Medical Schools Should Teach Sophistry
The Lesson of RFK Jr. is that we discount Ethos at Our Own Peril
If there are two dentists in your small town, do you visit the one with the perfect teeth or the one with rotten teeth? On the assumption that dentists don’t self-operate, the riddle goes, you should prefer the dentist with the rotten teeth.
Similarly, there’s an old saw that “all shoemakers go barefoot.” Why? One reason is that they’re dispensing their shoes to others or using them as models and so never have their own stock. A deeper, psychic possibility: the shoemaker knows the ingrained pain of primal shoeless-ness and rather than solve it for himself projects his need outwardly, by serving others, as if curing shoelessness in the world might give him the reprieve he seeks. A Jungian variation: all advice and admonishment that we offer is intended for ourselves.
The simplest interpretation of all shoemakers go barefoot, however, is that being a shoemaker (having domain expertise) doesn’t mean that you have practical wisdom (knowledge of how to take care of yourself). Knowledge of philosophy doesn’t make one virtuous (e.g., Heidegger), and plenty of decent people don’t have the brains or motivation to engage in abstract, self-reflective reasoning. Nassim Taleb would go further—all else being equal, we should prefer the unpresentable, slovenly surgeon to the well-dressed, neat one, because we can assume the sloppily dressed surgeon with wild hair hasn’t wasted her time on appearances and “marketing,” but has put all her focus into being competent. Likewise, if two people have the same job, but one has a good resume and one has a spotty one, we should assume the one with the spotty resume is more holistically impressive—they had to do more to win their position.
And yet there’s a meme going around contrasting “health expert” Bill Gates with “science denier” RKF Jr. with the implication that we should be skeptical of Gates and amenable to RFK on the basis of their physique. Should there be a correlation between fitness and health expertise? I don’t see why there should. Back in the day, plenty of Olympic athletes smoked cigarettes—and even believed smoking was a health advantage for them. They were wrong.
https://twitter.com/WallStreetSilv/status/1672979234342436865
The meme is popular because it touches on the most enigmatic dimensions of rhetoric, ethos. Gates’s logos may win in the pages of Bloomberg and WSJ, but RFK Jr.’s muscles win the visual medium of Twitter. We should appreciate that the culture war today is not simply about science vs. anti-science, but about logos vs. ethos, an old way of doing discourse vs. a new way. In the free market of attention, ethos is making a vicious comeback. The point of ethos isn’t whether you think the person is credible or not, its the presumption that what makes someone credible is their being rather than their argument. In matters of religion and ethics, we tend to weight towards ethos. The surprising point about health and fitness is that many people treat them like religion and ethics rather than like epistemology. Peer Review out, Gwyneth Paltrow in—and this isn’t a left vs. right thing so much as it is an elitism vs populism thing.
Should Peter Hotez debate RFK Jr. re: vaccine safety on Joe Rogan? I agree with Tyler Cowen that the debate will not advance the cause of logos. Asynchronic print culture, not live oracular bombast, filled with dirty play, is a more secure foundation for collaborative truth seeking. On this point, see Ben Lerner’s Topeka School, which describes the deformation of debate from a game of matched arguments into a game of making as many arguments as possible regardless of quality (also known as “the spread”) and then claiming you’ve won because your opponent didn’t have enough time to counter.
The question is whether fighting for ethos is worthwhile in a time when logos is discounted. I believe it is, I just don’t think it can be won by Hotez, so on tactical grounds he’s right not to enter a fight whose odds are not in his favor. But he should nominate a champion, a second in a duel, who does have the rhetorical chops and physical prowess to be a good public face for COVID vaccines.
If ethos matters, then sophistry must be learned. Medical schools should require doctors to start pumping iron and taking fitness tests. And getting good Instragramable bodies should count for something, especially for public facing jobs in science policy (as un PC as it might be to say). More radically, Med Schools might want to start requiring rhetoric, and making it a core competency for anyone seeking to go into public health. In a time when skepticism at the scientific establishment is high, are scientists doing enough to train in ethos, or merely doubling down on logos, acting as if they’ve done their part, while the barbarians charge the gates?