On Researchers and Implementers

Listen closely, and you’ll hear the war cries as the battle rages on. Listen closer, and you’ll hear the clang of swords clashing into armor, and the ping ping of arrows hitting shields, as the two sides fight on. Yet, they both carry the same banner, adorned with the same family crest. How did it all start? Where does it end? Sit down, and I’ll tell you my observations, and hopefully lend some perspective to both sides of the feud. Please do keep in mind that although the topic of argument was real, the viewpoints of each warrior is based on my idea of where they were coming from, and are not meant to speak on behalf of anyone in particular. With all that said, let’s hear the story of researchers and implementers. A tale of utter woe, miscommunication, and good intentions.

The question of how such a feud started is likely to go unanswered. Perhaps it stretches back to the beginning of communication – and the advent of miscommunication – but it clearly still rages on. Neighbors, and friends, arguing over the equivalent of a trespassing pig. Such a pig will wander past the fence of researcher twitter into the land of practitioner twitter or vice versa. Combine it with a spark of well intentioned correction, and the grease fire alights anew.

Usually, such turmoil begins simply: Dr. Practitioner will begin with some advice they typically use in their practice – this advice is often simplified for the layperson, or is just something that “works well” without anyone necessarily knowing why, or perhaps just assuming it does for some reason or another even if it’s incorrect. After this point, someone else may come in with questions or comments on the method.

For the sake of an example, let’s say the advice was “Eat fiber rich foods for satiation/satiety to fill you up so you eat less”. A discussion has now begun on this method, people all over chiming in that it does/doesn’t work for them, Dr. Practitioner saying it is advice that works for their clientele and so on.

And then the pig trespasses, often innocently, no agenda but the intent to go where it feels it belongs.

Mr. Researcher (citizen researcher or otherwise) steps in, and begins a new discussion on the original advice given, saying that this method or logic is flawed in some way – perhaps the rationale of trying to trick satiety signaling by filling your stomach with undigestable material doesn’t make evolutionary sense to them, or that fiber may result in satiation during a meal but not longlasting satiety.

They provide examples of people not needing fiber for satiety to work properly, that if you trick your body into eating less when it actually needs more it may result in undesirable outcomes, and further: that if you need to trick yourself into fullness this may be a sign something else is going on that needs addressing. If you’re eating properly, your body – and hunger/fullness – should be working like a fine tuned machine, making you hungry for energy and building materials when needed, and full when you have no such need.

Can you smell the smoke beginning to curl its tendrils around the discussion, already? It brings with it a heavy stench that will linger.

Not long after this discussion is started, all hell breaks loose. Even if Mr. Researcher didn’t intend anything bad by the comment, and was merely discussing the plausibility of the advice from their perspective, Dr. Practitioner may feel personally offended, or wronged – after all, they merely mentioned something that works for their patients. Is this other person calling them a liar?

Mr. Researcher likewise defends the dainty princess of scientific integrity and rational logical conclusions – isn’t it more hurtful and less efficient to use methods that mask a problem instead of addressing it?

Swords are drawn. Arrows readied. The grease fire of two like-minded groups talking past each other is well underway – there’s little ability to stop it at this point. Each further comment fuels it, each party’s conviction strengthens it, frustration mounts, the trespassing pig lays slaughtered.

But what is really going on here? What name does such a pig have? Could it be anything else, but the desire to help those who are suffering? In truth both of these parties are, essentially, aiming for the same target.

Both Dr. Practitioner and Mr. Researcher are both aiming to alleviate suffering caused by disease. Dr. Practitioner feels that their methods have merit, because the advice they give in their practice (or consultation business, or coaching service, or so on) results in success. Obesity and diabetes driven into remission, ache-y joints and depression gone without a trace, irritable bowel and eczema banished forevermore.

Mr. Researcher feels that, although the general advice Dr. Practitioner gives may overall have merit, as seen by their success, that only the advice that addresses underlying issues should survive. That which is backed by poor or little evidence, or flaws in logic, or acts as duct tape on a leaking dam, must be culled. The importance of this is reflected in prior assumptions that left many casualties strewn on the field, a death toll that still rings loud in the ears of Mr. Researcher, paired with the knowledge that such an occurrence could repeat if we allow assumptions and ‘just-so’ statements to abound the burden of knowing weighs heavy.

Dr. Practitioner, meanwhile, feels frustration mount – they must discuss with people every day how to be healthier, how to be happier, how to make lifelong decisions. If they take into consideration everything Mr. Researcher says, they would never get anything done! They are fueled by the passion to help people get better, and are fiercely protective of their beloved patients. Anyone who threatens that could very well be an enemy.

Dr. Practitioner may accuse Mr. Researcher of overcomplicating everything, of being a nitpicker, or someone who picks fights over tiny details just for their own amusement. “By overcomplicating everything,” Dr. Practitioner thinks, “My clients will be overwhelmed and not want to change anything. Everything has to be simple or no one will listen!”

Mr. Researcher may feel that Dr. Practitioner is being careless – that allowing advice, memes, or logic riddled with flaws and nonsense to leak through leaves the whole movement at risk. “If I can rip apart your statement,” Mr. Researcher thinks, “Then our mutual detractors would do it just as quickly, and even more viciously. Our arguments must be airtight, our evidence the strongest we can manage.”

Passion Shaping Perfectionism

Their passion fuels them both. Their desire to help those who are suffering drives and shapes their perfectionism and ire.

Sometimes these conflicts will result when each party is squarely on their own land, pig nicely contained, and only then do bystanders come by to open the gate and usher the animal through to the other side. For example, Mr. Researcher and his pack of rambunctious friends may be having a discussion on what initiates diabetes and someone else points out that the discussion they’re having is too complicated, will confuse everyone, and the discussion on how to treat diabetes with diet is already answered.

The spark alights again. Smoke can be seen from a great distance. People stand by on the sidelines with snack in hand, or duck to take cover from the impending fallout.

But these two core concepts is often where people begin talking past each other. There are often two conversations happening simultaneously. The first conversation is often had by practitioners, health coaches, bloggers, and so on. They deal with people who have severe health issues and must be given simplified guides, explanations, and advice in order to resolve the issue as quickly as possible. If one or two items on their list is benign, or the explanation isn’t quite accurate, it doesn’t matter because they get results. This is Dr. Practitioner’s job.

The second conversation is often had by researchers. They may also deal with people in impending health danger, but are more likely to deal with edge cases of people who are struggling even with the mainstream advice from Dr. Practitioner and others. More than that, they also tend to be trying to answer how something works, and what triggers it, more so than finding advice that generally works most of the time without understanding of how it does. This is not because they generally want to nitpick everything and annoy everyone, but because they’re well aware faulty assumptions can cause damage if they become widespread. Not only that, but even if you avoid the initial problem (say, diabetes from improper diet) if you don’t actually fix the problem and understand it, it may come back anew in a different form, because you never really understood the problem in the first place. Whack-a-mole with health problems is not a desirable outcome, even if it becomes messy and difficult to untangle. This is Mr. Researcher’s job.

In reality, both Mr. Researcher, and Dr. Practitioner, are doing their best to help those in the community. Dr. Practitioner fiercely defends their clientele, trying to simplify and shield them from the chaos and confusion so they can work on building themselves back to good health, and Mr. Researcher aims to defend the community against outside attacks that may discredit the movement as a whole by defending the strength of the arguments used. Dr. Practitioner may discuss how to treat a disease in ways that generally works for most people they come across, while Mr. Researcher may discuss what truly causes the disease and why certain things help to heal from it.

Certainly, these may overlap, and clearly they may sound quite similar, perhaps why there’s so much confusion and argument, but ultimately they have the same goal.

Perhaps things would go smoother if these two conversation priorities were clearly labeled – although confusion can abound even when clarifications are given. The concept that something which puts a disease into remission may not reflect what actually led to the disease is a confusing one, certainly (and believe me we’ll be thinking backwards on this concept a lot). And likewise, it could be said that even if this is so it doesn’t necessarily change the treatment.

But all the same both sides matter, and are necessary, and probably rooted in good. Perhaps the arguments will continue on forever, just like family bickering over the holidays is surely inevitable for many.

But perhaps at some point in the future we can begin to understand each other’s perspectives, come to compromise where it doesn’t hurt, learn to listen even if it does.

Hopefully my perspective on this amusing tale gave you something to chew on, if nothing else. Or perhaps something to argue about among friends. Until next time, my fellows.

Let’s argue again, sometime.

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