This article originally appeared in The Skeptic, Volume 5, Issue 4, from 1991.
In the field of strange beliefs which go against common sense, one of the strangest is the idea that we live not on the outside surface of a sphere, but on the inside. In the USA in 1869 an angel appeared to Cyrus Reed Teed. It told him that the Earth is hollow and that we live on its inner surface and that the stars, Moon and Sun are all tiny bodies inside the sphere moving along very complicated paths.
In 1870 he described this in his book The Cellular Cosmogony, or the Earth a Concave Sphere. He believed God wanted him to found a new religion, so he changed his name to Koresh and began a cult called Koreshanity. It soon attracted believers. In the 1890s he took his colony of believers to Florida where they built the town of Estero. It was not until 1949 that the cult’s magazine, Flaming Sword, finally ceased publication.
The idea of an inside-out universe was also adopted in inter-war Germany by Peter Bender. He, and after his death Karl Neupert, led a cult which published several books during the Nazi period. They attracted the attention of the Nazi leadership, some of whom were attracted to many strange beliefs. In April 1942, a secret expedition, approved by Hitler and Himmler, set off to the Baltic island of Rügen. Led by Dr Heinz Fischer, it included some of Germany’s top radar experts.
After they arrived, their radar equipment was pointed into the sky at an angle of 45 degrees. The other scientists in the expedition assumed this was merely a test of the equipment. It was only after the radar had remained in this strange position for several days that Fischer told them exactly why they were there. Hitler wanted the inside-out cosmos theory proved scientifically. This was to be done by sending radar waves up into the sky where they would eventually hit another part of the inside of the sphere and be reflected back. After doing this the expedition were then to try to get an image of the British fleet in Scapa Flow.
The inside-out universe idea still has some supporters. Martin Gardner (Skeptical Inquirer vol 12, p355) recorded that in 1981 a mathematician, Mostafa Abdelkader, described in a mathematical paper how the universe could be mapped point by point into the inside-out cosmos model. In this mapping the further an object is above the surface of the Earth, the nearer it is to the centre of the hollow Earth, and the smaller it is. All the laws of the normal universe would be much more complicated, but to an observer in that universe everything would appear to be the same as to an observer in the normal universe.
Both models of the universe are valid, but in the inside-out cosmos the laws of physics are much more complicated. As there are no advantages in using this model, Occam’s Razor suggests it should be discarded.
Read more in Umberto Eco’s The Book of Legendary Lands, 2013
In veterinary medicine (as in human medicine) we are often faced with people who believe that, despite our oath to advocate for our patients, there are veterinary professionals who are actively trying to harm animals.
As history shows with the likes of Harold Shipman, there are certainly sad and disastrous events that occur in human and veterinary medicine that we can learn from to ensure they never happen again. They are, thankfully, rare.
Yet sometimes, people believe – magnified and exacerbated by social media – that there is widespread harm being done because a mass of professionals is ‘in’ on a conspiracy, trying to make money, trying to harm pets, and more. This is not true. But, as with most things, the loud and vocal minority can make a lasting impact – especially when they set out to attack the integrity of a compassionate profession.
One example is anti-vaccination rhetoric. A 2020 study into human vaccination concluded that, over a 20-year period, vaccines were remarkably safe. Similarly, a 2004 canine study found no temporal association between vaccination and ill-health in dogs. Although there is always risk with any medication, and medication reactions obviously do occur, the preponderance of the evidence supports minimal risk of harm from vaccines. Even when we look more closely at some specific brands of vaccination that are particularly vilified, the evidence still suggests incredibly uncommon and rare adverse events.
You need only to look at the re-emergence of measles in the UK and USA; countries that had previously, due to vaccination, almost managed to eliminate the disease. New data suggests that it could soon become endemic again if vaccination levels remain as they are.
This re-emergence was fundamentally caused by a now-disproven paper that linked autism to a vaccine, and subsequent erosion of trust in science by misinformation. The General Medical Council found the paper’s author, former doctor Andrew Wakefield, guilty of serious professional misconduct – but, despite the publication’s withdrawal and being disproved by numerous studies, there are still people who continue to cite Wakefield’s research as evidence of the harms of vaccines.
Medical skepticism has been subject to social-psychological research, which found strong correlations between vaccine skepticism and adherence to complementary and alternative medicine and conspiracy ideation. A 2019 study by Cuevas et al. suggests that mistrust toward healthcare may unfavourably affect patient-clinician interactions and patients’ outcomes. To tackle it, we can’t just present facts, because facts do not change minds; we need to implement a more systemic long-term strategy to address the root causes of medical mistrust.
One 2020 paper (Scherer et al.) looked at three theoretical perspectives on why certain people are susceptible to online misinformation: lack of knowledge or literacy to discriminate between true and false information; having strong pre-existing beliefs or ideological motivations; and neglecting to sufficiently reflect about the truth or accuracy of news content encountered on social media.
Addressing pre-existing beliefs, research from Toomey et al. found that factors such as worldview, religion, and political beliefs have strong associations with rejection of science related to controversial issues. Not only that, but our bias towards those factors also means that we see data compatible with the beliefs we currently hold as more ‘valid’ than data that could refute those beliefs. This was further supported by a 2015 paper that showed acceptance of scientific evidence depends on the availability of such alternative points of view as religious faith and political ideology; if scientific results conflict with a readily available alternative view, individuals are less likely to defer to the research.
Furthermore, we are highly sensitive to the beliefs and actions of those in our immediate circle or community – is this the hunter-gatherer ancestral background rearing its head? One paper by Douglas et al., (2017) reported social motives (the desire to belong and to maintain a positive image of the self and the in-group) as a driver of conspiracy ideology.
Browsing Facebook, a very effective way to build mistrust in medicine – human or animal. Image by cottonbro studio, Pexels
So, while behavioural change can occur at the individual level, broader impacts require a focus on social networks and systems. This is a great example of how social media platforms are exacerbating these beliefs, as people enter an echo-chamber and feel part of that community or movement. Trying to engage in reasonable discussion with individuals who choose to engage aggressively is likely futile; data that runs contrary to their view is likely to drive them further away.
Additionally, the physical strain of your time and resources and mental drain on your emotions means direct confrontation is not likely to change minds. Does this mean we shouldn’t ever ‘call out’ or counteract medical misinformation? Perhaps not.
There is often a silent majority, quietly reading, sitting on the fence. These people, not yet aligned to any particular view, will potentially read your professional, calm, polite and robust replies, and you may make a difference to them. Evidence does show that those people exposed to correct information are less susceptible to conspiracy or misinformation than those who have not been exposed to the correct information first. This is called inoculation theory – offering a logical basis for developing a psychological “vaccine” against misinformation.
A paper by Douglas et al. (2017) discusses factors such as epistemic motives (the human desire to find causal explanations for events, building up a stable, accurate, and internally consistent understanding of the world) and existential motives (the need for people to feel safe and secure in their environment and to exert control over the environment) as other reasons people will latch on to alternative or conspiracy views – because it gives them an answer and control over a situation they feel out of control of.
This is noteworthy in veterinary medicine – sadly, animals get ill and die, and sometimes these events are unexpected. We do not always do a post mortem to confirm diagnosis, maybe due to financial cost, or owners’ wishes. Owners, in their understandable deep emotional state of grief or mental duress (anyone who has lost an animal companion can attest to this), can try to find answers as to what happened – and can settle on blaming the vaccine/medication the pet had a week, month or even year prior, especially when anti-vax info is easily accessible when you start to search for it. Again, vaccine reactions do occur – this is the importance of pharmacosurveillance – but overall they have been proven incredibly safe.
Toomey et al.’s 2023 study concluded that most attitudes and behaviours regarding research decision-making are not based on the rational evaluation of evidence, but determined instead by a host of contextual, social, and cultural factors and values. Therefore, providing additional information – even in accessible formats – is not likely to lead to significant changes.
So, facts will not always change minds, and a social media argument is unlikely to be beneficial, helpful or fruitful to you or the other person, and will probably cause both of you considerable anger, anxiety and frustration. Ultimately, you both believe you’re right, and on reflection want the same thing – a healthy, happy pet (you’re just going about it via different routes, one of which may not be evidence-based). But there is some indication that effective techniques exist.
With that in mind, how do we best get people to evaluate, remember and engage in evidence-based information?
‘Message elaboration’ is a term that broadly refers to the amount of effort that an audience of a message has to use to process and evaluate a message, remember it, and subsequently accept or reject it. One paper from 2022 looked into the presentation of a message and its contents, evaluating how successfully it was received. The results indicated that including statistical evidence in messaging reduced elaboration, improving audiences’ understanding, with fewer misperceptions and increased perceived message believability. Facebook messages presented in this way also were associated with higher audience intentions to share, like and comment, showing greater engagement and favourability. The research also found that messages including text and an image had better message elaboration than image-only messages. This shows that, if we want to engage effectively with people on social media, we should consider how we present our messaging, as well as what we’re saying.
Benecke and DeYoung’s 2019 study looks at the broader picture, and identifies the need for a long-term educational strategy. In their work, they explain that medical professionals must take a different approach to education, including outreach to vulnerable communities and individuals; they also note that social media platforms have an active role to play in monitoring and banning false information.
In terms of bridging the gap between medical professionals and the public, and opening up conversation that’s more likely to help than hinder, we need more spaces for group dialogue, where we can listen to multiple perspectives and “embodied knowledge”, which can help us alter our message to make it more likely to be well-received, and to think more carefully about whom we seek to target with our message. In essence, we should tackle medical misinformation, but we must be strategic in how we do so.
Direct contact with clients and veterinary teams can also end in a positive or negative interaction. Perceived dismissive attitudes, judgement or defensive behaviour by a veterinary team will likely build bigger walls and shut down opportunity for conversation and compromise.
Some of these issues can be mitigated by ‘physician-focused’ changes. For example, a study found the effects of mistrust can be countered using patient-centered communication skills. These include soliciting the patient’s concerns and priorities, and being responsive to the healthcare needs and belief system the patient identifies with. One study found that medical professionals might be able to buffer patients’ levels of medical mistrust using patient-centred communication.
Medical misinformation is rife in human and veterinary medicine. It is frustrating, and can cause poor patient outcomes. But we, as veterinary professionals, have to accept some accountability in how our behaviour shapes communication and our perceived image. There is no simple answer as to how we tackle it, but ensuring we engage in the right way can ensure we help, rather than hinder, communication with those with alternative views.
Further Reading
Kraft, Patrick & Lodge, Milton & Taber, Charles. (2015) Why People “Don’t Trust the Evidence”. The ANNALS of the American Academy of Political and Social Science.
The Skeptic podcast, bringing you the best of the magazine’s expert analysis of pseudoscience, conspiracy theory and claims of the paranormal since its relaunch as online news source in September 2020.
On my long commute home from work one day, I passed a sign that read “Holistic Health and Healing Expo” and I was reminded of the events that Michael Marshall and Alice Howarth attend and talk about on the Skeptics with a K podcast. I wondered whether this might be something to see firsthand so I emailed the podcast website, asking if it would be worth my time.
The host was nice enough to reply encouragingly with some helpful tips as to how to make the most of my experience. I talked my wife, Aimee, who was rightfully leery, into going along for support – reassuring her that we were not going to be confrontational, but to witness first hand and try to understand why these events appeal to so many people.
At the Morgantown Expo Center, we paid $10 apiece to get a wristband for the day. Besides that, there was ample opportunity to spend money, but I only bought some incense sticks for my son at home. For our 10 dollars we got a swag bag with a very nice coffee mug, a sample of elderberry and echinacea tea, a plastic sachet of tiny purple crystals, a strange stick of wood from ‘Appalachian ShaMomma’ with a card reading “mountains are calling… You going to answer?” (I have no idea of its purpose, as I did not see the stand), and an array of literature.
Crystals, books, tuning forks, Buddha bells, little statues, art, potions, teas and herbs lined the hall in various booths and tables. Everyone, with few exceptions, seemed very genuine and nice. Most of the vendors seemed to be true believers in their areas of “expertise”. I guess I should not have been surprised at how many of the presenters were trained masters of their professions, many of which were sufferers who decided to take up the calling themselves.
The first stand we visited, we both later agreed, was the toughest thing we encountered – the Health Benefits of X39 Stem Cell Activation Patches, run by Dr J. Thomas Acklin MD, who told us he was a former Johns Hopkins-trained neuroscientist. Dr Acklin was very forthright, asking what our ailments were. Aimee told him that she had thyroid disorder. He said, “No you didn’t”. I also apparently did not have the diabetes, which would probably come as a surprise to those who diagnosed me. We were informed that medical professionals were being purposefully deceptive, but it was never explained as to how or in what way.
Tricksy doctors, always making things up..! Photo by Movidagrafica, via Pixabay
Dr Acklin explained that he was disillusioned by the medical profession, so he left to produce X39 for “Microbiome reconstruction… rapid minor pain relief, reduced inflammation, better sleep”, and a whole host of other things. His partner explained how our stem cells migrate throughout the body to regions of distress, once they’re called by a “targeted and specific light frequency”. And almost like they were immunological entities.
We, however, knew this was not the way stem cells work – Aimee and I each have master’s degrees in advanced biology. She works at a large pharma company and I work as Molecular Microbiologist in a laboratory. I also taught in biology, up until the pandemic. Stem cells are generated locally or in bone marrow where they do migrate to the need area as a response to cell signalling whereas our immune system searches for problems and reacts accordingly. Their patches were designed to produce light frequencies that penetrate skin when attached to problem areas such as shoulder pain or malfunctioning beta cells in the pancreas. This man was very taxing, and when the first lecture session was called over the loudspeaker, we gladly excused ourselves.
My favourite booth was our second stop, where we met Bob Micklus and the Flowers in the Forest. It had a cabinet with rows of little blue dropper bottles labelled with flower names. Bob, soft-spoken and diligent, explained how each of his solutions did not contain any of the plant on the label. Water, according to Bob, has memory. His solutions worked like what seemed to me to be homeopathy with a botanical twist. Bob pointed to a compendium of plants and their respective benefits, qualities like “divine healing” and “stress relief”. He touted something he called “Florida Water”, which I read later goes for $10 for around 60ml. Three drops go in a glass of water daily, though for extreme cases they could be taken undiluted.
I would say about 70% of the booths were tailored to women. My wife, who is in her mid-40s, remarked how most of the attendees were women about her age. Men made up only a small part of the crowd. When Aimee and I split up, some of the booth operators seemed reluctant to spend much time on me; I assume because I was not their target demographic. No one seemed ready or willing to explain Reiki to me in any great detail at any of the four booths I visited alone.
While I was doing my best to avoid being too confrontational with the vendors, the thing I found hardest to hold my tongue over was where people with real issues were looking desperately for answers and miracles that modern medicine could not provide. Aimee noted a severely disabled man using a wheelchair rolling in the door and, who she imagined, frustrated with established medical treatments, was desperately looking for miracles.
Overall, our first visit to a Holistic Health and Healing Expo was quite fun, although my wife was thoroughly worn out from the long one-on-one chats she had with people who seemed well-meaning and thoroughly convinced by their own bad ideas. It’s an adventure we will always remember. Will we be quick to repeat it? Who knows…
It is curious to note how, in emergency situations, proposals appear that promise quick, safe and “natural” solutions. This is nothing new; we have already seen things like this in dengue epidemics, COVID-19 and cancer treatment. Even more worryingly, this has also found its way into obstetric emergencies, such as the “study” entitled “Use of Acupuncture in Cases of Hypertensive Emergencies during Pregnancy”.
Based on parts of a final paper for a postgraduate course in Acupuncture at CETN (Center for Studies of Natural Therapies), the supposed study illustrates the problem well: it is an experimental proposal that does not produce useful results, can delay conventional treatment and put the lives of pregnant women at risk.
The “study” in question reports cases of pregnant women with hypertension – supposedly classified as “hypertensive emergencies” – who underwent auricular acupuncture and bleeding from the apex of the ear, with the aim of reducing blood pressure. Although the text mentions the possibility of drug treatment after an initial “stabilization”, it is clear that alternative interventions were prioritised as the first treatment, instead of effective and urgent management of the hypertensive condition. This is alarming; an obstetric emergency cannot be held hostage by therapies without demonstrated efficacy and safety.
As is usual in “studies” of this type, the absence of a rigorous methodology is clearly evident: there is no control group (or, if there is, it is not adequately presented), the exact number of patients analysed is unknown (the number of participants in each subgroup is not even mentioned), there is no information on whether there was randomisation (probably non-existent, given the lack of a control group), nor is there any description of any type of reliable diagnostic criterion for classifying blood pressure as a “hypertensive emergency”. On the contrary, the cutoff point for considering inclusion in the study was a pressure above 120×80 mmHg; a value that, let’s face it, does not constitute an urgent or emergency condition according to any cardiology or obstetrics guidelines.
It is plausible that most of these patients, therefore, were not even in a condition of imminent risk, which calls into question any supposed effectiveness of the practice.
This “alternative protocol” draws attention precisely because it is indicative of a larger problem: the spread of pseudoscientific practices in healthcare. It perfectly exemplifies the creation of a seductive narrative to justify unfounded treatments. The original text evokes concepts from Traditional Chinese Medicine to explain pre-eclampsia, such as “wind rising from the liver”, “Yin deficiency” or “damp-heat”, without, at any point, providing evidence for this.
By trying to “fit” a very serious obstetric condition, such as pre-eclampsia, into merely traditional standards that have not been validated in the medical-scientific sphere, they attempt to legitimise dangerous practices that can delay or replace treatments that would have a real impact on reducing complications and maternal and foetal mortality.
The rush that saves lives
In obstetric emergencies, every minute counts. Pre-eclampsia can worsen rapidly, leading to seizures, pulmonary oedema, and other serious complications. If the patient is led to believe that “natural” measures must come first, she risks losing valuable time before receiving proven effective medication. The momentary feeling of “wellbeing,” without monitoring and without adequate monitoring of vital signs, can mask progression to lethal stages.
On the contrary, all of them indicate immediate clinical intervention, not only with the use of antihypertensives that are safe for pregnancy (such as nifedipine, hydralazine and, where available, labetalol), but also with the use of magnesium sulphate, which is essential for the prevention of seizures, careful evaluation of foetal well-being, hospitalisation, intensive monitoring in the most severe cases and, depending on the severity and gestational age, termination of pregnancy.
Causes of maternal mortality in Brazil in 2023. Hypertension is the highest specific cause of death, accounting for 27% of cases (40.9% of deaths had an indirect cause)
It is understandable that pregnant women may be afraid of medications, especially if they are uncertain about side effects or risks to the foetus. Unfortunately, this uncertainty leaves room for promises of “harmless” or “chemical-free” techniques.
The result is dangerous confusion, since what is at stake is the health of both mother and baby. When it comes to pre-eclampsia, supposed temporary relief does not guarantee that the disease will not continue to advance silently.
Added to this is our harsh reality: hypertension is the leading cause of direct maternal death in Brazil (and the leading cause as an isolated cause). We need more efficient prenatal care and quick responses when signs of pre-eclampsia appear, not dubious protocols that further delay correct referral.
Pseudoscientific bingo
This study serves as a perfect example of pseudoscientific logic, featuring elements that are common to this type of biased study:
Lack of explicit inclusion criteria and use of outdated nomenclature: women with blood pressure above 120×80 mmHg were labeled as having a “hypertensive emergency”. This is a gross mistake, as it does not comply with international standards. Furthermore, the article uses nomenclature that is no longer in use, such as DHEG (hypertensive disease specific to pregnancy).
Hasty conclusions: based on specific observations, the author concludes that “in 61.5% of cases, acupuncture was successful in reducing blood pressure levels”. Success based on what parameters? How long does this supposed effect last?
Absence of a control group: no comparison is made with pregnant women who simply rested and then had their blood pressure measured (which would not be indicated in an emergency, but is recommended in hypertensive crises, after 15 minutes, since with rest, in the latter, the blood pressure can actually drop); or pregnant women who received standard treatment with appropriate medications; or even pregnant women who received another harmless intervention (placebo). Without control, there can be no talk of efficacy. And when there is no evidence of efficacy, there is no therapeutic effectiveness, as we have already discussed.
Confusion between correlation and causation: Given the lack of reliable methodology, the study cannot prove that it was acupuncture that reduced blood pressure – or even that it was dangerously high at the beginning of the study.
Omission of critical data: no report of loss to follow-up (if patients returned to the emergency room with worsening of their condition), no mention of relevant maternal or neonatal outcomes (e.g. maternal mortality, neonatal mortality, incidence of eclampsia, neurological damage, etc.).
Vague, grandiose (and dangerous) claims: The final message that auriculotherapy “can be used to reduce blood pressure levels in pregnant women seeking emergency services” states much more than the data presented allows us to conclude. And worse, readers of the article may understand that it is acceptable to refuse or postpone obstetric management recommended by medical guidelines, believing in a false solution.
The “complementary” discourse: Advocates of alternative therapies often argue that they do not want to replace evidence-based practices, but rather complement them. In an ideal world, this justification might even sound reasonable. However, in practice, we see that such interventions are often presented as sufficient or as “first line” (as, in fact, this study suggests). Furthermore, time and money are both scarce resources. In this way, the “complementary” ends up becoming a trap that takes the focus away from what really needs to be done – and, in this case, done quickly.
“Emotional” causes for multifactorial organic issues: many “alternative interventions” are based on the mistaken notion that high blood pressure (especially during pregnancy) is the result exclusively of stress or emotional changes. We do not deny that psychological factors can momentarily affect blood pressure, but the pathophysiology of preeclampsia cannot be explained by “excessive nervousness” or anxiety. Reducing the complexity of this issue to a purely “psychoemotional” issue creates the dangerous feeling that simply relaxing (with lavender, teas, foot baths or auriculotherapy) is enough to control blood pressure. Patients with blood pressure lability (blood pressure that “rises with stress”) or with white coat hypertension (blood pressure that only rises during a medical appointment) have a higher risk of developing pre-eclampsia. This in itself is already a warning sign, requiring medical referral.
Systemic problem
Unfortunately, this study is not just an isolated daydream; it reveals what often happens when people in vulnerable situations (such as pregnant women) encounter, in the health system or on social networks, professionals who offer “quick and natural solutions” to serious problems. These are solutions based on beliefs without scientific basis and which can delay effective care.
This is not about demonising any practice that is not strictly pharmacological. The problem here is the use of unvalidated therapies as substitutes or barriers to conventional treatment, especially when the clock is ticking. The idea that “it doesn’t hurt to try” ignores the risk of delaying effective interventions.
There is also a social dimension. A poorly founded study, but with the guise of “academic research,” may be disseminated in lectures, social networks, or less discerning media outlets. Many people firmly believe that everything they discover through Google searches and online pages is true. Patients who read about the subject on the internet may ask: “Why not try acupuncture first, since an article said it works and is less invasive?” Not to mention the cases in which authorities and professional associations end up legitimising such practices simply because of their popularity.
Dr Google rarely provides useful information, especially on complex topics in times of high stress. Image by Foundry Co from Pixabay
The role of professionals who fight for a more scientific medicine is to monitor, report and inform the population about the risks involved in practices like this. There is no room, in emergency situations, for “experimental therapies” that do not meet the basic criteria of plausibility and ethical criteria of clinical research.
Final considerations
By proposing (and promoting) auricular acupuncture as a priority intervention in “hypertensive emergencies” during pregnancy, the “study” risks confusing professionals and patients, since the mere appearance of “academic research” may give a false impression of legitimacy. Although the initiative presents itself as “experimental,” it does not meet the scientific criteria required for this. The lack of an adequate methodological design, the absence of a control group, and the incorrect definition of the inclusion criteria seriously compromise the validity of the results presented.
Even more alarming is the fact that, under the guise of an experimental protocol, pregnant women were subjected to an intervention that delayed the administration of proven-effective conventional treatments, which constitutes a flagrant ethical violation. We were unable to find the aforementioned study published in any national or international journal, which in fact seems impossible to us, given so many serious problems and biases. However, we assume that it was approved by a Research Ethics Committee (REC), which, if proven, is unacceptable. How can a research project to treat hypertensive emergencies with auriculotherapy be authorised? How can a study with so many methodological flaws be allowed?
The real line in healthcare is not between “conventional” and “alternative” medicine, but between what is evidence-based and what is not. In emergencies, we cannot forgo what really works. If there is one lesson from this episode, it is the warning it provides: maternal health is not a place of illusion. When dealing with pre-eclampsia and eclampsia, every minute of delay in providing appropriate care can cost a life – or two.
Rock, Paper, Scissors (RPS) is a very simple game. So simple, in fact, it’s almost dull! However, it may be more interesting than you realise.
We all think we know how to play the game “correctly”, based on intuition alone. You simply choose your strategy randomly and hope to get lucky.
But how do we implement such a strategy in practice? If we had a calculator to hand, we could use the random number generator (RNG) function to generate a decimal between 0 and 1 and use the following rule to make our decisions:
0.00 – 0.33: play R
0.33 – 0.66: play P
0.66 – 0.99: play S
We’ll call this the RNG strategy. I suggest you try this the next time you and your wife are deciding whose turn it is to make a cup of tea; just for the reaction you’ll get if nothing else. An important detail about the pseudo-random RNG strategy is that it cannot lose (in the long term). By that I mean over time, as you play more and more games, your ratio of win:draw:lose will stabilise at 1/3:1/3:1/3 and your victories and losses will cancel each other out.
This is a common focus of Game Theory analysis. We accept that we cannot control short-term luck and instead turn our attention to long-term results using the law of large numbers, considering what would happen if we used this strategy over millions of games.
There’s an interesting paradox hidden within the claim we just made, though. Notice that we made no mention of our opponent’s strategy. Our ratio will converge to 1/3:1/3:1/3, regardless of what our opponent does.
To get an intuition for why this is true, imagine for a moment you’re playing against the most predictable opponent in the world; they always choose Rock. If we persist with the RNG strategy, then the following will happen:
1/3 of the time we play Rock vs Rock (draw)
1/3 of the time we play Paper vs Rock (win)
1/3 of the time we play Scissors vs Rock (lose)
In the long-term, our ratio is still 1/3:1/3:1/3, as we predicted. The amazing thing here is that it does not matter what ratios our opponent decides to use; our long-term results are exactly the same. For those of you familiar with probability trees, you can test this for yourself when your opponent uses the following ratios verses your RNG strategy:
Rock: 4/9
Paper: 2/9
Scissors: 3/9
Why perfection loses money
Some of the previous examples should be raising alarm bells. When one player uses the RNG strategy, it literally does not matter what the opponent does. They could be using the same RNG strategy, they could be playing Rock every time, or they could be doing anything in between. Our long-term expectation is the same: we’ll win about as much as we lose.
To frame this phenomenon a bit more mathematically, imagine you win £1 every time you win and lose £1 every time you lose (nothing happens when you draw). Then in the long-term you expect to win exactly £0. However, there is some nuance to consider, as the RNG strategy actually loses money.
Imagine the following scenario. You play a million games of RPS over your life time for £1 a game (you’re the world’s most boring gambling addict). At the end of your thrilling career, you have won exactly £0. But how much time did you spend playing? And what was the opportunity cost of that time? Could you have been doing something more productive with your time, something that actually made money?
A selection sub-£1 denominations of British coins. Image by Kelvin Stuttard, source: Pixabay.
This concept of opportunity cost is important, and it comes up all the time.
I was once asked to do an hour of online maths tutoring on a Sunday morning for £40. I declined because the patio needed de-weeding, and I wanted to save money – I wasn’t going to pay a handyman £20 for something I could do myself! The job took about an hour and my back was aching by the end of it. Did I save money? Well, yes, I spent £0 instead of £20. But I could have paid the £20 and used that hour to do the maths tutoring, leaving me with a net profit of £20 and the ability to stand up straight.
On the face of it, the conclusion is simple; don’t waste your time playing RPS. Or is there more to it?
Why you should be making mistakes
We’ve seen that when one of the players (or both) uses the RNG strategy, then RPS is a break-even game (losing even when you consider the opportunity cost). The reality, though, is that nobody is using the RNG strategy. Even if you know about the strategy, actually implementing it is very difficult without the use of a calculator. Just try playing RPS a hundred times in a row while trying to be as random as possible. It’s mentally exhausting and, no matter how hard you try, you’ll eventually fall into a predictable pattern. In fact, mass data analysis (MDA) suggests that, on average, people play Rock at too high a frequency (according to WRPSA, the World Rock Paper Scissors Association).
Something like the following is typical for someone trying to replicate a random strategy:
Rock: 37%
Paper: 30%
Scissors: 33%
We’ll call this the MDA strategy.
The necessary response is simple. Our opponent is biased towards choosing Rock, so we should be biased towards choosing Paper. And if you’re playing a one-off game against a new opponent, this is what I recommend you do; just play Paper. In fact, we can calculate our expected payoff when we use this maximal exploitative strategy versus the MDA strategy. We can expect to win, on average, £0.04 per game. It’s not much, but it’s certainly better than the £0 we expected when our opponent played perfectly!
Is this exploitative strategy a mistake? Well, the answer to that is nuanced. On the one hand, it maximises our expected payoff versus our opponent’s mistake. On the other hand, it is a deviation from RNG, and can be counter-exploited by our opponents (if they know we’re doing it). In fact, we’re about to see exactly how this “mistake” can be punished.
How mistakes can lose even more money
As we said, Game Theory is concerned about the long-term. What would happen if you played like this against the same person for 100 consecutive games? It won’t take them long to realise we’re playing Paper every single time. And just like that, our advantage is lost. Even the most unobservant opponents are capable of making adjustments against such obvious deviations and, when they do it, they may not be so obvious about it. If they realise what we’re doing and adjust their frequencies even slightly to something like:
Rock: 30%
Paper: 30%
Scissors: 40%
Then our expected payoff per game plummets to -£0.10 per game; we’re now losing money!
And this simple example sums up the problem with exploitation. By deviating from the safe confines of the RNG strategy, we have the potential to boost our win rate from zero to hero. But, take it too far and our opponents will adjust and we’re suddenly losing money.
Why sub-optimal mistakes will make you rich
Our mistake was to take things too far. I believe there’s a sweet spot somewhere between the RNG strategy (no risk, no reward) and the maximal exploitative strategy (high risk, high reward). I would call this sweet spot a marginal exploitative strategy (low risk, low reward). Something like the following might be one such choice when playing against the MDA strategy:
Rock: 30%
Paper: 45%
Scissors: 25%
We have a more conservative bias towards Paper but will now generate a measly expected payoff of £0.0095 per game, or about one penny! To put that in context, that’s 100 games to win approximately £1!
Is this suggestion the perfect balance between risk and reward? Who knows! That’s the beautiful grey area in exploitative Game Theory. How far can we push our luck before we run a serious risk of our opponent realising and adapting. I would suggest that for a game like RPS, we can’t push our luck very far.
Is all this effort worth it for a penny? That depends on a few things such as:
Opportunity cost – could we make more money elsewhere with less time and effort?
Size of the game – what if we played for £10 per game, or £100 per game? Our expected payoff becomes £0.095 per game and £0.95 per game, respectively.
Strength of opponent – the MDA strategy isn’t perfect, but it’s not far off. What if the exact person in front of you is even further away from RNG? Our marginal exploitative strategy will now generate a higher expected payoff.
Our skill edge – it’s not enough for our opponent to make mistakes. We need to have the clarity of thought to be able to identify: what mistakes they’re making; how to exploit them; how much to exploit them.
RPS vs NLHE
An important feature of RPS is its simplicity. By that I mean it’s very easy for our opponents to defend themselves. There’s only one decision to make when they play, and it’s the same decision every time. As such, there’s only one strategy to learn (RNG), and it’s relatively simple to implement something approximating it. Sure, they’ll make small mistakes, and we can exploit them a little bit, but our profit margins are so thin that it’s probably not in our interest to play when we consider opportunity costs.
Someone considers their next move with the deck of cards. Image by tookapic on Pixabay.
Compare this now to one of my favourite games; No Limit Hold’Em (NLHE) poker. There is no longer a single decision point (node) for our opponents to think about. There are in fact thousands of them spread across the entire game tree. Memorising (and implementing) the appropriate un-exploitable strategy at each node is simply not humanly possible. Not only that, but implementing something even approximating the optimal strategy is incredibly difficult for all but the strongest professionals.
Recreational poker players are, quite simply, making huge mistakes on a consistent basis. But how do we exploit them across thousands of different nodes, and how far can we push our luck (maximal vs marginal exploitation)? The over-simplified answer to these two questions is:
Mass Data Analysis reveals consistent patterns in the types of mistakes poker players make, generating useful heuristics to guide our exploitative strategies.
Each of the thousands of nodes occurs infrequently enough, that we can use maximally exploitative strategies across the board with very little risk of being detected (in live poker at least, where players don’t have access to a HUD).
The end result is that professional poker can be very lucrative for a dedicated professional who is willing to invest the time and hard work required to learn these exploitative heuristics. As with all games, there is short-term variance, high variance in fact for live poker. But, long term, it’s possible to make good money. At 5/5 live 200 cap in the USA, the strongest players can expect to make close to $100 per hour. Once their bankroll is big enough to handle the variance, they can move up in stakes and push that win rate higher and higher.
Conclusion
If you’re playing a one-off game of RPS, play Paper! You’re not guaranteed to win, but you give yourself the best chance. However, you probably shouldn’t take up professional RPS unless you can consistently play against very weak players for large amounts of money.
The more complicated the game, the more we can push our luck and play close to maximal exploitative strategies – it’s simply too difficult for our opponents to realise what we’re doing.
The Skeptic podcast, bringing you the best of the magazine’s expert analysis of pseudoscience, conspiracy theory and claims of the paranormal since its relaunch as online news source in September 2020.
If you’re on Facebook or Instagram, you’ve almost certainly encountered Reels, Meta’s answer to TikTok’s short-form video content that is so wildly popular with “the youth”. Reels are frequently interspersed in feeds and are optimised to make you wonder just enough to click. Once you’ve started watching, it’s very easy to just keep swiping through “related” content. As with other media websites, that “related” can often mean you’re only a few swipes away from some deeply disturbing and harmful content, such as medical misinformation, conspiracy theories, and bigotry, often all in one reel!
I’ve wanted to write about Reels for a while, as just another easy access point for people to encounter damaging and radicalising content, but that feels so par for the course these days it didn’t seem worth the cataloguing of well-documented horrors. That is, until… Jewtlantis:
Screenshot from the Jewtlantis video
It’s gonna be that kind of article. There are so many things wrong with just this image, not least of which is calling it ‘Jewtlantis’ when ‘Jewlantis’ is right there. I’d imagine that is a result of this being the sort of AI-generated slop slowly filling up every corner of the internet.
For many, the first coherent question they will manage to get out is some form of “who is making this content and why?”, the quaint sort of questions one might have expected to get answers to in the before times. A proper investigative journalist could probably track down more concrete answers to those questions, but I’m a pro-bono amateur gonzo journalist at best, so here’s what I found:
According to Instagram, Cyber-Zionist came online in January of 2025 and is based in Israel. It is also currently not affiliated with any memecoins, but it does associate its work with Kabbalistic sci-fi – a sort of Jewish spirituality-based reimagining of science fiction stories, similar to the Afrofuturism portrayed in media like Black Panther and HBO’s Lovecraft Country. While that may be their genuine goal, the implementation here is deeply flawed and likely to promote both unfounded antisemitic conspiracy theories and well-founded concerns about Zionist colonialism.
To understand why, we need to look at their larger body of work before we return to Jewtlantis. Many of their videos involve applying the same sort of AI-generated Jewish gloss to pop culture material, or sometimes random clickbaity material like cute animals or people working out at the gym. You’ve got Jewrasic Park, Game of Jews, Jews of the Caribbean and, my personal favourite, Jewhammer 40k:
Screenshot from the Jewtlantis video
We talk a lot about the death of satire, but not enough about how it has reincarnated as something far more mind-destroying. They even have a Jewish Rick and Morty, which honestly feels like something you’d see in the show. If this sort of cringe were all there was to the account, we could give this a pass. But then there’s Jewtlantis.
Screenshot from the Jewtlantis video
This is indistinguishable from Bioshock, a game series that heavily satirises extremist ideologies and the dystopian hellscapes they produce, which should be a red flag! The moral of Bioshock is not “we should also try to build an ideologically pure underwater empire”. Don’t take it from me though, the Nazis in the comments section have no trouble drawing the same comparison:
Screenshot of Jewtlantis Instagram comments
On top of serving as perfectly crafted content for Nazis, it’s crucial to remember that the story of Atlantis was popularised in the modern age by racists as a way to square White Supremacist narratives of history with the existence of significant non-white societies and the megastructures they built around the world. Combined with ancient alien pseudoscience, Atlantis was such a focal point for racist pseudohistory that the Nazis built a futuristic house dedicated to studying it.
Now, one major aspect of Afrofuturism and other approaches to sci-fi is to retell famous sci-fi stories from the perspective of marginalised communities who have been historically excluded or portrayed in racist ways in those contexts. Cyberzionist might try to argue they’re simply doing the same with Atlantis, but there are two things wrong with that.
Firstly, retellings of the Atlantis myths often involve Jews causing the downfall of Atlantis, usually out of jealousy or greed, and often in ways where they’re accused of secretly controlling advanced technology, such as Jewish space lasers. These glossy AI images are so perfectly designed to feed into those particular conspiracy theories, it is reasonable to wonder if Cyberzionist is actually a Nazi false flag psy-op, despite all evidence suggesting the creator is genuine in their Zionist messaging.
The bigger problem is that, in promoting an explicitly ethnonationalist vision of the future, they have abandoned the emancipatory ideal at the heart of futurism. Whatever kind of futurism, the shared goal is envisioning a future free from the suffering caused by colonialism, ethnonationalism, and any other dominance hierarchies. The protagonists in Black Panther begin in a place of xenophobia, but over the course of the story they learn that isolationism is not an ethical way of life. Shuri was right. By abandoning those ideals in favour of Zionism, Cyberzionist produces content that is both exclusionary and threatening, akin to the fascist visions of a shiny future where all non-White people are noticeably absent.
The colonialist aspects of Cyberzionists art is most explicit in the videos where they Jewify other cultures:
Screenshot from the Jewtlantis video
If this was the only image you saw, I could once again understand laughing it off as just being Internet-town, but the one on Indigenous American cultures makes the problem impossible to ignore:
Screenshot from the Jewtlantis video
This is really bad on so many levels. It is hugely racist towards these cultures to use stereotypical images of them and then slap Stars of David and Menorahs everywhere. It’s planting a colonial flag in a dehumanised culture, erasing indigenous people’s agency along with their identity. The image once again implies that these people could not have possibly built such a structure without the help of a more advanced culture.
As I discussed when covering the Hoteps, Jews are often seen as a malevolent race of literal space aliens. These videos reinforce a host of horrifying antisemitic conspiracy theories that claim Jews have controlled events across the planet since the dawn of civilisation. They are portrayed as always existing as either adversaries of society, parasites that feed on it, or the secret masters that are guiding it towards their nefarious ends. Again, it is impossible to look at that image and not at least wonder if this is a Nazi psy-op account. The comments sections are full of Nazis spewing hate speech, but also people claiming to be Jewish who think the content is inspiring. Poe’s L’chaim.
So, what is there to take away from the Parable of Jewtlantis, beyond the desperate need to help people comprehend that media like Bioshock is a warning, not a recommendation? We can see our likely dystopian future, where AI eliminates the barriers to flooding the world with reactionary slop that effectively reinforces bigoted biases and disinformation. We can hold out hope that genuinely emancipatory futurism will win out over all forms of colonialism in the longer term, but in the near term we’re in for a brutal ride to the ocean floor.
