I was a well-educated person before I got interested in epidemiology, but the study of epidemiology helped me learn how to truly dissect and understand evidence. Or rather: what is evidence and what is not. I started to study epidemiology more than ten years before the word became commonplace due to COVID, but epi was a highly politicized field even then. Wars between people on opposite sides of nutritional debates had been raging for decades. HIV and AIDS brought out the best and worst in scientists and those who use or misuse the evidence they produce. That may be what makes epidemiology one of the best vehicles for learning how to think. It’s so easy to do it wrong.
I had the advantage of first being in an internet group of incredibly smart people who batted around medical studies for fun, and later living with one of these people for a decade. Then I surrounded myself with brilliant researchers in nutrition, who were gracious enough to hang out with me and even buy me coffee and lunch on a regular basis. Finally I got my Masters in Public Health at Thomas Jefferson University. I am extremely grateful for the education I got there. My epi professor was an adjunct who worked full time in pharma, and she knew her stuff. The class was so hard that all the students but me complained, but I loved it. Love at first odds ratio, I used to say. I started a PhD in Population Health and got through almost all the course work before deciding that wasn’t what I wanted. During that time I had the opportunity to study with even more excellent professors and other students, most of whom came out of the pharma or healthcare delivery worlds. The decisions these students made would move millions of dollars and affect as many lives, and I learned a tremendous amount from them. It was an amazing opportunity to hone critical thinking skills.
It goes without saying that critical thinking skills are sorely lacking in our current world, but I just said it anyway.
That elaborate preamble could be a way of establishing my authority to discuss scientific evidence. Even if you were to accept that I know what I’m talking about, it would not be a good reason to believe anything I say about scientific matters without investigating the evidence for yourself. Argument from authority is always a fallacy, even if the person is right.
Maybe it’s obvious why this is important. So many people run around not just quoting idiots they read on the internet, but changing their lives to conform with these people’s advice. It’s hard not to see someone who sounds and looks cool and want to be like them, so do what they say. Yet it is a really bad idea.
Why? Anyone can be wrong. Those who are extremely emotionally invested in any cause, platform or ideology are even more likely to overlook any evidence, any little factoid, that contradicts what they already believe. Those who need faith are unlikely to see anything that contradicts what they want to believe.
I prefer to save my faith for religious practice, and navigate science on the basis of evidence. There is plenty of room for faith, mysticism, sitting for hours contemplating the universe or not (sometimes I am thinking of a recipe for the next dinner party for a moment during zazen), but questions of what is true in the biological, physical world should not be determined that way. Seemingly more abstract ideas, like how people’s minds work, what is the best way to overcome a substance use issue, what is the role of trauma in health outcomes, are also possible to study in ways that are more reliable than searching our hearts and souls for the answer we were hoping for.
Some of the smartest people I know have hit me with argument from authority when I (being the pesky little creature I am) disagreed with them on a point of science. “You completely disagree with (insert name of person who is supposed to know)!” Yeah, and? So I do. Show me the evidence. Would love to talk about it.
I question people I love and trust. I trust my Chief Science Officer (whose name must never be revealed on social media because he is that kind of person) more than just about anyone on earth, largely because he changes his mind frequently when confronted with new evidence, and is always looking for studies that challenge his way of thinking or practice. The guy can be downright annoying because he has never met a premise he could accept on the face of it, but he taught me how to read evidence.
The opposite is true too. Just because you don’t like someone, or disagree with them on major issues, does not mean they can’t be right. They may be on record in all major newspapers of the world being absolutely wrong about an almost indisputable premise, such as the earth is round, and yet be absolutely right about something else, such as the correct way to clean a cat box.
This is one of the worst parts of cancel culture. (Oh here we go.) How much of the great work of humanity will be dismissed, even disappeared, because someone said something that was not quite acceptable to some people?
[Aside: Until this week, I thought cancel culture meant how annoying it is that people are always canceling things at the last minute these days. It seems to me that people used to actually show up for dates they had made, parties they had RSVP’d yes to, and jobs. Not so much these days. It is one thing if people are ill - please, by all means, stay home. But I do like to know in advance how many people to cook for when I throw a dinner party!]
This past week, I’ve been reading a lot by the author Mark Judge. The two books I read are: Wasted: Tales of a Young Drunk, and The Devil’s Triangle: Mark Judge Vs. the New American Stasi. While I disagree with Mr. Judge on a few big issues, I absolutely loved these books. They were a ray of light in what is often a dark tunnel of bland, can be put on a lawn sign thought conformity. His writing is excellent and he raises some very interesting ideas. It either takes a lot of courage to write about deeply personal experiences, and it can make you a target. I admire his courage in quitting The Washington Post when they edited away one of the major points of a story he wrote. It is pretty cool that he still rides a skateboard.
I discovered Mark Judge when I was goggling “fetishization of sobriety,” wondering if someone had already captured that term. I found this article, Recovery: It Can Be So Addicting, from 2003. I liked it because I too have found that going to recovery groups and talking endlessly about addiction gets really old and counterproductive after awhile. I went on to read two of his other books, and sure enough, I enjoyed them.
I enjoyed the parts I didn’t agree with just as much as the parts I did. What fun is it to always read people you agree with? I also learned new things, thought different thoughts, and had questions. All of those things without which the brain eventually dies a metaphorical if not literal death.
I was experiencing a lot of anxiety about starting to blog again before I fired off the first few posts. I blogged for almost a decade from 2003 - 2012, and in that time, I was attacked, got death threats (for eating kale???) and generally experienced some of the unpleasantry that can come from putting your ideas out there with your name attached to it. These days, it is even scarier. It is easy to find out where I live, and there is so much gun violence in my area that I’m already in fear for my life even when no one knows or cares who I am.
Then I started to write my own work again. And I published it! It was scary to hit the publish button and I woke up yesterday morning expecting to read that lots of people were angry. I used to be expert at fending off angry commenters, and I suspect that censoring myself has taken a toll on my health that I haven’t quite quantified.
I feel better now.
I don’t believe anyone because of who they are, the degrees they have, or their record of accomplishments. I also don’t dismiss anyone’s thinking because of other things they have done or said, and especially not because of other things that other people say they have done or said.
The exception of course is personal experience. It is a common phrase in the field where I work: “Everyone is the expert on their own experience.” Actually, they tend to write it as, “Everyone is the expert of their own experience,” but I think that is bad grammar. Some things are factually true, others are a matter of perception. There is a SEPTA trolley that regularly stops at the corner. That is fact. How I feel when I get on it is entirely subjective.
And speaking of it, I must pop into town to do a few errands and get on with the day. Thank you for subscribing, and please feel free to comment.