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When other American soldiers were dodging bullets in Vietnam, I spent most of my time in military hospitals and research centers. This included stints in bacteriology where I got to observe the saga of Dr. Pseudomonas.
We called him Dr. Pseudomonas because of how often this species of bacteria (I think we determined it was P. aeruginosa) was found when the surgical incisions of his patients were swabbed and cultured post-op. There were several surgeons on staff at this small hospital, supported by the same surgical teams and in the same surgical suites. Their patients were placed in the same wards and rooms tended by the same staff. Different people collected swabs for culture. The only common factor in this unusual pattern of contamination was the surgeon.
He was not highly regarded by the nurses and corpsmen who cared for his patients. My barracks roommate at the time (a Vietnam combat medic and a very skilled stitcher in his own right based on my real-time observations of his ER work) said Dr. Pseudomonas’ suturing technique was reminiscent of that of the late Dr. Victor Frankenstein—large, too tight and certain to leave the largest scars possible.
One does not lightly accuse a lieutenant colonel M.D. of bad hygiene or poor technique. The documentation was assembled, a careful, discreet report made to the commander of the base medical unit, and everyone was ordered to remain silent about the matter. Naturally, all hell broke loose. Dr. Pseudomonas wanted the lone civilian employee in the BacT lab fired, the lab officer sanctioned and every enlisted man in the hospital questioned by MPs as to the origin of the nickname “Dr. Pseudomonas” (not sure who told him but the Army was then and ever shall be a gossip factory). Higher ranks and cooler heads prevailed but they did not remove this hack from doing surgery (but did accelerate his retirement, I was told).
After the Army, I went to Georgetown on the GI Bill, working nights in hospital labs. Some years later while I went to law school, because of this medical experience I was hired as a paralegal in a firm that did lots of high-end medical malpractice work. I have enormous respect (and sympathy) for the complexities, risks, and demands placed on physicians. I am also acutely aware that credentials are no guarantee of good performance.
It is not just that Dr. Pseudomonas was a hack. It was that he expected that his rank and position entitled him to deference and that absolutely no one beneath him in status had standing to question his work and that those of comparable standing should not come after a fellow member of the club. The kind of credentialism favored by Dr. Pseudomonas is pernicious and has widespread consequences.
In my various career experiences, I also learned that there are a lot of Ph.D.’s and MD’s out there who will give expert testimony for or against almost anything for a fee so hack lawyers (or politicians) can say to their opponents “my whore is a better liar than your whore—wanna settle?” [My employers never stooped to this nonsense to hire hacks like these and kept to extraordinarily high standards.] Later, when I did mostly lobbying work, I had to read many “studies” offered by activist groups, trade associations, and congressional committees that should have been regarded as literature, a highly specialized form of fiction. But the credentials of the authors of such work are invariably unassailable.
Not only does the US have a lot of bad policy ideas in effect because of nonsense from highly credentialed sources (e.g., our utterly unscientific COVID strategies, the militant exclusions of sane thus heretical climate science research, grossly incompetent foreign policy analysis, and social sciences not only divorced from reality but hostile to it thus adversely affecting education and child development) but bad policy ideas, like some sci-fi mutant parasite, are somehow now able to instantly grow defensive layers in academia, news media, politics and even social media “fact-checkers.”
These layers produce an annoying but now predominate social phenomenon we could call “credentialism by proxy” in which pointing out the failings of Dr. Pseudomonas is met with claims that the critic has no standing to question The Science because of the credentials of the accused. Logic, math, and data –and sometimes even comparable credentials–have no standing and no power to penetrate these defensive layers.
If a Dr. Pseudomonas injures a surgical patient, there are litigation remedies but if he offers a really bad idea relied upon by Congress or state governments that injures millions, there is no redress. I had thought that the conflict of credentialism, rank, and status versus evidence in the case of Dr. Pseudomonas was a unique, one-off event in my life. But now it seems like it’s happening all over and Dr. Pseudomonas’ side is winning often.Published in