I am going to post a wonderful comment I received from a reader of my blogs at the bottom of this posting which sums up my feeling about the patient physician relationship. But first, in honor of superhero movies in the zeitgeist, I am going to conjure up a blog based on the old Superman TV series opening catchphrase: “truth, justice, and the American Way.” I will argue that each of these builds upon the former and increases in difficulty and diversity of meaning.
What is Truth: let’s riff of a metaphor that came to me while visiting Ithaca and remembering the Odyssey in last week’s blog about why we need doctors.
a professional [doctor] steers us clear of the rocks where the Scylla of “unknown unknowns” and Charybdis of “things that we are sure of (but that are wrong)” lurk.
In biostatistics, there is a concept called Type 1 and Type 2 error. It can be visually represented by this 2×2 grid:
The six headed Scyla of “unknown unknowns” is the kind of false negative Type 2 error of that a brute force AI like Alexa or Watson makes. It assumes everything outside it’s model is false (the safest assumption) and deigns to tell you what you mean to spell and buy. It is fascist and dehumanizing.
The whirlpool Charybdis of “things I think are true that are false” is the kind of false positive Type 1 error that a clever, learning artificial general intelligence would make. The trouble with natural language learning machines is that they believe whatever you tell them and as I explain in this blog, that is perhaps even more dangerous because we can create monstrous delusions in them, just as xenophobic and overzealous parents have done for generations.
So how to we ascertain the truth? The laziest and least trustworthy is the sourcing heuristic as I blogged about here. Consider the source; trust accordingly. For those inclined to believe the corporate media despite their clear abandonment of objectivity, accountability, and truth telling, you are headed for a disappointment. But when seeking medical care, the same applies. Don’t assume your doctor or public health official is telling you the truth when he could lose money, time, and his license for doing so. Just look at the removal of medical exemptions in the California senate bill 276.
They say the way humans automatically read people is through body language, then voice intonation, and least importantly the actual word meanings. But just because a person acts like they are telling the truth, that doesn’t mean they intentionally faking it or just someone who is wrong and believes what they are saying (the Type I error, false positive, GIGO (garbage in-garbage out general intelligence mistake.)
So what is the most reliable and efficient way to get at the truth? Intuition! Intuition synthesizes everything: knowledge, logic, observation, experience, sourcing heuristics, and even telepathic transmission through the “100th monkey” timeless ether to discern truth. The reason I wrote The Telomere Miracle was to arm you with logic so that you can begin to observe and experience your own intuition and better lifestyle practices
A Question of Justice: According to Merriam-Webster online, a minor definition of justice is actually a synonym for truth : conformity to truth, fact, or reason : CORRECTNESS // “admitted that there was much justice in these observations”.
Unfortunately (or fortunately) justice in its application is often tainted by empathy as I explained in this blog about the eternal psychopath in all of us. It has never and can never be applied with equality because people are inherently biased by their unconscious identifications with or against the accused. Cops and doctors (from personal experience) often get a pass with traffic violations whereas young men with neck tattoos and attitudes probably don’t. One exception that proves the rule is the recent dropping of charges without a plea against alleged hate crime hoaxer Jussie Smollet.
This segues well into the final element of the Superman credo: the American Way.
The American Way: exceptionalism or enslavement?
“I choose to believe”- is the start of all things American. Was America Great? Or was it always unjust? Let’s choose a non-binary belief as I discussed in this blog.
On the one hand America has, by virtue of its Constitution and checks and balances, been a ever more successful experiment in liberty, opportunity, economic growth, and political dominance for nearly two and half centuries. The best and the brightest have waited years to come to our country to pursue their dreams in a pluralistic, tolerant, and socially mobile land of abundance.
On the other hand, America has waged non-stop genocide against its native peoples, enslaved people based on a visual false racial dogma, treated most non-Anglo/Germanic nationalities like chattle, and excluded Asians for nearly 100 years.
You reply that surely the America we love halted the fascist rise of Imperial Japan and Nazi Germany and quite rightly, those countries have choked on generations of shame built around their narratives of militarism, war crimes, and depravity.
But has the American foreign policy, brought forth in yesterday’s Bay of Pigs reboot in Venezuela, been such a stark contrast to the crimes of our WWII Axis rivals? Which country dropped two nukes and deindustrialized and then reindustrialized our foes for profit?
The American way is summed up by this Matrix-like idea: “I choose to believe that we are the good guys; we are exceptional not by virtue of equally applied justice or the weight of facts. We are the good guys because enough of us believe it is axiomatic.”
So what if Turks slaughtered Armenians, Huti killed Tutsi, and Khmer killed intellectuals? Somehow the only crimes we want to discuss are the ones of vanquished American foes from a war 80 years ago; we can topple regimes and commit war crimes and those people like Elliot Abrams and Colin Powell don’t face a Nuremberg tribunal but are instead celebrated despite their willful deception of a populace that has no interest in either truth nor justice equally applied. When was the last time you heard of an American person advocating for reparation for war crimes against Iraqis? I’ll wait. Oh, perhaps you can ask Chelsea (formerly Bradley) Manning who was recently thrown back into jail after being pardoned for not bearing state’s (and probably false) witness against Julian Assange.
Is America great? It is certainly one of the best of the worst. If you want to know what happens when power is concentrated in the hands of a few, go to Freshman orientation week for congressmen or Pitcairn Island, the place where the descendants of the HMS Bounty mutineers landed. Power corrupts and with the aid of the sycophant media and crony judicial classes, there can be no truth and no justice upon which to create a robust national ethos.
These days, superhero movies pull in billions of dollars. I wrote about the fact that zombie movies have a meta theme of our own dehumanization and that superhero movies speak to our desire for moral exceptionalism in the wake of out rather unjust and non-fact based interventions in the Middle East and elsewhere.
The irony is that the ubermensche (overman or Superman) concept of Nietzsche was not of a man becoming a god but rather become a fully actualized human. Just as the Type II fascist AI SKYNET doesn’t know what you mean to type or how to live in human laughter, ambiguity, and joy, the Type I untermensche (lower or herd man) American goes to the movie theaters and believes that we are great because few people dare to speak the truth about our lack of justice. Children and artificial general intelligence are gullible and lacking in wisdom and moral skepticism and are therefore a natural dipole to the coming AI overlord.
What is the essence of the American way? What true core of the American greatness? Ensconced in the Constitution are the Masonic values of universal truth and enlightenment. This means life, liberty, and the pursuit of happiness. This means deep distrust of the overreaching levers of government itself. This means that all people are created equal. This means that there is divinity and that we are created in that image even though we don’t need to agree on the alleged facts or details of how to call that divinity. They never believed in utopia or perfect. How can something be oxymoronically “more perfect”? It must mean that perfection exists only when there is constant struggle and not the abolition of dissent and the creation of a universal groupthink promulgated by coastal elites through their cultural wars of hegemony.
It might surprise you to know to be an American is the opposite of what liberals currently hold as desirable. They believe that America is a cog in an inexorable march towards sameness enforced by a global elite. They want to abolish the electoral college and mistrust the legitimate stakeholders turning all classes, genders, orientations, races, and religions against each other with reparations, recriminations, division, and acrimony. Some want to lower the voting age to 16, ban older citizens from voting, and permit non-legal immigrants to vote. What point is there to being a citizen of majority age if you are extending the right to young, denying the wise, and allowing non-citizens to determine politics?
In the end, I leave you with this Nietzche quote about what makes for a truly great American; he or she is a superman and an enemy of the fascist untermensche who will always aspire to be
“a smaller, almost ridiculous type, a herd animal, something eager to please, sickly, and mediocre.” (Beyond Good and Evil)
How can I proceed with exosome treatment knowing full well that it is not FDA approved, outside of standard of care, and could end up getting me in trouble if there are bad outcomes in people that very sick and struggling at the end stages of their lives? It is because I respect your liberty to decide according to your intuition, a sourcing heuristic of someone who actually takes the therapies themselves, and the science and anecdotes that I share. I may not feel totally free to tell you what I believe about certain anti-aging ideas I don’t believe in (because I have relationships the promulgators) and it may be unjust that only the wealthy can benefit. But it is the American way to engage you as a partner and disclose as much as I can so that you can decide based on my language, tone, and body language. My patients tend to be engineers and free thinkers, and that is just fine with me. As promised, here is the comment from my reader, Joe, who eloquently sums up the “more perfect union” ethics between doctor and patient that we should strive for:
We can’t help but be biased. We all are human. I honestly can’t trust a doctor to ‘make me healthy’ because standard of care is, it seems, hopelessly flawed. I have to look into things myself. I am responsible for my health. I am the one who either benefits from an intervention, or suffers the consequences. When I see a doctor, I need a conversation. I have questions. He/she may or may not have valuable information, or a sound, well thought out opinion. Often, the doctor had nothing but boilerplate recommendation. I’ve run into more than my fair share of arrogance. Of all the professions one may choose, the one where people literally put their lives in your hands requires, by far, the most humility. It’s not a job. It is a daunting commitment that never ends. Even after you retire, people will come to you for advice. If you live long enough, you will lose every patient you have ever seen. Something kills us all. So, what is your job? It is different with each patient you see. What is his/her objective? Long life? Quality of life? Vanity? Your job is not to write a prescription. It’s to help your patient navigate life. Find the answers, to the best of your ability, to your patients questions. Obviously, you do that. You have integrity. You are biased by that integrity. As a patient, I can tell you that countless doctors don’t. Boilerplate arrogance runs rampant. As a patient, I am biased by my experiences. I can’t appreciate all the headaches that must come from dealing with insurance, standard of care requirements, workload, etc. As a patient, I have no choice but to research the hell out of any condition that I have to face. The ‘system’ is hopelessly broken, because it wasn’t supposed to be a system in the first place. It was meant to be a relationship. Just like any relationship, the respect must go both ways.