Thread by @1goodtern

I've been trying to write this thread for about six months, but it's a mess.
It's full of conjecture.
It feels really judgmental.
It feels opinionated.
It feels uncomfortable.

But it's absolutely essential that we open a conversation about medical professionals and covid.

So I'm going to go for it, then you can shout at me afterwards.

Some medical professionals are (in my opinion) at the top of their game right now.
They're sharing compassionate intelligent wisdom about Covid, and promoting sensible behaviour and action.

Some medical professionals are (in my opinion) totally off the rails.
They've abandoned the principles of public health and the precautionary principle.
They're promoting a virus and endangering the vulnerable.

I'm going to call that lot group twos.

Some medical professionals are (in my opinion) somewhere in the middle, but by being there, they are abdicating their responsibility to promote health and failing everyone.

I'm calling them group threes.

I'm not going to address the first group. They're doing excellently, and you can find loads of amazing examples here on twitter. I think more are joining and finding their voices too.

Often they're quite busy in real life, so you might not find them on here much. 😅

The group twos aren't that hard to understand either.
You get toxic people in every profession.

Group twos are all about self promotion. They're into point scoring and putting other people down.

Group twos are narcissists, they don't care about other people.

Group twos only care about truth as they perceive it, or as it benefits them.

Group twos won't listen to opinions unless there's something in it for them, for example they're trying to get a favour in return.

Hospitals and surgeries are famous for group twos.
They elbow their way through departments.

Sometimes group twos are brilliant at their jobs, and that brilliance fuels their arrogance.

Sometimes group twos think they are brilliant, and that self-perception fuels their arrogance.

Sometimes group twos once did something brilliant, and they've never done anything useful since.

Group twos aren't a large proportion of medical professionals, but they're loud and they like throwing their weight around.

Group twos may be more interested in control, power, and inflience, so they often fight their way into positions of authority.

Group twos hate accountability, integrity, intelligence, compassion, and being told that they are group twos.

Group two medical professionals have been excellent useful idiots and bad actors for the coalition to pretend the pandemic is over.

https://twitter.com/1goodtern/status/1581172498745667584?s=20&t=nXGQRSDy5TkZ6sHX-aRTiQ

Group twos haven't baffled me.

They were toxic before the pandemic, and they're toxic now.

It's the group threes who have baffled me.

Group threes are the ones who
*should know better*.

I think group threes are the biggest of the three groups.
I don't know what the actual split is across the three groups, and it doesn't actually matter because this group is clearly the largest.

Group three medical professionals are people who think they are good people.

Group three medical professionals know they are part of the 'caring profession'.
So they do the things that they think are caring.

But in the case of Covid, they're not questioning the political narrative that covid is mild, harmless, defanged by vaccines, or over.

First off, it's worth recognising the potency of the political campaign to minimise covid. Read this thread for more on that.

https://twitter.com/1goodtern/status/1581172498745667584?s=20&t=nXGQRSDy5TkZ6sHX-aRTiQ

It has tried to convince good people that to be good people they must act like covid is over.

These group threes think they are good people.
They know they are good people.
And they bought the line that to continue being good people, they have to act this way.

Why haven't they seen through it?

For dozens of complicated and interwoven reasons...

They don't want to rock the boat or be seen rocking the boat.

Very little of modern medicine is built on independent thought or curiosity.

My impression is that a lot of the teaching of modern medicine is about learning the set answers to the set questions and then sticking to that narrative.

Modern medicine is also highly compartmentalised and specialised.

If an immunologist tells an anesthiologist that the vaccine has made covid safe, then the anesthiologist won't think too hard about it, especially if it's drummed in by the media and the managers.

But, we say, if hundreds of people are dying from covid each day, wouldn't the anesthiologist notice it, and start questioning the narrative that the pandemic is over?

No. Because those deaths are spread across ten thousand wards in a thousand hospitals. One individual doctor just won't be able to see the wide impact of the pandemic.

If you're a cardiologist, and you see fifty patients a week, you don't necessarily notice things are busier because however busy they get you'll still only ever see fifty patients a week.

Except there are now seven million people in the UK waiting to see [insert specialist here].

Does the cardiologist know if the waiting list is six days or six weeks?

Also, modern medical professionals are part of a team.

That's both a strength and a weakness.

They rely on other people in the team to make decisions.
The nurse relies on the doctor, the doctor relies on the consultant.

The pharmacist relies on the doctor.

And the doctor relies on the pharmacist.

They all really on the infection control team.

In terms of infection control, they have to stick to the infection control plan.

But just like everyone else, the infection control team is not there to think independently or act on curiosity or the precautionary principle.

They can't.

They have to follow government guidance.

It's worth emphasising this.

If you buck the system in modern medicine, you get ostracised and scapegoated fast.

Medical professionals learn immediately to paint only within the lines.

So everyone follows guidelines.

Everyone does what they're told.

They can't *not* do what they're told.

And worse than all this...

Infection Control does not answer to the doctors or nurses or porters or radiologists.

Infection Control should have the best interests of the patients and medical professionals at heart, shouldn't it?

Bad news, I'm afraid.
They answer to the managers, and they follow the government guidance that is set by the same politicians who are minimising the pandemic.

So there's no point pointing at the doctors and saying "but they're not wearing PPE" because they're only following orders.

The medical professionals rely on someone else to create the guidelines on when you change your mask.

The medical professionals rely on someone else to create the guidelines on what type of mask to wear in which area.

If the medical professionals only ever watch the news and read the papers, they would have almost no reason to question these policies.

And they don't question the policies, because they read that statement in March 2020 from the WHO that covid is not airborne. They saw that times article about how vaccines stop severe illness and death. They saw that BBC story that omicron was mild.

They're busy, and they're tired, and they know that they just have to do what they're told.

Besides, they're healthy and only vulnerable people were affected by Covid.

They've been told that people who are still concerned about Covid are suffering from anxiety.

They've been told that the only people getting seriously ill now are the unvaccinated or elderly or weak.

They've been told that stuff about the new variant is just scaremongering.

They've been told that the people sounding the alarm are only students.

And they look around at the other medical professionals with their surgical masks on their chins, and they look around at the in person conferences and the macarenas and they say to each other 'the pandemic is over! We don't need to worry about Covid any more."

But it's all just a result of groupthink. It's a combination of optimism, and blinkered thinking, and bias confirmation, and delegated responsibility, and misplaced trust.

And yes, there's arrogance in there too.

They're the gatekeepers of medical knowledge.

They have been the gatekeepers all their professional lives.

People come to *them* for help, so there's no way they could be wrong.

The dissenters are dismissed as scaremongerers.

The vulnerable are sidelined.

There's one huge positive thing though.

I think the group ones are starting to find their voices, and they are starting to influence the group threes.

I think some of the group threes are realising that the group twos are toxic.

I think the group threes just need to grasp the real narrative:
That covid was declared over for political reasons, not medical ones.

And as that starts to happen, we need to demand that people be put in charge of infection control who both understand the science and actually have the interests of the medical professionals and patients at heart.

We need to demand that the minimisers and denialists (very often group ones) are removed from their positions of influence.

We need to remove the people who have caused so much harm, and put the right people in place.

People who have a heart and a brain.

https://twitter.com/1goodtern/status/1579542889520332800?s=20&t=nXGQRSDy5TkZ6sHX-aRTiQ

I said this would be a messy thread.
I've probably missed some important bits, so I'll try to add them when I can.
Please share your thoughts ❤️❤️

One thought about 'keeping up with the research'.

I don't think group threes have the energy, time, or independence of thought to 'keep up with research'.

They don't think they need to, because they'll get told anything important.

But who is going to tell them?

The papers owned by billionaires won't.

The politicians owned by billionaires won't.

The trust managers owned by billionaires won't.

Independent thought was drummed out of them in whatever university or hospital or college trained them.

If you read all that carefully enough to spot the tweet where I called group twos group ones, give yourself a gold star 🌟

So how do you kick group threes out of the rut they're in?

The sad truth is that you're probably only ever going to change a few of them to group ones.

Some of them will even become group twos under pressure.

I think the fight may lie in the political and scientific spheres.

Sadly they're always going to do what they're told.

So we're going to need to tell them what to do.

And I've said it before, and I'll say it again, we need to destroy the grip that group twos have on the covid narrative.

We need to remove them from their positions of power and replace them with group ones.

And the group threes will just nod their heads and go "oh, we all have to use filters and masks, that makes sense".

The group threes will never ever think they did anything wrong.

We will have to pick off the group twos one by one.

Sometimes a group will go.

Sometimes they'll be replaced by more group twos.

But more group ones need to bite the bullet and choose the hard path of stepping into leadership.

Fighting for it.

Folks, this is a life or death battle.

It's the battle for the soul of the west.

Do we continue to allow ourselves to be led by the narcissists and psychopaths, the selfish and heartless, or do we step up?

Changing track, I'm going to add a few more ragtag thoughts about the world of medicine...

I mentioned the compartmentalisation.
I mentioned the arrogance (which in some ways is vital for medicine)
I mentioned the groupthink.

But on top of that is the very real problem that all of these people are human.

They're human in a very pressurised role.

The pandemic has put them under immense pressure.
Physically.
Emotionally.
Psychologically.

They've lived with the very real threat of death and disability.

Some will be suffering from the trauma of what they have seen and are still seeing.

I don't know how many people appreciate the almost military attitude there is in some medical staff.

Like veterans of war who have seen unnumbered horrors.

Some saw those and became compassionate.

Some saw them and their minds were broken by the horror.

Post traumatic stress is everywhere in healthcare right now.

Add to that the very real burden within hospitals of Long Covid among staff, and the psychological effects of it.

A lot of medical professionals have a weird thing about sickness and weakness being something that happens to regular people, but not to them.

Then they develop long covid and it breaks their worldview.

Many practising medical professionals are carrying their long covid with them as they go back into a workplace that castigates weakness.

The ones who have made it through without any significant effects will be working through the complexities of surviving, and what surviving does to the psyche.

Superstition and luck are as alive in hospitals as they are anywhere, but they're sciencified by doctors joking that maybe they're immune, or have teflon lungs.

And medical professionals, in their humanity, crave normality as much as all of us.

They are *desperate* for this to be over.

More than you or I, probably.

And in that desperation, they have been prime suckers for the hopium, misinformation, disinformation, misdirection, and deceit.

And in their humanity, as they have come even closer to facing their own mortality, they have been prime candidates to buy into the mass denial.

They are as afraid as the rest of us, if not more so.

And fear is the fertile ground in which denial grows.

And there's one last really harsh observation about the humanity of medical professionals...

And that is that they are as immersed in our selfish and greedy culture as all of the rest of us.

I think there's an illusory image of medical professionals en masse - we put them into one big group of selfless heroes, who saved us during the pandemic.

But that's so obviously a false portrayal of them.

For a hundred and something years, medicine had been the caring profession.

But as society has become less caring, every member of society has become less caring, including medical professionals.

I think an increasing number of young people chose to go into medicine for the money and influence.

And as the proportion changed, the culture of medicine changed.

Doctors, nurses, pharmacists, please feel free to put me right here.

I think society is toxic, I think medicine is toxic.

We need a new heart.

I know I haven't written this as well as I would like to.
Some of the ideas in here are not quite right yet, but the discussion needs to happen.

And I know that I haven't articulated some parts as clearly as I would want to.
Some of these ideas are half-formed and messy and awkward.

This thread is not the full picture.

But that's to be expected, because a random tern on twitter isn't going to figure this out on their own, and is probably going to get a load of stuff very wrong.

But if we don't try to share these ideas and work through them, we're going to end up in a very bad place.

Thanks for listening, sharing, and commenting. ❤️

Coming back for more...

For the last five or so years I've been booting round ideas for a book on stupidity.

Thinking of the humanity of medical professionals, we've got to remember that they are human.

Humans have only a finite memory.

Young humans have limited life experience, even if they are medical professionals.

Humans take time to learn.

We're advancing through the stages of this pandemic so fast that some people are still catching up on last year's news.

If you're working stitching wounds and treating dementia, you may be a little behind on what's actually happening in the world.

Medical professionals are human, and they are not immune to stupidity.

In fact, the more they specialise, the more stupid they get.

And the more they rely on the team around them to know things, the more stupid they get.

That's what enables them to be such incredible specialists. They can focus on their subject, because other people are dealing with the rest.

But if the people they're relying on are relying on people who are wrong, then the pyramid falls down.

The smarter you get, the more ignorant you can be.