‘Cancel culture’ paranoia and other right-wing hysterics reveal medical conservatism’s true colours

Historian David Olusoga has been speaking about the ironies of ‘cancel culture’:

Olusoga, whose work has explored black Britishness and the legacy of empire and slavery, said that people “feel perfectly comfortable making these comments about me without being able to point to a single reference or footnote in my books”. He said that in reality he is “an old-fashioned empirical historian who fundamentally tells stories and tries to create empathy and a public understanding of history”.

He told an audience at Hay festival: “Why the need to describe me as a critical race theorist? Why the need to describe me as an activist rather than a historian? These are all about delegitimising people’s voices.”

Olusoga was speaking as part of a debate on “how cancel culture has become a blood sport”, but said that the phrase did not capture his experience, since it is usually attributed to students, who he thinks are falsely accused of fomenting “cancel culture”, when in reality it reflects “a growing intolerance” in rightwing newspapers.

You know the drill by now: when conservative reactionaries want to shut down debate, what do they do? They complain loudly that their adversaries are seeking to shut down debate.

They want to silence others, so they allege that they themselves are being “silenced”, all while occupying positions of extreme privilege and having their every thought broadcast to the world. Many of them work with professional press officers, and enjoy frequent access to the mass audiences of major news media. These folk who claim to be “silenced” are often among the most omnipresent and over-powering voices in the public square.

Of course, all this mirror-image reasoning is deliberate, and is intended to delegitimise critics. Those with power never tolerate dissent from those without. The hyper-privileged always seek to deflect criticism by casting aspersions on their adversaries.

A frequent approach is to accuse critics of ulterior motives. Time and time again, we see powerful voices attempting to dismiss their detractors as “activists” or “campaigners”. As David Olusoga puts it, “Why the need to describe me as an activist rather than a historian?” There is no need, of course. It is just an ad hominem attack intended to undermine the credibility of complaints. The claim that critics are “activists” is basically a conspiracy theory.

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But the conservative playbook is not confined to politicians and cultural campaigners. Conservatism arises in every domain where some people have power and others do not. After all, the hoarding of power is what conservatives want to conserve. The right-wing instinct towards protectionism, to keep power structures as they are and to resist any yielding of privilege, is infused across society. Any hierarchy will bring it to the fore. And that’s why academia and medicine are especially riven with it, two deeply hierarchical professions where dominant seniority frequently stands in the way of progress.

I have written many times about medical conservatism, and the way senior figures in healthcare are often slow to change. Old ideas stay on the books long after their sell-by dates. Medical treatments that no longer make sense continue to be offered, simply because doctors and practitioners are convinced of their own wisdoms and believe their insights to be unimpeachable. The list of historical examples is long: symphysiotomy, thalidomide, insulin shock, homeopathy, even psychoanalysis. But modern healthcare is also subject to such reversal. One recent study identified nearly 400 common medical practices that are no longer supported by science, including

the universal use of protective gowns and gloves to reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA) in ICUs; mammography every 1-2 years after the age of 40 (not recommended until 50 years); the use of compression stockings to prevent clots in the leg veins after surgery; wearable technology for weight loss; and hormone replacement therapy for menopausal women’s health.

Regular readers will be familiar with another recent medical reversal, namely, the decision by the UK’s National Institute for Health and Care Excellence to remove cognitive behavioural therapy and graded exercise therapy from treatment recommendations relating to myalgic encephalomyelitis/chronic fatigue syndrome. In short, the two treatments were ditched after a review of the evidence suggested that they were of little or no use to patients.

Nonetheless, this decision was resisted by a number of highly privileged senior medical figures. Among other concerns, the panjandrums complained that abandoning these treatments would have an impact on their “commissioning and delivery of services.” In other words, they wanted NICE to leave the obsolete treatments on the books because discarding them would be bad for business.

Privilege is what privilege does.

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In defending their naked protectionism, these medical conservatives have adopted all the usual scare tactics deployed by right-wing hysterics. They have complained that they are “being silenced,” shamelessly adopting the standpoint of the oppressed and marginalised. They have accused those who criticise their bad science of being “activists,” as though they are being targetted by an organised conspiracy. They have insisted that they know the NICE decision was wrong because they have “done their own research,” ignoring the fact that this research has been exposed as deficient by NICE and others. They have actively promoted practises that amount to unambiguous pseudoscience, because, I guess, they have had enough of “experts”.

And most recently, they have leaned fully into right-wing paranoia. They have completed the Bingo card of the conservative persecution complex. Utterly succumbing to Godwin’s law, they have decided to imply that their adversaries are actual Nazis.

Yep, like Putin, they are trying to get people on their side by calling for de-nazification.

In a new book, a prominent defender of the two discredited treatments has seen fit to decry NICE’s decision by naming the relevant chapter after Martin Niemöller’s moving anti-Nazi poem:

Chapter 3. First They Came for the Communists: The bitter row over ME/CFS research

This is an outright attempt to diminish critics by juxtaposing them with the horrors of the Holocaust. The implication is that ME/CFS patients (and their advocates) who deign to object to medically obsolete treatments are, in fact, sinister malefactors aiming to overthrow the healthcare system by incrementally purging it of innocent doctors who just want to administer CBT. You know, just like the Nazis.

The ineptness would almost be amusing if it weren’t an inscription from the actual Holocaust Museum that the author — entirely unnecessarily — chose as their analogy.

Pretty horrible, I’m sure you’ll agree.

But then, if your conspiracy theory is that the plebs are out for your privilege, I guess nothing is off-limits.