Thread by @Medical_Nemesis

On Saturday, June 17, 1916, an official announcement of the existence of an epidemic polio infection was made in Brooklyn, New York. Over the course of that year, there were over 27,000 cases and more than 6,000 deaths due to polio in the US, with over 2,000 deaths in NYC alone.

What can we make of this Wikipedia entry? Is this a story? Is this a fact? What is the relationship of this collection of words and symbols to scientific knowledge, practice, and the society that thinks we are scientific?
en.wikipedia.org/wiki/1916_New_…

What is a good way to evaluate an event? What kind of a method is good for this purpose? How can we make sense of an event? What in this collection of words is true and what is not? How do we establish truth? What is the relationship of truth to science? What is science?

Numbers (what kind?) situated in any compulsion slogan "save lives", "eradicate disease" or "prevention is better than cure" is an ignorant approach to any problem outlined by emotions and slogans that sound good but are not good in and of themselves.

The hardest evidence to find to make sense of this outbreak of polio will be the witness accounts of the people who bore the suffering - the poor Italian immigrants of Pigtown, Brooklyn, NY. If they exist, they are dispersed in obscure memoirs.

What we imagine as the unbearable, the poor today and in the past, sometimes barely noticed. Your suffering, the perception of it, emerges against the multitude of other sufferings.

While no one wants to suffer, the methods to “eradicate suffering” may be unacceptable to those who suffer for a variety of reasons. Suffering may be preferable to the method of its eradication.

"If you report any more of our babies to the Board of Health, we will kill you... Keep off our streets and don't report our homes and we will do you no harm." Written in blood. (David Oshinsky. Polio an American Story.)

We can use our observation of the spectrum of reactions and responses by individuals, communities, groups, institutions, governments to the announcement of a supposedly new virus SARS-CoV-2 to gain insight into the events of 1916.

We are not the same people we used to be in 1916 yet there are some similarities. The carriers of the way of thinking poor man in 1916 had exist today. History never tells his story. The polio story as told through numbers is a myth that supports certain politics.

When we speak of eradication of a disease as success, we do not revisit how we treated the man who suffered from the disease. It used to be, long ago, the concern of a physician was not a disease but… a patient. It is a principle that nobody remembers.

Simon Flexner was a polio researcher who disdained the clinical side of medicine. He focused on the laboratory monkey experiments and didn’t bother with people. A hospital was a testing ground for his ideas generated in the lab. Is this important?

I think it is. The transition to scientific medicine that we think was a great success by numbers landed us in solitary isolation, muzzled, with q-tips stuck up our noses, and drugged to glory. We call it healthy.

Investigating the past and its relationship to present we must establish what was the bigger evil: the disease or the way we went about dealing with it. We will have to establish some measure of success not in the one metric victory but our overall state.

Vaccinology contributed to animal trade and care networks; Cold War and colonial politics; technologies of refrigeration, preservation, and shipping; human populations for testing; global exchange networks for biomaterials and animal and human plasma, sera, and cells.

“Fluid bonding” refers to non-barrier intimate relations through which fluid sharing occurs. This term explicitly recognizes that fluids can carry disease.

Vaccines have required animal biomaterials on which viruses have been grown and through which they have been passaged, often with little understanding by both scientists and those vaccinated of what kinds of fluid bonding relationships were being created.

By opening bodies to each other, biomedical and technological infrastructures choreographed zones that fundamentally altered and expanded viral dynamics and exchanges.

It is impossible to know in the case of 1916 polio and SARS-CoV-2 outbreaks to what extent a laboratory contributed to the spread of illness. Yet we can have questions. Both about the laboratory research and what is injected into man.

What kind of a disease becomes a concern? For whom? Why? When does a disease become a public health reportable condition? Does it matter whom the disease affects? Does it matter who takes interest in it and for what reasons?

1916 polio outbreak started supposedly (did it really) in a poor Irish and Italian community. You must understand how any immigrant fits into the established local population and how his ways of being present a threat to the structure of existing local society.

What is the relationship between power, wealth, science, medicine, and recorded history? Where does violence fit into this for the supposedly good ends? Can I inflict good unto you?

Pigtown was poor and immigrant, home to some of Brooklyn’s poorest Irish and Italians. The Brooklyn Eagle, ever the barometer of the way good and decent upper middle class white people thought about their neighbors, was merciless in its depiction of poor Irish and Italians.

Reporters would go to Pigtown and observe the way the people there lived. They would then condescendingly report on them, making fun of the accents, their culture, or the lack of sophistication.Pigtown was a fishbowl, always good for a feel-good story of how “those people” lived.

I doubt there are readily available stats for the mortality rates of children specifically in Pigtown readily available. We can imagine by using circumstantial evidence, it was probably not unheard of for children to die.
read.dukeupress.edu/demography/art…

We have this wonderful book detailing the agony of losing children. Not Italian. Irish. Slightly later date but close enough. Technically, not a clean match. An approximation. Still better than numbers or our imagination through modern day perception.

en.wikipedia.org/wiki/Angela's_…

A must watch to get a glimpse into the way of living of Italian immigrants. Stories go back into the time period of interest to us. Not Brooklyn. Manhattan.
en.wikipedia.org/wiki/Italianam…

So we have these poor people trying to make it in the New World. The government takes little interest in them. They suffer and somehow manage to bear their suffering. The government takes a lot of interest in them when it concerns an infectious disease. Why?

Government comes in to save the savage immigrants from themselves but the savages resist and don’t want to be saved. Why?

Probably, because the savages are not stupid. People tend to know government does not care about them.

Who then the government cares about?

A little boy John died on January 2, 1901. John Rockefeller McCormick.

In 1901 Rockefeller Institute for Medical Research is established. John D. Rockefeller. A devout Baptist. Business magnate. Philanthropist.

John D. Rockefeller’s personal physician was a homeopath. Rockefeller believed in homeopathy all of his life. He never came to believe in medical science. Why did he put his money into the development of what became unquestioned orthodox medicine - “scientific medicine”?

How did scientific medicine arrive at this take on infections in small children at highest risk for complications? How come we think being sick is good for small children? How does vaccination fit in it? Why did it become bad to be sick in 2020-2022? Why the sudden care?

In 1897 Frederick T. Gates (no relation to Bill Gates), a Baptist minister and adviser to John D. Rockefeller Sr., went on a summer vacation with his family at Lake Liberty, New York. While on vacation he read a book.

openlibrary.org/books/OL241670…

Having read the book, Gates was not too impressed. Detailed descriptions of diseases stopped short when it came to treatments. Gates decided that the US needed an institute like the Koch Institute in Berlin and Pasteur Institute in Paris where scientists could work on treatments.

When Gates presented the book and the idea to John D.Rockefeller Sr., it went nowhere. The proposal disappeared.

Frederick T. Gates was a financial and spiritual advisor to Rockefeller. Many people asked Rockefeller for money. Gates established a policy of refusing all individual requests for funds and concentrated on agencies that could be held accountable.

pubmed.ncbi.nlm.nih.gov/9230006/

Two seemingly trivial occurrences (not in one place, not by one man) of doing abstract good in the absence of any body… lab research of treatments in the absence of a patient and philanthropy in the absence of a wounded Jew, so to speak. The mystery of evil.
#IvanIllich

How does laboratory research of treatments and mass treatment of the population make us think that good numbers make a trespass against this one man who stands in front of us good in the name of a “greater good”? Can I harm one in the name of numbers?

https://twitter.com/Medical_Nemesis/status/1571286951860338688

Why does an old woman refuses medical salvation and goes to her death? “Transitioned peacefully into the life eternal, with Jesus” children at her bedside. Why does a poor immigrant community bear the deaths of their children and tells the saviors to get the hell out?

Who is dirty? What is contamination? What is order? What is disorder? What kind of a body is ordered? Disordered? Who decides?

Where is the location of the disorder? What is the significance of the location of laboratory research and the focus of its research? Is it the body? A place? Are they separate? What is the significance of a scientific metaphor “a part” and “a boundary”?

A certain kind of body was prominent during 2020-2022. There is a right kind of desirable and approved body and the wrong kind. Man who inhabits the body is also different. The struggles around vaccination brought him to light. The body must be tamed and ordered.

The kind of body you are is important when it comes to government, medicine, or public health taking kern interest in civilizing you into the societal order. You must be moulded to fit into the idea of man as a product of man.

Our Italian immigrants in Pigtown present an affront to the clean ordered ways to keep bodies and communities free of disease. They must be transformed. Not for their benefit. For the benefit of the clean lawful society of the healthy.

The same idea permeated the campaign against the unclean “natural” disordered unvaccinated during 2020-2022. If you look at who resisted the vaccination the most, it will be some kind of a “savage” or a “natural”. They upset the ideology of man as a product of technology.

What it means to live - this is a key difference between the standard definition of health in medicine and the old historical way of being that retains fear of what is bigger than us as well as the meaning of illness. Interfering in what we don’t understand that has consequences.

What is health? This varies a lot by who defines it. Lay definition of health is different from professional and institutional. What man can cope with vs absence of disease.

https://twitter.com/Medical_Nemesis/status/1248995808076316682

Institutional definition of health charge constantly for political reasons to adjust the expectations of the mirage of health.

https://twitter.com/Medical_Nemesis/status/1252923827102855168

It was a presentation by @KristinCollie20 at some graduation. I can’t find the clip. Understanding of health by a farmer.

https://twitter.com/Medical_Nemesis/status/1555371612748275712

Then there is a whole unhealthy thriving of a community that became obvious among the communities of faith that we consider unreasonable, old-fashioned, or extreme. Health is not the goal around which a community centers itself.

I have tweets I can’t locate where a study revealed Russian conception of health and sickness. It’s not there. It’s a dichotomy of alive or dead, if I recall correctly. If you are alive then no disease touches you. It means if you can get up and do stuff, you are alive thus well.

What was the conception of wellness for the Italian immigrant community in Pigtown during the polio outbreak? What was the conception of health according to public health authorities? What was the discrepancy between the two? Was public health making the community sick?

Frederick T.Gates at some point in time came to view health as an index of social progress, medicine as a way to reduce tensions in society, and science as a supplement to religion.

Scientific medicine was to improve the health of society’s workforce and thereby increase productivity. The material benefit is a healthier population thus a healthier workforce.

How does vaccination fit in this? Is it a concern for the wellness of man?

Is it clearer why our children are in daycares and not with mothers? Is it obvious why “management of infection” means upfronting disease in infancy when children are most vulnerable to reduce absenteeism from schools later? How many vaccines are rolled out to reduce sick leave?

How does forced vaccination become a possibility? It goes against every healing principle. You cannot force medicine that man, that is well to top that, refuses. Violence is the opposite of healing.

In 1889 Andrew Carnegie published “The Gospel of Wealth”. It called for the wealthy to channel their riches to the good of society by replacing individual charity with support for systematic social improvement, which was conducive to order, productivity, and secular advancement.

In the the early 20th century, many regarded philanthropy as a cynical use of exploitation-derived profits to counter the threat of working class unrest and growing political radicalism.

These philanthropic efforts helped stave off the welfare state in the USA and gave private interests considerable purview over social welfare.

thelancet.com/journals/lance…

I will include this here as an example of an imaginary consensus. These people imagine that if they agreed, their agreement means something important. What these delusional jokers are missing - does the community of men upon whom the public health experts inflict good agree?

https://twitter.com/OliuBarton/status/1590370505496096769

When a community faces a disease, be it polio in 1916 in Pigtown or in 2020 an invented disease Covid, there is a discrepancy between groups of people about what or if anything should be done about it.

There is this town called Oyster Bay, NY. Twenty thousand people lived there in the 1910’s. Theodore Roosevelt was one of its notable residents. It is an interesting place to add to our understanding of the polio epidemic in 1916.

en.wikipedia.org/wiki/Oyster_Ba…
maps.apple.com/?ll=40.759444,…

Oyster Bay reported nine cases of polio per 1,000 residents, five times the New York City rate, only a fraction of them in poor immigrant children. One of the highest in the nation.

It appears Oyster Bay was a vacation town for the well-off. Permanent population was less so. The last clip highlights the discrepancy between the priorities of the wealthy and ordinary people when it comes to spending on public health. Maybe the poorer people want to eat?

Oyster Bay is a classic study case in resistance to polio quarantine amidst a raging epidemic that was hitting the town supposedly worse than other places. Why? Why do people flee from a disease and quarantine alike? Why do they make peace with a disease more so than government?

This Guenter put his spin on the reasons why the public resists. A thoroughly unscientific way to approach this matter. Guenter plays for the institution “Bomb you for your own good” not the public.

The understanding of disease influences actions of government and towards whom it is directed. What kind of a body presents the biggest threat and why and who does this body threaten? Reality is of little consequence when we deal with disease, power, order, and control.

By 1900’s we were doing something that resulted in fewer people dying dying and more people surviving. What was it?To what extent did medicine or public health contributed to the decline in mortality? Why do we focus on mortality and not on how well rested you are in the morning?

https://twitter.com/Medical_Nemesis/status/1477760863847264260

An idea: the wealth and strength of the state depends strongly on the number and the character of its subjects. Note “combatting the plague” as a political matter. (I wonder if this is a direct quote of the language of war or modern paraphrase).

Laws, chaos, uncertainty, control, order. If you watch epidemic debate, these words are important. The leaking of the idea of a divine law into science. It is a matter of philosophy not formal science. The rise of statistical thinking to control for individual uncertainty.

How do these ideas play into the idea that mass application of medicine to every single man, well or unwell, regardless if the man finds it useful or harmful, is a very good idea? The greatest achievement of science.

How does statistical thinking play into science, particularly scientific medicine and its extension population medicine? What is the relationship between good, right, and truth and statistical thinking in medicine? Is it good to treat all for individual benefit?

How does the idea of “benefits” as opposed to “good” influence what we do? How does statistics as a branch of science give rise to the abstract idea of (population) risk and its extension - benefit?

What happens when we abandon some notion of being guided by what is good in favor of seeking the answers in statistical numbers? What constraints do we have that will prevent killing or solitary isolation or any biological/cultural deviation from becoming beneficial?

Banning of children from public places was a feature of polio public health measures. It is unclear what the reasoning was. It was not unlike isolating the old during COVID. It seems largely irrational.

As we can see, the reasoning behind public health measures in Oyster Bay, NY was not very clear, as the response from the public was polarized, not enough or too much, depending upon socio-demographic level. The reactions were similar to what we experience with COVID measures.

Although we think polio was a much worse disease than COVID, the playbook response was almost identical as was the opposition to it from regular people. Note the difference between the experience of physicians on the ground vs health bureaucrats.

It is painful to read the exact same ordeal of polio epidemic response, citizens protesting, appeals to historical precedents of quarantine, manipulation of statistics. Note that the public bore the burden of a scary disease and viewed governmental response as more harmful.

Here we can observe a change from a physician who was part of a community that the community trusted to a physician who was not and was in medicine to make money. We live in the aftermath of that change. Physician as as an agent of population medicine.

researchgate.net/publication/21…

How did we go from a physician attending to the sick who couldn’t manage on their own at home to routine medical treatment of the whole population? How do we justify inflicting harm on an individual non-sick patient for the greater good of the population?

History did not start in 2020, 1955, 1917, or the 19th century. There were many developments not in science but some ideas over the course of all history that make nonsense seem reasonable. Preventive population medicine sounds like a good idea when it is probably not.

Preventive population medicine is of little to no use for an individual. It also has potential to harm and does harm when a well citizen is subjected to tests and treatments to optimize for population outcomes.

Population medicine is contrary to what medicine was when a physician faced a sick man who reached out for help voluntarily. It was under these circumstances there was a possibility of some good arising. A fit between two knowers.

https://twitter.com/medical_nemesis/status/1248995808076316682?s=46&t=ups_Vjm9eLVBgYYCkSBCFA

A physician who knew his art of relating some abstract knowledge of disease to this man who knew what it meant to be him and suffer. Some truth of what was good to do here and now for this man so he could live within what was good could arise. It had nothing to do with benefits.

Keeping in mind the emergence of the concepts “labor force”, the strength and wealth of a nation state in the health and a certain type of a productive body, body as a possession to control and order to be a good productive citizen, political arithmetic, and statistical thinking.

The ideas of deviance, risk, and planning of services are of interest here. Is a deviant deviant? What is our baseline that we establish deviation from? Is being sick deviance? In what ideology? How does risk emerge? What do services have to do with it?

Is this deviance?

https://twitter.com/Cv4226/status/1591919029001789441

Risk is a 𝑝𝑜𝑠𝑠𝑖𝑏𝑖𝑙𝑖𝑡𝑦 of something “bad” happening. The very idea of bad is judgement. Possibility is not certainty. Risk arises through numbers in statistics. Risk as an epistemological and social phenomenon justifies population medicine and vaccination.

We are layering on the ideas that illness, disability, death are intrinsically bad thus must be eliminated no cost spared. Yet we are business minded and operate within an framework of costs and benefits. We also value control, order, and technology as the solution to “nature”.

Our order of philosophical complexity is rising when we face the spread of polio that cripples children who may die from the disease.What seems like a straightforward technical medical matter is grounded in a system of values, assumptions, methods of abstraction that are unreal.

Nature emerges as a theme opposite of man made technology. Nature carries some meaning as does technology.

If I give everyone a vaccine, a disease caused by polio virus disappears. Seemingly. It has to be good. No more suffering and death. From polio.

Since this is just out. Let’s throw it in. Great success. Is it if taken in all of its totality as a non-technological but a societal phenomenon of disruption? Vaccination is a tool of biopolitics. It has little to do with individual thriving.

https://twitter.com/VPrasadMDMPH/status/1592196452998340610

How does a mirage of polio eradication feed into the societal collapse that reinforces unprecedented way of existence by the ritual use of a vaccine? It is irrelevant if it is effective or useful medicinally. It is by the virtue of its existence and repeated administration.

You can persist in the reductionist delusion of a vaccine trial and fail to watch ruin and destruction all around you. Reality is not a trial. A victory on one front does not negate the destruction of war.

You fail when you take upon yourself to rule over life and death. You fail when you know no limits. You fail when you reach to engineer what you have no means to understand. The only miraculous thing here is a spectacular delusion.

We have an uneasy relationship with nature. We perceive it as benign/healing and dangerous/killing simultaneously. A lot of scientific endeavor and thought centers around the concept of nature and its conquest.

Today we think of risk as a fact of tangible reality. Objective reality. Risk is none of the above. Population risk as man made invention justifies medical treatment. Risk is a tool of politics.

Perception of danger is different from statistical risk. Risk in a population cannot be translated into individual risk. However, experts and individuals alike do that. When you apply population risk to yourself, Ivan Illich called it self-algorithmization.

A disease expressed numerically outside of any context has no meaning. Why do we see the numbers for 1916 polio outbreak as absolute numbers and not some rate to make it contextual? How do politicians manipulate numbers to trigger an emotion?

Does some number apply to this community?
- I saw seven women die at the hospital.
- We haven’t lost any women in this community for 16 years.
Who has a better chance at sensing danger?

How does a public health official look at polio devastation vs people in the community? Does a community perceive polio in relation to everything else or in isolation as a stand alone matter?

How does public at large perceive polio in context of other events? The US was on the verge of sending troops to Europe where WW1 was raging. How does perception of a disease fit in other perceptions of reality?

Polio that acquires some meaning in a family of a child afflicted by it is not the same as polio of medical, public health, or philanthropic significance.

How does eradication of suffering and disability affect us? Does suffering have meaning? If we think disability is of no benefit and is costly, what will we do with the disabled or potentially disabled? How does abortion fit into this? Euthanasia?

Then if we get in to the experimental nature of scientific medicine and the suffering it inflicts, we will see that every vaccine launch is an experiment with many unknowns. A vaccine arrests our quest to understand the complexity of disease and its causative agent in context.

Here is a discussion of the aftermath of a disastrous polio vaccine launch and the typical damage control for the greater good.

drive.google.com/file/d/13MEzjI…

The article details a fairly typical scenario of the difficulties developing and manufacturing a vaccine, subsequent changes in epidemic and diagnostic criteria, differentiation of diagnoses, manipulation of statistics, and reputation damage control.

The issues with less than perfect vaccines that cause separate problems and many unanswered questions about polio. Polio is not an eradicated disease and can re-emerge with vengeance. We are still in the middle of this experiment.
ncbi.nlm.nih.gov/pmc/articles/P…

What would be different had we devoted our efforts into therapy for polio as opposed to a vaccine? What happens when we eliminate one pathogen? Does another one take its place? Is there a limit to how many vaccines we should have? Are we sane?

Scratching the surface of a very complex issue. Is it a technical problem of disease or a the questing of being? t.co/n8ctq9PXSP