By Henry Ehrlich
I recently had the pleasure of attending a conversation at the Brooklyn Academy of Music between film director Martin Scorsese and the writer/raconteur Fran Lebowitz (who plays a judge in his new movie, “The Wolf of Wall Street”). Lebowitz is an inveterate smoker who claims that she and her kind now get more fresh air than anyone else because they are forced to go outside to indulge their habit. She accepts that smoking is bad for her, but asserts that the link between secondhand smoke and disease is a fraud. Her proof, paraphrased here, is that when her generation was growing up, all the grownups smoked around their kids and the only person her age she knows who has asthma is “Marty.” Scorsese’s asthma was famously so bad that it kept him from doing anything more strenuous than reading, going to the movies, and studying the behavior of neighborhood gangsters from a distance. Maybe that’s why he is a rich, celebrated filmmaker and so many of his contemporaries whose lives he chronicles in his movies are dead from natural causes like hot lead injections and ice picks.
Lebowitz says, “Now all the kids have asthma and no one smokes around them.” That’s her proof, but to me it looks suspiciously like anecdotal evidence.
Of course, I imagine she doesn’t believe this, and that she uses it to set up more caustic dissections of modern life. It’s certainly harmless, unlike a US Senator claiming that there is no link between air quality and asthma because asthma is increasing while our air is cleaner than it used to be and therefore there is no need to regulate pollution.
I don’t know my way around a laboratory any better than Ms. Lebowitz does (she was expelled from high school, although she received a GED), but I do know that with diseases like asthma, or food allergies, or any number of other medical phenomena, one-to-one, cause-and-effect relationships between exposure or behavior and disease are hard to prove. Furthermore, proof depends on the motives of those who are investigating. Take Lebowitz’s favorite vice—cigarettes. We know now how many years and how much money the Tobacco Institute spent disputing a connection between smoking and lung cancer. A more timely example is the relationship between football players’ concussions and chronic traumatic encephalopathy (CTE), which was denied for years by NFL doctors.
If Fran read this website, she would know that one of the causative factors in a child’s asthma was grandma’s smoking, as revealed by the science of epigenetics, in which the DNA’s “clothing” is subtly influenced by chemical shifts. This science didn’t exist when my kids were kids, let alone when Catherine Scorsese’s children were kids (Martin’s mother played the mother of bloodthirsty Tommy DeVito in “Goodfellas”), and doubtlessly accounts for much of the general increase of allergies and other inflammatory diseases.
Science is frustrating for those whose kids are sick now. Doctors, too. I interviewed Dr. Renata Engler, now retired from a career at Walter Reed National Military Medical Center, for my new book. She told me, “Fifty percent of evidence-based medicine is significantly revised and/or reversed in five years. Most money goes into confirming what we already know instead of focusing on the gaps where we could add information.”
We know that science begins with observation, but it shouldn’t end there. Can we all agree that the earth revolves around the sun?
Photograph by guestofaguest.com