Doctores

 

Earlier this year, an exchange between Joe Rogan and Bill Burr on Rogan’s podcast went something like this:

Rogan: Do you want people to walk down the street with a mask on?

Burr: I don’t want to start this bullshit. I’m not going to sit here with no medical degree listening to you with no medical degree, with an American flag behind you smoking a cigar acting like we know what’s up better than the CDC… I watch the news every two weeks and “I’m like, mask or no mask? Still mask? Alright, mask.”

Rogan went the technocratic angle pointing out how the WHO notes that cloth masks have limited effectiveness and primarily recommends masks for those caring for covid patients. But I wish he had taken down the underlying assumption that mere laity may not question declarations from those with a medical degree or the CDC. 

Why is this important? Because there are at least a half dozen reasons why medical advice from doctors can and should be challenged, and not doing so can lead to prolonged sickness and excess mortality. In this example, clinging to masks over ensuring grocery delivery for the elderly and improved air filtering and ventilation in buildings (especially multifamily buildings housing hundreds of quarantined individuals) has gotten hundreds of thousands of people killed while prolonging pointless arguments. 

This assumption that we can’t question doctors or the CDC is silly for a handful of reasons both high-level and specific to doctors. Let’s start with high-level. 

First: Credentialed experts almost always disagree. So no matter what, someone’s always going to be disagreeing with an exalted doctor. 

Second: credentials are not a guarantee of superior knowledge, they are a confirmation that an individual has completed an approved course of study, test, or practical experience at some point in time. 

It’s rare that you see this barrier to criticism applied to other professions. One doesn’t typically see the argument that a New York Times columnist can’t criticize a Republican tax plan because the columnist isn’t an economist or a political scientist. Or that someone can’t give a training to coworkers without an education degree. 

Third: Knowledge evolves, and credentials typically do not. My credentials measure a broad base of knowledge I demonstrated at a point in time, not whether I retain that knowledge or stay abreast of evolving knowledge. Continuing education or recertification requirements are often a joke. 

Fourth and related: Books and the internet make relevant, accurate information widely available to everyone willing to do the research, credential or no credential. 

Fifth: Specialization. Degrees are typically broad, today’s world knowledge is highly detailed and focused on a much more specific niche within that larger domain. A degree in electrical engineering is no guarantee that the graduate knows anything about 15-minute interval smart meters. 

Sixth and perhaps most important: Credentialed experts have their own interests and biases. Left unchallenged, it’s natural for them to promote advice and policies that are best for them, truth be darned. 

Seventh: Credentials require time and money, and not everyone with the suitable knowledge has the time or the money. 

How many critical discoveries have been made by those without “proper” credentials or job experience? 

A New York Times columnist who has spent six months researching tax policy and speaking to a diverse array of experts on the topic is far better qualified to pass judgment on a tax plan than an economist who got a degree 20 years ago, works as a consulting manager, has never specialized in tax policy, and whose firm receives significant money from customers directly benefiting from the proposed tax plan. 

Which brings us to medical doctors. 

Most doctors are unlikely to have recent, detailed backgrounds in epidemiology and aerosol transmission. The Washington Post enjoys reminding Senator Paul of this on a regular basis. 

Many of the peer reviewed studies on masks and aerosol transmission are publicly available to anyone willing to carefully read them. If you’re reading the same studies the CDC is reading at the same time, who’s more knowledgeable? Do the CDC experts have hands-on experience treating covid patients and measuring aerosol transmission? 

And finally, doctors in this country are overwhelmingly biased in favor of pharmacological intervention, often overlooking or ignoring obvious, less costly, and more healthy solutions to medical problems. It is a significant reason why Americans pay more per capita for health coverage with the worst health outcomes of major high income countries. 

Doctors have been wrong all the time. Everyone has a story of a doctor declaring “x months left to live” for relative Y who went on to live for another several years beyond the doctor’s estimate. Doctors and experts once endorsed tobacco smoking, thalidomide, DDT, asbestos, PCBs, and indiscriminate prescription of antibiotics, all found to pose major health issues. 

I cannot tell you the number of times this has hit home for me personally. I went to a nurse practitioner several years ago when my throat was so swollen I could barely eat. The diagnosis was acid reflux and the immediate recommendation was to take omeprazole. The omeprazole worked, but my gut felt weird after taking it and it made no sense that I as a 29 year old man needed to take acid reflux medication for the rest of my life. Sure enough, I cut out both the omeprazole and my morning glass of orange juice and have had no problems since. You’re telling me I shouldn’t be questioning doctors after that experience? 

My wife struggled for years with bad and incomplete advice from doctors on how to deal with her Hypothyroidism before making dramatic changes to her diet and supplement regimen. It is certain that after five years of study and practical experience my wife knows more about digestion-related autoimmune disorders than most primary care physicians, endocrinologists, and pediatricians we’ve spoken with. This has been proven time and again in her conversations with those doctors. 

Which brings us back to the original question on masks. You don’t have to have an MD or a CDC job on your resume to figure out whether a certain type of mask does or does not block the spread of viral particles, and it is silly to suggest otherwise. Refusing to question the medical establishment will lead to stagnation of knowledge, sticking with failed approaches, and hubris on the part of doctors leading to more failed health initiatives. 

This isn’t to say throw out any recommendations made by a doctor. Only to say that doing sound research, asking hard, insightful questions, and challenging assumptions is how the evolution of scientific knowledge moves forward. Shutting that virtuous cycle off for the vast majority of society is going to do more harm than good. 

Veritas Tua

 “Well that’s your truth!” While taking his sons to the park, a friend of mine recently overheard an old man saying this to another old man. Exasperated, my friend high tailed it away lest he morph into, as he says, “Furious George.”

This idea that truth varies for different individuals is an old one. Plato discussed this idea in the Theaetetus dialog. It has survived through the ages, showing up in the lines of Scar from Lion King. 

It is normally associated with young people, but I see it more commonly and more deeply among old people. The young people I know are often convinced that there is an objective truth. They use words like justice and equality in the belief that these are supreme goods, and many of these youths demand punishment for those who say otherwise.

Promotion of relativism by the elderly hits home for my family. We have relatives who insist that we must accept and affirm them without reservation, by which they mean we must affirm their rudeness, hurtful comments, and burdensome demands. In conversations with friends, this is fairly common among relatives in their 60s and 70s. I have some speculations on why this is the case, but we’ll get to those musings in another post.

The thing is this relativism breaks down immediately. My relatives maintain that they are the type of people who are owed affirmation when they take advantage of close family, start fights, and personally attack us in public. To which I respond that I am the type of person who is owed reciprocity, a peaceful and supportive family, and kindness. 

These things cannot both be true. My relatives either have to A) drop their pretense to universal equality to insist that they’re intrinsically more valuable than us, which would torpedo their political views, or B) reject their belief that each individual gets to decide their own moral standards and impose tolerance of them onto others. Instead they go with Option C) Go silent and refuse to confront the matter, hoping that we just shut up and make the discomfort go away. 

It makes one want to rewatch the final scene of Boondock Saints. “These are not polite suggestions. They are codes of behavior.” 

What’s most irritating is that there really is an objective moral standard they’re insisting on: Don’t make us uncomfortable. This is what Pope Benedict XVI termed the Dictatorship of Relativism. Relativism is never really relativism, it is an iron-fisted demand that pleasures and conveniences continue uninterrupted and unquestioned. 

It is like modern, secular governments pretending that they are neutral in regards to religion. The reality is state-enforced Agnosticism that excludes religion from education and civic life. The reason for doing this is ultimately more convenience for the government in keeping the peace and fostering uninterrupted economic growth. It’s easier to keep people quiet if they’re focused on amassing more stuff and never ask hard questions. 

The Dying Idol of Americanism

 

When I was a child in the 90s, there were (as there always are), assumptions that were not to be questioned. Among them: freedom of speech, assembly, press, and religion were unequivocal goods to be protected full stop, the goal of life is to obtain a good education leading to a stable job leading to economic self sufficiency and comfortable retirement, that the modern era was far better and had shed the problems of prior eras, that the government was generally good and trustworthy, that religion was a private experience meant to serve an individual’s need for inner fulfillment that must take a backseat to everything else I just listed. 

That 90s bourgeois consensus is dead. More and more folks in my generation perceive a binary choice: uncompromising progressivism or no-holds-barred conservatism. We are rejecting the promise of classical liberalism: lasting peace and economic prosperity can be achieved by abandoning the use of force to impose ideological conformity. 

In the last two years: 

-Conservative American pundit Tucker Carlson visited Viktor Orban in Hungary, a leader who openly rejects political liberalism

-A mob of supporters of the Republican President marched on the US Capitol to overturn the results of an election that had been backed by many Republican judges and state government officials

-Public schools, retail stores, and community events were shut down by executive fiat for an indeterminate time period to combat a pandemic that is at worst minor by historical standards

-The centrist Governor (son of a daily communicant) issued requirements to suspend baptisms and reception of Communion as done in Catholic rites until persuaded otherwise by backchanneling from his mother and the local Bishop

-The President of the United States who scarcely won election and promised otherwise imposed a requirement for tens of millions of workers to receive a vaccine that did not exist 12 months ago

-An activist group at Netflix launched a campaign to bar programs like Dave Chappelle’s from being hosted on the platform, following similar attempts to silence Jordan Peterson and even early gay rights sympathizer JK Rowling

Americanism is dying. Conservatives believe the need to protect Constitutional rights requires them to undermine democracy, liberals believe the need to protect social welfare and protect minorities requires them to undermine Constitutional rights.

In the midst of this and a deeper delving into the truths of the faith, I had to be honest with myself and let go of my idol of Americanism. It is true that many parts of the US Constitution are valuable because they articulate and enshrine timeless principles of natural, God-given rights. It is also true that a society whose only unifier is freedom has no unifier at all. Every generation must reanswer the question freedom for what? We do not have a shared culture expressed in architecture, history, cuisine, public events, and family traditions like those I saw in Spain, Croatia, and Israel. Democratic control over the political order has also convinced us that reality is likewise up for a democratic vote. And democratic votes can be manipulated by savvy influencers. 

For most of American history, those accorded Constitutional rights professed government neutrality in matters of faith but actually acted on the assumption that Christian moral principles were the basis of society. But this was not a sure thing. Though figures like Washington, Adams, Hamilton, and Lincoln came to understand the importance of faith and regular prayer, others like Jefferson preferred to censor the Bible to suit liberal attitudes about miracles, and Thomas Paine rejected institutional religion altogether. 

As de Toucqeville pointed out, America had no established aristocracy. It also had no overarching organized church or quasi hereditary institutions like guilds to act as competing centers of power. This soon created unbridled competition that allowed plutocrats like Andrew Carnegie and JD Rockefeller to amass enormous power, creating irresistible calls for expanded action by the only competing institution left: the government. In came the demagogues like Theodore Roosevelt and Woodrow Wilson, who ignored the Constitution to get their agenda across the finish line. 

Americanism is built on a deeply flawed and unsustainable foundation. The Constitution and American ideals have not stood the test of time. Beyond failing almost immediately when it came to Presidential elections (requiring resuscitation by the 12th Amendment), the country almost ended over the Constitution’s forced acceptance of slavery. More recently the vague language in the Commerce Clause and Equal Protection Clause of the 14th Amendment have allowed any branch of the federal government to do whatever it wants and get away with it. And they often use this license to demolish cultural norms and undermine freedom of religion. 

This is why the Catholic Church warned against Americanism until Americanist influence began running the show after WW2 and into the Second Vatican Council. A society with no guiding ideals besides freedom will produce selfish citizens seeking primarily to maximize their own gain, or competing identity tribes seeking to take care of themselves at everyone else’s expense. A society with no established church will see religion dominated by the selfish ideals of the state and cultural fashions. A society with no reasonable limits on speech, press, and educators will be flooded with misinformation. 

This is not theoretical. There is a reason the excesses of Wall Street, the explosion of identity politics, manufactured wars, and mass closure of churches and suspension of the sacraments are happening in America and in a Western Europe heavily influenced by postwar Americanism. 

This is why my generation perceives a choice. Not content with the limp libertarianism and careerism of Generation X, we either choose to pursue Americanism to its logical conclusion of the dictatorship of relativism, or we reject the misguided notions of freedom and rediscover the purpose of government as leading man toward the common good and the kingdom of God.