I’m an MD and can’t stand this stuff, but I have a lot of nonpolitical family members who buy into this stuff and derision just isn’t a helpful response. And it isn’t really even a US conservative thing (I have in laws in China and supplements etc are really popular there, where nobody cares about RFK). Searching 小红书/RedNote for “Huberman” will find surprising (albeit depressing) popularity. Blaming everything we don’t like on the Trump admin is unhelpful and just pushes more people into being open to that camp, because nobody wants to vote for someone who treats them with contempt
One trope we could maybe teach is actually similar to a frame resistance types love these days: sort of like “how would media describe [insert awful trump thing here] if it were happening in a foreign country”, how about we ask “what if this person was an immigrant from a country with a different culture and due to their background, they believe [insert RFK/wellness-y belief here]”. Cultural competency is important even if we have enough personal experience to dislike the culture in question
RFK has limited the availability of the COVID vaccine. I’m going to have to lie to get it (which is easy, but not everyone knows that). He’s going to kill people.
I understand it’s unhelpful to hector your friends about their kooky health ideas, but surely that’s different from condemning RFK in the strongest possible terms. There’s also a difference from *being open* to, say, possible benefits of acupuncture, and nodding along while he discourages healthy practices. He’s almost certainly going to say vaccines cause autism, which is not just as settled as any medical question can be, but is going to kill kids.
I also take issue with changes he’s making that encourage people to make actively unhealthy choices, like using different sugars in Coke, and then slapping a MAHA label on it. It is very likely that drinking lots of sugar is bad for you, and very unlikely that the type of sugar changes that calculus.
I mean I definitely agree RFK himself is bad. I pick my battles, but vaccines are absolutely one of those battles. And media needs to aggressively cover every death of a child from a vaccine-preventable infection
Also worried about hospitals and patient safety if we can’t distribute COVID vaccines to healthcare staff in hospitals this year. I like to think even someone who isn’t getting a COVID vaccine would appreciate the value of grandma’s and grandpa’s doctor getting a Covid vaccine
“… responding to Kennedy’s dubious claims with total derision is counterproductive to our larger aim of undermining his authority.”
Dr. Bedard, you convey the strength it must take to remain compassionate while battling endless unproven medical claims and treatments. If you will indulge me a medical metaphor however, conceptualizing any practice of medicine as a political project is potent auto-intoxication, a self-inflicted poisoning of everything you are trying to achieve.
RFK Jr deserves our scorn for standing with a group of goons leading humanity away from enlightenment principles which have served us so well for nearly five centuries. But I would trade my own adherence to these principles in a heartbeat if I believed it would restore health to my children affected by chronic disease. Millions of MAHA adherents have done just that.
For as you say reasons of both politics and science, ‘our larger aim’ should be to treat and prevent these conditions more effectively and until then humbly empower and support those whom we cannot treat.
Hi Jon - thanks for this thoughtful comment!! I think “potent auto-intoxication” is a fair and beautifully articulated concern. It’s the challenge for me with everything I’m thinking about and writing right now - what does it look like to squarely face the reality of this moment in health politics, to take the concerns and questions of my patients and fellow citizens seriously, to remain open to challenging ideas, without relaxing my own scientific rigor or commitment to the value of empiricism. It’s hard and I’m not sure I’m always walking the line correctly, but your comment gets at exactly the questions and feelings that are guiding my work right now. Thank you for reading!
He as a person deserves scorn. But the theory of mitochondrial issues being part of chronic fatigue syndrome deserves to be mentioned as a useful hypothesis that hasn’t been well-tested, might be relevant to many cases, but definitely can’t be diagnosed with any sort of confidence.
“they’re locked into a dynamic where they’re always speaking truth to the indifferent powers that be. They hear Kennedy’s mitochondria reference in a press conference as a signal that he shares their perspective. This dynamic is how Kennedy builds power with his followers and deepens divides between them and the rest of us: first, by affirming their ideas, and second, by daring us to overstep our bounds when we rush to shoot them down.”
Three cheers! This framing of authority as responsibility and liberalism as listening is so important. More articles like this one please, Jerusalem! In the spirit of trying to build on it, here is a hypothesis. Before the 1960s, what we now call the professional-managerial class, and college graduates in general, were such a small fraction of society that they had no choice but to grapple with being an elite. In this century, the well-educated, NYT-reading class is numerous enough that the majority of it has fallen into an identity trap: they identify with The People and participate in politics via expressive protests against bad authorities which turn off the less-educated and literate many and bolster (or at least fail to diminish) the authorities they disagree with. The way forward is to accept your membership in the PMC as a separation from the common person which gives you two responsibilities. First, you must listen to popular views which differ from yours but which must be represented in a democracy. Second, you must contribute with what Weber via Yglesias calls the slow boring of hard boards rather than the quick ephemeral high of self-expression.
It’s fine to listen and not immediately dismiss hypotheses but it’s not acceptable when a person in a position of power like Mr. Kennedy is trying to endanger our children with his potential changes to vaccine schedules. His theories and feelings about proven science is going to set back public health and risk American lives for years beyond his time as the head of HHS.
I do agree Americans could benefit from health and wellness programs and initiatives but where is his theories for actual change here? All he does is attack the CDC and put physicians like yourself of tough situations to either prioritize your patients health or follow guidelines that he wants to put into practice.
My wife is a CDC epidemiologist. She will angrily point out (when people try to claim CDC did things during COVID they did not do) that CDC guidance was fairly straightforward and mostly consistent during the pandemic. Public health influencers on social media did a lot of damage.
I just want to clarify what scares me the most is his obsession with denigrating vaccines, gutting the CDC, and potentially making vaccines impossible to get unless you pay out of pocket for them.
Even though a lot of people have bought into the manosphere (podcast bro) lifestyle and embraced select topics from the overall MAHA brand vaccinating kids has remained extremely popular.
To appeal to Kennedys audience embrace food industry reform, prioritize chronic disease management through drugs and preventative strategies, and empathize personal wellness through smart and achievable interventions.
Make America Healthier than it is right now without risking the future by allowing generations old preventable diseases to come back.
I can’t stand his phrase “food is medicine” for a number of reasons, but I’m fine with “exercise is medicine.” Obviously staying fit and lowering your risk of diabetes is a better health strategy than being obese and unfit, contracting diabetes, and then treating it (no judgment to those who are obese/unfit, it’s very difficult in America be fit and thin).
And being generally healthy is a great defense against a lot of diseases. Certainly I’m much more likely to get sick if I’m under-rested. But using that info to argue *against* medical interventions, or, even worse, that pharmaceutical companies want to keep you sick. That’s the entire point of capitalism — if your business model depends on providing an inferior service, another company can deliver a better service and steal your customers. It doesn’t depend on whether you’re a good person.
Well put, and I think this goes to a lot of the seemingly crazy ideas put out there by the right. They need to be refuted, not dismissed and ridiculed, otherwise those new to the argument think "why aren't they engaging? What are they hiding?" Like most conspiracy theories, there is usually just enough of a kernel of truth to make it plausible, supported by ballasts of weak arguments, poor correlation, and outright falsehoods.
Yesterday when I saw the RFK Jr thing go viral I was hunting around for information and this is exactly what I wanted. Thanks for putting it together so quickly!
I have a hard time squaring Attia “believes that mitochondrial dysfunction plays a prominent role in poor health” with his book “Outlive.”
Attia is in almost total alignment with standard medical science. To the extent that he disagrees, it’s mostly that his standards are totally unrealistic, like that your VO2 max should be in the top 5% of the cohort twenty years younger than you. His recommendations are pretty banal. Get plenty of sleep, reduce stress, exercise as much as you can, and try to find a diet that keeps you at a relatively low body weight.
He might, say, recommend a supplement because it has a 0.2% chance of boosting your immune response, but I don’t believe any of his recommendations or reasoning are grounded in vague concepts like “mitochondrial dysfunction.”
Yeah that took me off guard too. Probably the most radical things he preaches against standard medical practice is his arguments around testing and preempting disease much earlier than standard medical practice dictates.
My instinct is that punching down at popular figures like this without actually understanding what they preach probably doesn’t help the cause of winning the general populace back.
It’s not punching down, and Attia absolutely does take the possibility of mitochondrial dysfunction as a contributor to illness presentations seriously! He’s had podcast guests on about this. He also is a guy who draws on basic science a fair amount in his recommendations, although with a more rigorous weigh of doing so than most of MAHA leadership. But I’m very familiar with Attia’s thinking and work, have read his book and listened to him a lot, have lots of opinions about his application of evidence at various stages to clinical recs.
When it comes to refuting RFK and other anti-vaxxers' claims, it seems like it's an impossible task. Changes in technology have allowed people like that to have a voice they never had before. Trying to stamp out their claims is like playing whack-a-mole.
Views like RFK's are not fringe anymore. I wish it was otherwise, but I think the only way to put that genie back in the bottle is for a whole lot of people to learn the hard way. I don't know when that moment will come or if it ever will, but I don't see any other way of teaching people. I'd love to be proven wrong on that.
Vaccines have become a victim of their own success. They've eradicated or mitigated so many diseases hardly anyone today knows what it's like to have to worry about polio and MMR. It looks like many will have to relearn that.
Really good article thank you, I think you correctly identify how to respond. The snorts of derision have only worsened a problem that exploded during COVID.
The right obviously owns the majority of the issue with scientific illiteracy and clinging to fringe theories, but “owning” or “dunking” on them will not solve anything and the left needs to own their harmful reactions. This is not a theoretical problem, real world outcomes are at stake
I’m an MD and can’t stand this stuff, but I have a lot of nonpolitical family members who buy into this stuff and derision just isn’t a helpful response. And it isn’t really even a US conservative thing (I have in laws in China and supplements etc are really popular there, where nobody cares about RFK). Searching 小红书/RedNote for “Huberman” will find surprising (albeit depressing) popularity. Blaming everything we don’t like on the Trump admin is unhelpful and just pushes more people into being open to that camp, because nobody wants to vote for someone who treats them with contempt
One trope we could maybe teach is actually similar to a frame resistance types love these days: sort of like “how would media describe [insert awful trump thing here] if it were happening in a foreign country”, how about we ask “what if this person was an immigrant from a country with a different culture and due to their background, they believe [insert RFK/wellness-y belief here]”. Cultural competency is important even if we have enough personal experience to dislike the culture in question
RFK has limited the availability of the COVID vaccine. I’m going to have to lie to get it (which is easy, but not everyone knows that). He’s going to kill people.
I understand it’s unhelpful to hector your friends about their kooky health ideas, but surely that’s different from condemning RFK in the strongest possible terms. There’s also a difference from *being open* to, say, possible benefits of acupuncture, and nodding along while he discourages healthy practices. He’s almost certainly going to say vaccines cause autism, which is not just as settled as any medical question can be, but is going to kill kids.
I also take issue with changes he’s making that encourage people to make actively unhealthy choices, like using different sugars in Coke, and then slapping a MAHA label on it. It is very likely that drinking lots of sugar is bad for you, and very unlikely that the type of sugar changes that calculus.
I mean I definitely agree RFK himself is bad. I pick my battles, but vaccines are absolutely one of those battles. And media needs to aggressively cover every death of a child from a vaccine-preventable infection
Also worried about hospitals and patient safety if we can’t distribute COVID vaccines to healthcare staff in hospitals this year. I like to think even someone who isn’t getting a COVID vaccine would appreciate the value of grandma’s and grandpa’s doctor getting a Covid vaccine
“… responding to Kennedy’s dubious claims with total derision is counterproductive to our larger aim of undermining his authority.”
Dr. Bedard, you convey the strength it must take to remain compassionate while battling endless unproven medical claims and treatments. If you will indulge me a medical metaphor however, conceptualizing any practice of medicine as a political project is potent auto-intoxication, a self-inflicted poisoning of everything you are trying to achieve.
RFK Jr deserves our scorn for standing with a group of goons leading humanity away from enlightenment principles which have served us so well for nearly five centuries. But I would trade my own adherence to these principles in a heartbeat if I believed it would restore health to my children affected by chronic disease. Millions of MAHA adherents have done just that.
For as you say reasons of both politics and science, ‘our larger aim’ should be to treat and prevent these conditions more effectively and until then humbly empower and support those whom we cannot treat.
Hi Jon - thanks for this thoughtful comment!! I think “potent auto-intoxication” is a fair and beautifully articulated concern. It’s the challenge for me with everything I’m thinking about and writing right now - what does it look like to squarely face the reality of this moment in health politics, to take the concerns and questions of my patients and fellow citizens seriously, to remain open to challenging ideas, without relaxing my own scientific rigor or commitment to the value of empiricism. It’s hard and I’m not sure I’m always walking the line correctly, but your comment gets at exactly the questions and feelings that are guiding my work right now. Thank you for reading!
He as a person deserves scorn. But the theory of mitochondrial issues being part of chronic fatigue syndrome deserves to be mentioned as a useful hypothesis that hasn’t been well-tested, might be relevant to many cases, but definitely can’t be diagnosed with any sort of confidence.
“they’re locked into a dynamic where they’re always speaking truth to the indifferent powers that be. They hear Kennedy’s mitochondria reference in a press conference as a signal that he shares their perspective. This dynamic is how Kennedy builds power with his followers and deepens divides between them and the rest of us: first, by affirming their ideas, and second, by daring us to overstep our bounds when we rush to shoot them down.”
Three cheers! This framing of authority as responsibility and liberalism as listening is so important. More articles like this one please, Jerusalem! In the spirit of trying to build on it, here is a hypothesis. Before the 1960s, what we now call the professional-managerial class, and college graduates in general, were such a small fraction of society that they had no choice but to grapple with being an elite. In this century, the well-educated, NYT-reading class is numerous enough that the majority of it has fallen into an identity trap: they identify with The People and participate in politics via expressive protests against bad authorities which turn off the less-educated and literate many and bolster (or at least fail to diminish) the authorities they disagree with. The way forward is to accept your membership in the PMC as a separation from the common person which gives you two responsibilities. First, you must listen to popular views which differ from yours but which must be represented in a democracy. Second, you must contribute with what Weber via Yglesias calls the slow boring of hard boards rather than the quick ephemeral high of self-expression.
It’s fine to listen and not immediately dismiss hypotheses but it’s not acceptable when a person in a position of power like Mr. Kennedy is trying to endanger our children with his potential changes to vaccine schedules. His theories and feelings about proven science is going to set back public health and risk American lives for years beyond his time as the head of HHS.
I do agree Americans could benefit from health and wellness programs and initiatives but where is his theories for actual change here? All he does is attack the CDC and put physicians like yourself of tough situations to either prioritize your patients health or follow guidelines that he wants to put into practice.
I agree that Kennedy's actions endanger children (and all of us) so how do you propose winning over the people who view him as a credible messenger?
My wife is a CDC epidemiologist. She will angrily point out (when people try to claim CDC did things during COVID they did not do) that CDC guidance was fairly straightforward and mostly consistent during the pandemic. Public health influencers on social media did a lot of damage.
I just want to clarify what scares me the most is his obsession with denigrating vaccines, gutting the CDC, and potentially making vaccines impossible to get unless you pay out of pocket for them.
Even though a lot of people have bought into the manosphere (podcast bro) lifestyle and embraced select topics from the overall MAHA brand vaccinating kids has remained extremely popular.
To appeal to Kennedys audience embrace food industry reform, prioritize chronic disease management through drugs and preventative strategies, and empathize personal wellness through smart and achievable interventions.
Make America Healthier than it is right now without risking the future by allowing generations old preventable diseases to come back.
I can’t stand his phrase “food is medicine” for a number of reasons, but I’m fine with “exercise is medicine.” Obviously staying fit and lowering your risk of diabetes is a better health strategy than being obese and unfit, contracting diabetes, and then treating it (no judgment to those who are obese/unfit, it’s very difficult in America be fit and thin).
And being generally healthy is a great defense against a lot of diseases. Certainly I’m much more likely to get sick if I’m under-rested. But using that info to argue *against* medical interventions, or, even worse, that pharmaceutical companies want to keep you sick. That’s the entire point of capitalism — if your business model depends on providing an inferior service, another company can deliver a better service and steal your customers. It doesn’t depend on whether you’re a good person.
Well put, and I think this goes to a lot of the seemingly crazy ideas put out there by the right. They need to be refuted, not dismissed and ridiculed, otherwise those new to the argument think "why aren't they engaging? What are they hiding?" Like most conspiracy theories, there is usually just enough of a kernel of truth to make it plausible, supported by ballasts of weak arguments, poor correlation, and outright falsehoods.
Yesterday when I saw the RFK Jr thing go viral I was hunting around for information and this is exactly what I wanted. Thanks for putting it together so quickly!
I have a hard time squaring Attia “believes that mitochondrial dysfunction plays a prominent role in poor health” with his book “Outlive.”
Attia is in almost total alignment with standard medical science. To the extent that he disagrees, it’s mostly that his standards are totally unrealistic, like that your VO2 max should be in the top 5% of the cohort twenty years younger than you. His recommendations are pretty banal. Get plenty of sleep, reduce stress, exercise as much as you can, and try to find a diet that keeps you at a relatively low body weight.
He might, say, recommend a supplement because it has a 0.2% chance of boosting your immune response, but I don’t believe any of his recommendations or reasoning are grounded in vague concepts like “mitochondrial dysfunction.”
Yeah that took me off guard too. Probably the most radical things he preaches against standard medical practice is his arguments around testing and preempting disease much earlier than standard medical practice dictates.
My instinct is that punching down at popular figures like this without actually understanding what they preach probably doesn’t help the cause of winning the general populace back.
It’s not punching down, and Attia absolutely does take the possibility of mitochondrial dysfunction as a contributor to illness presentations seriously! He’s had podcast guests on about this. He also is a guy who draws on basic science a fair amount in his recommendations, although with a more rigorous weigh of doing so than most of MAHA leadership. But I’m very familiar with Attia’s thinking and work, have read his book and listened to him a lot, have lots of opinions about his application of evidence at various stages to clinical recs.
*rigorous way, weird typo!
"Attia absolutely does take the possibility of mitochondrial dysfunction as a contributor to illness presentations seriously!"
I'm unclear — are you suggesting that's a good or bad thing?
When it comes to refuting RFK and other anti-vaxxers' claims, it seems like it's an impossible task. Changes in technology have allowed people like that to have a voice they never had before. Trying to stamp out their claims is like playing whack-a-mole.
Views like RFK's are not fringe anymore. I wish it was otherwise, but I think the only way to put that genie back in the bottle is for a whole lot of people to learn the hard way. I don't know when that moment will come or if it ever will, but I don't see any other way of teaching people. I'd love to be proven wrong on that.
Vaccines have become a victim of their own success. They've eradicated or mitigated so many diseases hardly anyone today knows what it's like to have to worry about polio and MMR. It looks like many will have to relearn that.
RFK, Jr. is a sentient embodiment of the Dunning–Kruger effect…
Really good article thank you, I think you correctly identify how to respond. The snorts of derision have only worsened a problem that exploded during COVID.
The right obviously owns the majority of the issue with scientific illiteracy and clinging to fringe theories, but “owning” or “dunking” on them will not solve anything and the left needs to own their harmful reactions. This is not a theoretical problem, real world outcomes are at stake