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Stephen Strum, MD, FACP's avatar

Being Down to Earth is necessary to help others understand important concepts, key issues, and often what is considered factual or true information. We need to communicate with each other in an understandable way.

When I was an intern at LA County-USC Medical Center, working with my intern partner into the wee hours of the morning, I experienced those "in your face" moments that stay with you forever. One is relevant about the need to be clear in how we communicate. Peter W. was my intern partner, and we were attempting to care for an overload of patients during the flu epidemic of 1968 or 69. Patients were in gurneys lining the hallways. I was writing up my assessment of a patient when I heard Peter taking a medical history from an elderly woman.

"Do you have paroxysmal nocturnal dyspnea?" he asked. His question took me some time to process in my fatigued state, but when I realized what he had queried, I became hysterical with laughter, pounding my desk in disbelief. Peter heard my commotion, and as he walked towards me, his appearance of frustration made me laugh harder. "Do you know what you just asked?" I said. We both had a good laugh.

So when Mike says, "As I’ve argued elsewhere, algorithmic addiction doesn’t just amplify pre-existing beliefs—it fragments the cognitive infrastructure required to form coherent beliefs at all." all I can respond with is WTF is algorithmic addiction and how many people reading this will know what this means.

But I can say, plain and simple, for a Democracy to exist, it must be in a setting of a citizenry that values Democracy and knows what its loss means, as well as what it is likely to be replaced with. When our public education system ailed, we did not fix it. When immigrants entered this country, we did not require a level of their understanding that led to understanding America and valuing democratic principles.

What we have in many millions of voting citizens is characterized by the acronym AIL.

Apathy. A desire to spend more time watching football then picking up a book, reading a magazine, going online and searching about anything. Not bothering to vote or discuss issues.

Ignorance. Americans have become a nation of ill-informed and mis-informed people. There appears to be an epidemic of stupidity in the US. I wonder how anyone could watch MSNBC for 30 minutes and then do the same and watch Fox News and not see the difference between more factual reporting and mis-representation of current events. I have seen this too with patients that are attracted to charlatans (despite their MD) and who clearly cannot discern the difference between real medicine and hucksterism. This ignorance is related to apathy and a disappearance or lack of curiosity, but it is also related to the "L" in AIL- to Laziness.

Laziness. Our country has become the modern day version of the fall of the Roman Empire. It's hard to find those with a work ethic that was once characteristic of Americans. In my neighborhood in Oregon, most homeowners have gardeners, and of those gardeners, 99% are Hispanic. It's great that the US is becoming more and more a melting pot of different cultures, but it seems to me that much of the population have become "infected" with lassitude, and that lassitude eventuates in outright laziness.

For any system to work, its constituency must be involved, must work, take part, and be part of the proverbial "hive." I have not seen a bee hive of late where the bees just hang around, drinking nectar and watching flowers. Bees work. They are committed to the welfare of the hive.

It is certainly true what Marshall McLuhan has pointed out, and as Mike noted:

"... McLuhan’s insight applied to epistemic collapse." Epistemology, the validation of information, is a stepping stone or perhaps a Rosetta Stone in reaching closer to the truth. To make valid, to invalidate, to ensure the truth of, is so crucial "to know" and acquire knowing or knowledge. Yes, one of the factors that has brought us into this mess is social media, but that is one manifestation of what has happened to this country over many decades. Think about our fast-food mentality. It applies not solely to McDonald's and the many similar eating "establishments" but to all of our society, and it was happening well before X, Facebook, etc.

My field is no longer "medicine" but McMedicine. Fifteen fucking minutes to evaluate a dynamic, intricate biologic system. Would you bring in our car to be diagnosed and expect a well-trained mechanic to always diagnose what's wrong in 15 minutes or less?

Social media is a late stage expression of McReading. Sex without foreplay is McSex. Much of what we see on TV that is supposed to be News is McReporting. You do not get the gist of something valuable or important when 5 minutes is spent discussing it. That's what candidates are given in debates. Now all the major news stations are 5 minutes of reporting followed by commercial after commercial.

McLuhan is right in Woody Allen's Annie Hall. "You know nothing of my work." https://www.youtube.com/watch?v=sXJ8tKRlW3E

So why not have a real dialogue on CNN or BBC or MSNBC about social media and its danger. Why not bring up the points made by Mike a la McLuhan:

A platform that rewards immediate emotional reactions, tribal signaling, and attention-grabbing provocations doesn’t just amplify existing stupidity—it systematically produces confident incompetence by destroying the conditions under which competence could develop.

I do not know about others, but I often cannot handle the entire load of dirty laundry that Mike puts into one washing machine load. It is too much for my less evolved brain. It is too painful and creates overwhelming despair.

My father spent little time with me, but he did relate some pearls along the way.

"Son, if you fix one thing here, another there, before you know it you have fixed the entire "car." Bernie to Stephen

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Paula Massa Anderson's avatar

Maybe the messy beautiful dance of democracy isn't really tiring at all. If we step out there and meet people where they are, we may discover that coherence resides in that dance. Well done, Mike!

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