” LeTourneau said. “Some of us, I’m sure, are quacks. An additional complication.”

  A month ago, Dustin would have said something snide. Now he just nodded and said, “You’re not alone there. We have them in my field too. They’re just easier to expose.”

  He wondered how many people were attempting to do just that to him. Word was spreading that he had gone off the deep end. Colleagues were sending him e-mails with “WTF?” in the subject line. Others were calling him a sellout and a fraud. Treating him, in fact, pretty much like he had treated practitioners of alternative medicine until now.

  He couldn’t ignore the data, though. The results spoke for themselves. Dr. LeTourneau—and he used that term now without wincing —was clearly doing better than chance or mere placebo effect. The only thing now was to figure out exactly how what he was doing worked. Once they did that, and could reproduce it reliably, Dustin could have the last laugh.

  They had to run the trial for six months to gather enough data to be meaningful. Dustin and LeTourneau both waited with all the patience of a boiling teakettle, and their weekly reports to The Second Opinion became more and more frenetic as they speculated wildly about what might be going on. Viewership rose week by week until Shelly decided they should unseal their data live on the air.

  “Er . . . think again,” Dustin told her. “It’ll take days to crunch the numbers, and weeks to understand what they mean, if there are any meaningful correlations at all.”

  “I’ll give you an hour,” she said. “You can unseal it at the beginning of the show, and we’ll cut to you in an inset every couple of minutes during a debate between two of your colleagues to keep the audience in suspense. Then at the end of the hour you’ll announ
ce whatever preliminary conclusions you can come to by then.”

  “This isn’t how science is done,” he protested, but she merely shook her head and said, “This is how journalism is done, and we’re the ones footing the bill. We want to show you crunching the numbers, and we want to see results at the end of the hour.”

  “And I want those results to be genuine. My professional reputation is on the line.”

  “So is mine,” Shelly replied coolly. “Need I remind you who owns the data? If you won’t analyze it on my program, I’ll find someone who will.”

  That got Dustin’s attention. To get this close and not be allowed to crunch the data would be the worst possible scenario, worse even than learning that homeopathy was genuine. And he had no doubt Shelly would give it to someone else if he pushed her. She wasn’t in this for science; she was in it for the ratings.

  Dustin continued his protest out of form, but in truth, he had enough suspicions about what the data would show that he could prepare in advance. And if it didn’t go the way he expected, that would tell him plenty too. Whichever way it went, he could have a ready-made hypothesis to explain it.

  On the night of the great unveiling, he and LeTourneau sat side by side at the desk in the advertising director’s office, the only space in the studio besides Shelly’s set that looked professional enough to show on the air. A camera in the doorway covered both the doctors and the widescreen monitor hooked to Dustin’s laptop computer. It didn’t take a supercomputer to crunch statistical data; it simply took a spreadsheet and a little insight.

  The lights were on. The camera was on. Shelly and her two guests were on the sound stage down the hallway, with audio and video piped into a monitor just to the side of Dustin and LeTourneau’s computer screen. The cameraman in the doorway counted down from fifteen just like the sound tech in the main studio, then Shelly said, “Hello, and welcome to The Second Opinion, where tonight we’re going to prove once and for all whether there’s anything to alternative medicine. Doctors Dustin Wegner and Nathan LeTourneau are at their computer where they will unlock the data they’ve been collecting for the last six months and will do the analysis while my guests for tonight, Doctor Frederick Helms of the Committee for the Scientific Investigation for Claims of the Paranormal, and Doctor Diane Westmoreland of the Northwest Coalition of Naturopathic Healers, speculate on what the data will reveal. At the end of the hour, one of these fine doctors will wind up with egg on his face . . . or her face, as the case may be. Doctors, are you ready?”