Is sunscreen harmful?

Recently the Environmental Working Group (EWG) released a report on sunscreen recommending only 39 of 500 sunscreens investigated. The report has been picked up by media outlets and now sunscreen is being touted as cancer-causing and hormone-disrupting. The report is not fraudulent, but it is somewhat specious, inflammatory, and alarmist. I’ve researched some of the claims and there is no reason to run screaming from sunscreen, as we’ll see.

One of EWG’s concerns is that many sunscreens lack UVA protection. This was absolutely true at one time, but is quickly changing. Many sunscreens are now “broad spectrum” or “double barrier,” protecting against UVA and UVB radiation.

Ultraviolet radiation comes in UVB and UVA forms. UVB radiation is that type that gives you sunburns; UVA radiation is the type that penetrates deeper into the skin and causes breakdown and more permanent damage. Both UVA and UVB rays are known to cause cancer, so it is best to purchase sunscreens (and sunglasses) that protect against both forms of radiation.

Another issue raised by the EWG report is that SPF numbers on sunscreens are climbing higher and higher, but there is little proof that such products are necessarily better. Again, this is true.

The Sun Protection Factor (SPF) on sunscreen labels refers to how well the product protects against sunburn (UVB). For example, without any sunscreen at all it may take you 10 minutes to burn in the sun, but using SPF 15 sunscreen would extend that time from 10 minutes to 150 minutes.

There are a few important things to keep in mind. First, because SPF measures the amount of time it takes to burn, it is only a measure of UVB protection – not UVA protection. Second, as noted in this document from the U.S. Environmental Protection Agency, above SPF 15 there are not great differences in protection. SPF 15 protects against about 93% of UVB radiation and SPF 30 protects against 97%. It’s very gradual from there on up.

Therefore, more important than the SPF number are the amount of sunscreen applied and the frequency of application. SPF numbers are typically based on a recommended application of 30mL (about 2 tablespoons) for the entire body. Most people apply less than this. Also, sunscreen should be re-applied every two hours and always after swimming. If the correct amount of sunscreen and frequency of application are observed, it makes little difference whether you use SPF 30 or SPF 60.

Although the case is not 100% closed on the link between sun exposure and cancer, there is plenty of scientific evidence of a link between sun exposure and basal cell carcinoma/squamous cell carcinoma (the common but rarely fatal, non-melanoma cancers that cause ‘scabs’ that can be removed). Melanoma is much more rare, but frequently fatal. The direct link between sun exposure and melanoma is not as clear as it is with carcinoma, but this doesn’t mean that intentionally baking in the sun or in a tanning bed is a good idea.

The EWG report claims that there is “no consensus on whether sunscreens prevent skin cancer.” This is somewhat true. The research is not 100% clear on a link between sunscreen and protection against skin cancer, but it is fairly favourable so far; generally scientists agree that sunscreen can protect against cancer if, as stated earlier, it is applied in the amounts and with the frequency recommended. A quick slather in the morning may actually do more harm than good, providing people with a false sense of protection against the sun, causing them to have more exposure to dangerous UV radiation. (High SPF numbers may also provide this false sense of protection.)

Although I have been using the term “sunscreen” throughout this article, there actually is a difference between sunblock and sunscreen.

Sunblock, such as titanium dioxide and zinc oxide, is more effective than sunscreen and is opaque (like the white stuff lifeguards often wear on their noses). Particulate matter in sunblock reflects and scatters the UV rays, physically blocking the sun. Sunblocks protect against UVA and UVB radiation, are safe, and are photostable (photostability refers to whether/how quickly the ingredients are broken down when irradiated). Vanity is essentially what prevents people from using such sunblocks – because it is opaque people don’t want to spend a day at the beach with a white coating all over their body. Although there are titanium and zinc products available now that are nearly transparent.

Sunscreen filters and absorbs UV radiation, converting it to heat. Although more and more sunscreens are being made with UVA and UVB protection (“broad spectrum” or “double barrier”), the ingredients in sunscreen are broken down more quickly when irradiated (they are less photostable). Not to belabour the point, but because most people will choose sunscreen over sunblock for aesthetic reasons, it is vital to apply it in the quantity and with the frequency recommended.

The EWG report claims that there is “some evidence” linking sunscreen usage with an increased risk of melanoma. This “some” is spotty at best and can more reasonably be explained by the false protection issue discussed above. People who use sunscreen likely spend more time in the sun because they feel protected, but most people are using sunscreen incorrectly (not enough, not often enough) and so do suffer greater effects of sun exposure. This is not a direct link to sunscreen, but to incorrect usage of sunscreen.

Another concern highlighted in the EWG report is that sunscreen will reduce vitamin D absorption. Vitamin D from the sun is very important, so if this is a concern for you (even though there is a lack of evidence for it), there are vitamin D supplements, but please – if you think you need to supplement your vitamin D intake, go to your doctor and get tested first, then get her recommendation for a product and a dosage. Don’t just buy some vitamin D pills from your local drug store and start popping them like candy, as most people do with vitamin supplements. You can overdose on vitamins; they’re not innocuous.

The EWG report cites the ingredient retinyl palmitate (a form of vitamin A) as a primary concern because “available data from an FDA study indicate that…when applied to the skin in the presence of sunlight, [it] may speed the development of skin tumors and lesions.” The problem is that the FDA study of retinyl palmitate in mice is both inconclusive and incomplete (it will be completed and peer-reviewed in the next year or so). Reason suggests that in light of the lack of evidence, it would be more dangerous to avoid the use of sunscreen than to use sunscreen containing retinyl palmitate.

Retinyl palmitate is a very common “anti-aging” ingredient and is found in most skin care and beauty products. It is not, however, a necessary ingredient for sunscreen’s effectiveness. If it is a concern for you, then choose a sunscreen that does not contain retinyl palmitate. Problem solved.

The EWG report also cites the ingredient oxybenzone as a potential hormone disruptor. (More information on hormone disruptors exists than I can synthesize here, so I would suggest doing your own research if you are interested. Check out science and medical sites/books rather than “health” sites/books). Oxybenzone is an ingredient in some sunscreens and, again, most skin care and beauty products. It is also ubiquitous in our environment. Studies are inconclusive as to the health effects associated with oxybenzone, stating such effects as unknown and requiring more research. As with retinyl palmitate, good sense says that you should not avoid sunscreen due to the presence of oxybenzone because evidence for negative health effects is so lacking, but you can certainly choose a product that does not contain it. Again, problem solved.

The Environmental Working Group tends to be overly cautious and even at times alarmist; they discount far too many ingredients as harmful, hazardous, or risky based on false or inconclusive data. Running around like a Chicken Little knock-off suggesting that sunscreen will give you cancer is not productive. As I said, the EWG sunscreen report is not fraudulent, but it (and the media reports on it) does instill a little too much fear in the general public.

As any brochure on sun exposure will tell you, avoiding the sun and wearing protective clothing is the best way to protect against harmful UVA and UBV radiation. Your next best bet is sunblock (titanium dioxide and zinc oxide). If the aesthetic of that doesn’t appeal to you, then a broad spectrum/double-barrier (UVA/UVB) sunscreen will offer adequate protection if you wear enough of it and re-apply it often.

Check out the EWG report for some good sunscreen/sunblock recommendations, but if you’re going to read the whole report, take it with a grain of salt keeping in mind the things discussed here. And, as always, do your own (good) research.

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Quotation of the week

“Science knows it doesn’t know everything, otherwise it would stop. But just because science doesn’t know everything, doesn’t mean you can fill in the gaps with whatever fairytale most appeals to you.”  – Dara O’Briain

Best ever!

Is it redundant to call Dara O’Briain a brilliant genius?

Simon Singh and the British Chiropractic Association

Simon Singh is a science writer in London, England and co-author Trick or Treatment? Alternative Medicine on Trial. Singh published an article in The Guardian newspaper that exposed the fraudulent claims of the British Chiropractic Association (BCA) that chiropractic can be used to cure anything, including common childhood illnesses such as colic, ear infections, and asthma. The BCA is now suing Singh for libel.

The libel laws in England are much different than in Canada and the U.S. (and much stupider). There, the burden of proof is on the defendants to prove that their statements are true, rather than on the accuser to prove that they are false (in this case, the BCA does not have to prove that chiropractic can cure anything). The result of this, sadly, is the muzzling of authors, journalists, and speakers, and the restriction of their free speech unless they have the money to defend themselves in costly libel law suits.

The English libel laws are so sad that a phrase has been coined—“libel tourism”—which describes how individuals and corporations take their libel law suits to England to take advantage of their lax libel laws. No matter who you are or where you’ve published, someone can arrange to sue you for libel in England where the laws are much more favourable to them.

The United Nations has said that the English libel law violates human rights.

So, Simon Singh rightly and truthfully condemned spurious or fraudulent claims by the British Chiropractic Association, and they retaliated by trying to intimidate him with a law suit. Note that they did not sue The Guardian, which is a corporation with money, but Singh personally.

Nonetheless, Singh is not backing down.

Singh is committed to fighting this all the way, and he has the support of much of the blogosphere and mainstream press, including scientists, skeptics, critical thinkers, free speech defenders, and even celebrities like Ricky Gervais, Stephen Fry, Penn and Teller, Jo Brand, and Harry Hill. Among the prominent scientists backing Singh are biologist Richard Dawkins, former British government Chief Scientist Sir David King, geneticist Steve Jones, and astronomer Jocelyn Bell.
Sense About Science has started a petition to keep libel laws out of science. See who has signed it and sign it yourself here.

If you’re interested, you can read Singh’s entire account of this story here.

Now that the British Chiropractic Association failed to intimidate Singh with its law suit and the case will go to court, now that the public and mainstream media are talking about this, now that prominent scientists and celebrities are backing Singh, chiropractors are running scared. The British Chiropractic Association, McTimoney Chiropractic Association, and the United Chiropractic Association have all sent letters to their members advising them to remove any spurious claims from their web sites and printed materials. The McTimoney Chiropractic Association blanked its own web site and advised its members to do the same. Sadly, they don’t seem to understand how the internet works nor how much people care about real, honest, evidence-based science and medicine, because folks had already made copies of all of their web sites.

Here is the letter the British Chiropractic Association sent to their members:

4 June 2009

The BCA would remind members of their obligations under the Advertising Standards Authority (ASA) section 50 (relating to Health & Beauty Products and Therapies: see

Members are strongly encouraged to review their current marketing materials (whether they are paper- or web-based) to ensure that they are compliant with both ASA and GCC requirements. Note that the ASA has no jurisdiction over editorial materials placed on members’ own websites.

When reviewing your materials it may be helpful to consider the following:

1. Are there any claims made that cannot be justified by reference to evidence? Remember, the GCC requires chiropractors to practice evidence based care, which is defined as “clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners (which includes the individual chiropractor himself).

2. Be mindful of making promises that you cannot be sure of delivering on;

3. Be wary of listing conditions that are controversial and away from mainstream chiropractic care e.g. dyslexia/dyspraxia unless you have research to back this up. If you have made references to prolonged crying, sleep and feeding problems, breathing difficulties and frequent infections, as these are symptoms rather than condition specific, we suggest you remove these references.

4. Do not refer to yourself as a specialist in any particular form of chiropractic;

5. Do not use unfamiliar words for common conditions;

6. Do not unjustly criticise other healthcare professionals;

7. If you refer to subluxations, provide information to explain what they are.

8. Take care in the use of the Doctor title. Ensure that there is no way there can be any doubt that you are a chiropractor, and not a registered medical practitioner. Do not use the doctor title in paper advertising without explicitly stating that you are a chiropractor.

It’s pretty amusing.

And now blogs around the world are re-posting Simon Singh’s original article criticizing the BCA. Well, sort of. Bloggers have been advised to protect themselves from frivolous lawsuits by posting the a version if the article edited by lawyers.

But….

Orac has posted the entire article in its original form here, and has even bolded the sentences that the lawyers removed or altered. Huzzah!

And now, without further ado, is the lawyered-up version of Simon Singh’s original article. If you’re a blogger, please post it as well.

Beware the Spinal Trap,  by Simon Singh

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

Same-sex behaviour nearly universal across animal species

I hesitate to overindulge on queer issues, but this new scientific finding is really interesting.

For a long while now the scientific community has been stating that same-sex coupling is common among many species, such as bonobos, dolphins, and penguins. These are the most famous (not to mention cute and romantic) examples.

But now a new study from the University of California, Riverside, reveals that same-sex coupling is nearly universal across all animal species!

Read the National Geographic article. Click the link, if only to see the adorable photo of the female Laysan Albatross couple. According to the article, they “remain pair-bonded for life and cooperatively rear young.” Awwww…. See? Maybe there’s hope for us humans after all!

Published in: on July 7, 2009 at 4:16 pm  Comments (1)  
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Oprah gets called out for her quackery

Here is a really good article from NEWSWEEK calling out Oprah Winfrey and her parade of pseudoscientific guests for promoting quackery. The article doesn’t go too deeply into the science of things, so I just want to make a few comments.

The first one is brief. Regarding the woman who adopted the strategy of “The Secret” (I can hardly type that without gagging) and rid herself of breast cancer: There is such a thing as spontaneous remission. It is rare (estimates range from 1 in 60,000 to 1 in 100,000), but it is medically documented and happens often enough considering cancer rates. For more on spontaneous remission, read this.

Now, a more lengthy comment on vaccinations and the anti-vaccination movement. There are no discernible links between autism and vaccinations. Nearly 20 scientific, reproducible studies have been conducted throughout the world to date, and the indisputable conclusion is that there is no association between autism and vaccines. Study after study after study, including the U.S. Autism Omnibus proceedings, prove that there is no link between vaccines and autism.

The major battle cry of anti-vaccinationists was that thimerosal (the preservative used to prolong the shelf life of vaccines) was the cause of autism. In 1999, the U.S. Food and Drug Administration investigated thimerosal in vaccines and found no evidence that it causes any harm. However, they ordered the removal of thimerosal from childhood vaccines as a precautionary measure (in essence to placate the hysterical). Ten years after thimerosal was removed from vaccines, autism rates have continued to rise.

One “study” and the “doctor” who conducted it, Dr. Wakefield, connected the MMR (measles, mumps, rubella) vaccine with autism. Despite not one scientist being able to replicate the results of this study for years, the anti-vaccinationists have clung to it as all the proof they needed.

Except that Dr. Wakefield’s findings have now been shown to be completely bogus:

“…there has emerged potential explanations of how Wakefield was able to obtain the results he did. This evidence, combined with unprecedented access to medical records, a mass of confidential documents and cooperation from parents during an investigation by this newspaper, has shown the selective reporting and changes to findings that allowed a link between MMR and autism to be asserted.”

One study—a fabricated study—has caused people to hysterically decry vaccinations, many refusing to have their children vaccinated. The result? No more herd immunity, for one. Herd immunity occurs when enough of the population is vaccinated that protection is afforded to the unprotected (and in some cases especially susceptible, perhaps because of illness or poor immune systems). The mechanism is simple—infection can’t easily pass from person to person when the majority of the population is protected. The chain is broken. Now in the UK vaccination rates have sunk so low that herd immunity is not maintained. And in North America, we’re getting close to that.

The result is that children will die needlessly of measles, mumps, and rubella. We think of these diseases as antiquated, but that’s only because in the past immunizations and herd immunity has protected children from them. Now that some parents are listening to the anti-vaccinationist wackos and refusing to vaccinate their children, these diseases are on the rise. And they can be deadly.

It is true that autism rates have been rising, but the cause of this rise is a controversial subject. Either true autism rates are rising, or increased surveillance and a wider definition of “autism” has made it appear as though the rates are rising. The second hypothesis is more strongly supported by available evidence. Simply, it is that more cases are being diagnosed, not that more cases are occurring.

So Jenny McCarthy, the head cheerleader of the anti-vaccination movement (who has recently recruited her boyfriend Jim Carrey to the battle), and all of the other credulous folks who believe the propaganda and pseudoscience, are actually endangering your children by not having theirs vaccinated.

One wonders why they aren’t concerned with the real causes of autism, focusing their energy, time, and money on scientific research that may one day provide an answer.

Amnesia: Right. Of course.

On the episode of This American Life entitled “How to Rest In Peace,” host Ira Glass begins the show by saying the following:

“This is one of those things that you’ve probably never heard, but as soon as somebody tells you, you’re like, ‘Right, of course.’ You know how murder figures into so much of American pop culture? On crime shows and thrillers and video games, and all kinds of stuff? Well if you knew somebody who actually got murdered, it turns out you might not be into that stuff so much.”

Right. Of course.

Rachel Howard, whose father was murdered, talks about how she can’t watch Law & Order or play Clue or go to a murder mystery dinner theatre. She makes the very obvious point that they don’t have rape mystery dinners, where people show up and have to try to discover who the rapist is. “Everybody would feel that was deeply distasteful,” she says.

Right. Of course.

And yet murder is pop-culture fodder.

In Act 3 of another episode of the show that I listened to recently entitled “The Friendly Man,” Scott Carrier sets out to discover if amnesia really exists.

After randomly asking people on the street and in the grocery store if they’d ever had amnesia, he comes up short (save the odd story of concussions or drug hazes), so he seeks out a psychologist, hoping for more insight into amnesia.

The psychologist can only tell one, anecdotal, story of amnesia, about a fellow service member during Vietnam. This is a psychologist—who can’t recount one clinical case of amnesia? A psychologist who can’t provide references to any clinical cases of amnesia? Or even recommend a book on the topic?

Excellent research skills there, Scott.

At one point Scott asks the psychologist if he had the power to flip a switch and invoke amnesia—“you won’t remember your name, you won’t remember who you are”—whether he would do it. Would he flip the switch? The psychologist laughs in response and turns the question back on Scott, who says that he would want to do it, because then he would lose his ego and he would have a clean slate. He says that is sounds attractive to him, that it would be a good thing: “I think I would be smart enough to realize that this is a gift.”

I echo the doctor’s response: “Give me a goddamned break!”

Having come up short again, Scott decides to try and induce his own amnesia. He goes to a hypnotherapist and asks if she could hypnotize him to forget everything about himself and his life. He’d like to do it for hours, or days, but she convinces him to do it for just a half an hour and to limit the things he will “forget” to just a few.

Of course the hypnosis fails; he remembers everything.

Scott seems to conclude that real amnesia is extremely rare and wonders if the reason it is so pervasive on television and in the movies is because it’s a story we want to be true. “Everybody loves the idea of a second chance,” he says, “of starting over without the burden of the past. I think that’s why amnesia is in so many movies and TV shows and romance novels—we somehow want to believe in it.”

I know that it is hard to be aware of all of the things in this world that we should be sensitive towards. It makes sense that murder should not be fun and games and entertainment, but it’s not something you really think about until it’s pointed out to you by someone like Rachel Howard.

I cringe at the thought of anyone listening to Scott Carrier’s story and coming to the conclusion that “real” amnesia does not exist. My stomach turns at the thought of anyone romanticizing amnesia, being so callous, uninformed, naïve, and ignorant as to consider it a good thing, a “clean slate,” a “second chance,” a way of “starting over,” or “a gift.”

Amnesia is not a gift. It does not clean anything. Rather, it causes indelible psychological and emotional trauma for the sufferer and their loved ones, and often life-long disability, depending on the type. As someone who has suffered the amnesia of a loved one, I will hopefully make some people say, “Right. Of course.”

First, a little about the different types of memory.

Sensory memory refers to information about a stimulus that is held in memory—in the exact form in which it was experienced—for only a few seconds until it can be further processed. For example, a visual stimulus is stored in the sensory memory as a “picture.” The brain has yet to process such information.

Short-term memory refers to memories that last for a few minutes. Unlike sensory memory, the brain has already processed short-term memories in some way. So that visual stimulus may still be seen as a picture, but will also be stored as an abstract concept.

People can generally keeping about five to nine items in their short-term memory at one time before new information bumps it out. But, short-term memory can hold information in chunks. As we know from the example of phone numbers, ten digits can easily be remembered in three small chunks.

BrainWe are capable of storing information in our short-term memories for longer periods of time through repetition. If you need to remember a phone number, you repeat it to yourself over and over again. Once you’ve written it down, or dialed it, or just forget to repeat it to yourself, it will usually fade. Repetition can also increase the probability that information will move from short-term memory into long-term memory.

Long-term memory lasts for years or longer. Everything we know about the world and about ourselves, language, etc. are all long-term memories. Long-term memory is stored, organized, and retrieved via a number of different routes and systems in the brain. For example, you may retrieve the concept of “sun” by seeing the sun, feeling its warmth, seeing or hearing the word (or the word “son”), etc.

Most types of memory appear to be stored in the cortex, with different kinds of information residing in different parts. So, a visual representation of a thing resides somewhere different from the word representation of that thing, which resides somewhere different from the concept of that thing. Different parts of the brain talk to each other constantly, which is how we can see a visual stimulus such as the sun (which resides in one area), recall the word “sun” (which resides elsewhere), and abstractly conceptualize the sun as warm and life-giving (residing elsewhere still).

Now a little about the different types of amnesia.

Just as there are different forms of memory and different ways in which memories are stored and retrieved, there are different forms of memory deficits. (I’m talking only about amnesia here, not age-related memory loss, Alzheimer’s, etc.)

Amnesia can occur because of damage to any of the brain structures that are important for memory. Damage to a specific area may cause someone to be unable to see a guitar and know the word “guitar,” but they may be able to recall that it belongs to the category of “musical instrument”, or they may retain their ability to play it.

The three main classes of amnesia are anterograde, retrograde, and psychogenic.

Anterograde amnesia is caused by damage to the hippocampus and parts of the temporal lobe. Anterograde amnesia does not cause the loss of long-term memories, but the inability to store any new memories. Retrograde amnesia is the loss of old memories. Retrograde amnesia can cause the sufferer to forget months, years, or decades of his or her life. The final class is the rarest, yet the one most seen in movies and TV shows: psychogenic amnesia, also known as fugue state, which involves temporary loss of identity. Anterograde and retrograde amnesia usually result from brain injury or disease, but psychogenic amnesia is a psychological condition caused by psychological or emotional trauma.

Anterograde amnesia results from brain injury and impairs a person’s ability to learn new information. Long-term memories of experiences or events that took place before the injury are not generally affected, but memories of events that occur after the injury are not retained; there is an inability to create memories of new facts and events. This is often referred to as declarative memory—memories of what happened to you yesterday, the name of someone you met, etc. In cases of anterograde amnesia, short-term memory is usually okay; a person can carry on a conversation, for example, but it will fade from memory in time or if he or she is distracted.

Here is something fascinating about anterograde amnesia: A sufferer can be taught a new skill, such as how to perform a specific task. The next day, the person will claim to have no memory of this task, but can often still execute it well!

Retrograde amnesia results from brain injury or trauma and impairs a person’s ability to remember events or experiences from before the injury (ranging from a few minutes to several years). Memories lost in this form of amnesia are generally never recovered, although they can come back over time, in flashes and spurts, often when a person experiences things that are associated with a specific lost memory. For example, walking down the street one grew up on, they might be able to remember their old house number.

The fugue state (psychogenic amnesia) is the rarest form of amnesia. It seldom happens that a person forgets their entire life and identity—but it does happen. Unlike how it is depicted in the movies, this is often not brought on by a conk on the head, nor is it “repaired” by another conk on the head. Deep psychological and/or emotional trauma will cause someone to enter a fugue state. While it is generally temporary, there are case studies of people never regaining their identity as it existed prior to the trauma.

The reason I just did the synopsiest of all synopses about memory and amnesia is because it is interesting to me and I hope interesting to others. But also because I am not a doctor, psychologist, neuroscientist, or even a person producing a radio story about whether or not amnesia exists, and yet I have been able to find stacks and stacks of information about it. Professionally and ethically, I think Scott Carrier dropped the ball and I hope that in the future people will actually research a topic before writing or talking about it.

But also, like Rachel Howard, I have been personally affected by amnesia, and so I don’t see it the same way most people do. It shouldn’t be a contrivance of film and television. Even a movie I love, Wall-E, had the contrived (and offensive, to me) amnesic moment at the end, with his memory being miraculously restored by a kiss. This kind of thing is something you probably never think about, just as you probably never thought about how a murder mystery dinner is just as distasteful as a rape mystery dinner would be, even though it is ubiquitous.

As I said, it’s impossible to be aware of all of the things in the world that should be treated with sensitivity, gravity, solemnity. I hope, however, that I have contributed in some small way to people realizing that amnesia, like murder, is not only real but devastating to anyone who has experienced it. Given this, perhaps some day we can stop treating it as pop-culture fodder.

Not “just” a theory

In response to this blog post, Graydon wrote:

“To be a little nit-picky: there aren’t very many science *facts*. There are a lot of theories, and they are often very sound theories in that they hold true with observed historical data and they predict future observed data. Mr. Goodyear could have just said he didn’t believe in the theory of evolution, and that would have been one thing (admittedly not a great thing, evolution is a pretty widely trusted theory). But I agree, to link it to his religious beliefs has frightening implications that his religious beliefs affect his ability to make scientific decisions. That is to say: goodbye stem cell research in Canada?”

And he is correct. Most of scientific knowledge is composed of theories. However, there is a very big difference between the colloquial definition of theory and the scientific definition of theory.

Generally we understand theory to mean speculation or hypothesis. One cannot reach an evidence-based conclusion via a set of facts, so one posits a theory.

The following explanation of scientific theory is taken from the U.S. National Academy of Sciences book Science, Evolution, and Creationism:

“Some scientific explanations are so well established that no new evidence is likely to alter them. The explanation becomes a scientific theory. In everyday language a theory means a hunch or speculation. Not so in science. A scientific theory is a well-substantiated explanation of some aspect of the natural world, based on a body of facts that have been repeatedly confirmed through observation and experiment. Such fact-supported theories are not ‘guesses’ but reliable accounts of the real world. The theory of biological evolution is more than ‘just a theory.’ It is as factual an explanation of the universe as the atomic theory of matter or the germ theory of disease. Our understanding of gravity is still a work in progress. But the phenomenon of gravity, like evolution, is an accepted fact.”

The following explanation of scientific theory is taken from the National Academies web site:

“The formal scientific definition of theory… refers to a comprehensive explanation of some aspect of nature that is supported by a vast body of evidence. Many scientific theories are so well established that no new evidence is likely to alter them substantially. For example, no new evidence will demonstrate that the Earth does not orbit around the sun (heliocentric theory), or that living things are not made of cells (cell theory), that matter is not composed of atoms, or that the surface of the Earth is not divided into solid plates that have moved over geological timescales (the theory of plate tectonics).

Like these other foundational scientific theories, the theory of evolution is supported by so many observations and confirming experiments that scientists are confident that the basic components of the theory will not be overturned by new evidence. However, like all scientific theories, the theory of evolution is subject to continuing refinement as new areas of science emerge or as new technologies enable observations and experiments that were not possible previously.

One of the most useful properties of scientific theories is that they can be used to make predictions about natural events or phenomena that have not yet been observed. For example, the theory of gravitation predicted the behaviour of objects on the moon and other planets long before the activities of spacecraft and astronauts confirmed them. The evolutionary biologists who discovered Tiktaalik [http://en.wikipedia.org/wiki/Tiktaalik] predicted that they would find fossils intermediate between fish and limbed terrestrial animals in sediments that were about 375 million years old. Their discovery confirmed the prediction made on the basis of evolutionary theory. In turn, confirmation of a prediction increases confidence in that theory.

In science, a ‘fact’ typically refers to an observation, measurement, or other form of evidence that can be expected to occur the same way under similar circumstances.

However, scientists also use the term ‘fact’ to refer to a scientific explanation that has been tested and confirmed so many times that there is no longer a compelling reason to keep testing it or looking for additional examples. In that respect, the past and continuing occurrence of evolution is a scientific fact. [Emphasis mine.]

Science depends wholly on empirical evidence and testable explanations that have been overwhelmingly substantiated. All accepted scientific knowledge has withstood extensive testing and retesting by various scientists across the world and over time. Evolution, for example, has been tested by thousands of scientists for 150 years.

Creationists or intelligent design proponents (“neo-creationists”) count on the public’s ignorance of the definition of scientific theory when they say things like, “Evolution is just a theory.” Yes, and so are gravity, the theory of relativity, germ theory, the genetic basis of heredity, and the circulation of blood. All just theories. In truth, they are factual descriptions of the natural world accepted by scientists.

Anti-evolutionists will also claim that there is still disagreement within the scientific community about evolution. This is a half-truth. Scientists do not question whether evolution is true, but they still debate the mechanisms by which it works. As always takes place in science, scientists continue to study how things work after they have concluded that they do work (see above example of gravity).

Again from the National Academies:

“Because the evidence supporting it is so strong, scientists no longer question whether biological evolution has occurred and is continuing to occur. Instead, they investigate the mechanisms of evolution, how rapidly evolution can take place, and related questions.”

Don’t be entangled by those who would try to fool you with semantics. Scientific theory or more than “just a theory.”

Gary BADyear!

Aren’t I clever? See the pun above? The guy’s name is Gary Goodyear and I…well, you see what I did there.

Gary Goodyear, who is Canada’s Minister of Science and Technology, is a chiropractor by training, doesn’t seem to understand evolution and is not able to provide an explanation or valid example of it, and is probably a creationist.

Here’s what he had to say when asked if he believes in evolution: “I’m not going to answer that question. I am a Christian, and I don’t think anybody asking a question about my religion is appropriate.”

This is our SCIENCE minister!

The fact that he equates a question about evolution with a question about his Christian beliefs is evidence enough that he is a creationist. If he were a true scientist he would know that a question about evolution is a question about science, not religion.

He also said, “My view isn’t important. My personal beliefs are not important.” Argh. This is not about personal beliefs; it’s about scientific fact. Clearly he thinks that evolution is a personal belief. Maybe he thinks gravity is a personal belief, too. How about the fact that the earth is round? Is that a personal belief? Or that the earth goes around the sun? Germ theory?

He is our SCIENCE minister!

After refusing to the answer the question for a few days, he finally did on CTV by saying that he does believe in evolution. Goodyear then proceeded to provide the following laughable examples of his “evolution”. Anyone who knows anything at all about evolution should get a huge kick out of this (or a sharp sinking feeling in the pit of your stomach):

“We are evolving every year, every decade…. Whether it is to the intensity of the sun, whether it is to, as a chiropractor, walking on cement versus anything else, whether it is running shoes or high heels–of course we are evolving to our environment.”

This has caused many scientists to speak out. One of them, Brian Hall from Dalhousie University, was quoted in the Globe and Mail saying, “This is not evolution. The minister is confusing evolution with lifestyle adaptation.”

Evolution is small genetic adaptations passed from one generation to the next, causing big changes over hundreds, thousands, millions of years. As Brian Hall pointed out, the minister’s examples would be real examples of evolution if humans had adapted sun-resistant skin or extra padding on our feet to make them resistant to concrete. We have not.

Kudos to the media and the scientific community for being relentless on this one. They have continued to probe Goodyear, asking him to clarify his “explanation” of evolution. Guess what? He refused.

Now can we do something to get him fired?

What the hell is happening to my country?!?!?

(Here’s a great article about this on the CBC web site.)

Depression

Today is my mom’s birthday. I needed to order a copy of her death certificate a little while ago, and it was in my mail box when I got home from work. Is that irony?

In the past two-and-a-half years, my mom died, my gramma died, and the person I loved with my entire heart and soul got amnesia and forgot me and our entire relationship.

So I know a little something about sadness, grief, and depression.

When my mom died, I fell apart and mostly just cried and slept for days. I had a “day job” at which I worked 20 hours a week; after taking a few days off I had to go back to work, and I managed to slog through. But my booking and publicity company, which I ran from my home, suffered a serious blow and never fully recovered. I couldn’t work for weeks.

Eventually one morning I woke up and decided this would be the day—I’d indulged my grief long enough and today I must get back to work. I showered, had breakfast, went to my computer, checked my e-mail, hit the “reply” button…and I couldn’t type anything. I literally felt physically incapable of working. It was like my brain was refusing to participate.

And so I went to the couch and spent yet another day watching crap and eating crap.

I did very little for a couple of months. I watched more movies and TV shows on DVD than I care to admit, went on very long walks in the cold, and ate a lot of not-good-for-you food. I didn’t go to the gym. I couldn’t read; I would find myself stumbling over the same line over and over again before finally giving up. Eventually I did get back to the work of my business—there were tours that needed to be booked and I couldn’t let my clients down—but it was half-hearted at best.

In time I got over it. Which is to say, I got over this depressive period (you never really get over death).

Then I met the aforementioned love of my life. I fell in love, and I got happy again. And then she was diagnosed with a brain tumour, had brain surgery, got amnesia, and forgot me completely.

The depression this time lasted…wait, what month is it? (Joke.) Luckily I had taken a leave of absence from work, so I didn’t have to work at all for the first couple of weeks. (My business, along with my girlfriend, our relationship, and my heart was another victim of the brain tumour; it didn’t recover from this knockout punch). Again I did a lot of sitting around watching crap and eating crap. I didn’t take walks this time. I still couldn’t read or concentrate on much. I slept a lot.

But eventually I healed enough to get back to a normal life.

When my gramma died I didn’t leave my apartment for three days. It happened about three months ago and I still think about her every day. Sometimes I cry.

I consider all of these experiences small-d depression. My mood, work, sleeping and eating habits, energy level, ability to concentrate, etc. were certainly effected, but it was never debilitating. I still got out of bed, I showered every day, I ate and spoke to people, I worked when I had to. I never entertained thoughts of suicide or felt like I didn’t want to live.

Often depression can manifest itself as a cycle of guilt, anger, and self-blame. I went through a period of guilt when my mom died and I spend a few weeks doing nothing. I was angry with myself for not being able to get back to work, for not being able to just get over it already! That was until I spoke to a friend of mine whose brother had died at around the same time as my mom. She too was incapable of reading or concentrating on work and experienced many of the other symptoms I had. Our conversation was beyond helpful. Suddenly I felt validated. I didn’t feel like such a worthless failure. It wasn’t just me—it was grief, and I had to let it run its course.

When we are physically sick, say with the flu or a cold, we don’t feel guilty or worthless or angry with ourselves for being sick. Generally we allow our bodies to heal. We continue to feed them and give them plenty of rest and liquids, and eventually we get better. Our bodies tell us what they need—they’re very smart that way. When we’re tired, it means we need sleep. When we experience pain, it’s because our bodies are trying to alert us to something that needs our attention.

Depression can be considered a mental illness (I don’t mean that in the psychiatric way, I just mean as opposed to a physical illness). When we suffer mental pain, our minds need a chance to heal just as our bodies need to heal from the flu. Depression is our mind’s way of telling us that something is wrong and that it needs some time to make itself better. Inevitably small-d depression ends, just like a cold. I think of this kind of depression as a cure for mental pain; it’s the time my brain needs to heal itself.

Big-d Depression—clinical depression—can be debilitating; it can negatively impact one’s life in very serious ways and can effect one’s overall mental and physical health.

While some of the symptoms I experienced coincide with the symptoms of clinical depression (these include an inability to enjoy previously enjoyable activities, poor concentration and/or memory, anti-social behaviour, fatigue or lethargy, insomnia or oversleeping, changes in appetite, etc.), I never entered the realm of clinical depression for which I felt the need to see a doctor.

Big-d Depression may also include feelings of worthlessness, helplessness, hopelessness, self-hatred, and wanting to die. Very serious cases may also involve psychotic episodes, delusions, and hallucinations. For cases like these, medical attention is most certainly required. While I don’t advocate frivolous or ill-considered medicating, often medication can be very effective in treating clinical depression. The process of getting better in such cases can involve trying out a few different psychiatrists/psychologists/counsellors and/or a few different medications until you find the one that works for you.

In any case, we must pay attention to what our bodies and our minds tell us. If ever you feel like your depression is something serious, if it lasts for a long period of time, if your friends and/or family express concern, if important things in your life are suffering, if you don’t want to live, then seek medical attention.

There will always be hard days. The anniversary of the day my mom died, Mothers’ Day, Valentine’s Day, etc.—these all make me sad and conjure up painful feelings, as I’m sure my gramma’s birthday and the anniversary of her death will in the future.

Today is my  mom’s birthday, or it was (it’s after midnight now). I knew it would be a hard day, so I planned for it. I kept myself busy with work and the gym, and I made plans with some dear friends for tonight. I hardly spent any time alone all day.

But now I am alone. I should be sleeping, but I don’t feel tired. Instead I’m writing this. I’ve been staring at this death certificate thinking about my mom’s life and about how, in the end, your entire life can come down to the answers someone writes in a series of boxes on a form. It’s depressing. I’m sad. I’m crying.

But that’s just tonight, and tomorrow is another day.

NOTE: I am not a medical doctor or mental health professional and the content of this post should not be taken as a prescription for dealing with depression. Make sure you consult your doctor in the case of depression if it worries you—or someone who cares about you—in any way.