#101: When Doctors Were Scientists (Bret Weinstein & Heather Heying DarkHorse Livestream)
In this 101st in a series of live discussions with Bret Weinstein and Heather Heying (both PhDs in Biology), we discuss the state of the world through an evolutionary lens.Beginning with a discussion of Room 101 from Orwell’s 1984, we then share excerpts from Ross Douthat’s forthcoming book, The Deep Place, with discussion of how we arrive at medical consensus, how long-term illness is often misunderstood by the medical establishment, and how weirdos on the internet can get things more right ...
- Hey folks, welcome to the Dark Horse Podcast live stream 101.
Am I correct about that number?
Yes.
After a brief reprieve, we're back into palindrome territory.
It is a palindrome.
I had not even noticed that.
Do you know how I calculated that it was Livestream 101?
No, I did not.
I worked forward from last week's having been 100, and it was a straightforward back-of-the-envelope kind of calculation.
Yeah, here at Dark Horse we show our work.
On envelopes, if we have them available.
Where are they?
This is awkward.
Yeah, I think so.
All right!
All right, this week we are going to talk a little bit more about consensus, as we did last week, and illness and discovery.
And I'll just leave that sort of vague for now.
We are going to discuss a little bit about some new research from some obstetricians.
Not the research by obstetricians, but about obstetricians.
We have an article from the Washington Post that we want to say a few words about.
You've got something in the works that you have not told me about yet.
You're making a rabbit face at me.
You'd kill it if I told you ahead of time.
And we're going to finish up with a 1948 essay from C.S.
Lewis that a fan sent me yesterday, and it's extraordinary.
It's short, it's extraordinary, and it is very much of the moment despite having been written many, many decades ago.
So, first off though, let's do logistics and pay the rent.
Book is now in stock.
A Hunter-Gatherer's Guide to the 21st Century was in stock last week.
It's still in stock, so please, if you want it, go get it.
It should be available everywhere at this point.
If you read it and liked it, please consider giving a review on any of a number of places.
We have been hearing that some reviews have been disappearing.
We don't know why, but if you think that might have happened to yours, please consider going back in and And writing it again, or get the audiobook, or take it out of the library and read it.
Either, you know, any of those things.
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So, let's do it!
Let's do it!
Let me first say, we are very grateful to our sponsors because this is a very difficult moment and it would seem like good people trying to do the right thing on video is the kind of thing that would be very easy to support, but it turns out you need courageous sponsors and we appreciate you, so thanks.
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First, though, a little about nausea.
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Hell yeah.
All right.
Maybe first, maybe before we... Oh, I still don't have my book.
Hey, Zach?
No, no, no.
There's a book down on my desk in my office downstairs.
The DuFat book.
We are working without a net today.
She always goes missing.
She's lazy.
She did not come in for work.
No.
Luckily, Zach does, and he is ambulatory and is going to get my book.
He is ambulatory.
That's right.
He's not a slug.
He's a real live person.
Bipedal, even.
Nor a cedar tree or a maple tree.
Right.
But, okay, before I wanted to talk about this remarkable new book that's just about to be out, though, I did want to say something about it being Episode 101, which is evocative of Room 101 in Orwell's 1984.
This is the room.
It's been a while since I read 1984, and because of that and because I prefer hard copies of books, I only have the hard copy, and so I wasn't able to search.
Yes, perfect.
Thank you, sir.
I wasn't able to search on the book, inside the book, but But Google helped.
The Room 101 in 1984 contains a person's worst nightmare or fear.
You betray Big Brother and you find yourself in Room 101.
What's in there?
Whatever is worst for you.
O'Brien, who's a member of the party in the book, Uh, describes Room 101 thusly, quote, you asked me once what was in Room 101.
I told you that you knew the answer already.
Everyone knows it.
The thing that is in Room 101 is the worst thing in the world.
The worst thing in the world varies from individual to individual.
It may be burial alive, or death by fire, or by drowning, or by impalement, or 50 other deaths.
There are cases where it is some quite trivial thing, not even fatal.
Oh, I've got my Room 101.
I'm not sure you want to tell the world what's in your Room 101, but if you do, go for it.
I feel like it's written all over me, like they could just read it so easily, they already know what I'm about to say.
The door locks from the outside, and inside, it's customer service.
That's all that's in there, is customer service.
For everything, right?
Everything you need, right?
You have to go through the phone tree.
Well, there is no getting through the phone tree.
The whole point of it is to prevent you from getting what you need, right?
And so it's just, it's not even like starvation.
It's like starvation with the promise that if only you can reason your way through the phone tree, there might be something to eat at the other side, you know?
Locked in a room with no windows, with a phone tree that is endless.
No recourse to logic, to kindness, to human decency.
Right.
It's that.
It's that.
Mm-hmm.
I dare you, I defy you to try to think of something worse.
I think you're right.
I mean, Lake of Fire, that's nothing.
Yeah.
That has borders.
Lake of Fire, I mean, come on.
You just, you get used to it, right?
It doesn't promise you anything.
I mean, I feel like spoken as a guy who's not actually endured a Lake of Fire, but I don't know.
Maybe I just didn't mention it.
That's true.
You've mentioned a lot of stuff, failed to mention other things.
It's possible you just didn't mention it.
I forgot.
Yeah.
Okay.
um that That was surprising.
That was surprising.
So I don't know if the people watching or listening could hear that our awesome 17-year-old son slash producer just advised his father, Brett Weinstein, to stop moving the mouse, which was somehow making itself visible on the screen.
Why we have that power, I don't know.
Now we don't, right?
You've turned off the power?
I think I have disabled the mouse.
Excellent.
Okay.
Last week we talked a fair bit about consensus and enforced consensus, and you had a few phrases that you introduced around consensus and YouTube's terms of service.
Yes, I'm trying to remember the exact phrase we settled on for the title of last week's episode.
Yes, maybe our excellent producer will figure it out for us.
Yes, that'd be good.
Yes, because you had used one in the show, and then we used a slightly different one in the title.
But I said while we were talking about it, you know, the idea was that We are told right now that you need to follow the science, because the science is settled.
And you can tell because look at all of the people who say one thing and look at how nobody is saying anything else.
And there are a lot of reasons not to buy that particular line of reasoning, as we talked about last week.
But one thing I kept saying was actually, I know we're going to come back to this idea of consensus next week.
In service of, boy, we have sort of a mess here this week because some things failed and I can't actually get my computer in front of me.
Let's see if I can make this work.
Yeah, what was it?
The demolition of dissent.
That's it.
Yeah.
So, tech problems all over the place.
Okay, there is a book coming out next week called The Deep Places, A Memoir of Illness and Discovery by Ross Douthat.
We were sent an advance copy and it's excellent.
I recommend it.
It's not available quite yet.
I think it's coming out on Tuesday and it's really quite surprising.
It is nominally, as I've just read the subtitle as well as the title, A Memoir of Illness and Discovery.
Douthat is a New York Times columnist and this is a different sort of book for him.
He finds himself sick, not getting better, with symptoms that are extreme but which no doctor is able to diagnose.
He's referred to psychologists, of course, even his family is wondering if it's in his head.
As Duthat says in the book, in the first year or two as he's hoping against hope for a treatment that works and occasionally gets blips, you know, an hour or two, maybe even a day or two in which he's feeling better, he says, the feeling better moments never held and I kept falling back into the pain and dark.
And anyone who's experienced either chronic illness or deep physical trauma that took a very long time to heal or is not completely healing will recognize that sense of falling back into the pain and dark.
And, of course, it's also true that ongoing pain and illness is not just hard to take for the other people in your life.
One of the hardest things for the person experiencing it is the realization that it's fundamentally boring for the other people in your life.
It's boring for you too, of course, but Duthat reports that he would run into people or see people online that he hadn't seen in many months or even a couple of years.
And they would be surprised, like, wait, you're still dealing with that?
There's a disappointment, and indeed a sense that somehow you must be doing this to yourself, or that you're exaggerating.
And that's not helpful when you're experiencing something that you can't control, you can't diagnose, no one is diagnosing for you, and you're just miserable to be met also with the disappointment and boredom of those who love you.
That's one of the themes running through the book, and it's quite remarkably well done.
Here's a spoiler, but not really, because it emerges very early in the book.
It turns out that Duthat Had has still Lyme disease.
There's a lot to say here, but for me, the book really gets interesting.
Well, actually, I'm going to read a few short passages.
Early in the book, Without any more introduction.
I will say also, I have the advance uncorrected proofs.
They're sending me the final book.
I don't have it yet, so it's possible this isn't exactly what's in the final book, but it's quite good.
The consensus around Lyme disease was sealed in 1991, when there were enough new reported cases, 10,000 and climbing, for the Centers for Disease Control to begin national surveillance for Lyme, establish formal diagnostic criteria, and endorse a two-tier testing regimen, the ELISA test followed by the Western blot, two different ways of looking for Lyme antibodies in the patient's blood.
Diagnostic standardization was supposed to establish a consistent baseline for national case reporting, not rule out the possibility of atypical cases or constrain doctors from diagnosing them.
But in practice, it did exactly that.
Narrowing the range of cases that counted as real Lyme by encouraging doctors to limit their diagnoses to a CDC-approved set of symptoms, mostly visible manifestations like joint swelling and the famous rash.
Meanwhile, the testing rules had a similar effect.
The two-tier approach reduced the risk of false positives, but it created a larger chance of false negatives, missing anywhere from a third to half of early Lyme cases, and as many as 25% of cases even in late-stage neurologic Lyme.
The incentive structures forged by the CDC were a fascinating case study in how bureaucracy shapes science, as much as the other way around.
How without any conscious decision, let alone conspiracy, scientific research can end up pushed again and again down the same well-worn tracks.
The narrow diagnostic criteria became the benchmark not just for doctors treating patients, but for researchers when they applied for public grants, so that Lyme research increasingly focused on only the most certain diagnoses and left all ambiguous cases and potential false negatives alone.
This approach ratified the establishment's confidence in their own rules of evidence.
A study might show that most Lyme patients had the typical presentations—clear blood tests, consistent early symptoms—but only after making one or more of these presentations a prerequisite for being admitted to the study in the first place.
Likewise, after 1991, insurance companies began to deny payment for Lyme cases that didn't meet the CDC criteria.
If you were a doctor who wanted to diagnose or treat more broadly, you basically had to become a medical outsider, a maverick, the sort of weird specialist who didn't take insurance, who risked scrutiny from state medical boards, and so on down a list of attributes itself selected for eccentricity, stubbornness, and a touch of crankery.
So the CDC guidelines essentially ratified the split already opening in the 1980s between an official understanding of the disease and a dissenting view, between a medical establishment that felt satisfied with how it diagnosed and treated this novel-seeming pathogen and a growing population of patients and sufferers, or self-described sufferers at least, who felt ignored, abandoned, and betrayed.
It created not just two worldviews, but two cultures, two concentric circles of insiders and outsiders.
The inner one confident and authoritative and buoyed by institutional support.
The outer one more fluid and open-minded, but also necessarily more peculiar and paranoid and sometimes frankly gonzo in its theories and experiments.
There are even two different medical associations.
The Infectious Diseases Society of America issued the mainstream guidelines, while the dissenters formed the International Lyme and Associated Diseases Society, which issued recommendations of its own.
Let me read the few other excerpts before we talk about this.
So I'll say, I read the book and you have not read it, but I've been talking to you about it as I've been reading it.
Much later in the book, I won't say what page it is because I'm not sure the pages will be consistent between my version and the published version, Just this.
A data set can be meaningful and useful and suggestive, in other words, even if it falls short of the standards that are set by official medicine in its bureaucratized, safety-first, contemporary form.
Then this.
Let me offer a note of optimism.
If there is one thing that makes the chronic Lyme world different from other realms of alternative or outsider medicine, it's the centrality of antibiotics, a paradigmatic insider-approved treatment to its preferred cure.
Often in medical debates, the pattern is reversed.
The established recommends antibiotics, the outsiders and mavericks worry that they're overprescribed, the holistic types warn about their side effects.
But with Lyme, it's the establishment that retreats to mystery while the dissenters are yelling about how we already have the necessary drugs.
Three more.
Sorry, looking for it.
So at the end of the book, I had actually, I had reached out to the publisher to ask if it would be okay if I would talk about this as I didn't imagine.
That the author was going to talk about COVID at all, given I just didn't see any evidence of it.
And I wanted to make some connections to our current environment.
And it turns out he does.
And it turns out he got COVID.
And he and his son took the tests.
And his son's test was botched and therefore was inconclusive while his was negative.
He says a past version of myself might have been tempted to believe the result.
The new version, the one accustomed to inconclusive tests and self-doctoring, considered my distinctive symptoms.
Plus my family's distinctive symptoms, plus the timing, plus the fact that tests at that point had at least a 40% false negative rate and felt entirely comfortable with self-diagnosis.
On and on and on, he uses a number of the alternative treatments to which he has, he feels that he's been forced and now is finding some relief in with regard to Lyme to try for his COVID.
And he says, And long before it was picked up by Donald Trump, back when it was just an internet theory based on French and Chinese trials, I knew all about hydroxychloroquine, which had been prescribed to me by the Reassurer, his pseudonym for one of his doctors, long ago, in a bottle that still had a few pills remaining, which I now found and took.
And he took a few things.
He doesn't know what worked, but he knows he got better very fast.
Two more sentences, two more very brief excerpts.
From the beginning of the pandemic to its still unfinished end, there were weirdos on the internet, that's us, who were more reliable guides to what was happening, what was possible, and what should actually be done, than Anthony Fauci or any other official information source.
And finally, on nearly the last page of the book, maybe, yeah, very near the end of the book, It's completely understandable that the medical establishment doesn't want to officially endorse any of the various unproven paths.
But there's a difference between declining to endorse a single path and ruling further treatment out entirely.
A difference between acknowledging the diversity of case studies and claiming that no lessons can be drawn from the diverse attempts to treat them.
Wow.
No shortage of lessons here.
No shortage of lessons.
And so you see why I think I had just finished it at the point that we were on air last week, and I was thinking so much about the lessons that we can learn from how Lyme – we had students with long Lyme, which is now how I've come to think about long Lyme, long COVID, which Duthat clearly has.
And like with COVID, Very many people are asymptomatic, and very many other people actually follow the CDC mainstream, you know, course of symptoms and get better quickly, and some number of people don't.
And the idea that those people are therefore making things up, or shouldn't be trying other things, or should be forced into the fringes of the medical establishment, and often forced therefore in the U.S.
because of our crappy healthcare system, our crappy insurance system, forced to pay out of pocket, In their attempts to do things that in some cases he reports helped him, even though there are no RCTs for many of these treatments, right?
There's not even published research for some of them, and yet there's a whole internet of people Who find evidence that things work, and indeed he found some things that worked and some things that didn't, and part of the welcome to complex systems, some things will work for some people and they will not work for others, and that is to be expected.
Yeah, this is exactly what I was going to say, is that this is actually, even if we just look at, you know, an honorable, smart system trying to do the right thing, there's a fundamental problem at the ground floor here which is very difficult to solve.
Which is, let's say, so first of all we should distinguish between a pathology and a syndrome.
A pathology is an actual mechanistic description of how something goes wrong.
A syndrome is a list of symptoms that seem to go along with something.
And so very often, let's say that there's a pathogen circulating, but we haven't seen it yet.
It's very hard to isolate a pathogen.
And if you isolate a pathogen, it's very hard to know if it's a co-traveler with something that's causing a disease, whether it is causing the disease, right?
These are famously hard things to establish.
So, you very often have a list of symptoms that doctors start to notice showing up together, and then there's a question about what might be causing it.
And actually, you and I will remember back when AIDS had been spotted, but HIV was unknown, there was a huge Very strange, at the time, effort to figure out what it was.
Were gay men doing something?
Were they encountering some chemical?
Was something involved in gay sex?
Was it in the bathhouses?
What was it?
We didn't know.
And even after HIV was discovered, Even from very respectable people like Carey Mullis, there was a question about whether HIV was actually causal of the disease AIDS or was just simply correlated with it or something else.
But nonetheless, the point is, humans are complex.
Immune systems are complex.
People get Disfunction of all kinds of origins, right?
You can have a defective gene and it can cause a cascade of things to fail downstream of it and you may therefore look like you have the same disease as somebody who has a pathology that has interrupted the same pathway, right?
So the point is, when do, you know, A doctor noticing a set of symptoms that go together might be looking at two diseases.
Two doctors that see the same list of symptoms now have something, the basis of what might be a pattern.
It could also be a total coincidence.
Once you start recognizing these things, people who have mysterious ailments may spot the list of symptoms that overlaps what they have and discount the other ones because they want someone to pay attention to their problem.
It becomes necessary to set out a set of criteria to say, actually, these are the people who have the thing that we're trying to study and understand, and these people have something else, right?
But then once you set that up, as Duthat points out, you now have a circular problem, which is you're including only people who have the established list in your study sample, and that means that to the extent there's something you need to learn from the people who have, you know, three extra symptoms or two fewer symptoms, you won't learn it.
This is the problem with throwing out, this is the problem with the very concept of outliers at some level.
And you know, we're not, and Duthat's argument and yours and ours before has been actually, it's not even, there's one crazy erroneous case.
You know, like I'm looking at a data set and it's got thousands and there's, you know, a few things that are so far outside that we're just not going to pay attention to those.
It's that so often the borders of our categories are drawn too early and somewhat arbitrarily.
And the idea that, for instance, well, yes, you had Lyme, but if you still have Lyme six months later, then it's something else, even though your symptoms are the same.
That alone is a very crazy declaration, and that apparently is something that both Duthat and other people with long Lyme experience.
Like, oh yes, we will acknowledge that you had it, but given that it's gone on far longer than we recognize Lyme ever lasts, therefore you now have something that we're calling post-Lyme syndrome, or I don't remember exactly what it's called, which is itself a rather remarkable declaration.
I don't even know that it is, though, actually.
Because we are always, in the case of a pathogen that causes a disease, we are always dealing with an arms race where the pathogen and the immune system duke it out.
And the point is there are certain canonical strategies that work, right?
Like moving into tissue that is outside of the range of the immune system.
Moving into neurological tissue, for example, to hide from the immune system is a strategy that many viruses use.
And that means that they can be present and not detectable, right?
Because they're shielded.
It also puts the immune system in an interesting predicament, which is ordinarily the immune systems, like the cartoon job that we described in introduction to immunology, Is they distinguish self versus non-self and they attack anything that looks biological that is non-self.
But that creates a selective force that drives pathogens in the direction of looking like self in order to hide from the immune system, which then raises the possibility of autoimmune disorder.
And so it is, you know, and, you know, we heard from… Or to be, you know, other in self's clothing.
Right.
To cloak themselves.
Exactly.
Exactly.
But, you know, and we heard from… Pierre Corey, when he was on the podcast, that, you know, in the case of COVID, right, the actual pathogen's presence may be short-lived relative to the disease, because a lot of the disease are the cascading inflammatory effects that continue on afterwards.
And so all these things are on the table, and probably 20 others that, you know, are harder to describe.
And what, here's what I think the punchline of all of this is.
Long ago, A hundred years ago.
Doctors were scientists.
That's what they were.
And they had a much smaller toolkit.
But they were better at wielding it because their job was actually to spend enough time looking at patterns.
And, you know, I used to… And people.
Right.
And spending time with their actual patients in their physical presence for longer and often in their In their homes, exactly.
And so, the idea of a doctor who had a much smaller range of drugs they could prescribe about which less was known, right?
That doctor, nonetheless, had the ability to detect patterns.
And there's this very famous example of cholera being discovered in a water source in which the key piece of evidence was the geographic distribution of cases, right?
But if memory serves, I think that discovery was done by not one of the very local people.
I think someone came in and basically started mapping it out.
I think that's true.
I can't remember.
It's a very famous story.
I just don't remember the specifics.
But how often is something like this the case, which you don't see when people come into your office and, you know, how often does the doctor look at your address and say, huh, that's the fourth one of those cases I've seen from this neighborhood and I haven't seen one from anywhere else.
I wonder if there's arsenic in something.
Right.
I think more likely to be explanatory is the doctor walks into the patient's home and wrinkles his nose.
Do you have mold?
Or, oh, you've got eight parakeets.
Maybe you've got a bird allergy.
Whatever it is.
Or, oh, how many times does that train that just rattled your windows go by?
And you say you're sensitive to light and noise.
There's just so many things that you can learn about what could actually be affecting someone's health by seeing them where they live, obviously.
I mean, this is the most obvious thing ever, right?
By seeing them where they live and being empowered.
I mean, I think what people don't They can't fathom, right?
We have this very, I think, foolish relationship with the idea of intuition, right?
When people mention intuition, it's like they're treading right at the border of the mystical.
There's something mystical about this, right?
Intuition is an unconscious process that is either well informed or poorly informed by what the person has experienced, right?
And so, a person who has a lot of experience with something May have a very powerful intuition that that's the place to search, and that isn't.
And they're likely to be right, not because something came from outside, but because they perceived accurately.
But this is super important, I think.
I think the reason that many people think, oh, that's mystical, is because they have divided the world into two categories.
That which is understandable by science, and already understood, And everything else, which is somehow mystical or woo, and depending on their particular predilections, either therefore none of that is real, or therefore we just don't know anything about it.
What you were saying, we would argue, is intuition is you.
understanding something about the world that you don't yet have the words for.
And it may be that actually science does have language for what it is that you've perceived and how it is that you've done it.
And maybe science doesn't, but that doesn't mean just because science does or does not know yet what it is that you have done to get to the knowledge that you have, that it lives in some ethereal spirit world.
Right.
It's the mistake of us categorizing the mind as synonymous effectively with the conscious mind, which is actually a tiny fraction of the mind, right?
Even the thinking mind.
There's lots of the mind that is dedicated to doing stuff that doesn't have anything to do really with thought.
But there's a lot of thought that goes on outside of the realm of the consciously perceived.
So, for example, let's say you knew somebody.
And, you know, let's say they were basically honest, but they lied about some topic, right?
And you might begin to pick up something.
It might be that their vocal cords tense just slightly differently when they're in that lying phase.
People have a lot of tells.
Right, exactly.
And so you may not know.
Let's say that it is a frequency issue.
That the tone color in their voice is just slightly different.
The sonic frequency.
Right, right.
Even if you did, there was something in their voice.
It might be that the only thing you could actually say consciously is there's something about their voice that's a little different, but you might not be able to say, no, there's less in this register.
Right.
Most of us don't even have the language for it.
So the point is, A well-tutored intuition is actually the most important thing for somebody who knows a lot about a difficult topic, right?
You really want them to use their well-tutored intuition to limit the search space.
And the point is that doctors are being disempowered to be scientists.
They're becoming practitioners of something that is algorithmic, right?
When a person has these symptoms, they have this disorder, which is treated with this pharmaceutical.
And the point is, it's a very automatic process.
And we are now, in the context of COVID, watching it become even more automatic as doctors are being robbed of their ability, for example, to prescribe things off-label.
But the point is, in a complex system, you need somebody with an excellent intuition To come into your situation and to spot that although you have these symptoms which overlap the description of this disease you also have this other thing which puts you in some separate rarer category perhaps and you need somebody empowered to do that and that's frightening because you can't tell whether somebody is capable of it based on their degree.
No certainly not.
It's a skill beyond what can actually be described and tested right so you know just like we talk Sometimes in the context of science about somebody having lab hands, right?
Lab hands is like muscle memory.
It doesn't really exist, but it's very important.
No, but it does and you know I've had a number of healthcare practitioners in the wake of the boat accident and you know all of the All of the body work that I've had done, which includes people from DOs, you know, osteopathic doctors with prescribing privileges.
I haven't used them, but you know, through, you know, through structural integration and myofascial work and strain, counter strain, and just, you know, a lot of different kinds of work.
Some of everyone whom I have asked has said some version of I want to know the science.
I want to understand what it is that we know about why it is that my particular approach works.
But given what it is that I do, you also need to have the hands, and it's not clear to me that that can be taught.
And some of these people have actually tried to teach, have had proteges, have tried to mentor others.
And have said, you know, with sadness, oh, you know, I had this one person who was so, you know, so book smart, so brilliant, so capable of understanding why it is that this non-mainstream medical technique, in this case, it was strain counter strain, is so effective.
And yet for the life of me, I could not teach her the hands.
She did not have the touch and, you know, she was The person who was working on me had her protege working on her and had her working on other clients.
She said she cannot find the spots.
And there is reality to that.
Whether or not you like the language not sounding fully quantitative and sciency, there is reality to it.
And it's in many ways the most important reality.
I wonder, there's probably somebody who has a systematic way of understanding this, but there are many things, and I think to me there's a difference between can it be mentored and can it be taught.
Right?
The most important things are things that can be mentored but cannot be taught.
Right?
How do you formulate a good hypothesis for a complex set of observations?
I do not know.
There's no method you can use to describe how that is done.
Right?
It is a creative process and nowhere in talking about how science works, you know, do we talk about the art.
generating a hypothesis.
In fact, we pretend it isn't an art because that sounds embarrassing.
Well, it's creative and it's intuitive.
It's creative, it's intuitive, it involves a tolerance for crazy fanciful ideas that quickly fall apart.
You have to be ready to traffic in that, at least in your own mind, in order to get to the idea that's actually robust enough to be worth voicing.
And a tolerance for a period of whatever domain it is that you're interested in.
I think this exists for most people.
I know it did for me.
For me, famously, as you know this story, and as I write about in my first book, An Antipode, You know, being walked into the lowland tropical rainforest in Costa Rica for the first time as would-be scientists.
We'd already traveled a fair bit, but with John Vandermeer, the professor that we were in Costa Rica with, along with four other grad students, he sort of spread his arms wide and said, look at all the questions And I was like, God, it just looks green.
I don't see any questions.
I just see a lot of leaves.
I don't know what's going on here.
But I was fascinated.
I was driven.
I was excited by what I did see.
It just didn't come in the form of questions at first, and it took so much time.
It took just so much time honing my hypothesis eye, my hypothesis brain and my scientific eye and observational skills and just sitting, sitting and being in the place where I was interested in learning how to do pattern recognition and waiting for the patterns to reveal themselves.
And for some people, it doesn't or they don't have the patience or it turns out it's not the work they want to be doing.
And I think for some people with regard to the hands, with regard to body work, Regardless of how much they think they want to do it, it may just not come to them.
Right.
Oh yeah, there's some things that you can't… some people are… the window of opportunity has passed before you ever get around to saying, hey, can you do this thing?
Yeah.
I remember John saying… you see all the questions and… Boy, did I. Yeah, you did, right then.
I mean, at some level, it is not intuitive how it wouldn't be obvious that all of that pattern is basically, you couldn't possibly sort all of the questions that are suggested even by just that one static scene, right?
The distribution of stuff.
But anyway, you can mentor this.
And, you know, you and I did a lot of exploring of what good teaching space looked like and how it actually worked.
And it was surprising how often there was something useful to say that was just borrowed from some realm that wasn't supposed to be relevant, right?
Like immersion language.
Biology is not linear the way some other topics are.
There's nowhere to start, right?
If you walked into a forest and you said, well, where do you start?
There's nowhere to start.
You can start anywhere because it all leads to everything else.
And you have to start somewhere, which means that your first question is going to be shockingly out of context.
And you're quickly going to discover all the demands you know nothing about and have to just shut down some of them and be like, I can't know all the demands.
Right.
In terms of the difference between mentoring and teaching, I never figured out the first useful thing to say about how you formulate a hypothesis.
But you can play a game, which is you can put the pattern I disagree with the dichotomy here.
And you can say, here's a pattern.
I don't know why it's there and neither do you.
What are some hypotheses that might work?
And then you can do something that's more like volleying. - I guess I don't, I disagree with the dichotomy here.
I don't think that's not teaching.
No, it is.
It's well, I like mentoring better because it is teaching.
But the point is teaching to me suggests we know how this is conveyed rather than you're going to have to discover how this is conveyed.
You're going to have to discover how this is done on your side.
And your method may not look like anybody else's, nor will you necessarily be able to describe it.
Well, I guess I am going to be stubborn here and say just like the word feminism, and even more so the word woman, for instance, like, I'm going to hang on to those words.
And I'm not going to let the version that is passing for standard increasingly take over.
And so teaching, it's been, you know, decades now, the teaching is largely done the way that you're talking about it.
But I think, you know, what we were doing in the classrooms was a combination of a lot of things, including a very lot of what you're talking about, and it was all education.
Sure, it's all education, but the problem is if, you know, if mentoring and teaching are effectively synonymous, we're not getting the full value out of the fact that there are two terms that have a different connotation.
And I think the point is there's a lot of stuff that can be taught, right?
And then there's a lot of stuff that must be learned.
That cannot be taught and is not It is not hopeless to convey something useful, but that the process right the process by which the tennis pro teaches the The player who is learning to play right does not involve It just simply involves the tennis pro returning The volleys of the student such that the student gets better and better over time
Right, but that's still teaching.
I mean, I think this is ultimately a non-interesting semantic argument, but I feel like what you're putting into the category of teaching is that which can already be described.
And it's exactly what we talk about when we say, you know what, that thing where you're conflating the products of science with what science is, that's not true.
And so, you know, the thing that we can describe fully as if by litany or as a recipe, only that is the stuff that can be taught.
I'm not interested in foregoing all of the things about which there is uncertainty, and where serendipity is important, and creativity and intuition, and where discovery is part of the point.
Yeah, that is where an education, encouraging that behavior and facilitating people in their engagement with those sorts of behaviors is what an education should be, because all the rest of it you can Google.
Right, but I guess I don't understand.
It seems to me I'm not saying to surrender on that stuff.
I'm saying the most important stuff is the mentored stuff, which is the stuff that cannot be made methodological, right?
And so the point is it's the hardest stuff to teach, if that's the word we're going to use.
And so I just think that, I mean, you know, we can we can let it go.
But I think the category of mentorship is where The most important stuff is done and it may be that you need to teach a bunch of stuff to get to the point where mentoring is necessary, right?
We may need to teach you to do arithmetic before we mentor you in traversing a frontier in mathematics, but that If we synonymize the two, then it becomes very confusing because the point is people are, you know, people are seeking someone to teach them how to do things that may not be teachable.
They may be only mentorable.
Yeah, I'm not arguing for synonymizing.
I think I just have different definitions of both of these terms than you do.
And I don't want to forego, I don't want to lose within teaching so much of the most valuable part of what education is.
It feels like it is a devaluation of teaching.
But you, I feel like we're making some point more… Well, my point was… The idea of a system that is going to rob doctors of their autonomy and their ability to navigate the unknown and say, medicine has figured out what we do with people no matter what symptoms they walk through the door with.
There's a checklist that we can go through that will tell you exactly what pill to send them out the door with.
And the answer is no, that's never been good medicine.
And it's especially bad now because we're dealing with such a large range of novel inputs and such an increased exposure to a variety of pathogens based on the way we travel around the world and all.
So what you need is- And the easiest way for medicine to make money is with pills.
Right.
It's the easy thing, which is, you know, this happened in psychology too, right?
We went from people who, you know, traversed the workings of the mind based on talking with them, which of course can't be systematized, right?
To, oh, you know, here are the six, you know, any three of these six criteria mean you have such and such disorder, and here's the pill that fixes that, because of course we know so much about neurobiology that we can just Drop a pill on it and it'll fix you.
Because you've got bad genes for your teeth.
That explains your teeth.
And you've also got a serotonin deficiency or something.
Oh, you're not making enough serotonin.
You're making too much serotonin.
Yeah.
It's the same kind of absurd, reductionist, metric-driven, anti-scientific argument that passes for medicine or psychiatry or whatever it is passing for.
It is shoehorning.
The truly complex into these simple rubrics in order.
It basically flatters your ability to fix stuff.
And then, of course, those fixes don't really work, right?
Like maybe you find.
Yeah.
Some pill that has, you know, arbitrary large effects across the brain and of course it disrupts whatever pathology you have going on among other things.
And it may cause three others but we've got pills for those too.
Right, we've got pills for those too and it may turn out that the effect isn't all that useful because it was just basically distracting and then... Or it's temporary but addictive!
Right.
So anyway, all of these things are the same damn error.
And the answer is, you know, human beings haven't gotten any simpler.
And the environment hasn't gotten any less noisy.
So, you know, we need people with really well-tutored intuition that comes from exposure to a wide range of Examples, and they need to be free.
That's the thing.
In order to do the job well, they have to be free.
And we're doing the opposite to them.
We are doing the opposite to them.
Indeed.
Shall we move on?
Sure.
Maybe this is the place for the one note that I wanted to add in here.
Follow on to... It depends on what your note is about.
I don't know.
It's about a closely related topic.
Okay.
I also have closely related topics, but you go.
Okay.
So the closely related topic has to do with artificial consensus.
Okay.
Right?
Which we talked about a little bit last week.
And I wanted to follow up on the story of the paper by Jessica Rose and Peter McCullough on myocarditis following COVID vaccination.
People who watched last week will remember that this paper had passed peer review and was headed towards publication when the Elsevier Cardiology Journal Replaced the preprint of the paper with a note saying it had been temporarily moved and that if it was not fully restored, the new version of the paper would contain an explanation of why it was temporarily removed.
And we pointed out how unusual this was.
This wasn't a paper being rejected because of some issue.
This wasn't... the authors were literally not told what the problem was.
That was highly unusual.
And, in any case, it suggested some kind of behind-the-scenes shenanigans that we are left to guess at.
And, of course, on a topic where we are told there's a scientific consensus, and you should follow it.
And the answer is, well, why is there a scientific consensus?
Here's a paper that ran against that consensus, and suddenly mysterious things are happening to it.
And I must say, many people wagged their finger at me when I tweeted about this and said, you're imagining things.
Stuff goes on all the time with papers.
There's a problem with this, that, or the other.
It all turns out to be nonsense.
And what has happened in the intervening week?
What has happened in the intervening week?
What has happened in the intervening week?
Aren't you glad I asked?
Yeah, I am glad you asked.
Thank you.
You're welcome.
Zach, do you want to put up the… I want you to put up the correspondence.
So what we have here, can you put it on a bigger screen so we can read it?
So what this is, is a letter from Current Problems in Cardiology.
It hasn't changed.
It's still too small.
It's a letter to Peter McCullough in which the journal is explaining that in fact they have rejected this paper.
Now rejecting a paper is not so unusual, but rejecting a paper after you have accepted a paper is unusual.
No explanation is given for why this is taking place and what happens is that the journal is simply asserting that they have the right to do this.
Yes, there's no explanation.
So for those who are... You want to read it?
Oh, God, I hate reading things.
People are going to be looking at my nose here.
I hate that the screen is way up there.
You can get them to close their eyes.
Dear Dr. McCullough, this is dated October 21st.
Thank you for your email of 15th of October.
I am afraid that the journal is not willing to publish the paper.
We do not agree that there has been any sort of breach here.
The publishing agreement that was signed, attached, contains the following clause which makes it clear that articles may be rejected at a late stage in the publication process.
The editor's decision to reject the paper is final and all rights have reverted to you so that you are free to submit the paper to another journal.
And the paragraph on reversion of rights reads, Articles may sometimes be accepted for publication, but later rejected in the publication process, even in some cases after public posting in articles in press form.
In which case, all rights will avert to the author, see link.
Yours sincerely, Diana.
So again, I just want to emphasize how unusual it is for no reason to be given, right?
It definitely suggests that something has happened behind the scenes and in light of the contentious nature of the phenomena in question, it appears to be the construction of the appearance of consensus by the targeting of anything that goes in the other direction.
I mean, among other things, as deeply flawed as peer review is, had this paper been rejected at peer review, the authors would have been given the three sets of comments by the peer reviewers.
And they may have been banal and cryptic and uninformative, but there would have been something there.
And some justification is required.
When a peer reviewer says, no, I don't think you should publish this paper.
So here we had, you know, two or three peer reviewers who said, yes, publish.
The journal published and then pulled it and there's no, there's not even any information that would be found in, you know, largely not very useful negative peer review.
There's, there's nothing.
I've, I've actually, just as you said last week, never heard of anything like this.
Now, you know, I'm not in the weeds on peer review and journals at this point, but I was for many years and this strikes me as extraordinarily unusual.
Right, so I would point out, I accidentally borrowed a phrase from Eric that I didn't realize I had borrowed at the time, but the phrase is, follow the silence.
And in this case, this is a clear example.
What you've got now is an absent journal article, right?
journal article that points in the direction of a pathology following on from vaccination that is worth knowing about.
Obviously, whether or not to mandate vaccines would require a cost-benefit analysis, which would require us to know what the harms are, to be able to calibrate how common they are, how serious they are, all of these things.
It requires this evaluation.
And so in any case, what I would say is it is intolerable that thoroughly qualified scientists and doctors are having publications that have passed peer review, that have done everything correctly, eliminated from the record before they that have done everything correctly, eliminated from the record before they even emerge without So we can't even evaluate for ourselves whether or not this journal has made some discovery that's important about this publication or not.
Presumably it hasn't, or it would have said what the problem was.
So, in any case, I think the point is Read the books that they want to burn, right?
That's the way that we win against the censorship.
Read the books that they want to burn, right?
Seek out the stuff that they don't want you to see.
Talk to the people that you're supposed to not listen to, right?
That is the way to figure out whether there is something there of importance or whether it truly is nothing.
This is actually a perfect segue.
I wasn't going to do this next, but Zach, if you would show my screen.
This is a Washington Post article from yesterday, from October, that would be the 22nd?
I don't know what day it is anymore.
It is October.
Thanks.
What, Zach?
Zach, your father is endlessly helpful.
I have the sense you're being ironic.
So at the Washington Post, as we all know, democracy dies in darkness.
Here is an article published on October 22nd of 2021 called Five Tactics Used to Spread Vaccine Misinformation in the Wellness Community and Why They Work.
So, I'm sorry for the vertigo-inducing scroll here.
This is online and I'll link to it in the show notes, but I'm just using my PDF so I can show you highlighted sections.
Two little sections.
Taking science out of context.
This is their third of five points of how the wellness community is causing problems in basically compliance with public health Pronouncements taking science out of context.
The public is observing the scientific method up close and in real time.
The uncertainty inherent in the process and the rapidly changing public policy based on it has eroded trust further and authorities made it easier for members of the wellness community who are vaccine hesitant to present scientific material in a misleading way, experts said.
I'm going to read that first sentence again.
The public is observing the scientific method up close and in real time.
Since when?
What the fuck are they talking about?
I mean, this has been our point from the beginning.
Early on, in March, April, May 2020, when the preprint servers were buzzing, they were so full of papers, And those of us who were interested and, you know, felt that we had the chops to wade in and read those papers, it was amazing.
It really did feel like the Wild West in the best sense of the word, right?
Like you could see what people were finding and what they thought it meant and watch hypotheses being tested and thrown out and not falsified and, you know, tested again and it was amazing and that stopped.
Like, we're not seeing that anymore.
And never was that at the mainstream media.
The public is observing the scientific method up close and in real time?
No, it's not!
No, it's not!
This is a flat-out lie!
Or, actually more likely in this case, not a lie.
Washington Post and the New York Times and NPR and CNN and, you know, all the rest, maybe actually believe this.
They think that if you come out wearing a lab coat or just flash in your letters like PhD or MD or whatever and say, I say the same thing that everyone else has said, that you're seeing the science.
The scientific method up close in real time.
Bullshit.
Sorry.
Okay, next paragraph from this paper, from this article in WAPO, in Washington Post.
Another tactic is cherry-picking data.
For example, some will point to the Vaccine Adverse Event Reporting System, known as VAERS, as evidence of widespread deaths and injuries from vaccines, while ignoring the broadly acknowledged limitation of its data.
One of the broadly acknowledged limitations.
So what do we have then?
Point us to the source of data on what would be adverse events, unless you're literally claiming there are none, and then we can talk.
The one source of data that is possible, the only objection is, well, but it's flawed.
Prove it's flawed, but also until and unless there's another system in place, are you seriously comfortable with the idea that there is actually no way to collect data at all on adverse events and that's going to be fine?
Yeah, it's amazing.
They've left us with a situation in which their argument amounts to the thing that suggests there's a serious problem isn't good enough to be relied on, leaving us with no information.
It's very much like what Duthat was finding with regard to Lyme disease.
So you were taking notes while I was ranting.
Are you done ranting?
You know me, I could rant for a long time.
Let me see, did I want to say anything else?
Yeah, just that, it's quite the opposite.
We're not being allowed, we're being shoved, having conclusions shoved down our throats, which is exactly the opposite of the scientific process.
We are being told that the little bit of data that we can see isn't real data, so don't pay attention to that.
We're not being shown the analysis of anyone who claims to come to conclusions.
Those people who come to conclusions that are different from the mainstream, like Rosa McCullough, have their papers disappeared with no explanation.
So we're seeing the scientific process up close and personal?
No, we're not.
No, quite the opposite.
Exactly the opposite.
And if you think we are, you have accepted a very large lie.
Yeah.
If anything, if you're paying attention, you're seeing what upends the science process happening in front of your eyes.
But it's all too easy to ignore.
Yeah, well, what I was thinking was, you know, last, I should confess to the audience that we are with our children.
Please don't send Child Protective Services.
Our children are old enough to handle it.
We are watching Mad Men with our children.
We've watched it before.
It's extraordinary.
It explains a little too much about some of the mess the world is in now.
It explains a lot.
But in any case, it has this kind of an advertising frame of mind.
Last week, we proposed a slogan for the YouTube Community Guidelines folks.
YouTube Community Guidelines, because you can't handle the truth.
And I have one here, The Washington Post.
This is free work.
They're entitled to use it.
I grant them rights if they would like to replace their current slogan.
You are so generous.
I am a very generous person.
The new slogan I'm proposing, it's a variation on the theme they've already got, is democracy dies in darkness, as will you if you don't get on board with the sanctioned public narrative.
Right?
Maybe in Room 101.
In Room 101, for example.
For example.
For example.
One of many possible outcomes.
Yeah.
Not making any promises, though.
That's good.
I mean, it may be a little compressing.
It needs a little tightening.
Yeah, it's wordy.
It's wordy for a motto.
It's a little wordy.
But, you know, so are they.
Yes.
This piece that I just read from just goes on and on and on and on, and those were the ones that popped out at me as the most egregious, but the whole thing is garbage.
It's just garbage argument after garbage argument.
And what they're trying to do is convince you that if you have thoughts that don't fit with what they have already told you you need to think, then it's because you're being misled, it's probably because you're stupid, you're maybe not educated enough, you've probably fallen prey to some hucksters and weirdos online.
And, you know, are there hucksters and weirdos online?
Yeah, of course.
There are hucksters and weirdos in the political system, in the medical system, and everywhere.
And what you need to do is embrace the concept of thinking for yourself and actually try to assess the arguments that you hear from everyone as much as possible from data, from first principles, from logic, and then try out what you have arrived at on your friends, on your family, on yourself in your worst moments.
Say, you know, what would I have to see that would falsify this thing that I now think is true?
Do that.
No, you don't just accept the word with the guy who has the degree or the lab coat or the glassware.
No, that's not getting to the scientific process up close and personal.
Quite the opposite.
Yeah?
Yeah, no, I think I feel better, a little bit.
Okay, so this paper, interesting, you're just banging on all sorts of things today.
No, I'm trying to get the groom and the bride to kiss or something.
Isn't that what you do?
Does Zach bring someone home?
I will find out.
Okay.
There's a paper out this week.
Here it is.
I'll just show my screen briefly.
Brett.
Brett.
Zach.
God.
Okay.
Yep.
Research article in science, heuristics in the delivery room.
And actually I'll just No, actually I won't.
Heuristics in the Delivery Room.
So give me my screen back if you will, Zachary.
Thank you.
This is a very interesting piece of research.
It's about obstetricians, the obstetricians to which I referred at the top of the hour.
Helping women through labor and delivery, L&D, have a lot of moving parts to assess, obviously.
It's high stakes, high stress job.
One of the things that they have to decide is what kind of delivery women are going to have.
The two, basically the two, there's probably other options, but basically vaginal or c-section, cesarean section.
The first being the norm, whether or not it's, and then under certain circumstances c-section is required.
And of course, there's a whole lot of literature and thinking on how there was a rise in c-sections over the last several decades, and I think it's actually begun to reverse because it was too often done for convenience and to be able to time birth rather than actually for the good of the
But this research finds that if an obstetrician, I'll put it in a hypothetical term which is not what the paper does, if an obstetrician has two deliveries in one day and the first mother has a vaginal birth but she has complications that were unexpected,
That obstetrician going to the second birth is more likely to direct that mother to and to give that mother a cesarean section than if the first mother had not had complications from a v-birth, which is both alarming and so very human, right?
So it is The two mothers presumably have no risk factors in common, and certainly the regional research made sure that that was the case, precluding maybe something about the hospital environment that is making one or the other type of delivery particularly dangerous, in which case that would be a broader scale problem than just this obstetrician, where any hospital but a very rural place is going to have more than one obstetrician working at a time.
So, the idea that whether or not you get shunted into one of the other kinds of modes of delivery is in part predicted by whether or not your obstetrician's previous delivery had complications that he or she wasn't expecting is something that women going into labor and delivery and their partners and their support People need to know, right?
But it also points to me to, like I said, this kind of human universal, right?
tend to assume dependence between events that don't have dependence, right?
There's no way that two women who happen to be giving birth at the same time in the same, say, you know, urban hospital inherently have similar risk factors that were unusual in the first one that would make a particular birth more difficult.
Well, let's slow down slightly.
Yeah.
Okay.
So first of all, I just want to point out this is a very elegant, uh, it's more or less a natural experiment.
I hesitate to use the term because usually natural experiment is like different populations on a series of islands or something like that, and obviously there's nothing natural about a hospital.
The idea that the data is generated by just a series of events.
It exists there.
It's an observational study.
It's an observational study that compares two things.
And assuming a rational model of hazards in giving birth, then this does seem to reveal a Non-medical pattern.
Yes, right.
This is a pattern of human psychology Not a pattern of medical need and it's one with important consequences because these two versions of birth are not equivalent in terms of their hazards and benefits on the other hand, I mean There let's just try to find a mechanism by which this would actually be rational.
Mm-hmm.
That's plausible I've got one.
I don't believe it for a second, but I know that formally it works.
Okay.
So let's say that there is a lot more about complications in birth that has to do with the obstetrician.
Right?
If the obstetrician is detecting, oh, I, the obstetrician, am having an off day, and as much as I don't like to do C-sections, I don't want to have a complication that's unnecessary.
So although it's more risky on average when I'm having an off day, it's actually the safer of the two options, right?
then you could find this pattern and it in fact would be medical in nature.
Yep, that's true.
If the complications are downstream of obstetrical behavior, then this would actually be perhaps a good finding, of benefit to the mothers who are later in the day.
I'm struggling over the language, too, because if this were our native territory, the point is this pattern is either adaptive or not, right?
In this case, I'm using medical as a substitute, meaning, you know, to the benefit of the patient.
Again, I don't believe for a second that that's what's going on, because I think much more often the complications are about, you know, a cord wrapped around the baby's neck.
Well, and the over-medicalization of the process in the first place, like, you know, lying down, highly drugged.
Don't move at all while you're in labor.
There's just a whole lot of stuff that will tend to cause births to become sluggish and slow, and then ultimately, at the point the mother's super exhausted, things don't go right.
Instead of, okay, get up, walk around, let's hasten this process, which is much more likely to result in a safe, excruciating, but faster and non-complicating vaginal birth.
Yes.
I will also say, as much as I am a firm believer that there is some good method that we could, you know, if we were completely open-minded about what actually works and what actually doesn't, and we, you know, didn't talk ourselves out of stuff, I bet you could find exactly that walk-around method or whatever it is, or I know the Russians were experimenting with.
Births into water, and who knows?
But the point is, it may also be that some of this is not solvable because the inputs to the system are novel.
In other words, the nutrition that the mother has is also novelly good, right?
And so the baby is likely to be unusually large compared to what an ancestral baby would be, which means that the system... That's true, but that doesn't change day to day.
Right, right, right.
That doesn't change.
I'm just saying, you know, Yes, the process has been over-medicalized.
It may be the case where it's become somewhat medicalized out of necessity downstream of some kind of novelty like plenty of food.
Yes.
But… But certainly some of the medicalization was about sort of I don't know exactly when, but let's just call it sort of early to mid-20th century, taking agency away from others as if they were just bystanders, passive bystanders.
Just, you know, trust the authorities who aren't pregnant and not the baby to, you know, bring this baby into the world, and you just happen to have like, you know, been the transport or something, which is an insane view.
We took the agency away from motherhood at Mothers and now we're taking the motherhood away from Mothers by gender neutralizing the process because we've gone batshit crazy.
Yes, yes.
I'm not going to go there today, but I did on Twitter this week.
Oh my god.
Yeah, now we can talk about differences in how male fetuses and female fetuses and the placentas.
So placentas are fascinating, actually, and I did not do my research before saying anything here, but there's like at least four different distinct forms of placentals among placental mammals.
Different evolutions.
It seems like it.
I didn't say that because I think that we think that placental mammals, eutherians, the so-called true mammals, as opposed to kangaroos, middle mammals, as opposed to the monotremes, the echidnas, and the duck-billed platypus,
The placentals, which includes basically everything you can think of except all the mammals in Australia plus possums and not also the platypus and echidnas, are the placental mammals, the eutherians.
I think there's something like four maybe more different maybe evolutions of placenta and in at least one of them I think the placenta is maybe entirely maternally derived.
And at least in one of them I think it's entirely fetally derived, but in us and our close relatives and some other group, I don't remember which, it's both.
So our placentas are a mixture of maternal and fetal genes, which is just… and cells.
Extraordinary.
And these things have, it will not be obvious to most of our listeners, but This has profound implications over the mediation of the conflict between fetus and mother, which will vary quite a bit based on the mating system of the species in question.
So there's a kind of whole hidden landscape of conflict here.
Yes, yes.
Essentially, if, let's say you have a species that mates for life, right?
If you have a species that mates for life, there's very little basis for a conflict between the fetus and the mother over how much resource to deliver.
It's not zero, but the offspring has an interest in the mother remaining healthy at the end of the pregnancy because all future offspring will be full siblings, right?
At the point that the baby is produced inside of a species in which that is not the expectation, then the point is actually draining the mother of more resources than it is in her interest to give up actually makes some kind of sense.
And so the placenta is in a perfect position to mediate this, and which kind of placenta it is is going to have an effect over who has the upper hand, or is it a stalemate?
Very much so.
So sort of downstream of David Higgs' work in the early-mid 90s.
Absolutely.
Yeah.
I don't know where we were, but let's – oh, I guess the one last thing I was going to say about about this research on obstetricians was assuming that your proposition is not right and that there really is no reason to assume dependence between mothers in an obstetrical ward.
People tend to find dependence between events where there is none.
We're pattern seekers, and we're really good at finding pattern where there is none.
That tendency is what the scientific method is for, that's what statistics is for, that's what all these sorts of things to reduce bias are for.
But absent that, we're going to over-generalize pattern and apply our understanding where there wasn't anything to apply and be wrong about it.
So, take that tendency and add category errors, like these things that are being used to immunize people against COVID are vaccines in the same way that the yellow fever vaccine is a vaccine.
We can call them both vaccines, but there's a lot of reason to think that actually those weren't different words.
Yes, they warrant different words and what you're pointing to and what we have pointed to before in terms of basically the delivery mechanism as a proxy for something is also very human, especially in light of the fact that all of us, almost all of us, Um, have some sort of an uneasy relationship with needles.
Sure.
Now, you and I have faced a lot of needles.
I think we have much lower sensitivity to needles than most people, but the point is, every time I get... Well, no one should be excited about the prospect of a needle approaching them.
Right, and fluid being injected into a tissue where there's no space for it is, it's an uncomfortable thought, you know, how does it expand?
Is it tearing tissue?
Whatever it does.
So the point is, the human being has a kind of proxy sense of like, Okay, I'm about to be punctured, I'm gonna have some stuff injected, and then it's gonna be over, and then there's relief, right?
The point is actually almost nothing that matters is that.
Well, I won't say that, actually.
Dr. John Campbell did a very interesting video, which I think should have been much more widely viewed.
It was widely viewed, but it should have been even more widely viewed, in which he discussed The fact that there was, it used to be that the method of giving a vaccination involved pulling back on the plunger to make sure that you hadn't hit a vein, because the idea was not to inject the vaccines into the circulatory system, right?
It's supposed to be in the interstitial fluid.
And anyway, the way to detect that is to pull back on the plunger and see if you get blood.
And there's a question about what fraction of adverse events are actually the result of the fact that the vaccination itself mechanically didn't go the way it was supposed to.
It just didn't get to the tissue it was supposed to get to.
It went to the wrong tissue.
It went to every tissue because it got injected into the circulation.
So anyway, these things matter.
But putting that aside, The important thing that happens on the injection is really about all of the complex stuff downstream of it.
It's the immunological stuff, which most people have a very crude intuition for at best, right?
The idea of like, oh, well, it created antibodies.
Okay, well, what fraction of the immunity to this particular disease is based in antibodies, right?
That's already a complicated question.
Right, right, right.
Yes, the proxy, because there is a small trauma that comes along with getting an injection and it's very finite in time and it's always the same or pretty close to it, right?
The actual fact of injection, people have a very narrow model and the point is the really intriguing stuff is involved in what is inside that syringe.
Right?
And all of the impacts that it may have, which is something most people have no model for.
Right.
And I guess, I mean, I think that's, at first I thought maybe you were making almost the opposite point that I was going to arrive at, but I think it's the same really, which is that this tendency to effectively imagine dependence between events or correlation between events that isn't there, Is being weaponized against us with regard to, well, you've gotten the shots before, so just… Are you pro shot or anti shot?
Just do it.
Right.
So that's, I guess that's, that's that point.
I think it's time to read the C.S.
Lewis essay.
All right.
Unless you have something before that.
Nope.
Okay.
I don't think we're there.
You have not heard this yet.
I have not.
to me yesterday, and I happened to be in front of my email when it came in, therefore I actually saw it, unlike a remarkable number of the emails that come in that I don't seem to see until months later, if ever.
This was published in 1948 by C.S.
Lewis, called On Living in an Atomic Age.
In one way, we think a great deal too much of the atomic bomb.
How are we to live in an atomic age?
I am tempted to reply, why, as you would have lived in the 16th century when the plague visited London almost every year, or as you would have lived in a Viking age when raiders from Scandinavia might land and cut your throat at night, or indeed as you were already living in an age of cancer, an age of syphilis, an age of paralysis, an age of air raids, an age of railway accidents, an age of motor accidents.
In other words, do not let us begin by exaggerating the novelty of our situation.
Believe me, dear sir or madam, you and all whom you love were already sentenced to death before the atomic bomb was invented.
It is perfectly ridiculous to go about whimpering and drawing long faces because the scientists have added one more chance of painful and premature death to a world which already bristled with such chances and in which death itself was not a chance at all, but a certainty.
If we are all going to be destroyed by an atomic bomb, let that bomb when it comes find us doing sensible and human things.
Praying.
Working.
Teaching.
Reading.
Listening to music.
Bathing the children.
Playing tennis.
Chatting to our friends over a pint and a game of darts.
Not huddled together like frightened sheep and thinking about bombs.
They may break our bodies.
A microbe can do that.
But they need not dominate our minds.
What the atomic bomb has really done is to remind us forcibly of the sort of world we are living in, in which, during the prosperous period before, we were beginning to forget.
And this reminder is, so far as it goes, a good thing.
We have been waked from a petty dream.
Um, nope.
We have been waked from a pretty dream, and now we can begin to talk about realities.
It is our business to live by our own law, not by fears, to follow in private or in public life the law of love and temperance even when they seem to be suicidal, and not the law of competition and grab, even when they seem to be necessary to our own survival.
For it is part of our spiritual law never to put survival first, not even the survival of our species.
We must resolutely train ourselves to feel that the survival of man on this earth, much more of our own nation or culture or class, is not worth having unless it can be had by honorable and merciful means.
Nothing is more likely to destroy a species or a nation than a determination to survive at all costs.
Those who care for something else more than civilization are the only people by whom civilization is at all likely to be preserved.
Those who want heaven must have served earth best.
Those who love man less than God do most for man.
Let the bomb find you doing well.
That is a very challenging essay.
Yeah.
So I'm struck by a number of things.
You know, one, I do think that part of the issue that he raises is something I think about a lot, which is, you know, your own death is Something you're wired to avoid under most circumstances.
But the extinguishing of your lineage and then ultimately your species is that thing magnified.
Yeah.
Right?
You ought to be much more alarmed at the elimination of You know your family or your tribe than you are at the prospect of your own death And the elimination of your species is even worse and he specifically counsels in there That survival at all costs is not the right answer But that raises some questions too, right if one has to compromise their values
To get through a bottleneck so that your lineage can continue.
Surely there are some cases in which that is exactly the right thing to do, and it is not the destruction of those principles.
And then there's another way in which he's right.
If your species is going to be, you know, a cancer on the universe by virtue of You know, being a purely destructive evil force that cares not that it creates suffering, then maybe the universe is just better off without it, right?
So anyway, I don't know.
I also hear it as counsel against fear and against shutting down life.
Because you are fearful of the newest thing that has arrived that is at risk of taking you out Yeah, I agree with this exactly and I must say I do a little correction for myself Which is you know, I find the prospect I don't find my own death particularly Troubling I find I do You know, I find your death, the prospect of your death very troubling, and I find the predicament that I will leave on my death troubling, but I don't find the fact of it troubling.
But as you scale up, it gets more and more horrifying to a point.
Right?
If you run the exercise of, alright, the Earth is about to be destroyed by some impossibly large force about which nothing can be done.
Is it the Fogons?
Something Vogan like or you know a large object emerging from you know That's been orbiting the Sun at some very low periodicity or something like that right somehow that is Even though as it occurred you would experience a death that would presumably I mean unless it was instantaneous be troubling and painful or whatever else it would be there's a way in which
It's just sort of easy to accept it because there's nothing to be done, right?
I don't think I feel that way.
You don't?
No.
Gosh, I guess I just found a defect in my personality.
Or binary, we just disagree.
I don't see why there's any reason to assume a defect.
I mean, I'd be curious.
Actually, I don't know.
I don't know how that would split for most people.
And it's not clear that there's two positions, right?
There are probably a lot of positions.
But I think on first pass, hearing that, my reaction is, oh, I don't like the idea of there not just being no future for me, but no future for anyone.
Right.
I mean, maybe the difference is, you know, there's some part of me that has, it needs to just confront the existential to get rid of it.
Right?
Because ultimately, you know, it is all existential.
I mean, yep.
Let's put it this way.
There is no justification for the claim that being alive is better than being dead, right?
I am firmly convinced that holding on to life is a great idea, but of course I would be, wouldn't I, being the descendant of, you know, three and a half billion years of creatures that preferred life over death, right?
But, you know, is being organized better than being disorganized as a crystal, better than a, you know, a puddle.
Right?
There's just philosophically nothing to do with it.
And similarly, there's no, no lineages getting out of here alive, ultimately.
Right?
Yeah.
In light of that, okay.
He's just going, like, full and existential here.
No, but I guess, look, first of all, there's a kind of, my grandfather used to rail, I think, against existentialists, right?
Because there was a kind of, it was an excuse for not doing things.
The fact that it was all futile, right?
I don't, in general, I don't tend to read the existentialist that way.
That's more, you know, Hedonism is the excuse existentialism.
I agree.
There's a bifurcation between the hedonist response to this and another response, and I'm definitely in the other camp, which is, yeah, let's put everything into doing this as well as possible, even though, ultimately, It will be futile.
Yeah, and let's pray if that's your thing and work and teach and read and listen to music and bathe the children and play tennis and chat to our friends over a pint and a game of darts.
Right.
Right?
Dear lineage, let us leave it all on the field, right?
Yeah.
Why not?
You have this unbelievably improbable opportunity, right?
Yeah, so what are you saving it for?
Right, so what are you saving it for?
Yeah.
What are we being asked right now to save it for, as in most of the countries where people are listening to us at the moment, we are being told, this just might not end.
You might have your activities and your behaviors and your freedoms restricted and restricted and restricted, and it might just go on indefinitely.
For what?
What even are you imagining that you're promising us at the end of this?
To just go back to what we already had, which we didn't have to ask for?
Right.
Why wouldn't we strive to get it right?
And that's the thing.
He makes the point very well.
At any moment that it happens, whenever it is, whatever it is that's coming for you, at the point that it happens, the point is you want to be worthy of whatever.
And he labels it as heaven, and you and I wouldn't do that.
But the point is it's a good proxy for something, you know?
Did you make good use of your opportunity or not?
And not everybody has the same opportunity, so you can't judge everybody by the same standard, right?
But given what opportunity you had, did you make use of it?
Did you do it well or did you waste it?
Or did you accept that this moment is so terrifying And given that what you're being told is, has with it a vague hint of a promise that isn't even a promise, that if you just do what we tell you to do, it will all get better, you're going to be in stasis for God knows how long.
Well, and maybe, maybe this is the thing, and I think, you know, I've been trying to wrestle this into a form that can be conveyed, right?
Because it's the kind of thing that either a person already gets it or it's very hard to get it.
But the point is, In objective terms, this is a very terrifying moment, right?
We know lots of highly intelligent people who are now gathering, people who don't know each other, who are gathering around the idea that something terrible is afoot, that we don't know exactly what it is, and that the trouble is going to get worse, right?
That's a paralyzing thought for many.
But it can be a liberating thought too, right?
The point is, this is a moment that is full of meaning.
It is full of hazard.
And in some sense, I think, you know, if it was a wall of fire, right?
But it was just a wall of fire.
Then the point is, okay, not going into fire.
That's the initial instinct, but going through the wall of fire might be the right instinct, right?
It might be the only one that is actually defensible.
If you understood, you know, even not knowing how thick it is, just the chance that it's just a wall of fire and it's not, you know, a landscape of fire, uh, you know, it's, it's, it's Beringia effectively, right?
If you didn't know what was beyond the wall of ice and you didn't have a choice, then the answer is okay.
Beyond the wall of ice, if there is such a thing.
Well, this is going to muddle it, but to go back to your first invocation of fire today, uh, it doesn't look like a wall of fire to which some number of people would be like, okay, I'm, I'm suited up.
I don't know.
I don't know if I can make it, but I know what I have to do.
And this, this feels more like your room 101.
This feels more like customer service hellscape.
Like what?
What even is this?
It's coming from all sides.
I'm in it.
I can't escape.
I can't opt out.
- What do I do? - But that's it.
And I don't know that I can say it, but you've got customer service as the alternative to what might be a wall of fire.
Customer service will always feel safer than confronting the wall of fire.
Always.
There's no minute in any day when the wall of fire seems better.
On the other hand, if you've got a wall of fire, And the idea is, well, I'm just going to resort to talking to customer service, right?
I'll just hang out over here with my customer service buddies.
I'll be right over here in room 101 with customer service.
That is not the solution to your problem, right?
That is delaying confronting the problem because you can't guarantee that there's anything good that comes from confronting it.
On the other hand, you know, we have an opportunity and we are squandering it.
And as much as evolution sets us to a game in which its objective is the persistence of genes into the future, that needn't be our objective, right?
And I'm going to return to this theme at some point in the future, but I do wonder The Chinese, and I don't mean the Chinese lineage, I mean the Chinese government, right?
The governing structure seems to have figured something out, right?
It's very effective, right?
It may have just conquered an important level of weaponry that we're going to struggle to catch up with this hypersonic stuff, among other things, right?
It's figured out a lot.
Is it worth it?
The system doesn't liberate people.
And so the point is, let's say it is stronger, better, less easily distracted.
Better by some objective standards.
Right.
Better by an objective standard that we would all agree is good.
Like, yeah, getting into the future is good.
Maybe it's better at getting into the future, right?
But who wants to go into the future that way?
And that's not the only objective standard by which we should measure the value of our lives.
And in fact, what I'm really arguing, I think, is Given that objective standard, I'll take a subjective standard.
I'll take decent people formulating their own subjective thing and saying, look, I'd rather do something better, aesthetically better, more compassionate, right?
And not be so goddamn effective at getting into the future that we surrender all the special stuff about being a human and we're just some kind of protoplasm that Yes, it's still around in some distant location in, you know.
Yeah.
The next millennium.
Oh, that's good.
I think that was, that's both an excellent place to end and pretty deep and dark.
Just end the podcast.
You're not ending.
No.
Okay.
That's it.
I'm out.
I think maybe people appreciated the brief conversation about sea lions last week.
And as it turns out, you saw evidence that someone had been watching, and no, sorry, that someone had most definitely not been watching, had presumably gotten into their car at the coast, failed to look at their check sea engine light.
Failed to check their no.
I can't even say it.
Failed to look at their check sea lion light.
Perfect.
There it is.
Failed to recognize why they were doing this the entire drive inland from the coast, the Oregon coast, was because there was in fact a sea lion, a pair of sea lions on their hood.
Got to the Willamette, stopped short as I advised.
The sea lions flew off into the water where you apparently saw them.
Yes.
You came home from a walk by the river and said, saw two sea lions, and I still don't believe you.
Yep.
No, I was standing with a couple of friends of ours.
We were talking about the predicament that we, you know, people find ourselves in, you know, in the present and all.
And yeah, I was sort of tracking out of the corner of my eye, something was going on and it didn't… Were they flying at that point?
Were they being launched?
No.
No.
There was something in the water.
I could see the ripples.
It was a large thing.
I felt it must be a paddleboarder or something that I couldn't see somehow.
Oh, great.
Now we look like sea lions to you.
Some more than others.
But yeah, two sea lions swam past, headed up river.
Apparently, in the aftermath of this extraordinary event happening, I did look it up, and it turns out that this is, I don't know if it's an annual occurrence, but it's certainly happened before.
And apparently, they swim up the Willamette, which, you know, we're pretty far inland.
But they swim up the Columbia, presumably, to the Willamette.
They don't take a train.
I mean, unless they happen to be on someone's hood.
But they don't come over land.
Yeah, no, they swim all the way.
But I think they go to the falls in Oregon City.
Oh, yeah.
And they eat steelhead, apparently sturgeon, and lamprey.
No one misses the lamprey.
Not even the lamprey's mothers.
The sturgeon are fascinating, actually.
I saw a dead sturgeon flung up on the rocks over the summer at one point when I was paddle boarding.
A turkey vulture trying to get into it could not.
The turkey vulture could not break into the sturgeon, but they're amazing fish, super ancient, as are lamprey.
And then steelhead.
So you saw a particular sturgeon?
I did.
Not like the Sturgeon General.
No, it was not the Sturgeon General.
No, it was not.
It was the Sturgeon Particular.
Yes.
The steelhead are the anadromous non-salmon, like what?
No, they're salmon.
They're salmon.
Right, but they're oncorhynchus.
They're non-semiparous.
Ah.
They're iteroparous anadromous salmon.
Let's define our terms here.
Oh, of course.
We're going to have to.
So, oncorhynchus.
Let's start with oncorhynchus.
Okay, you start.
You spell it.
It starts with an O, you go on.
So, Oncorhynchus is the genus to which all the Pacific salmon and... It's not really that smart, but... To which all the Pacific salmon, but not the Atlantic salmon, belong, and then there are a few other species too, which we call trout, including steelhead.
So, you know, king salmon, coho, silver, Whatever, chum.
There's one more I can't think of.
And we use the words, so anadromous and then iteroperous and semiperous.
The Pacific salmon are both semiperous and anadromous.
Semiperous, semil, sem means somehow one, and itero is like iterated, means many.
Perous is like mating event or reproductive event.
So species that are semiperous mate once, then die.
Species that are iteroperous mate multiple times.
And the Pacific salmon are semiperous, so they do this famous thing where they're born in freshwater, they go out to sea and spend their adult years at sea, and then begin to change their physiology as they come back to freshwater.
And that move from fresh to salt and back to fresh is the anadromy part.
That's anadromousness.
And then they come back into their natal stream to find mates and then die, and that's the semelparasp part.
But steelhead... So trout are salmonids.
They're in the same clade as the salmon.
As the Pacific salmon, and they're much more closely related to Pacific than Atlantic salmon.
Right.
The trout are the salmonids that are not anadromous, and they are also not semilparous.
Except steelhead, you say.
Except steelhead are the exceptions.
So steelhead, I think because they are iteroparous, that is to say reproduce in multiple years, they go back out to sea and then come inland.
Commuters.
They are Described informally as trout, but they are in fact salmon that break the Semelparis rule.
We can come back another day to my hypothesis for why the Pacific salmon are Semelparis rather than Itteroparis, with the exception of the steelhead, in contrast to the East Coast salmon.
Salmo.
Yeah, Salmo, exactly.
Yeah, let's do that.
If you can bear it.
Let's come back there.
Yeah.
Yeah, let's actually do that next week because we're in that part of the year right now here on the Pacific coast.
I actually don't know what the mating cycle and everything of Salmo is on the Atlantic coast, but Pacific salmon are coming back except for, what is it?
Is it silver that are spring breeders?
But everyone else is returning to their natal homes right about now.
Yeah, we should go check it out.
Yeah.
Okay.
Right now?
Now we got a Q&A to do.
Yes.
All right.
With that, we just keep on going.
We are going to take a 15-minute break, as we tend to do, longer depending on the tech, and then be back with that live Q&A.
You can ask questions at darkhorsesubmissions.com, www.darkhorsesubmissions.com.
Email any logistical questions, but not questions for us to answer in the Q&A, to darkhorsemoderator at gmail dot com.
Again, the open question asking period is right now at my Patreon through midday tomorrow Pacific Time, midday Sunday, October 24th.
And then the monthly private Q&A will be a week from tomorrow.
And seriously consider reading our book.
If you are enjoying the kinds of conversations we're having here, some of it is directly about the stuff that we talk about in the book, but that provides the evolutionary toolkit with which to be able to empower yourself to think through claims being made by officials and authorities and begin to try to figure out whether or not they're making evolutionary sense.
So, anything else to say?
No, I think we're there.
Alright.
Be good to the ones you love, eat good food, and get outside.
