social justice doctor
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They fight racism, not cancer. Will your doctor sound like a self-absorbed neurotic?:
I am racist, shaped by the sometimes subtle tendrils of white supremacy deeply embedded in our culture. I mean this not as a sanctimonious admission of guilt, but as a call to self-reflection and action for us white physicians.

-- Deborah Cohan, M.D., M.P.H., "Racist Like Me - A Call to Self-Reflection and Action for White Physicians" at New England Journal of Medicine (paywall)
We hope no one facing a difficult diagnosis has to listen to someone whose basic mission in life sounds like dumping on herself instead of serving others.

The journal was urged to get woke. While the predations of the raging Woke in science is not a core mission for us at UD, we think we should let readers know when it is happening, especially if it could affect you.

Back in October 2018, the oldest and one of the most prestigious medical journals was looking for a new editor-in-chief sometime within the next year, as the current one announced that he was planning to retire. The journal has received, as one might expect, a lot of advice, including
Dr. Richard Smith, former editor of the BMJ, offered this advice: Change the raison d'etre...

Looking ahead, Smith said, as science moves away from journals as the most important medium for delivering information, the next editor of NEJM will have to adapt.

"The main job of journals will not be to disseminate science but to 'speak truth to power,' encourage debate, campaign, investigate and agenda-set - the same job as the mass media. The NEJM needs to strengthen that side of the journal." (Smith may have a model in mind. Fiona Godlee, the current editor of the BMJ, has called her publication an outlet for "campaigning" against what see sees as flaws in the biomedical edifice.)

-- Adam Marcus and Ivan Oransky, "At NEJM, a change at the top offers a chance to reshape the world's oldest medical journal" at STAT

Comment: Say what??

In short, Smith

1) sees mass media journalism as a "campaign" with an "agenda" Sadly, that's true today. (Cue further mass media layoffs.) Mass media were more useful (and better read) back when they told us things that the elite of none of the parties in power wanted us to know. Now that they are so often just political operatives with bylines, it is less of a timewaster to follow the politicians directly.


2) He makes clear that science contributes only a little to NEJM's perspective in the pursuit of that goal.

For one thing, once getting woke comes to be seen as a positive benefit, it could cover a great deal of incompetence. That's nothing new in highly politicized environments: Correct opinions or feelings become much more important than correct actions and good outcomes.

The good news is that this stuff is behind a paywall at NEJM and the better news is that there are still medics out there who fight cancer, heart disease, ebola, and such. For now, this will spread.

The historic medical publication The Lancet has also gone weird:

A science writer asks, citing several distinctly odd viewpoints aired in the journal that was founded in 1823, including
The Lancet is a highly respected biomedical journal that rightly carries a lot of clout in the scientific community. That's what makes its recent turn toward sensationalism and clickbait so incredibly odd.

We first noticed that something was strangely amiss in 2017 when the editor-in-chief of The Lancet praised Karl Marx in a bizarre editorial. The piece made multiple dubious claims, such as, "Medicine and Marxism have entangled, intimate, and respectable histories." The 100 million (or so) graves of the victims of communism beg to differ.


This year, the weirdness continued. A paper in The Lancet argued that certain food experts should be banned from food policy discussions. (Of course, the experts that should be banned are any that are associated with industry, because industry = bad.) And then, The Lancet slandered surgeons, using shady statistics to blame them for killing millions of people every year. The study was so bad that our typically calm, cool, and collected Dr. Charles Dinerstein worried that his head would explode.

Apparently, whoever is operating The Lancet's Twitter feed said, "Hold my beer, and watch this." Here is what the organization posted today...
Lancet medical post twitter
© @TheLancet/Twitter
The study itself may be fine, but The Lancet's tweet about it is misleading at best. Disease, violence, and inequality threaten more adolescents than ever before. Really?

The statement is absurd on its face. Violence has decreased all over the world. The Medieval period was a particularly rough time to be alive. Not only were people dying of things like the Black Death (which killed 1/3 of Europe in the mid-1300's), homicide rates were incredibly high.

As recently as the 20th Century, smallpox is thought to have killed 300-500 million people. Likewise, measles killed millions. But vaccines have prevented millions, if not billions, of deaths.
(See charts from Our World in Data.)


Putting this all together, it's easy to see that humanity has never had it better than in 2019. To quote The Beatles, "It's getting better all the time." So, what on Earth is The Lancet talking about?

The only possible explanation for the tweet is that the journal decided to ignore the indisputable trends and instead hyped absolute numbers. That's extremely misleading in this case because there are more people on the planet now than ever before. (It would be like comparing the cost of a TV in 1960 versus 2019 without adjusting for inflation.) The data need to be standardized, which is why percentages are really the only honest way to do this analysis.

-- AlexBerezow, "The Lancet Has Gotten Really Weird" at American Council on Science and Health
Wethinks the most likely reason is the need to cater to the raging Woke. Science is roadkill when you are really scared.