Slow and steady cures disease -but loses the hearts and minds of America

My output on Substack is not unlike the bowels of a 90 year old woman: slow and irregular, but rigidly structured when it emerges.

I apologize to those of you who are kind enough to follow me here and regret to inform you that I will never manage to pass a daily newsletter the way a lot of other writers do. I do write short, irreverent medical blurbs on LinkedIn with greater frequency, but I reserve this space for deeper reads, which take longer to produce in my spare time.

My recent silence was due to work on a peer-reviewed article on that which I hold closest to my heart:

Factually eviscerating the arguments of charlatans who poison the well of knowledge despite their trappings of expertise.

It’s bad enough when drop-outs or experts in unrelated fields (finance, law, IT, B2B sales, etc) brazenly distort public understanding of medical issues, but when its an honest-to-god medical professional, I am more ready to throw hands than any guy in a TapOut shirt (which actually isn’t saying much, for those unfamiliar with the scenario).

Medical professionals who spread medical disinformation deserve an especially toasty spot in Hell because:

1. They have the education and (usually) the experience to know better.

2. They know that there is insatiable public appetite for “secret” remedies because many believe in magic, and even more are understandably desperate to evade suffering and/or death.

3. They abuse the trust in our profession and abandon their duty to protect the pubic -for personal gain.

A health professional who spreads disinformation is no different than a municipal water quality manager who drops a deuce in his community’s freshly purified drinking water. Not even just once -but each and every time he feels a bit of rectal urgency (because these guys are relentless). This is beyond unacceptable.

Enough about principles: let’s talk about friends and concealed explosives

Back in November, my dear friend Brad (who writes a way better blog than I) sent me an article penned by one Vinay Prasad. Given that the author was a full professor of oncology at UCSF and held a masters in public health, I assumed that he would know what he was talking about. Perhaps because he did know a lot, he used that knowledge to fawn over RFK Jr.’s antiscientific beliefs in a nauseating display of political ambition. His piece was easily accessible to the medically unsophisticated reader (8th grade reading level by Flesch–Kincaid), confident in tone, and filled to the brim with disinformation -sanctified by his credentials. It is an anathema from start to finish.

Brad said: “this sounds reasonable, don’t you think?”

What I thought was, “I am going to have stroke” because he was right: it sounded reasonable. But that’s the problem. Hippos seem plump and adorable but they eat more people than lions. Cyanide smells like almonds, but that doesn’t make it amaretto. Minefields look like placid meadows or easy-to-pass terrain… but it’s specifically intended to look that way, which is the closer of the three analogies to Prasad’s work.

Prasad’s no-nonsense tone is camouflage for the deadly medical nonsense of RFK Jr. Outraged, I started writing out how his points violated fact and logic, and realized that suddenly, I had 20 pages of angry scrawling -and my family was mad at me for disappearing into a hyper-focused fugue for a few hours. Worse, I realized I had only scratched the surface of his parfait of sycophantic falsehoods.

Only later did I realize that Brad was trolling me. As an expert in autonomous killing machines, he doesn’t share my knowledge of biology and medicine, but he’s measurably more intelligent than I. He also commands a wealth of information about concealed explosive devices, and could sense that a few bombs had been cleverly hidden in Prasad’s skillful sane-washing piece on RFK Jr.

Time keeps on ticking

I could not stop thinking about the intellectual cancer that Prasad released into the minds of people who were just reading the news. I was compelled to unwind it methodically, referencing the millions of man-hours of research that he defiled in its creation.

After a few days, I had enough material to write a formal scientific paper. Cool!

After a few weeks, I was still not done, but had more material than any journal would be willing to publish -because like Twitter and poorly plumbed toilets, scientific publishers have strict rules on what constitutes too much length.

After a some savage editing, I was done. I submitted to journals that promised me that size didn’t matter, but learned that they all carried the same stark warning: if you are submitting an editorial (and I was), don’t submit your manuscript unless you were invited to do so (and I was not -because I am nobody). I submitted anyway. I’m a rebel like that.

Much like asking Sydney Sweeney out for coffee, Nature and JAMA turned me down. The American Journal of Preventative Medicine however (still well above my bottom-tier status) was interested. Proof that it never hurts to shoot your shot.

Acceptance… that science moves slowly compared to lunacy

Much like the figurative constipated lady after a successful defecation, my article was recently approved for publication, bringing me enormous relief. But while I toiled, a whirlwind of related events went down in the disinformation-space (which sadly includes the US federal government now and for the foreseeable future).

It took nine months of research, writing, and back-and-forth peer-review editing before my manuscript was accepted. In the same span of time, Prasad went from:

1. RFK Jr.-apologist blogger to…

2. the head of the FDA’s CBER to…

3. fired by online influencer Laura Loomer, (who doesn’t even work for the government) to…

4. reinstated to CBER for the vaguest of reasons (sorry, Laura).

In 9 months you can complete a single pregnancy or write a single peer-reviewed article, but the careers of populist political appointees will churn furiously across vast distances under the force of trivial opinions.

Disinformation moves faster than the speed of thought, because it is largely thoughtless.

This saves you a step in a one-step process. When used as a lever for governing a civilization (instead of for selling tabloids or supplements), acting on false thoughts transforms from a simple grifting tool, into a genuine threat to humanity: disinformation is effortless to create, naturally attention-grabbing, cultivates influence that lingers for decades, and spreads with blinding speed. Disinformation is like an outbreak of food poisoning on a crowded cruise ship: ugly, contagious, foul-smelling, and memorable for a lifetime.

Many Americans are actively cheering on the return of vaccine-preventable diseases, the curtailing of food-inspection for pathogens, and weakening our ability to forecast hurricanes and other natural disasters. This is a direct result of disinformation taking hold in our minds, through a combination of politicization and general ignorance to science. Even if the disinformation doesn’t infect everyone, the catastrophic results will. None of these disasters will happen overnight, because biological threats born of ignorance are far more insidious than engineering errors. Elected officials count on the short memory of the electorate to not connect the dots once things like measles, campylobacter, and unexpectedly severe floods start to reemerge… which they are.

This wouldn’t be a problem if disinformation could be countered quickly with facts, evidence, and sound scientific principles. Science takes enormous effort to develop, is often super boring even if it’s a pivotal discovery, and is painfully slow to take root in scientific consensus -let alone penetrate the much more rigid gestalt of a general population that believes dinosaurs coexisted with humans.

Even the effort of pointing out pre-existing knowledge in a verifiable way is much more onerous than just making things up like:

• seed-oils are more dangerous beef tallow, -in fact, the opposite is true, or

• bird flu isn’t that bad for chickens -when it is almost 100% fatal.

What will Chick-fil-A fry in an America with lots of beef tallow and no chickens? We may find out in a year or two if Kennedy gets his way on livestock management. The point is, Kennedy has simply lied repetitively to justify his idiocy, which is a lot easier than looking something up to prove he lied.

The cause of gastric ulcers, the reality of evolution (I realize it’s a theory, but so is gravity and people accept that without question when approaching a cliff), climate science, cosmology, and many other well-established principles -meet with substantial, ongoing public misunderstanding or ill-informed denial. Disinformation fuels the disconnect between science and acceptance of science by non-scientists -who remain ironically dependent upon science to survive into their 40’s, despite their opposition to it.

Brandolini’s Law

Brandolini’s Law (affectionately referred to as The Bullshit Asymmetry Principle) states that the effort required to refute someone else’s disinformation is at least an order of magnitude greater than the effort it took for the originator to concoct said bullshit. I demonstrate it in my paper by disproving each of Prasad’s false statements point by point, identifying which are rhetorical flourishes, logical fallacies, outright lies, or some combination of each, referencing the literature extensively. My paper is over 5 times as long as his, and I only covered the first 80% of his assertions.

Given that disinformation is so hot in the US right now, that is a lot of effort placed in the laps of those of us who know that it’s all bullshit. I argue that we have a duty to make that effort to overcome the damage done by those among us who have abandoned their duty to care for humanity by way of unflinching rationality, and of compassionate appreciation for reality.

The study that angered the worm

In July of this year, a study was published in the Annals of Internal Medicine. It was original research conducted on over 1.2 million children, based on data collected over 23 years that conclusively demonstrated that the aluminum adjuvants in vaccines do not cause neurodevelopmental disorders like autism. Of course, we already knew this because it has been studied multiple times in the past, but verifiably is a cornerstone of solidly reliable science, and this was one of the biggest confirming studies of all time.

RFK Jr., avid student of both heroin and law, who has never read a journal article for anything other than confirmation bias, who has never participated in science beyond experimenting on himself with nicotine pouches, mercury, sewage, roadkill, and radiation… demanded that the study be retracted. Retractions only occur for major methodological flaws or credible evidence of fraud -neither of which are present here.

Scientific American called this “a rare move,” but in fact, it is unprecedented in the history of the world

Even the Nazis and the Soviets simply chose to ignore or criticize “Jewish science,” and “bourgeois pseudoscience,” respectively. I am alarmed that any government official (particularly an uneducated one) would feel sufficiently empowered to demand direct censorship of science at it’s source (science that wasn’t even conducted in this country), simply because it disagrees with their strongly-held yet demonstrably-false beliefs.

While I remain thankful that this administration has not resorted (as the Nazis and Soviets did) to imprisoning or executing scientists that they find politically displeasing, we are forced to wonder what’s next given that federal demands to suppress the understanding of reality is largely uncharted territory.

To a worm, any small pile of dirt or excrement looks like a mountain

The study by Andersson, et al, represents over two decades of data, covering the salient medical histories of well over a million children, with millions of man-hours of labor involved in actual medical care, maintenance of medical records, study design, data-collection, statistical analysis, writing and research, and peer-review. It is hard to assign a magnitude to the effort it took to create this empirically robust study, but it is infinitely more than the effort it took RFK Jr. to express his baseless criticisms only a few days later. Sources cited by Kennedy in rendering his demands: Dude… trust me, et al.

To be fair, when Kennedy states that there are “mountains of contrary literature documenting the neurotoxicity of aluminum and its association with autoimmune and allergic diseases,” he does cite a single study… which only studied asthma, NOT neurotoxicity. It only found a tiny association with persistent asthma, and did NOT establish causality from exposure to aluminum salts. The authors state “these findings do not constitute strong evidence for questioning the safety of aluminum in vaccines.”

One paper is not a mountain, Bobby, particularly when you lie about what it says. Meanwhile, there are over 100 papers that demonstrate no significant difference in safety between aluminum adjuvants and placebo (not including the one that Kennedy is upset about).

Trial Site News’ disclaimer distancing themselves from Kennedy’s opinions is longer than Kennedy’s supporting list of evidence. In the absence of his authority, this would be a laughable effort.

The September Surprise:

We in medicine have a pretty good idea of why Kennedy was so rabid in his rejection of this study: it almost certainly confounds a central point in his sham study to be released in September that will “reveal the causes of autism.” By the way, science doesn’t work like that. If you start studying something on something in April, you can’t know that it will be done in September. I mean, that’s how K-drama might work, but scientific inquiry doesn’t operate on a fixed schedule. It’s done when it’s done, and you don’t hold it back for dramatic effect if you finish early.

I do not gamble, but in this one instance, I would bet SO MUCH money that aluminum adjuvants are a central feature in his manufactured narrative, and he’s having some big feelings about how Andersson’s well-structured, thoroughly-investigated study will steal the spotlight from his unvetted fairy-tail.

Husser’s Corollary

As it turns out, RFK Jr. has demonstrated that Brandolini’s Law works even more potently in reverse, which I would like to not-so-humbly call Husser’s Corollary. No matter how much effort was made to create a methodologically, mathematically, and verifiably sound set of conclusions about objective reality -a bullshit artist can in their minds (and in those of their followers) overturn those conclusions with no effort whatsoever via reflexive contrarianism.

Simply put, the effort needed to refute extensively investigated verifiable facts is the effort of immediately saying “nah, I don’t buy it,” which is effort that approaches zero. This holds true only among the ideologically deluded and aggressively gullible.

Childish fact-denial is even easier than preemptively making up false narratives that sound believable, so expect to see more of this in the future because anyone who writes their signature policy for national health with ChatGPT, is definitely taking as many careless shortcuts as possible. The tragedy here is that these are shortcuts of conceit that objectively cost Americans in health, prosperity, and life.