Why I left the NIH

Francis Collins oversaw some of the most revolutionary science of the last few decades at the National Institutes of Health. A few months ago, he suddenly resigned. One of America's foremost scientists could no longer do his job. What does that mean for the US? And for science? Guest: Francis Collins, former director of the NIH For show transcripts, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠vox.com/unxtranscripts⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠vox.com/unexplainable⁠⁠⁠⁠⁠⁠⁠⁠⁠ And please email us! ⁠⁠[email protected]⁠⁠ We read every email. Support Unexplainable (and get ad-free episodes) by becoming a Vox Member today: ⁠⁠⁠⁠⁠⁠⁠⁠⁠vox.com/members⁠⁠⁠⁠ Help us plan for the future of Unexplainable by filling out a brief survey: ⁠⁠⁠⁠⁠⁠voxmedia.com/survey⁠⁠⁠⁠⁠⁠. Thank you! Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Speaker 00

  Support for the show comes from TikTok. If you listen to this show, you probably enjoy discovering new things. It is built into the DNA of the show that curiosity is its own reward and that there's always a deeper dive to do. And one place to explore some of the topics we've covered here is TikTok. Whether it's how to forecast volcanic eruptions, strange phenomena that the James Webb Space Telescope picked up near the beginning of time, or a literal deep dive on the ocean's deepest reefs, TikTok has a wealth of fascinating videos just waiting to be discovered. Your next discovery is waiting on TikTok. Learn more at tiktok.com/discovermore.

• 0:49Speaker 01

  Companies shouldn't have to choose between speed and control. Amex Corporate connects cards with flexible spending controls and real-time visibility to help teams adapt faster. Built to simplify, designed to scale. This is Amex Corporate. Get started at go.amex slash Amex Corporate. Terms apply.

• 1:13Noam Hassenfeld?

  One, two. Okay, good to go. A couple of weeks ago, I called up this scientist I've been wanting to talk to for a long time. I've particularly been struck by your writing because it feels like it encapsulates the mission of Unexplainable, of our show. Like, we're all about leaning into the things we don't know. You know, the importance of uncertainty and humility in science.

• 1:39Speaker 03

  I think you got it right. Science is pursuing the unexplainable, trying to explain it. And sometimes we succeed, and sometimes, ah, that hypothesis wasn't right. Let's try something else.

• 1:53Noam Hassenfeld?

  Francis Collins is easily one of the most important scientists of the last few decades. He led the Human Genome Project, which won him the Presidential Medal of Freedom. He was the Director of the National Institutes of Health under three presidents. And he led the NIH's work on developing the COVID vaccine, which saved millions of lives. But the reason I wanted to talk to Francis right now is because of the chaos that's been going on at the NIH. I've been hearing about cuts, about firings, about grants not getting funded. And I wanted to talk to someone on the inside, someone who's worked under this version of Trump and the previous one.

• 2:33Speaker 03

  I was, after all, the NIH Director during Trump's presidency, number one. I reported to him in various ways, especially during the really serious tumult of COVID-19 in 2020.

• 2:47Noam Hassenfeld?

  To be honest, I wasn't sure exactly what he was going to say. I thought, you know, if he could make the COVID vaccine under Trump's watch five years ago, maybe he knows something I don't about what's really going on.

• 3:01Speaker 03

  Well, I had experienced transitions before where things that one administration wanted to do, another one did not. And those were bumpy sometimes. I was kind of used to that. But I didn't expect science to be under this kind of full bore attack, which is really what happened almost immediately after inauguration day.

• 3:22Noam Hassenfeld?

  Francis says it started in his research lab.

• 3:26Speaker 03

  I've got a tiny little office there that can barely fit me and one other person.

• 3:31Noam Hassenfeld?

  When he saw a notification on his computer.

• 3:33Speaker 03

  It was an email saying, "You may not start any new projects. You can only work on things that you were working on before January 20th."

• 3:42Noam Hassenfeld?

  Francis walked out of his office into the lab, and he saw everyone else reading the same thing.

• 3:47Speaker 03

  Everybody gets up and we all start talking to each other like, "I didn't see that one coming. Hopefully, that's not going to last more than a few days. Maybe this is still just an idea of the new team trying to figure out what they're doing. They can't possibly mean this." I looked at people around me, and we just shook our heads like they were disbelieving. It's like, "This is the United States of America? This is the NIH? Ah, it can't be right."

• 4:13Noam Hassenfeld?

  But more orders kept coming down.

• 4:17Noam Hassenfeld?

  Over 1,000 employees at the NIH were suddenly fired. Those firings are still being challenged in the courts, but as of now, those people are still out of work. Researchers were prevented from studying certain topics like vaccine hesitancy, or even things like the health effects of wildfires. And officials rolled out communications gag orders.

• 4:39Speaker 03

  No scientists working for NIH were permitted to speak in any kind of setting, even a scientific meeting with no press. Or if you felt you had something you had to say, it had to be cleared at the level of the Department of Health and Human Services, which generally was not interested in clearing it. So you were effectively muzzled.

• 4:59Noam Hassenfeld?

  It seemed like new rules were getting announced almost every day, sometimes on really basic things.

• 5:05Speaker 03

  We were told you can't buy any supplies. And a little while after that, they decided, oh, you can use your purchase card now, but you can't buy anything that costs more than $1. Which was an insult. It was clear that this was intended to induce trauma. This was cruel. This was not reasonable. Here's why we're doing it. Don't worry, we love you. The message seemed to be, you are lazy bureaucrats, and we are going to do everything we can to make your life miserable.

• 5:37Noam Hassenfeld?

  Francis wasn't really sure what to do. He wasn't sure what he was allowed to do.

• 5:42Speaker 03

  We were all kind of in crisis. I felt some really bad things are happening here, and yet I'm not able to speak about it. I would get lots of press inquiries saying, can you tell us what's really going on? The New York Times, the Washington Post. And I would have to say, I'm sorry, I can't talk to you.

• 6:03Noam Hassenfeld?

  It got to the point where Francis felt like he just couldn't do his job anymore.

• 6:07Speaker 03

  It was feeling increasingly powerless and hopeless. And frankly, also getting a sense that there might very well be an action taken to get rid of me, because I was not seen as friendly to the administration. So I pulled my folks together in a conference room. They didn't know what was coming. And I told them, by tomorrow night, I'm no longer going to be here. And we all cried. I never thought it would end this way. My wife came to pick me up on that last Friday. And I just walked out of the building and got in the car and said, I guess this is it.

• 6:52Speaker 03

  That's how it ends.

• 6:57Noam Hassenfeld?

  Most medicines developed in the last few decades, from cancer treatments to vaccines, have relied on NIH research. But the current administration wants to cut its budget almost in half. So how did we get from a world where the NIH was universally recognized as a jewel of scientific research to a world where the government is essentially tearing it down from the inside? From a world where the same scientist who developed a life-saving vaccine in Trump's first term is now resigning under pressure in his second?

• 7:33Noam Hassenfeld?

  I'm Noam Hassenfeld, and today on Unexplainable, Francis Collins on how America lost trust in science and how we might be able to get it back.

• 8:02Noam Hassenfeld?

  Francis had been at the NIH for a long time, 32 years, and he'd seen it through all kinds of administrations. He started working on the Human Genome Project under Clinton. He finished it under Bush. He became NIH Director under Obama and was still in charge under Trump when he led the NIH work on the COVID vaccine. And in the last few years, he'd moved from NIH Director to running a diabetes research lab there. The whole time, he says, there was never a question whether scientific research was important.

• 8:34Speaker 03

  Yeah, I mean, gosh, when I was NIH director, one of my jobs was to meet with members of Congress. I did that like at least a half a day a week for all 12 years to try to explain science and why it mattered and what we were doing at NIH that might make a difference in terms of people's lives. And support was always just as good on each side of the aisle. It was one of the last remaining bipartisan things, all the way up to about 2020.

• 9:02Noam Hassenfeld?

  You know, it feels like during this time, there's been a bigger shift, not just in government, but I'm constantly hearing that Americans themselves have lost trust in science.

• 9:15Speaker 03

  They have.

• 9:15Noam Hassenfeld?

  Yeah, does it, does it feel like they have? Is that fair to say?

• 9:18Speaker 03

  I think it's totally fair. You can look at all the surveys about trust. And let's be clear, Americans have lost trust in almost every institution. But I think it was more than that. I think COVID did a lot of harm to people's trust in science because, well, first of all, it was a huge disastrous experience for the world. There were days where thousands of Americans were dying. And as one of those people who was communicating with the public about what we knew about the virus and what they might do to protect themselves, we were doing the best we could with the information we had, but the information was incomplete. And so we often had to change recommendations over time because we learned more about the virus

• 10:03Speaker 03

  and about the pandemic. And people began to wonder, do these guys know what they're talking about? So it is a fairly recent development that suddenly this has become about whether science is something that's good for our country or not.

• 10:19Noam Hassenfeld?

  So your most recent book, The Road to Wisdom, it's all about trust.

• 10:23Speaker 03

  Yes.

• 10:24Noam Hassenfeld?

  If you were telling the story of the loss of trust and everything going on in the science agencies today.

• 10:30Noam Hassenfeld?

  How far back would you start? Like, you know, once upon a time, where is your beginning?

• 10:35Speaker 03

  Depends on the particular demographic you're talking about. I'm a person of faith, by the way, and certainly people of faith have tended to be among the most skeptical of science. And that goes back 150 years or more to the sense that maybe science is up to something that's trying to do damage to our Christian faith. And that was there certainly well before COVID. But I think COVID did something to take what had been maybe a little bit of a tendency for science to be political and turned it into a really big deal. So if you're a Democrat, you're much more likely to get vaccinated than if you're a Republican. Does that make sense? Not in the slightest, but that's how it was.

• 11:22Noam Hassenfeld?

  The COVID vaccine. That's when Francis really understood just how bad trust in science had gotten, which was ironic because it was one of the highest points of his scientific career, the fastest vaccine development in history.

• 11:36Speaker 03

  I thought it was pretty unlikely that this could get done in less than maybe a year and a half. And even that would have been a world record. The fastest one before now was five years.

• 11:46Noam Hassenfeld?

  Five years, okay.

• 11:47Speaker 03

  Yeah. But people were dying around us, so we had to try.

• 11:50Noam Hassenfeld?

  Yeah.

• 11:51Speaker 03

  And I also knew that most vaccines fail. Or if they succeed, they have sort of modest efficacy, maybe 40% or something. And it was pretty likely that whatever we ended up with in this big push during 2020 was going to be a far less satisfying than we would have hoped for.

• 12:12Noam Hassenfeld?

  Francis still remembers the moment he knew it worked. They'd done this huge trial with 40,000 people. Half of them had gotten the vaccine, half of them had gotten a dummy shot, and no one knew which was which. Not the patients, not the scientists, just to be sure they weren't accidentally influencing anything. Until one evening in November 2020.

• 12:34Speaker 03

  I remember holding my breath as they were pulling off the labels and basically revealing the results. Because I'd prayed about this a lot here. And it was astounding.

• 12:47Speaker 03

  The efficacy to prevent serious disease, hospitalization and death was 90 to 95%. So much better than anybody would have thought possible. This was a stunning result.

• 13:00Noam Hassenfeld?

  Where were you? Do you remember where you were when you got these results?

• 13:03Speaker 03

  It was a Zoom call, of course, because we were all wearing masks if we went outside. Remember, it was November 20th, so nobody ever got together in person. But I was supposed to speak to the group then because I had the leaders of the effort, including from pharma on that. And I found I couldn't.

• 13:22Speaker 03

  I got all choked up and I had a few tears to shed and I didn't know what to say. It felt like we have hope now. Prayers have been answered. Science has triumphed. This is probably the most amazing achievement that science has ever managed to produce to save humanity. I think it'll stand up that way over the course of time, to do this in 11 months and to have that kind of result.

• 13:49Noam Hassenfeld?

  At a certain point, though, it became clear that a lot of people were not getting the vaccine.

• 13:55Speaker 03

  Yeah.

• 13:56Noam Hassenfeld?

  Do you remember when you found out?

• 13:58Speaker 03

  It happened over time, this sort of increasing unease. And by the time we got to this sort of April, May, June of 21, there was no reason for somebody to say, "Well, I just can't get access." And then it was clear. We're talking about more than 50 million Americans who said, "No.

• 14:17Noam Hassenfeld?

  Yeah.

• 14:18Speaker 03

  I don't want this." I didn't see that coming.

• 14:21Noam Hassenfeld?

  Really?

• 14:22Speaker 03

  I guess I didn't realize how strong the political polarization was, or how strong just our own sort of cognitive biases are. And I don't mean to put down these good, honorable people who made that decision.

• 14:37Noam Hassenfeld?

  Yeah.

• 14:37Speaker 03

  They were doing the best they can, being barraged with information coming from lots of different directions and having a lot of political messages that tapped into other parts of what they cared about. It was a terrible position to have people put in. But what group was most resistant to accepting the vaccines? It was white evangelical Christians. I'm a white evangelical Christian, so those are my people. But I broke my heart to see how that happened.

• 15:06Noam Hassenfeld?

  For his part, Francis never really felt this tension between science and religion that so many other Christians have been dealing with. He actually came to Christianity through his work as a doctor.

• 15:16Speaker 03

  I know it surprises people, and believe me, it surprised me at the time when it happened. No, I was raised in a home where faith wasn't considered relevant or important. I was an atheist by the time I was in graduate school. And then there I was, sitting at the bedside of people who were facing the end of their lives. And I had a patient who simply asked me one day, "What do you believe?" And I realized, I've spent no time at all on that question. I thought, okay, I'm a scientist. I'm supposed to study all the questions, so I better study this one so that I'll have a better answer the next time about my atheism.

• 15:54Noam Hassenfeld?

  You're saying, oh, I'm a scientist, I need to consider the possibility of God as a scientist?

• 15:59Speaker 03

  Right, right. And I have never encountered a place where I thought some scientific insight about the universe could not be fitted fairly conveniently with what I know as a Christian. And I lived that during 2020 because I was praying for those vaccines to be successful. But I was also expecting that if God answered those prayers, it would be through the science that we were all deeply engaged in. And that way, I think the laboratory and the cathedral are not all that different. They're both places where you can worship.

• 16:32Noam Hassenfeld?

  When Francis started seeing this happening, over 50 million people, and particularly these people just like him, white evangelical Christians, rejecting the vaccine, he thought he might be able to bridge the gap in trust.

• 16:49Speaker 04

  Does Jesus, for example, have an opinion about how we behave during this pandemic? And even whether we get vaccines? Do you think that the Bible speaks to these issues?

• 17:00Speaker 03

  I think the Bible speaks to virtually every issue. And that's where I often go when I'm trying to sort something out that I can't figure out on my own.

• 17:08Noam Hassenfeld?

  Francis went on TV shows, he went on podcasts, he gave all kinds of interviews, all to show people what the vaccine meant to him as a Christian.

• 17:18Speaker 03

  When you see how much time Jesus spent doing healings, and even Jesus sometimes used things like water and mud. Well, maybe that was his particular divine way of accomplishing a healing. We humans, as God's children, have been given the tools of science to kind of come up with our own way to work through God's grace, to provide an opportunity to prevent suffering. And I think that's what vaccines are and have been all along.

• 17:47Noam Hassenfeld?

  Francis wanted people to know that the vaccine wasn't something in opposition to his faith. It was a culmination of everything he believed in.

• 17:56Speaker 03

  This is not a threat, but an answer to prayer, a God-given gift that is going to save lives. This is truly a love your neighbor moment. And some people will go, well, God will take care of us. Well, God does expect us also to answer the call. And maybe it helped, maybe it would have been worse without that. But things were so dug in that I guess it wasn't good enough to convince people that this was something they would want for themselves and their family. And a lot of people died.

• 18:27Noam Hassenfeld?

  The Kaiser Family Foundation estimates that vaccine hesitancy costs 234,000 lives. And now I hear Francis looking back, trying to do a sort of autopsy on all of those lives lost. But I also hear him looking ahead to the future lives we might lose because of what's currently happening at the NIH. The cuts and the censorship that led him to leave the institution he led for so long. A place that's supposed to be saving lives.

• 18:57Speaker 03

  If you cut out the foundational work that NIH supports, you're not going to have breakthroughs that otherwise are on the track to be there. But it's more than that. There are people on clinical trials for cancer who suddenly have been told, I'm sorry, the trial was stopped. And that might have been their best hope. So there are casualties here that are absolutely immediate and desperate and put people's lives in jeopardy. Let no one misunderstand that.

• 19:27Noam Hassenfeld?

  It feels impossible to wrap my head around all of this. The people at risk right now, the treatments that might not be discovered down the line. But I wanted to know if Francis had learned anything from his experience with the vaccine, from all those people turning their backs on a treatment? And whether that experience helps him make sense of what's going on now? When it's becoming clear that more than 50 million Americans aren't taking the vaccine, you know, one of the most remarkable scientific achievements in human history. Did that tell you anything about the pursuit of science and how it works?

• 20:04Speaker 03

  It certainly woke me up to the fact that we apparently had not done a very good job, going back some time, in giving people some sense of science literacy about why can you both recognize that science is tackling some really hard problems and occasionally gets the wrong answer, but it's going to get self-corrected because it's about truth? Science is not just a bunch of people who are coming up with answers that they like. These are answers that aren't going to be sustainable unless they're actually true. And maybe here's also where I began to realize that's another problem that society has, that I was unaware of in terms of its severity, that the importance of truth, the fact that

• 20:49Speaker 03

  there is such a thing as objective truth, but not everybody shared that. Well, that might be true for you, but it's not true for me. I would hear people say that about things that were established facts. And that's a road to destruction of a society if it becomes widespread. And unfortunately, it seems to be doing so right now.

• 21:11Noam Hassenfeld?

  It feels like you believed that all you had to do was develop the vaccine, get to the thing that worked, and then people would take it. And there's this whole other piece of convincing people that you or the scientific community at large didn't do.

• 21:30Speaker 03

  Yep, I was naive about science communication and how it works. And I was kind of, without knowing to call it this, I was an adherent to the knowledge deficit model.

• 21:41Noam Hassenfeld?

  What does that mean?

• 21:42Speaker 03

  That means that if you're trying to communicate science to get somebody to make a decision, it's because they're missing knowledge and you're going to provide that. You're going to fill their deficit and then everything will be fine.

• 21:53Noam Hassenfeld?

  You just tell them, here's a fact.

• 21:55Speaker 03

  Yeah, here's a fact.

• 21:56Noam Hassenfeld?

  Now you believe the fact.

• 21:57Speaker 03

  I'm an expert and then they'll make the right decision. No, it doesn't work that way, especially when there's already skepticism and distrust. You're seen as an elitist who maybe has an axe to grind or something you're trying to put over on them. You may even do more harm than good by going after somebody's misunderstandings face on. They're just going to dig their heels in more thoroughly. I guess what I've learned is we need to do a lot more listening with the science communication part of this, really understand where people are coming from and also be prepared to tell stories instead of going down the road with statistics. Yet for a scientist, that sounds like an anecdote. I would never get away with that in the seminar room.

• 22:38Noam Hassenfeld?

  Yeah.

• 22:39Speaker 03

  This is not the seminar room, people. We need to actually find better ways to help people understand what we do.

• 22:49Noam Hassenfeld?

  You might be listening to all of this and thinking, okay, sure, that sounds good in theory, but it's got to be pretty hard to have these kind of tough conversations that actually change people's minds in the real world, right?

• 23:04Noam Hassenfeld?

  In a minute, a tough conversation that actually changes people's minds in the real world.

• 23:16Speaker 00

  Support for the show comes from Shopify. Starting a business requires you to be resourceful. And the more you flex that muscle, the more you start to see opportunities for growth. For example, launching your business with Black Friday approaching means you can take advantage of the extra online traffic. And Shopify is there to help you make it all happen. Shopify says they are the platform for a record-breaking, reliable holiday selling season for businesses at every stage.

• 23:45Speaker 00

  They have pre-built website themes and an AI site builder, which should make it easy to launch a beautiful, professional-looking store. And you don't ever need to touch a line of code to do it. They also have a mobile app that lets you run your store from anywhere. And they say their AI e-commerce expert sidekick can help you manage almost any business task with a single prompt, including holiday discounts. With Shopify, you can easily sell everywhere people shop: online, in person, across social media, even in AI chats. If you are ready to launch your business before Black Friday, go to Shopify.com/unexplainable to start your free trial.

• 24:28Speaker 00

  That is Shopify.com/unexplainable. Go to Shopify.com/unexplainable today to hear your first.

• 24:41Speaker 00

  Support for the show comes from TikTok. Being curious is endlessly rewarding. There are few better feelings, in my opinion, than asking a question and then having that question lead you down a rabbit hole, might even be the beginning of a new set of interests that was not on your radar beforehand. Maybe you're looking up at the night sky one night and you start to wonder what the most distant thing you can see with the naked eye is. One place to start searching for answers to a question like that is TikTok. First, you might discover a video about the Andromeda Galaxy. And then, next thing you know, you're learning how to find different stars, or how to identify

• 25:24Speaker 00

  constellations, or how different astronomical discoveries got made, or how constellations got their names. You don't need serious equipment to make serious discoveries. To start with a simple question, and suddenly, you're somewhere you never expected to be. Your next discovery is waiting on TikTok. Learn more at tiktok.com/discovermore. At tiktok.com/discovermore.

• 25:56Speaker 05

  Life is all about making decisions. Sometimes you make questionable ones, like buying a new TV that's too big for the wall because the electronics store employee was a little too good at their job. Then sometimes you make great ones, like protecting your home and auto with Progressive. You get customized coverage options so you can be sure you have the right coverage. Get your quote today at progressive.com. Progressive Casualty Insurance Company affiliates and other insurers, not available in all states.

• 26:27Speaker 06

  Forget the world around you. Forget the people around you. You are entering unexplainable, alone with your own thoughts.

• 26:38Noam Hassenfeld?

  Too many of us have lost trust in science, in institutions, in each other. So how do we get it back? In 2023, Francis tried something new.

• 26:51Speaker 05

  Good evening. Shall we get started?

• 26:54Noam Hassenfeld?

  He started working with a group called Braver Angels, which brings people together on opposite sides of an issue. So everything from immigration to gun control to public health.

• 27:05Speaker 05

  This discussion, of course, is entitled, "An elitist and a deplorable walk into a bar." We'll let you decide in the course of the evening who's the elitist and who just walked into a bar.

• 27:18Noam Hassenfeld?

  Francis was on stage with Wilk Wilkinson, this outspoken critic of COVID lockdowns, who ran a trucking company in rural Minnesota.

• 27:27Speaker 05

  I am somebody who certainly doesn't have the bona fides of a scientist. I have spent more time in bars in my adult life than I did in a classroom.

• 27:36Speaker 03

  The first time I met with him, I thought, well, we're never going to be able to get along here because let's just say he is very articulate and very outspoken.

• 27:45Speaker 05

  So when Braver Angels confronted me with this opportunity to speak with Dr. Francis Collins, first of all, I was like, what?

• 27:55Speaker 05

  Like me? This doesn't make sense, but I'll talk to anybody.

• 28:00Speaker 03

  He was very strong in his views about how the government had trod upon liberties and freedoms and made stupid recommendations.

• 28:10Speaker 05

  There were so many problems with the communication. The science was changing and that was not ever communicated well by anybody.

• 28:19Noam Hassenfeld?

  Francis had gotten criticisms of his communication and his decision making all the time. But having this kind of conversation was different.

• 28:27Speaker 03

  I needed to listen, I mean, really listen to people who were very angry and distrustful of the government's approach and felt it had done them harm.

• 28:38Noam Hassenfeld?

  And when he really listened, Francis could see that he agreed with a lot of Wilk's points.

• 28:43Speaker 03

  So what we did wrong, what I did wrong, because I had plenty of these moments in television interviews, is we failed to say every time there was a recommendation, this is the best we can do right now, there's a good chance this is wrong. We didn't say that. We wanted to be sure people actually motivated themselves by what we said because we wanted change to happen in case it was right. But we did not admit our ignorance. And that was a profound mistake and we lost a lot of credibility along the way. And that one I will not forget.

• 29:19Noam Hassenfeld?

  Francis had a whole bunch of conversations with Wilk that went way beyond this one on stage. And they made him understand lots of different ways public health officials had been kind of narrow minded.

• 29:32Speaker 03

  Out of that, I think I have a better sense of how our one size fits all approach, at least initially to the country, just didn't feel like it made any sense when people were in various rural communities and wondering, why do I have to close my business? I haven't even seen any cases here yet. I learned about that. As a guy living inside the Beltway, feeling this sense of crisis, we weren't really thinking about what that would mean to Wilk and his family in Minnesota, 1,000 miles away from where the virus was hitting.

• 30:08Speaker 03

  It also helped me understand something that I maybe hadn't quite understood for myself, which was when I was in the middle of this, my number one goal was to save lives. I'm a physician. I took the Hippocratic Oath. I assumed there were other people worrying about the economic effects of this and the effects on children's learning when they were kept out of school. And it didn't feel like that was my thing. My thing was to try to keep people from dying. But it became clear to me that that may have been something I was a little bit wearing blinders about. Maybe those other factors about economic harms and harms to children's learning should have been a bit more front and center to the conversations that I was part of.

• 30:55Noam Hassenfeld?

  So I understand, looking back on it and saying, okay, it would have been better, more accurate to communicate the level of uncertainty, to just say to people, this is evolving, we don't know. Do you think that would have led to a different outcome?

• 31:08Speaker 03

  I don't know. I wish we could do the experiment and maybe we could figure out a way to do it in some sort of controlled space. But the way in which this failed to land as effectively as I wish it had, I would say 20% of the problem was the less than perfect communication of the science and 80% of it was the deluge of misinformation and disinformation. And that contaminated the conversation to the point where a lot of people stopped listening to the actual facts. But there didn't seem to be any penalty for stating something that's absolutely false. And I haven't heard anybody apologize for that.

• 31:51Noam Hassenfeld?

  You know, when I think about this willingness to have difficult conversations, you know, to accept responsibility for mistakes.

• 32:00Noam Hassenfeld?

  It seems like this is something that most people are not doing.

• 32:04Speaker 03

  Not doing.

• 32:05Noam Hassenfeld?

  And I've heard you mention, maybe we could have something like a truth and reconciliation commission, or a pandemic amnesty on a larger level, where people could really be open about their mistakes. Do you think that could have any effect?

• 32:19Speaker 03

  You know, I proposed the idea of amnesty in one of these Braver Angels large-scale settings, and the audience blew up. They were not there.

• 32:27Noam Hassenfeld?

  Huh.

• 32:28Speaker 03

  People are too angry.

• 32:29Noam Hassenfeld?

  On both sides?

• 32:30Speaker 03

  On both sides. They're feeling too hurt. Too much harm has been done to them. So amnesty, I don't think we're there. Truth and reconciliation, people were like, okay, because they can imagine that those other people are going to have to ask for forgiveness for what they did.

• 32:47Noam Hassenfeld?

  Yeah.

• 32:48Speaker 03

  But right now, we're so dug in. I hope that this truth and reconciliation option is out there. Right now, it doesn't quite feel like people are ready to go there.

• 32:58Noam Hassenfeld?

  One of the things that you say, looking back on your time during COVID, is that we needed to have more uncertainty. You needed to be communicating uncertainty all the time.

• 33:08Speaker 03

  Mm hmm.

• 33:08Noam Hassenfeld?

  It's something that the scientific agencies don't do enough of, and it's clearly now happening in the other way, where RFK is saying things like, we're going to find out the cause of autism. No uncertainty. It seems to me like what we need is more people embracing uncertainty, more people talking about their mistakes, whether it's people with their friends who they disagree with, or whether it's the highest scientists in our scientific agencies. How do we get there? Because we weren't there during COVID when we were doing Operation Warp Speed, and we're not there now.

• 33:46Speaker 03

  Yeah, we're a long way from there. And I guess, when you're in this circumstance where there seems to be a real pitched battle between the various tribes, the idea that anybody would say, I might be wrong. The fact that I've been willing to say that has resulted in a lot of attacks. Even from people who I thought were my friends, like, oh, no, you can't show weakness like that.

• 34:11Noam Hassenfeld?

  Huh.

• 34:12Speaker 03

  Well, yeah, we really do need to do that, but we need to all do it and not just expect a few people who are then going to get whacked for it. It's hard right now, and you don't see a lot of that in our country.

• 34:27Noam Hassenfeld?

  Yeah, I mean, I don't want to come off as naive here. Like, I don't assume that just emphasizing uncertainty is going to be the thing that saves us from a full frontal assault on science. But, I mean, your response was resigning because it doesn't seem like you could do anything. What do we do about this situation?

• 34:44Speaker 03

  Well, I didn't resign to go play golf or fishing because I'm not good at either one. I wanted to have a chance to try to do something productive about this circumstance. So that's a lot of what I'm working on right now. I do think the action is basically to build on what maybe is starting to happen. A general sense in the public that medicine is important, that maybe this is not something that should be attacked in this way. There's some signs there. There was a meeting of the full Senate Appropriations Committee chaired by Republican Susan Collins,

• 35:24Speaker 03

  and four senators made strong statements about how this is something that is one of the crown jewels of the federal government and should actually be sustained and if anything expanded. So there is some, maybe, glimmers of support there, but I think our case is so strong. We just have to figure out how to get that message to enough people, and we'll get this back on track.

• 35:50Noam Hassenfeld?

  Francis can find hope in a lot of places, like even in Susan Collins kind of places. But it's clear he's worried about the lives this could be costing right now and about the future of his profession.

• 36:04Speaker 03

  Even though I'm not there anymore, I still talk to lots of trainees. And that is the most disturbing part of this. Talk about unexplainable. How could the talent that we have in this country, much of which is international, trainees that have come from other countries because they thought America was the place where you could really pursue your dreams. And now they're losing confidence that there's a path for them. And fully a third of the young scientists I talk to, graduate students or postdoc, are seriously looking at the opportunity to leave the United States and take their science somewhere else and wondering, is there a hope for me here?

• 36:41Noam Hassenfeld?

  Yeah. If I were a young scientist and I wasn't sure whether I should stay or whether I should even take this on as a career, what would you say to me?

• 36:51Speaker 03

  I would say you're at a really paradoxical time because this is the most incredibly exciting moment for biomedical research. So many things are becoming possible that I would not have dreamed would happen in my lifetime. And we're on this exponential curve of gathering insights. So if that's your dream to be part of, don't give it up. Now, the paradox is, right at the moment, there's a lot of negative things happening in the United States that seem to be threats. But the case here is so compelling that I don't believe those facts can be suppressed for very long. You can already look at polls to say, when the American public is being asked, are you

• 37:35Speaker 03

  worried about some of the things that are happening right now? And one of the things they say, I don't think they should be harming medical research. That's right there. Seventy-seven percent of Americans raised that point. So that's people on both sides of the aisle. So there's some momentum there.

• 37:53Speaker 03

  So I wouldn't, right now, make your plans to move to Australia, although you might want to have that in your back pocket in case it takes longer than I think it will for us to get back on track.

• 38:11Noam Hassenfeld?

  Before we go, one last thing. This episode was us trying to wrap our heads around the current moment in science, all the changes at places like the NIH, the NSF, USAID. We're trying to figure out exactly what's happening. What do all these budget cuts mean for science right now? What do they mean for the future of science in America? And we want to hear from you. Are you a young scientist just starting out, scratching your head about how to build a research career right now? Have your plans or dreams changed? How is all of this affecting you? We want to hear stories from people working in science about what's changing on the ground right now.

• 38:53Noam Hassenfeld?

  So if you're up for it, send us a voice memo or an email to [email protected]. We'll get back to you as soon as we can. And with your permission, of course, you might be featured in a future episode. This episode was produced by me, Noam Hassenfeld. We had editing from Julia Longoria, mixing and sound design from Christian Ayala, music from me, and fact checking from Melissa Hirsch. Meredith Hadenot runs the show. Jorge Just is our editorial director. And Bird Pinkerton couldn't believe it. She thought the platypus was on her side. But suddenly, she saw other platypuses coming out of the grass. She'd been betrayed.

• 39:36Noam Hassenfeld?

  Thanks, as always, to Brian Resnick for co-creating the show. And if you have any thoughts about this episode or any episode, send us an email. We're at [email protected]. We love hearing from you. We read all the emails. And you can also leave us a review or a rating wherever you listen. It really helps us get in front of new listeners. You can also support this show and all of Vox's journalism by joining our membership program. You can go to vox.com/members and you'll get ad-free podcasts, as well as a whole bunch of other goodies. Plus, you'll be helping keep this place running and you'll make us very happy people. Unexplainable is part of the Vox Media Podcast Network, and we'll be back next week.

• 40:28Speaker 05

  Life is all about making decisions. Sometimes you make questionable ones. Like buying a new TV that's too big for the wall because the electronics store employee was a little too good at their job. Then, sometimes you make great ones. Like protecting your home and auto with Progressive. You get customized coverage options, so you can be sure you have the right coverage. Get your quote today at progressive.com. Progressive Casualty Insurance Company affiliates and other insurers. Not available in all states.

• 40:58Speaker 05

  When everyone's finally together, what makes mornings even brighter? Keeping things deliciously simple. Whether you're pouring up a glass of morning refreshment, or topping off festive drinks for a family brunch, Simply Orange brings that 100% fresh squeezed taste to every moment. Deliciously bright and delightfully easy, Simply Orange is made for all your seasonal gatherings. Simply Orange: Say Yes to Simple.