Beauty is Skin Deep…

But Ugly goes to the bone.

I was trained as an Oculofacial Plastic and Reconstructive Surgeon and spent more than 30 years in that craft.  We would use that phrase, sometimes in jest, but sometimes as an accurate description of the problems we would face. Many times when faced with serious cosmetic abnormalities, especially those caused by trauma, a satisfactory result could only be obtained when the underlying skeletal abnormalities were attended to first.

No one really knows where that phrase originated:

https://quoteinvestigator.com/2020/09/25/skin-deep/

It is attributed to Dorothy Parker, but it probably stems from an understanding much earlier than that.  We use the same type of logic when we look at a house that has seen better days, but take heart because “it has good bones”.

I was reminded of the phrase this week when contemplating an example of the ugliness that has unfortunately afflicted medicine.  Like the massive facial trauma deformities I so often confronted as a clinician, the bones of my profession have been broken and smashed.  An attempt to merely try to mask the bony deformity will invariably fail.  Something more definitive is needed.

Recently a panel discussion on Diversity, Equity and Inclusion in the academic community was scheduled to be delivered.  The speakers, a United States Senator, the Chair of the State Assembly Committee dealing with University Affairs and a national expert on the topic were set to speak in in the upcoming week.  The event was organized by the National Association of Scholars:

https://www.nas.org/awareness?gclid=Cj0KCQjwmN2iBhCrARIsAG_G2i4wkcnSRp9xZaQV-DwgnKwLGzaba_AEyPTm-Zf6IVlQKFaLebW2TIQaAvPKEALw_wcB

but it was cancelled by the University President for a variety of stated reasons, not the least of which was a petition circulated by students and faculty supporters of DEI which demanded the event be cancelled.  It is hard not to see this, in a large part, as an example of the “Heckler’s Veto”.

We have seen the cancelling of inconvenient speech a lot in medicine these past 3 years.  All efforts at implementation of early multi-agent treatment of COVID -19 were shouted down.  Even when such interventions as increasing intake of Vitamin D were shown to possibly be potentially lifesaving, the medical establishment, Big Pharma, Big Tech and Big Media drowned out all efforts to give patients the choice.  The careers of those brave physicians who stood up for their patients were systematically destroyed.  It is small consolation that now, most, if not all, of their statements have been proven to be true.  The virus seems certain to have originated in the lab.  Masks do not work.  Lockdowns did far more harm than good.  The so-called vaccines do not prevent transmission nor confer long-lasting immunity, at least in the way we understood it for decades, if not centuries, before the Great Covid Disaster.

It is hard not to see that those same elements of society that pushed this false narrative about COVID have also been the most vociferous in their support of DEI measures.  This support has often gone hand-in-glove with COVID “measures” pushing a differential in treatment based upon race and race alone. Not on risks but solely  on race.

It would take numerous pages to reference all the articles on the influence of DEI on admission to medical school and advancement in the profession.  What only a few years ago would be unthinkable is now laudatory.  Questioning it, as in this instance, results in immediate censorship.

But it is not just DEI.  There is also a common thread in likewise demanding “gender affirming” programs and denying parents any input into the medical care of their minor children. 

Has anybody bothered to ask why?  Why is there such a partition in our society?  Why is COVID the one medical condition in which informed consent is not only NOT required, but criminalized?  Why is it now a virtue to deliver unequal medical care on the basis of race all in the name of “equity”?  Why can minor children not legally drive a car, drink alcohol or give consent for a tattoo but are free to decide on whether or not to undergo a surgical or pharmacologic sex change?

While I don’t presume to know the entire answer, I have some suspicions.  All three of these instances— COVID treatment, DEI mandates and “gender affirmation” --  involve huge amounts of money.  If simple, inexpensive therapies were allowed for COVID treatment, the trillions of dollars in payment for Emergency Use Authorized “vaccines” would not have been possible.  Likewise, the mainstreaming of “gender affirming” care is a lifetime of pharmacologic income.  Without DEI programs, millions, if not billions of dollars on re-education would not be available. A whole army of consultants would have to find other fields.

Yes, that is a shocking point of view.  Money.  Is it really just about greed?  Of course not.  And it isn’t only about just medicine.  Teachers and clergy have, for the most part, been only too eager to comply with the mandates or have perhaps been too cowardly to speak against them.

Why is that?  It seems so illogical….so crazy… so ugly…so evil.

The fictional character, Sherlock Holmes (actually created by a fellow ophthalmologist!) made an observation that is apropos:  First eliminate the impossible.  Whatever is left, no matter how improbably, is the answer.

Is Evil the improbable, but true, answer?  There is indeed evidence that it is.  It has happened before.  A number of times.

An exhaustive investigation of the effects of Evil, especially the active choice of the “Dark Side”, on human misery is beyond the scope of this substack.  It is, however, something that is sorely needed, especially as it relates to medicine.  We see glimpses of it stretching back 3,000 years in the Books of Judges, Samuel, Kings and Chronicles in the Bible.  There was at least a correlation, if not an actual causation, between human misery and the rejection of the God of the Bible and worshiping of other gods.

There is little doubt that both the French and the Russian Revolutions sought to stamp out the God of the Bible.  They too were associated with countless instances of human loss and tragedy.

The evils of Nazi Germany and their client fascist states are common knowledge, as is the concentration on the Occult among the elite Nazi leaders:

https://nyupress.org/9780814730607/occult-roots-of-nazism/

But why did so many physicians follow this?

https://www.tabletmag.com/sections/history/articles/fernandes-doctors-who-became-nazis

Moreover, how did German medical ethicists justify this?

https://forward.com/culture/376484/did-the-nazis-really-have-a-system-of-medical-ethics/

 In contrast to the French, Russian and Nazi Revolutions, the American Revolution was not associated with the same degree of hatred and violence.  Could it be that the cornerstone of that struggle was stated in these words?

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.

Is it significant that nearly two and a half centuries later, the US president could not bring himself to mention the word “creator” but replaced it with, “you know, the thing”:

You be the judge…

These words were uttered on March 2, 2020. We were in the midst of worshiping “the science” and Anthony Fauci, who said he personified science, complete with votive candles and unquestioned faith:

https://www.amazon.com/Anthony-Fauci-Celebrity-Prayer-Candle/dp/B087NFJP6B

Was this merely a wry attempt at harmless humor or was it actually something deeper than that?

In the past 3 years, we Americans have experienced our own struggle with medical ethics as the “experts” systematically cancelled those attempting to use all of our available weapons in the treatment of COVID instead of limiting our approach to such things as lockdowns, masks, social distancing and “waiting for the vaccine”.  Once that “vaccine” was available, it was pushed on everyone, including pregnant women and young children, with no thought for the risk/benefit ratio.  “Informed Consent” was non-existent for this disease, and this disease alone.

We even had our own medical ethicists postulate that denying care to the unvaccinated, even if they had durable natural immunity, could be morally allowable and even exemplary:

https://www.medscape.com/viewarticle/958434

Churches were closed, but liquor stores remained open.  While some pulled down statues and demonstrated in the streets we were told that such “social action” demanded an exception to the masking and social distancing requirements because it was morally required. Did we ask “Why?”.  Some of us did, but were shouted down.  The leaders of the Black Lives Matter movement at the forefront of these actions explained the “spiritual” underpinnings of the movement:

https://religionnews.com/2020/06/15/why-black-lives-matter-is-a-spiritual-movement-says-blm-co-founder-patrisse-cullors/

The World Economic Forum, which saw COVID as a tool to reach what they call “The Great Reset” also has a deeply “spiritual” side.  Yuval Noah Harari, who can best be described as the prophet of this organization, describes the “spiritual side” of the movement in Homo Deus: A History of Tomorrow:

https://www.goodreads.com/en/book/show/31138556-homo-deus

His quest is to “transform humans into gods”….Funny, but I seem to have read about that somewhere else:

Genesis Chapter 3

Now the serpent was more crafty than any of the wild animals the Lord God had made. He said to the woman, “Did God really say, ‘You must not eat from any tree in the garden’?”

² The woman said to the serpent, “We may eat fruit from the trees in the garden, ³ but God did say, ‘You must not eat fruit from the tree that is in the middle of the garden, and you must not touch it, or you will die.’”

⁴ “You will not certainly die,” the serpent said to the woman. ⁵ “For God knows that when you eat from it your eyes will be opened, and you will be like God, knowing good and evil.”

Jonathan Cahn has described that, over the past few years, the “old gods” have returned:

https://www.goodreads.com/book/show/61254830-the-return-of-the-gods

This has been echoed and amplified upon by Naomi Wolf:

Have the Ancient Gods Returned?

It seems that the old gods have indeed taken a vise grip on medicine.  We no longer call them “Baal”, “Ishtar” and “Molech”, but “Diversity”, “Equity” and “Inclusion”….”DEI…what a strange coincidence that this is the Latin nominative case for “gods”…….

Sadly, I have concluded that my profession has indeed become “ugly to the bone”. The obligation to the patient has been replaced by the obligation to the herd, or “the experts”, even if that obligation is subsequently found to be based on error, the financial gain of a few, or both.  Critical thinking is frowned upon.  Unquestioned orthodoxy is demanded.

To remedy this will require extensive reconstruction of the skeletal structure, not just a touch up on the surface.  We must change the criteria we use for both admission to, and advancement in, the health professions.  We cannot rely upon the profession to police itself without some degree of outside oversight.  The current leadership in academic medicine, medical  and scientific journals , public health and professional societies have failed miserably in that responsibility and society can no longer rely upon them.  New leadership, across the board will be needed.

Education in the health professions must be not only directed at the STEM subjects, but at assuring courage, truly ethical behavior, and moral responsibility.  It must begin with a concerted effort at the undergraduate level at the latest, but preferably in secondary or even middle school.  In addition, we must give health professionals the education, training and ability to understand and create true broadly-based, both vertically and horizontally, Communities of Practice.  These must include individuals from ALL the health professions, at all stages in their careers. They must be self-sustaining and self-perpetuating so that real life-long learning is achieved and valued.

Finally, as a nation we also must admit that we have not achieved a “secular” utopian society.  In fact, we remain drawn to the spiritual.  We have just replaced the spiritual object of our worship.  We have replaced “God” with the “old gods” or “self”.  How has that worked out? 

Any serious student of history or human psychology could easily follow the breadcrumbs of ancient civilizations and accurately predict the outcome of our current path if it is not changed.

It is highly improbable that we will achieve the “History of Tomorrow” envisioned by Yuval Noah Harari.  We just are too flawed to become “gods”, no matter how hard we try…..