RealClearScience Newton Blog

The 'Miles Per Gallon' Illusion

Ross Pomeroy - February 14, 2019


Consider the case of two car owners: One is looking to switch their SUV averaging 12 miles per gallon (MPG) to an SUV averaging 14. The other is looking to switch their compact car averaging 30 MPG to a newer model averaging 40. Both individuals drive 10,000 miles per year. Who of these two people would save the most gasoline and money?

Duke University Professors Richard P. Larrick and Jack B. Soll originally posed this scenario back in 2008 in an article published to the journal Science. To many people, the answer might seem obvious: the second individual would save the most, as they are boosting their MPG by 33% (vs. 16.7%) and will be able to travel 10 miles more per gallon (vs. just two). But this is completely wrong, and it just takes some quick math to figure out why.

Dividing 10,000 miles by 12 MPG, we find that the SUV owner currently uses 833 gallons of gasoline per year. Upgrading would reduce that number to 714 gallons, saving 119 gallons. Dividing 10,000 miles by 30 MPG, we learn that the compact car driver burns through 333 gallons per year. A more fuel efficient car would take that down to 250, saving only 83 gallons. For the SUV owner, a measly two miles per gallon makes a huge difference!

Larrick and Soll used this example to expose 'miles per gallon' as an "illusion" – a flawed measure of fuel efficiency. The duo also conducted three different surveys involving over 300 participants, each of which backed their hypothesis that MPG leads people people to underestimate the large fuel and cost savings of upgrading gas-guzzling cars.

How Sex Killed Tyrannosaurus rex

Ross Pomeroy - February 9, 2019


Tyrannosaurus rex, king of the tyrant lizards, may have been the most fearsome land predator to ever exist on planet Earth. Yet despite its lofty position and regal name, T. rex did not live a pampered, kingly lifestyle. True, no other dinosaur species directly predated upon T. rex after it reached the age of two, when an individual would have grown large enough to dissuade any would be attacker, but that doesn't mean that tyrannosaurs cruised through life, succumbing only to death from old age. In reality, life at the top was not a walk in the (Cretaceous) park.

The most obvious source of peril was prey. Tyrannosaurs would try to pick off juvenile, smaller, or sickly dinosaurs, but would still have to reckon with an angry Ankylosaur, Triceratops, or Edmontosaur in the process. A swipe from a clubbed tail could shatter bones, rendering a T. rex unable to hunt and susceptible to starvation. A stab from a horn could result in infection and eventual death. Herbivores may have had to contend with being hunted, but at least they didn't have to do battle every time they wanted a meal.

Infant T. rex suffered the highest mortality, endangered by predators and disease, but upon becoming a juvenile around age two, life was fairly safe, with nearly three-quarters of individuals surviving to their 13th birthday. Here was where things started to get hairy, however

The pre-teens heralded sexual maturity. Combat for mates and nesting sites would turn T. rex against T. rex. Females would also likely experience extreme stress from laying lots of eggs. Between the ages of 13 and 18, mortality for T. rex might have spiked to as high as 23 percent a year. According to Florida State paleontologist Gregory M. Ericksonover half of the known T. rex specimens seem to have died within six years of reaching sexual maturity.

If You Wanted to Find Someone in an Amusement Park, Should You Roam Around or Stand Still?

Ross Pomeroy - February 4, 2019


It's a conundrum rendered obsolete in the age of cellphones, but still interesting to think about: If you and a friend were at an amusement park (or some other large venue with fixed boundaries) and became separated, should you stand still and let your friend find you or should you roam around looking for them?

A curious Redditor raised this scenario three years ago, evoking a pleasant cascade of enlightened responses.

Answers were limited under the following assumptions: "The other person is constantly and randomly roaming. Foot traffic concentration is the same at all points of the park. Field of vision is always the same and unobstructed. Same walking speed for both parties."

Fascinated readers set about solving the problem by running statistical simulations on square grids of various sizes, from 20 x 20 to 320 x 320, with thousands of trials. In a single trial, two people were randomly placed on the grid. One person always roamed while the other person either roamed or stood still. Each turn, the people moved randomly one space north, south, east, or west, unless they were blocked by a boundary, in which case their movements were limited to open squares. A trial ended when the two people "found" each other by occupying the same grid. Running tens of thousands of trials, the readers tallied the average numbers of moves required for the people to find each other.

Anne Hathaway's Lesson on Celebrity Pseudoscience

Ross Pomeroy - January 29, 2019


Whether or not she intended to do so, actress Anne Hathaway recently presented a valuable lesson on celebrity-endorsed pseudoscience.

During an interview with Ellen Degeneres that aired last week, the 36-year-old Oscar winner dished on her love for "The Wonder Years" star Fred Savage as well as the interests of her three-year-old son before asking Ellen and the members of the audience to join her in peeling some clementines. As everyone proceeded to tear the orange flesh from their respective citrus fruit, Hathaway shared a cutesy story:

"So over the holidays, we took a family road trip up the coast of California. And we found this amazing former hippie enclave from the '60s. And there was a little secondhand bookstore in there… and I found a book in there by this guy who used to be really big – Dr. Q. And he wrote a book called Citrus Healing. And it was all the ways that you can incorporate citrus into your life to kind of like raise your health. And one of the things was how to incorporate citrus into your meditation practice. And it was called Clementime. It was cute."

The collective eye rolls, face palms, and sighs of a skeptical audience might have halted Hathaway from continuing at this point, but this was not a skeptical audience, and so she pressed on unabated.

What Hunted Ancient 'Humans'?

Ross Pomeroy - January 24, 2019


Modern humans have the minds of prey and the powers of superpredators. We're flighty, anxious, and fearful, yet readily capable of hunting entire species to extinction. What explains this paradox? After all, most humans have never been safer than they are today. The answer arrives through the lens of evolutionary history. For millions of years, as the hominid brain was developing, our ancestors were less the hunters and more the hunted. In our present epoch, the Holocene, the Earth is essentially humanity's playground. The Pleistocene was far more terrifying.


Near the dawn of the Pleistocene, roughly 2.8 million years ago, a young child belonging to the early hominin species Australopithecus africanus was killed. The child's worn and scratched skull was discovered in 1924 along with the mangled bones of other small to medium-sized animals. Archaeologists dubbed the skeleton "Taung Child" owing to its proximity to Taung, South Africa. Today, the best explanation for the skull and the accompanying collection of skeletons is that they were gathered by an ancient, large bird of prey. – the leftovers of many, many meals. This realization evokes a horrifying scenario: after being plucked from the ground and carried off into the sky, this was where the young Australopithecus child was eaten.

As adults, our ancestors were big enough that they probably didn't have to worry too much about winged predators. Still, the ground presented its own array of horrors. One concern was ancient crocodiles, which launched ambush attacks from bodies of water. An individual of the species Homo habilis dubbed OH8 may have fallen victim to such an attack 1.8 million years ago in what is now Tanzania. OH8's left foot was discovered with its toe bones, or phalanges, completely missing. Moreover, the metatarsals were conspicuously broken. A team of scientists determined that the damage seen at those break sites matched that of bone damage characteristic of a crocodile attack. It seems that OH8 lost half of its left foot to a ravenous crocodile.

More dangerous than crocodiles or birds were leopards. Today, the streamlined and powerful cats predate on baboons, monkeys, chimpanzees, and even occasionally gorillas. Their taste for hominids almost certainly extended to our ancestors over the past three million years. Direct evidence comes from the cranium of a Paranthropus robustus, an early hominin discovered in South Africa. The skull cap, which belonged to a juvenile, has two distinct puncture marks that scientist C.K. Brain matched to the mandible of an ancient African leopard. Unfortunately for this ancient hominin, it was very likely ambushed by a leopard then dragged over some distance before being consumed.

Dentists Could Use Viruses to Treat Tooth Decay

Ross Pomeroy - January 22, 2019


Your mouth contains a world's worth of bacteria. Roughly 7.7 billion humans dwell on Earth while some six billion bacteria inhabit the human oral cavity.

If you brush regularly and eat a balanced diet devoid of exorbitant amounts of sugar, your mouth's resident bacteria remain well-behaved and generally innocuous. But for those who slurp down soft drinks and ignore their oral hygiene, the story is much different.

With copious sugars to munch on and no toothpaste to police them, oral bacteria can run rampant. Streptococcus bacteria form dental plaques that cake your teeth and gradually eat away at them. Enterococcus faecalis can burrow to the root canals of your teeth and destroy the nerve, blood vessels, and connective tissue within. Porphyromonas, Tannerella, and Treponema might inflame and irritate your gums.

Dentists employ a variety of methods to treat these bacterial incursions, some of which you've likely experienced firsthand. Antibiotics constitute one of these tools – in 2016, dentists wrote 25.7 million prescriptions for them.

World Health Organization Declares "Vaccine Hesitancy" a Threat to Global Health in 2019

Ross Pomeroy - January 18, 2019


The World Health Organization (WHO) recently announced ten threats to global health in 2019. Outlining these challenges at the beginning of each year has been a habit of late for the world's leading health agency. Usually, the WHO zeroes in on specific diseases, malnutrition, and potential pandemics, but this year, a health threat of a different variety also made the list: vaccine hesitancy.

"The reluctance or refusal to vaccinate despite the availability of vaccines... threatens to reverse progress made in tackling vaccine-preventable diseases," the WHO declared.

That ominous prediction already started coming true in 2018. As vaccination rates dipped across Europe, cases of vaccine-preventable illnesses skyrocketed. Measles, a highly-infectious disease characterized by a furious fever and a menacing, body-covering rash, was particularly widespread, rising from 24,000 cases in 2017 to more than 60,000 last year. The disease was previously on the brink of elimination in Europe.

"It is unimaginable that we have deaths because of measles – children dying because of measles. We promised that by 2020 Europe would be measles free," the European Union’s health commissioner, Vytenis Andriukaitis, lamented to The Guardian.

How to Survive an 'Internal Decapitation'

Ross Pomeroy - January 15, 2019


In January of last year, 22-year-old Brock Meister of Plymouth, Indiana suffered an "internal decapitation" during a serious car crash. When his car flipped over after hitting a patch of ice, the ligaments connecting his skull to his atlas – the first vertebra of the spine – were severed, leaving his skull perilously close to detaching entirely.

Internal decapitation, more formerly known as atlanto-occipital dislocation, was first described in the medical literature back in 1908. It results from traumatic hyperextension of the neck backwards. Simultaneous sideways twisting can make a tear more likely and exacerbate damage. Occuring in roughly one percent of all spinal injuries, it is often fatal. Seventy percent of victims will die instantly, as the lack of supporting ligaments combined with an outside force leaves the skull completely disconnected from the spine, damaging the brain stem's medulla oblongata in the process. Any injury to this vital part of the brain can result in cardiopulmonary arrest, as it controls the heart and lungs.

Fortunately, this fate did not befall Meister, as the car crash left his skull detached but his vital brain regions relatively unharmed. Friends wisely prevented him from moving after the accident to prevent any further harm, and when paramedics arrived, they quickly fitted Meister with a neck brace.

Stabilizing the neck after an accident can be a lifesaver in cases of internal decapitation. Often, paralysis and loss of consciousness will clue medical professionals in to the presence of the rare spinal injury, but occasionally, only neck stiffness and pain will be present. If the patient's neck is free to move around, any swift or sudden movement could detach the skull from the spine. A CT scan or MRI is required to diagnose internal decapitation.

When NASA Got WANKed

Ross Pomeroy - January 12, 2019


In 1989, NASA fell victim to one of the first computer worms of all time. For five weeks beginning on October 16th, thousands of computers were accessed by a malicious code that caused monitors to display the below message. The worm also informed startled users that their files were being deleted (without actually doing so) and changed their account passwords so they would be locked out of their systems.

The WANK worm, as it called itself, was an apparent attempt to cause mayhem in advance of the launch of the Galileo spacecraft, slated to study Jupiter and its moons. At the time, Galileo elicited controversy for being a nuclear-powered satellite. In a world slowly emerging from the Cold War, anxiety over nuclear weapons was commonplace. Moreover, a little under four years after the Space Shuttle Challenger disaster, critics expressed unfounded concerns that a launch explosion could spread radioactive fallout across Florida.

WANK started at NASA, but it didn't stay at the space agency. Workers at the Department of Energy in the U.S., CERN in Switzerland, and RIKEN in Japan soon found their computers "WANKed" as well.

The worm was followed by a slightly more sophisticated bug known as OILZ, which wreaked similar mischief. Both WANK and OILZ were eventually quelled with immunization scripts distributed by IT staff. They ended up costing an estimated $500,000 in wasted time, but did not actually succeed in halting their intended target – the Galileo spacecraft launched on October 18th and would spend eight eventful years in the Jovian system before crashing into the gas giant in 2003.

Five Ways Logical Fallacies Get Misidentified and Abused

Ross Pomeroy - January 3, 2019


A logical fallacy is fundamentally an error in reasoning. Ardent practitioners of scientific thinking are probably aware of many of these fallacies and can point out when an opponent succumbs to one during a debate. However, the human mind is the irrational elephant in the room, causing many thinkers to misidentify and abuse logical fallacies over the course of a debate. Steven Novella, president of the New England Skeptical Society, pointed out a variety of these abuses in his book, The Skeptics' Guide to the Universe.What follows are five logical fallacies, along with descriptions of how they can be misused and abused.

1. Argument From Authority. Just because a group or person is an authority or expert does not mean that they are necessarily correct about a certain claim. To assert that something is true because an authority says it's true is a logical fallacy. However, too often people misapply the "argument from authority" fallacy to dismiss a solid scientific consensus. GMOs are safe. Vaccines don't cause autism. Earth's climate is changing and, at present, humans are the primary cause. Organisms evolved. These are all scientific facts touted by prominent scientific organizations based upon mountains of evidence. Claiming an "argument from authority" because somone referenced, for example, the National Academies of Sciences, doesn't change that.

2. Correlation and Causation. Correlation does not prove causation. To say that it does is a logical fallacy. However, correlation absolutely can be evidence for causation, the quality of which depends upon, for example, whether the correlation is actually feasible, how strong studies show the link to be (effect size), and whether or not the variables in question demonstrate a dose response (if X fluctuates, does Y also change in a predictable way?).

As Novella noted in his book, the tobacco industry once attempted to argue that smoking doesn't cause cancer because correlational studies can't prove it. Those studies, however, were so convincing that only an ideologue (or tobacco lobbyist) could deny their findings.

The (Ultimate) Top Ten Science Stories of 2018

Ross Pomeroy - December 29, 2018


Like a rocket soaring through the atmosphere, 2018 blasted by. If you need some help remembering exactly what happened, RCS has you covered with our annual aggregation of top science story lists.

Methods:

Our methods remain the same: We performed a Google search for "top science stories" lists, selecting only those from go-to RCS sources. Points were awarded to each story based on its ranking. For example, on a typical "top ten" list the #1 story earned ten points, #2 earned nine, #3 earned eight, and so on. Lists that had fewer than ten rankings were normalized to a 10-point scale. For the lists that did not rank the stories, each story earned 5.5 points, which is the average score if you add together all the digits from 1 to 10 and divide by ten.

The List:

Deer Are a Menace and We Need to Kill a Lot More of Them

Ross Pomeroy - December 20, 2018


In 2017, the total deer population in the United States was an estimated 33.5 million, down from 38.1 million in 2000. Hunters should rejoice over their excellent shooting, and then get outside and kill millions more.

This macabre call to arms might unsettle anyone whose heart ached at viewing the plight of poor Bambi, but it's a prescription that's sorely needed, for at their current population, deer are ravaging ecosystems across the country.

This wasn't the case in the very early 1900s. Then, after decades of wanton hunting, there may have been as few as 300,000 deer left roaming the wilds of America. Hunting moratoriums, favorable human-caused ecosystem changes (i.e. more farm land), declining wolf and cougar populations (the major natural predators of deer), two world wars (leaving fewer hunters at home), and yes, the influential film Bambi, all combined to send deer populations skyrocketing during much of the 20th century. The recovery was wonderful for deer, but terrible for other organisms.

Deer devoured countless wildflowers close to extinction and devastated saplings of cedar, hemlock, and oak. All of this eating, amounting to more than 2,000 pounds of plant matter per deer per year, might account for widespread declines of North American songbird populations, which rely on many of the plants upon which deer gorged themselves.

The Biggest Junk Science of 2018

Ross Pomeroy - December 17, 2018


Science is essentially the search for and recognition of reality. Each year, there are those who ignore this endeavor entirely, preferring fictitious narratives to concrete truths. There are also those who willfully deny fact for their own gain. Both groups of people can do real harm by flouting the truth, and so, at the closing of the year, we highlight their most egregious missteps over the preceding twelve months. In highlighting these junk science stories, it is our hope that they won't be replicated.

 

11. Doctor Oz Endorses Astrology. Celebrity physician Dr. Mehmet Oz is a quack doctor, plain and simple. Once a respected surgeon, he left behind his legitimacy long ago by touting questionable health advice, bogus cures, and weight loss "miracles" on his popular daytime television show. This summer, he fell even further down the rabbit hole by tweeting an endorsement of astrology. Astrology, not to be confused with astronomy, suggests that the positions of celestial objects affect the fortunes of people and outcome of events here on Earth. Though patently ridiculous, the pseudoscience has still been tested and – unsurprisingly – been found to be completely bogus. But bogus is good enough for Doctor Oz, it seems.

 

The Top 10 Websites for Science in 2018

Ross Pomeroy - December 10, 2018


The sheer amount of substandard science content on the Internet will make your head spin. Too many websites are chock-full of copy and pasted press releases, ideologically tainted writing, or downright lazy, hyped, or misleading reporting. RealClearScience's job is to filter out all of the garbage to bring you the most relevant, interesting, and accurate science news and opinion. During this pursuit, we notice a number of websites that rise above the rest. Here are our picks for the top websites for science in 2018.

First, the honorable mentions (in no particular order):

The Atlantic

Smithsonian

Five Perpetual Motion Machines, and Why None of Them Work

Ross Pomeroy - December 3, 2018


To the eccentric inventor, perpetual motion probably seems a low-hanging fruit. Sure, those pesky Laws of Thermodynamics tell us that no machine can do work forever without some sort of energy input, but there's no reason these archaic, esoteric musings can't be overcome. Just a single spark of ingenuity would rattle physics and earn never-ending fame and fortune!

Many have tried, of course, and all have failed.

Let's take a look at a few more notable attempts.


The Overbalanced Wheel. Perhaps the earliest recorded inkling of perpetual motion came courtesy of renowned medieval mathematician Bhaskara in the 12th century. The Indian thinker proposed an "overbalanced" wheel in which weights would swing on one side, applying a greater torque to keep the wheel spinning. A quick glance at the wheel in motion reveals why this idea is doomed to fail. One side of the wheel will always have more weights, thus keeping the torques boringly in balance.

Albert Einstein: A Prophet for a Religion of Science?

Ross Pomeroy - November 30, 2018


Albert Einstein once modestly remarked that he had just a "couple of ideas" in his scientific career. Though few in number, these ideas garnered Einstein enduring notoriety. Recently, however, Einstein's religious views have been earning media attention. A handwritten letter he penned a year before his death is set to go on public display in New York today before being auctioned for an estimated $1.5 million on Tuesday. In the letter, Einstein writes, "The word God is for me nothing but the expression and product of human weaknesses, the Bible a collection of venerable but still rather primitive legends. No interpretation, no matter how subtle, can (for me) change anything about this."

From this statement, one might surmise that Albert Einstein was irreligious, or even an outright atheist. But when asked, he denied it. There are people who say there is no God,” he told a friend. “But what makes me really angry is that they quote me for support of such views.” 

"You may call me an agnostic," Einstein clarified on another occasion, "but I do not share the crusading spirit of the professional atheist whose fervor is mostly due to a painful act of liberation from the fetters of religious indoctrination received in youth."

Many writers have repeatedly tried to pigeonhole Einstein into one camp of belief or another, or at least deny one side's claim of ownership over the famous physicist, but when it came to religion, Einstein's innumerable writings and musings suggest that he walked an enlightened middle way, a path guided in various respects by an entirely new "cosmic" religion, one founded in rationalism and opposed to dogmatism, without churches or central teachings, whose God is not a being but rather the structure of the universe itself.

Do Plants Behave Like Animals?

Ross Pomeroy - November 26, 2018


Your daffodils don't care what you have to say. They aren't uplifted by Mozart's symphonies. They don't feel pain when being pruned.

These myths originally reached the mainstream with the book The Secret Life of Plants, which later became a feature documentary. Occult author Peter Tompkins told readers that plants might very well be sentient. To support his claim, he cited a polygraph expert attesting that his lie detector test caught sparks of activity in plants exposed to various stimuli, including subtle threats. Tompkins also referenced a crank scientist who claimed that he had detected plant consciousness and also found that mustard seeds could receive interstellar signals from the cosmos, perhaps from plants on distant worlds.

The scientific community brutally panned Tompkins' work, but the public ate it up. Soon, gardeners all over the world were reading to their plants and playing them classical music. Oddly enough, subsequent studies actually showed that these tactics may boost plant growth, but not because seedlings enjoy a soothing voice. Sound waves cause vibration, and this vibration seems to trigger a beneficial response via a yet unknown mechanism. Sunlight, water, and nutrients matter much, much more to a plant's wellbeing, however.

Decades after The Secret Life of Plants, there's a more nuanced scientific debate going on: do plants behave the same way that animals do?

Why Doesn't a Super-Bacterium Take Over the Ocean?

Ross Pomeroy - November 19, 2018


To the naked eye, great expanses of ocean can seem nearly devoid of life. But examine just a teaspoon of seawater and you'd reach a drastically different conclusion. Not only is there life, there is gobs of it – anywhere from one million to five million bacteria. In that same sample, you'd also find up to fifty million viruses, which aren't technically alive, but buzz with activity. How these viruses and bacteria interact in this hidden world shapes the fate of the entire ocean.

As many as a billion species of bacteria inhabit the oceans, and if it were up to any one of them, they would probably rule uncontested. Such a monopoly would prove devastating for most other ocean life, however. When bacterial species explosively bloom unchecked, they can produce toxins in large concentrations, block out sunlight for photosynthesizing organisms below the surface, and deplete oxygen in the water. Sometimes this can happen over hundreds of miles. Imagine a bloom that covered an entire ocean!

Thankfully, the ocean's viruses, which are mostly bacteriophages (attacking only bacteria), prevent any single bacterial species from achieving unfettered control. When one bacterial species does bloom out of proportion, it becomes a tantalizing target for viruses. Stephen Palumbi, a Professor of Biology and Director of the Hopkins Marine Station at Stanford University described what happens next in his book The Extreme Life of the Sea, co-authored with his son, science writer Anthony Palumbi.

"Viruses mutate, and some of those mutations allow them to attack the huge hoard of bacterial prey, infiltrating the bloom. Fresh viruses exploded from a dead bacterium need only travel a few microns to the next bacterium to start the next killing cycle."

The Silliest Lawsuit Against Monsanto

Ross Pomeroy - November 13, 2018


Monsanto may be gone, but the lawsuits against the former agricultural company live on. When German life sciences company Bayer acquired the agribusiness behemoth earlier this year, they inherited around $15 billion in revenues, $2.2 billion in profits, as well as at least 8,000 lawsuits. Most recently, Northern California groundskeeper Dewayne "Lee" Johnson, who sadly is dying of non-Hodgkin's lymphoma, successfully garnered $78 million from the company after winning a civil suit contending that chronic exposure to Monsanto's weedkiller Roundup caused his cancer, even though his claim sharply conflicts with a mountain of scientific evidence.

Jury judgments such as these are unfortunately based on poor thinking rather than reasoned thought. Fear of supposedly insidious chemicals and GMOs, all created by "Monsatan," drives people to irrational decisions.

Perhaps the best example of this occurred back in 2011. The Organic Seed Growers & Trade Association (OSGTA), a group representing a quarter of the nation's organic farmers, sued Monsanto to "protect themselves from being accused of patent infringement should [their crops] ever become contaminated by Monsanto's genetically modified seed." Yes, organic farmers were suing Monsanto in order to prevent themselves from being sued by Monsanto.

In court, they claimed that Monsanto sues organic farmers when genetically modified soybean, corn, cotton, sugar beet, and canola seeds blow into organic crops and germinate. They further claimed that this threat had sowed a "climate of fear" throughout the organic farming community.

1910: The Year American Medicine Changed Forever

Ross Pomeroy - November 8, 2018


Medical education in the United States is generally regarded to be the finest in the world, and for that, you can thank Abraham Flexner. In 1910, the Louisville native and education reformer published an in-depth, damning, and eye-opening report on the state of American medical schools. In the quarter-century after the Flexner Report's publication, the entire medical profession was dissected, examined, and reforged, transforming from an unregulated free-for-all to an expert, science-based endeavor.

American medical education was in a sorry state in the early 20th century. More than 160 institutions pumped out 4,400 graduates each year, most of whom were woefully undertrained and received uneven instruction. With no agreed upon standards, many schools focused on pseudoscientific fields like electrotherapy, homeopathy, chiropractic, and naturopathy. For a patient seeking medical attention, there was no standard of care, just a daunting morass.

Seeking to cure this sickness was philanthropist and business magnate Andrew Carnegie. In the waning years of his long and fruitful life, Carnegie dedicated himself to giving away much of his amassed fortune, which tallied near $400 billion in today's dollars. One mission he particularly deemed worthy was improving healthcare in America. As part of this goal, he turned to Abraham Flexner.

Henry Pritchett, head of the Carnegie Foundation, heard about Flexner by reading his first book, The American College, which heavily criticized lectures as a method of teaching. At his own experimental college preparatory school, Flexner promoted hands-on learning and eschewed traditional tests and grades. Impressed, Pritchett tasked Flexner with surveying the quality of medical schools throughout America and Canada and providing suggestions for their improvement.

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