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20Nov 2013

Less is more: A much too lengthy debate over microbes, autism, celiac disease, and allergies,

Microbes

When it comes to debating science stories and medical claims, sometimes less is more.

During the past 15 months, Moises Velasquez-Manoff, a science writer and the author of An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases, has published three articles in the Sunday Review section of The New York Times.

Each has made an unproven and controversial claim. The first, published in August, 2012, argued that "at least a subset of autism — perhaps one-third, and very likely more — looks like a type of inflammatory disease," possibly because we no longer live in "environments that resemble our evolutionary past, full of microbes and parasites."

The second, in February of this year, argues that "the rapidly increasing prevalence of celiac disease"--often treated with a gluten-free diet--may be occurring because "we have neglected the teeming ecosystem of microbes in the gut — bacteria that may determine whether the immune system treats gluten as food or as a deadly invader."

And the third, published on Nov. 9, asks, "Will the cure for allergies come from the cowshed?" It goes on to say that while "some of the vulnerability is surely genetic," studies have shown that "microbes are one intriguing protective factor. Certain ones seem to stimulate a mother’s immune system during pregnancy, preventing allergic disease in children."

I didn't take great notice of these stories at the time they were published. I didn't find anything that required comment when I read them, and rereading them now, I find that while they are clearly and strongly advocating a particular point of view, they are reasonably argued. I wouldn't go nearly as far as Velasquez-Manoff in endorsing these claims, but I don't find fault with him for doing so.

The apparent increases in allergies, gluten sensitivity, and autism are controversial and certain to spark heated debate, and that's what has happened here.

The reason I looked at the stories again is because Matthew Herper of Forbes, in a post on Nov. 10, the day after Velasquez-Manoff's third article appeared, expressed incredulity--and anger, I think it's fair to say--that the argument "has been plastered across the Sunday Review not once but three times, with no notation that scientists or experts might find Velasquez-Manoff’s conjectures, well, to be polite, to be conjectures. To my memory, the Times has not made the opposing case — that autism or celiac disease might be caused by factors other than lacking exposure to the right germs — at all." (Deborah Blum criticized the autism story on the Tracker in two posts--which you can find here and here.)

Herper continued:

I like argumentative writing. But I do believe in balance, in the idea that an article should give readers a sense of the other side of an argument, even if only to disparage it. I don’t think any of these articles do that, and the Times, which outside the Sunday Review strains as hard as any publication to be objective, really should do better.

Herper and I differ on that, but his criticism is perfectly fair. He also accuses the Times, in his headline, of "breathlessly promoting a science book it panned," a reference to a negative review Velasquez-Manoff's book received in the science section of the Times. That's not so fair, and probably not accurate. Rather than accuse the Sunday Review of promoting the book, I'd accuse its editors of forgetting what they had already run, and of not knowing that there might be another side to the story. I suggest it's poor editing; not a conspiracy.

But I'd like to get to the point, lest I be accused of making the same error I'm about to pin on others.

Herper's piece is brief, but the responses to it were not. Velasquez-Manoff posted a long response on his website in which he seems to respond to every single critical point that others have made about his work. It reads more like a legal brief than a rejoinder to Herper and others. I read through it, and Velasquez-Manoff makes some important points. But they get lost in a mass of detail. How many readers will push through to the end?

Yesterday, the volume of required reading expanded again, when Brandon Keim, a science writer who acknowledged that he and Velasquez-Manoff are friends, put up a long post responding to some of the critics. It, too, makes some very important points--but how many readers will see them?

I urge readers to read Velasquez-Manoff's stories, the Times review of his book, Herper's critique, the responses, and other pieces, such as Emily Willingham's criticism of the autism story, also at Forbes. You will experience a high-level, intelligent discussion of very important issues regarding autism, the hygiene hypothesis, and science writing.

But, honestly, who has the time? I know I'm setting myself up as a target here, but could it have been a better idea for the discussants to post shorter, more focused posts that would be more widely read?

Perhaps not; some issues become clear only when examined in great detail. But brevity has its virtues--something I'm going to try to remember when I try to make a point myself. I'm not the first to note that Lincoln in the Gettysburg Address did a pretty good job of arguing a case of titanic legal, social, and political importance, and he did it in fewer than 300 words.

-Paul Raeburn

Comments

Very nice Gettysburgization. (Poor Abe must be in agony.)

Here's to defending our friends, a noble undertaking. And I agree--the pleasant tone of the tweets was nice to see. Especially for me, because if it had turned ugly, you all had me way outnumbered.

Cheers,

Paul

Well, it is true that I'm no Abe Lincoln … but you, sir, are no Jack Kennedy.

(Sorry, I've always wanted to say that.)

As background … I originally wrote my comments with an audience of about five people in mind — it was kind of an insider baseball thing, and I didn't expect such a big crowd. They were so lengthy because I didn't want anyone to be able to say, "Oh you're just taking Velasquez-Manoff's side because you're his friend," and also because I thought that a lot interesting, solid science was getting overlooked/dismissed in criticisms of how he portrayed it.

But if anyone wants the shorter version, I'll Gettysburg (can that be a verb now?) it thusly:

"Velasquez-Manoff's a good, hard-working journalist who's reporting on and writing about a powerful, potentially hugely important idea: that changes in our microbiome underlie many autoimmune diseases. This is still a hypothesis, and details will vary by disease — but there's some compelling evidence, and a lot of scientists are taking it very seriously. Some critiques of Velasquez-Manoff's work are too casually dismissive, and would have benefited from the critics having talked to him and to scientists studying these questions. Also I think  those talks might have happened if he had a higher profile within the online science writing community."

So, 201 words left to spare!

And on a closing note … I was worried that the discussion could turn nasty and accusatory. Instead it was civil and constructive on all sides. And that was just a lovely thing to see. Something I often hear is, "Science writers are really nice people" — and I think it's true.

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