immanence

The Covid-19 pandemic has offered all kinds of interesting case studies for those who study controversies in science, technology, and medicine. Hydroxychloroquine is one of them. It’s a bit unusual in that it highlights how the left-liberal mediasphere has sometimes followed similar trajectories as more commonly found on the (Trumpist) political right. But it’s interesting all the same, and perhaps even more so for that reason.

Norman Doidge, psychiatric clinician, popular science writer, and “neuroplasticity guy,” has written a helpful analysis of the controversy that, to my mind, qualifies as a kind of “popular STS” (science & technology studies), providing some interesting insights into the workings of medical and other sciences.

To be fair to Anderson Cooper, Anthony Fauci, and others who look less than perfect in this particular case, we are all on the battlefield trying to make sense of all the dimensions of this crisis AND to represent it in ways that counter some of the more deleterious representations that are out there already (including from the U.S. president). When so many data points show Trump making stuff up to boost his own interests, it makes a lot of sense to assume that that’s what’s happening here, too. When that battlefield starts to involve the scientific and medical establishment, that’s not necessarily a strike against that establishment; it’s more a demonstration of how we need a more sophisticated understanding of science.

The moral of the story here — or one moral at least — is that science and medicine are complicated and won’t always play along with political morality tales, no matter who is telling them.

There are some secondary “morals,” which I’ll just list without expanding upon:

1. “Big data,” far from being a panacea, leaves a lot to be desired. (There’s so much little data to support this point by now that one could almost claim that big data undermines itself. But I’m still willing to be proven wrong on that.)

2. Headlines, almost by their nature, are almost always misleading. (The article points to this once or twice, but doesn’t make a big deal of it.) One could even conjecture a formula about this: the more you get your news from headlines as opposed to from reading actual articles, the more misinformed you will be.

3. Not a moral so much as a caveat: Doidge is writing a popular article, not a peer reviewed scholarly one, which means that it’s probably easy enough to correct and/or tweak some of the details to make a very different case, through a simple reframing of emphasis. In this sense, it’s not so much the “case” that matters as it is the empirical richness of the detail provided. This brings us back to the overarching moral: that science and medicine are complicated. There’s a richness to that complication that’s worth appreciating.

4. If part of Doidge’s point is that peer reviewed scholarship can run into its own dead ends — note the “replication crisis” (or reproducibility crisis) — then the issue becomes: how do we tell what is reliable from what isn’t? What exactly does the replication crisis put into question, and what does it leave intact? When can we trust the representatives of “organized science” and when can we not? These are important questions, and the best response to them, in my view (and this is a complicated, pragmatist response), runs something like this:

• Trust the process. Science is complicated, but due to its self-correcting nature, scientific opinion over time tends to settle into coherent and fairly reliable narratives. And even if (or as) these get corrected later, they will, in aggregate (i.e., outside individual cases), be more reliable than not.
• In those instances where they are unreliable in the aggregate, it’s because there’s a paradigmatic weakness at play. (Sample paradigmatic weaknesses: when the corporate profit orientation has come to dominate a sector of scientific research, such as pharmaceuticals; or when ruling metaphors that once seemed obvious — like the mechanistic and reductionist model of nature, for instance — no longer do, but are still held to as if they did.) If there’s no good reason to suspect such a weakness (i.e., if there’s no respectable theory to account for it), then it’s best to go with the scientific consensus. (That raises the question: could it be that no one yet haas come up with an adequate theory to account for the anomalies and discrepancies? But let’s just put that into the anomalistics bin and let it sit there until it accumulates enough buzz to warrant our concern.)
• Understand how the system might be skewed by political-economic interests, at least in settings like the U.S. where that power (in its corporate-capitalist form) is privileged.
• Support the publicly accountable oversight structures that keep that power in check. Or create those structures where they don’t exist. (Of course, those structures are among the things the Trump administration seems most interested in demolishing.)