Two Kinds of Scientific Fool Are Equally Frightening

The last two days I have been resting at home, reading Chen Cunren Medical Records in the mornings and afternoons, and in the evenings studying English with my child. But even so, my mind is not empty; there are still all kinds of messages from online readers.

The one who impressed me most was a reader, who, after reading my blog for a while, came up and asked: do I really believe that Chinese medicine can cure cancer?

It so happened that that day I was reading Chen Cunren Medical Records, in which Mr. Chen treated several cancer patients, and it was all documented and well-founded. I sent him links to several cases I had treated myself with good results, and also to a few doctors with excellent cancer treatments whom I know.

This reader saw these cases and then said to me: these are all anecdotal case reports; they are not scientific evidence. Real medicine should rely on statistics, double-blind controlled trials, and evidence-based medicine. I asked him what he does for a living; he said he is a professional cook.

A cook who, having read a few popular-science articles, now lectures me on evidence-based medicine and double-blind controlled trials. I really do not know what to say. This is a classic scientific fool: they have only a smattering of knowledge, yet they think they understand science, and they start demanding evidence and statistics from others.

In fact, there are two kinds of scientific fool. One kind is the person who has learned a little bit and thinks they understand it all, and starts criticizing others; the other kind is the person who has studied something and begins to believe only in themselves and distrust everything else. The second kind is more frightening than the first.

The first kind, the half-educated fool, is actually easy to deal with. Show them a few real cases, let them see the data, and they will back off. At most they mumble a few words and go away.

The second kind, the person who has studied and then believes only in themselves, is hard to deal with. They have read many books and done many experiments; they think their methods are the only correct ones, and any result that does not conform to their methods is unscientific.

This second kind of scientific fool is everywhere in medicine. Some have studied Western medicine and then deny all Chinese medicine; some have studied Chinese medicine and then deny all Western medicine. Their conclusions are simple and absolute; they do not allow for nuance or exception.

True science is not a belief; it is a method. The scientific method is: observe, hypothesize, experiment, verify, revise. It does not set up a fixed conclusion; it allows for error and correction. If a conclusion cannot be revised, it is not science but dogma.

Many people who call themselves scientists are actually dogmatists. They have learned a set of dogmas and then shut their ears to anything that does not fit. This is not science; this is scientism, or even scientistic religion.

The cook who questioned me is the first kind, and I am not very worried about him. He may eventually learn more and become more humble. But the second kind, the learned dogmatist, is the real danger, because they are often in positions of power and can influence policy, education, and public opinion.

For example, some Western-medicine scholars insist that only randomized controlled trials count as evidence, and that all case reports are anecdotes. But cancer is an extremely heterogeneous disease; every patient is different, and one size cannot fit all. A good case report can reveal a pattern that a large trial may miss.

Conversely, some TCM scholars insist that because the classics say so, it must be true, and they dismiss any laboratory evidence as inferior. This is equally dogmatic. The classics are a record of experience; they are not infallible scripture. We should use the classics as a starting point, not as a cage.

When I read Chen Cunren Medical Records, I see a physician who was open to both traditions. He used Western diagnostic methods when needed, and he used Chinese herbal formulas when appropriate. He did not care whether a treatment was Chinese or Western; he cared whether it worked for the patient in front of him.

This is the attitude I try to cultivate. I do not worship Western medicine, nor do I worship Chinese medicine. I only care about results. If a Western drug works, I use it; if a Chinese formula works, I use it.

The cook who questioned me represents a widespread social phenomenon: people with a little learning but no depth, quoting scientific terms they do not fully understand to put down others who have spent decades in the trenches. This is not science; this is intellectual vanity.

The learned dogmatist, on the other hand, has depth but no breadth. They know their own narrow field very well, and they assume that everything outside it is unscientific. This is also vanity, of a more dangerous kind.

So when people ask me whether I really believe Chinese medicine can cure cancer, my answer is: I do not believe in Chinese medicine, and I do not believe in Western medicine. I believe in observation, in trial and error, in what works.

If you ask me for a double-blind randomized controlled trial proving that a certain formula cures a certain cancer, I may not be able to produce one. But I can produce a patient who walked in unable to stand, and walked out able to walk. That is evidence too, though it is not the kind of evidence the cook demands.

The greatest obstacle to the development of medicine is not the lack of data; it is the closed mind. If every physician could be a little more open, a little more humble, and a little more willing to learn from traditions other than their own, our patients would be better off. This is the lesson I draw from reading Chen Cunren Medical Records.