The Origins Podcast with Lawrence Krauss - Sally Satel | The War on Science Interviews | Day 7

Episode Date: July 31, 2025

To celebrate the release on July 29th of The War on Science, we have recorded 20 podcast interviews with authors from the book. Starting on July 22nd, with Richard Dawkins, we will be releasing one interview per day. Interviewees in order, will be:Richard Dawkins July 23rdNiall Ferguson July 24thNicholas Christakis July 25thMaarten Boudry July 26thAbigail Thompson July 27thJohn Armstrong July 28thSally Satel – July 30Elizabeth Weiss – July 31Solveig Gold and Joshua Katz – August 1Frances Widdowson – August 2Carole Hooven – August 3Janice Fiamengo – August 4Geoff Horsman – August 5Alessandro Strumia – August 6Roger Cohen and Amy Wax – August 7Peter Boghossian – August 8Lauren Schwartz and Arthur Rousseau – August 9Alex Byrne and Moti Gorin – August 10Judith Suissa and Alice Sullivan – August 11Karleen Gribble – August 12Dorian Abbot – August 13The topics these authors discuss range over ideas including the ideological corruption of science, historical examples of the demise of academia, free speech in academia, social justice activism replacing scholarship in many disciplines, disruptions of science from mathematics to medicine, cancel culture, the harm caused by DEI bureaucracies at universities, distortions of biology, disingenous and dangerous distortions of the distinctions between gender and sex in medicine, and false premises impacting on gender affirming care for minors, to, finally, a set of principles universities should adopt to recover from the current internal culture war. The dialogues are blunt, and provocative, and point out the negative effects that the current war on science going on within universities is having on the progress of science and scholarship in the west. We are hoping that the essays penned by this remarkable group of scholars will help provoke discussion both within universities and the public at large about how to restore trust, excellence, merit, and most important sound science, free speech and free inquiry on university campuses. Many academics have buried their heads in the sand hoping this nonsense will go away. It hasn’t and we now need to become more vocal, and unified in combatting this modern attack on science and scholarship. The book was completed before the new external war on science being waged by the Trump administration began. Fighting this new effort to dismantle the scientific infrastructure of the country is important, and we don’t want to minimized that threat. But even if the new attacks can be successfully combatted in Congress, the Courts, and the ballot box, the longstanding internal issues we describe in the new book, and in the interviews we are releasing, will still need to be addressed to restore the rightful place of science and scholarship in the west. I am hoping that you will find the interviews enlightening and encourage you to look at the new book when it is released, and help become part of the effort to restore sound science and scholarship in academia. With no further ado, The War on Science interviews…As always, an ad-free video version of this podcast is also available to paid Critical Mass subscribers. Your subscriptions support the non-profit Origins Project Foundation, which produces the podcast. The audio version is available free on the Critical Mass site and on all podcast sites, and the video version will also be available on the Origins Project YouTube. Get full access to Critical Mass at lawrencekrauss.substack.com/subscribe

Hi, and welcome to the Origins Podcast. I'm your host Lawrence Krause. As many of you know, my new book, The War on Science, is appearing July 29th of this year in the United States and Canada. And to celebrate that, we've interviewed many of the authors of the 39 authors who have contributed to this volume, and we have 20 separate podcast interviews

that will be airing over the next 20 days, starting July 22nd, before and after the last. the book first appears with many of the authors in the book on a host of different subjects. The authors we will have interviews with in order of appearance over the next 20 days are Richard Dawkins, Neil Ferguson, Nicholas Christakis, Martin Budry, Abigail Thompson, John Armstrong, Sally Sattel, Solveig Gold, and Joshua Katz, Francis Wooderson, Carol Hoven, Janice Fiamengo, Jeff Horsman, Alessandro Strumia, Roger Cohen and Amy Wax, Peter Bogosian, Lauren Schwartz and Arthur Rousseau, Alex

Byrne and Modi Gorin, Judith Sisa, and Alice Sullivan, Carleen Grible, and finally Dorian Abbott. The topics that will be discussed will range over the need for free speech and open inquiry and science and the need to preserve scientific integrity stressed by our first podcast interviewer Richard Dawkins. and will once again go over historical examples of how academia has been hijacked by ideology in the past and the negative consequences that have come from that to issues of how specific disciplines, including mathematics, have been distorted,

and how certain departments at universities now specifically claim that they are social activists and a degree in their field is a degree in either critical social justice or social activism, not a degree in a specific area of scholarship, how ideology has permeated universities. We'll proceed also to discuss issues in medicine. Sally Settel will talk about how social justice has hijacked medicine. And also, when it comes to issues of gender affirming care, we have a variety of authors who are going to speak about the issues there and how too often gender affirming care claims are made.

are not based on empirical evidence. In fact, falsely discuss the literature in ways that are harmful to young people. We will talk to several people who, for one reason, another, have been canceled for saying things. Francis Whittleson at Mount Royal University in Canada, and Carol Hoven from Harvard, who eventually had to leave Harvard after saying on television that sex is binary in biology will be talking to people who've looking at, at the impact of diversity, equity, and inclusion in academia, and how it's restricting free inquiry, and also restricting, in many ways, scientific merit at those universities.

And finally, Dorian Abbott, the last contributor to our series, will be talking about three principles he believes are essential to separate science and politics and keep academia free from ideology and more for open questioning and progress and to make sure that science is based on empirical evidence and where we go where the evidence is, whether it's convenient or not, whether it's politically correct or not, and we're willing to debate all ideas that nothing is sacred, a central feature of what science should be about

and what in some sense this podcast is about. So I hope you really enjoy the next 20 days and we've enjoyed bringing it to you. So with no further ado, the war on science, the interviews. Well, Sally Sothal, thank you so much for being on the podcast. It's always a pleasure to talk to you. And also thank you for writing your wonderful piece for the book. I really appreciate it.

Thank you so much. Love to be, by I participated. Yeah, it's great to have you part of it. But what you may not be aware of is that The Origins podcast is called The Origins podcast. and I'd like to find out about people's origins of how they got to the point where they are to where we're discussing what they're doing. So I want to have a brief discussion of how you got to the point of writing this piece, which goes way back.

And I get to learn about you, even though I've known you for 20 years, I get to learn things I didn't know before, which is, so what, well, you did your BA at Cornell. What was it in? Oh, it was in biology. Just straightforward biology? Okay. Yeah. And so where do you, I think of where you grew up.

Where do you grow up? I grew up in Queens, New York. I figured that. Somehow I could say out. From my accent. Yeah, exactly. Which is where there, but for the grace of God, I would have been. Because I was born in Queens, but I happily moved where I was three months old.

But so were your parents, you became a, maybe they wanted you to become a doctor. But what got you interested in science? What do your parents do? I don't know. Oh, well, my mom was a housewife and my dad was a photographer. And honestly, they didn't really think that I, they kind of would prefer that I went to college, but they never felt pressured.

Oh, wow. And they were wonderful parents in that. I never felt, frankly, pressure to do anything. And they were always supportive. But, you know, I think my mom, you know, read. So, you know, there were always books around. But I think what was probably one of the biggest influences on me is that I went to a school. It was a public school. But my classmates were really smart and ambitious and their parents were professionals. And so that context,

you know, really, really helped me to probably be exposed to more things to have more, you know, friendly competition, more stimulation. I'm grateful for that. Well, that's great. It's what I tell people about going to college, too. It doesn't matter where you go, go to a place where your peers challenge you, and that's the best thing you can have. But what got you interested in science then or in biology in particular? Oh, Mutual of Omaha's Wild Wild Kingdom. I watch that every Sunday with my dad. Oh, that's so wonderful.

to be, sorry, of course I wanted to be Jane Godal because what girl doesn't. And, you know, I was horse crazy. But, and I really thought I'd be a vet, a veterinarian. But then when I got to Cornell, I met William Provine, who was a historian of science and especially evolutionary biology. And I, that kind of got me on the path to evolutionary biology. And I applied to, to the University of Chicago to get a Ph.D. in that. And I tell you, it didn't last. I was there in my department for three years, loved every minute of it, loved the University of Chicago, loved Chicago, loved my colleagues. But, and this is a story I've only been, I feel like able to tell them in the last few years, but my first year, I got an infection.

and the standard treatment for that, it was an inflammatory condition, was high-dose steroids, you know, prednisone. Most people have been on it at some point. And one of the side effects of prednisone, especially if it's high dose, and I was on a high dose, was that you could develop psychiatric symptoms.

And I didn't know this. My doctor didn't tell me. And I basically went a little mad. I got profoundly depressed. I mean, like at a level that was just unfamiliar to me, where it was practically immobile and, you know, just kind of slept all the time and the kind of condition where if you had more energy, maybe you'd kill yourself if you thought this could never end. And the most bizarre symptom I experienced was receptive aphasia. So most people have heard of expressive aphasia.

It's typically associated with strokes. And it means that you know what you want to say, but you can't form the words or get it out. You can't communicate. But receptive aphasia, which is more rare and almost, I think, undescribed as a side effect of high-dose steroids, means you can't understand what people are saying to you. And it was really, if it weren't so fascinating, it's so horrifying, it really would have been fascinating. I kind of couldn't read.

I remember reading the paper, and there was an ad for carpets. And I remember asking someone, well, why would anyone need a pet for their car? I mean, if things just made no sense. And then I told my doctor, And he kind of half laughed and said, oh, that's the steroids. And I thought, oh, yeah, thank you for telling me.

And so with steroids, as you may know, if you've been on them for like two weeks or more, you can't just take a person off them, especially if you've been on at a pretty substantial dose, because then you'd become effectively adisonian. You would just lose all cortisol because it would take a while for your adrenals to start producing their own. And so that was like a four to six week process of slowly coming off. And by the time I got off it, you know, I was fine. I knew what carpet meant and I could do my work again, although I should say my department at the University of Chicago was wonderful. They just said, take as much time off as you need. So basically I took off maybe two months. But anyway, when I came out of the whole thing,

I thought, you know, oh, my God, there are people who go through experiences like this, and they're not because they're due to some medication, and it's not time limited, and it will end when that medication is, you know, withdrawn, that their own neurotransmitters were effectively revolting on them, and they never really know when it would happen again. They might be dependent on medication to keep that from happening. And I thought, I am leaving graduate school and going to. a medical school to become a psychiatrist. So that's my origin story.

Well, that's a great origin story. That answers a lot of my questions. I wonder why you're a wonderful thing. And what a wonderful way to think about that. Your story, I'm surprised Oliver Sacks didn't write something like that about your story. But anyway, but the medication. So you went to medical school and I was going to ask if you want to be a doctor, you want to be a psychiatrist.

But now I know you want to be a psychiatrist. and I have to say you're one of the few psychiatrists that are to talk to. But anyway. Not charging you enough clearly. Yeah, good. Help me. But, okay, so that's great. And but then what's interesting to me is your interest, so you were interested in, you know,

hard science and you became a doctor. But then you clearly, that didn't satisfy your interest alone because then you almost immediately went to become a policy. for a Senate committee. So somehow your interest, or at least, you know, it wasn't just treating people. There were some more general aspect of science policy, which interested you, which is going to be relevant for what we're going to talk about in your article, too. So what caused you to become a policy fellow? Why do you want to do that? Well, I'm always interested in unintended consequences, even when they're classically medical, and that's usually called iatrogenic effects. I'm also interested when there's like socialiatrogenesis.

And I saw that at the VA. That's where I worked as a resident in the West Haven VA. And then after I finished residency and I stayed on in my department, I worked for five years at that VA. And there were two basic observations I made. What had to do with the way we were doing research on drug addiction? It was a completely legitimate line of inquiry. It had to do with trying to find. medications that could help with crack addiction.

But I remember thinking, first I would have been very surprised to ever find a medication that could basically cure addiction the way you can cure pneumonia with the right antibiotic. And I was dismayed that there were some of my colleagues and even professors sort of saw it that way. It's obviously a condition that has enormous, you know, psychological and social dimensions to it. And so that really has more to do with my sort of academic interest. But then I also worked with, as I mentioned, worked with veterans and post-traumatic stress disorder, which of course existed since a Peloponnese war. I mean, any that's been around, all you need is a central nervous system.

to develop basically a fear reaction that doesn't extinguish once the stressor is removed. That's a technical definition of PTSD. But that definition was so politicized and understandable in the context of the Vietnam War was such a fraught phenomenon in our culture. But we were, I felt that we were diagnosing people who really didn't have PTSD, but there was pressure to do that. and the pressure. It came from, some of it was probably programmatic.

They just wanted to fill their new programs because PTSD was not recognized as such until 1980 by the American Psychiatric Association, you know, the DSM was three at the time. And but I saw that the way we were treating some of these folks was making matters really worse. And one element of that was the disability, the whole disability system at the VA. You basically created a perverse incentive where people were rewarded for remaining ill.

And so the incentives were in all the wrong directions. And so that thought me very interested in sort of the politicization of psychiatric illnesses and other factors that are extra clinical, so to speak, that determined how we diagnosed people, how we treated them, how they saw themselves, we saw them. And so that was, I guess, the basis of it. And then I made the move into the policy world in 1993, 1993, when I took a Robert Wood Johnson Health Policy Fellowship, which brought folks to D.C.

It really was an incredible experience, and you worked with a, a congress my case was a congresswoman and um and one of the issues that came up it was just an amazing like the stars are really aligned because um one of the issues that came up was basically the misuse in this case it was social security disability income so there were real parallels between social security and the veterans what's called service-connected um disability entitlements which is to say that people would get their disability checks and spend it on drugs. And so that was an issue I also got involved with at the VA, which was, you know, how can we help kind of curate these funds

so that they serve as incentives for people to quit drugs as opposed to facilitating, you know, their habits. And that came up in the form of Social Security when I worked on the Hill. was an amazing thing because there was a big investigative report on how people were getting money from what's called SSI's supplemental security income. And it would come often in a huge lump sum because people could be awarded what's called back pay. In other words, it wasn't until this current date that you gave me the disability, but I applied for it many, many years ago. And to make matters even more intense, one of the disability diagnoses could have been addiction.

So in other words, you could have been receiving public funds because you were too high or intoxicated to work. And it was just a very strange kind of program. So I worked with the senator who said Nancy Casabalm of Kansas to try. try to make that program more feasible. In other words, it would be time limited that people would have to go to drug treatment if they're going to be in it. And we have to conceptualize it more as a treatment scholarship than a disability payment. And anyway, I was just hooked.

And then I ended up at American Enterprise Institute. And then not only you've been in this instance as possible, but you've been no stranger to controversy. I mean, your own case of having to have a kidney replace or having to have a kidney and discussing the challenges of getting a kidney, it's just remarkable. And then you actually also, the subject of what, you know,

your article for the book is called Social Justice MD, Medicine Under Threat. But you did write a book a long time ago, a book called PCMD 20 years ago, which is, you know, about politically correct constraints on doctors. So this issue that that, that, that you write about here is nothing new for you in a sense of being concerned about medicine itself as a so the the the the way medicine is carried out nationally the medicine as a

profession and interestingly enough the first you start your piece with with a department wide lecture you gave at Yale University in psychiatry in 2021 and it relates to clearly something you also you'd done and I was going to ask why In 2018, you'd gotten a grant to, I think, to go to look at Ironton in Ohio, and it was a place that was reeling under the opioid crisis. So what caused you to, before we talk about what happened is when you talked about that lecture, in your lecture, when you talked about your experience, what caused you to want to do that to take a year off to spend in somewhere?

in Ohio in a place where the opioids had clearly affected the entire community. Yeah, actually, I tried to do that for two years. I tried to help out in that Appalachian community. And I went through what you call Locum Tenons kind of situations. In other words, where doctors are sent to various needy places. But I didn't want to go to Alaska. I didn't want to go to Montana, which is where the options were. And finally, of all things, a colleague at AEI suggested I asked J.D. Vance.

And this was the pre-Trump J.D. Vance. And he'd written, of course, Hillbilly Ellogy, which is really an excellent book. So he was able to find me this small town in Ohio population in 10,000. It's right if you can envision it. It's right at the southeastern tip. So it's at the tri-state area with West Virginia, Huntington, West Virginia, and Ashland, Kentucky, and Ironton, Ohio, which is the smallest of the three cities meet there, right, on the Ohio River. His probation actually supported it, right? He had a foundation with the proceeds of that book, I assume, and it was the J.D. Vance Foundation that supported your effort? Yeah, partly, yes. And so, but I wanted to do that because,

You know, only half the counties in the country even have a psychiatrist, let alone an addiction person. And there were, I'd seem to just constantly read about pleas to have, you know, for substance abuse professionals. And that was the clinical field I went into, ultimately, is addiction psychiatry. And I thought, well, I can go. And so it took me two years, but finally I got there. And so I stayed for a year and helped out and interviewed a million people.

And hopefully in 2006, you'll see the book that is the result of that experience. So it's really about addiction, but it's told through the lens of this small town. Okay. And so it sounds like a very something that a psychiatry problem would be very, you know, amenable to and very sympathetic to. And you lectured in January, 2021. Your lecture was about that year, assisting treatment efforts, and you discussed the depth of despair phenomena, first described by, I'm reading you now, Princeton economist Angus Dieton in an case, and showed photos of haunted industrial landscapes. And you spoke up with a culture of prescribing in rural mining towns and many factors that caused crisis,

and you would do attention to the dimensions of personal agency and addiction. And maybe that was the triggering thing. because, you know, it sounds like a remarkable lecture. And then afterwards, you got an email from the chairman of the department, who you've known, you know, I know you were at Yale for a long time, and you'd known since your interns together. And he admitted that he had not anticipated, quote, the extent of the hurt and offense that folks would take place to your presence.

He appended an anonymous complaint that he received from an unspecified number of, quote, concerned Yale psychiatry residents. have to read this. They wrote that the language you used in your presentation was dehumanizing, demeaning, and classes towards individuals living in rural Ohio and for rural populations in general. We find your canon to be beyond a difference of opinion worth debate. And basically argued that your canon of your work was racist. So, and so that, that must have been a surprise. And what happened? It was a surprise. It was no black people. I mean, very few. you in Ironton.

I haven't, my theory is that somebody directed them to other work I did write, which was certainly not racist, but was critical of the interpretation of health disparities, whether that's another issue. But in any case, yes, you're right, the idea that talking about agency and addiction was a trigger. and also I pointed out that while Purdue Pharma certainly has a role, had a role in instigating the opioid crisis, you know, through their aggressive marketing of Oxycontin, which happens to be an excellent drug for many people, not all, but many in chronic pain. If you want to understand epidemics, you can't just look at one factor. it's almost incoherent to look at one element of the supply side of the equation.

There has to be demand for these intoxicants. And that gets to the whole story of Appalachian other places since, again, the dawn of time. Ever since there have been epidemics, epidemics are community phenomena. Why is the community in such pain? Because I'm a big believer in the self-medication model of addiction, that people use drugs for reasons. Clearly, there are genetic aspects to it. Of course, there's the neuroscience of addiction.

No question about any of that. Drugs affect the brain. But these are, those are just one dimension of a far more complex, you know, phenomenon. And I think they were somehow taken aback that I did not, want to blame, you know, an easy villain. You know, it's just a much more complicated story. Pardon me? You know, I mean, that obviously triggered people, but what amazed me is the letter said,

would you continue to invite grand round speakers with racist and classist mindsets like Dr. Sattel? And they requested that you, they, that the chairman revoked your lectureship at Yale because you're a lecturer at Yale and he did not do so. So, I mean, so this is. But you left out the retramatizing part. Was that? You left out the part, the timing of this was two days after January 6th. Yeah, okay. So instead I re-traumatized them.

Yeah, okay, yes. That's two days after January 6th, the attack in the capital. And so you re-traumatized people. So you have professionals who are two things. One, clearly arguing that some social justice basis should be at the bed, should govern speakers and not speakers, but also that somehow there are adults and they could be retramatized by hearing words that somehow affect them and that they don't want to hear it.

And it's shocking and we'll go on to that. But I mean, that clearly, that aspect in this case in a medical school is particularly concerning that hearing things you don't want to hear somehow traumatizes you. you think that that happens a lot, especially in psychiatry. But, but, but, and I'm told that, and then you next say that it was three years later when you were next time you were going to speak and that, that journal club was canceled, right? I mean. Yeah.

I did speak to them. That was last year. So then this year, I, a few months ago, I met with the new residency director, who I was very impressed by. And I think we'll be able finally to reactivate my involvement. And I'm grateful, you know, they reappointed me. And that made me nervous because the, you know, the form you have to fill out for reappointments is, what have you contributed this year to Yale education?

Yeah, it's like, nothing because you won't let me. But then, someone seemed to understand that. And I'm grateful. Having at least, I'm happy that your, that your lectureship continues. But what is surprising is the next thing you write about, which is shocking to me, is after the Floyd murders, the epidemiologist Jennifer Nuzzo at Johns Hopkins Bloomberg School of Public Health, informed would-be marchers that, quote, the public health risks of not protesting to demand an end to systemic racism greatly cede the harms of the virus. This is COVID. And days later, 1,200 health professionals cheered her all. on in an open letter.

Comment. I mean, it's remarkable. It's remarkable statement. It really is. I mean, from the standpoint of the actual text, it's incoherent. I mean, you can't attach metrics to what happens if you don't do something or even the long-term effect of marching on race. So, I mean, she was probably just caught up in the moment.

I gather she's a good epidemiologist. I don't doubt that for a minute. So there's that. There's three levels on which this is odd. One, it's just a sort of a scientifically or even logically bankrupt statement. The second is, of course, the hypocrisy. And this has been noted by many other people. So in other words, if we all wanted to go out and march for life or go to a temple or

whatever, that would have been way too dangerous. But assuming we did that outside even, but this was obviously something that was not prohibited by, you know, public health folks. But, but the third, and to me, this is the most important inference of all this from that tweet is that, you know, her job and the job of others, she wasn't alone, believe me, in her sentiments, but, you know, that job, is not to tell us which risks to take, it's to tell us what the risks are. And admittedly, they can't do that perfectly, but in good faith, certainly that's what epidemiologists do. You know, tell us what the risks are. We will take them into account and decide what we want to do. But don't tell us which risks are worth taking and what our moral prerogatives should be,

which is basically what she was doing. And that, to me, of all of those three, of the three problems with that statement, that to me is just the most, it's the most problematic because it reflects, it's the one that reflects on what's going on in, you know, in public health schools and in medical training today, that, you know, the social justice imperative has just become really ascendant. And in some schools, not all, you could still get a good medical education, but increasingly, you know, honestly, next to pathology and hematology and, you know, pulmonology, there's indoctrinolegy, which happens to be my term for kind of what's becoming valued in medical schools.

Well, you point out that in 20, in 2021, again, George Floyd, the AMA advocated mandatory anti-racism training as well. part of its directed that all physicians, quote, confront inequities and dismantle white supremacy, racism, and other forms of exclusion and structure oppression. I mean, this is the AMA saying there's white supremacy in medicine. And they produced a 54-page document called Advancing Health Equity, a guide to language, narrative, and concepts,

which basically argues that standard medical education and standard medical practice is, is bad. Well, they're, yeah, they're putting their social, you know, their ideological politics really, you know, over patients. The real question is how does that, how is that playing out in health care today? I'll give you one example that could have gone very badly because I'm sure it'll come up again in some other form.

And this also was COVID-related and also was in the news, but it's worth repeating, that in late December of 2020 when the vaccine was finally on the horizon, and there was lots of discussion about how we're going to allocate it because, you know, it's a scarce resource. And there are always models for this kind of triage. Either the people with the best prognosis should get it, the people who are most likely to be infected should get it. some triage schemes actually do first come for serve or even lotteries.

I mean, these are, and in various, depending on the particular circumstance, some may make more sense than others. But what no one has ever said makes sense is race, is prioritizing on the basis of race. And that is what the advisory council committee on immunologic practices for the CDC had actually recommended. This was the ACIP committee that RFK just disbanded. But they actually talked about health. They were basically adopting a health reparative,

as in reparations, kind of a mindset to this. And the logic was that if we do prioritize age, which it would be, an obvious demographic factor to prioritize because those folks were the most susceptible, then we will inadvertently give this injection to more white people because the population over 65 is disproportionately white. So we suggest not doing that. Now, to be fair, you know, they all agree that first line practitioners should be, should definitely, be first in line and front-facing employers, you know, fine. But then, you know, then it became

a question of, well, then who next, who next, who next? And they put race much higher. I was about to say much higher on the scale that it should have been, but it shouldn't have been on a scale at all. Of course, you do this by clinical factors. And this was just outrageous. And even the CDC itself, which, to their credit, of course, did not adopt this. recommendation, did calculations which show we'd have more deaths overall if we followed your recommendation, including elderly black people. So that is an outrage. And it was averted. Less well-known were a handful of bioethicists who felt we should adopt the same reparative strategy with the distribution of ventilators. Well, luckily, we learned early on that that

wasn't, you know, the way to go for acute, you know, COVID. But same idea. Black people have been, you know, disadvantaged by the health care system, let alone the society. And this is a way to compensate. No, it's not a way to compensate. I mean, that's a discussion you can have in a social sphere, but in the medical one, that's not a variable that's coherent. Yeah, exactly. It's not a relevant medical thing. And you point out also that this fixation on this fixation on inequities and social justice that may or may not exist and whether they're irrelevant to the medicine itself. But they also reduce, I was, you know, you talked about pro-Palestinian medical students and doctors when wearing cafes and the job at

UC San Francisco. And, and I love your statement. You didn't need to be hip-hawks. to know that patient trust in doctors and medical institutions depends on health care professional strict duty to un-couple their political ideology from their clinical work. So if you see these doctors marching for whatever political cause, and then you have them in, you know, come and have to treat you, it changes your willingness to trust them, clearly. Yes. And they, you know, they could be excellent, absolutely excellent clinicians. Well, why should a patient even have to think twice. That's a burden you should never put on a patient. And this kind of activism, admittedly, I mean, I like to think that was a real outlier, you know, the end of a bell curve

and not the tip of an iceberg. But still it's outrageous and less intense forms of that are going on. And that's because, again, in many medical schools, you know, the mission, there's an effort to really shift the mission of medical training from kind of healing to sort of. social justice and the identity of physicians from doctors to activists. And some medical schools have actually courses on activism. And they don't seem to, now it's one thing. Now, as you know, with this beautiful bill here, a lot of Medicaid costs are going to be cut. And frankly, I'm terrified of that as a doctor. All my patients are on Medicaid. I think that is a perfect legitimate target for physician activism, advocacy, whatever, to protest that. I do. But what's

considered acceptable in many quarters are what are called upstream factors, things that are not directly related to patient care, things that physicians have no deep expertise in, and things that if they get to involve, as you said, may affect patients' attitudes and trust and their colleagues. I mean, you know, you've got to collaborate with your colleagues to save people and treat them. And when you even just trust a colleague, that's not a healthy environment. Yes. And it's, well, exactly. There's that. And you point out, I mean, again, to get back, that this is cut, this is, this attitude is being reinforced in medical schools. And you, you talk about a course on, at UCLA, a mandatory course on structural races. in which the guest speaker led students a chance of free, free Palestine,

demanded that they bow down to Mama Earth while praying for black, brown, and homeless people who died because of their capitalist lie of private property. I mean, that to be a medical school is just remarkable. And so the bulk of the rest of your piece is about ways in which social justice medicine, or indoctrology, as you call it, poses a danger to open inquiry. And there are several examples. And you start with the example from Katie Herzog. You want to briefly, we'll think of that one.

Right. Well, Katie talked, she interviewed a number of doctors. She should say. So go on. Yeah. And so she interviewed doctors who, many of whom told her, you know, we're basically muslin ourselves. You know, we feel we can't talk freely. And I have seen the same thing.

I've seen many clinicians, and I should add, teaching in medical school is different than teaching in a college. You have a big class or maybe you have a seminar, but in medical school, it's on the ground. You take patients around, excuse me, the students around, small groups usually to talk with a patient, and then afterwards you talk about what you've seen and the diagnosis and what could have treatment and all this. And it is so easy to step, it's just so easy to step on a landline. you know, some microaggressive, you know, explosion goes off. Maybe you've misgendered someone, heaven forbid. Or maybe in a different context, you would talk about even affirmative action in medical schools.

Maybe you would talk about the fact that health disparities, which is defined as differences in access and to care and health status between various groups, maybe it's all not due to systemic racism. And even to the extent some parts of it, maybe once we're due to systemic racism, they are not the factors that sustain these problems. And that's what we have to look at, that these kinds of discussions are just, let's say, frowned upon at least and actively suppressed at worst. And so these physicians who have, often they have discretionary teaching. They could spend more time in a lab or they could spend more time in a clinic.

but they elect to do rounds or whatever with students are backing away. They are backing off interaction, these senior seasoned people who know so much and have been around for, you know, the medicine for so long, they are backing away from having interaction with medical students. And this is an insidious loss of expertise. None of this is quantified. I haven't even seen, I've been begging to try to do some sort of polling of doctors. And I, so I wish I had more systemic data for you. I could certainly say that there is a, there's an age gradient, you know, doctors who are older, much more outraged, offended.

I used the word offended, so I shouldn't, you know, disturbed by this trend. younger doctors, you know, less so. There's good data. Younger doctors being farm, younger doctors are most commonly and in large percentages on the left of the spectrum. Well, there are also younger doctors, after all, are being educated in the system you've just described, where they're told that's part. Yes. It's a combination of all of that.

It's a combination of right, just a cohort of fact. But in college and, you know, and then graduate school or medical school, they've, been unculcated in this mindset, then they already are amenable to the mindset because they have, their politics are left of center. And then this is really controversial, something I want to look into a little bit more. You know, Corey Clark has done really fascinating work with psychology professors and their receptivity to cancellation, to the idea of canceling. colleagues who they perceive as being somehow inimical to the cause of social justice, and that they are overwhelmingly female, and medical students now are increasingly female. So I don't, I mean, I realize that's quite provocative.

There are, of course, spectacular female doctors, I go to one, I know many, but that's a trend that I wonder, as I just speculate, that that may also be, fueling this. Okay, interesting. Okay. And that, okay, but let's now, there's another example you talk about the article of, you know, this is people, this is in a bit, the, the stifling of open inquiry. And you talk about Jeffrey Flyers, the former dean of the Harvard Medical School, not, not, you know, no slouch. And his experience, Jeffrey Flyer, forward dean of Harvard Medical School, graduate of Mount Sinai School of Medicine, signed up for educational modules offered by the school in the wake of George Floyd. As flyer described in an article he wrote in 2024 in free press,

the sessions comprised of sustained accusations of white supremacy and medicine, dismissal of the scientific method and medical research, with a scolding a flyer thrown in for good measure when he gently questioned the value of the vague term anti-racism and discussions of improving minority health. And when he submitted a paper in academic medicine outlying some of his concerns about the anti-racism instruction, the paper was rejected in two days, he wrote,

without peer review or editorial explanation, which is just remarkable. So why do you, why do you relate that? What happened to him? Yeah. Well, luckily, he will be editing his own issue of a journal just on these topics. And I really hope because, I mean, it is an academic journal. Unless it's science or nature, they typically don't make headlines. But I really am hoping that his volume, which won't be out until 2026, of course,

course. And he's invited, you know, people to contribute will really get some attention. Let's hope so. But as you point out, a number of people do say people keep their heads down and their mouth shut for good reason. And another good reason is another example you gave, which is Norman Rack Wang. What happened to him? That's just an outrage. And he just lost his last lawsuit as a a month ago. So I don't know if he has it in him to keep going. But he is an absolutely brilliant electrophysiologist. That's probably one of the most demanding fields within cardiology. And he wrote an article, a peer-reviewed article for the Journal of the American Heart Association. I think he wrote the article back in 2021. And it was on affirmative action and in medical training. And in medical

training and he put an emphasis on cardiology. And it was a pretty data heavy paper. And he concluded both from what he's seen in his experience, but also EM focused on the data, which showed that minority students will get admitted to medical school. This is all averages, obviously, but with substantially lower MCAT scores and GPAs than white or Asian students. And so basically his argument was that, you know, this is just not good for patient care. And as an aside, of course, you know,

we could talk forever about the educational pipeline and how deficient and just criminally negligent, some schools are, you know, in the elementary level and so on, that has to be fixed. That's a national outrage. But medical school is not where you compensate for these things. That's just too far down in the, you know, in the sequence. And so he said this, not with the same polemical sense that I'm saying it now, but it came out loud and clear that this is just not good for patient care and for the profession.

And his department took his fellowship away, meaning he was the director of the Electrophysiology Fellowship at the University of Pittsburgh Medical Center. They did not allow him to lead that fellowship. They, not clear to me if this is still true, but they did not allow him to have contact with medical students or other trainees. His paper was retracted. And it didn't allow it because his views were, quote, inherently unsafe. Yes. Yes. This dangerous electrophysiologist.

And then he was just excoriated on Twitter. We're in the middle of saying that. I'm sorry. I interrupted you. Just to make a clear. Well, his paper was retracted. And the reasons were the kinds that would warrant a letter to the editor that they had to do with him quoting someone. questionably out of context.

And, well, and apparently the Heart Association tweeted that his article, quote, does not represent the American Heart Association's values. Not whether the science was correct, but the values were wrong. Yeah. And so, right, and his, and he

was just savaged on Twitter and even his colleagues, you know, were just a bleh, cut this out where I'm saying, blah. You better. Anyway, yes.

And his colleagues were at the University of Pittsburgh were just undone. They were beside themselves, how they could have a colleague with such malignant views. Okay. So, I mean, this is what happens if you speak out. And, you know, people can disagree with you. But in this case, you're actually removed from your positions for actually merely in this case questioning whether a policy is a good one.

But actually it's bad enough that you point out a team writing in health affairs in 2020 warned researchers and this is the case of race and genetics which is a highly not controversial but a highly politicized issue. It says warn researchers

who planned to publish on health disparities to never offer genetic interpretations of race because such suppositions are not grounded in science. And they propose that medical journals reject articles on racial health inequities that fail to rigorously examine racism. And they say that the review process requires editors who are well-versed in critical race theory. And so this whole area of genetics and race in any way, you can't talk about it because if you do, they're subject to huge problems. Well, there are two things here.

First is the meta message, which is you can see the deterioration of journals, what they will accept. This is just a completely baseless commentary. And that has been all over the, from the New England Journal of Medicine to JAMA down. So that's one problem, is that there's been just such accommodation of grievance articles. it's quite incredible. We don't get enough funding. Basically, give us more funding without even looking at, you know, scores of, you know, scores you get on your grant application and, and the quality of, anyway, just all, again,

disparate impact kind of analysis. But, yeah, as far as genetics, now, to be fair, there still is this research going on, especially in a topic dear to my heart, which is, of course, kidney research, where genes really do genes and the African-American race or African, I suppose, ancestry really do matter for certain forms of renal disease. It's really one of the most powerful illustrations. I mean, there's kidney function of gene called APOL 1, which the point is, if you refuse to look at that, what you're doing is risking people's lives. because there are certain genes that are different in different racial groups. Of course. And I think to argue that, and this is one of my favorite statements in your place.

You said the objectivity of research is not a form of complicity and structures of power. It's the very condition for the discovery of treatments that are genuinely universal. So to argue that, you know, objective research is complicit in some evil system and therefore one should not do it, is basically arguing against the discovery of treatments that can help people. And you point out in this case, as I say, EPP won this gene, is one really good example. And it's that you're risking people's lives because of your social justice imperatives. And what's always struck me is that when you talk about these issues in terms of population genetics, you know, the idea that there are going to be certain alleles that are going to be just more frequent,

depending on where one's ancestry, you know, over the millennia, you know, come from. And that's going to affect, you know, going to affect the probability that they may have or may not have certain conditions. Is something almost everyone, they don't have to be that sophisticated in their knowledge of, you know, genetics. They get that. Everyone gets that. And yet somehow in this sort of environment, it gets, it just gets, you know, turbocharged and politicized. But, you know, it's pretty, it's a fairly simple concept on the, you know, on the surface.

And, well, it doesn't translate. Somehow that never translates into, in this other realm. They're like parallel universes. Well, I want to give you the last word by reading some of your last. words. Do no harm is a covenant that doctors make with patients, not with political systems and hierarchies. If health is completely at the mercy of social forces and social justice ND insists, will the importance of self-care be given adequate attention? If certain topics are off limits and every possible hypothesis is not open to investigation, how will knowledge mature and innovation

progress? Will a health equity agenda so distort the priorities of medicine that patients will be harm. The pragmatic imperatives of clinical practice may be the best buffer against ideology. The surgical suite, the emergency department in the examining room are the definitive consequential spheres of political intervention. And finally, you say that in the realm of medicine, doctors do their best work aiding those who are most vulnerable and in need, regardless of group affiliation. And my favorite sentence in the whole book is, the best way to be an anti-racist doctor is to be a good doctor. And I thank you for being well to speak out about this topic, which of course is politically charged. But it's important for medical education. You think,

you know, as I've often said in physics, oh, well, it doesn't matter if someone gets a PhD, what can they do, put out a shingle-prank physicist, you know. But you'd hope that doctors, the medical education doctors would concentrate on medicine and not something else. And most people and hope their doctors have been so educated. And I applaud your willingness to speak out on this and many of the subjects, even if it's politically incorrect. Well, thank you, Lawrence. And your book is in advance in that direction because I think one reason that it's continuing to go on

is because the public doesn't really know about it. They know about the trans situation. That's much more visible, but this is not. So this is part of a larger effort to get the word out. and thank you for allowing me to do that. Well, thanks, and you're right. That's what the part of this is about, to let the public know what's going on,

and to have it from people from inside. Too often we hear criticism for people outside academia or outside science, but these are people like you, distinguished researchers and colleagues and writers who are concerned about this from within. So it was a great piece, and it's always a pleasure to talk to you. And thank you.

Thank you, Lawrence. Hi, it's Lawrence again. As the Origins podcast continues to reach millions of people around the world, I just wanted to say thank you. It's because of your support, whether you listen or watch, that we're able to help enrich the perspective of listeners by providing access to the people and ideas that are changing our understanding of ourselves and our world and driving the future of our society in the 21st century. If you enjoyed today's conversation, please consider leaving a review on Apple Podcasts or Spotify.

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