“He was very unsettled and he very deeply believed that vaccines hurt him and were hurting other people.”

RFK, Jr. promises to ‘clean up cesspool of corruption at CDC’.

“In such a world of conflict, a world of victims and executioners, it is the job of thinking people, not to be on the side of the executioners.”- Albert Camus

Medicine is high-bias, in the mathematical sense of a model that is relatively insensitive to changes in data. Like a linear model vs. a higher-order model that can follow complex multidimensional curves in the data. Medicine over-indexes on pedigrees like Harvard PhDs. It is slow to accept revolutionary ideas even in the face of evidence, and then gives Nobel laureates who originate them possibly undue deference. “Science progresses one funeral at a time”, as explored by Thomas Kuhn.

For life-and-death decisions, this is usually for the better.

Science needs falsifiability and verifiability, or it’s not science. Statistical evidence is a very dull, sample-inefficient knife. For instance, it’s generally accepted that cigarettes contribute to cancer, or that high cholesterol of certain kinds contributes to heart attacks. But it took a while. People have argued and maybe still argue that medicine is wrong, it’s more complex than that, that both cigarettes and cancer are downstream of e.g. stress and lifestyles and genetics that make people want to smoke.

So you can expose lab animals to cigarettes (or high cholesterol), or to the toxins in cigarette smoke, and see what happens. You can randomly target people with anti-smoking or anti-cholesterol interventions. Complex systems are hard, like maybe the cholesterol in arteries doesn’t come from dietary cholesterol but from high carb diets. But at some point, it becomes perverse to deny some degree of causality, as calculated by increasingly systematic methods, even if they only gradually approach the truth.

On the other hand, health influencers like Andrew Huberman, Dr. Mike, Dr. Phil, Dr. Oz (if it quacks like a quack) probably over-index on engagement.

There are probably ways to synthesize slow research and fast, extreme social media, to leverage all the crowdsourced data and discussions to make medicine better and more adaptable over time, and customized to different populations and individuals, and communicate and educate better. Doctors should be a bit concerned how often people report that ChatGPT does a better job of listening to patients and diagnosing.

People get mad when medicine is slow and hidebound. And they also get mad when it seems to change advice on e.g. masks or diets, and what was bad is now good. They can even get mad when it cures a pandemic. Not because it was too slow or too fast but because…well I’m not really sure what the problem is. They say the mRNA vaccine is ineffective and risks outweigh the benefits but it certainly seemed to end the pandemic, and evidence of widespread problems seems scant.

Also they are canceling research into messenger RNA therapies, not just the current crop of vaccines. Reprogramming the immune system is just too powerful, we don’t want to have cancer vaccines I guess. It’s not enough to say the climate science is wrong, we’re not allowed to even collect data now.

Cultishness might be a better description than engagement of what newer social-media movements over-index on, the health influencers, Trump and TESCREAL and bitcoin.

Unfortunately it’s a recurring story of our era. There’s a lack of trust in institutions attributable to emergence of social media. Internet vibes are more real than what goes on in labs and models. And it might keep getting worse and collapse entirely. Or we might figure out how to use AI to make it better, more trustworthy.

There is truth to the notion that institutions have some catching up to do with technology. It’s not like we would have flying cars by now if government didn’t stand in the way, but government tends to slow things like new drugs and Ubers down. And we should have real-time payment clearing and real-time spending and jobs data.

But what’s happening is like living with a crazy person. With crazy people you can nod and say OK and let them think and do what they want. But the inmates are running the asylum, and now you can’t even get those and therapies because they won’t be approved or offered and the research will happen elsewhere. It seems more about control than reality. You can’t tell me what to do, any thinking or data-gathering about systemic effects and behaviors is socialism or tyranny or something.

Then trolls like Q and Alex Jones find the pressure points, and the mountebanks like Dr. Oz, RFK Jr., Fox, Trump, Musk attack them relentlessly to gain wealth and power. And then Dr. Fauci gets death threats, and people shoot up hospitals and medical research offices.

Its a con man’s carnival, a grifter gravy train. The information space is just completely captured by memes divorced from reality, and by hustlers, scammers, trolls, and con artists. We really need decent reality-grounded folks to figure out how to recapture the marketplace of ideas, or we’re doomed to government of the shitposters, by the shitposters, for the shitposters. There are folks like MeidasTouch and the Krassensteins who sometimes get labeled grifters and clout chasers. But maybe every successful business is a bit of a cult or a racket, everything human that endures has an element of grift and graft. They had to sell indulgences to build the Sistine Chapel.

US democracy is pretty low-bias and high-variance; It’s boundedly responsive to voters, and to money. It also has a lot of apathy, most people can’t be bothered by politics or understanding policy, and stuff generally just works without their participation. Until recently there was a reasonable amount of consensus around obvious stuff like measles and polio vaccines, and fluoride conspiracies were way outside the mainstream. But US democracy has pressure points, and you can make a buck selling crazy viral stuff. Folks like Putin and Murdoch and Musk figured out how to exploappealing self-serving nonsense to their benefit. The founding fathers talked about this a lot, they wanted indirect election of the president, lifetime judge appointments to introduce high bias (lower sensitivivity to public opinion) and avoid high-variance populist demagogues and big changes in direction. Later governments did the same by delegating authority to commissioners and the Federal Reserve to conduct independent analyses and policies.

Of course, it was just a nut who shot at the CDC, just like it was just a nut who beat Paul Pelosi with a hammer, just like it was just a nut who gunned down legislators in Minnesota etc., etc.

But, you know Trump did January 6, he invoked 2nd amendment solutions, he wanted to call the military out against protestors, he repeatedly said stuff like, back in the day we took care of bad people. The Army is there to shoot bad people. Let’s pass laws to make it OK for righteous people to run over protestors or ‘stand their ground’ against bad people. When the looting starts, the shooting starts. He refused to call Gov. Walz because he’s a bad guy. His minions reshared stuff about the shooter being a Walz appointee, just like they shared stuff about Pelosi getting attacked as part of some kind of gay love triangle. Could write 10x as much on extreme right-wing violence and Trump stoking it with eliminationist rhetoric, and you know it’s true. Even Grok admits it.

There’s a shitposting strategy to constantly be doing and saying outrageous stuff to keep the narrative on him and away from sensitive topics, and to be so crazy and fast-moving that any reasoned, evidence-based response is responding to the stuff from 2 news cycles ago. It’s about control, not reality.

There’s an iterated prisoner’s dilemma game of building trust, and there’s a one-time prisoner’s dilemma game of defection, where you have to crash the cockpit door and kill the woke mind virus or else nothing else matters.

Of course, every election is a Flight 93 election now. So the Republicans want to redistrict Texas and do a new Census now. And some Democrats are like, OK in that case we’re going to redistrict NY and California to be 90% Republican. On the one hand, OK you might have to fight fire with fire and play to win. But if one side wants to kill democracy, they are happy to see you abandon democratic principles. You go down that road it’s not much of a democracy.

There is a logic of peace which is to try to find common ground, and there is a logic of war which is to destroy the enemy before they destroy you. The side that wants to end democracy is guaranteed to win eventually. Defection breeds defection. They only have to win once, unless they are stopped in a relatively final way first. There’s a reason the extreme right hates Churchill.

In my lifetime the conservatives were the high-bias party, respecting tradition and hierarchy and wealth and pedigree, standing athwart history yelling ‘stop’. But now they are the party of revolution and chaos, they got hostile-taken-over by ends-justify-the-means Jacobin reactionaries, and it will evolve in exactly the same way. Poorly and violently.

It will make great TV, or TikTok. In the words of the greatest Doctor, we’re all just stories in the end so make it a good one. Not one that looks fire on TikTok (literally). Not one that future generations will say, wow, how could they believe this guy who can’t utter a coherent sentence, who is a congenital cheater and sex abuser, and likely child molester. I mean, given what we know about Epstein, how likely was the option presented, and how likely was it to have been taken.

In the words of Yeats:

Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere   
The ceremony of innocence is drowned;
The best lack all conviction, while the worst   
Are full of passionate intensity.
Surely some revelation is at hand