It is no small thing to realize that one’s trust in doctors has been shaken. In addition to putting one’s health at risk, at least in the long term, such a recognition has the potential to shatter one’s self-conception as an Enlightenment-oriented rationalist. Granola-munchers and witches may glance with suspicion at the contemporary medical establishment, but white-collar professionals do so at their acute psychological peril. While my own journey to skepticism and mistrust has been reluctant, it is, I think, representative of that taken by a great number of conservatives. We would like to believe in an ordered world of disinterested therapeutic recommendations, but the behavior of physicians as a class has rendered that conviction well-nigh impossible.

Perhaps I ought to begin by stating that I and others of like mind obviously do continue to trust doctors when the question at hand is discrete, fundamental, and unideological — a category that used to include much more than it does today. If a medical professional tells me that I have cancer, I am likely to believe him. The same is true if a surgeon wishes to set my child’s broken bone or repair a loved one’s artery. What I cannot trust is that any particular physician will speak honestly if the issue of the moment resides at the ever-expanding meeting place of medicine and culture. There, a doctor who is also a friend might whisper the truth sotto voce, but an M.D. chosen at random from the local practice’s website is almost certain to project an institutional viewpoint that is monolithic, totalizing, and false.