The Clothiers of Chaos

“It would not be impossible to prove with sufficient repetition and a psychological understanding of the people concerned that a square is in fact a circle. They are mere words, and words can be molded until they clothe ideas and disguise.” - Joseph Goebbels

We are living in the age of disinformation, and it’s not just confusing us – it’s killing us.

Many are attracted to putting on these garments of deception, depending on the fashion of the moment. For some they are “statements” of self-expression, and for others they are the coverings used to hide the ugly lesions that have erupted on the skin beneath.

In ancient times, it was myth. In the 18th and early 19th centuries - tall tales and urban legends. Totalitarianism introduced us to the much finer haute couture raiment of propaganda – which has never gone out of style for the discerning, and rumor has always been with us – reeds and leaves morphing over time to leather sandals and boots to the high-tech composite skips, kicks and birks of today.  

As self-expression, we wear it to broadcast our biases and interpretations of the world and also revel in the fact this communicates to others who think the same way. In covering us, it allows us to obscure the unsightly fears we do not want others to see, and to protect the fragile membranes of belief we subconsciously know might easily be pierced by reason. More importantly, it obscures our actual motives, which are rarely pure when we dress this way.

The problem, of course, is defining what is “reason” – fact, or truth.

In “The Nature of Scientific Revolutions”, Thomas Kuhn introduced we are constantly seeking truth in science, but due to the unfolding nature of our comprehension of all things, we are constantly revising and redefining truth. He suggested we do “normal science” until we reach a “crisis” point, where our theories are weakened by the weight of new information, and we then experience a sudden “paradigm shift” to a “new truth”. His model for seeking truth therefore is not a straight line moving upward from left to right, but a series of stairsteps. However, disinformationists do not pursue truth in the Kuhnian tradition - stepping from one insight up to the next one on the stairway to ultimate truth. Instead, they step into elevators going nowhere, and ask us to join them behind doors that slide shut and obscure our view of what has been clearly understood and agreed to as “more truthful” in the past.

While there is no established hierarchy for the danger of disinformation, I would put scientific disinformation high on the list, and medical disinformation at or near the top. Disinformation applied to personal motivations or political disagreements – such as theories about hidden emails and computer servers or global plots to abuse children using pizza parlors as a front – can undermine society in many ways - but medical disinformation threatens our lives.

Unfortunately, the COVID-19 pandemic has encouraged disinformationists to launch an extensive new and dangerous "ready-to-wear" line of medical disinformation conspiracies – ones that promote that stay at home orders are simply an attempt to limit constitutional freedoms, the novel coronavirus is no more dangerous than a cold or the flu, vaccines in development should not be trusted, Dr. Anthony Fauci is withholding useful treatment information, the pandemic is caused by 5G technology, and that a number of billionaires are secretly part of a group that created the pandemic to thin the population.

As a result, this crisis has now also highlighted the need for physicians – some of whom are wondering what their jobs will become in a cresting era of artificial intelligence and the imminent arrival of more self-care – to accept a new role. A role not only needed in the present, but one that will become increasingly important in our now hyper-connected and unfiltered world.

That role is arbiter of truth.

At one point, this was the primary role of the physician. Moving forward from the Renaissance and into the early 20th century, medical science stair-stepped its way to a new understanding of human disease. Despite the fact many conditions would not be treatable for some time, the ability to name the beast that threatened patients and better inform about what to expect alone was transformational. Physicians, previously feared and caricatured at times as quacks and charlatans gradually became trusted advisors. However, over the past 50 years this role has transitioned from trusted advisor to technician as powerful new technologies have allowed them to conquer numerous acute diseases, but has also (along with financial and efficiency demands) distanced them from their patients.

Social media is a double-edged sword – allowing everyone to speak, but also facilitating the malign voices of medical disinformation who view people as nothing but means to their selfish ends to be heard in ways previously limited and more easily dismissed. And the best stuff? It immediately confuses and dupes the suggestible, while sowing doubt among the stronger-minded. 

Let's bring disinformationists into the examination room, where their own colorful finery can be removed and their bare motives expertly inspected, palpated and probed. Following, in addition to gentle redirection with patients and friends, let's all to step up and onto the podium, the television screen and every online megaphone possible to make the self-inflicted conditions of these clothiers of chaos - more infectious and dangerous in many cases than COVID-19 - known to all.