A Failure to Communicate

My plea with all of my colleagues out there, whatever your station, whatever your audience - give people reasons to trust you

Nowadays, just about every profession seems to give rise to their own celebrity circle who come to be recognized in media and offer forth their thoughts and acumen (real or alleged) to instruct, entertain, or inspire. Business executives? “Shark Tank”. Music industry? There is literally a show called “American Idol”. Crab fishermen of the Bering Sea? Mike Rowe’s sultry narrative voice has your fix on “Deadliest Catch”.

The healthcare profession is no different. For years, we’ve watched healthcare professionals in the limelight, perhaps as news correspondents or social media figures. And for years, I’ve observed that positioning with increasing alarm. Recently, a tweet from the famed podcaster Joe Rogan to the vaccine scientist Peter Hotez, and subsequent response, was my tipping point to publicly discuss that alarm. To summarize, Hotez criticized Rogan’s recent show. Rogan offered Hotez $100,000 to debate Robert Kennedy Jr, the guest on said show, and refute a number of specious vaccination claims Kennedy Jr had made. Hotez demurred, then refused, then every person with a partisan stripe started aligning with or maligning Hotez, offering justification for or against the debate.

I don’t care much about Rogan and his podcast, or Hotez, or some political figure trying to generate momentum in his campaign. What bothers me is the increasing number of people who pine to be social media darlings first, and healthcare professionals second. I’m bothered by messaging that has an inward focus, where friends and like-minded colleagues are the target audience, and not the public. I’m bothered by professionalism, duty, and ethics being surrendered for validation and elite social circle approval. I’m bothered by how any opposition or dissent is labeled as “anti-science” and dismissed just as quickly.

Worse still, people who lack formal scientific training (that is, your average Joe or Jane) are often lumped in with that opposition. I’ve lost track of the number of times I’ve heard “the science” phrased as a means to browbeat or belittle somebody. Speaking about science as though it were an idol to praise was once the subplot of a South Park episode, but now this rhetoric appears on primetime news. Such a dogmatic rendition of the scientific method demands a lot of submission to authority, and any supposed gains it makes come at the cost of public trust and connection.

But back to Rogan. Hotez refused the debate, and the post-hoc justifications for his decision could be diluted down to; “Debating him will just legitimize his claims”, and, “They don’t actually want to debate, they just want to make you look bad”. That was the crux of a recent post from science.org:

“First, it gives [Robert F Kennedy]’s garbage equal footing with principles that have been established by centuries of science. The second is that to a lay listener, the scientist just comes off as fitting the stereotype of a nitpicking nerd and RFK looks like a powerful communicator.”

I have a few problems with at least one of these claims. First, it is superbly arrogant to believe that misinformation merely requires your attention to survive. That consenting to a debate and thereby giving it your presence of mind means it will now flourish. It’s textbook narcissism. Misinformation has existed since the dawn of time, following every one of us in our shadows and sometimes on our countenances. Do you really think it will somehow cease to exist if you just pretend it’s not there?

But you’re missing the point, you amplify misinformation whenever you debate their nonsense. I think there’s rationale to say that a larger audience may hear the misinformation, but that doesn’t mean they’ll accept it. But true as that is, everyone who heard Rogan’s podcast, will only hear Rogan’s podcast. There is nothing for them to weigh because only one side of the scale was filled, however poor the quality of the filling. He already has an audience, and one way or another, they’ll get content. Refusing a debate on these grounds is not so much a victory, but a lost opportunity to talk to the public.

So that means I need to invite a Holocaust denier on anytime I discuss the Holocaust? You know what, I can’t believe I’m saying this, but, it’s starting to feel like the answer to this question should be, yes? Frankly, all evidence indicates humankind seems to have a short memory. Our default attention focuses on what is right in front of us, while only conscious effort will make us look ahead or contemplate what is behind. I was shocked to read a 2014 Atlantic piece that reported results of a massive global survey on knowledge of the Holocaust. As reported by the survey, only 33% of the world’s population had heard of the Holocaust and believed it was accurately depicted in history. Think about that. A modern-day, massively coordinated effort to exterminate an ethnic group, and globally, 67% of people either do not know it happened or believe it was falsely reported. Even wilder, consider that in the Middle East, Sub-Sahara Africa, and North America, that number is 8%, 12%, and 55%, respectively.

I know Holocaust denial goes beyond the immediate subject of debating vaccination with a blowhard, but, is it at all possible that we take for granted the hard-learned lessons of humanity? That a presumption of shared knowledge is in fact, ironically, contributing to its decline in the minds of every subsequent generation? If the answer to either of those questions is ‘yes’, well, consider why that is.

Now as to that second point about attempting to make Hotez look dumb. Honestly, this strikes me as a more valid critique, especially given the present situation. There’s no denying from his numerous televised segments, Hotez is not a man of rhetorical talent. I’m sure he’s smart, but he’s a fairly thin-skinned individual who wears the same white lab coat, bow tie, and disheveled hair for most of his guest appearances on television. To his credit, Hotez did appear on the Joe Rogan show in April of 2020 right as pandemic state lockdowns were picking up speed. He claims he’d do it again, but not to debate Kennedy Jr, believing it would simply be a farce. I believe that was a mistake. If Hotez feared getting a verbal swirly from the likes of Rogan and Kennedy Jr, why not send a stand-in? “I don’t have a politician’s tongue,” he could have said, “but I’m happy to recommend a colleague of mine who shares my positions and can counter these points.” Robert Kennedy Jr is a conspiratorial nutjob, and it does not bear well that people don’t believe that either Hotez or anyone else is capable of defending their positions, or dismantling Kennedy’s.

But beyond the critiques of legitimization and discrediting campaigns, there’s a more insidious reaction producing even more damage. We’re seeing these celebritized healthcare figures replacing good communication practices with general disdain and disregard. It grows uglier every year, and the grand irony to it is a press that wrings its hands and cries out in despair, “Why aren’t these incompetent simpletons listening to us?!” And as these healthcare officials grow more draconian and dismissive, the public grows more distant.

It’s really not complicated. If you don’t listen to them, somebody will.

If you tell people to “Grow the f**k up and get the vaccine!” so that you can help second-rate comedians garner guffaws from their audience, people will probably stop voicing their worries and hesitancy to you.

If you equate every person’s questions or misunderstanding with intentional obfuscation, sooner or later, people stop asking you their questions.

If you elevate voices that tell people they’re too stupid to understand an explanation, I don’t think they’ll stick around.

If you establish yourself as the iconography of “the science”, and excuse your persistent incompetence as a function of how “the science changed”, people will eventually see through that.

People will misunderstand, or not care, or stare facts in the face and retain their prior conclusions. But no matter the outcome, if science is your profession, your job is to communicate it as best you can to your colleagues and the people you serve. My plea with all of my colleagues out there, whatever your station, whatever your audience - give people reasons to trust you. Listen to them, engage their concerns, share your disagreements [respectfully], address their fears. Do everything except close the door if they are sincere or at least willing to listen. And to take it one step further, stop elevating voices that refuse to do this.

Training, practice, and educational background matter, but they do not confer godhood. That man or woman you dismiss as ‘uneducated’ may have less training than you, but credentials be damned, none of us will tolerate mistreatment from healthcare professionals if we don’t have to. It is going to be a long, long road to recover the public trust that has eroded over the last few years, but the way forward is not lined in coercion. The public still remembers that “the science” is the servant, not the master.

We’d be wise to remember that as well.