How To Perform Open Heart Surgery (and recommendations for better thinking)

By David Metcalfe

July 5, 2018

Cardiology Is So Simple!

Doctors think they know so much just because they have “proper training” and “experience”. And yet, with all this supposed “knowledge”, more than 90% of open-heart surgeries are complete failures that result in the death of the patient. So, I did my own research, and figured out how you are supposed to do open heart surgery.

First, you need to wash your hands. A lot of cardiologists forget to do this. Second, you need to give the patient some anaesthetic. Then you grab a scalpel and cut a line through the skin kind of where the heart is. You’ll see a giant red thing pumping; that’s the heart.

If we’re doing a coronary bypass, you will need to find the artery that isn’t doing as well as the others. Just watch how much blood is flowing from each and whichever is the least is probably the clogged one. Once you’ve found the clogged one, find where it’s clogged and grab a straw to stab into it just above it. Then below the clog, stab the other end of the straw in. The blood should now be flowing through the straw and thus avoiding the clog.

If we’re doing a transplant, just cut out every where around where the heart is attached, and remove the heart. Put it onto a hygienic surface. Then grab the new heart from the bag, put it in the right configuration, and attach all the arteries into the right places.

After you’ve successfully saved this person’s life, don’t celebrate too quickly. You can’t leave them with their heart exposed. You need to close up the skin, and stitch it back together. Now it’s time to celebrate.

Why Don’t Cardiologists Get It?

The fact that cardiologists mess up such a simple operation so often is astounding. There are only two possibilities: 1) Cardiologists are incompetent, or 2) Cardiologists are malevolent.

Incompetence Theory: Cardiologists have somewhere around 14 years of education: 4 years of undergrad, 4 years of medical school, and 6 years of residency. So, you might ask how they could still be incompetent. Well, this is because the entire 14 years spent “studying” is a total waste of time. They don’t actually learn anything. In their first four years, they do all kinds of courses in random things that have nothing to do with cardiology, like physics, chemistry, and English. Then in medical school, they learn a bunch of anatomy and physiology. But that’s useless, because all you need to know is that the heart is on the left side of the chest (anatomy) and that it pumps blood (physiology). You might need to know a bit about arteries, but that takes four minutes to learn, not four years.

The residency is useless because you are being taught by a cardiologist who is incompetent. They are simply passing the incompetence down the line with each new student. Why would you ever learn from someone who fails 90% of the time?

So, we can see that the entire education system is severely flawed, but the cardiologists themselves mean well. They are merely victims of a misguided system.

Malevolence Theory: Someone wants open heart surgeries to fail, because it is advantageous to them in some way. It might gain them profit, be part of a master eugenics plan, or be simply out of pure evil. All of the cardiologists are either in on it, or are being tricked into it.

Who Wants To Get Surgery From Me?

Let me ask you: are you convinced that I’m better than a licensed cardiologist at performing open heart surgery?

Obviously not! That would be totally absurd to think that. I’m no advocate of social Darwinism, but if you read that and honestly thought that I am more capable of open heart surgery than a licensed cardiologist, I think natural selection may have to take its course there.

But what I want to ask you is why. Why weren’t you convinced by what I said? Hopefully, you realized that every sentence is stupid, but I left some extremely obvious indicators of absurdity in it. Here are the most notable ones:

“more than 90% of open heart surgeries are complete failures that result in the death of the patient.”

It’s just factually untrue. Anytime there is a statistic, it needs to have a source. If it does have a source, that source needs to be checked before the statistic is accepted. A quick fact check is useful. If I google search “success rates of open heart surgery”, I can see right away that a New York Times article suggests that open heart surgery is 90% successful, which is the complete opposite of what I said (NYT, 2008). Even though the New York Times is a high-quality source, I still should compare it to other sources. We find that Healthline and Medical News Today suggest that the survival rates may be even higher. But these are all secondary sources (reports from a study), so we need to find a primary source (the actual study). The fifth option down is an article from the US National Library of Medicine that was published by a group of researchers from the University of West Virginia. Just by reading the abstract, we can see that the five-year survival rate for open heart surgery patients over 70 was 85% (Khan, et al, 2000). Accounting for the number of people under 70 who get open heart surgery, we can see that the original estimate of 90% is probably accurate.

“First you need to wash your hands. A lot of cardiologists forget to do this.”

Umm..what? To think that cardiologists forget to wash their hands is just stupid. And to say that without any evidence whatsoever…good lord.

The rest of my instructions are terribly oversimplified. Can I really just grab a straw and stab it into the artery above the clog? You don’t think I’m, perhaps, failing to account for some complicating variables? Or to think that I can just cut out the heart like a piece of cake. Like, don’t you think there might be a little more to that?

For the section “Why Don’t Cardiologists Get It?”, I really am being logical. If I’ve assumed that I have absolute, objectively correct knowledge to perform open heart surgery and that all the experts are wrong, I am forced to choose between thinking them stupid or evil. This now becomes a conspiracy theory. I’m forced to believe that the whole system is flawed, and I’m the only one who found out.

And you can’t argue “facts” with me, because I can just dismiss everything as “fake news” paid for by the cardiologists. So, that New York Times report, the reports from Healthline and Medical News Today, and the study from the University of West Virginia are all lies; part of the corrupt system. This leads to the necessary expansion of the conspiracy theory, and the formation of dogma. Anything that agrees with my presupposition is accepted, and anything that disagrees with it is rejected.

How To Form a Stupid Opinion

You might say, “well, David, no one is actually stupid enough to believe that the field of cardiology is all a big scam.” And you’re mostly right. There does not exist a strong movement of people who are against cardiology, although there are a few oddballs here and there (as with anything). Cardiology has clear and direct enough results that there is not much potential for crazy theories to develop. The less direct the results of a certain thing, the more grey area there is, and thus the more opportunity for alternative theories to develop.

For example, everyone agrees that gravity causes objects to fall down towards the earth. If you don’t believe it, someone can just let go of a pen and watch it fall to the floor. That debate is solved very easily due to the very direct results.

The existence of God, however, cannot be solved nor dismissed easily at all. If two people disagree, there is no way to get a direct result. Perhaps you could try it “Elijah style” by asking God to perform a certain task to prove his existence. However, many believers of God do not believe that God works that way, but rather as some kind of intangible force that flows through the universe. It’s very ambiguous, and there is tons of grey area. That debate is not solved easily at all, because there is no possibility of a direct result.

Those are both fine occurrences, but the problem lies where there is not a direct result that can be personally seen, but can be directly seen by others through certain means, most notably, through advanced knowledge and experience. This results in a discrepancy between experts and layman.

In modern America, this is seen in a variety of movements such as: anti-vaxxers, climate change deniers, flat earthers, young earthers, pure capitalists/socialists, and a variety of different types of anarchists. All of them display a contradiction between experts and certain layman who think they know better. All of these stupid opinions follow the same three steps:

1) Make an unevidenced assumption

2) Assume you know better than everyone

3) Conclude the experts are incompetent or malevolent

Allow me to explain how this works in the case of anti-vaxxers:

1) Make the assumption that vaccinations cause autism due to an interpretation of one study.

2) Assume that you now know better than the entirety of modern healthcare.

3) Conclude that the healthcare system must be either totally ignorant of the link between vaccinations and autism, or that the healthcare system must be purposely giving children autism due to evil intent or some kind of monetary gain.

How Can We Create Smarter Opinions?

Stop The Stupid Early On

Stupid opinions are like a cancerous growth; the earlier it is removed, the better. Opinions form our worldview, and get deeply embedded over time. Eventually, they become a part of who we are.

An opinion like being against climate change may start small. Someone may say, “I haven’t noticed things getting warmer.” But then they hear some scientist on the news say that we need to reduce our carbon emissions and start more recycling programs. They get mad that some scientist is telling them what to do, and become more adamant in their opinion. They may go online to find support for their belief, and in today’s world of free-for-all journalism, they will find some. There will be some crazy website about how climate change is a scam that scientists are pulling so they can destroy our economy. Over time, this person may come to identify more and more strongly as being a climate change denier, and even get hostile at anyone who disagrees with them.

If we had been able to stop it early, we would have been dealing with someone who casually hasn’t noticed the earth getting warmer. We could simply explain that global warming is very subtle yet very powerful, and that the small, mass changes are causing major damage on a large scale, although it may not currently be directly noticeable. Since their belief was very weak and not well formed, they will easily be conformed to the expert’s opinion.

However, if we leave it to the end, it becomes very difficult. We are then dealing with someone who has huge amounts of misinformation, and has a very strong belief. They will think they have responses for the expert’s arguments. For example, you may say, “The entirety of the United Nations believes that global warming is a real threat, and they have based their opinions on a global consensus of the world’s leading scientists.” To which they will reply with something like, “they are all being tricked. They just want to hurt America’s economy by wrecking our industry.” The scary thing is, they may even have a bunch of statistics and quotes from biased sources that are completely false. There is almost no arguing them at that point, because they have become so biased that there is no chance that you can reason them out of it. They have embraced dogmatism.

Time To Get Smart

There are 3 things to consider when forming any opinion in order to make it an intelligent one:

1) An Appreciation of Complexity

-understand that big issues are extremely complex, and cannot be solved easily

2) Humility and Recognizing Expertise

-be willing to admit that you do not know all that much in comparison to people who have studied it all their lives, and learn to understand what it takes to be an expert, and how to find the people who are

3) Be Open Minded and Reasonable

-even if you have an opinion on something, be open to the idea that you may be wrong, and are willing to change your opinion at any time if new evidence is presented

Let’s form an intelligent opinion about economic theory as an example:

1) There are many different views on what makes for a better economy. Adam Smith thought it was capitalism, Karl Marx thought it was communism. Many countries in the world have some kind of combination in order to stimulate economic growth while maintaining basic welfare for its citizens. We can see that pure capitalism caused the 1929 stock market crash, and thus needed to be regulated to allow for a less severe boom and bust cycle. Franklin Roosevelt’s “New Deal” showed us the beneficial role of government intervention. China’s economy failed to promote economic growth with communism, and allowing capitalism into it has resulted in huge growth and much better welfare for its citizens. Currently, all first world countries have some type of mixed economy, known as a free market welfare state.

2) There are much smarter people than I who study this sort of thing, and I am interested to hear what they say. Jeffrey Sachs is the main economic advisor for the United Nations, has overseen the successful economic development of many countries, is a professor at Columbia University, and has written multiple best-selling books. He believes in a free market economy that provides basic life necessities and public services to all citizens through a progressive tax. His biggest critic is William Easterly, a professor at New York University, who is also held in high standing and has done major work in overseeing the development of third world countries. He also believes in a free market welfare state. In fact, all modern economists nearly unanimously agree on that. What is being argued is not socialism or capitalism (that’s already been figured out) but rather the exact way to go about it.

3) I’m pretty sure that a mixed economy of a free market welfare state makes the most sense. However, it may not be, and if there is significant evidence somewhere that shows that not to be the case, I will examine it thoughtfully and consider changing my opinion to whatever is the most reasonable.

Congratulations! Although you are not necessarily an economics expert, you have now formed an intelligent opinion about it. You realized it was complex, sought out proper experts, and finished by keeping an open mind.

This can be applied to any of the other issues I mentioned.

Conclusion

Forming a stupid opinion goes like this:

1) Make an unevidenced assumption

2) Assume you know better than everyone

3) Conclude the experts are incompetent or malevolent

Forming an intelligent opinion goes like this:

1) Appreciate Complexity

2) Be Humble and Recognize Expertise

3) Be Open Minded and Reasonable

If everyone did this, we could finally stop arguing things that have already been solved, and move on to more important things. The fact that huge portions of the American population refuse to vaccinate their children (9%) (Blake, 2015), won’t take steps toward reducing climate change (31%) (Wike, 2018), and don’t understand the importance of a socially democratic free market welfare state is simply holding us back as a nation and as citizens of the world.

Believing that the earth is flat or arrived as is 6000 years ago is an insult to the brilliant work of thousands of scientists who are actual experts in their field, and have contributed great research. Undermining them because of your bias is stupid.

There are certain things that science can’t solve, like the existence of God or finding the love of your life. Those are meaningful, personal quests that each one of us can work towards. Perhaps, if you go into a certain discipline, you can work on solving a certain subject area that can be very meaningful to yourself and those around you. But when it comes to forming an opinion when you’re not an expert, it’s not up for you to decide. The experts know best, and we need to trust them. If you really think that some random person can just form an opinion independent of the experts, I am happy to try my best at performing open heart surgery on you.

References

Blake, A. (2015). Here’s how many Americans are actually anti-vaxxers. The Washington Post. Retrieved from https://www.washingtonpost.com/news/the-fix/wp/2015/02/09/heres-how-many-americans-are-actually-anti-vaxxers/?noredirect=on&utm_term=.fd3d647a8f44

Khan, J., Magnetti, S., Davis, E., Zhand, J. (2000). Later outcomes of open heart surgery in patients 70 years or older. The Annals of Thoracic Surgery. 69(1). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10654507

NYT. (2008). Good Survival Rates Found in Heart Surgery for Aged. The New York Times. Retrieved from https://www.nytimes.com/2008/11/11/health/research/11heart.html

Wike, R. (2018). What the world thinks about climate change in 7 charts. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2016/04/18/what-the-world-thinks-about-climate-change-in-7-charts/