Phenomenology (Skeptical Empiricism)

Plead Ignorance of Biology: Phenomenology

I have explained that phenomenology is more potent than theories—and should lead to more rigorous policy making. Let me illustrate here.

I was in a gym in Barcelona next to the senior partner of a consulting firm, a profession grounded in building narratives and naive rationalization. Like many people who have lost weight, the fellow was eager to talk about it—it is easier to talk about weight loss theories than to stick to them. The fellow told me that he did not believe in such diets as the low-carbohydrate Atkins or Dukan diet, until he was told of the mechanism of “insulin,” which convinced him to embark on the regimen. He then lost thirty pounds—he had to wait for a theory before taking any action. That was in spite of the empirical evidence showing people losing one hundred pounds by avoiding carbohydrates, without changing their total food intake—just the composition! Now, being the exact opposite of the consultant, I believe that “insulin” as a cause is a fragile theory but that the phenomenology, the empirical effect, is real. Let me introduce the ideas of the postclassical school of the skeptical empiricists.

We are built to be dupes for theories. But theories come and go; experience stays. Explanations change all the time, and have changed all the time in history (because of causal opacity, the invisibility of causes) with people involved in the incremental development of ideas thinking they always had a definitive theory; experience remains constant.

As we saw in Chapter 7, what physicists call the phenomenology of the process is the empirical manifestation, without looking at how it glues to existing general theories. Take for instance the following statement, entirely evidence-based: if you build muscle, you can eat more without getting more fat deposits in your belly and can gorge on lamb chops without having to buy a new belt. Now in the past the theory to rationalize it was “Your metabolism is higher because muscles burn calories.” Currently I tend to hear “You become more insulin-sensitive and store less fat.” Insulin, shminsulin; metabolism, shmetabolism: another theory will emerge in the future and some other substance will come about, but the exact same effect will continue to prevail.

The same holds for the statement Lifting weights increases your muscle mass. In the past they used to say that weight lifting caused the “micro-tearing of muscles,” with subsequent healing and increase in size. Today some people discuss hormonal signaling or genetic mechanisms, tomorrow they will discuss something else. But the effect has held forever and will continue to do so.

When it comes to narratives, the brain seems to be the last province of the theoretician-charlatan. Add neurosomething to a field, and suddenly it rises in respectability and becomes more convincing as people now have the illusion of a strong causal link—yet the brain is too complex for that; it is both the most complex part of the human anatomy and the one that seems most susceptible to sucker-causation. Christopher Chabris and Daniel Simons brought to my attention the evidence I had been looking for: whatever theory has a reference in it to brain circuitry seems more “scientific” and more convincing, even when it is just randomized psychoneurobabble.

But this causation is highly rooted in orthodox medicine as it was traditionally built. Avicenna in his Canon (which in Arabic means law): “We must know the causes of health and illness if we wish to make [medicine] a scientia.”

I am writing about health, but I do not want to rely on biology beyond the minimum required (not in the theoretical sense)—and I believe that my strength will lie there. I just want to understand as little as possible to be able to look at regularities of experience.

So the modus operandi in every venture is to remain as robust as possible to changes in theories (let me repeat that my deference to Mother Nature is entirely statistical and risk-management-based, i.e., again, grounded in the notion of fragility). The doctor and medical essayist James Le Fanu showed how our understanding of the biological processes was coupled with a decline of pharmaceutical discoveries, as if rationalistic theories were blinding and somehow a handicap.

In other words, we have in biology a green lumber problem!

Now, a bit of history of ancient and medieval medicine. Traditionally, medicine used to be split into three traditions: rationalists (based on preset theories, the need of global understanding of what things were made for), skeptical empiricists (who refused theories and were skeptical of ideas making claims about the unseen), and methodists (who taught each other some simple medical heuristics stripped of theories and found an even more practical way to be empiricists). While differences can be overplayed by the categorization, one can look at the three traditions not as entirely dogmatic approaches, but rather ones varying in their starting point, the weight of the prior beliefs: some start with theories, others with evidence.

Tensions among the three tendencies have always existed over time—and I put myself squarely in the camp attempting to vindicate the empiricists, who, as a philosophical school, were swallowed by late antiquity. I have been trying to bring alive these ideas of Aenesidemus of Knossos, Antiochus of Laodicea, Menodotus of Nicomedia, Herodotus of Tarsus, and of course Sextus Empiricus. The empiricists insisted on the “I did not know” while facing situations not exactly seen in the past, that is, in nearly identical conditions. The methodists did not have the same strictures against analogy, but were still careful.