I was recently reading Modern Times: A History of the World from the Twenties to the Eighties by Paul Johnson. I have been recommended this book many times (the original – not the newer versions) and finally gave it a whirl. I have read several of his very short books, but had been intimidated by this very long one (817 pages!). It sat on my shelf for a couple months staring at me, calling to be read, especially late at night and early in the morning when my girls were asleep. Upon hitting the bottom of the first page, I was immediately pulled in. It became very clear why the book—nonmedical and written 40 years ago—was recommended to me so often by physicians, historians, researchers, and, of course, my extremely intelligent newsletter readers.
Besides the fact that the dense and schizophrenic history that occurred after the World War I land grab is fascinating and sets the scene for much of what transpired over the past century, the story of Einstein is where the major relevance comes in with regards to two major topics I like to discuss here: medicine and research. To make a long story short, when Einstein developed the theory of relativity, he refused to believe it as fact until he tested it repeatedly in several distinct scenarios through intense experiments. If it continued to hold up under intense scrutiny, he would finally bow to its veracity. Only after taking swing after swing at his darling and, in the words of William Faulkner (or maybe it was actually G.K. Chesterton), trying to kill it, and seeing it still standing did he acknowledge its credibility of his theory.
Give that some thought. The greatest genius of the modern era would not believe a theory coming from his own mind—a mind with a level of intelligence that likely remains unsurpassed. This great mind would doubt his findings until incontrovertibly proven to be correct. Of course, counter this with modern day researchers and take a stroll up the steep incline to visit the unquestionable ivory tower on the hill that the modern academics occupy, peering down at us. Questioning these modern gods will often get you a call to the principal’s office, and as we have seen recently, firing, public humiliation, blacklisting, and other attempts to ruin one’s life are not off the table.
One key difference between Einstein’s theory and modern-day “science” is the often confusing between research findings and policies or consensus reports and recommendations. Scientific theories and findings are meant to be questioned, whereas policies are more-often demands bestowed upon us from above by the top-down “leaders”, some (or in other cases, many) of whom got to their positions through politicking, backstabbing, blackmailing, and filibuster approaches instead of by merit. Unfortunately, we see this often in medicine, where the doers are busy doing and the administrators and guideline creators avoid doing and instead advise everyone else on what they should be doing. Einstein be damned, no questions allowed.
For instance, I was recently part of an unnamed committee that creates recommendations and consensus guidelines. The guidelines proposed were a continuation of the typical calorie counting low-fat sacred cows from the 70’s. These recommendations have taken about a million more fatal blows than Einstein’s theory, yet continue to perpetuate as they are not scientific findings, but rather top-down policies. I took a dozen stabs at them during the review, with about 10 of them fatal, most of these included the absolute lack of evidence for many of the recommendations. What I realized was that the entire committee process was basically a bunch of people arguing and whoever refused to stop arguing would likely find their ideas promoted in the guidelines. It was not based on facts, science or merit, but merely politicking and filibustering. Consensus is quite distant from evidence-based research. While I am unlikely to be invited back, at the end they did remove all the specific dietary recommendations and replaced with one that aids in keeping excess adipose tissue off (score one for Champ!).
“And if ever, by some unlucky chance, anything unpleasant should somehow happen, why, there’s always soma to give you a holiday from the facts. And there’s always soma to calm your anger, to reconcile you to your enemies, to make you patient and long-suffering.”
– Aldous Huxley, Brave New World
We often see medical policies made by highly opinionated individuals (yes, we all know these academics with strong egos mixed in with a little personality disorder and perhaps a touch of narcissistic personality disorder) who do not like to be questioned, whereas scientific and research findings by legitimate researchers, like Einstein, are meant to be extensively questioned and batted around by academic discourse. What the last several years has exposed is that many academics are not academics at all, but policy pushers and administrators masquerading as scientists, violating the cores of research and scientific discourse, causing Einstein to spin in his grave.
As a side note—and as many of my readers have pointed out to me—these policy makers often have tension towards the doers, as their lack of merit festers inside like an eroding ulcer as they have done little besides push people around with policy. As a result, the doers—i.e., the people whom medicine and research ultimately rely on—have their progress curtailed by the policymakers and academic demigods with chips on their shoulders.
“Like alcohol, herd-poison is an active, extraverted drug. The crowd-intoxicated individual escapes from responsibility, intelligence and morality into a kind of frantic, animal mindlessness.”
– Adous Huxley, Time Magazine, 1958
This conflict is all around us, illustrated at its worst (at least in my opinion) by the disastrous dietary guidelines over the past 50 years, where the policy makers batting average is close to Andy Van Slyke in the 95 season (about the same percent that you non-Pittsburgher readers got that reference—and for the record I was and am a big AVS fan). He retired the next year, whereas our nutritional guidelines policymakers refuse to hang up the cleats.
Returning to my consensus guideline meeting, we literally had multiple, drastically different takes on dietary recommendations, and basically the most relentless politicker was the one whose guidelines would be published for all to follow. It is not difficult to see the massive issue with this approach. Luckily, in the end, we decided to put no recommendation whatsoever but simply follow a diet and lifestyle that promotes the avoidance of weight gain in the form of fat. This was a small victory, but if your batting average is under 200, whether you are a MLB pro or a dietary recommendation producer, it is time to hang up your cleats and call it a day. This committee had enough foresight to hang up the cleats.
However, peering across the valley to view the rest of the medical landscape is not so fortuitous, as policy and strong opinions camouflaged as “consensus” abound and get shoved down the public’s throat as “science.” The good news is that, much like Einstein, high quality researchers continue to question these policies, facing potential push-back and retaliation. Einstein’s message has not fallen on deaf ears and the real scientists will continue to question, and hopefully, so will you.
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