Here’s a reminder to myself: learning is always uncomfortable.
As I was reading through Seth Godin’s latest book, The Practice, I came across this gem of insight.
It is often the discomfort and tension that causes me to avoid learning new things and settling into my work. When I feel the anxiety rise, I’ll switch gears to something more comfortable or distracting. Instead, I need to embrace the suck.
Learning is voluntary – I must want to engage with it.
Learning creates tension – personal discovery in unfamiliar territory creates questions of tension, and each answer I find resolves the tension. Tension and release.
Learning is uncomfortable – it’s hard to willingly feel incompetent when our careers are geared towards increasing competence and confidence.
I need to learn that when I feel uncomfortable in the learning process, this means I’m on the right track and should embrace the feeling.
According to Seth Godin, there is no such thing as writer’s block. He’s been on my mind recently, not just because I listen to his regular podcast, but also because he’s doing the book marketing circuit on the podcast shows I typically listen to. As of writing (November 3rd), his latest book was just delivered to my door.
From what I understand, Seth’s belief is that writer’s block is a function of our desire to not ship bad work. Instead, we hold out until a good idea arrives and we work on it. His advice to overcome “writer’s block” is to constantly write regardless of how bad you think it is. It’s a bit of a spaghetti approach – you throw as much at the wall and see what sticks. He maintains that buried under all the bad writing, there is bound to be some good stuff. The job of writing bad stuff is to eventually unearth the good stuff for you to work on and polish to completion.
Seth is known for having posted on his blog every day for over a decade, tallying over 7000 posts. He says that for every post we read, there are up to 8 that didn’t get published.
I had a realization recently: I don’t think I’ve gone camping in the last thirteen years. That might not seem like much, but when I reflect on my childhood, it was full of camping. I was in Beavers, Cubs, Scouts, Army Cadets, and the Duke of Edinburgh program. My mom also used to take my sister and I camping during the summers. If I entered Beavers at 5, and my last outdoor adventure was my trip to Kenya in 2007, then I had an almost uninterrupted period of camping that spanned 16 years. At 33 now, I have only recently crossed the threshold for more years of my life not camping than all the years I spent in youth programs.
Camping was easy when I was in youth programs – so long as you participated, it was almost a default activity. But once I left for post-secondary schooling, it fell by the wayside. Camping didn’t seem very accessible to me – I didn’t have money to spend on equipment or transportation, and I chose to spend my leisure time occupied with other things. Soon, a year became two, then five, and now more than a decade has passed.
It’s not that I haven’t thought about this. A few years back, I decided to become a paying member of the Bruce Trail with the aim to avail myself of the various sections of trail nearby (admittedly, I haven’t done it yet…) My hike along the Path of the Gods route in Italy back in October was my most recent attempt to embrace activity in nature. It was a hard route for me and finishing it left me with an amazing sense of accomplishment.
Since then, I’ve been mulling it over in the back of my mind. The pandemic has both prevented me from attempting camping this year and gave me additional time to think about being more intentional with reconnecting with the outdoors.
One of the problems, I realized, is that my idea of camping is a little skewed. Since camping in my childhood was bound up in intensive adventures, hiking and camping has been intertwined in my mind with multiple days away in the woods – several night-stays while travelling a few dozen kilometres a day, sometimes while hiking in mountainous terrain far from civilization. In this way, camping requires planning, specialized equipment, and lots of experience or paid guides. In other words, camping and hiking requires a lot of time and money.
But recently, I’ve been rethinking of camping in a new light. Thanks to the magic of YouTube’s algorithm, I stumbled across Steve Wallis’s channel through his video Highway Rest Area Stealth Camping. I’ve since gone down a deep rabbit hole of his content. In short, he’s a guy out of Alberta who likes to stealth camp (short term, low impact camping, sometimes in areas where you aren’t allowed to camp). He will go out for a night, set up a hammock somewhere, and vlog the experience. He buys cost-effective gear from Canadian Tire and insists that camping shouldn’t be complicated or about expensive gear. I realized in watching his vlogs that he’s right: camping and hiking isn’t about long, expensive trips, and it doesn’t have to be an onerous undertaking.
I’ve since started looking at what kinds of opportunities I can avail myself nearby. I’ve dug out my old camping gear to see what I’ve got in storage. I ordered an inexpensive hammock online (since I don’t own a tent) and plan to try camping in my backyard for the fun of it. I’ve also started looking at the trails nearby and got out this weekend with the dog. It was a quick jaunt near a river that took an hour and was a short drive from my house. It was a lot of fun, and I felt great afterwards.
All of this has taught me three things: first, if I want to find the time to have adventures, I have to make the time. Second, camping and hiking aren’t the purview of the elite outdoors people, but should be enjoyed by anyone who wants it. Third, I should have the courage to try things out solo. It was easy when I was young and under the guidance of adults. Now that I’m an adult myself, I can’t wait around for someone to take my hand. I have to learn to rely on myself, and trust that I can do it.
Post-script – I wanted to title this post The Accessible Outdoors, but I didn’t want to confuse the topic. I’m not talking about accessibility in the sense of barriers to people’s ability to physically enjoy the outdoors. Sadly, as I write this, I remember reading a piece online about efforts of people to make camping and hiking more accessible to persons with disabilities and persons of colour, but I can’t find the article at this time.
As with many other people right now, I have chosen to go back and re-watch favourite television shows. I decided that with Star Trek: Picard’s recent release, it would be a great time to go back to the beginning (of the modern era, anyway) and revisit Star Trek: The Next Generation. I had probably watched every episode in my teen years, but I had always watched it in syndication, so this is my first time going through the show in order.
Approaching the series in my 30’s has been a real treat. I have more life and cultural experience to draw upon as I watch these incredibly written episodes play out. I knew the show was amazing, but I never appreciated how well it engages with moral issues.
I want to highlight one excellent episode from the third season – episode 7, “The Enemy.” The characters provide us with a moral issue about autonomy, and a good lesson in leadership.
The story centres on the conflict that arises when the protagonists rescue an enemy officer from an out of bounds planet. The officer, from a race of people called Romulans, is gravely wounded and requires a blood transfusion. There is only one member of the crew whose blood could be usable, but that crew member, Worf, has a history with the enemy’s peoples – Worf’s parents had been killed during a Romulan attack when he was a child. Worf, still carrying his anger for their death all these years, refuses to give his blood.
Meanwhile, a Romulan ship is en route to recover the officer. There is a tenuous peace treaty that prevents an all out war, but the Romulans have a history of subterfuge and deceit. It is believed they will cross the border and assume an antagonistic stance to provoke a war. Worf’s Captain, Jean Luc Picard, is seeking any means that would avoid an armed encounter, and decides to plead with Worf to reconsider his decision.
In this moment, it would be expedient to Picard and his crew to order Worf to donate his blood. He is about to contend with an adversary whom has no issue with breaking a peace treaty by provoking an attack (whether or not his side is initially in the wrong). Picard is seeking to recover a still-stranded crew member on the planet below, keep his ship safe, maintain the territorial sovereignty of the Federation, and maintain tenuous diplomatic relations with a rival group. This is all threatened because the one solution to his problem, keeping the enemy officer alive, is being blocked by a crew member whose personal history and honour motivate him to not help the enemy.
There is a beautiful scene where Picard appeals to Worf for him to reconsider:
Picard: So, there is no question that the Romulan officer is more valuable to us alive than dead. Worf: I understand. Picard: Lieutenant, sometimes the moral obligations of command are less than clear. I have to weigh the good of the many against the needs of the individual and try to balance them as realistically as possible. God knows, I don’t always succeed. Worf: I have not had cause to complain, Captain. Picard: Oh, Lieutenant, you wouldn’t complain even if you had cause. Worf: If you order me to agree to the transfusion, I will obey of course. Picard: I don’t want to order you. But I ask you, I beg you, to volunteer. Worf: I cannot.
In silence, Picard slowly walks back around his desk and sits in his chair.
Picard: Lieutenant. Worf: Sir? Picard: That will be all.
We then learn from the ship’s Chief Medical Officer that the Romulan has died. Picard has lost the only bargaining chip he had to keep things peaceful with the approaching enemy ship.
Picard could have chosen to order Worf to allow the blood transfusion. Instead, he chooses to respect his crew member’s personal wish, and as a leader deal with the hand he’s given. He also knows that making an order against the personal rights of a crew member under his command sets a dangerous precedence – that anyone is disposable if the captain judges it. Instead, he accepts that this closes off options. He knows that this places him not just on the back-foot, but also with his arms tied behind his back as he prepares for the possibility that his ship will be destroyed. However, the burden of command requires him to take these realities as they come and make the best decisions that he can. Events are being shaped around him that are beyond his control, but he strives to make the best decision that he can. He’s not perfect, but he becomes a role model in striving to do the right thing.
Even if the right thing might mean the death of he and his crew.
It’s a wonder piece of science fiction that I’m glad to be discovering anew.
I apologize for the late post this week. I had a few ideas kicking around in my head, but given the updates, I felt this ramble-post was a better attempt to capture some of the zeitgeist, rather than my usual attempt to feign some sort of authority on whatever it is I’m trying to accomplish on this site. Maybe I’ll rant another time about the scummy people who are profiteering through the COVID-19 scare.
Most of the information circulating concerns how an individual can help protect themselves from contracting the virus. Obviously this information is spread around not to protect any one individual, but because it’s the government’s attempt to flatten the curve and ease the economic and public health downsides to the current behaviours of people, from clogging up emergency rooms with sniffles to wholesale runs on items in the grocery store.
I’m not entirely sure what I should write about this week. It’s pretty hard to form a coherent thought when the majority of my bandwidth is occupied with keeping up with the shifting narrative around what’s going on. Thanks to technology, information (or misinformation) spreads quickly, and we are seeing multiple updates per day as a result. At my place of employment, they took the unprecedented step of shutting down face-to-face curriculum delivery. Unlike the faculty strike from Fall 2017, the College is working to keep the educational process running. While it may be that in the School of Engineering it can be impossible to replicate lab or shop time, the majority of faculty are working hard to translate their delivery to an online format.
So far, our employer has done a good job, in my opinion, with taking prudent steps to a.) keep people meaningfully occupied in their work so that no one has to lose their salary, and b.) do its part to stop the spread of the virus. I’m not saying that things couldn’t be better, but given the circumstances they’ve done a good job.
I’ve been thinking about the purpose of social isolation as a pandemic response. As I said above, the point is less about protecting oneself and is instead about protecting hospitals from being overwhelmed. If we’ve learned anything from countries around the world that are going through the worst right now, it’s that it becomes impossible to protect our vulnerable when there is a shortage of hospital beds. Hospitals are having to triage patients to focus on saving those who can be saved, who have the highest chances of recovering.
It is because of this that I’ve been thinking about the concept of a “brother’s keeper.” It’s not necessarily enough that governments or citizens remain mindful about the well-being of our vulnerable populations. Oftentimes while we are focusing on immediate dangers before us, we tend to not anticipate higher-order consequences of our policies or decisions.
Closing schools is great in theory – children are rabid spreaders of contagions, whether they are actually symptomatic or not, which means they infect their parents (some of whom are front line medical workers). But when we close schools, you have second order consequences that parents struggle with childcare, or children living in poverty lose access to food that is supplied at school.
When you close borders, you stop carriers of the virus from entry. But it also means that our international students (who are in some cases being vacated from post-secondary residences as school’s work to limit social contact among students) have no where to go. Airports are limiting international travel and the cost of purchasing tickets are skyrocketing. By them being in a foreign country, these students are vulnerable and caught in difficult positions on how to keep themselves safe.
By shutting down public spaces, you are helping to keep people from accidentally infecting each other. But when you close down businesses such as restaurants, you cut off people from the economic means they need to support themselves. Sure, the government is offering assistance to persons and businesses alike, but that will provide little comfort to people who can neither travel for groceries, nor pay for the supplies they need.
And let’s not forget what panic purchasing is doing to our supply chain – leaving store shelves cleared out of supplies, which means folks like the elderly are left without.
The hardest part I’m finding in all of this is the feeling of being powerless. You can’t control other people, and so you are forced to anticipate their moves to ensure you won’t be left without. But it’s this kind of thinking that leads to more drastic measures being taken. The virus also makes you feel powerless because you feel like an invisible stalker is coming for you – you don’t know who will be the final vector that leads to you. And you aren’t totally sure if our ritualistic hand-washing and hand-sanitizing is actually keeping us safe, or merely providing comfort. You can’t predict the future, and you can’t be sure you’re doing everything you can; you always feel like there is more you could be doing.
This reminds me of the story of the tinfoil house and pink dragons. A person covers their house in tinfoil, and when asked about it they say it keeps the pink dragons away. When asked if it works, the person shrugs and says “I don’t know, but I haven’t been attacked yet.” Of course, asking “if it works” is the wrong question here because there are no pink dragons. But as Taleb tells us in his book about Black Swans, there are always those highly unprobable events with massive downsides that we don’t see coming. Public policy and budgets are created to deal with clear and present dangers, and those policies and budgets are eroded when it’s felt that the money is not being allocated optimally. Therefore, you run into problems where you are never sure if the resources you spend to prevent something actually works – it’s really hard to prove causality in something that never happens.
Instead, we often are left to scramble to try and get ahead of trouble when we are already flat-footed, which means that our vision narrows as we focus on the fires in front of us that needs to be put out. Fighting fires is great (even heroic at times), but often the measures we take to deal with crisis have unanticipated second-order consequences that become difficult to deal with.
I’m not sure how to deal with this, but it makes me wonder about being my brother’s keeper, and what I can do to protect them.
From time to time, I catch myself thinking some pretty stupid stuff for entirely dumb reasons. A piece of information finds a way to bypass any critical thinking faculties I proudly think I possess and worms its way into my belief web. Almost like a virus, which is a great segue.
A perfect example of this happened last week in relation to the COVID-19 news, and I thought it important to share here, both as an exercise in humility to remind myself that I should not think myself above falling for false information, and as my contribution to correcting misinformation floating around the web.
Through a friend’s Stories on Instagram, I saw the following screencap from Twitter:
My immediate thought was to nod my head in approval and take some smug satisfaction that of course I’m smart enough to already know this is true.
Thankfully, some small part at the back of my brain immediately raised a red flag and called for a timeout to review the facts. I’m so glad that unconscious part was there.
It said to me “Hang on… is hand-sanitizer ‘anti-bacterial’?”
I mean, yes, technically it is. But is it “anti-bacterial” in the same way that it is getting implied in this tweet? The way the information is framed, it treats the hand-sanitizer’s anti-bacterial properties as being exclusively what it was designed for, like antibiotics. For example, you can’t take antibiotics for the cold or flu, because those are not bacterial infections but viral infections.
According to the author on the topic of alcohol-based hand sanitizers (ABHS),
There are some special cases where ABHS are not effective against some kinds of non-enveloped viruses (e.g. norovirus), but for the purposes of what is happening around the world, ABHS are effective. It is also the case that the main precaution to protect yourself is to thoroughly wash your hands with soap and water, and follow other safety precautions as prescribed.
The tweet, while right about the need for us to wash our hands and not overly rely on hand-sanitizers, is factually wrong generally. Thanks to a mix of accurate information (bacteria =/= virus) and inaccurate information(“hand sanitizer is not anti-bacterial”), and a packaging that appeals to my “I’m smarter than you” personality, I nearly fell for its memetic misinformation.
There are a number of lessons I’ve taken from this experience:
My network is not immune to false beliefs, so I must still guard against accepting information based on in-group status.
Misinformation that closely resembles true facts will tap into my confirmation bias.
I’m more likely to agree with statements that are coded with smarmy or condescending tonality because it carries greater transmission weight in online discourse.
Appeals to authority (science) resonate with me – because this was coming from a scientist who is tired of misinformation (I, too, am tired of misinformation), I’m more likely to agree with something that sounds like something I believe.
Just because someone says they are a scientist, doesn’t make the status true, nor does it mean what they are saying is automatically right.
Even if the person is factually a scientist, if they are speaking outside of their primary domain, being a scientist does not confer special epistemological status.
In the aftermath, the tweet was pulled and the person tried to correct the misinformation, but the incident highlights that the norms of Twitter (and social media more broadly) are entirely antithetical to nuance and contextual understanding.
It’s interesting how much information spread (memetics) resembles pathogen spreading. If the harmful thing attacking us is sufficiently designed to sidestep our defenses, whether that’s our body’s immune system or our critical thinking faculties, the invading thing can easily integrate within, establish itself within our web, and prepare to spread.
The one thing that really bums me out about this event is the inadvertent harm that comes to scientific authority. We as a society are caught in a period of intense distrust of the establishment that is coinciding with the largest explosion of information our species has ever seen. The result of this is not that good information is scarce, but rather the signal-to-noise ratio is so imbalanced that good information is getting swept away in the tide. If people grow distrustful of the sources of information that will help protect us, then forget worrying about gatekeepers that keep knowledge hidden; there will be no one left to listen.
During a throwaway thought experiment in his 1641 treatise, Meditations on First Philosophy in which the existence of God and the immortality of the soul are demonstrated, René Descartes posited the idea of an evil genius or demon that systematically deceives us to distort our understanding of the world. Contrary to first year philosophy students everywhere (a younger version of myself included), Descartes did not actually believe in the existence of an evil manipulator that was holding us back from understanding the nature of the real world. Instead, he was using it as part of a larger project to radically re-conceive epistemology in an era of rapid advancements in science that was threatening to overturn centuries of our understanding of the world. He felt that knowledge was built upon shaky ground thanks to an over-adherence on the received authorities from Greek antiquity and the Church’s use of Aristotelian scholasticism. Similar to Francis Bacon twenty years earlier, Descartes set out to focus on knowledge that stood independent of received authority.
Through Meditations one and two of his book, Descartes considers the sources of our beliefs and considers how we come to know what we think we know. He wants to find an unshakable truth to build all knowledge from, and through an exercise of radical doubt he calls into question many of the core facts we hold – first that knowledge gained from the senses are often in error, that we often can’t distinguish the real from fantasy, and through the use of the evil genius, that perhaps even our abstract knowledge like mathematics could be an illusion.
When I teach this to first year students, they either don’t take his concerns seriously because of the force of the impressions the real world gives us in providing sense data for knowledge (a stubbed toe in the dark seems to forcefully prove to us that the external world to our senses is very real), or they take Descartes too seriously and think Descartes really thought that a demon was actively deceiving him. Regardless of which side the student falls on, they will then conclude that Descartes’ concerns are not worth worrying about; that this mode of thinking is the product of an earlier, less sophisticated age.
Unless you are a scholar delving into Descartes’ work, the real purpose of teaching the Meditations is to provide students with a framework to understand how one can go about thinking through complex philosophical problems. Descartes starts from a position of epistemic doubt, and decided to run with it in a thought experiment to see where it took him. The thought experiment is a useful exercise to run your students through to get them to think through their received opinions and held-dogmas.
However, in light of my rant a few weeks back about informed consent and vaccines, I’ve discovered a new contemporary use for thinking about Descartes’ evil genius. In some sense, the evil genius is *real* and takes the form of fear that shortcuts our abilities to learn about the world and revise our held beliefs. Descartes posited that the evil demon was able to put ideas into our heads that made us believe things that were completely against logic. The demon was able to strip away the world beyond the senses and even cast doubt on abstract concepts like mathematics.
Much in the same way Descartes’ demon was able to “deceive” him into believing things that were contrary to the nature of reality, our fear of the unknown and of future harm can cause us to hold beliefs that do not map onto facts about the world. Worse yet, the story we tell about those facts can get warped, and new explanations can be given to account for what we are seeing. This becomes the breeding ground for conspiracy thinking, the backfire effect, and entrenched adherence to one’s beliefs. We hate to be wrong, and so we bend over backwards to contort our understanding of the facts to hold-fast to our worldview.
In truth, we are all susceptible to Descartes’ demon, especially those whom believe themselves to be above these kinds of faults of logic. In psychology, it’s called the Dunning-Kruger effect, of which there are all sorts of reasons given why people overestimate their competence. But in the context of an entrenched worldview that is susceptible to fear of the unknown lurks Descartes’ Demon, ready to pounce upon us with false beliefs about the world. Its call is strong, its grip is tight, and the demon is there to lull us into tribalism. We fight against those we see as merchants of un-truth and in a twisted sense of irony, the weapons of truth we yield only affect those already on our side, while those we seek to attack are left unaffected. It becomes a dog-whistle that calls on those who already think and believe as we do.
If we hope to combat this modern Cartesian demon, we’ll need to find a new way of reaching those we see on the other side.
I’ve hit a couple of milestones recently. For instance, last week I hit a nice big milestone in Duolingo when I hit 600 consistent days of doing lessons.
I wouldn’t say I’m particularly fluent in German, but during my trip in October of last year, I was able to follow some of the conversation going on around me and put into practice the lessons given by the app. I was able to manage thanks to small, consistent daily micro-lessons that expanded my vocabulary a bit at a time.
Something similar happened for this blog as well. From time to time I check-in on the site’s stats and analytics. I don’t have any plans or intentions to seek monetization, so I only check in on things out of a sense of curiosity rather than seeking optimization. I originally set up this blog as an exercise to see if I could keep a consistent weekly writing schedule. At the time, I had the aspirations to go back to school to become a paramedic, and so I also had intended to use this blog to apply the concepts I was learning to help me reinforce my learning. I’ve sinceabandoned that path, and so the blog largely remains a project to force me to come up with something to post on a weekly schedule.
I was looking at the stats last week and felt a sense of satisfaction for hitting a couple of milestones. First, it appears that I have not missed a weekly post in the last three years (I might be late posting, but I still get something up). Also, I’m happy to see that overall my words per post are trending upwards, though I hope this means I’m providing more meaningful, nuanced posts rather than just being verbose.
Then, I decided to check on how many words I had written for this blog.
Avg Words per Post
As it turns out, I had written the rough equivalent of a book in the four years I’ve been at this. Beyond the urge to create something and a desire to force myself to “write more,” the steady drip of a weekly schedule has now pooled into a large body of words.
I take a lot of inspiration from Seth Godin, and I learned from him the value of consistently showing up and putting in the work. It’s not about creating high quality giant pieces of work from fiat, but instead the slow, plodding, steady work of creating a little bit at a time. When you look back, you see the vast distance you’ve covered by forcing yourself to focus on putting one foot in front of the other. Not everything is going to be good – in fact, most of it will suck. But, over time you get better at the work, and sometimes you can find the good stuff emerging from the mediocre.
In the ethics of conducting research with human participants, there is the concept of “informed consent.” At its foundation, informed consent is the process of communicating a sufficient amount of information about a research project to a prospective participant so that the prospect is able to decide whether they want to consent to being a participant in a study. There is a lot of nuance that can go into selecting what gets communicated because you have a lot of necessary information that needs be shared but you don’t want to share so much information that the participant is overwhelmed by the volume of information.
When I review research ethics applications, I am privy to a lot of information about the project. In the course of reviewing the project, I have to make judgement calls about what should be included in the informed consent letters that participants read. It would be counter-productive if the participant had to read all the documentation I am required to read when reviewing an application, so we use certain best practices and principles to decide what information gets communicated as a standard, and what is left in the application.
There is, of course, some challenges that we must confront in this process. As I said, when reviewing a research project, you have to balance the needs of the project with the needs of a participant. All research, by virtue of exploring the unknown, carries with it an element of risk. When you involve humans in a research project, you are asking them to shoulder some of the risk in the name of progress. Our job as researchers and reviewers is to anticpate risk and mitigate it where possible. We are stewards of the well-being of the participants, and we use our experience and expertise to protect the particpants.
This means that one challenge is communicating risk to participants and helping them understand the implications of the risks of the research. In many instances, the participants are well aware of risks posed to their normal, every-day lived experiences and how the research intersects with it. The patient living with a medical condition is aware of their pain or suffering, and can appreciate risks associated with medical interventions. A person living in poverty is acutely aware of what it means to live in poverty, and understands that discussing their experiences can be psychologically and emotionally difficult. Our jobs (as reviewers and researchers) is to ensure that the participant is made aware of the risk, mitigate it as much as we can without compromising the integrity of the research program, and to contextualize the risk so that the participant can make choices for themselves without coercion.
The concept of informed consent is hugely important, arguably the most important component of research projects involving humans as participants. It is an acknowledgement that people are ends in themselves, not a means to furthering knowledge or the researcher’s private or professional goals. Indeed, without a respect for the autonomy of the participant, research projects are likely to not be moved into action even when research funds are available.
All of this is a preamble to discuss the anger I felt when I read a recent CBC report on how anti-vaxxer advocates are using the concept of informed consent as a dog-whistle to their adherents, and are using informed consent as a way of both furthering their awareness and raising money with well-meaning politicians and the public.
In fairness, I can see the chain of reasoning at play that tries to connect informed consent with concerns about vaccines. For instance, in the article there is a photo of supporters of a vaccine choice group with a banner that reads “If there is a risk there must be a choice.” This sentiment is entirely consistent with the principles of informed consent. The problem with this application is that the risk is not being communicated and understood properly within context, and instead fear, misinformation, and conspiracies that lead to paternalistic paranoia are short-cutting the conversation. Further, the incentive structures that are borne out of the economics of our medical system are doing little to address these fears. Because so little money is flowing from the government to the medical system, doctors are forced to maximize the number of patients they see in a day just to ensure enough money is coming into the practice to pay for space, equipment, staff, insurance, and supplies. Rather than seeking quality face-to-face time with a patient, doctors have to make a choice to limit patient time to just focus on a chief complaint and address questions as efficiently as they can.
I don’t think it’s all the doctor’s fault either. I think we as patients, or more specifically we as a society, have a terrible grasp of medical and scientific literacy. I don’t have a strong opinion about what the root cause of this is, but some combination of underfunded schooling, rapid technological innovation, growing income disparities, entertainment pacification, a lack of mental health support, increasingly complex life systems, and precarious economic living in the average household are all influencing the poor grasp people have about what makes the world around us work. Rather than being the case that we are hyper-specialized in our worldviews, I think it’s the case that “life” is too complex for the average person to invest time into understanding. Let’s be clear, it is not the case that the average person isn’t smart enough to grasp it (even if sometimes my frustration with people leads me to this conclusion). Instead, I think that people are pulled in so many directions that they don’t have the time or economic freedom to deal with things that don’t immediately pay off for them. People are so fixated on just making it day-to-day and trying not to fall behind that it becomes a luxury to have the leisure time to devote to these kinds of activities.
What this results in, then, is the perfect storm of ignorance and fear that congeals into a tribal call to rebel against the paternalism of a system that is ironically also too cash-strapped to allow the flexibility to educate people on the nature of risk. People don’t have the time and ability to educate themselves, and doctors don’t have the time to share their experiences and knowledge with their patients.
Within this gap, opportunistic charlatans and sophists thrive to capitalize on people’s fears to push their own agendas. This is why bad actors like the disgraced former doctor Andrew Wakefield and movement leader Del Bigtree are able to charge fees to profit from speaking at anti-vaccination events. I’m not saying a person who spreads a message should do it for free. What I am saying is that they are able to turn a personal profit by preying on people’s fears while doing little to investigate the thing they claim to worry about.
We must find a way to communicate two simultaneous truths:
There is an inherent risk in everything; bad stuff happens to good people, and you can do everything right and still lose. Nevertheless, the risks involved when it comes to vaccines are worth shouldering because of the net good that comes from it and the risks themselves are vanishingly small.
In the 22 years since Wakefield published his study and the 16 years since its retraction, there has not been any peer-reviewed credible evidence that supports many of the claims given by the anti-vaxx movement. The movement is predicated on fears people have of the probability of something bad happening to them or their loved ones. The motivation behind the fear is legitimate, but the object of the fear is a bogeyman that hides behind whatever shadows it can find as more and more light is cast on this area.
The anti-vaxx ideology knows it cannot address head-on the mounting scientific evidence that discredits its premise, and so it instead focuses on a different avenue of attack.
This bears repeating: the anti-vaxx ideology cannot debate or refute the scientific evidence about vaccination. We know vaccines work. We know how they work; we know why they work. We understand the probabilities of the risk; we know the type and magnitudes of the risks. These things are known to us. Anti-vaxx belief is a deliberate falsehood when it denies any of what we know.
Because of this, the anti-vaxx ideology is shifting to speak to those deep fears we have of the unknown, and instead of dealing with the facts of medicine, it is sinking its claws into the deep desire we have for freedom and autonomy. It shortcuts our rational experience and appeals to the fears evolution has given us to grapples with the unknown – the knee-jerk rejection of things we don’t understand.
Informed consent as a concept is the latest victim of anti-vaxx’s contagion. It’s seeping in and corrupting it from the inside, turning the very principle of self-directed autonomy against a person’s self-interest. It doesn’t cast doubt by calling the science into question. Instead, it casts doubt precisely because the average person doesn’t understand the science, and so that unknown becomes scary to us and we reject or avoid what brings us fear.
Anti-vaxx ideology is a memetic virus. In our society’s wealth, luxury, and tech-enabled friction-free lives, we have allowed this dangerous idea to gain strength. By ignoring it and ridiculing it until now, we have come to a point where it threatens to disrupt social homeostasis. Unless we do something to change the conditions we find ourselves in – unless we are willing to do the hard work – I fear that this ideology is going to replicate at a rate that we can’t stop. It will reach a critical mass, infect enough people, and threaten to undo all the hard work achieved in the past. We have already seen the evidence of this as once-eradicated diseases are popping up in our communities. The immunity and innoculations have weakened. Let’s hope those walls don’t break.