Arguing with doctors

People argue about wearing masks. Doctors and public health experts say we all should. Others dismiss this advice, ignore it, or ridicule it. This public argument with doctors reminds me of many private ones in my own work as a doctor. Patients disagreed with me often enough, sometimes politely.

An unsigned open letter recently crossed my desk. It was directed at a rabbi who is also a physician specializing in infectious diseases and epidemiology, who has been urging masking, social distance, and cooperation with health departments doing contact tracing.

The letter takes this rabbi/doctor to task on several counts: for being inconsistent, for citing inconclusive science, for not caring enough about education (the health department has closed schools), and for pushing “mesirah”—ratting out Jews to (presumably hostile) secular authorities looking for guest lists at celebrations where COVID infection has spread.

You may not know about arguing with doctors because you haven’t done it yourself. Or you may not be aware of it because for many disagreements, the medical stakes are too low to matter. Also, most people avoid confrontation. If they don’t like what their doctor suggests, they go elsewhere.

I think back to Greta, an amiable woman with a lot of eczema. I proposed a prescription salve.

“I use sour cream,” she said.

“Sour cream?”

“I’ve tried them all,” she said. “Market Basket low-fat works best.”

I nodded, bemused, much as I did when people told me that they use Calendula for rashes, tea tree oil for cuts, Vicks VapoRub for fungal toenails, and apple cider vinegar for pretty much everything.

Such arguments are not worth having. The worst that can happen is that people judge treatment ineffective and ask the doctor for something else. Not so often.

Sometimes, of course, the stakes are higher. I think of the man who showed up with a large black growth on his shoulder. “That is a melanoma,” I said, referring to a potentially fatal form of skin cancer.

“I know,” he said. “That’s what the test showed. But I consulted a faith healer in Milwaukee by phone, and she says it’s taken care of.”

“I don’t think it is,” I said.

“What makes you say that?”

“Because I can still see it.”

After some cajoling, he permitted a second — redundant — test. When that confirmed the diagnosis — again — he agreed to have the growth removed. Continued refusal would have left me no choice but to bow out of his care and refer him elsewhere.

All knowledge is imperfect and evolving. There is always room for skepticism and debate.

Still, you have to wonder: how can someone not see what is right before his eyes? To start with, fear is powerful. For that reason and others, people believe what they want to believe, about cancer, about masks, about most anything.

Most people don’t come to an office or clinic to pick a fight. By contrast, the anonymity of social media limits inhibitions to aggression, as does, for instance, opposing masks by styling yourself part of a Cause, like Personal Liberty or Religious Freedom. That elevates you from churl to crusader.

During this pandemic, private disagreements that once slipped under the radar now march out in full battle dress. The letter I referred to ends with a bolded flourish: masks and health-department edicts are leading to “communist Russia.” So far I have not been able to find a mask decorated with a picture of Leon Trotsky.

Widespread fear of COVID-19 has also flushed out fringe ideas: irritating, strange, even bizarre: that Bill Gates and Anthony Fauci planned the pandemic for financial gain; that just 6 percent said to have died of the pandemic actually died of COVID-19; that the pandemic itself is fictitious, overblown, or over with. Then there was the Genesis II Church, which touted bleach as both its “sacrament” and a COVID-19 cure (available for purchase). Lately there is a growing belief that satanic pedophiles have infiltrated the US government. These and other notions, each filled with passionate intensity.

Daniel Defoe tells of proliferating beliefs like these — absurd even in his time — in his Journal of the Plague Year, about the 1665 London outbreak of bubonic plague. Reading it may impress you with how much we moderns have not advanced.

How can people believe such things? How can you look at a black growth and decide it’s not there? People believe what they need to believe. If their needs are great enough, they can believe anything.

The rest of us must recognize such beliefs for what they are and try to protect ourselves from those who hold them. What we can’t do is argue their beliefs away. Whether Jonathan Swift said it first or not, you cannot reason someone out of something he did not reason himself into.

Who knows this better than Jews? How can anyone believe that we poison wells? Bake matza with blood? Cut Arab children up to sell their organs? (Sweden, 2009) Plot in secret to subvert and run the world?

The next time you see expert advice, medical or otherwise, negated or mocked — this afternoon on TV? — you might consider this not as something new under the sun but instead as an old and evil malady, updated and amplified.

In my office, I wasn’t often yelled at to my face and called an idiot, but I remember those few times well. When work gets too intense, you can go home. When the world around you goes mad, where is there to go?

About the Author
Avi Rockoff lives in Newton, Massachusetts
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