Intellectual Colonization (part 2)
And excerpt from the book "The Physician’s War"
I can't conceive a life devoted to playing the ethnic coadjuvant of a Hollywood action movie.
He is always honest, reliable, and has the raw wit of the uncivilized.
Also, he always dies before the American protagonist saves the day.
But, listen! The American protagonists won't save critical care!
Intellectual colonization is a mechanism of disempowerment and thought control.
The Physician’s War
The Story of the Hidden Battle between Physicians and a Science Based on Pathological Consensus
Please find the book on Amazon
Intellectual Colonization
[excerpt from Chapter 14]
[continues from part one]
(…) having your work validated by an American or European university gives you a higher position domestically.
Of course, a network of high-end achievers also grants prestige if you are a native American researcher. People struggle to get to the best universities, etc. However, seeking external validation is paramount for someone who sees himself or herself as a stray member of a higher culture. And that's why you are reading the words of a Brazilian intensivist, a proud gaúcho, writing in English. I am the prototypical "intellectually colonized".
Make no doubt about the abyssal difference between the American biomedical research enterprise and what you find in developing countries. For thousands of scientists, moving to America is the best way to advance in a scientific career. If moving to America is not for you, you can seek to participate in clinical trials, panel meetings, or anything led by America's top researchers. Structural academic privilege goes global.
The biomedical research industry, dubbed Big RCT, exported some of its good and bad traits to the rest of the world. The publish-or-perish culture is one of these features. Even in the developing world, you have to publish. Of course, the overarching influence of American researchers makes your work more publishable if you focus on what they are publishing. The American scientific environment spreads everywhere.
If the colonized scientists seek external validation, if they have to publish, and if the top American researchers command the industry, the foreign scientists will be happy to work for their American peers. If it is not possible, scientists will emulate what Americans do. It leads to ever-increasing uniformization. The rules that define what is publishable flow one-way from the colonizer to the colonized. The final consequences are disempowerment and a lack of diverse thought, everywhere.
Nowadays, a new idea emerging in the periphery of the scientific community faces such a headwind that it will certainly fail.
A field dominated by pathological consensus, like Critical Care Medicine, exports the vicious environment to the intellectually colonized. A peculiar dynamic is created. In a field where scientific discovery and discussion have been replaced by a panel of experts guessing diagnostic criteria, there is really no discussion to be made. Hence, the influence of the colonizer knows no limit in intellectually colonized countries.
Top American or European scientists, those who are or have been guessing diagnostic thresholds in consensus panels, receive the treatment of pop stars. People gather around them in the medical congress's alleys for selfies. The lectures are received with a sense of sacrality and communion. No real discussion is intended by the conference president. Questions are seldom asked, and if asked, they take the form of an apology. No one dares debate the presentation of the dogma.
Pathological consensus takes the form of dogma in intellectually colonized communities. Again, the medical congresses are illustrative examples of the transformation.
The meetings gradually became annual gatherings where people go to reanimate their faith in the string of commonplaces proffered by one of the initiated in the dogma. The closer to the consensus panel, the more reverence is paid. Locals with access to participants or even participating in the consensus panels are the ones who spread the word to those who can't understand English. They will spend the year reaffirming the dogma in small meetings that cannot afford a foreign superstar. From small to large gatherings, from ICU rounds to the local medical journal, dissidence is suppressed not by force, but by the soft powers of scorn and isolation.
In a field dominated by pathological consensus, networking and strict adherence to the dogma are your way up.
There are generations of closed minds not inclined to discovery. They would rather work for the colonizers in exchange for local prestige. With notable exceptions, the price of thinking by yourself is to abandon the research business.
However, with all due respect, guessing SIRS thresholds was not that impressive. I am sure we have dozens of intensivists working in Brazil, Saudi Arabia, India, Japan, or Colombia, to name a few countries, that could have come out with a better solution than SIRS + infection as the first definition of sepsis. But the forces of intellectual colonization and pathological consensus left no room for original thinking.
I am begging the hurting, excruciating question: why don't we even try?
Nelson Rodrigues, a famous Brazilian playwright, novelist, and journalist, coined the expression "Stray Dog Complex", in opposition to a purebred dog, to describe the act of voluntarily downplaying your abilities in front of the rest of the world.
He was thinking of Brazilians downplaying themselves after that ominous 1950 afternoon in Rio de Janeiro when we lost the World Cup to Uruguay. However, the analogy applies to the way we, the colonized, think of ourselves in matters of medical science, particularly in critical care.
Brazil saw other countries dominate the World Cup in the first half of the 20th century. Our neighbors, the Uruguayans and Argentinians, had already reached the status of world soccer superpowers by 1950. Perhaps due to higher standards of living, or having more exchange with Europe, or because Uruguay and Argentina also played rugby, the fact is they had already made it to the final match, and Brazil hadn't.
The American reader cannot imagine how much literature there is about South American soccer, and how cautious I have to be.
However, soon the gods of soccer (dioses del fútbol, gracias Galeano) looked upon the Brazilian team. The gods gifted us with Pelé and Garrincha, and Brazil presented the world with the genius and the undefeatable mastery that comes with authenticity. Finally, the Cup made its home in Brazil, and the game changed forever.
Of course, only till the Brazilian team started to emulate the Europeans. Now we are conventional participants, and even our defeats are ordinary, lacking the tragic dimension of a falling giant.
We South Americans are brilliant when we are authentic. I am sure the same applies to medical scientists from other countries.