Mistrust in science and medicine

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“Let us temper our criticism with kindness. None of us comes fully equipped.”
– Carl Sagan, The Demon-Haunted World

This month’s roundtable addresses a major — if not the key — challenge of our times: the growing distrust in science and medicine.

Among its many consequences are its exacerbation of unhealthful behaviors, including the rejection of long-standing vaccines with established efficacy and safety, such as those for polio and measles. In addition to the rejection of evidence-based therapies, it also fuels the endorsement and use of remedies either clearly disproven or lacking reasonable evidence. I extend my gratitude to our discussants — Jessica Greene, PhD; Nina T. Harawa, PhD, MPH; Isaac O. Opole, PhD; Roy H. Perlis, MD, MSc; and Katrine L. Wallace, PhD — for their insights, and now take the privilege of adding a few of my own thoughts.

First, it should come as no surprise that this mentality is peaking during a time of unprecedented political rancor and widespread social unrest. Although I have no interest in taking political sides, it is worth noting that this phenomenon is a recurrent pattern throughout history. As many brilliant scholars and writers — such as Lewis Thomas and Carl Sagan — have observed, science, and scientific thinking, which is so poorly taught in our country, is characterized by its willingness to be disproven. In contrast, pseudoscience avoids skeptical scrutiny and clings to theories that are not only demonstrably false, but also impervious to disproof. Consider, for example, the baseless claims of microchips being transmitted via mRNA vaccines.

Although I have no simple solutions to this growing mistrust, I take some comfort in recognizing that such skepticism tends to be cyclical, often emerging during times of unrest. Along with others, I posit that the current crisis is exacerbated by our inability to establish consensus on the limits and optimal use of social media. In today’s landscape, anyone can say anything, and the power of their voice depends more on the number of their followers than on their academic credentials or scientific contributions.

In closing, I urge all our readers to read or revisit Carl Sagan’s final book, The Demon-Haunted World: Science as a Candle in the Dark. It is one of my all-time favorite reads, which I first encountered long ago (published in 1996) and revisited during the early phase of the pandemic. It has since earned a permanent place on my bedside table. For reasons I cannot fully explain, I have been rereading my many underlined and highlighted sections since January 2025.

In this book, Sagan not only explains the cyclical nature of pseudoscience but also offers solace, urging us to remain steadfast in our belief in science. He champions one of science’s foundational principles — the capacity to embrace being proven wrong and regroup to test the next hypothesis.

Such an ethos is not widely shared among the nonscientific community, particularly among those who are less educated, disenfranchised or impoverished. Finally, as our discussants unanimously emphasized, we as healers can be positive forces in combating the anti-science wave, not by bullying or demeaning but by building trust and doing what we do best — offering our patients the best care and the best caring.

That is my perspective. What’s yours? Please share your thoughts with me at calabrl@ccf.org, rheumatology@healio.com or on X (formerly Twitter) at @LCalabreseDO.

• For more information:
• Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.

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