Dr. Harki Kaur and Dr. Aaron Vazquez hosted a Facebook live event recently and discussed Suicide prevention and provided an update on what is happening inside Psychiatry today. Dr. Kaur is a 4th year resident in Psychiatry and Dr. Vazquez is a practicing Psychiatrist. Both are graduates of the University of Medicine and Health Sciences and were happy to share their knowledge and expertise in this area in celebration of National Suicide Prevention Month. Please check out their recent interviews on the UMHS Blog. You can find the interview with Dr. Kaur here: <a href="https://www.umhs-sk.org/blog/umhs-alum-dr.-harki-kaur-on-psychiatry-national-suicide-prevention-week-2021" rel="nofollow">https://www.umhs-sk.org/blog/umhs-alum-dr.-harki-kaur-on-psychiatry-national-suicide-prevention-week-2021</a> You can find the interview with Dr. Vazquez here: <a href="https://www.umhs-sk.org/blog/dr.-aaron-vazquez-colleagues-host-facebook-live-on-psychiatry-during-national-suicide-prevention-week" rel="nofollow">https://www.umhs-sk.org/blog/dr.-aaron-vazquez-colleagues-host-facebook-live-on-psychiatry-during-national-suicide-prevention-week</a> If you are wanting information about how to become a Psychiatrist, please check out this article: <a href="https://www.umhs-sk.org/blog/become-a-psychiatrist" rel="nofollow">https://www.umhs-sk.org/blog/become-a-psychiatrist</a> The University Of Medicine and Health Sciences is a top rated medical school in the Caribbean and takes pride in providing world class medical education with personalized attention to each student. Please check out an overview of the Medical school here: <a href="https://www.umhs-sk.org/caribbean-medical-schools" rel="nofollow">https://www.umhs-sk.org/caribbean-medical-schools</a>

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I.

Seen on Twitter:

In case you find this hard to follow: ivermectin is an antiparasitic drug that looked promising against COVID in early studies. Later it started looking less promising, and investigators found that a major supporting study was fraudulent. But by this point it had gotten popular among conspiracy theorists as a suppressed coronavirus cure that They Don’t Want You To Know.

The media has tried to spread the word that the scientific consensus remains skeptical. In the process, they may have gone a little overboard and portrayed it as the world’s deadliest toxin that will definitely kill you and it will all somehow be Donald Trump’s fault. It turned into the latest culture war issue, and now there’s a whole discourse on (for example) how supposedly-sober fact-checkers keep calling it "a horse dewormer” (it is used to deworm horses, but it’s also FDA-approved for humans, but lots of the people using it are buying the horse version), and probably this is hypocritical in some way.

Enter the article above. A doctor named Jason McElyea apparently told local broadcaster KFOR that Oklahoma hospitals are “overwhelmed” with ivermectin poisoning cases, so much so that “gunshot victims” are “left waiting”. Some of the world’s biggest news outlets heard the story and ran with it. The tweet mentions the Rolling Stone version, but the same story, with the same doctor’s testimony, got picked up by The Guardian, the BBC, Yahoo News, etc.

Which brings us to the Sequoyah Hospital letter on the right. They released a statement saying that Dr. McElyea hasn’t worked there in two months, they haven’t had any ivermectin overdose cases, and they don’t know what he’s talking about.

In the comments, author Virginia Hume sums up the situation nicely:

I’ve recently been reading Scout Mindset (expect a review soon), which is kind of the rationalist movement in book form. It focuses on the difference between how we treat ideas that conform to our biases versus those that contradict them. If they conform, we ask “Are we allowed to accept this?” and wave them through, like a small town police chief dealing with a case involving the mayor’s son. If they contradict, we subject them to the harshest inquisition possible, like a small town police chief dealing with a guy named “Abdullah” with a sinister-looking beard.

The media was already looking to discredit ivermectin. So the report of one doctor - without even a phone call to confirm - was good enough for Rolling Stone, The Guardian, BBC, etc. It was “too good to check”.

II.

Did you believe that?

I did, briefly. Then I remembered the Law Of Rationalist Irony: the smugger you feel about having caught a bias in someone else, the more likely you are falling victim to that bias right now, in whatever way would be most embarrassing.

So, quick check: am I doing this? I notice this story is exactly tailored to appeal to me and people like me. It discredits the media establishment, who I don’t like. It’s a great argument for why we need more rationality, something I’ve been trying to push. It lets me feel superior to everyone: I am properly skeptical of ivermectin, but also I haven’t become a contemptible propagandist who joins in mass media smear campaigns.

And I didn’t even take a second to check if it was true! I’m relying entirely on the word of a Twitter bluecheck I’ve never heard of before, whose profile picture is some kind of dog (an Australian sheepdog? maybe some kind of weird collie?) Forget making a phone call to a hospital, I didn’t even read the original article!

The story was “too good to check”!

So I tried checking, and noticed that the third reply to the original tweet was this:

This…turns out to be completely true. The story never mentions Sequoyah Hospital! Dr. McElyea has worked at Sequoyah in the past, but he’s a traveling doctor and works lots of places. Plausibly Sequoyah just wanted to clarify that they weren’t like the hospitals in the story, they’re not turning away gunshot victims, and if you happen to be a gunshot victim you’re still welcome to go to Sequoyah and can expect timely care.

Apparently I’m not the only person who doesn’t scroll down to the third tweet. The right-wing Washington Examiner has an article on how Rolling Stone’s Ivermectin Fiction Shows Why Republicans Don’t Trust Media. Fox has an article on Rolling Stone Forced To Issue Update After Viral Ivermectin Story Turns Out To Be False. One Redditor puts it more bluntly: “Dr. Jason McElyea, who has been claiming that emergency rooms have been turning away gunshot victims because of Ivermectin overdoses, is a liar.” None of these sources mentioned that the original article had never claimed Sequoyah Hospital was involved.

Their story was - I guess - too good to check.

III.

Did you believe that?

I mean, that’s also a pretty cool story, isn’t it? Right-wing news outlets accuse the so-called “liberal media” of bias, then get hoist on their own petard? Seems a bit too cute. Have you clicked through to any of the links yet? No? Not even after I admitted I’m probably biased here?

Sequoyah Hospital might not be the particular hospital that the doctor in the story was thinking of. But isn’t it suspicious that other hospitals are so packed with ivermectin cases that they have to delay care to gunshot victims, yet Sequoyah says that it “has not treated any patients due to complications of treating ivermectin”? Seems weird for there to be that much difference.

Okay, this time I promise I’m not trying to psych you out. Here’s what I’ve actually been able to figure out about this situation:

• Rolling Stone seems to think that the Sequoyah Hospital statement casts doubt on their account. They changed the title of their article to “One Hospital Denies Oklahoma Doctor’s Story…” and edited in a long prologue about the hospital’s statement in a way that suggests they feel bad about their reporting. They say that they have reached out to various relevant doctors and hospitals for comments but have not heard back from them - which I guess is good, because if your hospital is so busy that you don’t have time to treat gunshot victims, you really shouldn’t have time to give interviews to Rolling Stone.

• In an unrelated issue, the photo on top of their article was previously a bunch of Oklahoman-looking people standing in a long line outside a building. This had a caption, in small print, saying that it was of Oklahomans waiting for the COVID vaccine. Critics pointed out that in context, people would have interpreted it as being a picture of people waiting outside a hospital which had long lines because it was too full of ivermectin victims. Whether or not that criticism was fair, Rolling Stone has taken down that photo and replaced it with a photo of ivermectin pills.

• Five days ago, local Oklahoma news reported this story about how Oklahoma hospitals were overwhelmed because of the COVID pandemic (the title says “it’s not just COVID”, but from the article I think this means that COVID is taking up the space that would usually be used for other conditions, and the combination of COVID and other normal conditions is causing the overcrowding). The local news interviewed lots of doctors and hospital administrators, who all agreed this was true. One of those doctors was Dr. McElyea, who told his story about not being able to find space for a gunshot victim - but here he doesn’t mention ivermectin, and it seems to be just part of the general overcrowding.

• Also five days ago, McElyea gave this interview on a local news station, where he warned people not to take ivermectin, said he’d seen some ivermectin overdose cases, and mentioned how overcrowded the hospitals were. The flow of the local news report very much implies these two things are connected, but I notice that Dr. McElyea himself doesn’t state this in so many words. There’s just a clip of him saying ivermectin is dangerous, immediately followed by a clip where he talks about how overcrowded the hospitals are. The local report seems to want you to link those two things, but their exact wording is a little weaselly.

• As best I can tell, all the other articles on this subject are downstream of that local news report. Rolling Stone, BBC, Yahoo News - they all quote the stuff Dr. McElyea said on that show, and retain the show’s framing where the ivermectin and overcrowding are connected. Some, including Rolling Stone, openly cite the local news interview as a source. Others, like BBC, said that Dr. McElyea told them directly, but quote the same talking points he used on the show. Maybe they watched the show and then also talked to him to confirm?

• How many people are actually having problems with ivermectin poisoning? Matt Yglesias gets data from the National Poison Data System (source):

  

  It looks like maybe this month there were ~500 reported ivermectin-related incidents nationwide, most of which were pretty mild? I don’t know what percent of incidents get reported, but this seems consistent with the problem being real but minor; even the largest hospitals should only see a handful of cases.

• The AP recently reported that 70% of recent poisoning incidents in Mississippi were related to ivermectin, but later issued a correction that it was actually 2% (the 70% number was the percent of ivermectin cases who had used the horse version of ivermectin)

I think the most likely scenario is that ivermectin is causing a few hospitalizations, but pretty few. Oklahoma hospitals are overcrowded for unrelated reasons (eg there’s a deadly global pandemic). A doctor talked on the local news about the overcrowding and the occasional ivermectin cases, and someone at some point - either the doctor or the local news people - intentionally or unintentionally recast things so that the ivermectin was causing the overcrowding. Maybe they thought this was fair, because even one case “contributes to” the overcrowding in some sense. Then national and international media picked it up. Then some unrelated Oklahoma hospital put out a bulletin saying they weren’t involved in any of this, and lots of people interpreted this as disproving the whole story. It didn’t really disprove anything, but by happy coincidence the story had been false all along, so whatever.

I’m still not really sure about a lot of this, and I still haven’t done anything extreme like call any of the hospitals or doctors involved. It’s just what I think is the most likely picture.

This story doesn’t make me feel smug and superior to everyone else. It makes me feel confused and annoyed. This is how true things usually make me feel, so I think I’ve dodged the Law of Rationalist Irony and might have some chance of being right this time.

(by the Law of Rationalist Irony, I have to be wrong about this in the most embarrassing possible way, so feel free to tell me what it is in the comments)

But I really am reading Scout Mindset, and it really does have me thinking about the ways our irrationality is polarizing us.

A Democrat reads some fraction of this story, and sees a bunch of idiot conspiracy theorists taking deadly horse medication to cure COVID. A doctor warns people that his hospital is overcrowded with poisoning cases, and the media dutifully reports on this. Then an unrelated hospital puts out a press release saying they’re not involved and - even though this changes nothing - Republicans seize on this to declare the entire media is “fake news” and nobody should trust anything they read and the horse dewormer conspiracists were right all along.

A Republican reads some fraction of this story, and sees the media falsely reporting that ivermectin is overcrowding local hospitals, even though the hospitals themselves are denying this. Also, using a fake photo of something else to imply that lines at local hospitals are stretching out the door. Also, declaring that 70% of poison incidents are due to ivermectin when it’s really 2%.

Both sides end up even more convinced that they are right and the other side is selectively misinterpreting the news to feed their own skewed narrative. Only you, reading this ACX article, are getting the full story and learning more about the world instead of just confirming your biases.

Did you believe that?

Click here to go see the bonus panel!

Hovertext:
All examples from the book Noise, by Kahneman, Sibony, and Sunstein, which I'm enjoying right now.