On Experts, and a Growing ‘Antipathy to Expertise’

A recent article in Harvard Magazine, “The Miracle of Knowledge,” gave me occasion to reflect on my ordeal with knee pain. A political scientist by the name of Tom Nichols has noticed in American public discourse “a new and accelerating – and dangerous – hostility toward established knowledge.” The article refers to it as an “antipathy to expertise.”

The article caught my eye, because in a sense I suppose my knee pain recovery can be construed as an “antipathy to expertise.” Ultimately I rejected what my doctors and physical therapists – the true experts – told me about my prognosis for healing, and about what my treatment should consist of. I became a Google’ing omnivore, devouring all I could find about knee pain similar to mine, and sifting for clues about how I could beat this condition.

In the end, I think I proved the experts – at least those in my immediate circle – wrong. I healed, when I was told I couldn’t, and did so by rejecting the core muscle-strengthening advice of my physical therapist. If there were a parade of “don’t trust the experts” activists you might expect me to be right up front.

Except I wouldn’t be. Not at all.

In fact, I pretty much agree with Nichols. I'm also worried about the erosion of belief in experts, which is all too often replaced by the conviction that an ignorant opinion, or a private consensus reached after consulting the Google hive mind, works just as well. “Who needs doctors, climate scientists, whatever?” This attitude frightens me because today, more than ever, a cavalier disregard of facts and truth is becoming acceptable.

So to be clear (and some of you have heard this before):

* If you have knee pain, I would always start by seeing a doctor. In comments on this blog, I’m careful to say that. At the least, a doctor can order imaging and other tests that can shed light on what’s going on in your joint. But more than that, a doctor will typically have the intelligence, breadth of knowledge, and experience (gained from examining scores of patients like you) to make a better diagnosis than Mr. Google.

* My rejection of the experts wasn’t knee-jerk and immediate. It arose from three main things:

(1) Doctors never gave me a plan for getting better. A plan – “do this, then this, then this” – I would have respected. A fatalistic shrug, or the tepid suggestion to avoid activities that bother my knees – that feels like a dereliction of duty.

(2) In other cases, the plan I was given failed. At some point, when confronted with repeated failure, you have to wonder, “Is it just me or could the advice I’m getting be faulty?”

(3) I tried to approach the puzzle of my knee pain in a scientific-minded way. If my doctors knew X and Y, I looked for Z, the thing that perhaps clinical trials had discovered, but that wasn’t commonly accepted when my doctors were being taught in medical school, five, 10, 20 years ago. An example: I located a clinical study where cartilage defects improved, at a significantly high rate. This is part of what informed my optimism about my knees getting better. And I also looked for smarter, out-of-the-mainstream experts. I was lucky to find a few.

So with experts, I would not reject their opinions out of hand. Experts are experts for a good reason. But there are times when they are wrong, and that possibility, no matter how small in a given instance, can’t be overlooked. They are not some monolithic, omniscient body. They are people. And people are fallible.