Episode Transcript
Speaker 0 00:00:00 Hi everyone, and welcome to the 133rd episode of the Atlas Society asks, my name is Jennifer Anju Grossman. My friends call me Jag. I am the c e o of the Atlas Society. We are the leading nonprofit organization introducing young people to the ideas of Iran in fun, creative ways, like animated videos and graphic novels. Today we are joined by Jean Lenzer. Uh, before I even get into introducing our guest, I want to remind all of you who are joining us on Zoom, Facebook, Instagram, Twitter, LinkedIn, uh, you YouTube. You can use the comment section to type in your questions. As always, go ahead, get started, and, uh, you'll be at the top of the queue. We'll get to as many of them as we can. So, our guest today, Jean Leer, she is an award-winning independent investigative journalist and author whose work has appeared in medical journals such as the BMJ and the Journal of Family Practice, as well as the New York Times, Washington Post, Smithsonian Magazine and The Atlantic. She is the author of The Danger Within US America's Untested, unregulated Medical Device Industry, and One Man's Battle to Survive It, which explores threats to medical science that undermine public health. Uh, what really also caught my eye is, uh, gene has brought a unique perspective, um, coming from out of an investigative journalist to bear on the, uh, covid lockdowns and things like vaccine mandates, uh, which is informed by her research over the past three decades into the intersection of government money and medicine. So, Jean, thank you so much for joining us.
Speaker 1 00:02:01 Thanks so much for having me.
Speaker 0 00:02:04 So, um, you have a rather unique origin story. Could you share a bit about what originally led you to pursue medicine as a career, and then the events and the discovery process that led you to switch fields to become an investigative journalist? Yeah.
Speaker 1 00:02:26 Well, um, I was very interested in the physician associate program at Duke University. It was the first to start training people, uh, to treat patients where there were shortages of physicians. And, um, uh, it wasn't long after I graduated from the program and started working that I started to realize that, uh, there were some very serious illusions in medicine. And I mean, I was absolutely captivated. Um, and one of the first things that I stumbled into is exactly what led me. Um, it was one of, of the things that led me to, uh, leave practice and, and work as an investigative journalist. And, and when I talk about medical illusions, I'm talking about things where we really believe that the data show us, and that we have the evidence and that we're doing the right thing, and that we're saving lives only to find out later that we were actually causing more harm than good.
Speaker 1 00:03:19 And, um, one of the examples that that just killed me was I was working solo in these rural ERs where, um, patients would come in with chest pain. And I did, like all physicians are trained to do across the country guidelines from the American Heart Association were that patients who had chest pain should be treated to prevent this certain type of abnormal heartbeat. So there are these premature beats called PVCs, and if people are developing a heart attack and they have a pvc, it can trigger, it can touch off a deadly rhythm ventricular fibrillation, where they'll be dead within minutes. So we routinely gave these medicines to stop these PVCs and it was amazing because, I mean, I, I don't know how many times I've ordered the drug for chest pain patients and watched whatever PVCs they have just melt away. They disappear. It's fantastic.
Speaker 1 00:04:12 We knew that those abnormal beats were associated with higher mortality. So surely we were saving lives by stopping these abnormal eats. Took more than a decade of this drug being on the market and recommended by the a h a before they bothered to do a study that actually looked at the difference between whether you gave people the drug, the whole class of drugs, um, that were similar to lidocaine versus placebo. And what they found was fascinating, even though they did get rid of the PVCs, people who were treated with a drug were 3.6 times as likely to die as patients given placebo. And this just started me on a whole pathway of looking at it, you know, if, if, if, if we were, um, misled about this, if we didn't see this, how many other things were we missing? And I found that there are illusions like this in virtually every aspect of medicine. And I've written, actually, one of my favorite articles that I've written was in Smithsonian about this very issue of medical illusions. And, um, I give a lead example there, a very different type, but, but that's what led me to investigative journalism. I was fascinated by why didn't we know this? Why didn't we see this as clinicians and what kept this happening? And that's where I started to see the collision of medicine and science. I mean, I'm, I'm sorry, money in science and how money often played a role in distorting what we thought was science.
Speaker 0 00:05:45 Yeah. Well, I I thought it was interesting in, in reading your book, um, how it's not just, you know, this anecdote or, um, this particular scandal, but you really put it into a context of what were some of the things that happened to change the way that that, uh, medical care is delivered. And a lot of that was driven by public policy changes. So, um, so it's a very interesting area of, uh, of research on, on multiple levels. And I think for this audience that is interested in philosophy and interested in politics, um, it's, uh, it's, it's really terrific. Now, uh, you wrote in, um, in, uh, mother Jones in 2001, questioning whether corporate donations to the American Association might have influenced, um, its drug line drug guidelines. Yeah. Do you think such influence happens more or less, uh, in a post covid world as you look back two decades?
Speaker 1 00:06:50 You know, I don't know that it's any more or less likely to happen in terms of industry influence. Industry influence is ubiquitous, and multiple studies show over and over that, um, when industry conducts studies, they're much more likely to come out with positive outcomes for their products and much more likely to sort of ignore and even, um, to conceal the harms of their drugs or devices. So, um, industry's an issue. I mean, they, they, uh, spread their large s everywhere, um, to patient groups, to politicians, to the F D A, uh, and unbeknownst to most people, to the C D C to the N nih. So that's a problem in and of itself. But, um, covid, what it has done is to, I think, make people more amenable to lowering standards of science. And historically, that's a real problem. We have examples that we should have learned from the past.
Speaker 1 00:07:48 And one example is what happened during the aids, uh, epidemic when, uh, that's when they started dismantling the rules of science at F D A. And, uh, Greg Gonzalez is one of the people as an AIDS activist, an ACT up. He was one of the ones who fought mightily to lower the standard saying, we can't wait for two randomized control trials. We need results now. Well, after years of finding that, you know, rushing science doesn't work, I mean, you can sometimes spend more energy getting people to study a problem and come to a quicker conclusion, but you can't force it. You can't force discoveries and the rules of science still have to stand. And that's exactly what he's come to. Now. He's an epidemiologist at Yale, arguing that the F D A needs to strengthen its standards and that it should not be lowering standards. One of my favorite books of all time is Aerosmith. And that's all about, um, how, again, money interfered because they were anxious to get a vaccine out during a pandemic, and they wanted this guy to just promote this vaccine before it was ready to be, uh, promoted. That was a hundred years ago. All the same forces that we're talking about right now, money, medicine and science, just not you, you can't study gravity and say, it's gonna happen because I decided it's gonna happen. Well,
Speaker 0 00:09:11 That's very much in line with Objectiveism, and as Ayn Rand says, you can evade reality, but you can't evade the consequences of ev evading reality. Um, and interesting that you used, uh, both the AIDS epidemic and, um, what happened with, uh, with the covid interventions and vaccines as examples of lowering standards of science, who, of course was a pivotal figure, uh, during both of those, um, episodes as, uh, Dr. Anthony Fauci. So perhaps we can get to that a little bit later on. But I, I also wanted to touch on another piece that you wrote, uh, an opinion piece that you co-authored with Shannon Brownlee in Scientific American entitled The Covid Science Wars, uh, which I understand <laugh> triggered attacks on the article and attacks on you, uh, personally, um, scientific American then published, uh, set of false and misleading corrections. If I understand to the article
Speaker 1 00:10:17 You for putting that in
Speaker 0 00:10:18 <laugh>, please tell, tell us what thank, uh, tell us what happened.
Speaker 1 00:10:23 Yeah, it's pretty disturbing. Um, so our article, the gist of it was that we need everyone at the table. Science doesn't advance by saying, we're only going to listen to one set of witnesses. We're not gonna listen to this other set of witnesses. And we gave a historical example, um, related to cholera, where two different scientists ha came at it with very different points of view about what caused it. And the important thing is that both of them had a piece of the truth, and both sides had something important to say. And we were just saying, you know, don't shut down. Um, one side of this conversation. Now, um, the side that was being shut down largely was anyone who dared to say that we shouldn't lock down. And, and that was within the medical community. I mean, it's very different in the lay community, but within the medical community was largely accepted.
Speaker 1 00:11:17 You must lock down and you must use masks, and you must use these vaccines, et cetera, et cetera. And, um, uh, Sweden was pointed to us a total disaster. And we were just saying, wait a minute, let's get data first. Let's understand this. Let's hear everybody out. Well, what happened next is that rather than discussing those issues, we got attacked saying that we had, um, somehow had this conflict of interest because two of the people we cited and quoted were John Jonita and Vanai Prad, two physicians of some renowned, very respected, who both published, um, important, uh, works. And, um, the conflict was allegedly because I had co-authored, uh, with, and I think Shannon had too, we had co-authored with Dr. Jonita and Dr. Prad in the academic literature years ago. I, it's like six or eight years ago, we'd published an article. Now there's no money that changed hands. There's no <laugh>.
Speaker 1 00:12:19 I, I couldn't get a promotion as a journalist because, you know, I did. I mean, there, there was no conflict of interest. And yet, despite the fact that there was no conflict when we first published about Jonita in, um, UN Dark, the, the magazine associated with m I t, um, I sent them an email saying, look, out of an abundance of caution, I just want you to know that I did co-author with these guys. And so they said, okay, we'll make this an opinion piece. Well, after the firestorm broke out, and it was a firestorm of attack, that somehow I had this terrible conflict of interest, um, uh, un dark acted as if we had never notified them. But I had the email, I have the email where they acknowledged me saying it to them, and where they even said, okay, we'll make sure this is listed as an opinion piece.
Speaker 1 00:13:09 And then Scientific American, um, exacerbated the whole problem by repeating the lie that Andar had, which was that we hadn't declared. Now, also, scientific American had given us a conflict of interest form. We answered every single question. They never asked about, did you ever publish a scientific article? Because nobody ever asked that That's not considered conflict of interest. So the whole thing was clearly politically based. It was not based in science, it was not based on anything that we quoted wrong or did wrong. It wasn't attacked because we dared to, um, say, let's hear out these both sides.
Speaker 0 00:13:45 Right. Really a a position of, uh, a free speech, and it's important to scientific progress. So, um, pretty, pretty insane. So, um, we have been following carefully, uh, the Swedish experiment. Uh, I had Johan Anderberg who wrote, um, the Herd on our program, uh, from Sweden, journalist over there, um, who talked
Speaker 1 00:14:15 About, yes, I'm sorry, I missed that. I've heard him, yes.
Speaker 0 00:14:18 Yeah, the behind the scenes of, of, of what happened and, and how the, the leaders in that country just resisted incredible pressure, very, very Howard Rourke, uh, to turn away from what they, they were, you know, interpreting the science and saying that this is actually the, the best way to proceed. So, um, you, uh, and a good friend of the Atlas Society, uh, Dr. Jeffrey Singer, um, were on a panel for Cato, uh, which I thought was very, very moderate, you know, very reasonable <laugh>. This is not, uh, exactly a, a bunch of ideologues at, by any stretch, people coming from, from different perspectives, from journalism, um, from epidemiology. Uh, and I would love to the panel focused comparing on, uh, Sweden's response to Covid to that of the United States. Could you please expand on why you think that covid deaths aren't necessarily a consistent way for countries to measure the effectiveness of, uh, covid interventions?
Speaker 1 00:15:27 Yeah, there's actually multiple reasons not to rely on covid deaths, not to compare them. Um, one would be age alone, the demographics of a society. So say in Swaziland, the, uh, lifespan, there is 49 years of age, 75% of covid deaths in the US occur in people over the age of 75. And that's true throughout the world. It was really a disease of the elderly. So if you don't have any elderly people, you're gonna have a very low covid death rate in general. That's one aspect. If you don't have older people, the other thing is socioeconomic status. Uh, in a poor country, everything is worse if you're poor, whether it's cancer, heart disease, suicide, whatever it is, if you're poor, it's worse. So, um, that changes what the outcome is likely to be. And a third reason is just reporting now among wealthy nations, it's pretty standardized, you know, all cause mortality, in other words, every single death is recorded, and it's recorded in a relatively timely way where you can understand what's happening to people. Um, but, uh, covid deaths for those, I just gave three different reasons, you know, that you may see variables, um, it's really not the way to go.
Speaker 1 00:16:44 So what we did was suggest that we use, uh, uh, all cause mortality. Yeah, yeah. And that, so, uh, do you want me to go into that now? Yeah,
Speaker 0 00:16:54 Yeah. Well, I was gonna mention your, um, you referenced the Kaiser study that showed that Sweden had almost no excess deaths for those under 75. So yeah, I would love to, to hear more about why excess uh, mortality, is it important, uh, benchmark and, and maybe just some insights into what's going on with, uh, all, all cause mortality in the different countries and the different approaches.
Speaker 1 00:17:19 So I was dumbfounded when I came across this Kaiser Family Foundation study, and the reason I was dumbfounded wasn't because I was surprised. I actually wasn't that surprised at the outcome. I was shocked because nobody reported the findings of the ki, I mean, Kaiser is used by outlets all around the globe. So I asked the lead author, you know, I mean, have you been contacted by any media? And she said, Nope, Nope. There was just no zero reporting on it. And what was so astounding was the outcome, as you pointed out, that there was no excess mortality in people under the age of 75 in Sweden. So how can that be? Well, it's not like there were no covid deaths among, uh, younger people. There were some, but as people stayed home voluntarily, there were perhaps fewer deaths from, uh, other infectious diseases, or from covid or from car accidents.
Speaker 1 00:18:16 So basically it stayed basically the same. And the way you look at this, all cause mortality translated as excess mortality. And I'm gonna explain that. So with excess mortality, what you do is you look, they took the five years prior to the pandemic, and you get the average number of deaths in that five year period. And say a country has a million deaths per year on average, and then during the pandemic, the first year of the pandemic, there are 1.3 million deaths instead of 1 million deaths, then there's a 30% excess mortality. And what's so valuable about excess mortality is it includes not just the bump from covid deaths, but it includes all the knock on effects of lockdown. And what was really important about the study was that it was in the year 2021 before the vaccines came out. So the only measures countries could take were public health measures, lockdown, and other measures like that, distancing, whatever.
Speaker 1 00:19:16 So what you saw was the effect of lockdown and then knocked on effects if people didn't go to the ER when they had a heart attack, cuz they were scared to go, or because they were committing suicide at higher rates or because they were turning to drugs. And that's exactly what happened in the United States, was a dramatic escalation in drug overdose deaths in homicides, um, just, and there were effects. People have heart attacks and people have drugs and things that they just weren't getting diabetes, things that got outta control. So that was a really valuable metric. And what the Kaiser Family Foundation did was they looked at 11 wealthy nations, pure nations. So we're looking at like, I think it was like England, Australia, Sweden, uh, New Zealand, uh, France, et cetera. And, um, it was the, on Sweden was the only country that had no excess mortality under the age of 75.
Speaker 1 00:20:11 Now, they were heavily criticized for having, um, deaths in, in the elderly. And, and, and they, them criticized themselves about, you know, not moving fast enough in nursing homes. However, even though they had, uh, some excess mortality among, um, those over 75, they have, uh, countries here, they still did better. I don't know where it is. They still did better than something like eight other. So out of the 11 nations, they did better than either seven or eight. I think they placed like eight in doing well, um, doing better than all these other countries. And effectively what we did with our lockdown was we transferred the harms of this con of this pandemic, both physically and financially from the elderly to young people. So if we had done what the Barrington folks suggested, which was focus protection, focus it on the people where it's needed the most in nursing homes for the elderly, and let younger people go about their lives instead, we scared the wits.
Speaker 1 00:21:17 I mean, saw kids just terrified living in fear. They lost a couple years of school, they were living in fear, they turned to drugs, and it's just insanity. And this is where, you know, it makes me sad that we couldn't just talk about what we needed is civil discourse. And that's what Shannon and I were arguing for in our Scientific American article, is that we need to just look at data and not make emotional accusations. Well, you're just out to kill people. I don't think any physician or public health expert or anybody who makes a recommendation either for or against lockdown, wants to kill people. I believe that my colleagues who really believe in lockdown, they wanna save lives. That's what they believe, I believe differently. But I think the answer to this is to discuss the numbers that data that we have, and discuss those data honestly. And unfortunately, you know, I'm a I I I'm on the other side of the fence here. I'm a lefty. And unfortunately it was my progressive and lefty friends who were attacking me and others who would dare to say, we gotta look at the numbers, not, not these emotional things about it's the right thing to do, <laugh>.
Speaker 0 00:22:29 Well, that was, uh, you know, one of the reasons, uh, that I particularly wanted to have you come on, um, because I, I'm hoping that people that have, uh, kind of made their cognitive commitments on these issues because of partisanship or ideology might be able to hear it or be, be open-minded hearing what you have to say and, and might be mistrustful of some of, of what I might have to say, <laugh>. I actually want my parents who, uh, who are quite liberal democrats to be able to, uh, to, to listen to what you are, are bringing to bear, because it is, um, unfortunate that, uh, that this has become such a politicized issue. But I I do also appreciate that you're the sort of open, objective, benevolent approach to saying, I'm not going to attack your motives, and I'm, I'm not, uh, going to, um, just pick a, pick a fight with you. But I, but I'm open-minded as David Kelly says, if, uh, we are right, we have nothing to fear. If we're wrong, we have something to, to learn. So, um, the only thing I have to fear is gonna be our audience getting angry with me because I'm, um, hogging up our time here. And there are a lot of really great questions that are coming in. So, uh, Caitlin Temer on Instagram is asking, Jean, what was the most difficult issues you had to face in your medical investigations?
Speaker 1 00:24:12 Blow back from industry? I mean, there's no question about it. Their power is enormous. And, um, you know, they, they can make life very, very difficult and their threats are pretty continuous. And, and I, I, you know, I've, I've tracked a number of medical whistleblowers, doctors who have seen bad things happen, and I've seen what industry has done to them. And <laugh>, it can be rough. They play rough.
Speaker 0 00:24:38 Adam Martinez on Facebook says, do we have an idea of how much our medical establishment is just a mouthpiece for big pharma?
Speaker 1 00:24:49 You know, it's difficult. I mean, that's one of the things that, that I find so distressing is that, you know, I went into medicine because there are good things that medicine does, and it's, there's nothing more wonderful than to see a kid who's, you know, on the verge of dying from an asthma attack, and you pull them right out of it, or a diabetic and you can get them right back. Um, you know, so they're great things, uh, but, uh, industry is everywhere and they are tremendously exaggerating, um, outcomes and benefits. Um, and, and, and I'm actually tracking a story right now where, uh, the lead scientists at one of the drug companies acknowledged that they simply changed the deaths of patients, the causality, so that it wouldn't look like it was from their product just simply changed them. Didn't even talk to the doctors who made the diagnoses, they just changed it. So it's, it's a problem. It's serious.
Speaker 0 00:25:43 Are you gonna,
Speaker 1 00:25:43 And that's why I think, so my bottom line is what I, I hope for is that we bring back cruelly independent research, and we don't have that because pharma money is flowing into the N I H, the C D C and the F D A and, and, you know, we need something that's truly independent for the people that can, a address questions that are, you know, not necessarily profit making, but that people need to know.
Speaker 0 00:26:09 Ann, uh, on YouTube asks, what are the implications of people at Scientific Americans so easily catering to the biomedical state or even, uh, joining as enforcers for approved narratives?
Speaker 1 00:26:23 So well here, I don't know that, you know, I mean, just because something's independent doesn't mean it's gonna be right. Or that we don't all have our own biases that are a problem. And in fact, Shannon and I addressed this, um, in the bmj and then remind me, I wanna get to the thing about masks too. But, um, you know, yes, individual biases can be powerful, and we all know how our own, you know, we have our own opinions and they're strong, and they can be hard to let go of. And the same is true for researchers. However, industry has a very different effect. And that is that they have a unit directional effect. So personal biases, one person's gonna say this, another person's gonna say that. And you put it all together and you assess it. But industry makes sure that the narrative is always in one direction.
Speaker 1 00:27:10 It's unidirectional their product works. And anybody who says otherwise, they either drown out or actually kneecap. And I have a number of examples. I've, uh, done a lot on whistleblowers. So you look up lens or, and whistleblowers, you'll find, uh, stuff on that. Um, the other thing is, is that they have the power to trot out, um, their lawyers, their sock puppets, their social media activists, their pr flax, and, um, and thereby they can really, uh, change what the narrative is. So even if somebody, um, exposes something like Shannon and I will be doing about this drug I was just talking about, um, it won't, you know, they'll drown it out.
Speaker 0 00:27:51 Interesting. Alright, well, let's get, I'm gonna pause the audience questions and, uh, let's get to the, uh, study on masks that you referenced. I think it was the Bang Bangladesh study that came out last year about the efficacy of masks and how that became part of the rationale, uh, for masking kids at school in the United States. Yeah. Um, tell us a little bit about your
Speaker 1 00:28:16 <crosstalk>,
Speaker 0 00:28:17 So your experience with that study and its author.
Speaker 1 00:28:20 Yeah. So it wasn't just the Bangladesh study, but that sort of was a capstone by the time we got there. So Tom Jefferson and Carl Hennigan, um, in Britain had done, um, a lot of research with the Cochran Institute, which was the Cochran Collaboration, which was largely supposed to be very independent. It's not a hundred percent, but they, um, the idea is that they didn't wanna be an industry source. And so they looked at masking, uh, before covid for flu viruses, and they were unable to find really any significant benefit from, uh, masking for flu viruses. If they did, it was marginal, very marginal. Um, so they've been arguing that the whole masking thing is overblown. So we had that in the background. And then the Danes did a study, um, and that study was of 6,000 people. And, um, they found, uh, again, almost no significant difference when they did.
Speaker 1 00:29:19 So there's only two randomized control trials, and that was the Danish study and the Bangladesh study, all the other observational studies where people claim, oh, we know masks work that's based on observational data. And observational data has the exact same problem that the use of covid deaths has, because you have very different groups who choose to wear masks. You have have very different groups of people in certain areas if you observe them and say, well, this state wore masks and this state didn't, so you, you just can't compare. What you need is a scientific study. And only two scientific studies have been conducted, um, of mask wearing in Covid. And, um, like I say, the one was Danish. And, and I talked to the editor in chief of the Annals of Internal Medicine, which published that study. And they were taking a task for even publishing this study because it didn't find a benefit.
Speaker 1 00:30:12 And it was sort of like, how dare you publish this? You know, this is gonna discourage people. And they said, well, you know, we published what the facts are, this, we find them. So it took some courage on their part to do that. The Bangladesh study was massive, and that involved, I think it was like, they'll look here up my notes. I think it was like, yeah, it was 300, yeah, 342,000 people were in that study. And here they gave away free masks. They did, um, all sorts of notifications. They did text messaging, they followed the people around. I mean, they did everything to make sure that masks were worn and were effective and stuff like this. And that study was heralded as proof that kids should be masked. They masks work was a big headline somewhere. I, I tracked that down. Masks work. Well, let me tell you what the actual facts were from that study.
Speaker 1 00:31:04 And from my written communications with the lead author, there was a 99% failure rate. So the difference between those who wore masks and those who didn't wear masks went from 8.5% to 7.5%. That's a 1% difference. That means that 99% of the wearers achieved no benefit. So you can't say it's no benefit, but we're talking about pretty close to it. On top of that, the people who accrued any benefit were the elderly, not young people. And on top of that, to use this as an excuse to mask children, they excluded anyone under the age of 18. So they never studied it in children, I mean, <laugh>.
Speaker 0 00:31:51 Wow. And so, so October, the, the, the eight versus seven, so in the mask wearing group, uh, like 7% caught covid, and then the
Speaker 1 00:32:04 8% caught it in the right, in the non mask wearing group. Right.
Speaker 0 00:32:09 And that's
Speaker 1 00:32:10 The, so 1%
Speaker 0 00:32:11 That, that is, uh, that is justifying masking.
Speaker 1 00:32:15 Yeah. And, and so we have to look at where we put resources too. And one of the things we did not do during this pandemic was to pay health aids decent wages and nurses. So they're desperately taking on three jobs, working three different nursing homes at once, spreading it from nursing home to nursing home because they're so underpaid. Some of 'em don't even have healthcare as part of their benefits. I mean, it's tragic, this wealth gap that is driving people to extremes and, and, and into poverty. I mean, we have people working in nursing homes who, you know, have to use, uh, food stamps. Uh, they, they get paid so little and they do the hardest, most unrewarding work. So it's nutty. We could be using money better ways than filling all our rivers with a bunch of discarded masks, I think. But, you know, not, probably not that expert.
Speaker 0 00:33:05 Uh, alright, I'm gonna jump back into the, uh, audience questions here. Um, and tomar in 86 on Instagram asks, Jean, you mentioned the stress and fear that young people dealt with during, uh, COVID. What are your thoughts on the current state of, uh, mental health in, in America?
Speaker 1 00:33:33 Well, here, I worry once again, um, back in, um, I forget what year, um, I think it was about 2004 ish Bush mm-hmm. <affirmative>, uh, president Bush recommended that everyone in the United States be screened for depression. And what that meant was that, and by the way, guess who wrote the screening tool that's used every time you go to a doctor and they ask you, have you been depressed lately? That's a screening tool that was devised by the drug company. So guess what happened to drug sales? They went up, up, up. And do we have any evidence that it's really an approach that's working? I think, you know, our focus on drugs is just unhealthy. And so this whole thing, yes, we're all anxious, we're all having troubles during this pandemic. Um, we're worried about a lot of things, all of us. Um, but I think the focus right now that we should start screening everyone, which is what just happened, the U S P S T F is now recommending that everyone gets screened for anxiety.
Speaker 1 00:34:36 It means that we're gonna start prescribing more drugs and some people who may benefit and need medicines, and that's fine. But we know that getting market share is what the drug companies want. And so they devise these tools. I'll tell you an example. Um, there was a pre, uh, uh, what do you call it? Um, postnatal depression. Okay. So women who get postnatal depression. Now, I've never given birth, so I don't know, I just took the little quiz to see, but they phrased the questions in such a way that if you're a human being, if you're alive, if you have feelings, you're gonna have to answer yes to at least one or two of those questions. So I got diagnosed with postnatal depression <laugh>, according to the screening tool, which means I what
Speaker 0 00:35:21 I'm drawn, you know, after giving birth to your, your book
Speaker 1 00:35:25 <laugh>. Right? Right, right. Yeah.
Speaker 0 00:35:28 All right. Well, um, we've got a question here from Carl official on Instagram. Where has there been the most damage in, uh, in done in regards to how medical industry has conducted itself, uh, during covid? Um, is it people's trust in authority or people's trust in, in science? So science with the quotations, sort of the, the science tm.
Speaker 1 00:35:57 Yeah. Well, I'm sad, sad, sad, sad to see how little scientific understanding of basic, basic concepts there is among the public. And, you know, doctors don't understand, a lot of doctors do not understand critical appraisal of medical research, so they rely on the f d A for for what they think. But I'll, I'll come back to this issue of trust in science. You know, we, we lose the trust of the public when we exaggerate benefits and when we pretend that we have answers. I mean, not, one of my favorite articles was by a former, um, editor in chief of the New England Journal who talked about uncertainty and the need to sit with uncertainty. That the drive to get an answer right away is really detrimental. And, um, I, I don't see any way out of this mess. I mean, we have people who, you know, they, they believe that there are, you know, uh, what is it, lizard people, I mean, there's not much we can do with that.
Speaker 1 00:37:03 Um, but scientific principles, basic understanding of, you know, that you want to look at a group of people who have an intervention and you wanna separate that group of people from another group of people who are virtually the same and they don't have that intervention or they have a different in. And that's how you learn. That's the only way we have to know. And I'll, I'll give another example. Um, I was fascinated by the whole Vioxx debacle. So some of your people too young to remember this, but there's a painkiller of an aspirin like painkiller called Vioxx. And it turns out that it probably killed about 60,000 people according to, uh, the f d a safety monitor, David Graham. And, um, he was shot down. I mean, they really did everything they could to keep him from going public with that, um, information. But eventually it did become public and Vioxx had to be withdrawn from the market.
Speaker 1 00:37:55 But my, my question to myself was, I mean, we all prescribe that drug, that painkiller is very commonly used. It was used for millions of people. Why didn't we see the carnage? Why didn't we see those deaths? The answer is actually somebody worked it out mathematically. And I, I wish I could find that study. If anybody knows about it, let me know. Because what he did is he looked at the average number of patients that any doctor sees. And if he's have a panel of say, 4,000, 5,000 patients, how many of those patients are gonna be elderly? Cuz those are the people who are taking these painkillers regularly. They took it for arthritis. So, and then of those, how many were likely to die in any one year? So you have seven of your patients who die, and how do you know, did they die because they were old and gonna have a heart attack anyway?
Speaker 1 00:38:40 Or did they die because they took Vioxx? And one of the most telling examples was one doctor who was in his fifties, a runner, very athletic and healthy. He took Vioxx himself because he believed the propaganda that was in the New England Journal of Medicine about the drug that the drug company had promoted. Um, he took it himself, he prescribed it to a patient. His patient died of his patient had a heart attack. And I don't know if he died or, and his family sued, but the doctor himself developed a heart attack. So he sued the company saying, you misinformed us. So he hurt both a patient and himself. And the only way we discover that is through these large scale studies, these randomized controlled trials, we can't see it. You can't rely on somebody saying, oh, I've treated lots of people. They're fine. It's not good enough.
Speaker 0 00:39:32 All right. Here, let's see. Craig Leon on Facebook asks, why is there not a bigger push for exercise and other therapeutic remedies? No money in it, question mark. So I guess he's Oh,
Speaker 1 00:39:46 Exactly.
Speaker 0 00:39:48 To, uh, you know, covid and, and, uh, what the push for vaccines,
Speaker 1 00:39:56 Uh, say that again, that last time. Covid
Speaker 0 00:39:58 Covid, covid, covid covid. And the push for, for vaccines that really, uh, you know, you, you must be vaccinated. Uh, and regardless of whether you've had pr previous infection Oh yeah. Or not, yeah, that natural immunity is, uh, downplayed. Um, but yeah, in, I guess it, it could also be be more broadly.
Speaker 1 00:40:18 So. Well, the first part of the question, I think about exercise. So I mean, there have been studies already showing that workplaces that have gyms, you know, do better. They have less, um, sick leave and, and problems like that. So, you know, I mean, there are a lot of things that we could do that are for the common good, um, that don't get looked at if there isn't a profit motive behind it. And that's where I really believe that we need more public funding for actual public good. Um, as for the, the vaccine, yeah, I mean, this is the whole issue of surrogate endpoints. So I'll talk about that for a minute. Um, I remember very early in the pandemic, uh, I asked that very question of one of the leading experts on vaccines. And I said, you know, how do you know that once somebody has covid, that they're not better protected than with the vaccine perhaps, or as well protected?
Speaker 1 00:41:08 And he said, well, we know it because their antibody titers are higher. Well, again, think of antibody titers, like I mentioned, the pbcs, those abnormal heartbeats. Th that's a surrogate endpoint. A surrogate endpoint is what's used almost entirely now by F D A to approve drugs. It's not a finding that you've either extended a patient's life or made them feel better. What it is, is some measure like the size of the tumor, did it shrink or the level of glucose in a diabetic or cholesterol in a heart patient. So those things, see, the, these are, that's where the illusion lies. Yes, we know that high blood sugar and diabetes kills people, but just because you lowered their blood sugar doesn't mean you're not killing the patient's liver. So surrogate endpoints can only measure benefit. They cannot measure harms. And so this assumption that because we got rid of the nasty thing, we got rid of, you know, the, um, tumor size, yeah, you can shrink a tumor, you can <laugh>, uh, you can laser beam it away and kill the patient. We need to know a, a clinical outcome. And that's unfortunate what's been dropped. So the same thing with antibodies. My next question to 'em was, well, you know, just because the antibody titer is higher, are they doing any better? Are they any less likely to die? And of course, they didn't have the answer to that at that time when I asked the question, but this is typical. The acceptance of a surrogate endpoint is somehow translating into benefit.
Speaker 0 00:42:41 All right, well let's turn in some of the time that we have left to your book, the Danger Within Us, we're gonna show that on the screen. Um, and I also want people to check out the audio version of it that Jean narrates herself. And I told her, if, if this investigative journalism thing doesn't work out, she's got another career as a narrator, cuz it's really just, just one wonderful voice. Uh, so what was the inspiration behind, behind the book?
Speaker 1 00:43:18 Well, a patient came to me and um, uh, he said that he had nearly been killed by a medical device. And, um, he really taught me a lot because I was completely unaware of yet another illusion. And that's exactly what was going on with this device where everyone assumed that when it was used, it was benefiting the patient and not harming them. And the illusion is
Speaker 0 00:43:44 Talk, talk about that. Talk about that
Speaker 1 00:43:46 In particular. Okay, so he, he was, he, he had epilepsy and, um, there was this device called a vagus nerve stimulator. And the idea was that it would, they, they would insert this, uh, uh, device in just like a pacemaker in under the skin near the collarbone. They'd thread a wire up around the, uh, uh, the vagus nerve and then they'd stimulate it. And the idea was that somehow magically it was gonna stop seizures. Nobody knew how or had any science behind it, but they did these studies and allege that it did. Now here's where things get really tricky in medicine. When you say that a drug we prove this drug has benefit, benefit in medicine does not mean net benefit. So you can pick five different things, things that a drug does, say you've got aspirin and it reduces, uh, temperature and it reduces inflammation and it reduces pain.
Speaker 1 00:44:38 So you pick an endpoint out of 20 different endpoints and you, you say that one works and you're not looking at any of the other end points and you're not looking at harms. All you're doing is saying, I found this particular benefit. And here it gets even more bizarre. And that's where it took me a lot of time to catch on to what this patient was saying that is that the benefit measured was any decrease in seizures. What they didn't mention was that the patient, all the patient's overall in these studies almost had an equal number of patients who had increased seizures. But that wasn't, you didn't subtract the increase in seizures from the de decreased seizures. You just announced, well, 30% of people had a 25% reduction in seizures you don't add. And 29% had a 33% increase in seizures. And I'm not, don't quote me on those numbers, but that's vaguely the arena of what happened.
Speaker 1 00:45:34 I mean, it's crazy. Yeah. And, and it's so confusing even to doctors when, when a study is reported as showing benefit, they assume it really means net benefit. And when you and I talk, if I say I went, you know, I, I bank with this bank because you know, it's the best one, I benefit from it. We assume that that means neck benefit, that any fees I had to pay were less than, than what I got in interest. But that's not true in medicine and that's not true for a reason. I mean, if you give a patient a drug for, to prevent heart attacks and it reduces heart attacks by say 10%, that's really something. But it maybe causes liver failure in 1%. You can't quite subtract liver failure from heart attacks. So you do have to report benefit and harm separately. But here it was truly bizarre cause the benefit and harm was seizures itself. Not to mention that it was also causing people's hearts to stop. Yeah,
Speaker 0 00:46:32 Well that was what happened, <laugh> with the, the patient that, uh, that got you interested in it and that you followed. And, and that was, um, a really interesting story because the device was sort of triggering, was it every three minutes or so? Yes. And yeah, and uh, every three minutes he was losing consciousness and they were like, oh, he is just having a seizure every three minutes. But in fact he was, uh, having a massive drop in in blood pressure, um Right. Leading to
Speaker 1 00:47:05 Yeah, exactly. I mean his, that's what got my interest is he sent me his EKGs and I, cuz I always asked for the medical records of anybody who, you know, I have to vet everything. And that comes through and, and I mean, I've worked ERs for many years and you only see a flat line that long when somebody's dead and dying. And it was just stunning to see this happen. Um,
Speaker 0 00:47:27 And also so
Speaker 1 00:47:28 Followed through to
Speaker 0 00:47:28 See yeah, the, uh, in the, his, his attempt to challenge and get some kind of, um, restitution for this, that the defense was, uh, that <laugh> this was not caused by the device even though, um, the, the phenomenon stopped when the device was turned off. Right,
Speaker 1 00:47:50 Right, right, right.
Speaker 0 00:47:51 I was like, okay. Um, yeah. And then you also point to some sort of structural, uh, as I mentioned before, the kind of the context in which all of this is is happening. And, you know, you and I are would probably disagree on some of it, but you've done a lot more, uh, research and study into it. So, um, you talk about the, uh, how Medicare has, uh, affected the cost of, of treatment while acknowledging, um, some positive aspects of the program. You also point to how fee for service aspect, uh, of payment has distorted incentives, uh, leading to more tests and more procedures and more pills. So tell us a little bit about that history and that impact.
Speaker 1 00:48:41 Yeah, my colleague Shannon Brownley is really much better to address this than I am. But the, um, so, and she educated me about my illusions about Medicare because I, I thought, well, Medicare isn't that like socialized medicine and we should have that for everyone. And I didn't realize that it is a fee for service program. And so it can allow for a lot of overtreatment over-testing and things like that. Um, conversely, um, you know, some of the H M O programs, uh, they extract their profit by not delivering services. They promise the world and then don't deliver so that they can extract those. So neither is really a great alternative. So people are talking about, you know, well let's get rid of the advantage Medicare Advantage programs. So we just have Medicare, uh, they both have problems. And, um, I don't think either is a, is really a great solution.
Speaker 1 00:49:34 And as a practitioner, I always emphasized that I don't want my income to be affected by doing more. I don't wanna get more money for doing more, and I don't wanna get more money for doing less because there was a move to incentivize doctors too. Um, not do overtreatment not do over testing. I'm like, no, no, no, that's the wrong incentive. We need to do it because it's the right thing to do. Fund doctors to, you know, serve a a panel of patients and just do the right thing. And yeah, we're all, you're not gonna make mistakes and do the wrong thing. And sometimes overtreat and sometimes undertreat, but there shouldn't be a financial incentive that's driving you in either direction. I don't think a patient who comes into the office wants to believe that the prescription you give or the, you know, surgery that you recommend or whatever, um, is going to enrich you or enrich you, you because you say no, you don't really need it. Uh, that, that would be such an incredible conflict of interest. We wouldn't let a, a, a judge take money from one side, uh, uh, from the prosecution or the defense. Why do we let doctors,
Speaker 0 00:50:42 How did these changes lead to the rise of the, um, hospital, hospital-centric system that we have now? Uh, one in which you write that quote, house calls, uh, house visits went the way of cup bleeding and, and the leach
Speaker 1 00:50:56 <laugh>. Yeah,
Speaker 0 00:50:57 I I hadn't read realized till I read your book, uh, how remarkably the, the way we deliver care has changed. Um, yeah,
Speaker 1 00:51:06 It is a medical industrial complex now, and I feel bad sort of saying this stuff about doctors because by and large doctors are not driving this problem so much. It is now a medical industrial complex. Most doctors are employees, I believe I'm saying that. I may, I may be, you need to get Shannon Brownley on your show cuz she can address this whole, she really focuses on this, uh, um, what, uh, private equity groups are doing, taking over nursing homes, taking over hospitals, and the problems that this is creating.
Speaker 0 00:51:38 Uh, alright, well we do have a lot of libertarians, uh, in our audience and, uh, you know, which is about diametric opposite of, of your kind of political perspective. And so, um, I, we did wanna, you know, we, we, you talked about, you've written about the rampant, uh, corruption, elaborate coverups, uh, and the shameless profiteering. Um, wouldn't it be in the rational self-interest of these companies, uh, to produce products and services that are, that are safe and effective with or without oversight, uh, in other areas of the marketplace? Consumers, you know, steer clear of crummy, uh, products and services and, um, the com companies that offer them are, are punished by poor reviews, bad press, low sales. So why is the medical device industry so different?
Speaker 1 00:52:40 Well, not just the medical device, but of course the big pharma as well. Um, and I think that's where illusion comes in that, you know, I'm for consumers
Speaker 0 00:52:52 Because they're so is it, is it because they're so complex that, uh, you know, that you're able to have these illusions because people aren't experts or medical professionals themselves? And, and so it's just to think
Speaker 1 00:53:07 In part, some of the illusions are very seductive. And, and in my Smithsonian article, I, I talk about, you know, I mean, I was seduced by watching the PVCs disappear. I thought I was saving lives. Um, so there are many ways in which we can be seduced by what we think we see and what we think we know. And that's why I'm so adamant about the need for scientific evidence. Um, but, uh, you know, consumer goods, it's one thing people can see whether they like their sneakers or not, or whether they like their TV or not. Um, what has been shown over and over with and study after study with doctors and patients is that we tend, all of us to way overestimate the harms of a condition. So we think that if we, um, get breast cancer, we're gonna die and a lot of us are gonna die.
Speaker 1 00:53:56 And in fact, way, I mean, I can't remember the numbers, but it's, it's astounding the, the, the gap between what women think about their likelihood of getting breast cancer and dying and the actuality. So that's true for both doctors and patients. They think the diseases are worse, and they also think that the interventions are far more beneficial than they are. So you see these things like, oh, this drug prevents this deadly disease, um, in, uh, slashes it in half. And everybody says, well, I have to take that only problem is if one in a million people were gonna die, you know, say you had two in a million people were gonna die, and now it's one in a million, treating all a million people for something that they weren't gonna die of anyway, and getting all the side effects. So these kinds of illusions, you know, I mean, I, I gave grand rounds to a group of physicians once, and I gave them the actual numbers that they needed to come to a conclusion about whether they would want to take this drug or not.
Speaker 1 00:54:54 And so, like, you know, such and such a percentage would die. This is how much it's gonna reduce it. This is how many, what percent will die with it. And I asked them, how many of you would take the drug? And clearly the numbers that they were more likely to die if they took the drug. They all raised their hand because it just, it, it, there's something called prior probability and it's very hard for people in to conceptualize that You need to know what your risk was before you go into something. And so it's, it's hard. It's very confusing and, you know, we need a more independent, good science to guide people.
Speaker 0 00:55:32 All right. Well, we've got about five minutes left. I'm gonna squeeze in one more audience question then. I just would like to end with, um, you know, we've covered a broad variety of, of topics and, uh, wanted to allow you to give any final thoughts or any areas, uh, that you, uh, wanted to elaborate on or that you feel like you haven't been able to address. So from Facebook, mark Alex solos asks, did the definition of a vaccine, uh, and its use get changed due to covid? Or have people always had a misconception about what a vaccine is?
Speaker 1 00:56:12 I don't, I don't think no one answer to that in terms of what people
Speaker 0 00:56:16 Think. Um, I mean, I think that previously people thought that a vaccine was something that you would take and you would gain immunity, um, from catching that disease. And now it's, uh, seems to be, well, you won't necessarily gain immunity from catching that disease, but you will have some benefit in terms of, uh, the severity of outcomes. So, so anyway, I'm, I'm not sure that people had a misconception about what vaccines are. So it does seem that it was, uh, just even that the dictionary, uh, felt victim or in, in this case, um, yeah, yeah, actually the dictionary and, and the c d c definition of, um, vaccines were modified on, and based on this all encompassing sweep to, uh, make sure that everyone got vaccinated all, you know, a hundred percent, uh, regardless of their risk or, um, in, in fact, uh, uh, immunity status. So with that, Jean, this has been wonderful. Any, any other thoughts or, uh, maybe, uh, tell us about your next, are you gonna write another book? I certainly hope so. No,
Speaker 1 00:57:37 Leslie, I just, i I just wanna thank you for doing this. I mean, it's really, uh, tribute to you that, you know, you make this kind of conversation possible across lines. That's very important. We so need that now. And, um, I thank you for your courage in doing that, having me, and making it easy to talk.
Speaker 0 00:57:57 Well, likewise, Jean. Uh, first of all, I have a lot of practice as the only Republican and family of, of, uh, Democrats. Um, wow. But, but also, I mean, I'd say that, uh, the pressure is, if anything, even more, you know, intenses on people like you that, you know, oh my God, like, or, you know, people that would be on the left and, and, uh, that you'd get ostracized if you were to go on to Fox News or Yeah, we're, we're a little bit different cuz we're not really libertarians. We're, we're, we're more objectives, uh, than anything. So, um, so we, where is the best place for us to follow you and keep, uh, keep tabs on, on your work?
Speaker 1 00:58:43 Oh, I left Twitter. I mean, that <laugh> tell you that I'm tough, but I ain't that tough. Um, so I do have a website, gene linzer.com and, uh yep. Working on my next projects and something will come out soon enough.
Speaker 0 00:58:58 Oh, fantastic. We really appreciate it. And also, I appreciate all of you who came and listened and asked your excellent questions. Again, go out and buy Jean's book or listen to the audio version. Uh, I, I definitely know I've made two, at least two sales, uh, with this program because, uh, the two Dr. Roseman, uh, in this house are gonna go and, uh, read it. So, so thank you and, uh, thanks to all who have watched, if you are, uh, enjoying the kind of content that we provide and the work that we do with introducing young people to ein rand's literatures and philosophy, then tis the season folks. Uh, just a few more DA days in 2022. So go ahead and make your tax deductible donation to the Atlas Society to support our work and tune in Next week I'm gonna be talking to Professor Israeli, professor of psychology, Sam Vacin, about narcissism and victimhood and its connection to woke ideology. So we'll see you next week when the Out Society asks. Thank you. Thank you so much.
