Saturday, May 29, 2010

Causation or Coincidence?

First, thanks to those of you who left comments or sent private messages after my last post, A Minor Medical Mystery.  I really appreciate it,   And I want to quickly acknowledge that this is far from the worst that could happen.  As I understand it, kidney stones are generally not that serious of an illness, the pain is about as painful as pain can get, but that's about it.  And on that score, things have improved, as I haven't experienced the worst of the pain in the last couple of days.

On Thursday morning, I was checked by an urologist, the stone should pass at some point, and I have to drink lots of fluids, and take Tamsulsin, which increases the flow.  With all that, well, you might say a river runs through me!  Oh, and I have painkillers to take, as needed.

But, here's the interesting part, or at least mildly interesting.  In my previous post, I mentioned how the emergency room doctor characterized getting this kidney stone after a colonoscopy as a "bizarre coincidence" and how my family physician was of the same opinion.  But in a comment Michael left on A Minor Medical Mystery, he said, "The stuff that you take to clean out your system can have an impact on the kidneys," and he is quite right, indeed.

Specifically, my urologist said that the preparation for a colonoscopy involves draining the water out of your digestive track, along with washing everything else out), and that dehydration leads to kidney stones.  In fact, he said that this is the kidney stone season (did you know kidney stones have a season?  I didn't), as it's been quite hot in the area lately, up into the 90s, and that results in people getting dehydrated as well.  I haven't been out that much, though, so it's really about the dehydration from the colonoscopy preparation, which no doubt pushed whatever was already forming in my kidney past the tipping point.

Of course, this is not to say that there's any proof that the dehydration from cleaning out my digestive system caused the kidney stone problem I encountered a few hours after my colonoscopy, just that it's a possible explanation for this not so bizarre coincidence, and a reasonable explanation for it.

Part of the problem in pinpointing the connection is that, rather than simple cause and effect, we have cause and side effect, where the side effect occurs in a system other than the one being acted upon.  We also have cause and indirect effect, where there is one or more intermediary effects, in this instance colonoscopy causing preparation (which came before the colonoscopy itself, but was required for the procedure, so a case where the cause precedes the effect), preparation causing dehydration, dehydration causing stone.  The problem of dealing with side effects and indirect effects comes up quite frequently in media ecology, as we try to understand how changes affects systems (e.g., technological innovations affect social systems).

When folks work from a non-scientific approach, they sometimes dismiss the possibility that anything can be a mere coincidence.  In one sense, this fits in with an ecological approach, all things are interconnected.  But in terms of linear cause and effect, that's not the case, which is why post hoc ergo propter hoc is a logical fallacy.  For those unfamiliar with this, the Latin phrase basically means after this therefore because of this, in other words, because one event came after another, the earlier event must have caused the later one.  Certainly, we expect the cause to precede the event, so temporal sequence is part of the story, but it's not the whole story when it comes to causation, as there must be a direct link between cause and effect (or a series of direct links in a chain of causes and effects).  Assuming that there is a direct link when there isn't is, in general semantics terms, assuming that it's a statement of fact when it's only an inference.

Put another way, researchers will caution that correlation is not causation.  By the way, when there's correlation without any necessary temporal sequence, say when two events happen simultaneously, that sort of thing is associated with another logical fallacy, cum hoc ergo propter hoc, with this therefore because of this.  Again, the fallacy is believing that there is causation involved, or even some direct interrelationship, rather than simply coincidence, that is, simply a temporal relationship of co-incidence.  Or synchronicity.

For example, I said above that "you might say that a river runs through me," and that was meant as a humorous allusion to the book and film title, A River Runs Through It.  I made that little joke before checking to see what new films have been added to the Starz On Demand cable television service for this week, and when I went to check, I kid you not, the 1992 Robert Redford film A River Runs Through It had been added to the line-up!  Did I somehow cause it to happen?  Did some kind of supernatural force line the two events up in time?  Or is it mere coincidence?

Another, different kind of example.  Today, my mother called me up.  She was upset, because she was watching TV, and a commercial came on for one of those law firms saying to come and see them for getting compensated for various medical conditions.  I've seen them before, no doubt you have too.  Well, she saw one that I had never seen or heard of before, one where they included on their list of possible causes for legal action, if your kidneys have been damaged by a colonscopy!  There is at least some element of coincidence in her seeing this commercial at this time (and I reassured her that what I have is a stone, not kidney damage (as least I hope not)).  But apparently there is enough of a causal relationship to merit malpractice suits, and advertising time!  And quite a few hits on a Google search as well!

Proving causal relationships is always problematic, which is why the cigarette companies were able to get away with denying that tobacco causes lung disease for so long.  It finally took a collective cry of BULLSHIT! and some legal and legislative action to get them to own up to it.  On the other hand, there's a psychological syndrome that's not all that uncommon where people genuinely believe themselves responsible for something they couldn't possibly have caused, say someone is looking at a stranger on a city street, and that person gets hit by a car, and the onlooker thinks that he somehow caused that to happen.

Or, on the lighter side, one of the silly amusements we engaged in, as I recall from my misspent youth, was to put on an album that we liked, turn on the television with the sound off, and enjoy the random connections that could be made between the music and the moving images.  I vaguely recall watching figure skating with some rock album on, and the synchronicities had me and my friends in stitches.

One thing such practice that diffused through the social networks a bit after my time was that you could watch the classic film, The Wizard of Oz, with Pink Floyd's trippy album, Dark Side of the Moon playing, and you'd see remarkable coincidences.  My guess is that this didn't really come up until after the movie came out on video, which would have been around 1981 or so.  It probably also followed the introduction of the Compact Disc in 1983, as vinyl would require flipping the album over, whereas the practice is to set the CD on repeat (it plays three times through to the end of the movie).  I think we can consider it an early form of the mash up or remix.

For a rundown on all of the synchronicities that come up, check out The Darkside of Oz -   For a more balanced account, take a look at the Wikipedia entry on The Dark Side of the Rainbow.  And to see for yourself, at least through the first third of the film, take a look below, courtesy of the good people at Google:

My thanks to Chad Calease, who brought this video to my attention via Twitter.  Chad's website, thinfilms, and his thinfilms blog, are worth checking out.

So, what do you think?  For my part, I can see being in college and checking this out with a group of friends, everyone inebriated and finding it absolutely amazing, and hilarious.  Context is everything! But now, watching it on my own, sober and older, it's just, meh.  Cute, but the coincidences seem few and far between, and not all that much.  What really amazes me is that some people actually believe that Pink Floyd deliberately recorded The Dark Side of the Moon, which came out in 1973, long before CDs and home video, to sync up with The Wizard of Oz in this way.  Causation?  Or the Pink Floyd ergo Oz hoc fallacy?

But it's no coincidence that someone came up with the idea of commercializing what can arguably be termed a "folk" practice, that is, a practice that originated from people, as a form of play and creative expression.  And so, we have for your convenience!  And not only do they sell a DVD of The Dark Side of Oz sync, but twenty other syncs as well!  All for $189.99!  The perfect gift for any occasion (check it out by clicking here)!  They also have a groovy page of Sync Links you might want to check out, if you're into conducting further research on the subject.

As for me, I'm stuck with the dark side of the kidney stone, drinking lots of liquids, which means that I'm constantly running off to see the wizard, if you know what I mean...


Bruce I. Kodish said...

reading about the Wiz
and problems with taking a whiz
gee whiz
I got a bit more wise

chad calease said...

I agree! I hadn't ever taken the time to match Oz and Moon up, however, i'd always intended to upon hearing about it way back when. Imagine my own disappointment when i, too, found the coincidental synchronization between the two to be marginal at best. well, i was bummed but only a little ; )