Contra Scott Alexander on Literally Everything

I really owe an awful lot to Scott Alexander. If nothing else, he’s had a huge influence on the way I write. I first became acquainted with his work in my twenties, and I’ve read virtually everything he’s written since then. He’s a solid writer, and he was and remains one of the few people I’m aware of who tackles complex subjects in an in-depth way both effectively and without hiding behind big words or academia-speak. If my writing sometimes comes off as being produced by a discount-brand Scott, there’s a reason for that.

He also taught me a few important lessons, one of which is that it shouldn’t ever be acceptable to make shitty arguments to people you know will agree with you. As an agnostic mostly-left type of guy he’s very much not in my bubble in most ways, but where I find myself disagreeing with him it’s not because he’s counting on his choir to accept his preaching - he has always worked pretty hard on his arguments. When I started reading Slate Star Codex, the world was awash in people making arguments just good enough to be accepted by their in-groups; SSC set a higher standard.

So he’s a decent guy, really solid writer whose work I love and who is a huge influence on me. I appreciate him, and to this very day I continue to read basically everything he writes.

And then he goes and writes stuff like this, and my heart breaks.

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The linked article above is a response to a recent controversy regarding a Rolling Stone article claiming that patients are overdosing on the anti-parasitic drug Ivermectin, and are flooding Oklahoma emergency rooms to such an extent that gunshot victims are being left on the side of the road to die. Further, these would mostly or entirely be instances of people self-medicating, often with doses of the drug meant for animals. If true, the practical implications would be pretty bad; it would mean that a group of people were disregarding expert advice and imposing serious, lethal externalities on uninvolved parties.

The implications are also heavily politically coded. In the US, ivermectin is widely regarded as a right-wing thing (two separate links there, mind you). To the extent this article is true, it reads to anyone familiar with US journalists as something like “See? Conservatives everywhere are selfish murderers. This is a Trump thing, right? Trump is pretty bad” or similar. For the very left-leaning Rolling Stone, this is absolutely a hard jab at their out-group; it confirms everything they already knew about the idiocy of those who lack less than complete confidence in the FDA, the CDC or their overall handling of the pandemic. The bigger and worse this is, the better they are and the worse their enemies look.

If you’ve already clicked the linked article above, you are at least partially aware that this claim has not gone well for Rolling Stone. A hospital in Oklahoma at which the doctor quoted in their article had worked tried to step out of the crossfire by revealing that they hadn’t had a single patient with any kind of ivermectin complications at all, let alone enough that they were leaving people to die in order to treat horse-medicine self-dosers. This in turn caused basically everyone to turn around and ask “You didn’t rush to print this claim on the unsubstantiated word of a single previously unknown doctor, right?” Rolling Stone’s confirmed that, yeah, basically they did:

Update: One hospital has denied Dr. Jason McElyea’s claim that ivermectin overdoses are causing emergency room backlogs and delays in medical care in rural Oklahoma, and Rolling Stone has been unable to independently verify any such cases as of the time of this update….Following widespread publication of his statements, one hospital that the doctor’s group serves, NHS Sequoyah, said its ER has not treated any ivermectin overdoses and that it has not had to turn away anyone seeking care. This and other hospitals that the doctor’s group serves did not respond to requests for comment and the doctor has not responded to requests for further comment. We will update if we receive more information.

Note that at this point, RS has played pretty dirty regardless of whether the claims end being true or not. A nobody showed up and made an incredible claim, and they printed the claim as true without the slightest bit of verification. This is bad. It’s worse if you think that you should have anything like a higher standard of proof when you are printing an article that tickles your biases and makes your enemies look bad, but even discounting that it’s pretty terrible journalism.

It’s a bit worse because the available data on ivermectin overdose seems to indicate the story’s conclusions aren’t even possible. Scott linked to this Yglesias tweet:

Matthew Yglesias @mattyglesias

In percentage-wise terms there has been a huge increase in Ivermectin-related poison control calls but it’s from a low base. But the good news is the scorn and mockery seems to be working and the numbers are going back down. piper.filecamp.com/uniq/ZO3aGrYGX…

Something like 9% of ivermectin exposures were bad enough to perhaps require hospitalization; that’s ~100 people. Even if they were all in Oklahoma as opposed to the 2-5 we’d expect, that’s probably not enough to overload all the emergency rooms in the way described.

We find ourselves with a pretty straightforward story - Rolling Stone played dirty/lazy, got caught, and immediately backed off. Anybody writing about this in a normal way has a pretty easy job; they just report someone misbehaved and got called on it. But as you probably already guessed, this isn’t what happened.

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Presented with the story above, Scott wrote this article (I know I’ve linked it twice; please go read it). As opposed to my take above, Scott casts this as a “everyone is trying to trick you” sort of read; he essentially acknowledges that Rolling Stone printed an extraordinary claim that is by all important measures false, but takes a surprising turn when assessing the people who called them on it; he treats them as if they are liars as well, coequal partners in deceit. Here’s his phrasing when revealing that Rolling stone is full of shit:

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”.

He then doubles back, revealing that Tweets like this:

Were equally bullshit:

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

In case you’re as confused as I am, NHS here = “Northeastern Health System”, an Oklahoma health care group. Britain is not involved.

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.

This makes sense at first glance, but Scott actually has to be incredibly contorted to get into this position. He’s a good writer and hides it, but to break it down:

1. Rolling Stone has printed an article coded to stick it to those stupid conservative republicans on the word of a single here-to-fore unknown doctor. This is already absolutely very bad no matter what the truth ends up being here.

2. Scott is saying conservative outlets are wrong for pointing this out, because they are relying on the official press release of an Oklahoma hospital reporting that the situation on the scene is that nobody has showed up for any ivermectin-related problems at all, which is 100% inconsistent with what you’d expect if the claims of the doctor in question were true.

It’s not impossible to honestly believe both 1 and 2, so long as you believe that one Oklahoma hospital in the territory in which that doctor works is so atypical in some way that it can have zero ivermectin cases while other hospitals are absolutely overloaded. But Scott doesn’t seem to actually believe this:

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.

Stripped of all the careful framing, Scott’s asking you to look at a situation where a publication made an incredibly unlikely claim relying on a single source of unknown quality, got called on it with very reasonable evidence that its claims were false and conclude that both the people committing the journalistic assault on an outgroup and those defending themselves from it are equally wrong. And he’s asking you to believe this in a situation where even the original offending publication has pretty much thrown up its hands and gone “Welp, you caught us… haha, right? Crazy how we did that.”

It’s hard to say what could have prevented this “everybody was equally wrong” framing. An awful lot of the work Rolling Stone should have done to vet this story has already been done for them. It’s hard to pin down how much Scott would need here before he’d be OK with people noting that the already-unbelievable claim was incredibly likely to be factually false; would official statements from 20% of Oklahoma hospitals have been enough? Would missing a single hospital and thus leaving open a slight possibility that there was a hospital at which this was true be insufficient?

I obviously think he’s wrong here, but the reasons why I think he’s wrong is this way probably aren’t what you think.

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In 2018, Scott wrote an article sketching out the differences between conflict theory and mistake theory as explanations for political differences between groups. The article is worth a read, but a quick summary of both is that conflict theorists believe they are involved in a high-stakes war driven purely by passion where facts don’t matter at all, and that mistake theorists understand we are all involved in an ongoing debate where good faith and good ideas will eventually prevail - as opposed to conflict theorists who believe their opponents are ruthlessly trying to destroy them and thus must be ruthlessly destroyed, mistake theorists believe differences in opinion are primarily due to simple mistakes one or more parties have made and that calmly talking them out will solve them.

If this seems like an oversimplification and that no person should believe his opponents are acting entirely in good faith or that dialogue should be abandoned even if they aren’t, I agree. But the article has none of that nuance. Scott describes mistake theorists in words that make them seem like good-hearted logicians beaming love down from a Bayesian Olympus, while conflict theorists get language seemingly meant to invoke bloody communist revolutions:

Mistake theorists treat politics as science, engineering, or medicine. The State is diseased. We’re all doctors, standing around arguing over the best diagnosis and cure. Some of us have good ideas, others have bad ideas that wouldn’t help, or that would cause too many side effects.

Conflict theorists treat politics as war. Different blocs with different interests are forever fighting to determine whether the State exists to enrich the Elites or to help the People.

Mistake theorists view debate as essential. We all bring different forms of expertise to the table, and once we all understand the whole situation, we can use wisdom-of-crowds to converge on the treatment plan that best fits the need of our mutual patient, the State. Who wins on any particular issue is less important creating an environment where truth can generally prevail over the long term.

Conflict theorists view debate as having a minor clarifying role at best. You can “debate” with your boss over whether or not you get a raise, but only with the shared understanding that you’re naturally on opposite sides, and the “winner” will be based less on objective moral principles than on how much power each of you has. If your boss appeals too many times to objective moral principles, he’s probably offering you a crappy deal.

Note that he assigns all good qualities to people who don’t believe there’s a conflict, and all the questionable qualities to people who do. I think this makes more sense when you consider that Scott cut his teeth in an era where polarization was already increasing at an alarming pace, and was broadly successful at least partially because he was so damn reasonable; he went to great lengths to give both sides an equal shake and to work hard to weigh things dispassionately, and most of his fame-related rewards came out of that.

Where that becomes a negative is in situations like this. Scott is so very, very deeply committed to the “Conflict = Bad” line of thinking and mentally avoiding all instances of “my side is right” that he simply won’t deviate from it even when non-deviation means his commentary is substantially wrong, as I believe is the case (and as I believe he knows is the case) here. His commitment to both-sides-are-fine-let’s-come-together thinking is so strong that he’s basically incapable of calling out one side more than another; he’d no sooner acknowledge one side was worse here than he would be to use a term like “libtard”, and for what I suspect are for him internally consistent reasons.

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The easiest and most accessible reason for why Scott is like this is simple political bias; a lot of people think that he’s simply more politically attuned to the left, and cuts them extra slack. On a surface level this makes sense. He’s a San Francisco kind of guy who lives in some kind of commune. He’s in a profession where most of his colleagues are going to lean very far to the left. I think that it’s reasonable to assume he likes the left better than the right (see the link in the next paragraph for why), but I don’t really think that’s the sole driver here.

If I’m accusing Scott of enforcing a reasoning on himself that often makes him wrong, I at least want to acknowledge that he puts his money where his mouth is to a greater extent than I’d expect from anyone else. Where the NYT decided to dox him in what sure-as-shit looked like a pretty blatant hit piece that was only partially averted by a massive public outcry, he was pretty consistent to this principle; at least outwardly he pretty much blamed himself equally with them. At the time I said this:

When you combine these two things, you get what you are seeing: Scott desperately wants to believe that he can win over the left and be accepted and important in their world, even though the left has made it clear they want none of this to the extent a non-monolithic group can make things clear. At the same time, this desire makes it really easy to correct towards over-charitability - even when it’s clear the NYT has treated him unfairly for reasons that almost certainly have to do with politics, he believes he can’t and shouldn’t acknowledge the most probable explanation.

I do think his political leanings played into how he reacted to his persecution at the time, but I want to be clear: for most people in a similar situation, I’d expect political leanings and bias would go out the window as soon as they themselves were threatened. The fact that Scott’s reactions were still “nobody can ever be blamed for anything in a way that can be construed as partisan” says something about him; he’s really really ridiculously committed to this principle.

That means Scott is a really mixed bag as far as reliability is concerned. For all the problems that you would expect when someone is uncharitable to their opponents (problems I’m prone to, for the record), he’s going to be very reliable; nobody is going to work harder to be fair to a fault than Scott is. This is far from worthless. If this was all he had, he’d be unique enough to be worth reading because of it; his excellent writing and research skills are icing on a cake that was already birthday party ready.

But when you look at the obverse side of the coin, he’s going to be supremely unreliable in situations where “somebody did something wrong, and should be blamed for it” is part of the equation necessary to get to a maximally accurate answer. He just can’t do it, and to all appearances never will.