We can't handle the scientific truth

"If the muscles and other cells of the body burn sugar instead of oxygen…"

Do they think we cannot handle the scientific truth?

I should really have gone to bed, but I was just surfing the channels in case there was some 'must watch' programme I might miss, and I came across a screening of the film 'A few good men'. This had been a very popular movie at one time, and I seem to recall watching it with my late wife. I remembered it as an engaging film, and as an example of the 'courtroom drama' genre: but beyond that I could really only remember Tom Cruise as defence advocate questioning Jack Nicholson's as a commanding officer – and the famous line from Nicholson – "You can't handle the truth!".

This became something of a meme – I suspect now there are a lot of people who 'know' and use that line, who have never even seen the film and may not know what they are quoting from.

So, I  though I might watch a bit, to remind myself what the actual case was about. In brief, a marine stationed at the U.S. Guantánamo Bay naval base and detention camp had died at the hands of two of his comrades. They had not intended to kill, but admitted mistreating him – their defence was they were simply obeying orders in subjecting a colleague who was not measuring up, and was letting the unit down, to some unpleasant, but ultimately (supposedly) harmless, punishment.

The film does not contain a lot of science, but what struck me was the failure to get some science that was invoked right.  I was so surprised at what I thought I'd heard being presented as science, that I went back and replayed a section, and I then decided to see if I  could find the script (by Aaron Sorkin*, screenplay adapted from his own theatre play) on the web, to see if what was said had actually been written into the script.

One of the witnesses is a doctor who is asked by the prosecuting counsel to explain lactic acidosis.

Burning sugar instead of oxygen?

The characters here are:

Capt. Jack Ross (played by Kevin Bacon) the prosecuting counsel,

Dr. Stone (Christopher Guest) and

 

 

 

Lt. Daniel Kaffee (Cruise's character).

On direct examination:

Ross: Dr. Stone, what's lactic acidosis?

Stone: If the muscles and other cells of the body burn sugar instead of oxygen, lactic acid is produced. That lactic acid is what caused Santiago's lungs to bleed.

Ross: How long does it take for the muscles and other cells to begin burning sugar instead of oxygen?

Stone: Twenty to thirty minutes.

Ross: And what caused Santiago's muscles and other cells to start burning sugar? [In the film, the line seems to be: And what caused this process to be speed up in Santiago's muscles?]

Stone: An ingested poison of some kind.

Later, under cross-examination

Kafee: Commander, if I had a coronary condition, and a perfectly clean rag was placed in my mouth, and the rag was accidentally pushed too far down, is it possible that my cells would continue burning sugar after the rag was taken out?

Stone: It would have to be a very serious condition.

What?

If a student suggested that lactic acid is produced when the muscles burn sugar instead of oxygen we would likely consider this an alternative conception (misconception). It is, at best, a clumsy phrasing, and is simply wrong.

Respiration

Metabolism is a set of processes under very fine controls, so whether we should refer to metabolism as burning or not, is a moot point. Combustion tends to be a vigorous process that is usually uncontrolled. But we can see it as a metaphor: carbohydrates are 'burnt' up in the sense that they undergo reactions analogous to burning.

But burning requires oxygen (well, in the lab. we might burn materials in chlorine, but, in general, and in everyday life, combustion is a reaction with oxygen), so what could burning oxygen mean?

In respiration, glucose is in effect reacted with oxygen to produce carbon dioxide and water. However, this is not a single step process, but a complex set of smaller reactions – the overall effect of which is

glucose + oxygen → carbon dioxide + water

Breaking glucose down to lactic acid also acts as an energy source, but is no where near as effective. Our muscles can undertake this ('anaerobic') process when there is insufficient oxygen supply –  for example when undertaking high stamina exercise – but this is best seen as a temporary stop-gap, as lactic acid build up causes problems (cramp for example) – even if not usually death.

Does science matter?

Now clearly the science is not central to the story of 'A few good men'. The main issues are (factual)

• whether the accused men were acting under orders;

(ethical)

• the nature of illegal orders,
• when service personal should question and ignore orders (deontology) given that they seldom have the whole picture (and in this film one of the accused men is presented as something of a simpleton who viewer may suspect should not be given much responsibility for decision making),
• whether it is acceptable to use corporal or cruel punishment on an under-performing soldier (or marine) given that the lives of many may depend upon their high levels of performance (consequentialism, or perhaps pragmatics)…

There is also a medical issue, regarding whether the torture of the soldier was the primary cause of death, or whether there was an underlying health issue which the medical officer (Stone) had missed and which might also explain the poor performance. [That is a theme which featured large in a recent very high profile real murder case.]

Otherwise the film is about the characters of, and relationships among, the legal officers. Like most good films – this is film about people, and being human in the world, and how we behave towards and relate to each other.

The nature of lactic acidosis is hardly a key point.

But if it is worth including in the script as the assumed cause of death, and its nature relevant – why not get the science right?

Perhaps, because science is complicated and needs to be simplified for the cinema-goer who, after all, wants to be entertained, not lectured?

Perhaps there is no simple account of lactic acidosis which could be included in the script without getting technical, and entering into a long and complicated explanation.

In teaching science…

But surely that is not true. In teaching we often have to employ simplifications which ignore complexity and nuance for the benefit of getting the core idea across to learners. We seek the optimal level of simplification that learners can make good sense of, but which is true to the core essence of the actual science being discussed (it is 'intellectually honest') and provides a suitable basis for later more advanced treatments.

It can be hard to find that optimum level of simplification – but I really do not think that explaining lactic acidosis as burning sugar instead of oxygen could be considered a credit-worthy attempt.

Dr. Stone, can we try again?

What about, something like:

Dr. Stone, what's lactic acidosis?

It occurs when the body tissues do not have sufficient oxygen to fully break down sugar in the usual way, and damaging lactic aid is produced instead of carbon dioxide and water.

I am sure there are lots of possible tweaks here. The point is that the script did not need to go into a long medical lecture, but by including something that was simply nonsensical, and should be obviously wrong to anyone who had studied respiration at school (which should be everyone who has been to school in the past few decades in many countries), it distracts, and so detracts, from the story.

All images from 'A few good men' (1992, Columbia Pictures)

 

 

 

 

 

 

 

 

 

 

* I see that ("acclaimed screenwriter") Aaron Sorkin is planning a new live television version of 'A Few Good Men' – so perhaps the description of lactic acidosis can be updated?