Book Reviews, Charles, Left-Liberalism, Political Discussion & Analysis, Science, Social Behavior
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First Do No Harm (Paracelsus)

A review by me of this book has been published in the excellent journal IM-1776. The first paragraph, and a link to the entire review, and the journal itself, can be found below.

America is already a low-trust society, and with good reason societal trust is rocketing further downward. Yet Americans still, by and large, trust medical institutions — perhaps more than any other set of entities. The pseudonymous Paracelsus, a practicing physician, in his book with the deliberately ironic title First Do No Harm, narrates how we are foolish to trust the medical profession, what is really the medical industry. Published by Calamo Press, First Do No Harm tells us, in short, that the two words that characterize American medicine are not “health and healing,” or even “science and rationality,” as one might think, but rather “corruption and oligarchy.”

. . . Read more at IM-1776!

19 Comments

  1. Carlos Danger says

    Great review, as always. Interesting to see you on another website with this review and the earlier one on insurance. Those websites recognize quality when they see it.

    I’ll have to get this book and read it. I’ve read many books on our medical system, and those of other countries like Japan, and find the topic interesting. I thought seriously about going to medical school, but hate to be around sick people and didn’t want to spend my career in a non-patient-facing part of the profession. Perhaps my many hours studying medical books and talking with doctors about the practice of medicine reflects the fact that my early interest never died out.

    My suspicion after reading your review, though, and the few reviews on Amazon is that this book is too ranty for my taste. One clue is Paracelsus’s insistence that “the ‘vaccines,’ aren’t vaccines at all, but prophylactic/therapeutic drugs of very limited efficacy and likely significant short- and long-term side effects, about which we are forbidden to talk”. To me, that’s more rant than reason.

    The Covid-19 vaccines are indeed vaccines. No question about that. A vaccine stimulates the immune system to fight a disease without giving you the disease. That’s what the Covid-19 vaccines do. How safe and effective they are at doing that is a different question.

    A doctor like Paracelsus should know that all vaccines (for Covid-19 and for other diseases) are either prophylactic or therapeutic drugs, as all vaccines are drugs. The Covid-19 vaccines are prophylactic drugs because they are used on patients who do not have the disease. Some vaccines are therapeutic drugs for patients who already have a disease (like cancer or Alzheimer’s disease) to help their immune system fight off the disease more effectively.

    The real question is not whether the Covid-19 vaccines are vaccines, but are they are safe and effective vaccines? And we’re not forbidden to talk about that. Quite the contrary, there’s plenty of discussion on that, and lots of data available. These Covid-19 vaccines have been studied more carefully than any other vaccines in history as we have a lot more tools to study them with than with prior vaccines.

    From what I’ve seen by digging in data, the Covid-19 vaccines were initially oversold and the promises made of efficacy and safety were too rosy. But though the vaccines don’t perform as initially hoped, and advertised, to my eye at least the data does show that they are safe and effective weapons against severe illness and death from Covid-19.

    Maybe Paracelsus gives data to support his statements about the Covid-19 “vaccines”. If so, I’ll be glad to read that. But if he doesn’t, and his words are just a rant that he want us to take on faith, that doesn’t interest me. You talk in your review about trust, and when it comes to topics like this, I follow the dictum often (erroneously) attributed to Edward Deming: “In God we trust. All others must bring data.”

    • Charles Haywood says

      There is some data, but not much, so I understand the points. Others do bring data. But frankly, I no longer pay much attention to the point-counterpoint on the vaccines. It’s clear that for me and my family, they provide zero value, and likely negative value (as in the data this week showing drops in birth rates, very dramatic, in several countries for births that should have been conceived during the first vaccine rollouts, covered on ZeroHedge). Life’s too short, and the number of people open to rational discussion is, we can agree, very few.

    • Mike says

      You wrote in your lengthy screed
      “The Covid-19 vaccines are indeed vaccines. No question about that. A vaccine stimulates the immune system to fight a disease without giving you the disease”
      As with much of what you wrote with absolute certainty, you only wrote half truths you sibilant creature. A “vaccine” is also supposed to do other things which this goo does not. A “vaccine” is not supposed to cause thousands and thousands of adverse events. Half a lie is still a lie. Shame on you.

      • Carlos Danger says

        Since I wrote my “long screed” on the mRNA vaccines, my interest in them has been pricked by personal experience. We had a family get-together a couple of weeks ago where the Covid-19 virus decided to join us. Tracking who got the disease and who did not by their vaccination status was interesting, though of course only anecdotal.

        As the disease felled person after person (but not me, strangely — perhaps “sibilant creatures” are immune), I took a look at the reported data around the world on the safety and effectiveness of the mRNA vaccines. Billions of people have taken the vaccines, so there is plenty of data to look at.

        The most recent variants of Omicron apparent evasion of the vaccines paints an interesting data picture, well worthy of a close look and informed discussion. But I take Charles’s point that very few (if any here — certainly not Mike) are interested in a rational discussion, so I will keep my comments to myself.

        • Charles Haywood says

          Hey, I’m interested! And, Mike, direct insults to other commenters are not (generally) permitted. Carlos makes many valuable contributions here, including his thoughts on Covid topics.

          • Carlos Danger says

            Thanks, Charles. Let me say a few words then about the vaccines, starting with the experience of my family.

            My family gathered last month and over the space of a week 16 people stayed in my mother’s house. Of those 16, 9 caught Covid, ranging from a 3-year-old to an 88-year-old. All 16 were vaccinated, but some had only one shot (the non-mRNA J&J) and one had 4 shots. Two people had Covid before, one of whom caught it again. Vaccination status seemed not to matter in who caught Covid.

            In Japan, my wife’s sister’s family gathered this month and over the space of a week 7 people stayed in her house. All caught Covid, ranging from a 6-year-old to a 75-year-old. All 7 people had 4 shots of an mRNA vaccine. None had caught Covid before.

            What to make of this? If people who have been jabbed four times are catching Covid, are the vaccines effective? It’s hard to tell from small groups, so I looked at numbers for the larger populations in the US and Japan (which is going through a huge spike in cases and deaths, the biggest of the pandemic). Still very hard to tell. I could use the numbers to make a case either way — effective or ineffective.

            That’s not unexpected for a complex adaptive system like the immune system. Indeed, immunologists quickly learn that they cannot rely on intuition and common sense but need to rely on data and other tools.

            [Ed Yong wrote a very interesting article in The Atlantic two years ago called “Immunization is Where Intuition Goes to Die” (the title is a saying common among immunologists). https://www.theatlantic.com/health/archive/2020/08/covid-19-immunity-is-the-pandemics-central-mystery/614956/%5D

            Enter causal inference as one of those tools. Causal inference is a process of analyzing statistics to help determine cause and effect in a complex system (which by definition has murky cause and effect relationships). When does a statistical correlation show causation? Causal inference is a tool to help tell.

            Causal inference grew out of the debates between Ronald Fisher on the one hand and Richard Doll and A.B. Hill on the other over whether smoking causes lung cancer. In the late 1940s and early 1950s that was in doubt. Lung cancer cases started to rise after the war, and some scientists thought that may be due to smoking. But tests on animals appeared to rule out a link.

            Richard Doll and A.B. Hill started a study on why lung cancer cases were rising. Richard Doll later said, “I personally thought it was tarring of the roads. We knew that there were carcinogens in tar.” But as the data came in his mind changed, Doll drolly saying, “Two-thirds of the way through the study I gave up smoking.”

            Ronald Fisher, perhaps history’s greatest statistician, went to his grave a smoker in 1962. (He died of cancer, but not of the lung, and he smoked a pipe, not cigarettes.) He criticized the work of Doll and Hill, saying there was not strong enough statistical evidence of a causal link between smoking and lung cancer. And he was right, by statistical methods as they stood then.

            [Richard Doll and Ronald Fisher both followed their beliefs with regard to smoking. Others found it more difficult to do so. In 1954 British health minister Iain Macleod called a news conference to announce, “It must be regarded as established that there is a relationship between smoking and cancer of the lung.” He was chain-smoking the entire time he spoke.]

            In 1965 A.B. Hill laid out some principles for determining causation in the so-called “Bradford Hill criteria”. Those principles grew into what we now call causal inference, which continues to develop and evolve. People like Judea Pearl have done a lot of work on these causal inference principles, but they remain more art than science.

            [Judea Pearl is probably best known to the public as the father of Daniel Pearl, the Wall Street Journal reporter abducted by militants in Pakistan and beheaded on camera in 2002. Some computer scientists know Judea Pearl as a winner of the 2011 Turing Award, sometimes known as the Nobel prize of computing. (Note that the Turing Award, named after Alan Turing, has been awarded every year by the ACM since 1966, just 12 years after his death. It’s not just recently that Alan Turing has been recognized as a genius.)]

            So what does this have to do with vaccines? We need to be more soberly scientific and less passionately political in deciding what to do about vaccines. We need to treat with great skepticism people like Paracelsus and Alex Berenson, who say “the mRNA vaccines are not even vaccines!”, as well as people like Tony Fauci and Rochelle Walensky, who promote vaccine mandates by insisting they stop transmission of Covid (a position for which there is not now and never has been any evidence to support).

            [The same applies to the complexity of climate change. We should treat with great skepticism people like Greta Thunberg, who thundered in her braids at the UN “how dare you!” for our supposed failure to take climate change seriously, as well as people like Alex Epstein, who insists we have a moral obligation to pump, drill and burn fossil fuels even more furiously. ]

            We should share information and beliefs and ideas about these complex topics. The more we do, the better. But we need to calm down and use our heads instead of our fists. Some parts of Twitter have become a cesspool where (metaphorically) people scoop up sewage and throw it at each other. Some websites and media are little better. We are lucky to have The Worthy House where the discussion (usually) has depth and substance rather than slapstick shallowness.

          • Charles Haywood says

            Very interesting. You are right there are many wild claims thrown about. Still, it is interesting that the British papers are now admitting that the UK is experiencing an ongoing massive increase in Covid-unrelated excess deaths. They attribute it to lockdowns, with the claim that people didn’t get care. Maybe. Or maybe the vaccines are killing them. If it’s the latter, will we ever be allowed to know the truth? Probably, but it’s hard to say.

          • Carlos Danger says

            Good example, Charles. The rise in excess deaths in the UK is a case where the study of cause and effect matters. If the vaccines are causing some or all of those deaths, we ought to know.

            And we should be skeptical about what US government people like Tony Fauci, Debby Birx and Rochelle Walensky say about the safety and efficacy of vaccines and other public health measures. Their hubristic arrogance has been galling and appalling enough to make me sick (certainly sicker than Covid ever did!).

            That’s nothing new for the Centers for Disease Control and Prevention (CDC). Long before the pandemic I was critical of the CDC for their ignoring the most basic principles of causal inference in their eagerness to promote political views.

            Take second-hand smoking. The CDC website says this: “Since 1964, about 2,500,000 people who do not smoke have died from health problems caused by secondhand smoke exposure.” Sounds like scientists have been able to show a cause-and-effect between secondhand smoke and deadly disease using the principles of causal inference. But if you track down their reference you find that is not true–the 2.5 million people figure is simply made up.

            The government does that with climate change too. They don’t bother to give any data and causal analysis to support figures for things like the “carbon budget” we have to stay under to limit the heating to a 1.5 degree or 2.0 degree Celsius increase. That’s because they don’t have any. Those carbon budgets and those 1.5 and 2.0 figures are nothing more than gussied-up guesses.

            We deserve better. And just as important, we should hold ourselves up to high standards. The basic principles of causal inference are not that hard to understand and apply. “Correlation does not imply causation” is the most basic, and the now-outdated but still helpful Bradford Hill criteria build on that. Counterfactuals play a part, and a little logic.

            It’s not rocket science, it’s accessible. And it’s important. In our complex world, learning the “science of cause and effect” (as Judea Pearl called it in his The Book of Why) ought to be commonplace.

            But it’s not. Much of the debate, on both sides, about the safety of vaccines flaunts those principles. People debate like twits in tweets, and fire off links to news articles as if that makes their point for them. Data and even the most basic analysis get short shrift.

            That can be dangerous. One graphic example. Dr. Naomi Wolf (not a medical doctor, but a PhD in English literature) has long claimed the vaccines are killing babies in the womb. Just the other day she posted a video claiming to have discovered a Pfizer study of a group of 50 pregnant women that showed that 44% of them suffered a miscarriage after getting the Pfizer vaccine. She teared up at this proof of Pfizer perfidy.

            But Naomi Wolf was wrong. She misread the Pfizer study, badly. The miscarriage rate was normal. And had she thought about it, she should have realized that over a billion women have been vaccinated over the past year and a half, some of them pregnant.

            Didn’t Naomi Wolf think we would have all heard if an unusual number of all those women were suffering a miscarriage after getting the vaccine? Over 25 studies have been done specifically to look for a link between vaccination and miscarriage or stillbirth. None (to my knowledge) has been found. (Indeed, it’s the opposite. There is evidence that the vaccine helps prevent pregnancy problems.)

            Luckily most people questioning the safety of the vaccines are smarter than Naomi Wolf. But I see too many people like Paracelsus and Alex Berenson saying that the vaccines are not even vaccines, raising the heat without shedding any light. We can do better than that, can’t we?

          • Carlos Danger says

            Charles, you mentioned “excess deaths”, which is related to “all-cause mortality”. The number of such deaths seems to be going up when one might expect it to go down as the pandemic shifts into an endemic phase. Many people are wondering why the rise.

            Let me talk about that intriguing question specifically. I certainly don’t know the answer. Questions like this are devilishly difficult to answer, as it’s hard to do experiments or make predictions, and those are the only reliable tools science offers. We have to rely instead on causal inference, and that tool is hard to wield objectively to give solid answers.

            Some blame vaccines for those deaths, and they may be right. But I worry as I see people like Alex Berenson and Robert Malone raise the alarm. The scientific evidence we have so far shows that the mRNA vaccines are safe and effective (or at least, were effective on earlier variants). Those raising the alarm about those vaccines don’t have any scientific evidence to counter. So I’m skeptical.

            We should look carefully into this, and people are doing that. If vaccines are responsible, that will be good information to have. Maybe we should take action too even before we know, to be cautious. Little harm in that.

            But the vaccine alarmists seem too close for my comfort to the climate change alarmists. They each have enough observations and statistics to make a plausible, and perhaps even persuasive, case. But they mislead many into thinking that they have scientific support for their opinions, when they don’t.

            That’s dangerous. Alex Berenson in particular claims to have made several million dollars from his writings about the pandemic. Reaping rewards for alarmism I’m sure skews his views. We benefit most from sober science, and that’s not what we’re getting.

          • Charles Haywood says

            The crux of the matter, I think, is “We should look carefully into this.” Will we? Or will this be a forbidden topic, like many other scientific topics, where every scientist knows his career will be over if he comes out with the wrong result? I’m betting the latter, at least in America, since all those in power can only be harmed by the wrong answers being let out. After all, alone among all relevant countries, I think, we are still requiring non-citizens to be vaccinated to enter the country. That level of stupid suggests they’re going to act to protect themselves, by suppressing any information that could suggest not only that they were wrong, but people are dead as a result.

          • Carlos Danger says

            Good points, Charles, but I think people are barking up the wrong tree by claiming that the mRNA vaccines are not safe or not effective. There’s no scientific evidence of that. In fact, the science goes the other way.

            People like Alex Berenson, Robert Malone and Naomi Wolf make claims that the mRNA vaccines cause excess deaths or a reduction in births, but they don’t have the evidence to back that up. When they make serious claims without serious evidence they look seriously silly.

            What tree should we be barking up? As you say, the government mandate that all foreigners coming to the US be vaccinated. That public policy has no scientific support. Indeed, no scientific evidence supports vaccine mandates of any kind. Same with lockdowns. Same with masks.

            We should bark loudly about those mistaken mandates. Those are political judgments that can be questioned without support from scientific tools like causal inference.

            But whether the mRNA vaccines cause death or infertility are scientific questions. Those who say they do need to make their claim with scientific rigor. So far, they haven’t come close to doing that.

          • Carlos Danger says

            In my previous post I glossed over an important point. I criticized people who say that the mRNA vaccines are not safe or not effective. That was too broad a criticism.

            All vaccines have limits on their effectiveness. All vaccines have side effects that may cause or contribute to injury or death. Balancing safety against efficacy to decide whether a vaccine is worth the risk is a difficult thing to do for any one person. Those benefits and risks may differ depending on things like the person’s age, health, or sex, and may change over time as the virus evolves.

            So I have no problem with those who look at the risk/benefit balance and decide not to get one of the mRNA vaccines. That’s not a scientific question (though scientific evidence may be a helpful guide). That’s a risk management decision. Opinions may differ.

            What I have a problem with is those who think the mRNA vaccines offer no benefits or cause a large number of deaths or infertility. Those questions can be answered using scientific tools, and we have some good data showing efficacy and safety of the mRNA vaccines.

            While any answer is always provisional, people who challenge the answers should back up their challenge with science. I’ve seen no one who has.

          • Charles Haywood says

            This analysis seems correct, although the critics do in fact claim to have evidence. Whether they do, or rather whether it is true and adequate to raise real concerns, I can’t say, both because I haven’t paid much attention and because the evidence seems to be taken from aggregate statistics of various types, to which new data is being added. But you do not really address my point–it is hard to “back up a challenge” if those who are in the best position to do so are too frightened to do so. We know there are many scientific topics totally unrelated to the Wuhan Plague where this is true (e.g., racial differences, gender dysphoria, sex differences). We know the regime is beyond desperate to maintain control and if the vaccines harmed people, it would have a shattering effect on that control. We know California this week passed a law stating that any doctor who contradicted whatever the official Wuhan Plague narrative is at any time can have his license revoked. In this atmosphere, why do you think the truth will come out?

  2. Carlos Danger says

    Why do I think the truth will come out? Good question. I don’t have a pat answer, but let me give you a few thoughts.

    As you note, scientists are often under pressure to conform to orthodoxy, consensus or official policy. If they don’t, they suffer. Two areas I’ve studied closely–climate change and evolutionary theory–can be added to your excellent examples of racial differences, gender dysphoria, and sex differences (where the religion of Woke rules over science).

    That kind of thing is nothing new of course. Religious or political pressure often influences the (supposedly) objective search for truth that is science. (Think Galileo Galilei and Trofim Lysenko as examples.)

    But such pressure seems in recent years to have increased. In this age of the internet when one might expect information to flow more freely than ever, we instead find powerful people using their power to censor that information.

    That’s sad, but I don’t know that we can do much about it. What’s gladdening is that the truth still does seem to come out. People looking for data can usually find it. Take the vaccines as an example. Data about the pandemic in general and the vaccines’ safety and efficacy is more accessible to everyone than ever. It’s amazing what is out there.

    In my opinion, that means that people who try to hide the data about this pandemic are unlikely to succeed. Access to data is not the big problem. The big problem is interpreting that data and imposing policy based on it. And what bothers me is that both sides gloss over data to argue for actions that the data doesn’t support.

    On the one hand, lockdowns and mask and vaccine mandates never had any science to support them. They still don’t. But on the other hand, neither do calls to ban the vaccines or restrict their use based on safety concerns.

    We see the same thing as in climate science, where “alarmists” and “deniers” outdo each other to magnify or minimize the problem beyond what the data shows. Where climate science has its Greta Thunberg, vaccine safety has its Alex Berenson, Pierre Kory, Robert Malone and Naomi Wolf. All appealing to emotion rather than relying on reason. All failing to build their arguments on data.

    Climate and pandemics occur in complex adaptive systems, so we must deal with problems in them in a fog of uncertainty, with missteps inevitable. Know-it-allness and stridency don’t help with that. They hurt.

    We need to quit arguing in the abstract and get real, in the real world. Compare the growling of Greta Thunberg with Vaclav Smil’s discussion of global warming in his book How The World Really Works and there’s no comparison.

    Greta Thunberg preens with sanctimony, and smarm as she argues an extreme view and attacks her often equally extreme opposition. Vaclav Smil’s insights are presented with practicality, balance and facts as he argues from the middle.

    That’s important. As Vaclav Smil said in an interview with the New York Times: “We don’t need pushing to the sides. What we need is the dull, factually correct and accurate middle. Because only from that middle will come the solutions. Solutions never come from extremes.”

    On vaccine safety, I’m in the middle. No one should be forced to take the vaccines, but people do deserve better information about vaccine safety than they get from mongers of alarmism who profit from fear rather than fact.

    • Carlos Danger says

      There is an excellent video/article on Unherd today about the vaccines and excess deaths in England. Nice to see an intelligent and in-depth debate on the subject by two people who have looked into it.
      https://unherd.com/thepost/investigating-the-mystery-of-excess-deaths/

      The guy in the video, Stuart McDonald, reaches the same conclusion I do, for similar reasons. I’ve not seen anyone with any good data and analysis to counter it. Anyone that has, please let me know.

      As I’ve said before, causal inference is the key here. What Judea Pearl calls “the science of cause and effect” in his “The Book of Why”. Stuart McDonald makes the same point in this video as Judea Pearl in his book. The data tells us what happened. It doesn’t tell us why. We need to figure out the why in some other way.

      Computers are bad at doing that. Artificial intelligence (better called machine learning) can’t really help. Judea Pearl has done some excellent work trying to put some mathematical rigor behind causal inference, so that may change.

      For now, though, it still takes a lot of creativity, hard work, and data gathering to do a good job of inferring causality. That kind of analysis doesn’t lend itself well to tweet threads or comment boards (like this), as I’ve shown with my unpersuasive comments here, so I’ll stop with this comment.

      But it is all fascinating to me.

  3. Carlos Danger says

    I’ve posted many posts here disclaiming the claims of those who think there might be a link between the mRNA vaccines and excess deaths (or all-cause deaths). I’ve said that those people have not shown any solid basis for their claims.

    At least to some of them, I was wrong. There have been some good arguments made to support that link. I had just missed them.

    Here is a video/article on Unherd: https://unherd.com/thepost/study-into-mrna/

    The study mentioned in the video is: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4072489

    An article about this is: https://brownstone.org/articles/are-the-covid-mrna-vaccines-safe/

    Apologies to Alex Berenson and Robert Malone (though not to Naomi Wolf) for improperly casting doubt on their analysis. It’s not unusual for me to be wrong, and I need to recognize that when I am wrong.

    As you noted, Charles, we may never get good data on this. That’s unfortunate. There is enough evidence here that we should look carefully into whether the vaccines are killing people. The idea that the mRNA vaccines might be causing the excess deaths is very troubling.

    • Carlos Danger says

      I forgot to include an apology to you too, Charles. I glossed over your warning that these claims might have something behind them.

      • Charles Haywood says

        Certainly no need to apologize! But it does seem evidence is increasing of harm. Not to mention–why have the Chinese always rejected any use of an mRNA vaccine?

        • Carlos Danger says

          Good question. I don’t know why the Chinese failed to approve either the BioNTech or the homegrown Chinese mRNA vaccines. That’s just one of the questions for which we don’t have good answers.

          The safety of the mRNA vaccines presents the kind of complex issue that we humans find so difficult to deal with. We jump to an answer and then have trouble updating our views as our understanding deepens.

          Myself, I think both sides have some good data and good arguments to support their views. I guess we’ll see what happens.

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