Feb 18, 2019
Thank you to anyone taking the time to read this. The discussion this week may not be comfortable, but I do consider it necessary for a healthy society. We talked about Negan, quite the character from The Walking Dead. He's crass, brutal, and somehow charming. If you've read the comic or seen the show, that much is obvious. However, Negan's style is not as outlandish as you think. From where I sit, I've noticed that we as a community have learned to use Negan's communication style a bit too often. No, not the violence, or even the profanity. I'm talking about ad hominem attacks. The idea that in order to prove a position, you have to prove that the person is flawed. Well, surprise, we're all flawed! That doesn't challenge the content of a debate. Somehow, social media points are not worthy of reading if they don't have an exasperated face, split-second screencap, or other sarcastic photo to drive the so-called point home. The other person is not only an opponent; they are THE ENEMY. They are dangerous, stupid, weak, and easily manipulated. But you, oh no, not you. You are smart, resolute, compassionate, and steel-willed!
Really? That's the best discourse we can do? Here, let me stop with generalities. I'll use an example that loosely ties in with The Walking Dead, and how easily we fall into Negan territory: vaccinations.
First off...wait, don't go! I swear this is valuable, if you give it a chance. I'm not going to be devil's advocate here, I'll tell you my actual view: vaccinations are an important component of modern medical practice, because germ theory has proven to be a vital component of our scientific knowledge, both in confirmation of prior experiences, and re-confirmation of current events. I am aware that this position is questioned on a regular basis; my concern is that any alternative has yet to produce a more positive outcome, even if the risks are considered valid and substantial, which they may not be.
What did I do there? I pointed out my position. I stated the reason I hold that position. I alluded to one or more alternative views. I discussed why I maintain my position even in the absence on details for or against that stance, along with a willingness to listen to other stances should appropriate evidence be presented, and that so far, I have not found anything that has met that standard. What do I usually read or hear? Anti-Vaxxers are absolute idiots and they're going to get their kids killed. Tell that to someone who is questioning the necessity of vaccines, and see how quickly they tune you out. Yet, that is the chosen tactic of the scientific community. I understand the frustration, but that does little to benefit society as a whole. Education inherently has a persuasive component, and the voice of authority comes through with minors. It usually does NOT come through with adults. I am looking to give an adult the opportunity to question me at every single turn. If I can't answer something, then I've gasp discovered that I need to learn more about my position. That is not a bug; that's a feature!
Let's continue with this vaccine discussion, both from a real life standpoint (measles, anyone?) and The Walking Dead (some sort of “turning” phenomenon). Rip my stance line by line.
Vaccinations are an important component of modern medical practice
Are they? Well, considering the mandates, someone considers them important. Physicians talk about it, parents talk about it, politicians talk about it. The number of physicians aware of the practice is (as far as I know) 100%. The number physicians opposing it is incredibly low. Why is that? Maybe they're paid off by Big Pharma...except if that were the case then why not advocate for the same process for bacterial infections? Or vice versa, whichever would generate more revenue? Businesses in general don't split massive profits unless they have to; they'd find the most profitable and run it into the ground. I find that doubtful as an alternative. I'm aware of the experiment of Louis Pasteur, and that information has been readily accessible for decades. I can find the escalation of vaccine use for multiple diseases, and the decline in those diseases. I'm aware of the harsh initial technique which would look barbaric today (inoculating a cut), but the fact that the style has been changed to sterile technique also supports what society has come to expect. In other words, as other aspects of medical have changed, the process of vaccinations have changed accordingly.
because germ theory has proven to be a vital component of our scientific knowledge
Is this still true? I have not heard of anyone espousing transmogrification (the idea that living creatures spontaneously generate a la carte from nonliving material) in centuries. We are aware that certain infections can lead to other physical consequences besides the immune response (the part where we feel crummy for a while then hopefully recover), but is that to be feared? We are aware of those who do not have such defenses or they are severely weakened. There are those whose immune systems are haywire and view random things as an enemy. How do those people respond to microscopic matter. Heck, how did people even conceptualize this BEFORE we knew there was microscopic matter? Also, is it accurate that this material can be transferred from one host organism to another? How? Touch, the air, a common external source, a vector...a combination of these? Actually, some of these things may be us already! What do we do about it?
both in confirmation of prior experiences, and re-confirmation of current events
I can look up prior descriptions of a disease during a time they were considered prominent. I can compare those descriptions to the current descriptions of an uncommon disease now. Should I consider that these may be separate incidents with no overlap? Do the proposed confluence of events match the most likely outcome now as they did then? Correlation does not equal causality. However, correlation in concordance with directly observable events, a reasoned theory, an attempt to validate this through experimentation, and the ability to reproduce those results, that's truly powerful. Magnitude matters for this as well. I'm not so naive as to think that external factors will overrule my personal anecdote, but I must simultaneously admit that I may be ignoring the equivalent of thousands...even millions of anecdotes that are in direct contrast to mine!
I am aware that this position is questioned on a regular basis
There is nothing inherently positive or negative about this. I attribute this to a combination of nostalgia bias and recency bias. What happened in the past was the best it's ever been. Even if it was bad, it's a story to reminisce about. What has happened most recently is the most important. Add those together, and I can understand the conclusion of some prominent people who state that people should get measles naturally because they survived, and they felt the need to use Twitter as a platform to comment on a measles outbreak in a section of a state that has a lower vaccination rate.
my concern is that any alternative has yet to produce a more positive outcome
I know the supposed reason to get vaccinated; to make sure the person doesn't get the full-borne disease which has had documented large negative consequences on the health of society including an increase in deaths. The other side is...this is where the next point comes in, I know. However, let's stick to the original premise. We want to avoid disease, right? Eating healthy, exercising, and maintaining good self care along with strong personal relationships remain the mainstay of our populous. None of those things, to my knowledge, eliminate infection. I'm not saying they have no effect! I'm saying that I am not aware of something that is reproducible in a large enough group of people (more than “one anecdote per one antidote”) that it can be administered systematically enough to “move the needle.” (See what I did there? That last comment wasn't a strength to my argument, just a cheap quip. Sorry, I'm sure other weasel tactics are there; I am who I am).
even if the risks are considered valid and substantial, which they may not be.
Oh goodie, we finally get to the loudest argument I've personally heard...vaccines and Autism. I promise not to brow beat with Lucille. I'll take the worst case scenario and say that there is a nonzero correlation and that early multi-dose vaccination is associated with a higher risk of Autism. I'm also aware of the longstanding higher correlation of the physical and neurological sequelae of the common viral diseases pre-vaccination...including death. Unless I am mistaken, I'm not aware of Autism itself as a diagnosis leading to those same consequences on a consistent basis. In fact, I am aware of several examples (from personal anecdotes to larger studies, but if there's one thing that changes minds it's the theatrical anecdote so we have those too) where society has consistently proven that Autism spectrum is not a diagnosis to be shunned, and people with that diagnosis are able to contribute to society. From what I've read, there is concern that vaccination as a choice itself is an assault on individual rights. But parents in theory would also have the individual right to starve a child (a known harm); that is the same argument taken to the extreme so a good action is done with malice; thankfully I DON'T think that premise is present in this discussion. I'd also like to point out that the argument has evolved through the last century. Initially, the fear was that vaccines kill more people than they save; is this still a thought? If so, I'd be intrigued because the census continued to increase globally into the billions and they failed (whoever “they” are). At some point, people had chicken pox parties because (and I was in this camp) it's better for a younger person to get the disease than when they are older. The nuanced premise of that logic has been lost; it is better to get a disease when you are in a stronger condition and have a higher chance to recover, than to be older and/or compromised and have a higher chance to die. That sounds like a prior iteration of society trying to cope with lack of a resource that is now available.
I'll admit, I may be naive, and indoctrinated with years of required studying these particular topics as part of my livelihood, and exposes me to a certain set of biases, but I also would point to that same exposure allowing me the opportunity to debunk every level of discussion up to this point. Can you imagine the monetary gain I could garner as a maverick psychiatrist who has stood up to the powers that be on the dangers of vaccination?
I hope I have given you some ideas to ponder on this topic, including your own debate technique for other topics as well. If not, then I can always fall back to pelting you with expletives and threatening to bash your skull in with a barbed wire bat.
It worked for Negan, right?