Tuesday, January 7, 2014

Science vs Wishful Thinking

There is a new book coming out next month by Dr. Richard Saul called "ADHD Does Not Exist".  Let's not both waste time reading it.  I'll do that for you, if you like, then report back here, where I plan to shred his conclusions.  That's right--the ones I haven't even read yet.  Please forgive the chutzpah.  Here's how I can be so sure I'll be disagreeing with him. 

Simply put, the title of the book, the first four words, is a gigantic scientific red flag:  Science cannot prove non-existence.  

Science can confirm that a thing exists and demonstrate connections between things, but it cannot prove that ADHD or any other construct does not exist.  Science can't examine the whole universe and report back on what the universe does not contain.  It can only examine a tiny fraction of the universe and say, "Yep, found it!" or "Nope, didn't see any."  "It doesn't exist" is maybe just for God to say, probably not for scientists.  

For forty years of medical practice, Dr. Saul has been thoroughly checking his corner of the universe--Northbrook, IL--which, if you haven't been there, is a suburb of O'Hare Airport.  Since he didn't find any ADHD, his conclusion should probably be the "Nope, didn't see any" version, and the title of his book, "ADHD, maybe not?"

This brings up an interesting question.  Thousands of doctors worldwide look for ADHD and subsequently find it.  How could someone examine children for forty years and not find ADHD?  What impairment of attention could prevent a man from seeing something right under his own nose?  

I would know a little about this, because I didn't believe in ADHD for many years.  I was a physician who didn't know very much about it, except that the diagnosis was confusing and time-consuming, the monthly prescriptions were burdensome, and I couldn't technically explain why we were giving stimulants to hyper people.  Even though stimulants work, they are inconveniently counter-intuitive, and they get very bad press.  

But the real, deep down reason I didn't believe in ADHD, was that I needed not to know I had it.  I wasn't ready to see it, because discovering I had it would change my concepts of myself and the universe I lived in.  So I made sure not to find ADHD in me or my patients.  

That began to change for me when I started reading the science behind ADHD.  If you go through the whole US National Library of Medicine and read all 24,358 entries for ADHD, [full disclosure--I haven't finished yet.] there is a mountain of evidence that is beginning to show what goes on in the brains of children and adults who struggle with poor self-awareness and self-control.  The science is early, but a coherent picture is emerging.  
Once my ADHD was diagnosed and treated, I gradually began to see it in some others, too.  Not everyone, just some.  In the past I disbelieved in ADHD.  Now, I accept it.  

"ADHD does not exist" cannot be a fact, but it can be a wish.  I'm going to read Dr. Saul's new book, because I wonder why he needs to believe that ADHD doesn't exist.  What about his world will change when he finds out it does?  

"There is none so blind as he who will not see."  --Ray Stevens

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