Everything you said here (other than your [and Vinay's] opinions on best political solutions to society's ills...lol) is spot on and resonates strongly with this hematologist/microbiologist. In many ways you are too kind with what you write-- write some more and you will get closer to Vinay's increasingly incisive style. (Just please avoid bioplausibility...)
But the scariest part of this entire piece, and the part that is most worrisome, is the fact that you, like many other doctors, feel the need to post anonymously. Many/most physicians have fallen into the "go along to get along" category. Some of us have been railing about this since the flip-flop on masking ("The first lie was the worst lie") because it demonstrates that without leadership from people who WILL stand up and be counted, it is entirely likely that the worst possible things will happen because power politics overrules science and medicine every time unless you fight it tooth and nail.
As you also noted, the presumption that people are stupid ("We are the smart ones") that you so strongly brought out here is something that deserves way more focus. This impacts not only residency selection but life in general. The medical profession has lost a major share of its credibility (and public health ALL of its credibility) by lying to people and then expecting them to blindly follow. Some constituencies will: that 10% of spikeshotted children are primarily children of white, college educated, democrat women. They do it as another form of virtue signaling (reading your meeting notes, masks are essentially the MAGA hat of democrats as near as I can tell -- you can doff the hat just like the mask and they are equally protective against respiratory viruses including influenza, RSV and covid).
Maybe the ID community is so left wing there is no saving it, but I can tell you that if you got up and made a speech with this same content for most specialties you would find an unexpectedly strong positive reaction in the audience. Many physicians of my acquaintance are really starting to regret going along and are recognizing what it has done to their reputation and their ability to positively impact their patients' lives. They are looking for leaders (like Vinay and others) that tell it like it is and actually do present truth to power. I understand your decisions, but I hope for the good of all of us that your courage to do/say the right thing grows as time passes -- you have an insightful voice which should be better heard.
Thank you for the interesting essay. I get why you posted anonymously, but also suspect your ideas are shared by many colleagues -- there is a false consensus manufactured by some loud / prominent voices. As you alluded to in your essay, the dissenting opinion on Covid as proposed by Dr. Prasad could be approximated by: "Scandinavia did it better." The fact that this position has generated outrage should generate outrage.
Very scary. The "trust the science" crowd has ruined the reputation of science. The vax mandate and masking requirements at their national conference are absurd.
While I agree with most of this, I disagree that gastroenterology is less intellectually engaging. We take care of every organ in the digestive system, manage complex liver diseases and IBD and perform challenging procedures. Just need to push back against the dumb GI narritive. I really think people don't go into ID because it's BORING.....so boring. Who wants to go to endless meetings about infection control-gowns/gloves/handwashing (yawn) or dig through a chart on someone who has been in the SICU for 2 months to figure out what antibiotics they have taken? I do agree the ourtward display of left-leaning politics of ID people is insufferable. Most the ID people I know wouldn't be very fun at parties, though I judge on a case by case basis.
This is a terrific article! There are many great points, but the idiocy that stood out for me is:
First, attending the meeting required proof of vaccination. Does anybody really believe that in October of 2022, vaccination status has anything to do with the ability to contract and/or spread SARS-CoV-2? Certainly infectious disease physicians should be among the leading people who understand this. Given this reality, what exactly was the purpose of the vaccine mandate at the recent conference? Was it to virtue signal that we are on the "right side"? Was it to increase vaccine uptake rates, which are already likely to be very high among ID practitioners? Was the IDSA "following the science" on this topic?
Embarrassing!
( I have been vaccinated. But I am intellectually honest enough to see that vaccines aren't stopping the spread.)
Unfortunately ID is not the only specialty that fell under the “do the opposite of Trump” politicization of medicine spell with regard to Covid. Family Medicine, Peds, and others are the same. So many doctors’ brains just got broken by this and they were (and still are) unable to accept the evidence as it stands now on all aspects of the pandemic. Some have dug their heels in and are just too stubborn to admit they have been wrong. It is very frustrating to work with these doctors because the rest of us are just trying to practice medicine the same way we always have - learn medicine, follow the data, adjust practices as evidence changes. Hopefully MANY doctors will see themselves in this essay, swallow their pride, and just get back to being normal doctors again. Thank you for your excellent writing.
Requiring the vaccine to attend the show is madness. My (simplified) understanding is that the URT mucosa has abundant ACE2 but few B cell antibodies thus making initial infection almost impossible to stop.
In Australia we have around 95% double vaxxed and around 60 triple.
Yet 14million out of 26 million have had covid but only around 1.5M are not vaccinated. You don't need any further information.
So theory would predict vaccines could not prevent infection and the stats support this.
Award named after Fauci. That's like a financial industry award named after Madoff. Or SBF for all you kids 😁. I've lost all respect for the CDC, the surgeon general, and the medical establishment. (With few exceptions like Drs Prasad, Offit, Makary et al) It's clearly not about being a Dem or GOP. Vinay is a self avowed progressive. It's about being SANE. The very people I need to be data driven worship at the alter of Fauci. Virtue Signaling is more important than patient care (cue college vaccine mandate and doctors just toeing the line). At least in NYC that's the case. I used to tell people"you have no idea how much people sacrifice to become doctors. They deserve all the money, respect and more". Now when I see a white coat, I actually feel anger. I think about my aunt who couldn't be with her husband of 50 years as he died alone. And still feel betrayed by the doctors. I hardly think I'm alone.
Generally speaking (there are always an exception) by paying so little, you are not getting the cream of the crop, but the bottom of the barrel. No wonder ID doctors are where they are and why they did what they did during the pandemic. Fear porn got them noticed and on talk shows and papers published. They are hard pressed to have original thought and go against the narrative that gave them so much recognition. No wonder this author posted without their name, they would be burned at the stake by the mob that will demand that they lose their license and their job.
I may be missing the boat here entirely (wouldn't be the first time) but I'm going to say it anyway. Isn't the bottom line here about admitting there is no answer yet and you aren't willing to speculate just for the people to have some answer? I think ID is viewed as the "minute clinic". You should have the correct answers now. It's ok not to know, but don't say something that a certain group with their own agendas are trying to push you into. Isn't this also about the guts to say you were wrong? ID seems to get stuck between a rock and a hard place much of the time. You're damned if you do and damned if you don't. Right wing, left wing, alt middle, sit down, be quiet, and let ID do what they do best. The answer will come when it comes.
Thank you for taking this risk. My faith in medical possibilities just went up a notch. My sense is that you are in good company, only they would not put their thoughts out for reading. Thanks again.
Everything you said here (other than your [and Vinay's] opinions on best political solutions to society's ills...lol) is spot on and resonates strongly with this hematologist/microbiologist. In many ways you are too kind with what you write-- write some more and you will get closer to Vinay's increasingly incisive style. (Just please avoid bioplausibility...)
But the scariest part of this entire piece, and the part that is most worrisome, is the fact that you, like many other doctors, feel the need to post anonymously. Many/most physicians have fallen into the "go along to get along" category. Some of us have been railing about this since the flip-flop on masking ("The first lie was the worst lie") because it demonstrates that without leadership from people who WILL stand up and be counted, it is entirely likely that the worst possible things will happen because power politics overrules science and medicine every time unless you fight it tooth and nail.
As you also noted, the presumption that people are stupid ("We are the smart ones") that you so strongly brought out here is something that deserves way more focus. This impacts not only residency selection but life in general. The medical profession has lost a major share of its credibility (and public health ALL of its credibility) by lying to people and then expecting them to blindly follow. Some constituencies will: that 10% of spikeshotted children are primarily children of white, college educated, democrat women. They do it as another form of virtue signaling (reading your meeting notes, masks are essentially the MAGA hat of democrats as near as I can tell -- you can doff the hat just like the mask and they are equally protective against respiratory viruses including influenza, RSV and covid).
Maybe the ID community is so left wing there is no saving it, but I can tell you that if you got up and made a speech with this same content for most specialties you would find an unexpectedly strong positive reaction in the audience. Many physicians of my acquaintance are really starting to regret going along and are recognizing what it has done to their reputation and their ability to positively impact their patients' lives. They are looking for leaders (like Vinay and others) that tell it like it is and actually do present truth to power. I understand your decisions, but I hope for the good of all of us that your courage to do/say the right thing grows as time passes -- you have an insightful voice which should be better heard.
Thank you for the interesting essay. I get why you posted anonymously, but also suspect your ideas are shared by many colleagues -- there is a false consensus manufactured by some loud / prominent voices. As you alluded to in your essay, the dissenting opinion on Covid as proposed by Dr. Prasad could be approximated by: "Scandinavia did it better." The fact that this position has generated outrage should generate outrage.
Very scary. The "trust the science" crowd has ruined the reputation of science. The vax mandate and masking requirements at their national conference are absurd.
While I agree with most of this, I disagree that gastroenterology is less intellectually engaging. We take care of every organ in the digestive system, manage complex liver diseases and IBD and perform challenging procedures. Just need to push back against the dumb GI narritive. I really think people don't go into ID because it's BORING.....so boring. Who wants to go to endless meetings about infection control-gowns/gloves/handwashing (yawn) or dig through a chart on someone who has been in the SICU for 2 months to figure out what antibiotics they have taken? I do agree the ourtward display of left-leaning politics of ID people is insufferable. Most the ID people I know wouldn't be very fun at parties, though I judge on a case by case basis.
I taught my boys that smarter people are better at doing things, including dumb things.
This is a terrific article! There are many great points, but the idiocy that stood out for me is:
First, attending the meeting required proof of vaccination. Does anybody really believe that in October of 2022, vaccination status has anything to do with the ability to contract and/or spread SARS-CoV-2? Certainly infectious disease physicians should be among the leading people who understand this. Given this reality, what exactly was the purpose of the vaccine mandate at the recent conference? Was it to virtue signal that we are on the "right side"? Was it to increase vaccine uptake rates, which are already likely to be very high among ID practitioners? Was the IDSA "following the science" on this topic?
Embarrassing!
( I have been vaccinated. But I am intellectually honest enough to see that vaccines aren't stopping the spread.)
I get it and yet, I don’t get it .
This is how a totalitarian state is conceived, born and nurtured.
Unfortunately ID is not the only specialty that fell under the “do the opposite of Trump” politicization of medicine spell with regard to Covid. Family Medicine, Peds, and others are the same. So many doctors’ brains just got broken by this and they were (and still are) unable to accept the evidence as it stands now on all aspects of the pandemic. Some have dug their heels in and are just too stubborn to admit they have been wrong. It is very frustrating to work with these doctors because the rest of us are just trying to practice medicine the same way we always have - learn medicine, follow the data, adjust practices as evidence changes. Hopefully MANY doctors will see themselves in this essay, swallow their pride, and just get back to being normal doctors again. Thank you for your excellent writing.
Wow.
Requiring the vaccine to attend the show is madness. My (simplified) understanding is that the URT mucosa has abundant ACE2 but few B cell antibodies thus making initial infection almost impossible to stop.
In Australia we have around 95% double vaxxed and around 60 triple.
Yet 14million out of 26 million have had covid but only around 1.5M are not vaccinated. You don't need any further information.
So theory would predict vaccines could not prevent infection and the stats support this.
Award named after Fauci. That's like a financial industry award named after Madoff. Or SBF for all you kids 😁. I've lost all respect for the CDC, the surgeon general, and the medical establishment. (With few exceptions like Drs Prasad, Offit, Makary et al) It's clearly not about being a Dem or GOP. Vinay is a self avowed progressive. It's about being SANE. The very people I need to be data driven worship at the alter of Fauci. Virtue Signaling is more important than patient care (cue college vaccine mandate and doctors just toeing the line). At least in NYC that's the case. I used to tell people"you have no idea how much people sacrifice to become doctors. They deserve all the money, respect and more". Now when I see a white coat, I actually feel anger. I think about my aunt who couldn't be with her husband of 50 years as he died alone. And still feel betrayed by the doctors. I hardly think I'm alone.
Generally speaking (there are always an exception) by paying so little, you are not getting the cream of the crop, but the bottom of the barrel. No wonder ID doctors are where they are and why they did what they did during the pandemic. Fear porn got them noticed and on talk shows and papers published. They are hard pressed to have original thought and go against the narrative that gave them so much recognition. No wonder this author posted without their name, they would be burned at the stake by the mob that will demand that they lose their license and their job.
I may be missing the boat here entirely (wouldn't be the first time) but I'm going to say it anyway. Isn't the bottom line here about admitting there is no answer yet and you aren't willing to speculate just for the people to have some answer? I think ID is viewed as the "minute clinic". You should have the correct answers now. It's ok not to know, but don't say something that a certain group with their own agendas are trying to push you into. Isn't this also about the guts to say you were wrong? ID seems to get stuck between a rock and a hard place much of the time. You're damned if you do and damned if you don't. Right wing, left wing, alt middle, sit down, be quiet, and let ID do what they do best. The answer will come when it comes.
Thank you for taking this risk. My faith in medical possibilities just went up a notch. My sense is that you are in good company, only they would not put their thoughts out for reading. Thanks again.