FRIDAY, JANUARY 6, 2023
No Thumbs On the Scales Left Behind: "How did things ever get this far?"
According to Francis Ford Coppola, that's a question which Vito Corleone once asked. A similar question might be asked of the crazily inaccurate factual claim which appeared in the Washington Post two years ago, and remains uncorrected today.
How did things ever get this far? How did things ever get so far that a crazily inaccurate statement like this could ever appear in print?
NORRIS (12/9/20): We are not just tussling with historical wrongs. A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result.
"A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain?"
On a simple factual basis, the statement in question is crazily wrong. It's also a deeply invidious statement concerning the most important topic in our failing American life.
How did things ever reach the point where the claim—and many variants of the claim—could ever appear in print? Today, we hope to provide a final accounting of the factors which let that vastly inaccurate, invidious claim go into print at the Post.
We'll start with a game of Telephone. Michele Norris' crazily inaccurate claim begins right here, in the abstract to the UVa study to which Norris refers:
Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., “black people’s skin is thicker than white people’s skin”). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs.
At least in theory, the authors of the UVa statement were examining an extremely important topic. In practice, they quickly offered an overview statement which is factually false, or is grossly misleading at best.
Is the highlighted statement accurate? Is it true that "half of [their] sample of white medical students and residents endorsed" a set of false beliefs about biological differences?
At best, that statement is grossly misleading. For reasons we'll revisit below, we think it would be more accurate to say that the statement is simply wrong.
Having said that, whatever! A pleasing game of Telephone would soon be underway. In an essay for an august medical org, Professor Sabin offered her version of that statement by the UVa authors.
In turn, Norris linked to Professor Sabin's essay as she offered her crazily inaccurate claim about what the UVa study had shown:
UVA AUTHORS (4/4/16): Half of a sample of white medical students and residents endorsed a set of false beliefs about biological differences between blacks and whites.
PROFESSOR SABIN (1/8/20): “Black people’s nerve endings are less sensitive than white people’s.” “Black people’s skin is thicker than white people’s.” “Black people’s blood coagulates more quickly than white people’s.”
These disturbing beliefs are not long-forgotten 19th-century relics. They are notions harbored by far too many medical students and residents as recently as 2016. In fact, half of trainees surveyed held one or more such false beliefs, according to a study published in the Proceedings of the National Academies of Science. I find it shocking that 40% of first- and second-year medical students endorsed the belief that “black people’s skin is thicker than white people’s.”
NORRIS (12/9/20): A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain.
The professor's statement is more precise than those of the two other parties. That said, she added the emotional resonance about the "shocking" / "disturbing" beliefs of the medical trainees, who she inexcusably described as throwbacks to the 19th century.
Norris took it from there! Linking to Sabin as her source, she authored a crazily inaccurate account of what the UVa study had shown.
In fact, did any of the medical trainees in the UVa study really "endorse" any of the false beliefs about those biological differences?
For reasons we'll revisit below, it isn't entirely clear that any of the trainees actually did—but having said that, so what? A poorly stated research finding had made its way to the Washington Post, where it served a tribal interest.
Norris authored a stunningly inaccurate, invidious claim about These [White] Medical Students Today. Her claim was stunningly inaccurate, but then again so what?
In these highly tribalized times, our profoundly unimpressive blue tribe loves to make invidious statement concerning matters of race. In our desire to produce such claims, we very frequently work from this framework:
No Thumbs On the Scales Left Behind!
How did things ever get that far? Consider again what Norris said:
In fact, the UVa study only claims that 16 of the 222 (white) medical trainees actually expressed the false belief which Norris specifically mentions—and 16 out of 222 is nowhere close to half!
That's what the UVa study claimed. In fact, it isn't entirely clear that any of the (white) medical students actually "endorsed"—actually said that they believed—the inaccurate statement which Norris specifically cited.
In one of the several major thumbs the study's authors placed on the scales, the authors ruled that a trainee had "endorsed" a specitic false statement if he or she merely said that the statement was possibly true.
The trainees weren't allowed to say that they simply didn't know if some statement was true. And, according to Kevin Drum, almost everyone who was scored as "endorsing" a false belief had actually checked the box which said that it was "possibly true."
DRUM (1/4/23): [The medical trainees were] allowed to mark an answer as "possibly," "probably," or "definitely" true or false. With one exception, which I'll get to, virtually every single person who marked a false statement as true said it was only "possibly true." Among all the false statements, there were 229 marks of "possibly true" and only 9 marks of "probably true." There was not a single mark of "definitely true."
The one exception to which Drum refers concerns the statement about thickness of skin. According to Drum, almost no one ever marked any other false statement as even probably true.
The woods are lovely, dark and deep. On its face, the research design of the UVa study strikes us a horrible scam, though we'll assume that the authors of the study were acting in total good faith.
At any rate, the thumbs which were placed on the scales began with the authors of the UVa study. When they published their account of what they had found, a game of Telephone ensued.
This short game of Telephone ended up "getting that far"—reaching the point where Norris, and the Washington Post, were publishing a grossly inaccurate factual claim about Those [White] Medical Students.
This grossly inaccurate factual claim involves the most important and consequential part of our failing American life—but so what? It was the kind of invidious racial claim our blue tribe instinctively seems inclined to believe and now desperately loves.
We've decided to stop right here today, with the game of Telephone and with one thumb on the scales. We've decided to wait for another day to list the full array of ways the authors of the UVa study put their thumbs on the scales in their design of this study.
Yesterday, an irate commenter to Kevin Drum's post offered an irate comment concerning Drum's assessment that UVa study was an ungodly mess. Below, you see what the irate commenter said—and in truth, we think this irate comment only makes our tribe's performance seem worse:
COMMENTER PERRY (1/4/23): Like Somerby, Drum substitutes his own lack of knowledge for the judgment of PNAS (Proceedings of the National Academy of Science) peer reviewers and pain researchers, dismisses a result he does not wish to acknowledge, and pretends that every study should be accessible to the general public without any background or training in medicine, pain research, measurement (creation of surveys) or experimental research. Neither Drum nor Somerby would be saying anything about this study if it did not touch on race, and the defensiveness of both men is obvious.
The irate commenter notes the fact that the UVa study passed through the hands of academic peer reviewers. Given the many baldly obvious shortcomings of the UVa study, this only makes it more amazing that things could have gotten this far.
(Inevitably, the irate commenter goes on to suggest that criticism of the UVa study is a result of bad faith in the area of race. According to all major experts, our brains are wired to produce such ad hominem denunciations—and for that reason, our own blue tribe will never stop producing these deeply unhelpful invidious claims concerning matters of race.)
We've shown you the way the game of Telephone worked. For the record, let us return to another high-level version of what the UVa study showed.
This version comes from Linda Villarosa, writing in the New York Times Sunday Magazine:
VILLAROSA (4/11/18): In 2016, a study by researchers at the University of Virginia examined why African-American patients receive inadequate treatment for pain not only compared with white patients but also relative to World Health Organization guidelines. The study found that white medical students and residents often believed incorrect and sometimes “fantastical” biological fallacies about racial differences in patients. For example, many thought, falsely, that blacks have less-sensitive nerve endings than whites, that black people’s blood coagulates more quickly and that black skin is thicker than white.
Villarosa isn't a general interest journalist, as Michele Norris is. Villarosa is a highly-regarded medical specialist whose current book, Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, has been chosen by the New York Times as one of the ten best books of the year.
Villarosa is a major medical specialist, but her highlighted statements about the UVa are just flatly false.. Beyond that, she adds the claim that These White Medical Students Today don't simply believe claims which are false. According to Villarosa, These White Medical Students Today believe fallacies which are "fantastical" concerning racial differences!
How did things ever get this far? In the end, only the anthropologists and the psychologists can hope to answer that question. But in our next report, we'll list the various thumbs on the scales which are found in the widely-cited UVa study.
Our own blue tribe is able to see The Crazy which often prevails with the red tribe. We have little ability to see the astonishing way our own tribe functions as we churn invidious claims about the most important single topic in our failing American life.
Next: Thumbs on scales? Let us count the ways!