The Chicago waterway system has several locks—why not simply close these and be done with it? Would closing the locks have a negligible effect on the economy of Illinois, as a study commissioned by the state of Michigan has claimed, or damage its economy irreparably, as demonstrated in a study preferred by Illinois? Would closing the locks risk flooding thousands of Chicago basements, as local officials say? How about the part of the waterway where there is no lock at all? Wouldn't the carp simply go that way? Will the new thirteen-mile barricade of concrete and special wire mesh designed to keep carp from swerving out of the Des Plaines and into the ship canal during flood times actually work? Will uninformed anglers introduce Asian-carp minnows while using them for bait? And what about immigrant communities from Asia who are known to perform ritual releases of fish and other animals during certain religious ceremonies? Might they have performed such rituals involving Asian carp already? Might they do so in the future? Will all this bring prevention to naught?

  The Illinois Department of Natural Resources addresses itself to many of these questions, as does the U.S. Army Corps of Engineers (Great Lakes and Ohio River Division), the Metropolitan Water Reclamation District of Greater Chicago, the U.S. Fish and Wildlife Service, the Senate Great Lakes Task Force, the Congressional Great Lakes Task Force, the White House Council on Environmental Quality, the interagency Asian Carp Rapid Response Team, and the interagency Asian Carp Regional Coordinating Committee's Asian Carp Control Framework. The Illinois Chamber of Commerce, the American Waterways Operators, and the Chemical Industry Council of Illinois put in a word for industry, while the Natural Resources Defense Council, Freshwater Future, the Sierra Club, Healing Our Waters Great Lakes Coalition, and the Alliance for the Great Lakes offer perspective from the environmental side. The Chicago Department of the Environment, the Great Lakes Fishery Commission, the Great Lakes and St. Lawrence Cities Initiative, and the University of Toledo's Lake Erie Center are heard from as well. For legal guidance, concerned parties refer to the Nonindigenous Aquatic Nuisance Prevention and Control Act of 1990 (revised as the National Invasive Species Act of 1996, revised as the National Aquatic Invasive Species Act of 2007); also, to the Asian Carp Prevention and Control Act of 2006.

  Man proposes, carp disposes. Through waving weedbeds of bureaucracy and human cross-purposes, the fish swims. Starting in 2009, tests for Asian-carp DNA in Chicago waters indicated that the fish might have moved beyond the barriers. In February 2010 the state of Illinois, hoping to calm its neighbors, began an intensive program of fishing for actual fish with electroshocking and nets, while the DNA tests continued. These efforts turned up more DNA but no fish. In March the Illinois DNR announced that six weeks of searching had found no Asian carp throughout the entire Chicago Area Waterway System. Then, on June 22, a commercial fisherman working for the DNR netted a nineteen-pound-six-ounce bighead carp in Lake Calumet, thirty miles beyond the electric barrier and six miles from Lake Michigan. Between this well-fed, healthy male Asian carp and the Great Lakes, no obstacle intervened.

  If the neighbors had been worried before, they began to sweat and hyperventilate now. Outcries of alarm came from officialdom in Minnesota, Wisconsin, Michigan, Ohio, Pennsylvania, and New York, as well as from Canada. Michigan's attorney general, Mike Cox, brought suit in federal district court to force the Corps of Engineers and the city of Chicago to close the locks immediately. Four other Great Lakes states, but not New York, joined on Michigan's side; two previous lawsuits for the same purpose had already failed. The Senate Energy and Natural Resources Subcommittee on Water and Power held hearings on the federal response to Asian carp. The governor and the attorney general of Ohio called on the president to convene a White House Asian Carp Emergency Summit. Dave Camp, a congressman from Michigan, proposed a piece of legislation he called the CARP ACT, for Close All Routes and Prevent Asian Carp Today.

  Senator Dick Durbin of Illinois announced that he had asked the president to appoint a Coordinated Response Commander for Asian Carp, and the president had agreed. This so-called carp czar was to be chosen within thirty days. The president made clear that he had a "zero tolerance" policy for invasive species. Senator Kirsten Gillibrand of New York announced her support for another anti-carp bill, the Permanent Prevention of Asian Carp Act. Michigan's Mike Cox accused Obama of not doing enough about the problem because he sympathized with his own state of Illinois. (Cox, a Republican, is running for governor.) Senator Carl Levin, Democrat of Michigan, sent Obama a letter asking him to act quickly to protect the Great Lakes from Asian carp, and thirty-two representatives and fourteen senators added their names.

  Unlike Romeoville, the place where the apocalyptic bighead was caught is quiet. To some it might even be paradise. The part of Lake Calumet in which the commercial fisherman netted this carp doubles as the water hazard beside the concluding holes of a luxury golf course called Harborside, rated by Golfweek as the third-best municipal golf course in the country. One afternoon I walked some of the course. To play eighteen at Harborside on a Saturday or a Sunday costs $95; new SUVs filled the parking lot. Several of the raised tees provided a panoramic view of the Chicago skyline, while the surrounding Rust Belt ruins and ghetto neighborhoods of south Chicago just beyond the fence seemed far away. I asked employees at the clubhouse golf shop, waiters in the restaurant, a bartender, and a man tending the greens, but none had heard of the nation-shaking carp netted here two months before.

  The reason the fisherman happened to be fishing there in the first place was that a team of scientists from Notre Dame had already found bighead-carp DNA in the water. Working for the Corps of Engineers, the university's Center for Aquatic Conservation has been doing DNA tests for more than a year. As part of the increased tracking of Asian carp, the Notre Dame scientists collected samples from bodies of water all over Chicago. David M. Lodge, a professor of biology, heads the center. I stopped by South Bend to see him on my way back from Illinois.

  Professor Lodge is a tall and genial man in his fifties, with a southern accent, blue eyes, and a D. Phil. in zoology from Oxford University, which he attended on a Rhodes. He wore a yellow tennis shirt, with his ballpoint pen and mechanical pencil stuck neatly in the button part of the neck, an innovation I admired, because I was wearing the same kind of shirt and had compensated for its lack of breast pocket by putting my pens in my pants pockets, always an awkward deal. He asked if I was writing something funny on carp. I said I probably was. "I know you can't not laugh when you see the silver carp jumping all over the place, but it's really not funny," he said. "It's a tragic thing, and people are wrong to trivialize it. We should focus on these fish's potential environmental and economic impact. In the Great Lakes—just as we're seeing now in south Louisiana—the environment is the economy. Look how the degrading of Lake Erie in the sixties and seventies contributed to the decline of Detroit and Cleveland and Buffalo. To people who say this is a question of jobs versus the environment, I say it's not either-or.

  "The bigger issue is how we as a country protect ourselves against invasive species. At the moment, we are not very good at preventing invasions. We're constantly reacting after it's too late. Most invasions, if detected early, can be stopped, because establishing an organism so it's viable in a new environment is not automatic. Our current approach is more or less open-door. Right now the canal-and-river passage across Illinois from the lake to the Mississippi is a highway for the dispersal of organisms. The Great Lakes is a hot spot for aquatic invasions. In the lakes there are a hundred and six species nonnative to North America that are not in the Mississippi, while there are only fifty in the Mississippi that are not in the Great Lakes. An even greater threat, really, is of invasions going in the opposite direction from the carp's—that is, going from the lakes to the Mississippi. The Mississippi system holds the richest heritage of biodiversity in North America. The electric barrier at Romeoville was built originally to stop a small invasive fish called the round goby from coming south—too late, as it turned
out, because today the round gobies are established in the Illinois. A later invasive, the tubenose goby, does appear to have been stopped. So the barrier may have helped. But over time it will not be able to stop everything.

  "As for the Asian carp and the lakes, worst case is they're already established there. We wouldn't necessarily know. Usually, the first sign we have that organisms are invading is that members of the public see them. But people aren't underwater, and netting and electroshocking are not good tools for finding out what's going on in a body of water, especially not in one as big as Lake Michigan."

  To explain more about how DNA testing for Asian carp works, David Lodge led me to the office of his colleague Christopher Jerde, a brown-haired South Dakotan who helped develop the technique. I did not follow all the science of it. Essentially, the technique uses DNA found in water samples to determine what species might have been present, just as DNA evidence can suggest that a person was at a crime scene. The DNA sequences in water samples are not followed to the point where individual fish are singled out, but that could be done, too. Christopher Jerde said that people who wanted to ignore the carp problem kept pooh-poohing Notre Dame's DNA findings before the confirming bighead carp was caught. They argued that the DNA could have been carried in on a duck's feathers or something. But in places where his team got multiple positive hits, he knew the fish had to be there. When he was proved right, he took no pleasure. The carp invasion only makes him mourn.

  Some planners who take a long view believe that the Midwest's invasive-species probiem requires a bold solution: the complete separation, or reseparation, of the Great Lakes from the Mississippi at Chicago. This huge infrastructure project would consist of concrete dikes, new shipping terminals, new water-treatment facilities, maybe barge lifts to transfer freight, maybe the rereversing of Chicago's wastewater flow so that it no longer goes south. Business interests tend to hate this idea. I asked Jerde about it, and he said, "Right here is where you could put something like that," and called up a Google Earth photo of Chicago's South Side on his computer. "This empty area here is a Rust Belt nowhere left over from old Chicago," he said. "The main hub of a new shipping and hydrological arrangement for Chicago could go right here." As it happened, the brown and empty region he indicated on the satellite photo was not far from the green oases of the Harborside golf course.

  "Well, we don't have opinions on policy," he continued. "We just provide the data. We give it to the Corps or the DNR, and they present it to the people who make the decisions, and it's out of our hands. When people were coming up with all those supposed rebuttals to our findings, we couldn't defend ourselves. It's frustrating. People say we're either wrong or exaggerating, so there's no problem and there's nothing we need to do, or else they turn around and say it's too late, the carp are already here, so there's nothing we can do. I don't know whether we can stop these fish, but if we do nothing I can guarantee this problem and plenty of others will get worse.

  "Now, let me just show you a few of the places where we've had positive DNA hits for Asian carp." He touched a button on his computer, and little yellow thumbtack-like circles appeared on the Google Earth photo. They followed the Ship Canal, they appeared in the Grand Calumet and Little Calumet rivers, they clustered at the south end of the Romeoville electric barrier—proof that it was stopping fish, he said. "Last summer we had a positive hit here, in Calumet Harbor, which is separated from the lake only by a breakwater," he said. Then he moved in to a closer view of Chicago's downtown. "We also got a positive right here." He pointed to a yellow thumbtack at the Chicago River Lock and Dam, under Lake Shore Drive, about a mile and a half north of the Shedd Aquarium.

  Lies, Damned Lies, and Medical Science

  David H. Freedman

  FROM The Atlantic

  IN 2001 RUMORS were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school's teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she'd like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor's and other colleagues' help, eventually produced a formal study showing that for whatever reason the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. "It was hard to find a journal willing to publish it, but we did," recalls Tatsioni. "I also discovered that I really liked research." Good thing, because the study had actually been a sort of audition. The professor, it turned out, had been putting together a team of exceptionally brash and curious young clinicians and PhDs to join him in tackling an unusual and controversial agenda.

  Last spring I sat in on one of the team's weekly meetings on the medical school's campus, which is plunked crazily across a series of sharp hills. The building in which we met, like most at the school, had the look of a barracks and was festooned with political graffiti. But the group convened in a spacious conference room that would have been at home at a Silicon Valley start-up. Sprawled around a large table were Tatsioni and eight other youngish Greek researchers and physicians who, in contrast to the pasty younger staff frequently seen in U.S. hospitals, looked like the casually glamorous cast of a television medical drama. The professor, a dapper and soft-spoken man named John Ioannidis, loosely presided.

  One of the researchers, a biostatistician named Georgia Salanti, fired up a laptop and projector and started to take the group through a study she and a few colleagues were completing that asked this question: were drug companies manipulating published research to make their drugs look good? Salanti ticked off data that seemed to indicate they were, but the other team members almost immediately started interrupting. One noted that Salanti's study didn't address the fact that drug-company research wasn't measuring critically important "hard" outcomes for patients, such as survival versus death, and instead tended to measure "softer" outcomes, such as self-reported symptoms ("my chest doesn't hurt as much today"). Another pointed out that Salanti's study ignored the fact that when drug-company data seemed to show patients' health improving, the data often failed to show that the drug was responsible or that the improvement was more than marginal.

  Salanti remained poised, as if the grilling were par for the course, and gamely acknowledged that the suggestions were all good—but a single study can't prove everything, she said. Just as I was getting the sense that the data in drug studies were endlessly malleable, Ioannidis, who had mostly been listening, delivered what felt like a coup de grâce: wasn't it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? "Maybe sometimes it's the questions that are biased, not the answers," he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?

  That question has been central to Ioannidis's career. He's what's known as a meta-researcher, and he's become one of the world's foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical co
mmunity; it has been published in the field's top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else's work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there's a problem.

  The city of Ioannina is a big college town a short drive from the ruins of a 20,000-seat amphitheater and a Zeusian sanctuary built at the site of the Dodona oracle. The oracle was said to have issued pronouncements to priests through the rustling of a sacred oak tree. Today a different oak tree at the site provides visitors with a chance to try their own hands at extracting a prophecy. "I take all the researchers who visit me here, and almost every single one of them asks the tree the same question," Ioannidis tells me as we contemplate the tree the day after the team's meeting. "'Will my research grant be approved?'" He chuckles, but Ioannidis (pronounced yo-NEE-dees) tends to laugh not so much in mirth as to soften the sting of his attack. And sure enough, he goes on to suggest that an obsession with winning funding has gone a long way toward weakening the reliability of medical research.