Saturday, December 21, 2024

Zaretsky and the Cynics

 

Cynicism is the operating mode in my office. Every day people visit with their problems and their hopelessness, asking for help from a system they fully expect will disappoint them.

When I tell them there's a drug prescription I can write which would likely help a lot, but the computer software tells me their insurance won't cover it, they smile bitterly and say, "Yeah, what a surprise."

Zaretsky


Not long ago a man who had type 1 diabetes from age 6 visited. He had over the prior three years achieved not just excellent blood sugar control using a new version of an insulin pump. His HbA1c, the measure of his average blood sugar had not just got to an excellent range, but to a normal range. Of course, we were both delighted. He was healthier than he'd been in years. 

Then his insurance company notified him it would no longer pay for his insulin pump supplies, effectively cutting off this therapy. Why? Well, his HbA1c's had been normal for 3 years so they were not going to pay for normal. As far as the 20 year old clerk in front of his computer in Minnetonka, MN was concerned, this patient was normal, and no amount of appeal helped. We spent 3 hours that day in the office, with my medical assistant progressing on her computer and by phone up the ladders of appeal to no effect. 

"So, my blood cholesterol and my blood thyroid levels and my blood pressure are now normal owing to my cholesterol and thyroid medication and my blood pressure medication. Are they going to stop those medications, too?" he asked me.

"What a surprise that would be," I said.

But that is not that sort of cynicism I worry about.

That sort of cynicism is what Robert Zaretsky describes in the Boston Globe Sunday Ideas section of December 15.  Zaretsky begins with the arresting observation that cynicism afflicts us all, "like an odorless toxic gas."

He then launches into a visit to the original Cynics of ancient Greece.

Diogenes


Now, I have to admit up front, anytime I hear someone jump back to ancient Greece my antennae sizzle and start to combust: Oh, here we go, trying to act all scholarly by referring to Socrates or someone who lived so long ago, surely we have no real idea of what he said, thought or lived, but every Oxford don loves to go there, because it makes them sound, well, you know, scholarly. Hey, this guy can read Greek on tablets--he must know something I don't.

But in Zaretsky's case, he actually makes this all relevant, alive and engaging. 

Diogenes, the original Cynic it turns out, is a guy I recognize. "In their eyes, civility equaled hypocrisy and conventions corrupted our nature."

Oh, that I know from way back. 

My father was like that. 

We lived in Washington, D.C., the ultimate place for parsed speech, for hypocrisy hiding behind every euphemism. Washington, D.C. was then a distinctly un-cosmopolitan, Southern town, where people always began with a "Bless your heart," and lots of Southern blather. "Why, Bless your heart, I understand why you might be upset about my insistence that no Negroes be able to use a Whites Only bathroom, but you know it's only about hygiene and it's best for everyone, the Negroes as much as us."

My father got to the point where he hated the mindless rituals, like saying, "Nice to meet you," or "Thanks for coming by." He just launched into people.

Polite Company


I saw the same thing in European immigrants who flooded suburban Washington after the second world war--they had no time for civility. The former fighter pilot up the street was like that. He had heard the colonel sending him out on another mission say stuff like, "We are all so proud of you," once to often. I can only imagine how he would react to that "Thank you for your service," thing.

But modern cynics, who orbit Mr. Trump do not insist on shoving aside the hypocritical to speak the truth.

"Unlike the modern cynic, the ancient Cynic insisted upon truth-telling. Not to be cruel for the sake of cruelty but to be blunt for the sake of our common humanity," Zaretsky notes. 

My father was a huge embarrassment to my brother and me because whenever we had to go somewhere social with him, he stood out, much as Diogenes, as uncultured, hostile and unsophisticated.

In a social world where people from South Carolina and Georgia, where lynching happened daily and the Whites just smiled politely, there were plenty of hot button issues everyone stayed away from, the third rails prevailed, even at a cocktail party of my mother's friends who taught at the high school where she taught. My curmudgeonly father could start a fight if we weren't minding him, and bottles and furniture might start flying.

Modern Day Cynic at his Lynching Trial


But now, that's what Trumplings want to happen. As if the fight, the provocation were all that mattered. Truth is irrelevant. The 2020 election was stolen; vaccines cause autism; COVID was a Chinese plot; climate change is a Chinese plot; wildfires are caused by Jewish space lasers; separation of church and state is not constitutional--the First Amendment is unconstitutional. Doesn't matter. Truth to power is no longer a thing--it's now the middle finger to power. Truth is irrelevant.

The story of Diogenes sunbathing and Alexander the Great walks up to talk to him and commands, "Make a request!" And Diogenes says, "Move out of my sun," is a splendid parable. "In effect, he reminded the hegemon-to-be that he was nothing more than a man."

I really don't care if this parable reports a real event any more than it matters whether Biblical parables are true. The point is, it is a relevant story for today.  This is why Musk is so topical: He's telling everyone to move out of his sun. He may be a weird reactionary but he's not wrong about everything. As Musk has pointed to a multibillion dollar fighter plane saying that sending up a man in an airplane, when a drone could serve the purpose better, has more to do with getting the pilot laid when he goes to the Tail Hook party later, than with national defense. 

Truth there, even coming from a nasty self serving source.

Zaretsky's article is worth a read. I was a science major in college but I did get to take the occasional non science course, even one in philosophy, but as soon as the professor started talking about how some word or concept actually goes back to the ancients, and all the other dons started smiling because they wanted to believe their mastery of ancient Greek mattered, my mind shut down. Zaretsky makes this stuff modern, makes it live.




My cynical patients,  care nothing for the truth; they just want to burn everything down, and they are as happy to embrace untruth as truth. 

Discovering truth is often a lot of work. 

Vaccines? Oh, horrible, more harm than good, better to have polio and measles abound than to risk a vaccine. 

Yikes. 

I presume Diogenes would not be amused. 


11 comments:

  1. The antithesis of cynicism is gullibility, something that is very evident with those that assail Trump. The gullible argue that of all the places on the earth for COVID to occur it is mere coincidence it was down the block from the Wuhan laboratory that was doing gain of function research on coronavirus. And of course NIH played no role in funding it. The gullible argue that Ukraine can win its war against Russia. That free trade is good for America. That the way to reduce crime is to relax bail requirements. That Trump is evil and the America press beyond reproach and unbiased. Cynicism used to be the hallmark of liberals who uncovered Watergate and the knew that the Vietnam war was a lost and meaningless cause. Now liberals like Mad Dog think cynicism is a negative attribute. It is this great inversion in thinking that hobbles the Democrat party. People should be cynical as they were lied to about Biden being cognitively competent about Trump being evil and going to jail about Harris being as competent as Obama. They were lied to about DOL jobs numbers this year that had a 800K discrepancy. They were lied to by the Federal Reserve who pronounced inflation as transitory. In medicine, people were misled and children endangered by physicians that authoritatively proselytized that all children should avoid peanuts. Mad Dog in his embrace of mindless, feckless credulity is on the wrong side of history and even science and the American people are robustly cynical as they should be- as it is our national strength not a weakness .

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  2. So, Anonymous, let's think about this together.
    1/ You say that I say cynicism is a negative attribute. Yes, I allude to a type of cynicism which is unhelpful, but did you think the insulin pump story was to decry cynicism?
    What did you think I was trying to say with that story?

    2/ You say physicians misled parents by proselytizing that all children should avoid peanuts. That has never been true, although some physicians may have, but, of course, science progresses as new data emerge, and if I'm not completely out of date I think the current trend is toward introducing peanuts early to allow the immune system to tolerate peanuts and not attack them as an invasive protein.

    3/ Ukraine may be unwinnable, but neither you nor I really know all that is in play there; of that much I am sure.
    You have no inside knowledge about Ukraine, and neither do I. You remind me of those guys I knew in college who had the inside dope on why we were really fighting in Vietnam.
    Now, having listened to the Lyndon Johnson tapes on the radio, decades later, I'm pretty sure I have a good idea about that, but none of us could really know that then. Same for Ukraine today.

    4/ You're still on Wuhan but you studiously refuse to answer the question I have put to you: So what?
    So what if Wuhan lab used Tony Fauci money to work on COVID and it got out? So what?

    5/ I am no expert on the Federal Reserve but the one thing I doubt the Fed thinks is that inflation is transitory. Seems to me their scheduled meetings are all about keeping up with inflation's rises and falls along with those unemployment graphs.
    6/ You never address the litany of assertions about wildfires and Jewish space lasers, vaccines causing autism.
    I agree, the right kind of cynicism is, or could be a national strength. But uninformed cynicism is not really cynicism, and that's what the good professor was saying. That insulin pump patient knew the truth: type 1 diabetes is not curable. It is manageable, if you are lucky, but all the insurance company was concerned about was getting off the hook for paying for his care. He was cynical about that, justifiably.

    FINALLY:
    Try actually responding to the points made, understanding what they mean rather than spinning off into your rants about the Wuhan lab being funded by NIH, as if that would have been a bad thing if it ever happened.
    (Listening to TWiV I think they said early on that Fauci and everyone at NIH said they had sent grants to Wuhan because China and the wet markets were where they expected the next spillover to occur, and so that's where you want the research to be done.)
    In fact, have you ever actually dialed into those old 2020-2022 TWiV podcasts? It's hard work listening to these guys, but fun and once you do the hard work and arrive at what you think may be the truth, then you have a right to be cynical.

    Until then, you're just some guy ranting about half truths he thinks make him an authority, using language like "gain of function" as if that makes you an expert. Clearly, you are no expert about gain of function or anything else in virology.

    Mad Dog

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  3. " It wasn’t until 2008, when Lack and his colleagues published a study showing that babies who ate peanuts were less likely to have allergies, that the AAP issued a report, acknowledging there was a “lack of evidence” for its advice regarding pregnant women.

    But it stopped short of telling parents to feed babies peanuts as a means of prevention. Finally, in 2017, following yet another definitive study by Lack, the AAP fully reversed its early position, now telling parents to feed their children peanuts early.

    But by then, thousands of parents who conscientiously did what medical authorities told them to do had effectively given their children peanut allergies."

    And by the way, yes the elite and highly educated Federal Reserve initially and formally deemed Post-COVID inflation as "transitory." The same Federal Reserve intelligentsia that in 2008 bailed out the banking industry, exculpated their actions, and through misguided governmental intervention maintained their opulent lifestyle while most American suffered through the financial collapse.

    What you repeatedly fail to concede is that highly educated elites refuse to admit their own self-serving fallibility and recklessness. They believe the war in Ukraine is winnable and it is not a defense to say, you don't know about warfare, there is common logic and the history of military combat that should inform your view. Maybe you should read up on WWI or Kennedy's caution in the Cuban missile crisis so as to not provoke a nuclear confrontation with then USSR.

    The presumption of professional competence when records and facts demonstrate the exact opposite is why the Democrats are failing to serve the American people and why people should be cynical.

    After all, as you cite, "The trouble with life is the stupid are cocksure and the intelligent full of doubt." --Bertrand Russell

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  4. And you still have not answered the So What? question about Wuhan.
    Why are you avoiding that one?

    But the peanut story is something I did not know about--I'm not sure until I read more about it in Google Scholar that I do know more about it from your rendition, but I'll check it out. It does have the ring of the plausible: pediatrics always was a study free zone, obstetrics, too--and a lot of old wives' tales because it's so hard to organize studies of these populations.

    But, to your point, when I went to our medical school reunion I wound up saying to my old classmates, "You know, at least 50% of what they taught us in medical school turned out to be wrong. Likely a lot more, maybe 80%," and to my surprise, everyone around the table laughed and nodded and said, "True that."
    And those professors were pretty intimidating and authoritative as they intoned their solemn pronouncements about things. Never in doubt, frequently wrong.

    I think what you seem to miss is that, at least in science, anyone who is any good freely admits we always live with uncertainty in medicine and we just act on what we currently think is true, but we are not wedded to it.

    Fauci freely admits when COVID began it made no sense to him that masks would be at all useful because to a virus the pores in masks look like the Holland Tunnel, but when studies got done, it turned out masks screened out droplets and that did mean they offered significant protection. And Fauci said, "Yup I was wrong about that. We are learning every month and we are operating in a data free zone."
    But of course, the entire QAnon i verse jumped all over him, "See! He flip flops! He doesn't know anything!"
    Of course, flip flopping is what science demands.

    And the TWiV guys said the same thing. "Hey," Rich Condit said, "We are telling you what the latest study says, but two months from now, there may be a new study saying just the opposite. That's science. So stay tuned. We are only just at the beginning of this thing."

    Real scientists and the best doctors are humble. They know they have only tentative answers about a lot of stuff.

    There's a great youtube with Paul Offit talking about the polio vaccines you would like. I had forgotten about the Salk "dead virus" vaccine vs the Salk live virus vaccine--TWiV covered that , too, but long ago, and this recent youtube revived it. But it's another one of those tales which is instructive about how we do the best we can, and sometimes succeed but then sometimes screw up a good thing.

    It's an hour long and I'm only half way through it, but the same guy who interviews him (Dr. Mike) did a history of polio vaccine which is really well done and worth watching. I suspect you'd like that one.

    This is not exactly a link, but you can cut and paste it into the youtube search thing.

    https://www.youtube.com/watch?v=A27ameSqcQs&t=1801s

    You do seem to have a certain modicum of curiosity. This might count as "doing my own research."

    Oh, here is the Dr Mike thing on the history of the polio vaccine. It is very well done and it is pretty much confirmed by the TWiV guys.

    https://www.youtube.com/watch?v=c-e6bjV-Wl4

    If you watch it before the Offit thing, you'll understand the allusions they make to the Cutter episode, which was a screw up by one company making a batch of vaccine they failed to "kill" completely and polio resulted in some of the recipients. But the ultimate fall out of that was exactly the wrong answer.
    Fascinating history from a medical, social and political standpoint. Bill Clinton, of all people, actually listened to the elderly Jonas Salk, and issued the corrective which finally resolved the problem and got the US back to the right polio vaccine.

    Mad Dog

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  5. That should be the Salk inactivated virus vs the Sabin live virus.

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  6. Mad Dog you ask: 4/ You're still on Wuhan but you studiously refuse to answer the question I have put to you: So what?
    So what if Wuhan lab used Tony Fauci money to work on COVID and it got out?

    Mad Dog is audacious to ask, "So what?" - I am confounded by your cavalier attitude on potential negligent responsibility for the loss of more than a million American Lives and other millions around the world. How callous can you be in seeking to protect the elite?

    This is the May 2024 finding of the United States Congress, that I trust under President Trump will find the truth to these vexing facts and, with a zealous AG, hold those who may be criminally responsible into the courts of justice in the United States.

    Key Hearing Takeaways:

    NIH Deputy Director and former Acting NIH Director, Dr. Lawrence Tabak, acknowledged that NIH funded gain-of-function research in Wuhan, China.

    Dr. Lawrence Tabak repeatedly refuted EcoHealth Alliance President Dr. Peter Daszak’s public and private testimonies. It is now clear that Dr. Daszak misled both the Select Subcommittee and the NIH on numerous occasions.

    Serious shortcomings and failures in the NIH’s grant awarding and grant oversight procedures enabled EcoHealth to facilitate gain-of-function research in Wuhan, China. These NIH deficiencies were exploited by Dr. Daszak and his team in an effort to avoid oversight and maintain funding.

    The U.S. Department of Health and Human Services’ (HHS) decision to immediately suspend funding and commence debarment proceedings against EcoHealth is backed by substantial evidence and necessary to protect America’s national security. The Select Subcommittee also recommends that HHS immediately begin debarment proceedings against Dr. Peter Daszak personally.
    The NIH often lacks the necessary subject matter and scientific expertise to ensure U.S. taxpayer funds are spent and overseen safely. Dr. Tabak testified to these gaps in NIH’s system today, and former NIH Director Dr. Francis Collins recounted similar problems during his transcribed interview found here.

    The Select Subcommittee’s investigation into EcoHealth’s impropriety is far from over. Chairman Wenstrup appreciates Dr. Tabak’s honesty today and intends to use his testimony to hold EcoHealth accountable for its facilitation of gain-of-function research and its blatant contempt for the American taxpayer.


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  7. Oh, so the COVID pandemic was really a conspiracy?
    The NIH should fund research to prevent disease which might come to America and harm American public health. That means we should fund virus research in China, where these virus spill over into wet markets, and in Africa where Ebola lives and malaria still kills.
    None of the stuff you cite shows that NIH grants to Wuhan or anywhere else caused mischief.
    Try getting off QAnon and start watching TWiV or Paul Offit. Try hearing the other side. You might disagree. You may be unconvinced, but real insight begins with questioning your own beliefs.

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  8. And BTW, you know freedom of speech is a basic right in America--you can publish any book and when you testify before Congress you may be sworn in but you can say whatever you think is true and the sources testifying at Congressional committees are chosen by each side of the aisle to support what each wants to say. So no, the sources you cite in the testimony are far from unimpeachable and are, for the most part simply dead wrong.
    Listen to better sources of information. Expand your horizon.
    It can be unsettling and scary to put yourself into a position where you may have to change your mind and say, "Hmm, might have been wrong about that one, but it can be liberating."
    Thank God for the first Amendment.
    Mad Dog

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  9. If millions died because scientific research went astray through negligence, or rogue through willful evasion or defiance, it can and should be investigated and prosecuted. Having an MD or PhD after your name is not license to commit mass murder. Only Mengle may agree with you in that thinking. Perhaps instead of touting some bizarre podcast Mad Dog, or naively dismissing real concerns as QANon conspiracy you should peruse the writings of experts in the field. The following can be found on the web, and I previously shared excerpts of it:

    A call for an independent inquiry into the origin of the SARS-CoV-2 virus
    Neil L. Harrison nh2298@columbia.edu and Jeffrey D. Sachs sachs@ei.columbia.eduAuthors Info & Affiliations
    May 19, 2022
    119 (21) e2202769119
    https://doi.org/10.1073/pnas.22027691

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  10. Hard to disagree with MD or PhD is not a license to murder.
    TWiV is hardly a bizarre podcast. Clearly, you have not listened to it.

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  11. OBTW: Harrison is not a virologist and Sachs is something else entirely. Having the name Columbia University behind yours does not make you an expert.

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