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The Cult of Superstar Doctors

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In this video, Rohin Francis, MBBS, discusses three stories of controversial figures in the field of regenerative medicine.

The following is a partial transcript of this video; note that errors are possible.

Francis: The trial of disgraced surgeon Paolo Macchiarini is due to conclude just a couple of days after I’m recording this. His wild story involves scientific fraud, death, betrayal, a love parallelogram, and the Pope, and his charge in the Swedish courts is aggravated assault for performing unlawful surgery on multiple people, most of whom died.

But just a few short years ago he was the toast of the medical profession with fawning articles singing his praises, a 2-hour NBC profile, and a showbiz life. Then, a sudden and spectacular fall from grace, and yet his trajectory is far from unique. Let’s examine the phenomenon of the superstar doctor.

When I say celebrity doctor, you probably think of someone like Dr. Oz, perhaps the archetype for medical influencer. Now, believe me, I have lots to say about celebrity medical grifters. I have something of a morbid fascination with them, which sometimes manifests itself as sarcastic Twitter threads or videos about Instagram doctors flogging some snake oil.

But this video isn’t about doctors who develop a media career and misuse their fame from social media or something. In fact, medicine has a celebrity problem that long pre-dates social media or even television. People have always romanticized the role of the doctor. Throughout history, word would spread of a gifted healer, attracting people over huge distances.

Whether they were actually effective is a separate question entirely. But while historians in other fields have suggested moving away from the “great man” model of understanding the past, in medicine it’s pretty much been par for the course. In the era of evidence-based medicine, should we still be practicing eminence-based medicine and elevating academic researchers or clinicians to rock-star status?

Ironically, it’s often those most dogmatic about preaching the gospel of science that get most caught up in the hype, perhaps because they better understand the promise of whatever the scientist is claiming. Snooty people might look down their noses at those who believe in pseudoscience that they hear from Gwyneth Paltrow or Joe Rogan, but they engage in the same magical thinking when it’s packaged in a way to appeal to their own biases — i.e., by donning the clothes of respectable science, or sometimes even the most discerning of commentators are deceived by out and out fraud.

When we start treating scientists like stars, we end up with many of the problematic traits of fandom that we find elsewhere, with these celebrities exploiting and lying to those that support them because they believe in their cause. While Instagram influencers can defraud viewers of some money, these scientists and doctors are occasionally granted power over someone’s entire life.

The pandemic has seen people like Didier Raoult and Pierre Kory become legitimate cult figures with devoted followings who believe with every fiber in their being that hydroxychloroquine or ivermectin, respectively, are wonder drugs that are being suppressed by the pharmaceutical industry and could end COVID overnight.

On the other hand, Anthony Fauci has also became a similar pseudo-religious figure inspiring fanatical support, even when he has made mistakes. In none of these cases were devotees won over by actual evidence. They were caught up in the fairy tale of a medical savior and based on their pre-existing biases they found their personal Jesus, MD.

Now, I’m not suggesting any of these people initially set out to deceive anyone or even encouraged the kind of following that they attracted, but they serve as evidence that the cult of personality infects every field. However, sensible advice for YouTube scripts and as well real life, let’s avoid COVID, shall we?

I recently made a video about the unrealistic over-optimism in the field of longevity medicine and a closely related field — which again has some incredible and entirely legitimate research going on alongside all kinds of quackery and biotech VC-fueled hype — is that of regenerative medicine, the promise of regrowing organs and tissues, and offering hope to some of the most desperate people, who have so far been let down by medical science.

Let’s explore three fascinating chapters in regenerative medicine’s patchy track record. I’ll start with a story that I’m sure many of you remember. Italian neurosurgeon Sergio Canavero made international headlines around 2015 when he said he was close to performing the world’s first human head transplant.

Sergio Canavero: “The chances of this working are 90%. Of course, there is a marginal risk. I cannot deny that.”

He gave TED talks, countless interviews with magazines and newspapers. They all responded with the same breathless wonder at this pioneer forced to move to China after being shunned by his closed-minded former establishment for his experimental bold ideas — or so his narrative went — but on the cusp of something truly momentous.

Now, this is a key trope to remember, the iconoclast or whistleblower whose colleagues try to silence him, and there is historical precedent here. The medical profession treated Ignaz Semmelweis awfully, who suggested that doctors should wash their hands, and, of course, he was proved to be right.

But modern celebrity doctors love to frame themselves in the same way. I’m no neurosurgeon, but I have done a fair bit of transplant medicine and Canavero’s claim rang a lot of alarm bells from the start. It was simply inconceivable to make such an enormous jump in our abilities from where we are now. That’s just not how something like this works in science. It’s much more about slow, incremental progress, especially when you’re considering something as complex as transplantation.

Canavero claims that he was inspired by the work of Robert White, who transplanted multiple primate heads in the 1970s, which Canavero refers to as successful operations. In recent years, he and his Chinese collaborator, Ren Xiaoping, claimed that they have performed the world’s first successful human head transplant. A small detail, which I believe is important here, is that this was performed between two corpses. Successful.

You keep using that word. I don’t think it means what you think it means.”

One can’t help but think of the famous joke about a stereotypical surgeon, who proclaims “the operation was a complete success, although the patient died,” yet somehow this seems even more ridiculous because both patients involved were actually dead before the operation even began.

This is Chapter 1 in the Rock Star Doctor Playbook. Short of actually lying, learn to be conservative with the truth and allow people to draw their own incorrect assumptions. In this case, it’s evident that Canavero, Ren, and their team have made huge leaps in terms of surgical precision at reattaching the myriad blood vessels and structures in the neck to at least give them that benefit of the doubt from what they have reported.

Rohin Francis, MBBS, is an interventional cardiologist, internal medicine doctor, and university researcher who makes science videos and bad jokes. Offbeat topics you won’t find elsewhere, enriched with a government-mandated dose of humor. Trained in Cambridge; now PhD-ing in London.

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