On the intolerance of ideas, and liberty …

I like thinking and learning.

Birthdays surely make one slower on the bike, but birthdays, it seems, do not have the same drag on the brain.

For me, birthdays have increased my appreciation of liberty. In the Constitution of Liberty, Hayek defines it as the absence of coercion. Such is a beautiful definition. Don’t coerce me to wear a bike helmet when I ride my Dutch bike to work. Don’t coerce an 85 year-old with life-limiting disease to stop smoking. And above all, don’t coerce people-without-complaints to have unproven tests in the name of health.

Piotr Skrabanek wrote in the Death of Humane Medicine that “the pursuit of health is a symptom of unhealth.” (That would be an apt blog title for this era of the quantified self.)

Birthdays have also brought me an appreciation of contrarian views. Christopher Hitchens famously said in Letters to a Young Contrarian that to be a contrarian is not to be a nihilist. When I question entrenched dogma, or a dubious new drug or the latest new toy for cardiologists, these views do not equate with nihilism. Hell, I sometimes ablate patients with dilated left atria and persistent atrial fib.

Medical culture shuns uncertainty. I like thinking about how little we know. Medical culture favors conformity. I find that tiresome and pretentious.

One of the challenges of being a medical writer is that embracing uncertainty and calling out hype can hurt one’s ability to function in the mainstream. You don’t get invited to the podium at medical meetings or ease through peer review if you highlight contrarian views: abuse of the p-value, financial conflict of interests, biased research and hyped results.

Illiberalism wise, cardiology is better than some areas of medicine. I will mention neither the less tolerant fields nor the specific no-go areas of medical topics–out of fear of public shaming.

Yet intolerance of contrary opinions in the medical sphere pale in comparison to the intolerance on many college campuses. Witness the Middlebury College and UC Berkeley incidents.

One somewhat fearless speaker on the matter of intolerance of ideas is the social psychologist Jonathan Haidt, now a professor of ethical leadership at the Stern School of Business (NYU).

Here are two interesting videos in which he contrasts opposing viewpoints. Gosh do we need more of this.

This is a lecture that belies its simple title.

This a discussion with Frank Bruni on the origins of intolerance on some college campuses.

I think we could use a Heterodox Academy in Medicine.

Think away readers.

JMM