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Follow the Science

In the English language, there are certain words and phrases that convey meaning beyond their literal translation. Ultimately, such words and phrases become slang, which is a form of speech that conveys an idea or emotion, beyond what is written or said. For example, bestowing praise and excessive flattery on an individual for the purpose of currying favor with said individual is “buttering someone up” in slang.  (Amusingly, slang is most effective and understood by native speakers of a language.  I once heard a non-native English speaker use the phrase, “salting and peppering” someone, when she actually meant “buttering up.”  I kind of like that and use it as an inside joke with this individual.)

There is another category of language that is the overused “catchphrase,” which is a phrase, either literal or slang that becomes so excessively used in writing and discussion, it is disdained as excessive and annoying. One of my wife’s trigger phrases is, “It is what it is.” That seemed particularly popular in Philadelphia, where we spent several years and it could always be counted on to annoy her.

And finally, there are signal phrases; phrases that foreshadow something that is to follow. One of my favorites is, “With all due respect.”  When you hear that, you know that the next thing you hear will be the most disrespectful thing the speaker can think of. Similarly, when I see someone’s pronouns in a bio, signature line, or on a name tag I pretty much know I can safely ignore anything that individual is going to say and expect some “woke” virtue signaling. (I think “woke” and “virtue signaling” are in all of these categories.)

One of the most overused signal phrases is “follow the science.”  Whenever you hear that, be prepared to hear something, likely without any scientific basis, that is serving to advance a political agenda. If I never hear “follow the science” again, it will be too soon.

True science is the investigation of physical phenomena and the testing of hypotheses, that is, asking questions and determining an answer. Science should be politically blind. A result of a scientific investigation should be just that, a result, which is neither good nor bad, republican nor democrat. It is said that some of the greatest scientific discoveries have started with the phrase, “Wait, this can’t be.” In my own career, I have been fortunate enough to be on the receiving end of looking into a microscope and thinking, “Wait, this can’t be.”  The experiments that led to the unexpected result were then repeated to confirm this new finding, this something that “can’t be.”  It is a pretty cool feeling.

Unfortunately, contemporary science is rarely just a presentation of an objective result. That would be boring and, God forbid, expect people to put thought behind scientific data and reach their own conclusions. Just like the nightly news, subjective “spin” is placed on facts to drive a thought or ideology, under the banner of “science.” The public, for whatever reason, is intimidated by and gives unnecessary weight to “science.” Oftentimes, the “science” and “facts” are anything but. In the echo chamber of the Ministry of Propaganda, I mean, the popular media, the word “science” is thrown about as a one-word rebuttal to positions and opinions that are inconsistent with the favored narrative. This is also true of the pro-abortion cheerleaders, who liberally use the words “science” and “facts” loudly (and usually accompanied by profanity) to reinforce nothing more than an opinion. We have previously discussed gender ideology, which is treated by organized medicine as settled fact, when, in reality, there is no scientific basis whatsoever for the management of gender dysphoria with “gender-affirming care” of hormones, puberty blockers, and surgery (1).

Another of these narratives center on the most favored religion of the new millennium, global climate change. (It used to be global warming, but it made less sense to call it that. Certainly, that was my thought one recent December when I arrived at the airport in El Paso, Texas, and had to shovel 8 inches of global warming off of my car in the long-term lot.) The patron saint of this religion is Greta Thunberg, a now 20-year-old young lady from Sweden who has vociferously, in Chicken Little fashion, been the voice of the climate change religion, despite having nothing more than a really strong opinion and confident belief that the world will end tomorrow, or next week sometime, or in 2024, unless drastic action is taken – NOW!  Unsurprisingly, Ms. Thunberg’s parents and grandparents are in show business. If one believes the narrative, young Greta, at age 8, became so alarmed by climate change that she stopped eating and started after her parents to modify their earth-destroying lifestyles. Around age 15, she started a movement calling for students to “strike” on Fridays and not attend school so they could protest all things non-eco-friendly. Apparently, she stood outside of the Swedish parliament with signs and whatnot. (It was a lot harder to skip school when I was that age, but I digress.)  For whatever reason, this autistic young lady attracted widespread media attention and has gone on to receive all sorts of awards, been nominated for the Nobel Peace Prize multiple times, and has addressed sessions of the UN. (Because the UN did such a good job in Rwanda during the Tutsi genocide.) 

Certainly, this meets the criteria of the drive-by media, an emotionally disturbed young child lecturing leaders on the world stage about their irresponsibility regarding the climate. I understand that Ms. Thunberg is a strong advocate for abandoning air travel and has eschewed flying in favor of crossing the Atlantic (multiple times) on large sailing yachts. Hilariously, she has been criticized for wearing wool by the vegan division of the Eco-warriors. (They know that artificial fibers and plastic/vinyl shoes come from petroleum, right?)

Not to be outdone, Alexandria Ocasio Cortez (part of the Democratic party’s brain trust and occasional bartender), has called for the abolition of gas stoves, because they somehow are also destroying the environment (no, I don’t get it either).  California has taken a momentary respite from murdering the unborn to enact legislation that will ban gas-powered furnaces and water heaters, mandating that no new gas furnaces or water heaters will be allowed in the state after 2030 and everything will be electric (2).  (I think they have a carve-out for gas stoves, otherwise, the San Francisco elites will not be able to have properly cooked omelets at their climate change seminars.) New York City has enacted similar legislation.  (Fortunately, electricity is magic and comes out of those little holes in the wall, so no climate will be harmed.)

This is all fun and games, and makes for amusing reading until it hurts you.  In fact, this church of climate alarmism can kill you.

Modern anesthesia usually involves the use of various anesthetic gases to maintain and sometimes induce a state of general anesthesia, allowing surgery to be safely and painlessly performed while the patient is “asleep.” (It is not really sleep, rather an artificial state of consciousness, but that is all technical.)  These gases are halogenated hydrocarbons, distant relatives of ether, and they have various properties, like any drug, that makes one better than another for a particular patient.  There are three different gases in use in the United States. The most commonly used gas is named sevoflurane. It is easy to use, like anesthesia training wheels, and relatively safe for most people.  It has the downside of accumulating in the tissues of the body, like fat and muscle, and takes a little while to eliminate, depending on the duration of surgery. It sometimes causes seizures, undergoes metabolism as part of its elimination (with metabolic byproducts), and may be implicated in long-term learning and memory deficits when used for prolonged periods and in multiple exposures. It is also pretty inexpensive, so hospital administrators like that.  

The other gas in wide use is named desflurane. Desflurane has some unique properties, including not undergoing metabolism (you just breathe it away in 5 minutes) and not accumulating in the tissues of the body, so patients wake up much more quickly and clear-headed. Patients are also safer, as they are breathing more deeply and efficiently sooner in the recovery room. Desflurane is almost a light-switch, on-off, anesthetic. It is a little more expensive and more difficult to use. I like the aircraft analogy, if sevoflurane is a Cessna 150, desflurane is an F-16. Harder to fly, but a lot more capable. This is particularly important in overweight and obese people. Obese patients are at significantly higher perioperative risk, as they can have sleep apnea and other breathing abnormalities, which are made worse by anesthesia.  Because desflurane is eliminated so rapidly and does not accumulate in fat and muscle, patients, even the very overweight, are breathing and more awake in the recovery room, and thus safer after a desflurane anesthetic. (I once administered anesthesia for a tonsillectomy to a 400-pound 10-year-old child with sleep apnea.)  Desflurane is the ideal anesthetic drug for these kinds of patients. I don’t know where you live, dear readers, but every day, here in Louisiana, we see children over 200 pounds coming to the operating room (and our adult patients are pretty big too). 

The problem here is the church of global climate change. Their high priests, Ivy-League academics in their ivory towers, have decided that desflurane is destroying the environment. You see, one of desflurane’s properties is that it is a fully-fluorinated hydrocarbon. For you non-chemists, this means it is incredibly stable and does not degrade. It is somewhat similar, in chemical structure, to CFC refrigerants like Freon. When you breathe it out, it goes through a suction hose connected to the anesthesia machine and is usually vented to the atmosphere through a pipe on the roof of the hospital. Because of this chemical property, desflurane is not degraded by sunlight. Theoretically, it just wafts around forever. (As an aside, because it does not degrade, it does not harm the ozone layer, but that is one of the “inconvenient truths” the climate church would like you to ignore.) Sevoflurane is degraded by sunlight, so, theoretically, it doesn’t float around. When the clergy of the climate church realized this (Auntie Em, it’s a twister, it’s a twister!) they concluded that eventually, we will all die from global warming caused by the blanket of invisible desflurane, trapping the heat below its malevolent layer. 

Right away, the climate clergy started writing “scientific” papers with conclusions like doing surgery with sevoflurane is like driving a car for 70 miles, but doing surgery with desflurane is like driving a car for 235 miles (3)! Greta Thunberg would say, how dare you!? Pro-tip, whenever you are reading a “scientific” paper and they have these sorts of comparisons, doing X is equivalent to driving some miles, but doing Y is the equivalent of driving a lot more miles, you are reading junk science. Those sorts of comparisons, and they are done for a lot of other things aside from climate, make for clever comments but have no real-world relevance. They are a lazy grammar trick to put a false value on an irrelevant finding. One can make all sorts of contrived comparisons and eventually “prove” that, if everyone in the world exhales while facing West, the Earth would stop turning and reverse its direction. It is nonsense, like the anesthetic comparisons the climate church is preaching. I will spare you the calculations (they are here if you are really that curious https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3325850/(4)), but the amount of anesthetic released into the atmosphere is massively, geometrically smaller than any other source of carbon for global warming potential, abbreviated GWP, to the climate scientists. To continue ridiculous analogies, if the annual worldwide GWP is represented by an area the size of the State of Kansas, the GWP of desflurane is an area of about 350 square feet. Here’s another one, if the annual GWP is a building the size of the Empire State Building, the annual GWP of desflurane is the same building, but only 0.4mm tall (watch your head).  Additionally, this is all theoretic. Desflurane, indeed none of the anesthetic gases, have ever been detected in the upper atmosphere! This is all theoretic hype dreamed up by the climate clergy riding in private jets to Eco-summits.

Amusing, yes. Stupid, most certainly. But dangerous?

This month, Scotland banned the use of desflurane for anesthesia because of its global warming potential (5). The climate clergy calls this, “an important first step.” In the United States, several “woke” hospitals have also banned the use of desflurane for similar reasons (6). Are you bothered yet?  A drug that has very real and distinct benefits from every other anesthetic, has been banned because of a theoretical hypothesis that has never been proven. Can one do anesthesia with the other gases?  Yes, you can do anesthesia with a lot of different techniques. Is it as safe as desflurane for certain patients? No. I suppose the Scots would say, “It’s safe enough.”  Comforting, and don’t get into an accident in Glasgow if you are overweight.

Follow the science, after all.

Along these same lines, the tool we use to place a breathing tube into patients during surgery is called a laryngoscope. It has a curved piece with a light that is placed in the patient’s mouth, coming out from a cylindrical handle. It is a vital tool in anesthesia, critical and emergency care, and is used millions of times a day. 35 years ago, when I was a resident, the laryngoscopes were made of metal and non-disposable. After each use, we scrubbed and washed the laryngoscope for the next patient. In the 1990s, infection control became a popular topic in health care and there was a push for disposable supplies. Metal, non-disposable laryngoscopes were replaced, in most hospitals, by plastic disposable units meant to be used for one patient and then discarded. Recently, there is a renewed push to go back to non-disposable laryngoscopes, and other medical supplies, for reasons of environmental friendliness (7).  So which is the science to follow, infection control or the environment?

The COVID pandemic is the most poignant example of “follow the science” hysteria used to push an agenda that had very little scientific basis. For those of us in health care, 2000 was a frightening year. We didn’t know much about this virus, but for years, people had speculated that someday, a killer virus might arise that would destroy the world. It has certainly been the subject of much apocalyptic science fiction. In the operating rooms and intensive care units, we didn’t know if this was “the big one” and we didn’t know if after caring for a COVID patient we would be alive next week. We said prayers, hid from our families, and waited for the end of the world. Gradually, we came to see that this was not the end of the world but a particularly nasty virus, at least in some patients.

The elderly and frail, overweight and obese, and those with pre-existing medical problems seemed to suffer the most from the infection. For most people, it was like a nasty flu or bad cold. Again, in those early days, we used things like hydroxychloroquine on ourselves, because of the thought that it might be protective against COVID infection. Was it supported by scientific studies? No. Was it dangerous? Also no. We felt there was little downside and potential protection. The problem is, using the rallying cry of “follow the science” Dr. Anthony Fauci and the pharma-industrial complex, aggressively pushed the narrative that hydroxychloroquine would kill you and it was malpractice to even think about administering this to a patient. “Madness, I tell you!” he might say. Physicians who advocated for its use were derided as conspiracy-theory quacks and subject to discipline by state medical boards. Even advocating the conduct of scientific studies to determine whether hydroxychloroquine had any beneficial effect was immediately shouted down as heresy. 

Similarly, ivermectin was immediately ridiculed as a “horse de-wormer” and anyone even speculating about its use was laughed at and threatened with loss of license and livelihood. The vaccines were aggressively marketed, indeed forced, as the one and only way to prevent COVID. Those who resisted the vaccine for religious or other reasons, like reluctance to have a new, mRNA injection administered for a disease that had an overall low fatality rate, were seen as a threat to public safety. There was serious talk, in the US and around the world, about “camps” for COVID patients and/or the “vaccine deniers.”  Physicians spoke openly about denying care to the unvaccinated and, indeed, some unvaccinated patients were denied organ transplants for that reason. How high and mighty. Even if the vaccine was completely effective and safe, denying care to someone who has contracted COVID because of their refusing the vaccine is from the Josef Mengele book of ethics. If we physicians denied care to patients who were ill because of their own fault or behavior, we would quickly go out of business. I saw no similar outcry about denying care to overweight diabetics, or robbery suspects shot by the police. There were no stories about healthcare workers’ “emotional fatigue” when caring for people injured in motorcycle accidents.

That is not how real science works. Drugs like hydroxychloroquine are taken by millions daily to prevent malaria. Similarly, ivermectin is widely used, by human patients, for the treatment of parasites, particularly in the developing world. Science means testing and evaluating their use for COVID. We now know that the COVID vaccines seem to prevent severe disease, but they do not prevent COVID infection.  We also know that there are many people, including someone in my immediate family, suffering long-term side effects from the mRNA vaccine. This does not necessarily mean the vaccine was a bad idea, but proper science demands that we be realistic about potential side effects and look to see if the technology may be responsible for those effects. If so, mitigation or reduction of vaccine side effects should be investigated without prejudice as to the outcome.  That is how science is supposed to work.

In 1933, the Nazi party won a preponderance of seats in the national election and Adolph Hitler was appointed chancellor. A lot of politics were involved, but he was widely seen as a moderate who could address the numerous problems of post-World War I Germany, particularly staggering inflation and poverty. In some ways, this was Germany’s COVID crisis and possible way out. In an unbelievably short time, 100 days, the Nazi party instituted numerous initiatives, including the beginning of legislating Jews out of German life, the creation of concentration camps, and the sterilization of “mental defectives” and other “undesirables.”  The term for this top-down Nazification, in the guise of “national unity” was, “Gleichschaltung” or “coordination” as Nazi ideology permeated all aspects of social and cultural life.  “Everything was subject to coordination: local government, professional organizations, social clubs, leisure activities—even those for children (8).” This, however, was not only a top-down phenomenon. The German public eagerly and immediately embraced “Gleichshaltung” and took it upon themselves to implement Nazi ideology, creating the one-party state, eventually resulting in one of the most organized genocides in history and a war that destroyed much of the world, with hundreds of millions dead from the war and its after effects, some of which persist today. The embrace of Nazism was so thorough, that a new term was coined, “Selbstgleichschaltung” or “self-coordination.”  Even Hitler was stunned by this rapid development saying, “Everything is going much faster than we ever dared to hope (5).”  

People often wonder, how did the Nazis do it?  How did one of the most cultured societies in human history seemingly go insane and slaughter their own people, along with the attempt to completely eliminate Jews from the face of the earth?  They were scared, they perceived a threat and they, for lack of a better term, “followed the science.”

The three most dangerous words in the English language are “public health emergency.” Overnight, and without any scientific basis aside from speculation and fear of COVID, American and global society changed overnight.  Lockdowns, masking, social distancing, and economic collapse were seen as a patriotic duty. People were chastised for not wearing (largely ineffective) masks and castigated as “enemies of the state” for vaccine hesitancy. In Australia, New Zealand and Canada, even more extreme measures were implemented. So, children couldn’t go to school, people could not go to Mass, for the sake of “public health” but participating in Black Lives Matter riots and marches was ok. Small local restaurants were forced out of business as “non-essential” while Wal-Mart continued operations.  The vaccine card became the new “identity papers” required to engage in commerce and public life. 

The “Selbstgleichschaltung” of America continues even to this day, judging from the number of people I see wearing masks in their cars while driving alone. Is there any doubt that, had the federal government required unvaccinated individuals to be in custody in “public health camps,” their friends and neighbors would not have turned them in? How many restaurants were forced out of business when someone reported them to the authorities for violating mask requirements?  The response of the American public to various COVID mandates and the continued push for ever more boosters, ever more fearmongering about “infectious variants” and the pictures of masked schoolchildren being read stories by unmasked politicians shows us precisely why it was so easy in 1933 and so easy in 2020.  Whenever people are scared, whenever a group of people is dehumanized, whenever God and eternity take a backseat to the selfish here and now, whenever a society justifies the killing of its most vulnerable, the unborn, frail, elderly, infirm, handicapped and disabled, anything is possible, indeed anything is likely.

Someday, when the next “public health emergency” comes around again, perhaps “follow the Science” will be on the sign above the gates to the “hygiene” camps.  “Arbeit Macht Frei”, was already taken.

This concludes the text of this blog post.