Rohan’s coffee with a friend was not a success. They had not seen each other for almost a year, but afterwards Rohan came home upset and angry. Their conversation had turned to the pandemic and to one issue in particular – vaccination. Rohan was fully vaccinated months ago while Sylvie has resisted, and in their discussion it became clear that they were at odds. Rohan argued that the vaccine offered a wonderfully effective way of reducing illness and worse. Sylvie suggested that vaccination is actually dangerous, possibly killing more people than it saved. 

Conflicts between friends can prove awkward but, as in this instance, their differences were soon put aside. However, what happened next was horrible and lasting. From an armchair at the far end of the room, Pierre, Sylvie’s husband, who had overheard the conversation, embarked on a loud anti-vaxx tirade directed against Rohan and her beliefs. She calmly countered his assertions but he spoke over her and, in a diatribe based largely on theories of conspiracy, he dismissed her claims one by one. A rational debate was out of the question. 

Hours later, Rohan, who was still seething, told me how she found it unbelievable that a teacher and scientist like Pierre could interpret the data in the way he did. How could he get things so wrong?

In response to her question I suggested that the difference in their two approaches might be explained by what I see as the ‘flagpole’ phenomenon whereby two sides can interpret apparently similar data differently. 

As a student, and later a young doctor, I was fascinated by how diagnoses were made. I watched as patients were admitted to hospital as ‘blank sheets’ and, in next to no time, had a defined condition on which to base their treatment. Those in charge – by tradition a team headed by a consultant whose say was final – used a standardised approach to make a decision based ultimately on how they interpreted the patient’s story and then integrated this with what they found on examination and later with the results of tests.

Hundreds, if not thousands of facts are sieved and a first step is to decide which findings most strongly point to a diagnosis. So, for example, when one patient described her illness, amongst other things she mentioned feeling sick and having tingling fingers but to the doctors the more pertinent part of her story, to which they give higher priority, was her shortness of breath and severe chest pain. With these two cardinal features a provisional diagnosis of heart attack (myocardial infarction) was flagged up. Once this particular flagpole was raised the team tried to confirm its position by asking her more questions, by re-examining her and by undertaking more tests. If everything remained consistent when integrated around the flagpole, then the original diagnosis would stand. If, however there were findings that didn’t fit, the working hypothesis would have to be modified or even abandoned. 

In all this, using the same process, a second clinical team with different insights and experiences might initially flag up an altogether different illness; for them the chest pain and shortness of breath might have been caused by a blood clot lodging in the lungs. For a third team the same features might have lead to a psychiatric condition. 

In each instance the teams saw the ‘facts’ from their own perspective and integrated them accordingly. Usually, however, differences in the diagnosis would be resolved with sophisticated and targeted tests which in my early medical days were difficult to come by. Creating a flagpole round which theories are declared and differences explored is the bread and butter of medicine.

In many ways, these principles, whereby individuals or groups select information in order to make a diagnosis, also operate in science and politics. Interestingly, in these instances, the flagpole may also become a bastion for adherents as zealots compete with opponents and detractors of other theories. 

Critically, scientific and political paradigms attract further research and analysis with those results that fit being integrated into the notional flagpole. Importantly, whatever its strengths, the paradigm will one day ‘fall’ when new information does not fit so making the original theory no longer tenable. Newton’s classical theory of gravity was, after all, superseded by Einstein’s position. 

One problem when creating a flagpole is that some people rely on evidence that is unreliable, even bogus. Moreover, some theory creators, such as those behind the anti-vaxx campaign, are not concerned about the validity of their sources; all that is sought is ‘evidence’ that strengthens their position.

The way in which medical, scientific or even political theories are developed through varying interpretations of data, inevitably leads to differences of opinion. Such differences, which should be recognised, are best resolved amicably, but this can be difficult if adherents are keen to proselytise. 

The illustration shows a picture of a rioter in France claiming, or so it would seem, that vaccines against the Coronavirus don’t work and give only a false sense of security.

For helping me write this blog I would like to thank Paul, Rohan and Vivien.

10 thoughts on “Flagpoles, Paradigms and Anti-Vaxxers

  1. This post has saddened and angered me; it has bought to the fore the same debates, arguments and incomplete judgments and views based on limited facts during the Brexit fiasco. The debates with friends were often fierce and passionate but respectful, whether to Brexit or not, to be vaccinated or not… the decision affects us all.

    I don’t believe I am an arrogant person and I am definitely not more knowledgeable, but what I do know is some of my more intelligent friends seem to have an inability to comprehend, what I see as obvious and clear. As you say, flag poles are raised and people align to them, but there is freedom of thought and courage to speak or offer a different opinion.

    I hope Rohan is feeling ok, and I really hope Sylvie and Pierre apologise for their behaviour; we don’t have to agree, we don’t have to have the same politics and viewpoints but without a doubt we must love and respect if we disagree.

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    1. Dear Carolyn, Thank you for your comments. As you indicate, disagreements are common and the key thing is to listen, discuss and, if differences remain to respect. As to your other two points; 1) Rohan soon recovered from the assault, and 2) I don’t imagine Sylvie and Pierre will ever apologise. Love, Joe

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  2. Cher Joe, j’espère que Rohan s’est remise de sa visite au pays où la terre est plate et la lune est creuse ? Le scepticisme deviennt du complotisme et c’est très inquiétant. Je finis quant à moi par craindre plus les “antivaxs” que le covid lui-même. Une voisine vient de m’affirmer qu’il est faux que les hôpitaux en Martinique soient archi-pleins, et que les photos montrées dans les journaux sont des montages destinés à tromper la population. C’est désolant. Merci pour ce blog. Amitiés. Annie

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    1. Dear Annie, Thank you for comments. There will always be disagreements but those that are held with religious vehemence coupled with lies are particularly dangerous. I agree, the agression of the anti-vaxxers is very worrying. Love, Joe

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    1. Dear Merrily, Thank you so much for your generous words. The link you included puts the world of fractured trust very well. Somehow we need to take note only of those we trust and assume they will continue to be true to themselves and to us. However, finding ones safe source is not easy and, of course they cannot have commented on everything. Love, Joe

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  3. Dear Joe,
    Thank you for this insightful analogy of the flagpole phenomenon. And sorry to hear Rohan has been upset by some friends. I almost fell out with my family because of the vaccine issue! And I had to find within myself a vast amount of emotional maturity to let go of the idea that I am right and therefore I should convince them!
    In the end, I guess that it’s not about being right or wrong but rather what we are able to believe in. Our mental filters, based on our personal experience of life, determine how we see and interpret the flapole. Hopefully, with hindsight, some people will reassess their interpretation of this flagpole …
    Bien amicalement,

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  4. Hi Joe I am sorry to learn of Rohan’s dreadful experience.
    The anti-vaxxer’s spin is challenging and in my experience there is an unshakeable element to their belief. Essentially this may be the issue separating the two groups. Whenever one encounters non-agreement on this matter my guess is that one or other party will feel abused. Whatever the case it would be great if Rohan’s hosts were sensitive to how she felt.
    Thanks for sharing.

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    1. Dear Aggrey, Many thanks for your commentary. In this instance it is true that non-agreement brought feelings of abuse but that is not inevitable. Indeed, having non- agreements and not allowing oneself to feel hurt is a goal in itself. Love, Joe

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