The doctor’s dilemma

Doctors don’t like to explain things. They know what they’re looking for, and there’s never any time to tarry. They might talk a little, but usually, they’d rather not be distracted from their incipient diagnosis by their patient. At first, I found this off-putting; honestly, I still do, but I think I understand it better now. They didn’t go to medical school to learn the Socratic method, and they don’t get graded on their bedside manners. A few of them develop it, but some really good ones never do. Hilary’s second surgeon is extraordinarily well regarded. If we ever were able to coax a complete sentence out of that guy, that would’ve been an unusually interactive day.

This means that doctors who do know how to communicate are now extraordinarily valuable — so valuable that I’ll gladly watch their narrowcasts wherever they happen to post them. By many orders of magnitude, they’ve been more helpful than the news. I’ve already written about Dr. John Campbell, who continues to put scary numbers in context without sugarcoating or sensationalizing anything; his daily dispatches have been a lifeline for me. YouTube made a deserving star out of the epidemiologist Kim Woo-Joo, whose late March interview on Asian Boss feels, in retrospect, like a turning point in the public understanding of transmission. Dr. Kim’s quiet but absolute incredulity at Western governments’ refusal to recommend mask-wearing was some desperately needed straight talk at a moment when Americans simply weren’t getting any. You’ll recall that in March, our authorities were, on the basis of nothing in particular, still assuring us that masks wouldn’t do any good. They were wrong, and the doctor was right. Eventually we’ve come around to his perspective. We should have deferred to him in the first place.

For his pains, and probably because of his skin color, too, Dr. Kim was accused of being in the thrall of the Chinese government. On its face, that seems like an absurd accusation to level at a South Korean scientist, but apophenia does create some crazy distortions in the minds of sufferers. Yesterday, Kim Woo-Joo went back on Asian Boss to dispel rumors, and address conspiracy theories head on. He made a persuasive case for a natural origin for the pandemic, and explained why the genetic sequence of the coronavirus ought to dispel any suspicion that it was lab-made. Dr. Kim likened misinformation-spreaders to climate change deniers, and, as scientists do, he stoically suggested that we should all be listening to scientists. Toward the end of the forty minute interview, he arrived at a moment of self-reflection, and he conceded that doctors can be abstruse. With the sort of absolute faith in the persuasive power of expertise that only good-hearted academics ever seem to possess, he told his interviewer that if we laid out the facts in the language of the common man, the public would come around.

Meanwhile, over on Dr. Campbell’s channel, the actual dynamics of common-man discourse in a media landscape dominated by click-driven tech companies was playing out. If you’ve followed my advice and watched Dr. Campbell’s videos, the YouTube algorithm has pushed you in the direction of wilder, more sensationalistic, and more partisan video channels — I’m not going to name any names, but you’ve seen the headlines by now. This is how social media companies work, and how they guarantee more time and attention spent on their sites: they start you off in the shallows, and then they let the rip currents of your own curiosity drag you out to sea. You think you’re going deeper, but really, you’re just farther from shore, and probably drowning. Anyway, Dr. Campbell’s comment section was overwhelmed by an army of enraged emigres from the audience of an irresponsible but very popular YouTube channel. Campbell’s offense: he’d reported on a New England Journal of Medicine study that had demonstrated that hydroxychloroquine was ineffective in the treatment of hospitalized coronavirus patients. He’d accidentally triggered a crowd who’ve maintained a near-religious devotion to the powers of hydroxychloroquine, even as the White House has, quite conspicuously, stopped talking about it. These self-appointed virologists threw stones at the study (useless, timed wrong, conducted improperly), the New England Journal of Medicine (a mouthpiece for the vaccine industry/big Pharma), epidemiologists in general (blind to the truth, haven’t watched Plandemic), and John Campbell (a dupe, or a plant, or worse).

Dr. Campbell was visibly stung by the criticism. It honestly broke my heart to see him on video the next day, attempting to direct his measured, reasoned, teacherly approach toward viewers who’ve got no interest in experiencing anything of the sort — people who’ve got it all figured out, and aren’t interested in changing their minds. Campbell, who has done nothing for months but make humble public service announcements, and who always posts verification links for everything he reports, tried his best to explain that he was merely relaying the findings of a medical journal. He was even generous enough to illustrate how hydroxycloroquine might interfere with the progress of the coronavirus: the chemical opens a gateway in the cell wall for zinc to penetrate, and the zinc blocks the pathogen from reproducing. Of course, he also had to point out that there’s no evidence yet that this works. I believe Dr. Campbell when he says that he’d like nothing better than for hydroxycloroquine to stop or slow the coronavirus; I feel the exact same way. But he’s not going to say it does until it’s proven that it does, because a real scientist never would.

I am not a scientist, but I am a science fan, and as a concerned fan, I’ve begun to wonder whether there is any room in the arena left for voices like Dr. Campbell’s, or Dr. Kim’s, or any other smart, compassionate medical worker who might demonstrate initiative and a similar facility with the camera. As the political argument rises in pitch, the good public health communicators are getting drowned out. The apparatus we’ve created — social media, I mean — is designed to suppress reasonable voices; it’s an outrage-fueled engine, and our crisis clicking has reinforced its efficacy. In March, social media provided platforms for reasonable people providing useful information about the pandemic. But once those first videos went viral, if you’ll pardon an expression that I hope we’ll now retire, the algorithms began pushing us toward outrageous expressions of similar ideas, baseless theories, casual calumny, whatever you’ve got. It’s been an accelerated version of the same phenomenon that has made rational discourse impossible and driven civil society into a ditch. If you’re going to use these services at all, please pick your spots wisely. Doctor’s orders, which in this case means it’s my order on behalf of the doctors.