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Critical Thinking in The Age of Censorship Pt. 1
An Introduction to Medical Epistemology
From The Forgotten Side of Medicine Substack, this essay brilliantly details the flaws within our academic institution which have allowed the nonsensical and continually contradictory evidence supporting the COVID-19 industry to remain unchallenged. In my previous articles, I have tried to elucidate how much of the evidence we are working with has been deliberately corrupted and has led to poor medical care for everyone because supports the pharmaceutical industry's greed. Our society not incentivizing critical thinking is something I have struggled against both throughout my medical career and now as I have tried to do my part to stop the COVID-19 train wreck. In the second part of this series, these concepts will then provide a roadmap for seeing through the misinformation behind many of the current COVID-19 debates we are facing.
To my knowledge, two of my articles (the first one I wrote here and one of the most recent) attracted enough attention to be “independently” fact-checked. The most recent one also got enough traffic to prompt Vimeo to deplatform my account and block my access to the videos I spent the last year uploading and will gradually need to re-upload.
I view this as a shame because I had previously endorsed that website since it was the only video-hosting platform that allowed you to embed videos directly into Substack articles and did not arbitrarily delete them (e.g., Youtube frequently pulls videos that I share which had been there for years!), and at present, I do not know of any way to upload videos that will play directly within articles here (thereby saving you time if you wish to view them) that are not also at a high risk of being censored. However, I also view all of this as a very positive sign, as it suggests a lot of people did not want the abridged and much more persuasive rendition of Died Suddenly to attract widespread viewership
Due to the poor quality of their widely promoted work, the last few years have made much of the public disdain the “fact checkers” who rapidly rose from obscurity after they were appointed to spearhead Big Business’ “War on Disinformation,” or censorship of unwanted viewpoints. While many find this scenario immensely irritating, I was slightly more emotionally prepared as I had previously had the opportunity to come to terms with earlier renditions of the industry and eventually learned to view their absurdity as a form of entertainment. In this regard, I best remember Snopes.com and Quackwatch.org, two widely promoted third-party websites aggressively peddling egregious falsehoods that industry and textbooks would often cite to suppress competition, such as natural forms of healing.
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Although I can understand the current frustrations, I also believe that fact-checkers provide a few valuable services. There is a lot of false information on the internet, and if it can be concretely disproven, fact-checkers will not hesitate to do so. For this reason, I typically double-check each claim I make there to see if the fact check shows that there is a real issue with a specific point.
On the flip side, one of the most common “bad” fact checks I have observed is a generally correct story having a few tangential details that can be brought into question. Many (Trump was best known for doing this, and I believe the creators of Died Suddenly utilized this tactic as well) exploit this reflex to bait fact-checkers into debunking those peripheral inconsistencies and thereby promote the original story to the general public (who then focus on the core message rather than on the peripheral details when they see the fact check).
However, there is also a much more important service that fact-checkers provide to the general public: they highlight the gaps in critical thinking that are now widely prevalent in the educational system, and because of how brazenly the fact-checkers do this, they are effectively teaching critical thinking to readers attempting to interpret their nonsensical fact checks. In the past, although I have felt obligated to address my detractors, I have avoided doing so because I do not want to waste my readers’ time on an argument over who is correct. I am making an exception in this series because I believe dissecting these fact-checks offers a significant degree of value to the readers.
Teaching vs. Learning
One of my personal frustrations has been how rare it is to find teachers who actually "teach.” Instead, most of them just authoritatively present information to you again and again, in a manner not that different from throwing spaghetti at the wall and hoping that some of it will eventually stick. What I found the most surprising about this dynamic was that I would frequently see concepts being repeated year after year in the educational process (e.g., college courses covered what I had learned in eighth grade, and every medical board exam I took retested a significant amount of the same content I had already learned for a previous examination).
There are a few interrelated factors that I believe account for this dynamic.
The first one has been a fundamental transformation of education to embrace the lie, best encapsulated by Ivan Illich, that “people must be taught to learn.” This lie has been incredibly destructive to our society because it takes away the intrinsic desire people have to learn (e.g., being forced to read a book makes many students learn to hate reading). Instead, this lie reframes education as a passive process of consuming educational products or services in place of the active process of an intellectually curious individual acquiring knowledge. This is important because humans have an incredible capacity to learn, and the modern educational structure divorces them from it.
The second factor is that very little focus on the passive teaching process goes into aiding learning. Students are expected to learn in this manner, and the failure of the process (which disproportionately affects those less intellectually gifted) is blamed on the student rather than the teacher. This is problematic because it is used to justify the hierarchal stratification our society uses to determine the appropriate social status each person should have.
The third factor is that no institutions exist that effectively teach teachers how to teach. As a result, teachers tend to default to teaching students in the way that worked for them while failing to recognize that they, the teacher, belonged to the small minority who benefitted from that style of education. I would also argue the shortcomings of our culture’s pedagogy are particularly problematic in many advanced areas of medicine or mind-body practices.
I side-stepped most of these issues by utilizing the minimal degree of energy necessary to learn what was tested and then devoting the majority of my focus towards either pondering the material rather than just memorizing it or self-teaching myself information related to the required material I thought was interesting. This approach benefitted me immensely, but it also caused me to heavily neglect certain areas I had been “taught” to never want to learn, which caused me a variety of problems later in life.
From a teaching standpoint, observing all of this has taught me that to teach a complex topic you must do the following:
•Determine each piece that needs to be known, so that a student can piece them together and gain the necessary insight into the complex topic.
•Determine the optimal order for sequencing the information so that each piece can best be learned.
•Identify which pieces are the most likely to be challenging to learn.
•Devise the most effective way to surmount these barriers (e.g., I often utilize metaphors and there are many other viable approaches as well).
•Continually monitor the student to identify when their awareness or ability to integrate the information is waning, and then alter your approach if this occurs (it is sometimes, but rarely productive to continue pushing information into the student at that point).
Unfortunately, it is rare for me to encounter teachers who do most of these things, and one of my challenges here has been to see how effectively my posts here inform my readers as they lack the direct contact and interpersonal exchange that is vital for education.
Commentary from Pierre Kory: I spent years teaching post-graduate fellows critical care medicine and was highly regarded for my teaching methods. The main thing I did differently from my colleagues was to explain my thought process for each patient to my trainees and highlight where I was uncertain, rather than making a few pronouncements about each patient that was expected to be taken as medical gospel. I always thought it was quite strange I was one of the only people who taught in this way, and I found once in training my graduates were much more equipped to handle challenging cases than their colleagues.
Lists, Lists, and More Lists
One of the things people always strive to do to improve an institution or system that fails to live up to its expectations is to create standardized rules the institution is expected to follow, to “optimize” its function. Sometimes these approaches help (for example in medicine there are many checklists we are required to follow that save lives). However, in many other cases, they create a situation where everyone is forced to cater to the lowest common denominator, and the amazing results that talented members of an institution can produce through their creativity are lost.
In the case of education, many different signs have shown that the American educational system has failed abysmally, and as the years go by, it continues to get worse. The response to this problem has been to try and optimize the educational process by standardizing it as much as possible. This is often highly counterproductive because it removes the aspect of the curriculum which allows students to creatively ponder the material and develop their insights toward knowledge.
All of this has converged to create the model we currently follow, where we are trained to memorize lots of lists (that often are put into algorithms) and repeat them back to our examiners. If we can replicate that process (which does not require critical thinking) we are rewarded. But if we attempt to understand the material without following the predefined cognitive "reasoning", we are reprimanded.
For example, one of the challenges I repeatedly encountered in college, both in mathematics and physics, was failing examinations because—while my answer was correct—my methodology for deriving the answer differed from what had been taught, and I had to spend hours explaining my methodology to demonstrate I had not cheated to get those points back.
I discussed this subject at length with my favorite calculus teacher (as he encouraged divergent thinking in class), who also taught at one of the most rigorous universities in the country. He shared with me that he was frequently reprimanded for teaching in the style he did there because most of his students just wanted a formula and algorithm they could copy to arrive at the correct answer.
The most common objection to this style of teaching is that it obliterates the learner’s capacity for critical thinking (since you aren’t thinking, you are just repeating what you were taught). However, I would argue that the more fundamental problem with a list-based algorithmic approach to learning is that it breaks everything into a black-or-white dichotomies, and this makes it impossible to appreciate many of the important nuances that exist in the grey zones (things are often not completely one way or another).
Once you begin perceiving things in a binary manner, it contracts the mind’s ability to expand and recognize complexity, as the thought process is changed from a free-flowing emergence of ideas to a disjointed linear process. Since there are many reasons why this can be problematic, I will only share a few.
Note: A similar argument has also been made that segregating students by age rather than having multiple grades learn together broke the continuity of learning and played a key role in the decline of American education. For these interested, this author has written much more about the many failures of the American educational system.
Shortcomings with Linear Thinking
I personally dislike the linear thinking process because it takes away much of the joy one can experience in the mental realm as it directs your mind to converge on a single point (which is sometimes necessary to do) rather than allowing a divergent thought process that expands the possibilities of your reality. Having observed this phenomenon for decades, I believe for many, convergent thinking is enticing because it creates the illusion the thinker has dominated or mastered the subject (humans like to feel in control) and spares the mental effort that is needed for one’s mind to expand and be at peace with the uncertainty around them.
For years, I frequently debated with the members of the orthodoxy tribe (those who aggressively defend whatever the current status quo is so they can feel secure and intelligent by identifying with the dominant and “smart” tribal ideology). Since I have less time now, I don’t do it as frequently, but throughout this process, I’ve noticed almost nothing has changed.
The orthodox tribe will attack unorthodox viewpoints with remarkably consistent responses. With experience, the algorithm they use can be identified and used to predict how they will respond to commonly held unorthodox positions, and arguments utilized to defend the orthodoxy. In most cases, these people do not recognize that many of their thoughts are not their own, and do not realize the degree to which their thought patterns are predetermined.
This, I believe, is a consequence of the modern educational system, as it conditions that exact type of thinking in its students. I feel this approach is particularly insidious because advanced education is always marketed to the most intelligent members of society as what they are supposed to do with their intelligence. Once these individuals go through the process, the capacity for rapid pre-determined algorithmic thinking is enhanced, while the capacity for other essential types of intelligence (e.g. physical intelligence, emotional intelligence, wisdom, or the ability to recognize the paradigm you are stuck within is dysfunctional and must be discarded) are reciprocally diminished.
These other forms of intelligence are essential (e.g., many smart people lead unhappy and unsuccessful lives because recurring emotional deficits sabotage their lives). As a result, many “smart” people who are simultaneously deficient in these critical areas could easily be characterized as idiots, who in many ways just “don’t get it.” The solution to this issue is to prioritize developing many different types of intelligence (which ultimately is necessary for maximizing traditional intelligence). However, in our culture (unlike many that preceded us), we are trained to primarily value our intellectual intelligence and focus on overdeveloping our strengths rather than our weaknesses (oftentimes the most effective way to further develop your “strength” is to instead focus on your weaknesses).
One of the most interesting studies I came across on intelligence, Cognitive sophistication does not attenuate the bias blind spot, quantified what I had observed throughout my lifetime. Typically, the more intelligent people are, the less they can perceive the totality of an opposing argument, and instead, the more they focus on rapidly looking for weak points in the argument which can be used to debunk and dismiss the opposing viewpoint (likewise educators have remarked that this tendency prevents competitive students from being able to work together as a team).
This form of convergent thinking is effective for asserting intellectual dominance and has led many to believe that “reasoning” evolved for “winning” arguments (hence why so many cognitive blindspots and forms of fallacious thinking have been evolutionarily conserved). Conversely, this type of thinking obstructs one’s ability to see the whole picture or appreciate the value of an opposing argument and to expand one’s knowledge or solve pressing issues that have remained unsolved.
On a human level, this process always makes me sad to observe because it feels as though their mind’s incredible capacity has been squeezed into a tiny box, and few will even recognize that this has happened to them. Sadder still, it takes the vibrancy out of intellectual discourse and transforms debates into a lifeless subject where the only satisfaction which can be gained from engaging in them arises from being “right,” rather than from experiencing the joy one experiences as the mind is opened to a broader paradigm.
Convergent Thinking in Medicine
One of the most common complaints I hear from medical school deans is the lack of critical thinking that has gradually emerged in their applicant pool (which in response I have argued is a reflection of critical thinking not being taught at our universities). This concern arises for the deans because the directors of residency programs (that students enter after medical school) complain that the applicants they see lack the critical thinking necessary for patient care.
Yet, despite recognizing this, those deans always seem to structure medical curriculums that reprimand critical thinking and instead encourage the memorization of lists and the repeated applications of algorithms. Going to medical school is commonly analogized to drinking from a fire hose, and thus, to learn the information required to pass the boards, many other critical aspects of medicine (e.g. developing critical thinking) must be neglected. So while I do not agree with this approach, I sympathize with it, as the deans need to ensure their students perform well on their board examinations (as that is a primary metric each school is judged by).
The result of this educational process is that it leaves the students mentally burned out and averse to learning information beyond what is required to be known. I view that as a shame because I feel that learning the nuances behind each binary concept that is taught, greatly enhances retention and the quality of medical care one can provide in the future.
Once students begin their clinical training, the general expectation is for them to replicate what their training doctor does, rather than critically evaluate the merits of each medical practice (the penalties for failing to model the supervising doctor’s expectations, such as dismissal from medical school, are quite harsh). This in turn leads to a tendency to default to the agreed-upon, highly repetitive, binary clinical algorithms which are practiced throughout the medical field.
Commentary from Pierre Kory: This was one of the most common issues I observed in my ICU fellows (there were adamant in following rote ICU practices rather than developing an individualized plan for each patient) and frequently led to problems I would discover in the morning after I left them with our patients for the overnight shift.
One of the greatest problems with this approach is that it often takes a complex medical process and artificially simplifies it into a dichotomy. For example, when we evaluate the nervous system by evaluating the cranial nerves, a cursory examination is done which leads to each of the 12 nerves being labeled as normal or abnormal, and in most cases, the designation for normal (“grossly intact”) is chosen.
The problem with this approach is that it is extremely common for patients to have subtle deficits in their cranial nerve function, which are often hugely consequential to the patient, but outside of some physicians with specialized training in neurology (e.g., functional neurosurgeons), these deficits are never recognized and instead placed under the highly ambiguous label of “normal”.
I (and other colleagues who treat chronically ill patients with complex neurological conditions the medical system has been unable to address) believe the skills to recognize these more nuanced patient presentations can be taught. However, in most cases, that training is not available. Physicians in practice are burned out from the heavy cognitive load they had to endure during their medical training and because of the excessive workload they experience in practice, do not have the time to look into these approaches. Additionally, they are often invested enough in the value of the world view they worked so hard to earn that they would rather promote it than critically examine its merits.
Many doctors nonetheless recognize the failures of their simplistic paradigm, but this internal dissent is normally stifled by the societal messaging that the orthodox form of medicine represents the pinnacle of medical science. This is a particularly challenging obstacle since it is paired with the viewpoint that nothing else should be considered unless it can be proven by the institution’s own standards (e.g., publication in a top medical journal), which is nearly impossible to achieve without adhering to the prevailing narrative in medicine or having a large degree of pharmaceutical funding, both of which do not lend themselves to supporting unorthodox views which challenge prevailing interests.
Binary Logic
Epistemology (the philosophy of how we know what we know) is one of my favorite subjects and the focus of one of the articles I am drafting. Within the field of epistemology, a debate has always existed as to what the correct approach is for determining truth, as each method we have is imperfect and thus cannot be fully relied upon, and the general consensus is that multiple approaches are necessary for each issue.
One common approach is using logic to discern the truth. The problem with this approach is that almost every single logical system is subjective and inherently excludes certain possibilities from existing (you can make expansive logical frameworks but these are rare). This dovetails with the common issue in medical education: all concepts ultimately being broken down into simple yes or no decision trees and then being logically threaded together to arrive at a “truth.” Put differently, the goal behind many medical "arguments" is not to determine a complex truth, but rather to aggressively assert the validity of the prevailing medical orthodoxy.
For example, consider the long-standing discussion regarding if mRNA vaccines can alter your DNA. For a variety of reasons (detailed here), I was quite concerned that the mRNA vaccines would alter the recipient’s DNA or cause cancer (which has since happened to many people in my circle). Unfortunately, when I investigated this question and reviewed leaked regulatory documents, I discovered that Pfizer had been exempted from the basic tests to establish if genotoxicity occurred, which I took as a tacit admission this was going to be a problem. Were this not the case, the results of testing to prove otherwise would have immediately been disclosed. Since that time, Pfizer’s vaccine has received full approval, and this lack of testing can also be viewed in public regulatory documents:
Genotoxic potential was not assessed, as genotoxicity studies were not considered relevant to this vaccine.
No genotoxicity studies have been provided. This is acceptable as the components of the vaccine formulation are lipids and RNA that are not expected to have genotoxic potential.
Given the carcinogenicity of the mRNA vaccines, that like many, I have witnessed firsthand, I am curious to see how regulatory statements like these will be looked at in the future.
As the vaccines began to enter the market, I began noticing countless media outlets stating that the vaccines could not change your DNA and that anyone who thought so lacked a basic understanding of science. When I looked at the evidence for this claim, I could not help but notice that no direct evidence for it was provided, and rather the basis for the claim was an expert’s authority (e.g., consider these statements by Paul Offit and Anthony Fauci) along with three common logical arguments:
1. The vaccines cannot enter the nucleus of the cell.
2. mRNA from the vaccines breaks down rapidly in the cell, so it does not have time to enter the nucleus and change your DNA.
3. mRNA is not DNA, and hence believing it can change DNA represents a fundamental lack of knowledge of biology.
There were a lot of problems with each of these premises (detailed here). I was thus less than surprised to later learn that researchers had discovered SARS-CoV-2 had “done the impossible” and had been observed to change the DNA of infected patients.
Not long after, when independent researchers finally examined the big question, they discovered that despite all the reassurances to the contrary, the mRNA vaccines did change liver cell DNA within 6 hours of exposure. In parallel, as Arkmedic discussed, another paper discovered that the spike protein was highly genotoxic and did enter the nucleus. As these findings were extremely damning to the NIH, the leadership chose to address this issue by forcing the paper to be retracted for spurious reasons.
This story is important because it illustrates a common problem in medical arguments. Premises that err by oversimplifying a much more complex reality end up being strung together to aggressively assert the orthodoxy’s position and push the opposing viewpoints into submission. I believe that if you design a more humble and open-minded logical system, many of these errors can be avoided, but since that does not happen, the best available option often is to have a way to empirically prove or disprove the conclusion of the argument. For these reasons, I am always suspicious of logical assertions on complex medical topics where easy-to-obtain data that substantiates the assertion is not presented.
There are three areas that these arguments frequently emerge, which I have found to be particularly problematic:
•Refuting the possibility that a medical injury could occur.
•Arguing that an unorthodox treatment cannot work.
•Insisting an illness that cannot be treated with conventional approaches is, in fact, untreatable.
If you consider this question, you too will be able to identify instances where false premises were imposed upon these topics and refute the possibility that any other perspective could be worthy of consideration. Although this may seem cynical, I have seen so many of these arguments emerge from PR firms subcontracted by pharmaceutical companies that I tend to assume obfuscating an inconvenient truth is often their primary purpose.
Rearranging Logical Symbols
Many of the things I do in my medical practice involve making small changes in the body, mind, and spirit of each patient I see (along with sometimes doing that within their social circle). Years of witnessing this process have given me an appreciation for how mutable many aspects of the human experience we view as fixed constants actually are. Similarly, the more I study the nature of reality, the more I come to recognize how many things I had previously held as unquestionable axioms also exhibit this changeability and uncertainty.
When I was much younger, I recognized that most of my peers were searching for something they could latch onto which would give them meaning and a purpose their minds could orient itself around. As I looked more broadly at this question, I realized that most of the options (e.g., hedonism) seemed fairly empty and I decided to have my “purpose” be oriented around understanding the truth of the reality we reside within regardless of where it took me.
One definition of intelligence is “the ability to manipulate logical symbols” so that they arrive at a configuration that is to your advantage, which I believe eloquently summarizes the previously described reason for the evolution of reasoning. As I began to dive further into the question of “What is true?” I began to realize truth was often an illusory concept as so many “truths” could be taken from the same event depending on how one decided to arrange the facts that were present.
Because of this, if one allows their cognitive capacities to focus on rearranging the facts to validate their pre-existing views, significant obstacles are created towards discerning what is true. This isn’t a new problem, but the scale we are encountering this on now is completely unprecedented, as it wastes well over a trillion dollars spent on scientific research each year along with incalculable hours spent on producing and publicizing that research (Malcolm Kendrick provides an excellent overview of this topic which he has termed “Zombie Science”).
One of the most common ways people “win” arguments is by framing the argument by asserting a series of premises on the subject, which logically concludes that the framer was correct. One of the most well-known examples of manipulative framing is opening a dialog with a loaded question like “when did you stop beating your spouse,” as this creates the premise that the other party is an abuser and thus not credible regardless of how they answer the question. However, while this type of blatant framing is easy to recognize, many more subtle examples frequently occur, which ultimately are yet another manifestation of rearranging logical symbols to win rather than discern the truth.
Previously, I devoted a series to addressing my readers who do not believe in the existence of viruses, because I wanted to illustrate a common problem I observed in this area. Much of our society revolves around establishing simplistic truths to explain complex subjects and then conditioning members of society to tightly grasp onto these premises. Since these premises often fail to convey the complexity behind a complex subject, those who hold onto black-and-white simplistic truths cannot appreciate the nuances within the grey zones of any subject.
This ends up being quite problematic because it causes many to vehemently reject important nuanced ideas for violating the simplistic truths they learned (the discussions regarding Brawndo in Idiocracy, for example, illustrate the extreme version of this phenomenon). In the case of the question of whether COVID-19 existed, I realized this was the underlying thread I saw in arguments against its existence (e.g., the government lying about or exaggerating the significance of the virus does not disprove the virus’ existence).
However, while misleading premises and simplistic truths are a problem within every field, what I have seen from the conventional medical community during COVID-19 has been particularly egregious. This is very problematic when there is a high degree of ambiguity on the subject at hand, as this leads to it being very easy to grab onto the premises necessary to defend one’s pre-existing views. In the second half of this series, we will examine how each of the issues outlined here applies to three common areas of contention with the spike protein vaccines and the previously mentioned fact-checks.
Source: Pierre Kory's Medical Musings
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