Mixing Elixirs in a Sea of Bias

Man is required to deal with a multitude of challenges to live a healthy and happy life. Some of these challenges are environmental, some are physical. Some result from other lifeforms or even quasi-living things taking advantage of preexisting human systems for their own benefit.

One such quasi-living irritant has been the focus of our attention since late in 2019.

When we as humans make a concerted effort to combat the things that would derail our healthy and happy living, we usually go about it one of two ways: (1) we figure things out, or (2) we get lucky. Sometimes it’s a bit of both.

To figure out a monkey wrench for pesky irritants like this new thing we have going on, a group of very smart people created something I am going to call Elixir A. It was designed specifically to impede certain functions of the little bad guys without messing about with anything important in normal people. It worked great in a lab, but unfortunately, it hasn’t ever worked much in real life. Still, that hasn’t stopped us from trying.

Not long ago we opened up some bottles of Elixir A with high hopes and a compelling need: this was exactly what it had been designed to fight, and sweet-cheese-and-crackers did we need a win.

So, we did some tests. The first test was with a bit more than 200 people. Unfortunately, it didn’t work. That’s a really small group of people, so we did another test. And another. And another, but all with the same disappointing results. Not to be dissuaded by data, we have kinda ignored the fact that it has never really worked and is expensive and can only be used in a dedicated facility, and so it remains – inexplicably – a mainstay of treatment. (Ref 1, 2)

Like a lot of our attempts to science our way out of the pit of despair, life is often much more complicated and usually comes with a sizable helping of bitter irony.

Some 50 years ago, a couple of guys stumbled on a family of compounds that killed worms in mice. This would turn out to be a big deal, as they would go on to perfect this stuff – Elixir B – that would improve the health and happiness of literally millions upon millions of humans. In 2015, we recognized their work with a Nobel prize.

Elixir B has a specific mechanism of action against these worms, but it doesn’t do the same thing to people, so it’s been shown to be really safe. In fact, the company that makes it has given away hundreds of millions of doses in almost 50 countries since the late 1980s, an effort that is said to have cost a quarter billion dollars. It can be given safely to kids as young as five and is over the counter in some countries. (Ref 3)

But right now we are not really worrying about worms.

When things got really desperate early last year, a different group of scientists decided to see if they could get lucky. (No, not that kind of lucky). They started throwing things we already had into test tubes to see what might happen. It turned out the Elixir B looked like it might be the break we needed, a proverbial can of Whoop-Ass. (Ref 4)

Before you get too excited, understand that – like Elixir A – we were still just talking test tubes. It’s a long way from in vivo to in vitro, and sometimes you just can’t get there from here.

But with Elixir B there was one big difference: all those hundreds of millions of uses that led to that Nobel Prize thing provided a safety history, so moving from the test tube to people was straightforward, the only question was would it really work. Like Elixir A, the first trial was about 200 people. Unlike Elixir A, Elixir B worked. In fact, it worked really, really well. (Ref 6)

Hallelujah!

Still, 200 people is only 200 people, so we set up some bigger tests to figure out just how good it was and how to make the most of it.

Or did we?

Honestly, it’s hard to tell. For sure there are a lot of studies with positive results and a lot of people swear by it, but there are also some people saying it doesn’t work, or rather, it just can’t because that’s not what it was designed for. Some people are saying it’s dangerous (despite those hundreds of millions of past uses – billions, actually), and that danger means it has to stay locked up until it’s proven. So, the people in charge are asking – demanding – that we wait for more data. In a second helping of bitter irony, these are actually the same people who decide what studies get done. (Ref 7, 8)

That’s a bit like saying that no one goes home until the floor is swept when you are the one holding the broom.

With Elixir A, the study reports are readily available, no one is arguing the disappointing results, and yet it is the weapon of choice. With Elixir B it seems the more positive the results and the more utilization, the more vehement the resistance. In fact, the use of Elixir B is illegal in some areas and those who even suggest it could be of benefit are being called irresponsible and even accused of promoting harm.

It’s almost as if some people don’t want to solve the problem…

I wish I was exaggerating, but I am not. Not even a little. And to make matters worse (if that’s possible) the real issue has nothing to do with Elixir A or Elixir B or labs or science or any of that, it has to do with information. More specifically, how we get it and how it is given (or fed) to us. This pesky irritant is just another of life’s ongoing challenges, but what has changed is how we react to these challenges – or more specifically how we have willingly allowed the manipulation of information so that we can be successfully persuaded, en mass. Virtually all of the methods that connect us in the modern world are influenced by a variety of self-serving forces. We know this, and yet we don’t seem to mind. Some even deny it’s true, though as my mental health therapist once told me: manipulation doesn’t work if you know your being manipulated. And so, our most important connections – the things that allow us to work as a cooperative, to make good decisions, to act on logic and scientific data – are horribly corrupted.

How do we move forward? For starters, stop reading headlines and stay the course through the whole article. I remember a time when we scoffed at people who just looked at the shocking pictures on the front page of the National Enquirer. For sure, life and science has become exponentially more complicated, which means we must rely on experts to decipher the data and help us apply the nuanced results to the complexities of the wide variety of individuals. And so, if you are one of those experts, it’s your job to read the studies yourself, not just the summary or headline pushed out by someone else. Despite the power of the internet, I literally cannot find the credentials of the authors of the large review of Elixir B studies that the entire world is simply deferring to without reading the paper or even questioning the methodology that led to the published conclusions. (Ref 9) And that methodology is laughable, except it is not at all funny. The myriad of front-line experts who have both education and real-world experience in this arena are being systematically discredited, but no one is even asking who the people are that are literally crafting public policy which is subsequently accepted as gospel.

This is kinda important stuff. Like life or death. Shouldn’t someone be allowed to assume some personal risk if it might protect others?

As for me, I find myself unable to blindly follow orders when I can see the corrupt motivations and believe there are safe things that we can be doing to genuinely help people and potentially save lives. Luckily, I am not alone. A growing number are banding together and sharing information and experience, extending options where possible and when doing nothing may not be the best plan. We are applying the available data to situations at hand as best as we can. (Ref 10)

This – not my specialty – is what defines being a doctor.

Salmon Upstream, LLC

Mixing Elixirs in a Sea of Bias