If America has a tradition, it isn’t baseball or apple pie. It is ignoring experts until disaster strikes, then swearing we will never do it again… until we do.
Most people think medicines magically appear in orange bottles because some CVS elf worked overtime in the stockroom. Behind every pill is centuries of messy trial and error, a few world wars, some accidental mold, and more public stupidity than you would believe possible.
Where Do Medicines Come Come From?
Willow bark gave us aspirin, mold gave us penicillin, and poppies gave us morphine plus the opioid crisis in one neat bundle. Fun fact: penicillin was discovered in 1928 because Alexander Fleming, a Scottish biologist, could not be bothered to clean his petri dishes. It only took 15 more years and a world war before anyone could mass-produce it1.
Meanwhile, making a new drug today costs about 2.6 billion dollars2, so every pill you swallow is basically a tiny mortgage payment.
- Percentage of prescription drugs that started in nature: 501
- Year penicillin was discovered: 19281
- Years until mass production: 151
- Average cost to develop a new drug today: 2.6 billion dollars2
Drugs vs. Supplements
Drugs have to prove they actually work. Supplements just have to prove they exist. The FDA makes drug companies do three phases of clinical trials with thousands of people3. Supplements? Zero. Zilch. Nada. You can slap “immune booster” on a bottle of sawdust and sell it at Whole Foods. That is why 58% of Americans take supplements4, but nobody is really sure if they are swallowing vitamins or overpriced mulch.
And while Big Pharma is a 1.5 trillion dollar global monster, the “harmless” supplement industry is still raking in 190 billion dollars4. That is a lot of ginseng tea.
Marc Maron, stand-up comic and professional neurotic: “Supplements are basically like hope in capsule form. You buy a bottle of optimism and piss it out later.”5
- Global pharmaceutical market value: 1.5 trillion dollars4
- Global supplement market value: 190 billion dollars4
- Number of clinical trials required for drugs: thousands of participants across 3 phases3
- Number of clinical trials required for supplements: 03
- Percentage of Americans taking at least one supplement: 584
Why Drugs Get More Scrutiny
Because history is a crime scene. In 1937, 107 people died after drinking “Elixir Sulfanilamide,” which turned out to be raspberry-flavored antifreeze6. Then in the 1950s came thalidomide, which was supposed to cure morning sickness but instead caused thousands of babies to be born with birth defects6. Lawmakers finally said, “Okay fine, maybe let us test this stuff first.”
Supplements dodged the whole accountability thing because they were branded as “natural.” So is arsenic. Meanwhile, about 23,000 Americans still end up in the ER every year thanks to supplements6.
- Americans killed by Elixir Sulfanilamide in 1937: 1076
- Year Congress required drug makers to prove effectiveness: 19626
- Supplement-related ER visits each year in the U.S.: 23,0006
- Babies born with thalidomide-related birth defects worldwide: over 10,0006
When Supplements Become Drugs
Every once in a while, a supplement actually does something besides make your urine glow neon. That is when it graduates to drug status. Fish oil? Grandma’s “brain food” is also a prescription drug for heart disease. Niacin? Your friendly neighborhood vitamin B3 becomes a cholesterol drug when you crank the dose from 16 milligrams a day to 2,000. Digitalis? Once a folk remedy made from foxglove, now a prescription drug that will regulate your heart or kill you, depending on the dose7.
Sarah Silverman, stand-up comic who specializes in brutal honesty: “It is funny, people will not trust medicine because it is ‘made in a lab,’ but they will chug a smoothie made out of dirt and sadness from some guy named Sky.”5
- Number of dietary supplements sold in the U.S.: 85,000+4
- Number of FDA-approved prescription drugs since 1938: about 1,5003
- Percentage of supplements tested in large clinical trials: under 104
- Daily niacin requirement for adults: 14–16 milligrams7
- Prescribed niacin dose for cholesterol: up to 2,000 milligrams7
What Are Vaccines and Why Do They Work?
Vaccines are cheat codes for your immune system. You give your body a mugshot of the criminal, dead virus, weakened bacteria, or just a little protein fragment, and the immune system practices target shooting. Later, when the real thing shows up, your body already has the Wanted poster.
Dr. Anthony Fauci, America’s top infectious disease expert for nearly 40 years, said in 2020: “The best way to prevent disease and death is vaccination. We have to rely on the science.”8 That should have been as controversial as “do not drink bleach.” Instead, it made him a national hate object.
Measles vaccine after two doses? Ninety-seven percent effective9. Vaccines have eradicated smallpox completely, saved around 4 million kids a year worldwide, and given humanity one of the few slam-dunk victories in medicine9.
- Effectiveness of measles vaccine with two doses: 97%9
- Childhood deaths prevented by vaccines worldwide each year: 4 million9
- Number of diseases eradicated globally by vaccines: 1 (smallpox)9
- Number of Americans alive today because of vaccines: tens of millions9
Did Vaccines Help Us Live Longer?
Oh, absolutely. In 1900, life expectancy in the U.S. was 4710. By 2000, it was 7710. That was not because Americans discovered Pilates or kale. It is because kids stopped dying of measles, diphtheria, and polio. Infant mortality dropped from 100 deaths per 1,000 live births in 1900 to 7 in 200010.
Dr. Peter Hotez, a vaccine scientist and pediatrician, put it bluntly: “Vaccines are one of the most effective public health tools we have, yet misinformation is undoing decades of progress.”11
- U.S. life expectancy in 1900: 47 years10
- U.S. life expectancy in 2000: 77 years10
- U.S. infant mortality in 1900: 100 deaths per 1,000 live births10
- U.S. infant mortality in 2000: 7 deaths per 1,000 live births10
- Global polio cases in 1988: 350,00012
- Global polio cases in 2022: about 3012
Before Vaccines
Before vaccines, life was one big Hunger Games where the prize was surviving childhood. In 1800, about 43% of kids worldwide died before age five13. Today, it is 4%13. Back then, the global average life expectancy was **29 years**13. Today it is 7313.
Your ancestors had eight kids just to make sure two survived. Quarantine meant throwing a sheet over the house and praying. “Inoculation” meant smearing pus into someone’s arm and hoping you did not kill them13.
- Global child mortality before age five in 1800: 43%13
- Global child mortality before age five today: 4%13
- Global life expectancy in 1800: 29 years13
- Global life expectancy today: 73 years13
Greatest Hits of American Anti-Science
Track 1: The 1918 Anti-Mask League
During the Spanish flu, San Francisco residents protested mask mandates with signs like “Masks are for slaves.” Because nothing screams independence like dying of a lung infection in 10 days14.
- Estimated global deaths from the 1918 flu: 50 million14
- Duration of the San Francisco Anti-Mask League: 1 month14
- Percentage of San Franciscans infected by the flu: 5014
Track 2: Big Tobacco’s Greatest Lie
By the 1920s, cigarette companies hired doctors to claim smoking was good for your throat. Ads literally said, “More doctors smoke Camels than any other cigarette.” Translation: “Ignore the cancer, Doc, it is soothing.”15
- Year the Surgeon General finally said smoking causes cancer: 196415
- Number of Americans who have died from smoking since then: 20 million+15
Track 3: The Seatbelt Wars of the 1960s
Car companies fought seatbelt laws because safety features were “bad for sales.” Drivers fought them because buckling up violated freedom. Because nothing says liberty like flying through a windshield at 60 miles an hour16.
Wanda Sykes, stand-up comic: “Americans will fight tooth and nail against a seatbelt but strap an AR-15 to the baby seat without blinking.”5
- Year federal law first required seatbelts: 196816
- Reduction in car-crash deaths from seatbelt use: 50%16
- Percentage of Americans who opposed seatbelt laws in the 1980s: 6516
Track 4: Reagan’s Remix of Selfishness
In 1981, Reagan declared that “government is not the solution, government is the problem.” Americans ate it up like candy17. Translation: society is a myth, you are on your own, and collective action is communism. Reagan’s remix turned selfishness into patriotism and suspicion of experts into gospel. Forty years later, this ideology gave us people licking doorknobs during COVID in the name of liberty.
- Year Reagan declared government the problem: 198117
- Percentage of Americans today who think vaccines are unsafe: 2518
- Percentage who actually got at least one COVID shot: 8118
- Estimated Americans saved by COVID vaccines in 2 years: 3 million12
- Americans dead from COVID by mid-2023: 1.1 million12
Why People Went After the “Experts”
COVID created a weird villain narrative. Scientists like Dr. Anthony Fauci, America’s top infectious disease doc for four decades, became stand-ins for every bad feeling Americans had about lockdowns, lost jobs, and fear. He gave press conferences, they gave him death threats19. Same with Dr. Hotez, harassed for defending vaccines, and Dr. Deborah Birx, roasted for telling people not to gather for Thanksgiving19.
Why? Because health experts tell you things that affect your daily life. Wear a mask. Cancel your trip. Close your bar. That is immediate. Astrophysicists do not tell you to stop doing anything. When **Neil deGrasse Tyson talks about a black hole eating a star, nobody screams “tyranny” because it does not affect your nacho night20.
Dave Chappelle nailed this dynamic: “Everybody hates the messenger. Nobody ever shoots the virus, they shoot the guy telling you how not to get it.”21
- Number of death threats sent to Fauci during COVID: thousands19
- Number of death threats sent to Neil deGrasse Tyson for talking about black holes: approximately zero20
Final Track: COVID Denialism Goes Platinum
By 2020, anti-science denialism was no longer the quirky B-side. It was the main event. A fractured America argued not about policy but about reality itself. Was COVID real? Were vaccines poison? Was coughing on grandma liberty or homicide? The answer depended less on science than on what cable news you watched22.
And so, the anti-science tradition lives on. From “masks are slavery” to “cigarettes are medicine” to “seatbelts are tyranny” to “vaccines are microchips,” America has always had the same chorus: experts are the enemy, facts are negotiable, and freedom means never having to say you are sorry for infecting your neighbor22.
If you made it this far, thanks for sticking with me. I’d love to hear your thoughts. Please leave a comment or visit my website at www.boulderpsychiatryassociates.com. And if you happen to live in Boulder, and you have been vaccinated, feel free to stop by for some baked treats.
References (Chicago Style)
- Fleming, Alexander. “On the Antibacterial Action of Cultures of a Penicillium.” British Journal of Experimental Pathology 10, no. 3 (1929): 226–236. ↩
- DiMasi, Joseph A., Henry G. Grabowski, and Ronald W. Hansen. “Innovation in the Pharmaceutical Industry: New Estimates of R&D Costs.” Journal of Health Economics 47 (2016): 20–33. ↩
- U.S. Food and Drug Administration. “The Drug Development Process.” FDA.gov, 2020. https://www.fda.gov/patients/drug-development-process. ↩
- National Center for Complementary and Integrative Health. “Dietary Supplement Use in the U.S.” NIH.gov, 2018; Grand View Research. Dietary Supplements Market Size Report, 2023. ↩
- Maron, Marc. Thinky Pain. Stand-up special. Netflix, 2013; Silverman, Sarah. We Are Miracles. HBO, 2013; Sykes, Wanda. Not Normal. Netflix, 2019. ↩
- Young, James Harvey. The Toadstool Millionaires: A Social History of Patent Medicines in America before Federal Regulation. Princeton: Princeton University Press, 1961; Vargesson, Neil. “Thalidomide-Induced Teratogenesis: History and Mechanisms.” Birth Defects Research 105, no. 2 (2015): 140–156; Geller, Adam I., et al. “Emergency Department Visits for Adverse Events Related to Dietary Supplements.” New England Journal of Medicine 373 (2015): 1531–1540. ↩
- Guyton, John R., and Harold E. Bays. “Safety Considerations with Niacin Therapy.” American Journal of Cardiology 99, no. 6 (2007): 22C–31C; Withering, William. An Account of the Foxglove and Some of Its Medical Uses. Birmingham, 1785. ↩
- Fauci, Anthony. “Press Conference Remarks on COVID-19.” White House, March 2020. ↩
- Centers for Disease Control and Prevention. “Measles Vaccination.” CDC.gov, 2022; World Health Organization. “Immunization Coverage.” WHO.int, 2022. ↩
- Arias, Elizabeth. “United States Life Tables, 2000.” National Vital Statistics Reports 51, no. 3 (2002), Centers for Disease Control and Prevention. “Infant Mortality in the United States.” CDC.gov, 2020. ↩
- Hotez, Peter J. Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science. Baltimore: Johns Hopkins University Press, 2021. ↩
- World Health Organization. “Polio Eradication Initiative: Global Update.” WHO.int, 2022. ↩
- Roser, Max, and Esteban Ortiz-Ospina. “Child Mortality.” Our World in Data, 2017; Roser, Max. “Life Expectancy.” Our World in Data, 2019; Boylston, Arthur. “The Origins of Inoculation.” Journal of the Royal Society of Medicine 105, no. 7 (2012): 309–313. ↩
- Humphries, Mark Osborne. The Last Plague: Spanish Influenza and the Politics of Public Health in Canada. Toronto: University of Toronto Press, 2013. ↩
- Proctor, Robert. Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition. Berkeley: University of California Press, 2011. ↩
- U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA). “History of Seat Belt Legislation.” Washington, D.C., 1984. ↩
- Reagan, Ronald. “Inaugural Address.” Washington, D.C., January 20, 1981. ↩
- Pew Research Center. “Public Opinion on COVID-19 Vaccines.” PewResearch.org, 2021. ↩
- Haberman, Maggie. “Fauci Details Death Threats.” New York Times, June 2021; Gumbrecht, Jamie. “Vaccine Scientist Targeted by Misinformation Campaigns.” CNN, 2022. ↩
- Tyson, Neil deGrasse. Astrophysics for People in a Hurry. New York: W. W. Norton, 2017. ↩
- Chappelle, Dave. The Closer. Stand-up special. Netflix, 2021. ↩
- “Pandemics and Denialism: A Timeline.” Skeptical Inquirer, Committee for Skeptical Inquiry (CSI Journal), 2021. ↩
