Do as I say. No really, I mean it.

My whole world now revolves around designing and implementing a therapy for poverty. How this relates to an app that facilitates transportation and deliveries is a bit much to get your head around, but the best part is that if it works, you won’t have to understand why.

My whole world now revolves around designing and implementing a therapy for poverty. How this relates to an app that facilitates transportation and deliveries is a bit much to get your head around, but the best part is that if it works, you won’t have to understand why. It’s kinda like a virus in that regard.

Along this journey, I had an important figure in local government make a statement – twice, actually – that left me speechless (both times). I am reluctant to repeat it here for fear that it will somehow be attributed to me or that I will be accused of spreading fake news, but it’s public record, so here goes nothing. This person (I will try to deidentify them as much as possible) said to me: “There is no reason to try to eliminate poverty, because the cause and cure is well known: graduate from high school, work a forty-hour week, and put marriage before the carriage.”

This, in my opinion, shows a lack of understanding of human behavior.

Human behavior is a tough nut to crack, and it is a constant struggle for doctors. Look at diabetes and even obesity: we have cures for both of these, and yet they directly result or significantly contribute to the lion’s share of our healthcare spend. In a perfect world, we would have exactly zero complications from either of these diseases. If you are carrying a few more pounds than you would like, then you at least understand that people don’t always act in their own best interest.

The more separation between someone doing what they want to do but shouldn’t do and whatever bad thing is going to come of it, the harder it is to curb a behavior. One more slice of cake won’t hurt anything…

And now we are seeing this behavior in a bit of a worst case scenario, and we seem to be handling it about as well as we usually do. The most frustrating part of all of this is watching the ones who are supposed to be setting policy that will generate the greatest collective good just botch this all up like a proverbial train wreck.

When you tell people to do something they don’t want to do, you are not going to get 100% compliance. Ever. The more you push – and the more dissociated the negative consequences – the more people will rebel and tell you to pound sand. And once you lose them, you are not getting them back. This is true whether we are talking about staying in school or working a job or screwing around or eating too much.

And it’s just as true when you are talking about a virus, especially one that doesn’t affect them very much. If you say, “Stay home, and stay away from other people,” some people will tolerate this just fine, but many will not. So what will happen? You aren’t going to have 100% compliance. And when people do get together and break their isolation, then what? For the vast majority, absolutely nothing.

OK, what if you scare them with stories and data about how they are going to die? Will that get everyone in line? It works for smoking and drugs, right? Well, no. For some strange reason (called human nature), some people just don’t seem to get it, especially when their whole world is shut down.

What happens next? Some people start yelling at other people that they aren’t doing what they are supposed to do, and since we said this was going to kill people, well they are really upset about it. That just made things worse. So then we threw in masks, because wearing a mask is easy, right? And to try to make things better, we said that doing this simple thing – so simple that surely everyone will go along – we said that doing this will protect other people.

Perfect. That’s going to go over as well as me saying you are fat because that guy ate too many donuts.

Who thought we were going to get 100% compliance with masks? Which person that is supposed to be smart enough to understand virology and public policy thought everyone out there was going to do this just because you asked them to and because you said it was important? At what point in the history of our country has this every worked? Not only was it not going to work, it was without question going to create two groups of people that we can now see: one group in masks, one group not in masks. And they are not going to get along. As if that’s not enough, we started blaming the effects of a virus on the other group: you shut down the world and are killing us! No you won’t wear a mask so you are killing us! It’s all your fault, you clueless shithead!!!

Our current situation was so predictable that suggesting it was not anticipated and is being used to advantage by politics and industry is ludicrous.

The whole debate about masks was never about whether or not they work, it’s about how people work. It’s not about what people should do, it’s about what they will do. People don’t always act in their own best interest, and trying to shame or force them to do something they don’t want to do backfires every time, whether it’s school or work or sex or smoking or donuts or socializing. Or wearing a mask. Every. Single. Time.

Once you lose them – once people decide they are not going to follow your lead – you will not get them back. Doctors know this: once a patient stops listening to you, they might as well find another doc. You can’t use fear and undo it. You can’t use hatred and take it back. There is no way to get the people to just shake it off and come together and work together, especially with a big election on the horizon and social media amplifying our division. No, this train has done come off the rails, and there is nothing much to do but sit back and watch what happens.

And keep working on my therapy for poverty, because it is designed to take advantage of how people actually work, so I have that going for me.