Rant: The Traitors
When I talk about menopause with women of age, I explain that there are two main sources of estrogen and progesterone: the ovaries and the adrenal glands.
Your stress throughout your life makes the adrenal gland's hormones go a bit bonkers, but you just don't notice it. This is because the ovaries are pumping out much greater volumes of them with a bit more consistency.
After menopause, the ovaries move to Florida to retire and throw eggs (ironically enough) at people wearing masks, and aren't around any longer to beef up the hormone numbers.
It's then you REALLY notice how your stress affects your hormones, as you hot flash just waiting to find out if Ian Flanigan will win The Voice (he didn't, but he should have).
This long-winded analogy is the perfect setup for my rant this month, because the level of batsh*t crazy stuff has been so high that an underlying, problematic wackiness hasn't really captivated my attention—until now.
You see, licensed, educated medical professionals have joined the ranks of charlatans in record numbers during the pandemic to contribute to the dissension, to tear down efforts to communicate responsibly, to sow distrust in our institutions, and to contribute to a hysteria that didn't need to be.
Perhaps wackiness is the wrong word. Wickedness is probably best suited for the folks I've come to deem, "The Traitors."
In today's rant, we talk about this phenomenon and discuss who is responsible in the fight against the wicked.
The Most Wonderful Time of the Year
It's time! It's time for... a lot of things, actually.
It's time for this crap pandemic to be over. Heck, it's time for this YEAR to be over! On a positive note, it’s also time for Santa and over-consumption in all aspects of our lives.
Today, it's time for the plow guy to come. I write this on a snow day post Blizzard 2020, because why not be stuck indoors for another day or two?
Enough with the setup… It's time for the FINAL RANT OF THE YEAR!
This rant serves as a thematic bookend to "Where Are Our Leaders?" where I call out the elected officials and others who failed us so early on (and seem to continue to do so).
The question today's rant asks is, "Why does Tom Cruise have more sense of responsibility than some of our medical professionals?"
Throughout this whole thing I've been pissed-off-and-not-afraid-to-shout-it at all of the wellness industry charlatans promoting pseudoscience and misinformation to sell a record number of Vitamin C, glutathione, and other bottles of false hopes.
I’m used to those dopes. It’s what I’ve built my business around—giving people the clarity, quality, and results the wellness industry promises but simply can’t deliver.
What I’m not used to are all of these traitors...
The worst people through all of this have been the licensed medical professionals who've espoused misinformation and/or contributed to downplaying the severity of this pandemic.
I've got too many examples to count. Let's introduce a few I’ve experienced both locally and in national conversations.
The It's Not That Bad Crowd
These folks are the ones downplaying the severity of the virus. “It’s no worse than the flu, it only kills 2% of people, there are plenty of hospital beds left, we only have 1000 active cases in this area.” You know, all of that.
They liken the cautious words to "fear mongering." These folks are the most pervasive and seem to like to be a part of every public conversation about the virus.
Very early on in the pandemic, a local chiropractor moved from the “it’s not that bad crowd” to the “everyone has failed us except the people that actually failed us” crowd. He became a vocal CDC dissident.
I’ve made great friends with many chiropractors, but I’m unsure of their coursework in immunology, infectious disease, and public health to REALLY be qualified to speak to the CDC outside of their obviously politically charged talking points.
And today's, we find that the CDC was politically silenced, with whistleblowers lining up saying that the ONLY organization best positioned globally to manage this was crippled and suppressed from the beginning.
That anti-CDC dude has a pretty big following. What power do you think his words had over his “people”?
Unproven Therapy or Bust “Professionals”
I have called out a regional doctor for his BS protocols filled with glutathione and Plaquenil. Now he's on the prowl promoting ivermectin, a medicine often used in animals with some lab activity against COVID but which clearly doesn't work in humans.
A bro-pharmacist of mine spoke to me of the clinic doctor in his building, saying he has no mask mandate and prescribes Plaquenil (hydroxychloroquine) to everyone.
These medical professionals point to unproven or disproven therapies as the answer that “the man” is hiding from the public. They’re quick to share protocols with clinical implications they themselves don’t really understand.
Probably the biggest offenders at a national level, the doctors and talking heads that ‘star’ in the conspiracy theory videos. These folks let some larger group with nefarious purposes tokenize them and their degrees as a part of a clearly coordinated disinformation campaign.
And if not the BIG videos, we have PLENTY of “Dr. This” or “Dr. That” starring in their own personal videos, giving advice where they really have no place.
The problem with all of this is that it’s not some mentally ill person in a shack somewhere telling people that Bill Gates is putting microchips into our vaccines to control us. They are licensed professionals that we regard highly because of the amount of education, the licensing process, and the perceived oversight from government.
The Reality Reprioritization
These aren't examples of solid academic discussion made in good faith, or "looser than we'd like" interpretation of the data, or even trying to offer innovative solutions. It's the opposite.
They’re the medical equivalent of the armchair quarterback screaming at Tom Brady. Except they’re not just yelling at the screen, they’re pouring their vitriol into the minds of folks everywhere—football fans and otherwise. Would it be going too far in the analogy to say they’re actually also supporting movements to run Tom Brady off the field or shut down the NFL all together?
I have to be frank: many of these people offering up their opinions are pretty cocky, as it’s clear they’re WAY out of their league. Do they believe their own rhetoric so much that they feel they can speak confidently so far out of the scope of their practice?
I’ve tried to be clear: I’m not that smart but I know plenty of VERY smart people. That qualifier seems lost with others.
This phenomenon shouldn’t be as surprising as it is to us, because we’re seeing it literally everywhere in society today. It’s a manifestation of the American emotional crisis.
What do I mean by that? Let me walk you through my muddled mind and how I perceive our modern misinformation malignancy...
We're first and foremost humans participating in an objective reality. Because our brains stink, there are a number of factors that influence the perception of reality. Some good, like advanced education, and some bad, like bias.
Behind that is where the ideological reality should sit. This is the story we tell ourselves about the world, who we are, and what we’re here to do.
We logically engage with reality, understanding the good and bad that alters that perception, and then tell the story about what this existence is.
Our American emotional problem is that the ideological—the mythology—is now being prioritized before the objective reality. This is seen in practically every segment of American life, even in the conversations around America itself.
Our pursuit of mental wellness is successful when we strip away the different cloudy, smudged, or funhouse mirror-like lenses and see the world for what it is. It’s a constant battle, it’s difficult, but it is a part of being human.
It’s clear to me that many of these traitors, who should be in service to objective measures, data, science, and more, put those things far behind their ideological views.
How any physician, pharmacist, or nurse could look at this pandemic and do anything besides preach caution and responsibility is beyond me. It's only when you understand that these folks are reprioritizing education and professional oaths to social constructs of identity that it makes sense.
Whether they're actively diminishing the importance of their education, or making political and ideological viewpoints the highest priority, they're wrong.
It’s jarring to us because we hold our medical professionals in such high regard. We believe, or at least we HOPE, they’re above this nonsense and are instead in duty to science and the practice of medicine for the best for their patients.
They may pay lip service to that last sentence, but it’s a thin veneer on a rotted “practice,” and a dereliction of duty.
Who Watches the Watchmen?
To write these rants, I normally ask my smart friends their thoughts on the topic. Three friends asked, and three friends shot back this, in some essence: "How can a medical professional maintain licensing/certification while peddling misinformation that directly contradicts established parsimonious research?"
Put another way, without needing a thesaurus: "How the f*ck can these people get away with this?"
The overarching thought was put most succinctly by an opinion piece in the NYT:
"When doctors use the language and authority of their profession to promote false medical information, they are not simply expressing their own misguided opinions. Rather, they have crossed the line from free speech to medical practice — or, in this case, something akin to malpractice.”
-Richard A. Friedman
How is it not medical malpractice to spit these wack lyrics?
You and I can believe this is malpractice, but there's a legal grey area.
It's weird and it's complicated, but basically, each state has different rules about who and what they can or will regulate. In New York, for example, unlicensed practitioners get to roam free unless they do some really horrible stuff that gets a bunch of complaints from patients or other practitioners.
It’s even more loosey-goosey in other states.
Holding people legally accountable is difficult because all licensed practitioners are allowed to 'practice' legally and within their scope. This allows for wide interpretation of what 'practice' means, as the 'research' itself can be up for interpretation. One could argue they were making decisions based on ‘cutting edge research,’ for example, and win, especially if no harm was done directly.
The regulatory bodies aren't going to burn resources unless they know they can influence some outcome. They're not going to chase dead ends.
That's what makes this frustrating. I agree with Richard A. Friedman, these people are using the power of their authority and position in our minds, then wielding that sword quite carelessly. They then retreat behind "practicing medicine" when held accountable or proven incorrect.
And now, in 2020, it isn’t practitioner vs practitioner, it’s following vs following. Laypeople are lining up to support their ideology of choice, and they justify it with that whole “both sides" thing.
Hopefully, My Final Take on "Both Sides"
I’m so sick of the belief that “my opinion or interpretation of reality that’s clearly biased is equivalent to scientific consensus.”
Let me show you an example where “both sides” are legitimate, and where it’s used as a shortcut to justify misinformation. I’ll use a controversial topic in supplements: statin drugs.
We KNOW, with clear scientific consensus, that statin drugs will reduce strokes and heart attacks in a population, especially when used appropriately in high risk or sick patients. The degree of that benefit is strong enough, and they’re among the best options we have from a non-invasive medicine standpoint.
The drugs themselves carry risks, of course. Also, the benefit to the individual may be unclear or not guaranteed, due to the dozen or so factors dictating that individual's total risk picture as well.
Here’s side one: Most responsible practitioners will push for the utilization of the medicine, because that’s where the consensus falls and their experience has taught them most people either won’t take the lifestyle steps to course correct, or they’re so at risk they can’t green-smoothie away the problem.
Here’s side two: Some will prioritize away from the medicine, balancing the patient’s total picture and proof of responsible actions (what I’d like us to refer to as true holistic care). But the medicine is still in play, and together with the patient, they’ll decide when that measure is best and choose the best option for them.
Then there’s the third guy or gal, who says the medicine is the devil, the system’s just trying to kill you or keep you sick while profiting off of you, and then sell you a fake statin called Red Yeast Rice, made by some horrible company from some far away country, so the product you get is rife with harmful contaminants or adulterants.
Ready for some fire? I’m bringing it.
There’s “both sides,” and then there’s wrong.
Not every scenario has “both sides.” Or, at least not equivalent sides, or sides that are even in opposition.
The over-saturation of this concept of “both sides” and its liberal application to all scenarios is a bullshit cop-out, self-awarded as the participation trophy of the decade to folks who can’t handle the truth: they’re wrong.
Somewhere along the line, we’ve allowed our machismo, our lack of global and historical context, and our dramatic emotional immaturity to build psychological defenses so massive, we can’t accept the simple fact that we may be wrong.
It’s just like the border wall that was promised, if I can get even more spicy... “Both sides” is meant to be a grand structure protecting us from those who are hurting us so, when in reality it’s a piece of sheet metal duct taped between a few trees in Texas and the problem isn’t coming from Mexico... it’s coming from within.
There are scenarios when medical professionals, in the absence of great data, must use OK, or even meh data, but we do so with good intentions for our patients and society as a whole.
As the data becomes more abundant, we must abandon our old views, especially if there is risk to the patient.
It is not responsible medicine to grab onto any contrarian piece of garbage data to support your opinion—an opinion that exists to serve some non-medical purpose of either attention, profit, or both—then using every logical fallacy in the book to convince people who trust you (almost solely for your authority) that you, in fact, are the centrist truth teller and everyone else is to blame.
Especially if those ill-informed and poorly supported opinions come at the expense of others. Like during a pandemic.
So, no, Dr. So and So, there isn’t “both sides.” You’re being irresponsible to the point where we could call it malpractice.
Who Will Save Us From Dr. Evil?
If we can’t legally punish the traitors among us, what can we do? We can look to our national organizations.
Have they done enough? Have they said enough? I may have missed it, or it may not have made the media rounds, but my opinion—admittedly just my perspective here—is that even those groups have failed us.
For some reason, medical groups, pharmacy groups, and nursing groups aren’t in the business of calling out their members directly. Even during a pandemic, where the stakes are the highest they’ll ever be, I don’t feel like I hear enough outcry against the scientifically ambiguous.
Again, probably because it’s a fruitless endeavor. The practitioner isn’t accountable to anyone except the legal practice and the patient. I know it.
Maybe it’s a marketing problem. Maybe these groups’ messaging isn’t strong enough
I can’t help thinking of our awesome new clinical pharmacy network, CPESN. Could I point to members that have talked smack about this pandemic, yet are in line to do testing and vaccines because it’s profitable?
So no legal ramifications, at least that are swift enough. No clearcut, loud messaging from national professional organizations. Slow-as-hell-late-to-the-party social media networks selectively enforcing misinformation policies definitely aren’t helping.
Who’s left holding the bag?
Yeah, I’m going to say it again, but I’m not happy about it: the damn patient is. People are. The non-medical professionals.
Because there aren’t enough voices within the industries themselves speaking loudly enough in service to the patient and against misinformation, the burden now falls on the patient.
This is a bitter pill for me to swallow. Am I to tell folks, “clearly no one cares about you, so you’re on your own!” Do I tell them “sorry, ya just have to be more judicious in how you engage with and consume information”?
We all have shared responsibility with our consumption of the media and ownership of our bias, and how we prioritize objective reality vs our ideology. But I can’t push this on lay people any more. Not at this point…
Conventional practitioners are not sought out for “holistic” care or wellness advice because they relinquished responsibility. We didn’t spend the time listening to our patients. We were dismissive of supplements due to the poor quality and lack of data.
It didn’t stop people from seeking this modality out, in fact, it energized them. And it allowed pseudoscience and misinformation to run rampant.
And here we are again. To stop the cycle, and to stop the traitors, we need to pick up the power and take the responsibility, as medical professionals.
This is Our Problem To Solve
I’m a bit charged up. It’s justified.
Yesterday we had 245,000+ cases and over 3600 deaths. For some reason, 3000 deaths on 9/11 or 50,000 in Vietnam are national tragedies that are mourned for generations, yet the nearly 400,000 deaths caused by this pandemic is so ::yawn:: to people that they’re not only not motivated to rise to the occasion, they’re actively attacking those who are doing so.
If you’ve been following me, you know why I’m upset. I’m upset because of the nurses, docs, and front line staff that have DIED doing their JOB. That every police officer is armed to the teeth yet folks were in garbage bags and month-old surgical masks. And I say that as an advocate for police!
I’m upset for the staff that now have PTSD because of what they have seen. I’m upset that New York, again, took it on the chin for the nation, and again, it and everything after was entirely avoidable.
This was it. This was the time for all of us to get serious. For medical professionals and wellness ‘practitioners’ to fall in line TOGETHER and have a unified front. Across all disciplines, to loudly reject unproven speculation passed off as cures. To call out individuals perpetuating gross misinformation.
What we needed (and still would benefit from today) is what we saw with the vaccine manufacturers around the election. They loudly stated, “Nope. Absolutely not. We’re not playing that game. We’re doing this right. We’re in charge. We won’t allow misinformation or any influence to challenge the quality”. They kept the line strong.
We can’t make up for lost time, though. It doesn’t mean we are lost.
Vaccines are moving around now, but this pandemic isn’t over, by far. In fact, we’re probably at the halfway point.
That means there’s still time.
There’s still time to answer the question I asked in March: “Where are our leaders?” If our governments, regulatory bodies, or professional organizations aren’t there to squash these cockroaches, then who will? Do we leave it to our patients to sort out?
It’s up to us medical professionals to form that coalition similar to those vaccine manufacturers. It’s up to us to lead.
There’s time for us professionals to stop playing nice and start calling out these clowns. Eh, I know that most are non-confrontational and probably better people than me, but you still can help.
We all have a sphere of influence. The individual practitioner may not be able to influence practice or beliefs thousands of miles away, but we can start in our own minds, houses, and communities.
The answer to “Where are our leaders?” was “we are our own leaders, and we lead in our tiny worlds.”
The question of “what do we do with the traitors?” is answered with “the professionals speak up and speak out, starting and ending in our tiny worlds.”
I believe the onus of ridding the traitors falls flatly on their more respectable peers.
It’s difficult to do, I know. Being such a voice of reason feels lonely and sometimes fruitless. You must know that positive, mature calls for accountability are more than welcome in 2020.
I leave my rants of 2020 with this closing call to action:
Brothers and sisters of the medical world, we cannot let the people we've sworn to serve be the ones to sort through the mess weaved by the traitors among us. It’s on us to outspeak, outnumber, and outlast them at every turn.
We owe it to the people who trust us, our professions, and all of those who have sacrificed so much in this difficult journey to get a little uncomfortable and be a Big Mouth.
Just trying to keep it real...
Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth