2021-09-28 - What But Why Gets Wrong About Medicine and Science


So recently I was exploring youtube and I discovered the channel “But Why?”. This channel is a rapidly growing channel approaching 100k subscribers and concerningly produces very questionable quality of scientific content. Unlike other popular channels with so much misinformation, “But Why?” is educated enough to explain basic physics knowledge to give the appearance of scientific knowledge to their audience on other subjects, most worryingly medicine. Since this channel already is attracting a lot of attention from undergraduates, I felt the need to work with my friends to debunk some of these problematic claims.

Even his presentation in his strong point, physics, is questionable - the most recent video, “How to leave behind a stellar corpse”, already left me with a sour taste of the channel. While the nuclear and quantum mechanics is likely mostly correct, and he did correct mistakes in the comments, much more frustrating is his portrayal of Einstein as an arrogant fool who denied the existence of black holes. This is outright absurd from a historical perspective, and gives viewers a naive understanding of the production of science.

Einstein produced his theory of general relativity in 1915, which soon after Karl Schwarzchild produced exact solutions that eventually described what we know as a simple form of a black hole. Einstein rejected this solution representing a real phenomenon - which is why “But Why” says that Einstein didn’t believe in black holes. But it’s important to remember that field equations can describe not just how things actually work, but also phenomenon that may likely not exist, but still have a mathematical interest. Nobody during most of Einstein’s life probably thought that black holes were physical phenomenon, and it wasn’t until scientific developments exploring stellar collapse, gravity, atomic physics and quantum mechanics was it that black holes were taken more seriously. Additionally, the tools for detecting these supermassive invisible objects was not availble until the second half of the 20th century (recall that radio was only first discovered in 1886!).

Portraying Einstein in this light misinforms the public on how science actually progresses as a subject. It makes viewers believe that scientists simply deny important realizations through arrogance, rather than analyzing the known facts first. It teaches us also to not see the perspective that Einstein was coming from, as a person who had much less information than we do today. It also makes us not realize the significance of the kind of thinking that Einstein needed to create his theory of general relativity. It reduces Einstein’s value as a thinker into a few papers rather than the influence as a whole he had on the discussion for years.

Anti Aging Nonsense

Much more worrying though is when a physics student suddenly decides they are an expert on medicine. It’s very important to understand that the subjects of physics are completely different from that of medicine, and removed entirely from a human experience. “But Why” shows little to no care or nuance for understanding the impact that these serious medical conditions have on the lives of patients. Not only this, but he misinforms an impressionable audience, who may be directly impacted by these conditions, and spreads misconceptions at large about how these complex conditions work.

For example, a very questionable pair of videos, titled “The New Theory of Aging - A Degenerative Disease” and “We Can Reverse Aging”, presents a narrative that aging is a disease caused by evolution that can be “cured”. They use a set of decades-old known mechanisms regarding regulation of cell death to make this tired, cliched pop science argument about how cell death is the leading cause of aging and can be reversed through hijacking specific cellular chemical systems. To say that this presentation of aging is misleading is an understatement. The author even goes as far as to imply that this knowledge can help “treat aging”.

These arguments promote a complete lack of understanding of many age-based conditions, and make the assumption that aging can be equated to automated cell death. For example, conditions like Alzheimers, which are caused largely by the buildup of “garbage” chemicals that form plaques in the brain, would not be reversible through this process. Conditions like heart disease and diabetes also cannot be reversed in these ways, because in most cases these conditions are caused more by environmental factors than cell repair. Additionally, living longer also means a higher rate of cancer - a problem that is offset by programmed cell repair slowdown.

Additionally, even in ideal conditions, stopping this slowdown of the body would not be beneficial. Some organs of the body grow larger and larger constantly, such as the liver and intestines, which grow in response to damage. This means that stopping this cell slowdown could lead to enlarged organs that greatly interfere with everyday living and can be extremely disabling and even life threatening in of themselves. Scar tissue on such a liver would eventually impede on its ability to function. These relationships are already observed in alcoholics who do profound damage to these organs through their addiction, or those who struggle with fatty liver disease caused by diet.

Assuming that DNA “only exists” to spread itself through reproduction is a major mistaken understanding of evolutionary biology as well. While DNA carries a means of creating more bodies of a species through reproductive processes, there are larger social factors such as upbringing and larger communities that have nothing to do with reproduction that allow for reproductive success. For example, it can be argued that the wisdom accumulated from living a long time gives long-lived people a direct evolutionary advantage for the entire community. Eusocial insects product thousands of individuals who have no reproductive capacity but still serve an obvious important ecological role, so reducing aging into “throwing out old people” is reductionist and ignores complex ecological interactions. Not even discussed is the possibility for aging to be a means of population control, which would have been very important in extreme environments primative humans often found themselves in.

This is not to say that this research has no potential useful application in human health. As he cites in his sources, there are treatments being explored using this research to try to treat certain kinds of blindness. It is far beyond my capacity to know whether or not this is a viable treatment, but the much larger problem is how very few people actually watching this video understand the actual potential value of this research. By conflating this important research with an absurd “treatment of aging” narrative, viewers are completely unaware of how this research impacts treatments and our relationship with medicine.

Split Brain Spectacle

Another frustrating set of videos are “Why We Have Two Brains” and “The Role of Your Two Brains and the Importance of Communication”, which discusses split brain patients and laterialization of the brain. Frustratingly, like most pop science introductions to split brain patients, “But Why” shows little interest or sympathy in the actual lives of split brain patients, using them as a curious example for onlookers. Instead of focusing on the management of these patients, which has been an important source of research regarding brain lateralization, he continues the trend of focusing on their unusual symptom set. He also doesn’t use any other case studies regarding similar conditions to talk about lateralization, such as cases where children have half their brains removed for severe childhood seizures, or serious one-sided brain injuries. Additionally, he uses the confusing term “split brain personality” which not only implies this symptom set is related to personality traits, but surely confuses some audience members with the old psychological term “split personality”, more often called dissociative identity these days.

On the subject of lateralization, he discusses the commonly spread myth of “left brain being cognitive, right brain being conceptual”, an association that can be naively observed but has been disproven for decades. Not only does this model not account for any sort of abnormality or unusual development in the brain (for example, some people are born missing entire parts of the brain or lose parts of their brain to early surgeries) but it also fails to account for social factors that may impact how both sides are developed into this pattern. It is true that lateralization provides a major benefit for organisms though - through the merging of two different perpsectives - but the way that this process is presented makes the viewer naively believe this lateralization forms along preconceived constructs. Very worryingly, he also provides a lecture on how language processing works in this model, which is entirely unsourced.

The claim that split brain patients can no longer process a singular self is technically misleading. The curious experiments that “But Why” links to in the video are specifically designed to bypass a split-brained patient’s ability to identify a singular self, which is useful for researching some aspects of lateralization - but as presented, it also transforms a person with a mostly invisible disability into a spectacle. Watching this video, which also includes footage of the patient and their everyday life, makes it clear that not even the patient really observes this “dual brain” effect outside of specific circumstances. This is because both sides of the brain are able to use social conditions as a form of therapy or accessibility to overcome this damage, a subject that is not explored in the video either. Does “But Why” expect us to simply ignore the profound effect of these social conditions as he discusses lateralization as they present themselves to the viewer?

It’s worth pointing out that such casual dips in brain research has real consequences for how people interpret the mind as a subject. While these kinds of arguments may satisfy some inexperienced viewers who are unfamiliar with the field, it also causes those who are more skeptical of these claims to make them believe the entire field of research surrounding brain lateralization is flawed. It’s very important to present research and scientific theories as carefully as possible because the public already struggles with understanding the consequences of this research and how it impacts their lives.

Autism and Lateralization

Far worse though is how he then suggests how lateralization may play a “significant role” in autism. The way that this research is presented is beyond irresponsible. First and very importantly, Autism research is one of the most hotly contested fields in all of medicine, involving millions of researchers worldwide exploring competing theories, and is influenced heavily by governments, education, and especially autistic people themselves and their relationship with their own treatment. One can find plenty of research in any of these theories and believe that it presents significant evidence that their chosen pathway plays a “significant role” in the development of autism, but this doesn’t necessarily correlate with an actual significance. The fact that “But Why” doesn’t provide counterpoints to contrast these theories with is extremely worrying, and the weakness of the research provided calls into question why this was even included, especially since many viewers likely have autism and he is directly misinforming them about the research of their own condition. “But Why” does rightfully point out that the meta analysis cited states that the information is inconclusive and more research is needed despite an observed trend, but it forces us to ask - why did he even discuss this in the first place as if it played a “Significant role” in autism?

While he does discuss a little about some of the details regarding prevailing theories of congenital autism and their relationship to over-innervation, he does not seem to understand that these symptoms are the result of a wide and varying range of possible conditions, as reflected in the diversity of morphologies of nervous systems of autistic patients. He concludes this segment by stating that “this is why having two brains is so important”, subtly implying that autistic people have a disadvantage due to these claimed differences. “But Why”’s presentation of autism isn’t necessarily bad because it is loaded with factual errors, but rather because he knows so little about the subject matter and its contexts, he constructs an overly simplistic perspective of autism. Even if its based on research, that research does not include the context of how it was produced or the relationship that it actually has with autistic people, nor how that research interacts in the larger context of autism research.

Emotional Valence

Also questionable is his explanation of emotional processing and lateralization. He explains that emotional valence, which is a relationship between a subject’s emotions and their perceived positive or negative value, is territorially distributed between the two sides. He concludes this from a study where patients were injected with anesthesia on different sides of the brain, reporting different emotions - a study he doesn’t cite. Regardless of the authenticity of the study, such a conclusion is very hasty - the brain’s activity was impacted by the anesthesia, but also likely impacted by imbalances elsewhere caused by these issues. This is actually why research on emotional valence often instead uses patients with brain damage as subjects. Neglected as well is the discussion is the importance of facial recognition and emotional response in these studies, which have more reliable results than the method described. Ultimately, the subject of emotional valence is quite complicated and is heavily oversimplified in this video.

Disability and Pop Science

All of this is then returned back to ask a question that focuses on a subject that is as mundane as it is uninmportant - why do people often prefer to listen to music in the left and people in the right? However, even this conclusion is faulty. For example, I have a persistent itch in my right ear that makes earbuds less comfortable in my right ear - surely this accounts for my preference somewhat. How can we also account for microscopic levels of deafness or small neurological issues that could cause this difference? Why does any of this really matter anyways? A serious social problem with our relationship with medicine becomes apparent: Misrepresenting the medical research and multiple disabilities for a cute presentation that pulls us back into a subject that matters as much as what you ate for breakfast this morning demonstrates how, despite being the very subject of all of this research, despite being the very reason why these theories exist - disabled people do not matter as much as an answer to a simple question.

Why did I get so upset about these mistakes? I understand the person creating this channel may be just simply yet another inexperienced person in the world trying to educate people. But when these claims start to be about people’s lives, about the relationship that people have with medicine and disease, it is ultimately an ethical responsibility to be as accurate and respectful as possible. Perhaps if “But Why” wants to continue making videos about medicine, they consult someone who has direct experience researching or teaching about these subjects instead of relying solely on intuition to produce some interesting videos. After all, this video wasn’t made alone either. But when we make a public statement on science, especially medical subjects, our words have real power over people’s lives. For almost 15 years on this platform I’ve seen the medicine surrounding our struggle be captured for entertainment or advertising purposes, is it so much to ask that those who produce this kind of “educational content” make a realistic presentation of these issues?


Videos criticized: How to Leave Behind a Stellar Corpse: https://www.youtube.com/watch?v=n1FhudqXgvI The New Theory of Aging - A Degenerative Disease: https://www.youtube.com/watch?v=qoc29xFMRdM We Can Reverse Aging: https://www.youtube.com/watch?v=cY25i_bkUys The Roles of Your Two Brains and the Importance of Communication: https://www.youtube.com/watch?v=hV2I36qAl9Y


Brains can be rewired: https://www.researchgate.net/publication/12530150_Visual_Behaviour_Mediated_by_Retinal_Projections_Directed_to_the_Auditory_Pathway Brain matter missing in otherwise ordinary patient: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61127-1/fulltext An Evaluation of the Left-Brain vs Right-Brain Hypothesis: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0071275 Severed Corpus Collussum Patient: https://www.youtube.com/watch?v=lfGwsAdS9Dc&t=0s Autism Signalling imbalance theory (requires access): https://pubmed.ncbi.nlm.nih.gov/14606691/ Autism Predictive coding theory https://www.frontiersin.org/articles/10.3389/fnhum.2011.00077/full Autism and Lateralization Meta-analysis (requires access): https://www.tandfonline.com/doi/abs/10.1080/1357650X.2013.772621 Autistic people in autism research: https://www.spectrumnews.org/features/deep-dive/meet-the-autistic-scientists-redefining-autism-research/ An Example of an Emotional Valence Facial Study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676801/


US National Institute on Aging: https://www.nia.nih.gov/health/alzheimers-disease-research-centers


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