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An Interview with Sebastian Simpson: The Satanic Temple of West Florida

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: June 15, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,298

ISSN 2369-6885

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Sebastian Simpson on far left.

Abstract

An interview with An Interview with Sebastian Simpson. He discusses: family background in Satanism; best argument for Satanism; tasks and responsibilities in The Satanic Temple of West Florida; After School Satan; Aleister Crowley, Timothy Leary, Anton LaVey, and others, and core values; the seven core tenets for protection from theocracy; perennial threats to Satanists in West Florida and America; protections from those threats; coming together to protect Satanists from bad law, from bullying of some religious individuals or communities, from mainstream and dominant religious encroachment and imposition, and so on; becoming involved and donating to The Satanic Temple of West Florida; and final feelings and thoughts.

Keywords: Sebastian Simpson, The Satanic Temple, West Florida.

An Interview with Sebastian Simpson: The Satanic Temple of West Florida[1],[2]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: Was there a family background in Satanism? What were some pivotal moments for becoming one, for you?

Sebastian Simpson: I have no family background in Satanism. My interest in Satanism goes back to the so-called “Satanic Panic” of the 1980’s and 1990’s. I was just a kid back then, but I distinctly recall seeing, for example, Geraldo Rivera’s endeavouring to “expose devil-worship.” The fear in my community was palpable. Initially I, too, was afraid that there was this invisible evil lurking in the music I was listening to and the literature I was reading (admittedly the perceived danger was also part of the appeal); however, that initial fear ebbed and transformed into genuine curiosity about Satanism and an affinity for this benign aesthetic that nevertheless had incredible rhetorical power. The realization that the Satanic conspiracy stories I was seeing in the news were nonsense also ignited a rebellious flame in my young mind, for I could see the baselessness and injustice of the witch hunts. At that point, however, my affinity for Satanism was purely aesthetic. Mostly due to the limited availability of Satanic literature such as The Satanic Bible to a youngster growing up in the American Midwest prior to the internet, it wouldn’t be until later, in my mid to late teens, that I recognized the intellectual aspects of Satanism.

2. Jacobsen: What seems like the best argument for Satanism to you? Now, what makes this philosophical and ethical worldview self-evident to you?

Simpson: Speaking only for myself, one aspect of modern Satanism that I found to be compelling, at least as I encountered it, is that it does not share with many other mainstream religions this idea of conversion. You’d be hard-pressed to find individuals who identify with mainstream Satanic organizations who also have an interest in convincing others to adopt Satanism per se. Certainly this is true with The Satanic Temple. A necessary component of what it is to be a Satanist is to identify as such. Satanism’s emphasis on individuality is patently at odds with the idea of convincing someone to identify in a certain way; I would never deign to convince someone to adopt an identity. That said, the ethic underlying the Seven Tenets of The Satanic Temple certainly isn’t self-evident and ought to be rationally defensible.

3. Jacobsen: What tasks and responsibilities come with work in The Satanic Temple of West Florida?

Simpson: I maintain an open line of communication with the National organization. Managing our social media presence, including responding to every message we receive via Facebook and our website it a huge commitment. Along with others in the Chapter, I coordinate social events such as Chapter picnics, public meetings so that interested individuals in the community can meet with us and see what we’re about, and campaigns such as our recent “Socks for Satan” campaign through which we collected over 500 pairs of new socks for Pensacola’s homeless population.

4. Jacobsen: One of the more delightful provisions for kids, or adolescents, is the After School Satan program, which broadens the landscape of programs for kids or adolescents. It seems needed now. How can parents, or students, contact The Satanic Temple of West Florida and set one up?

Simpson: The Satanic Temple is currently working towards establishing a volunteer based program for non-TST affiliates in time for the next operating school year. For more information, please email info@thesatanictemple.com with the subject line “After School Satan Clubs Inquiry.”

5. Jacobsen: Some of the more common names in the Satanist community might be Aleister Crowley, Timothy Leary, Anton LaVey, and others. LaVey wrote The Satanic Bible in 1969. It is a growing and changing Temple. Its core values are “compassion, justice, reason, free will, personal sovereignty, and science.” How do these values play out in the life of a Satanist and their worship? How do these differ from traditional religious institutions or worship structures? Why these principles above others?

Simpson: First I should mention that while LaVey’s contributions are certainly part of our intellectual heritage, we have no official affiliation with The Church of Satan. We are a distinct organization. Indeed, our core principles and their emphasis on compassion, science, and reason are in tension with The Church of Satan’s emphasis on selfishness/egoism, social Darwinism, and supernaturalism in so far as it plays a role in ritual magic. To the substance of your question: worship has no role to play in The Satanic Temple. Being a nontheistic organization, we worship no supernatural entities. The way the values you mention play out in the life of a Satanist are exactly as one would expect and would be as varied as the individuals who embrace those values. For example, there are many ways to be compassionate. As champions of reason, we seek to expose the rotten core and deleterious effects of superstition and baseless conspiracy theories. This is evident in the work of TST’s Grey Faction, part of whose mission is to expose therapists and psychiatrists who, in their professional practice, propagate the myth of organized, institutional Satanic ritual abuse and employ such discredited and pseudoscientific techniques as facilitated communication and recovered memory therapy to “discover” repressed memories of Satanic ritual abuse. See greyfaction.org for more information.

6. Jacobsen: The Temple has seven core tenets:

  1. One should strive to act with compassion and empathy towards all creatures in accordance with reason.
  2. The struggle for justice is an ongoing and necessary pursuit that should prevail over laws and institutions.
  3. One’s body is inviolable, subject to one’s own will alone.
  4. The freedoms of others should be respected, including the freedom to offend. To willfully and unjustly encroach upon the freedoms of another is to forgo your own.
  5. Beliefs should conform to our best scientific understanding of the world. We should take care never to distort scientific facts to fit our beliefs.
  6. People are fallible. If we make a mistake, we should do our best to rectify it and resolve any harm that may have been caused.
  7. Every tenet is a guiding principle designed to inspire nobility in action and thought. The spirit of compassion, wisdom, and justice should always prevail over the written or spoken word.

Why these tenets? How can these protect society from theocracy, and continue the separation of church and state as well as respect the individual in a nation?

Simpson: Theocracy is inimical to reason. By their nature, theocracies shut down free inquiry and privilege dogma over rational inquiry. So long as beliefs conform to reason and are informed by our best science, there will be a formidable opponent to theocracy. Indeed, our very Constitution has protections against theocracy in the First Amendment, which prohibits the establishment of a state religion and ensures the free exercise of religion. We have been vocal proponents of the right to free and legal exercise of religion. This right accords to Satanists as well.

7. Jacobsen: What are some perennial threats to Satanists in West Florida and America?

Simpson: It is obvious that a large contingent of Christians in Pensacola/West Florida would like to silence us. This is evident from the fiasco that ensued when we were granted the opportunity and privilege to deliver a Satanic invocation at a meeting of the Pensacola City Council. Christians showed up in droves to protest and spoke over David Suhor as he delivered his invocation. A week before this event, the City Council held an “emergency meeting” to consider the possibility of instituting a moment of silence in lieu of an invocation; we would have been happy with that result since we believe that government should stay out of the religion business. However, despite the fears of Pensacolans that we would be bringing a curse to the city, the public as well as several council members, made it clear that an inclusive moment of silence was not acceptable. Consequently, we delivered our invocation the following week amid an angry horde. In West Florida, and Pensacola in particular, we are engaged in a constant struggle to keep the municipal bodies in line with the law by not discriminating against religious minorities or pandering to the religious majority by granting them special privileges. Several local government bodies hold prayers and discriminate against religious minorities by ignoring their requests to deliver invocations, ourselves included.

8. Jacobsen: What are some protections from those threats?

Simpson: The best protection against the steady efforts to impose religion into the public sphere is for secularists and religious minorities of all sorts to take a stand and resist complacency. Be visible and vocal. Elected officials do not represent only the religious majority.

9. Jacobsen: How can the Satanist and associated communities come together and protect their beliefs from bad law, from bullying of some religious individuals or communities, from mainstream and dominant religious encroachment and imposition, and so on?

Simpson: Speaking from personal experience, I reach out to other secular groups and foster good relations. Satanism isn’t for everyone, but that doesn’t mean that we can’t unite for shared causes. Be in touch with organizations known to legally represent the interests of religious minorities such as the American Civil Liberties Union or the Freedom From Religion Foundation. Document cases of religious discrimination and report them. In secular societies there are laws that exist precisely to protect minorities from the tyranny of the majority; we must insist that these laws be enforced and upheld. Be aware also of bills intended to expand the reach of religious organization; we see a lot of this in the US, especially Florida very recently. This requires that one be aware of bills that may be coming before legislative bodies. Productive and peaceful civic engagement and building healthy communities—that is my advice.

10. Jacobsen: To become acquainted or involved with The Satanic Temple of West Florida, you have website, linked before, and a Facebook page. How can people support, even donate to, The Satanic Temple of West Florida?

Simpson: W do run campaigns and individuals can visit our Facebook to discover ways to contribute. For example, we set up a gift registry online for our Socks for Satan campaign. Apart from that, sharing the information we disseminate via social media is a great help in getting the message our concerning TST campaigns such as our Religious Reproductive Rights campaign and our monument campaigns in Arkansas and Minnesota.

11. Jacobsen: Any thoughts or feelings in conclusion?

Simpson: Thank you for giving me the opportunity to speak with you. Ave Satanas.

12. Jacobsen: Thank you for your time, Sebastian.

References

Anderson, J. (2016, July 14). VIDEO | Satanic prayer disrupted at council meeting. Retrieved from

http://weartv.com/news/local/satanic-prayer-at-council-meeting-disrupted-by-crowd.

Barnett, C. (2016, July 6). WILL FLORIDA CITY COUNCIL ALLOW SATANIC INVOCATION?. Retrieved from http://www.worldreligionnews.com/issues/will-florida-city-council-allow-satanic-invocation.

Blake, A. (2016, July 15). Satanic prayer opens Pensacola city council meeting; police forced to remove protesters. Retrieved from http://www.washingtontimes.com/news/2016/jul/15/satanic-prayer-opens-pensacola-city-council-meetin/.

Bowerman, M. (2016, August 1). ‘Educatin’ with Satan’: Satanic Temple pushing after school clubs. Retrieved from https://www.usatoday.com/story/news/nation-now/2016/08/01/education-after-school-with-satan-santanic-temple-elementary-school-good-news-christian-clubs/87904884/.

Bugbee, S. (2013, July 30). Unmasking Lucien Greaves, the Leader of the Satanic Temple. Retrieved from https://www.vice.com/en_ca/article/4w7adn/unmasking-lucien-greaves-aka-doug-mesner-leader-of-the-satanic-temple.

Dunwoody, D. (2016, July 14). City Council Invocation Sparks Anger, Preaching. Retrieved from http://wuwf.org/post/city-council-invocation-sparks-anger-preaching.

Gibson, D. (2016, July 1). Florida city council may halt opening prayers to stop Satanist’s invocation. Retrieved from http://religionnews.com/2016/07/01/florida-city-council-may-halt-opening-prayers-to-stop-satanists-invocation/.

Holly, P. (2016, July 20). Why a Satanic Temple member wants to perform rituals before a city council in the Bible Belt. Retrieved from https://www.washingtonpost.com/news/acts-of-faith/wp/2016/07/20/why-a-satanic-temple-member-wants-to-perform-rituals-before-a-city-council-in-the-bible-belt/?utm_term=.3e75771a4c7d.

Kuruvilla, C. (2014, December 10). Satanic Temple Wins Battle To Bring Lucifer Display Inside Florida State Capitol. Retrieved from http://www.huffingtonpost.ca/entry/satanic-temple-florida-capitol_n_6277082.

Minogue, H. (2016, July 7). The Satanic Temple Of West Florida Will Deliver Invocation. Retrieved from http://wkrg.com/2016/07/07/the-satanic-temple-of-west-florida-will-deliver-invocation/.

Moon, T. (2017, March 19). Pensacola Satanists aren’t all pitchforks and red tails. Retrieved from http://www.pnj.com/story/news/2017/03/19/pensacola-satanists-atheists-secularism/99300312/.

Mortimer, C. (2017, March 20). Satanist church holds drive to collect socks for the homeless. Retrieved from http://www.independent.co.uk/news/world/americas/satanist-church-pensacola-west-florida-holds-drive-socks-homeless-collect-charity-pagan-a7639881.html.

Naftule, A. (2017, May 3). The Satanic Temple on Menstruatin’ With Satan And Messin’ With Texas. Retrieved from https://phxsux.com/2017/05/03/the-satanic-temple-on-menstruatin-with-satan-and-messin-with-texas/.

News Service of Florida. (2014, December 4). Satanic Temple approved for display in Florida’s Capitol. Retrieved from http://www.tampabay.com/news/politics/stateroundup/satanic-temple-approved-for-display-in-floridas-capitol/2208943.

(2016, July 20). A Satanic Temple Member Gave the Prayer Before a City Council Meeting in Florida. Retrieved from https://relevantmagazine.com/slices/satanic-temple-member-gave-prayer-city-council-meeting-florida. Sullivan, E. (2013, July 22). Happytown: Satanic Temple to rally in Florida. Retrieved from http://www.orlandoweekly.com/orlando/happytown-satanic-temple-to-rally-in-florida/Content?oid=2245633.

The Satanic Temple. (2017). The Satanic Temple. Retrieved from https://thesatanictemple.com/.

The Satanic Temple of West Florida. (2017). The Satanic Temple of West Florida. Retrieved from http://thesatanictemplewestflorida.com/.

 

Appendix I: Footnotes

[1] Professor, Psychological and Brain Sciences, University of California, Santa Barbara; Director, The Center for Mindfulness and Human Potential.

[2] Individual Publication Date: June 15, 2017 at http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Sebastian Simpson: The Satanic Temple of West Florida [Online].June 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, June 22). An Interview with Sebastian Simpson: The Satanic Temple of West FloridaRetrieved from http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Sebastian Simpson: The Satanic Temple of West Florida. In-Sight: Independent Interview-Based Journal. 14.A, June. 2017. <http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Sebastian Simpson: The Satanic Temple of West Florida.” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Sebastian Simpson: The Satanic Temple of West Florida.” In-Sight: Independent Interview-Based Journal. 14.A (June 2017). http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida.

Harvard: Jacobsen, S. 2017, ‘An Interview with Sebastian Simpson: The Satanic Temple of West FloridaIn-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Sebastian Simpson: The Satanic Temple of West FloridaIn-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Sebastian Simpson: The Satanic Temple of West Florida.” In-Sight: Independent Interview-Based Journal 14.A (2017):June. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida>.

Vancouver/ICMJE: Jacobsen S. An Interview with Sebastian Simpson: The Satanic Temple of West Florida [Internet]. (2017, June; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-sebastian-simpson-the-satanic-temple-of-west-florida.

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An Interview with Minister Amanda Poppei

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: June 8, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,618

ISSN 2369-6885

amanda headshot

Abstract

An interview with Minister Amanda Poppei. She discusses: family background; professional and theological qualifications; pivotal moments and the ‘calling’; best argument for ethical culture; main reasons for people becoming involved in ethical culture and the Unitarian Universalist community; tasks and responsibilities; demographics of the Washington Ethical Society; pastoral care; differences with traditional definitions; awards and The Tip of the Iceberg; fulfillment from recognition; extra responsibility with the recognition; importance of connecting youths; main threat to ethical culture; common problems in the community and perennial threats; and becoming involved or donating to the American Ethical Union or the Washington Ethical Society.

Keywords: Amanda Poppei, ethical society, minister, Unitarian Universalist.

An Interview with Minister Amanda Poppei: Senior Leader & Unitarian Universalist Minister, Washington Ethical Society (Ethical Culture and Unitarian Universalist)

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

 

1. Scott Douglas Jacobsen: Let’s delve into your own family background. What is it – geography, culture, language, and religious/irreligious beliefs, principles and values?

Minister Amanda Poppei: I was raised in upstate New York, in a white family grounded in academia–my mother was a college professor, and my father had been studying for his PhD in Biology before leaving to make furniture. He worked out of a barn in our backyard, crafting beautiful pieces–really an artist. In my earliest years I didn’t attend any congregation, but in 4th grade I went on a sleepover to a friend’s house and attended church with her the next day. I came home and promptly announced that I wanted to go to that church! My mother was a little worried–we were a humanist family–but quickly relieved to discover it was Unitarian Universalist congregation. She had actually been raised UU, just hadn’t gotten around to taking me to Sunday School. I attended religiously (ha!) through middle and high school, participating in their Coming of Age program in 8th grade. It was during that year that I first articulated a desire to become clergy myself one day.

My family raised me with a strong sense of social justice; my mother in particular followed in her own mother’s footsteps, building her life around making the world a better place. I knew I was raised with a lot of privilege (white, formally educated) and that part of the rent I needed to pay in the world was making sure that others had similar opportunities. My mother took me to Washington, DC for my first national march when I was in 3rd grade, supporting the Equal Rights Amendment. For his part, my father instilled a curiosity about how the world works, from the planets to the atoms, and a love of the outdoors. Both my parents raised me to challenge racism, misogyny, and homophobia. I feel incredibly lucky to have been raised with those values and to have the opportunity now to live them out in my work and home life.

2. Jacobsen: You have many qualifications. Some selected ones include senior leader of the Washington Ethical Society since 2008 connected to formal qualifications including a Masters of divinity from Wesley Theological Seminary in Washington, District of Columbia and a bachelor of arts in religious studies from Yale University. All three relevant to the discussion today.

Most citizens in the US probably don’t know what ethical culture and Unitarian Universalists are, I think. So what might be a good educational campaign for ethical culture adherents and Unitarian Universalists to pursue in the US?

Poppei: I’m sure that’s true! Ethical Culture is a very small movement–just 24 congregations across the country–and although Unitarian Universalism is much larger–over 1,000 congregations–that’s still small in the overall American religious landscape. In many ways, I think the justice work we do is the best advertisement for both movements. We have always had an influence in the world that’s larger than our size, as we have fought for equal rights, fairness, kindness, and mercy. UUs and Ethical Culturists show up at rallies, marches, organizing meetings, and town halls all across the country. Although we may have different beliefs (Unitarian Universalist is a pluralistic religious movement, and Ethical Culture welcomes people of all beliefs), we share a strong commitment to justice and a belief that every single person is worthy.

I think we also have a special appeal to families. More and more parents are choosing to raise their children outside of traditional religion–but they are still seeking a grounding in values, and a community to support their family. Both UU congregations and Ethical Societies offer that. Our education for children is based on encouraging questions and exploration, and creating a safe and nurturing space for children to spread their wings. We incorporate study of world religions, comprehensive sexuality education, and ethics education into almost every age group. And we mark the passages of the year, through celebrations like Winter Festival and Spring Festival, and the passages of life, through baby namings, weddings, and memorial services.

3. Jacobsen: So with the family background described and the academic qualifications listed, what pivotal moments, and subsequent momentum, lead to these important stages in life within the ethical culture and Unitarian Universalist movements? When did ministerial/chaplaincy/pastoral work become a ‘calling’ for you?

Poppei: 8th grade! I was on a Coming of Age trip to Boston with my Unitarian Universalist congregation, and had been visiting some of the sites around the city where famous Unitarians and Universalists had lived and wrote and worked. We went to visit the headquarters of the Unitarian Universalist Association, and as I stood in the bookstore and looked around at the titles I suddenly thought: I want to spend my life thinking about these things!

As time went on, I continued to think about ministry. In high school, I would have said that congregations seemed like the best way to organize people to do good in the world (and I still think that). In college, I was a Religious Studies major and began to learn more about the role of religion in American life. And then of course in seminary–which I entered a few years after graduating college–I deepened my understanding of the values, theology, and philosophy that ground my life’s work.

4. Jacobsen: What is the best argument for ethical culture or for Unitarian Universalism that you have ever come across?

Poppei: We are not alone in the world–we are connected to each other. We need to practice what it means to be human together, to be in relationship as a way of supporting our own growth and as a way of working for justice in the world. Both Unitarian Universalism and Ethical Culture remind us of these core truths, and give us a place to practice, learn, and transform.

5. Jacobsen: What seems like the main reason for individuals becoming a member of the ethical culture and Unitarian Universalist community? For example, arguments from logic and philosophy, evidence from mainstream science, or experience within traditional religious structures, even simply a touching personal experience.

Poppei: I think it’s a bit of all of those things. Most people that come to the Washington Ethical Society–the congregation I serve–have done a lot of thinking about what they believe. Whether they were raised in a traditional religion or raised secular, they’ve been thoughtful about their beliefs and worldview. Almost all of them share an essentially naturalistic worldview, and a sense that they want to be grounded in the here-and-now. What they’re looking for when they come to us is a community in which they can live out those values, where they can have the benefits of a congregation but without dogma that no longer works for them. They are looking for a place to support their family, or to care for them if they have a crisis, or just to provide a set aside time each week to be thoughtful and introspective. They often choose our community because they like our commitment to justice work. Ultimately, I think they are searching for a sense of belonging and a chance to make a difference in the world.

6. Jacobsen: What tasks and responsibilities come with the senior leadership position?

Poppei: I am responsible for our Sunday morning gatherings–I speak 2-3 times a month, and support guest speakers for the other Sundays. I provide pastoral care, visiting people in the hospital and offering counseling as needed (and I also work with a great group of members who do that work too). I serve as head of staff, and am responsible for managing the day to day operations of the congregation, everything from creating and tracking the budget to overseeing programming–although in all of that work I collaborate with a wonderful staff. And I work with the Board and the entire membership on setting vision and strategy for the congregation. Finally, I work out in the world, outside the walls of the congregation, fighting for what is right. That’s very often done in coalition, with interfaith groups or with secular groups.

7. Jacobsen: What are some of the demographics of the Washington Ethical Society? (Age, sex, political affiliation, and so on)

Poppei: We are a majority white, generationally diverse membership. We have slightly more women than men. Most WES members are progressive, ranging from pretty liberal to quite radical! We have Millennials, Gen X-ers, Boomers, and Silent Generation, plus of course children and teens who are the newest generational cohort. The number of people of color in our community is small but growing. Most (but not all) WES members have a college degree, and many have a Masters or other advanced degree. They work in many different fields, but the helping professions (teaching, social work, etc) and public service and nonprofit work are highly represented.

8. Jacobsen: What is pastoral care within an ethical culture/Unitarian Universalist framework?

Poppei: It looks pretty similar to in any community. I work with a team of lay Pastoral Care Associates, members who are specially trained to offer care in times of crisis. We support members in practical ways–like bringing meals and giving rides to the doctor–and we also just visit with people and try to be present to them when they are struggling. I offer pastoral counseling as well, to people who are struggling with hard choices or just having a hard time in life.

9. Jacobsen: How does it differ from traditional definitions, theory and practice? Are there major differences?

Poppei: Of course we don’t believe that the things that happen to people are part of God’s plan, so there’s a difference perhaps in the overall conceptual framework. But the practice of caring for people is really the same no matter what your ideas behind it are–it’s about showing up for people when times are hard and celebrating with them when times are good.

10. Jacobsen: You earned the National Capital Area Big Sister (2007) award from Hermanos y Hermanas Mayores/Big Brothers Big Sisters and the Anti-Racism Sermon Award (2006) from the Joseph Priestly District of the Unitarian Universalist Association for The Tip of the Iceberg. What was the background for the awards? What was the content and purpose of The Tip of the Iceberg?

Poppei: That was a long time ago! I was talking about the differences between overt racism–like using racist slurs–and systemic racism, which is sometimes harder to spot but still incredibly damaging to individuals and to society as a whole.

11. Jacobsen: How fulfilling is this recognition?

Poppei: It was great to be recognized, especially at that time when I was still a seminarian, still training for the ministry.

12. Jacobsen: What extra responsibility to the public comes with the recognition?

Poppei: None. But certainly work on issues of racism continues to be a vital part of my work.

13. Jacobsen: What is the importance of connecting youths to an ethical culture and Unitarian Universalist base for the sense of shared community?

Poppei: Adolescence is a time of incredible transition. Having the support of a community bigger than one’s family can be so important–knowing adults beside your parents who care about you and want to see you thrive. Our LGBTQ teens know that they are supported and welcome in this community, as well. And in general our teens get to connect with others who support their values, who want to make a difference in the world. I am always blown away by their thoughtfulness and passion; we learn a great deal from them.

14. Jacobsen:
What do you consider the main threat to ethical culture and Unitarian Universalism in America? What have been perennial threats to them?

Poppei: I’m not sure I think in terms of threats in this way. Injustice and bigotry are threats to all people, and we work against that. Not sure what this question might mean.

15. Jacobsen:
What are the common problems of community found at Washington Ethical Society?

Poppei: Like any community, we have conflict–that comes from people being in relationship with each other! We are a diverse community, with many backgrounds and beliefs represented, which means we don’t always like the same music or styles of speaking. But that also is part of the richness in our community, and most folks really love the opportunity to learn from each other.

16. Jacobsen: How can people become involved with or donate to the American Ethical Union or the Washington Ethical Society?

Poppei: They can check out our website at www.ethicalsociety.org and click on the “give” button on the top right to donate…or explore the rest of our website to learn about our activities. To find other Ethical Societies, check out http://aeu.org/who-we-are/member-societies/ and to find other Unitarian Universalist congregations, try http://www.uua.org/directory/congregations.

Jacobsen: Thank you for your time, Minister Poppei.

Appendix I: Footnotes

[1] Senior Leader & Unitarian Universalist Minister, Washington Ethical Society (Ethical Culture and Unitarian Universalist).

[2] Individual Publication Date: June 8, 2017 at http://www.in-sightjournal.com/an-interview-with-amanda-poppei; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Minister Amanda Poppei [Online].June 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-amanda-poppei.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, June 8). An Interview with Minister Amanda Poppei. Retrieved from http://www.in-sightjournal.com/an-interview-with-amanda-poppei.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Minister Amanda Poppei. In-Sight: Independent Interview-Based Journal. 14.A, June. 2017. <http://www.in-sightjournal.com/an-interview-with-amanda-poppei>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Minister Amanda Poppei.” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-amanda-poppei.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Minister Amanda Poppei.” In-Sight: Independent Interview-Based Journal. 14.A (June 2017). http://www.in-sightjournal.com/an-interview-with-amanda-poppei.

Harvard: Jacobsen, S. 2017, ‘An Interview with Minister Amanda PoppeiIn-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-amanda-poppei>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Minister Amanda Poppei’In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-amanda-poppei.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Minister Amanda Poppei.” In-Sight: Independent Interview-Based Journal 14.A (2017):June. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-amanda-poppei>.

Vancouver/ICMJE: Jacobsen S. An Interview with Minister Amanda Poppei [Internet]. (2017, June; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-amanda-poppei.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Professor Jonathan Schooler (Part One)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: June 1, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,178

ISSN 2369-6885

Abstract

An interview with Professor Jonathan Schooler. He discusses: family background; influence on development; family involvement in psychology; interests and in particular brain science; and the University of California, Santa Barbara and tasks and responsibilities.

Keywords: brain science, Jonathan Schooler, mindfulness, psychology.

An Interview with Professor Jonathan Schooler: Professor, Psychological and Brain Sciences, University of California, Santa Barbara; Director, The Center for Mindfulness and Human Potential (Part One)[1],[2]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: To preface the conversation, you authored over 200 academic papers. Too much to cover here. Nonetheless, the conversation can develop with the central aspects of the theses. In terms of geography, culture, and language, where does your family background reside?

Professor Jonathan Schooler: My family background is Eastern European, Jewish. My mother’s family is from Poland. My father’s family is from Ukraine. My parents grew up in New York city. I grew up in Washington, D.C.

2. Jacobsen: Following from that, naturally, how did this influence development?

Schooler: Another important thing I should mention. [Laughing] Almost everyone in my family for generations are psychologists. From my grandmother’s perspective, she wasn’t a psychologist, but she was a special education teacher. She had two brothers. One of whom became a psychologist and was a professor at NYU. Then she had two children. Both became psychologists. My father married Nina Schooler. She is also a psychologist. They had two kids, myself and my brother. He was a psychologist.

I am a psychologist. Myriam, my father’s sister, married Ivan, also a psychologist. They had two children. One of whom became a psychologist. The great uncle had a grandson, who got his PhD at the University at Pittsburgh – and I served on his committee – and is also a psychologist. My oldest son is a graduate student at UC Santa Cruz. He also is a psychologist. My daughter is still in college. She is trying to fight her fate, but time will tell. There must be something in the culture that I grew up influenced my career choice. [Laughing]

Jacobsen: [Laughing].

Schooler: Genetics probably as well.

3. Jacobsen: I am stunned by that. That’s great. Leading into your own life with that broad background, with psychology behind and ahead of you, what about pivotal moments and major influences in major points of life up to and including undergraduate studies? 

Schooler: That’s a challenging question. I would say that one of the most important things is a certain kind of attitude that my parents always had with me. It was one of being on an equal playing field in some really fundamental way. It is interesting. I called my parents by their first names rather than mom and dad. In fact, I have my kids call me mom and dad. So, I’m not sure I would necessarily advocate it. It would influence me. That is, we are all on the same playing field and to appreciate that everyone is really there. I think that influenced me in the way that, I hope, I interact with people and ideas.

In the sense of giving them a chance and expecting possibilities from them, and so I feel like that is a big influence on the way that I approach things, it has carried on to this day in the way that I try to respect the differences of perspective that show up in the fields that I am involved in, time and time again. It doesn’t mean that they aren’t reasonable if you don’t see the topic the same way. I have managed to find a middle ground and have discussions with people on both sides of the debate, who often had hard times talking with one another.

So, it came from an experience of respect within my family, also with my kids. Other important things are my kindergarten teacher, Mrs. K. She talked, not like a lot of adults at you, with me. It is the same thing of acknowledging and respecting that someone is there like you on the other side. Then in 6th grade, I had a teacher named Mrs. Gibson who asked us to think about utopia and ask what we wanted in a country to create a country. It showed things in a more abstract way than I thought before.

In senior year, I took a course by a professor named Michael Kersberg at Georgetown University. It was on power. We read all of these books on power and how power influenced them. Another thing that was absolutely one of the most pivotal things, I’d say, is when I was 14 my father gave me a copy of the book by Alan Watts in which he introduced Hindu and Buddhist thought, with the idea that the university is playing hide-and-seek with itself. That there was a certain playfulness to the world, and the yin and yang to the world. A bunch of different perspectives on reality.

Also, Deb Herman, my mentor got me thinking about memory and how memory fits into our everyday experiences, and reflecting on phenomenal experiences and, of course, my graduate mentor, Elizabeth Loftus, who taught me how to challenge and take on the establishment if you have disagreement with it. That is, courage is an important part of science, and then the elegance with which she carried out her research and breaking her problems down into answerable questions. Now, that brings to me to my professional career.

4. Jacobsen: There’s two questions associated a tiny bit before that. You mentioned the family involvement in psychology, one after the other, and the K through college influences, also the particular moments of interest in psychology. What brain science in particular? When did brain science become a specialty interest?

Schooler: I would say that that has been an ever-increasing appreciation, but I didn’t come into it from a brain science perspective. I really came in from a psychology perspective, and what has become increasingly career is looking at the brain can help to inform my interest in any of the basic psychological questions. But I must say, though I have done quite a bit of it myself, it is more challenging than is reported – to extract meaningful, deep, new understandings about psychological processes from brain processes.

There are definitely people who do that, who accomplish that, but when you really look closely at a lot of research. It is not obvious how it actually informs our basic understanding. If informs our understanding of where the basic understanding of the brain, but doesn’t necessarily inform our understanding of the process. I am more interested in the process.

5. Jacobsen: You are a professor at the University of California, Santa Barbara. You teach courses in mindfulness, cognitive psychology, memory, and consciousness. As a primer for all of that, what tasks and responsibilities come with this position?

Schooler: [Laughing] A great many, the most important ones are the hardest to put into words. Obviously, there are a lot of basic responsibilities to do with teaching, supervising students and participating in committees, travel, meeting people, having endless, endless meetings. I have collaborators all over the world. So, I am constantly meeting with people and corresponding with these people and trying to keep track of all of the projects. That does take a large portion of every day, but, really, it is the generation of the ideas and the pursuit of the bigger vision that is a major challenge of my career.

What I try to do as best I can is to delegate and empower and help, and it is really great when it works, with the generation of ideas and the discussion of their execution, and to help others to carry it out, and to be there on the other side of the write-up and the spin, my students ask for Schooler’s spin. My students and postdocs refer to “Schooler’s spin.” many of the titles of my papers, if you peruse them, have a quality to them, and that is not by accident.

6. Jacobsen: In brief, what do the top topics include for students, whether mindfulness, cognitive psychology, or consciousness?

Schooler: Consciousness is one of my favourite themes. It is covered in one of the many classes that I teach. Typically, from a combination of cognitive and social influence, there is a peculiar pecking order in psychology, where fields attend to their higher level. The level that is higher in the hierarchy rather than the lower ones, the ones lower in the pecking order. For example, cognitive psychologists have been paying very close attention to neuroscience. Neuroscientists look at the chemistry, chemists look at physics. I guess, we tend to look less at the field below them.

Neuroscientists tend not to look at the cognitive psychologists. They do now, some, but it doesn’t do the cross-talk as much. In social psychology, in social cognition, they pay a lot of attention to cognitive psychology, but cognitive psychology tended to not pay as much attention to social psychology. I have gained from that. I think there are some low-hanging fruit, where there are some amazing insights in social psychology.

Although, I characterize it as a hierarchy. I think many of the greatest ideas from the mind have come from that field. So, with respect to mindfulness, that has been great fun for me because it allows you to integrate ideas, the really fundamental ideas from different fields such as contemplative studies, and social psychology, cognitive psychology, and neuroscience. All of this contribute to the idea that when people deliberately tend to their experience in a non-judgmental way and make a practice of honing their attention, and sharpening it in the present, that that has really remarkable repercussions throughout their lives in many ways.

That’s an exciting topic. It is very timely. There is an increasing amount of research. it is exciting because it ties together ancient traditions and modern science. it shows there’s great value to perennial wisdom. With respect to cognitive science, I am interested in how we construct reality, our memories, our perceptual systems, all conspire to produce a construction, which corresponds in some general to physical reality – but is a projection of it in our own minds.

I try to illustrate this throughout. We are dealing with projections of reality rather than real reality. With memory, it is very much the same idea. It is the constructive nature of reality. This is really what we are really doing We are creating meaning and narratives from everything around it. Again, it has a correspondence to what happened in the real world. It is dynamic, selective, and hold on to some facts that serve it. It is motivated. We remember things to suit our agendas in some fundamental ways.

Appendix I: Footnotes

[1] Professor, Psychological and Brain Sciences, University of California, Santa Barbara; Director, The Center for Mindfulness and Human Potential.

[2] Individual Publication Date: June 1, 2017 at http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Professor Jonathan Schooler (Part One) [Online].June 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, June 1). An Interview with Professor Jonathan Schooler (Part One)Retrieved from http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Professor Jonathan Schooler (Part One). In-Sight: Independent Interview-Based Journal. 14.A, June. 2017. <http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Professor Jonathan Schooler (Part One).” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Professor Jonathan Schooler (Part One).” In-Sight: Independent Interview-Based Journal. 14.A (June 2017). http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one.

Harvard: Jacobsen, S. 2017, ‘An Interview with Professor Jonathan Schooler (Part One)In-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Professor Jonathan Schooler (Part One)In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Professor Jonathan Schooler (Part One).” In-Sight: Independent Interview-Based Journal 14.A (2017):June. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one>.

Vancouver/ICMJE: Jacobsen S. An Interview with Professor Jonathan Schooler (Part One) [Internet]. (2017, June; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-professor-jonathan-schooler-part-one.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: May 22, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 3,002

ISSN 2369-6885

Gordon Guyatt

Abstract

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC. He discusses: academic scientific organizations, research groups, and laboratories and their importance to the health of a society; observed impacts of evidence-based medicine in Canada; skepticism and importance of increasing academic and public awareness of critical thinking; hypothetical worst case scenario; hypothetical best case scenario; uncomfortable truths in the Canadian medical research community; uncomfortable truths in the international medical research community; concerns about Canadian culture and general medical knowledge; most correct ethical philosophy; most appealing political philosophy; most appealing social philosophy; clarification on social philosophy; most appealing economic philosophy; principles interrelating the philosophies; and principles that interrelate the philosophies.

Keywords:  biostatistics, epidemiology, evidence-based medicine, Gordon Guyatt, McMaster University, research.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: What makes academic scientific organizations, research groups, and laboratories important to the health of a society with substantial technological sophistication such as Canada?

Professor Gordon Guyatt: Aside from the economic drivers, they lead to useful things for the economy. Ideally, they are treatments or management, or sometimes tests, leading to better patient outcomes, meaning people live longer or live better. Medicine has not been the number one contributor for living longer and living better

2. Jacobsen: What have been the observed impacts of evidence-based medicine in Canada?

Guyatt: That is a bit of a challenge. One that is unequivocal is that every educational program, undergraduate or post-graduate says, “We have to teach people to use the literature.” As you know, when the Royal College comes along and looks at residency programs, people who license universities to teach doctors. They say, “Are you teaching this EBM stuff?” Students are learning it. Indeed, it is standard for institutions to teach it. Guidelines have become more evidence-based.

The stories I told, you won’t see treatment where the evidence is in and the recommendations are ten years behind the times. You won’t see a new treatment where the randomized trials suggest the thing is useless, or even harmful to people. You do not see that anymore. We have a way to go in terms of dissemination now, but care is much more evidence-based than before. Values and preferences are still neglected! Ironically enough. However, people are doing things much, much more on the basis of the evidence than was previously the case.

3. Jacobsen: You mentioned a value in the home at the very outset of the conversation to do with skepticism. Something important to develop early in life, seems to me at least, comes from a natural philosophic or scientific bent, and logic and general doubt. Canadian, American, British, and Scottish cultural heroes state this in one way or another including David Suzuki, Carl Sagan, Bertrand Russell, the aforementioned David Hume, and others. What seems like the important of their – dead or alive, I know many of them are, 3 out of 4 – role for the increasing of academic and public awareness of critical thinking and evidence-based decision making?

Guyatt: Now, you’re asking me to be a social scientist, which I am not, I have a general notion: we’re always building on what is there before. EBM is skepticism-oriented. I don’t think we’re conscious a lot of the time about what has created the culture. So if you asked me who were the most prominent in intellectual history in Western culture, and in creating an atmosphere of skepticism, you listed a bunch. If you asked me before you listed them, I would have been in big trouble in terms of listing them myself.

You’re right. They created the milieu. When I went into it, and my mentors went into it, they had a natural skepticism. I am not a social scientist. I don’t know how this happened or how these things infiltrate the culture, but they do.

4. Jacobsen: Hypothetical worst case scenario: if Canadian citizens do not have accurate science information when making decisions about medicine, science, and public policy, how would this affect their everyday lives?

Guyatt: It depends on the particular decision. I will take one public policy item, which is the safe needle programs. The Harper government tried to shut down the Vancouver site. The safe needle program saves lives. This was interesting. It went to the Supreme Court. The Supreme Court said, “You can’t do this because of the evidence.” My political background and ideas lean Left. So it will not surprise that I was not fond of the Harper government, but their anti-science, suppressing the science in areas of the environment, in the areas of health, were extremely problematic.

One public policy issue where it was very problematic was the safe needle programs. The Supreme Court said, “Okay, you can’t ignore the science.” The science saved us.

5. Jacobsen: Hypothetical best case scenario: if Canadian citizens do have accurate science information when making decisions about medicine, science, and public policy, how will this affect their everyday lives?

Guyatt: That [Laughing] goes beyond medicine. To me, the swings in education are striking. Now, we should be structured. Everybody taking examinations and licensing. Ten years later, it is all wrong. We are restricting people. Nobody is being imaginative, and so on. Just do the rigorous experiments, and we would be able to find out what really is optimal.

The same thing happens in health care organization issues.  At one point you see the provincial government saying, “Oh, let’s centralize all healthcare decision-making in the province.”

Then a few years later, “Oh, it’s all going wrong.. No, no, let’s give more power to local decision-makers”  Then, a few years later. “No, no, that doesn’t work, let’s take the power back.” There are these swings. Why? Because nobody bothers to test it properly. Let’s get together, Canada is big enough. Let’s randomize jurisdictions to have decisions centralized, or take the responsibility and have the money going with it to local decision-makers. There are different ways of organizing decision-making. Let’s test it out!

As opposed to saying, or having people doing it out of conviction, “It sounds like a good idea. It kind of makes sense.” In medicine, we have recognized that’s not a good idea. People once thought bloodletting made sense as a treatment of pneumonia. Most supported bloodletting for all sorts of illnesses. It doesn’t make sense anymore, but it made sense to people before. As opposed to doing things because they made sense, the “what makes sense” is extremely fallible.

We have been conducting experiments and finding drugs thought to be beneficial, which end up killing people. Unfortunately, it happens from time-to-time. To do that within the wider realms of all kinds of public policy would be really nice.

6. Jacobsen: What seem like some uncomfortable truths in the medical research community at the moment in Canada?

Guyatt: I am having trouble, but one we may be swinging another way. We’re undertreating pain with narcotics. A lot of people suffer, unnecessarily. That was what was being told to everybody 10 years ago. Now, we have the epidemic of narcotic deaths. People were not prescribing properly. So there would be one example. Another one is everybody should be taking large doses of vitamin d for anything that ails you.

Now, fortunately, vitamin d is pretty innocuous. So we’re probably not hurting anyone, but the evidence in support of vitamin d helping anything is limited even in an optimistic analysis. It seems to have caught on as a rage. Like I say, the narcotics examples have terrible consequences. People might take too much of an unnecessary vitamin. Fortunately, it is not having – aside from the pocket book – minimal adverse effects.

7. Jacobsen: I could see a reason for that. 200,000 to 70,000 years ago, when we were roaming around from Lebanon’s Beqaa Valley to Mozambique, in the Great Rift Valley along with our other Great Primate ancestors, you’re in the sun all day. So you’re going to create a lot of vitamin d. I could see a reason for evolutionary mechanisms selected for that would buffer against or that would make it innocuous.

Guyatt: Yes, you’ve given a good example of physiological reasoning, which sometimes leads us in the right direction and occasionally in the wrong direction.

8. Jacobsen: What about in an international context, outside of Canada in other words?

There are unscrupulous people selling stem cell therapy for anything. In low and middle income countries, where things are not regulated as much, there are whole buildings and clinics built to take advantage of vulnerable people. Another thing would be cancer treatments. Another good example is multiple sclerosis. There is an Italian surgeon who came up with something about the blood vessels. It became a big rage. Everybody went off to different places all over to get his treatment.  Now, it has been recognized as completely without foundation.

There are drugs not in use in Canada, but are in use in India – where things are not regulated as well. These are useless. They are different than vitamin d. They have side effects. In low and middle income countries, where the dollar is much more crucial, there are all sort of unfortunate things happening.

9. Jacobsen: What about Canadian culture and general medical knowledge concerns you? Because that seems to me like the root of both to you of the things you’ve described.

Guyatt: One of my favorite mentees and a good friend is – he’s about my age – late in his career, and his current enthusiasm is about treating critical health thinking to grade school children. When I started in EBM, I realized this isn’t about healthcare, but this is about everything. I have given the education example, but people are talking evidence-based this, that, and the other thing now. I am delighted to hear it.

We need skepticism. The appropriate standards of what to believe and not to believe in every area. To an extent, my colleague succeeds in getting it into the grade schools and developing critical thinking is, or would be, a very good thing.

10. Jacobsen: What ethical philosophy seems the most correct to you?

Guyatt: “Correct” is an interesting word. How about substituting “appealing” for “correct”? Which tells you what I think about ethics, I told the story of the ethical standards with the 95-year-old demented person, which was radically different in North America, Peru, and Saudi Arabia. When people believed different things, the ethical decisions would differ. None of them is right. Healthcare, one of the big issues is equity. So we talked about equity versus choice. In the US, choice is a big value. I should be able to pay for better healthcare. A different ethical stance is equity is important. The fundamental thing, in politics and healthcare, my belief is equity is a much more important ethical principle than choice.

11. Jacobsen: What political philosophy seems the most appealing to you?

Guyatt: I am an old time socialist. [Laughing] I believe in governments. I believe in strong governments. We have seen plenty of evidence. When you don’t have governments regulating banks, and businesses, you have catastrophic results. I believe in income redistribution. Those responsible for the public wellbeing do things to ensure the public wellbeing.

12. Jacobsen: What social philosophy seems the most appealing to you?

Guyatt: Social philosophy, I am really ignorant. Quickly, educate me what is meant by “social philosophy.”

13. Jacobsen: By “social philosophy,” I mean the ways in which we should more efficiently, or better, arrange our social structures as a group or as individuals.

Guyatt: We are rich by interacting with each other. It is important to respect one another and to respect different ways of doing things.

14. Jacobsen: What economic philosophy seems the most appealing to you?

Guyatt: I do not like liberalism in the sense of economic liberalism and letting free markets do their thing. We have lots of examples. Obviously, there seems to me a big overlap between political and economic philosophies. I mentioned looking at the catastrophes of letting free markets operate in an unconstrained way.

15. Jacobsen: What principles interrelate these philosophies?

Guyatt: Equity would be one. Equity would be something that cuts across political and social philosophies. In contrasting between what’s more important, individual freedom or the wellbeing of the group, the individual freedoms, lower individual freedoms, and more emphasis on the wellbeing of the group. Those would be two.

16. Jacobsen: Any feelings or thoughts in conclusion?

Guyatt: The feeling and thought, and conclusion, is having the opportunity to hold forth in this way. I have really enjoyed it. Some of what I’ve achieved in education on some things. It has been a lot of fun. Thank you for thinking of me.

Jacobsen: Thank you for your time, Professor Guyatt.

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  5. Cassar, V. & Bezzina, F. (2015, March 25). The evidence is clear. Retrieved from http://www.timesofmalta.com/articles/view/20150325/life-features/The-evidence-is-clear.561338.
  6. Clarity Research. (2016). Clinical Advances Through Research and Information Translation. Retrieved from http://www.clarityresearch.ca/gordon-guyatt/.
  7. Craggs, S. (2015, July 21). We can actually win this one, Tom Mulcair tells Hamilton crowd. Retrieved from http://www.cbc.ca/news/canada/hamilton/news/we-can-actually-win-this-one-tom-mulcair-tells-hamilton-crowd-1.3162688.
  8. Escott, S. (2013, December 2). Mac professor named top health researcher. Retrieved from http://www.thespec.com/news-story/4249292-mac-professor-named-top-health-researcher/.
  9. Feise, R. & Cooperstein, R. (2014, February 1). Putting the Patient First. Retrieved from http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56855.
  10. Frketich, J. (2016, July 8). 63 McMaster University investigators say health research funding is flawed. Retrieved from http://www.thespec.com/news-story/6759872-63-mcmaster-university-investigators-say-health-research-funding-is-flawed/.
  11. Helsingin yliopisto. (2017, March 23). Clot or bleeding? Anticoagulants walk the line between two risks. Retrieved from https://www.sciencedaily.com/releases/2017/03/170323083909.htm.
  12. Hopper, T. (2012, August 24). You’re pregnant, now sign this petition: Group slams Ontario doctors’ ‘coercive’ tactics to fight cutbacks. Retrieved from http://news.nationalpost.com/news/canada/youre-pregnant-now-sign-this-petition-group-criticizes-doctors-who-encourage-patients-to-sign-anti-cutbacks-letter.
  13. Kerr, T. (2011, May 30). Thomas Kerr: Insite has science on its side. Retrieved from http://news.nationalpost.com/full-comment/thomas-kerr-vancouvers-insite-clinic-has-been-a-resounding-success.
  14. Kirkey, S. (2015, October 29). WHO gets it wrong again: As with SARS and H1N1, its processed-meat edict went too far. Retrieved from http://news.nationalpost.com/health/is-whos-smackdown-of-processed-meat-a-considerable-overcall-or-just-informing-the-public-of-health-risks.
  15. Kolata, G. (2016, August 3). Why ‘Useless’ Surgery Is Still Popular. Retrieved from https://www.nytimes.com/2016/08/04/upshot/the-right-to-know-that-an-operation-is-next-to-useless.html?_r=0.
  16. Maxmen, A. (2011, July 6). Nutrition advice: The vitamin D-lemma. Retrieved from http://www.nature.com/news/2011/110706/full/475023a.html.
  17. McKee, M. (2014, October 2). The Power of Single-Person Medical Experiments. Retrieved from http://discovermagazine.com/2014/nov/17-singled-out.
  18. McMaster University. (2016). Gordon Guyatt. Retrieved from http://fhs.mcmaster.ca/ceb/faculty_member_guyatt.htm.
  19. Neale, T. (2009, December 12). Doctor’s Orders: Practicing Evidence-Based Medicine Is a Challenge. Retrieved from http://www.medpagetoday.com/practicemanagement/practicemanagement/17486.
  20. Nolan, D. (2011, December 31). Mac’s Dr. Guyatt to enter Order of Canada. Retrieved from http://www.thespec.com/news-story/2227923-mac-s-dr-guyatt-to-enter-order-of-canada/.
  21. O’Dowd, A. (2016, July 21). Exercise could be as effective as surgery for knee damage. Retrieved from https://www.onmedica.com/newsArticle.aspx?id=e13a0a94-5e96-43b9-86b7-7de237630beb.
  22. Palmer, K. & Guyatt, G. (2014, December 16). New funding model a leap of faith for Canadian hospitals. Retrieved from http://www.theglobeandmail.com/opinion/why-new-funding-model-a-leap-of-faith-for-canadian-hospitals/article22100796/.
  23. Park, A. (2012, February 7). No Clots in Coach? Debunking ‘Economy Class Syndrome’. Retrieved from http://healthland.time.com/2012/02/07/no-clots-in-coach-debunking-economy-class-syndrome/.
  24. Picard, A. (2015, May 25). David Sackett: The father of evidence-based medicine. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/health/david-sackett-the-father-of-evidence-based-medicine/article24607930/.
  25. Priest, L. (2012, June 17). What you should know about doctors and self-referral fees. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/ask-a-health-expert/what-you-should-know-about-doctors-and-self-referral-fees/article4267688/.
  26. Rege, A. (2015, August 5). Why medically unnecessary surgeries still happen. Retrieved from http://www.beckershospitalreview.com/population-health/why-medically-unnecessary-surgeries-still-happen.html.
  27. Science Daily. (2016, October 26). Ultrasound after tibial fracture surgery does not speed up healing or improve function. Retrieved from https://www.sciencedaily.com/releases/2016/10/161026141643.htm.
  28. Spears, T. (2016, July 7). Agriculture Canada challenged WHO’s cancer warnings on meat: newly-released documents. Retrieved from http://news.nationalpost.com/news/canada/agriculture-canada-challenged-whos-cancer-warnings-on-meat-according-to-newly-released-documents.
  29. Tomsic, M. (2015, February 10). Dying. It’s Tough To Discuss, But Doesn’t Have To Be. Retrieved from http://wfae.org/post/dying-its-tough-discuss-doesnt-have-be.
  30. Webometrics. (2010). 1040 Highly Cited Researchers (h>100) according to their Google Scholar Citations public profiles. Retrieved from http://www.webometrics.info/en/node/58.

    Appendix I: Footnotes

    [1] Distinguished University Professor, Health Research Methods, Evidence and Impact, McMaster University.

    [2] Individual Publication Date: May 22, 2017 at http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

    [3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

    [4] Credit: McMaster University.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four) [Online].May 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, May 22). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four)Retrieved from http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four). In-Sight: Independent Interview-Based Journal. 14.A, May. 2017. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four).” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four).” In-Sight: Independent Interview-Based Journal. 14.A (May 2017). http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four.

Harvard: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four)In-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four)In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four).” In-Sight: Independent Interview-Based Journal 14.A (2017):May. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Four) [Internet]. (2017, May; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-four.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: May 15, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,849

ISSN 2369-6885

Gordon Guyatt

Abstract

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC. He discusses: Sigmund Freud, Michel Foucault, Hirsch Index, and secure placement in the annals of medical and general history; evidence-based medicine (EBM) and its definition; the three principles of EM; and what one should do with evidence as value dependent.

Keywords: biostatistics, epidemiology, evidence-based medicine, Gordon Guyatt, Hirsch Index, McMaster University, research.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: In a list, and many others, with the most cited researchers in Canada, and in the world, with inclusion of the dead such as Sigmund Freud and Michel Foucault, that is, the ranks done by a Hirsch Index – the calculation of papers and the citations per paper to derive an individual academic’s Hirsch Index.[5] You have over 187,000 citations with a Hirsch-Index of about 217. In short, you are one of the most cited researchers, or the most cited researcher, in Canada and the 12th most cited researcher in the world, circa second week of February, 2017. Your position in the annals of medical and general history is secure. Based on the accomplishment, what does this mean to you?

Professor Gordon Guyatt: You described an evolution during my career. This electronic counting of citations was not something around until about a decade ago. It became a standard by which people are judged because you can count it. In the past, you can say, “This paper is good. It seems to have influenced people. People seem to like it. I get the impression people are using it.” However, that is different than the figures there. You can say, “Okay, here people are reading this, and they are using it, and researchers are citing it in their own work, and so on and so forth.”

It has downsides, where journals are judged this way, too. The journals are rated by their impact factor, which is how much they are cited. It goes into gaming. The impact factor is the citations per article. One way to improve your impact factor is to publish less studies. Only publish the ones going to be cited. Then you make a deal, “Okay, this type of article. It is just really a type of opinion piece. It is going to count in the denominator of my ranking.”

It potentially has negative effects as opposed to using other criteria for important research, at least important to some people. Is it well done? It is good research? Those things may still be important. Is it going to be cited? How much is it going to be cited? Sometimes, complete baloney may get lots of citations. Leading journals always publish because of the newspaper value of their articles, but perhaps even more the case because the way the journal is evaluated is on the basis of this impact factor. It has to do with citations.

Even so, it is nice to have this objective standard of the fact that work has made an impact, but I am not sure this is healthy. However, it is nice. Usually, what happens with an article is that it comes out, has 2 or 3 years of high citations, citations fall off, and then 5 years 10 years later, it is not cited. Probably, it is the same for most publications. It is gratifying for me. I have papers cited a 100 times during a year. That is a lot of citations. Some are 20-years-old and getting about a 100 citations per year.

Even if 20 years later they get 25 citations per year, that says, “It is a major test of time. People find it useful.” That is, you do a piece of work, then somebody builds on it. Then what you did before, and what people cite the paper tells you that they have built on it, particularly if it gets cited 20 years later.  The original work is still compelling enough to people that they say, “Okay, I’m citing the work that started us down this road.” The way these things work with the electronic counting is nice.

It has downsides. It is distracting. One colleague made fun of me. I was saying, “Hey! I was checking my h-factor, and it is still going up.” My colleague responded, “Mirror, mirror on the wall…”, referring to one of the queens in the fairy tale saying, “Mirror, mirror on the wall, who’s the most beautiful of them all?” It was warranted. There are downsides, but it is nice to have objective criteria. It says, “People pay attention to your work and value it.”

2. Jacobsen: The phrase, sometimes mistaken for a term, “evidence-based medicine,” (EBM) originated in a paper by you. What defines EBM?

Guyatt: In 1990, I coined the term. 1991 was the first published paper that used the term. People often don’t notice that one. 1992 was the paper that caught the world’s attention.

3. Jacobsen: You summarized its principles. Principle one, summarize evidence to help make and guide the best decisions. Principle two, hierarchy of evidence for randomized trials. Principle three, context of value and preferences for expert decision making. What else defines evidence-based decision making? As per the presentation style, what are some examples?

Guyatt: To start, what you listed was not there at the beginning, it evolved. The values and preferences stuff was not there at the beginning. We didn’t get it. People thought values and preferences were in the sub-conscious, but we didn’t get it. It had to be added. The 1990s were the EBM aspect. 5 years later, we tweaked the values and preferences. The way we characterize it now is one principle is that you need to summarize and have systematic of all of the highest quality evidence to make good decisions.

An illustration would be that in many areas one paper says, “This treatment is great.” Another paper says, “It is not at all great.” A focus on either one will result in a misleading presentation. You need systematic summaries of the best available evidence. I tell stories. The stories illustrate treatments for myocardial infarction, where there’s one treatment where – this has been superseded but – we put in a drug, clot-busting drugs, that broke up the clots that were causing the heart attack.

Turns out that these clot-busting drugs reduces mortality by about 1/4. It was 10 years after the answer came back from randomized trials before the community got it. It was before the era of the systematic summaries. Another story is about another drug. People have heart attacks. They have arrhythmias, which means abnormalities of the heart beat. It can kill them.  The drug was given to obliterate or decrease nasty-looking arrhythmias. We thought, “Okay, if you get rid of the nasty-looking arrhythmias, you’re going to get rid of the ones that kill people.”

It didn’t. In fact, there have been a number of such promising looking drugs that have ended up killing people more. When I was in training, I was giving one such drug out all of the time. The evidence said this wasn’t a good idea, but nobody systematically summarized; people were picking studies here and there. We systematically summarize the best evidence to avoid that problem. Next, we need to know what makes the best evidence.

You mentioned a hierarchy of evidence. EBM has been criticized for being excessively randomized-trial focused; in the past, that might be true, but it has evolved. Now, we have much more sophisticated system, that acknowledges randomized trials may be poorly done. They may give inconsistent results. They may not be applicable to your patient. I work as a general internist. I have a lot of people over 90. A lot of randomized trials out there. It raises questions about the extent to which I can apply the trials to those over 90.

Trials may be small and less trustworthy. Anyway, we recognize randomized trials as a good thing. However, you might lose confidence in your randomized trials for a variety of reasons. Similarly, we don’t need randomized trials to show insulin works in diabetic ketoacidosis – where people are dead pretty quickly if you don’t use it. We don’t need randomized trials to show epinephrine works in people with anaphylactic shock who are about to die. We don’t need randomized trials to show that dialysis is a good thing for people with renal failure, et cetera.

There’s an explicit formulation, “Yes, in general, randomized trials generally give higher quality evidence, but sometimes not without limitations, and in general observational studies have lower quality evidence, but not always with large and clear effects.” So we developed a much more sophisticated hierarchy. Some evidence is more trustworthy than others, but we have developed a more sophisticated hierarchy.

The third principle is values and principles. I introduce values and preferences by saying, “What do you think about antibiotics for pneumonia?” Even the lay people will say, “Good idea! Yea, antibiotics worked for pneumonia, we all agree on the evidence. Antibiotics for pneumonia.” I say, “Let me tell you about a patient. He’s 95 years old. He’s severely demented, incontinent of bowel and bladder, lives in a long-care institution. He’s 95, nobody’s been to visit him for 5 years, and he moans in apparent discomfort from morning to night. This individual develops pneumonia. Do you think it’s a good idea that he gets antibiotics?”

In North America, 95% of people say, “No.” They think this guy would be better off dead. So treating the pneumonia is not doing him any favours, if you ask most people, put yourself in the situation of such an individual, would you want to be treated? Most people would say, “No, thank you.” In North America, 5% of people say, “Yes, it is a good idea to treat the person.” So we all agree on the evidence. Our disagreement as to whether this individual should be treated has nothing to do with the evidence.

It has to do with something else. We label that “values and preferences.” So I go on with the story. I used this example repeatedly to illustrate the values and preferences. I went to Peru probably 10 or 15 years ago. I already used the story in North America many times. I went to Peru and said, “Who thinks this is a good idea to treat this patient?” About 2/3rds of people raised their hand and said, “Yes.” I thought, “Wow, something’s wrong here. This is a Spanish speaking audience. I’m speaking English, I have not communicated properly.” I go over it slowly, again. two thirds of the people still say, “Yes.”

I asked the host afterwards, “How come it is so different?” They said, “Catholic culture.” That was their attribution. I go to Saudi Arabia. 95% of the people say, “Yes, the patient should be treated.” All of us agreed on the evidence. That’s not why there are differences. It is something else. That’s what we call values and preferences. Then I tell stories of people at risk of stroke. The treatment reduce stroke but will increase their risk of bleeding. Some people say, “Yes, use the treatment.” Because there’s big values in preventing stroke. Some people say, “No.” Because they are terrified of a bleeding, and so on.

In other words, evidence never tells you what to do, whenever there’s trade-offs with their values, preferences, and judgements, those are always important in making the right decision.

4. Jacobsen: This goes to some of the earliest, or more modern, empiricists like David Hume with his is/ought distinction. You can get the highest quality evidence you can get, even with modern technology, but what you should do with that evidence is going to be culture and value dependent.

Guyatt: That is exactly right. That is exactly right.

References

  1. Bennett, K. (2014, October 31). New hospital funding model ‘a shot in the dark,’ McMaster study says. Retrieved from http://www.cbc.ca/news/canada/hamilton/news/new-hospital-funding-model-a-shot-in-the-dark-mcmaster-study-says-1.2817321.
  2. Blackwell, T. (2015, February 1). World Health Organization’s advice based on weak evidence, Canadian-led study says. Retrieved from http://news.nationalpost.com/health/world-health-organizations-advice-extremely-untrustworthy-and-not-evidence-based-study.
  3. Branswell, H. (2014, January 30). You should be avoiding these products on drug-store shelves. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/health/you-should-be-avoiding-these-products-on-drug-store-shelves/article16606013/?page=all.
  4. Canadian News Wire. (2015, October 8). The Canadian Medical Hall of Fame announces 2016 inductees. Retrieved from http://www.newswire.ca/news-releases/the-canadian-medical-hall-of-fame-announces-2016-inductees-531287111.html.
  5. Cassar, V. & Bezzina, F. (2015, March 25). The evidence is clear. Retrieved from http://www.timesofmalta.com/articles/view/20150325/life-features/The-evidence-is-clear.561338.
  6. Clarity Research. (2016). Clinical Advances Through Research and Information Translation. Retrieved from http://www.clarityresearch.ca/gordon-guyatt/.
  7. Craggs, S. (2015, July 21). We can actually win this one, Tom Mulcair tells Hamilton crowd. Retrieved from http://www.cbc.ca/news/canada/hamilton/news/we-can-actually-win-this-one-tom-mulcair-tells-hamilton-crowd-1.3162688.
  8. Escott, S. (2013, December 2). Mac professor named top health researcher. Retrieved from http://www.thespec.com/news-story/4249292-mac-professor-named-top-health-researcher/.
  9. Feise, R. & Cooperstein, R. (2014, February 1). Putting the Patient First. Retrieved from http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=56855.
  10. Frketich, J. (2016, July 8). 63 McMaster University investigators say health research funding is flawed. Retrieved from http://www.thespec.com/news-story/6759872-63-mcmaster-university-investigators-say-health-research-funding-is-flawed/.
  11. Helsingin yliopisto. (2017, March 23). Clot or bleeding? Anticoagulants walk the line between two risks. Retrieved from https://www.sciencedaily.com/releases/2017/03/170323083909.htm.
  12. Hopper, T. (2012, August 24). You’re pregnant, now sign this petition: Group slams Ontario doctors’ ‘coercive’ tactics to fight cutbacks. Retrieved from http://news.nationalpost.com/news/canada/youre-pregnant-now-sign-this-petition-group-criticizes-doctors-who-encourage-patients-to-sign-anti-cutbacks-letter.
  13. Kerr, T. (2011, May 30). Thomas Kerr: Insite has science on its side. Retrieved from http://news.nationalpost.com/full-comment/thomas-kerr-vancouvers-insite-clinic-has-been-a-resounding-success.
  14. Kirkey, S. (2015, October 29). WHO gets it wrong again: As with SARS and H1N1, its processed-meat edict went too far. Retrieved from http://news.nationalpost.com/health/is-whos-smackdown-of-processed-meat-a-considerable-overcall-or-just-informing-the-public-of-health-risks.
  15. Kolata, G. (2016, August 3). Why ‘Useless’ Surgery Is Still Popular. Retrieved from https://www.nytimes.com/2016/08/04/upshot/the-right-to-know-that-an-operation-is-next-to-useless.html?_r=0.
  16. Maxmen, A. (2011, July 6). Nutrition advice: The vitamin D-lemma. Retrieved from http://www.nature.com/news/2011/110706/full/475023a.html.
  17. McKee, M. (2014, October 2). The Power of Single-Person Medical Experiments. Retrieved from http://discovermagazine.com/2014/nov/17-singled-out.
  18. McMaster University. (2016). Gordon Guyatt. Retrieved from http://fhs.mcmaster.ca/ceb/faculty_member_guyatt.htm.
  19. Neale, T. (2009, December 12). Doctor’s Orders: Practicing Evidence-Based Medicine Is a Challenge. Retrieved from http://www.medpagetoday.com/practicemanagement/practicemanagement/17486.
  20. Nolan, D. (2011, December 31). Mac’s Dr. Guyatt to enter Order of Canada. Retrieved from http://www.thespec.com/news-story/2227923-mac-s-dr-guyatt-to-enter-order-of-canada/.
  21. O’Dowd, A. (2016, July 21). Exercise could be as effective as surgery for knee damage. Retrieved from https://www.onmedica.com/newsArticle.aspx?id=e13a0a94-5e96-43b9-86b7-7de237630beb.
  22. Palmer, K. & Guyatt, G. (2014, December 16). New funding model a leap of faith for Canadian hospitals. Retrieved from http://www.theglobeandmail.com/opinion/why-new-funding-model-a-leap-of-faith-for-canadian-hospitals/article22100796/.
  23. Park, A. (2012, February 7). No Clots in Coach? Debunking ‘Economy Class Syndrome’. Retrieved from http://healthland.time.com/2012/02/07/no-clots-in-coach-debunking-economy-class-syndrome/.
  24. Picard, A. (2015, May 25). David Sackett: The father of evidence-based medicine. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/health/david-sackett-the-father-of-evidence-based-medicine/article24607930/.
  25. Priest, L. (2012, June 17). What you should know about doctors and self-referral fees. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/ask-a-health-expert/what-you-should-know-about-doctors-and-self-referral-fees/article4267688/.
  26. Rege, A. (2015, August 5). Why medically unnecessary surgeries still happen. Retrieved from http://www.beckershospitalreview.com/population-health/why-medically-unnecessary-surgeries-still-happen.html.
  27. Science Daily. (2016, October 26). Ultrasound after tibial fracture surgery does not speed up healing or improve function. Retrieved from https://www.sciencedaily.com/releases/2016/10/161026141643.htm.
  28. Spears, T. (2016, July 7). Agriculture Canada challenged WHO’s cancer warnings on meat: newly-released documents. Retrieved from http://news.nationalpost.com/news/canada/agriculture-canada-challenged-whos-cancer-warnings-on-meat-according-to-newly-released-documents.
  29. Tomsic, M. (2015, February 10). Dying. It’s Tough To Discuss, But Doesn’t Have To Be. Retrieved from http://wfae.org/post/dying-its-tough-discuss-doesnt-have-be.
  30. Webometrics. (2010). 1040 Highly Cited Researchers (h>100) according to their Google Scholar Citations public profiles. Retrieved from http://www.webometrics.info/en/node/58.

Appendix I: Footnotes

[1] Distinguished University Professor, Health Research Methods, Evidence and Impact, McMaster University.

[2] Individual Publication Date: May 15, 2017 at www.in-sightjournal.com; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Credit: McMaster University.

[5] Webometrics. (2010). 1040 Highly Cited Researchers (h>100) according to their Google Scholar Citations public profiles. Retrieved from http://www.webometrics.info/en/node/58.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three) [Online].May 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, May 15). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three)Retrieved from http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three). In-Sight: Independent Interview-Based Journal. 14.A, May. 2017. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three).” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three).” In-Sight: Independent Interview-Based Journal. 14.A (May 2017). http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three.

Harvard: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three)In-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three)In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three).” In-Sight: Independent Interview-Based Journal 14.A (2017):May. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Three) [Internet]. (2017, May; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-three.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two)

Interviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: May 8, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,553

ISSN 2369-6885

Gordon Guyatt

Abstract

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC. He discusses: personal research style; good and bad educators, and good and bad students; earning professional recognitions; responsibilities associated with exposure in the media; and what makes a good speaker and presentation on medicine and public policy.

Keywords: biostatistics, epidemiology, Gordon Guyatt, McMaster University, research.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: What defines personal research style to you?

Professor Gordon Guyatt: A couple of things. One style may be a little obsessive-compulsive, which is required to some extent. I contrast myself with an extremely successful researcher who has everything planned for the future. He knows. For this guy, with his 5-year plan, he can go right up to 4 years and 11 months. He knows. He has a direction. I am at the other extreme. Where you ask me what I am going to be doing 3 months from now, I couldn’t tell you.

It suits me, especially with the different graduate students. Each doing something different. I can’t even track them. I follow along. So the contrasting strategies are a careful plan versus whatever idea occurs to you today and follow it along. Those are extreme differences.

Another style issue is collaboration. I’m in this extremely collaborative environment, but there are gradients. There are people who like to collaborate, but they prefer more to do their own thing. They like to lead projects. The contrast is between enjoying the collaborative working environment whatever one’s roles as opposed to being the boss.

Some investigators like to be a boss and equality in collaboration with younger or junior folks is less their style. I see myself at the other extreme of someone who loves collaboration and loves creating teams of people. Others may not be ready to treat juniors as equals, not ready to tell them explicitly, “It’s your project. You make decisions. I’ll make suggestions. I’ll make a case. I’ll tell you if I think you’re going wrong. I’ll tell you how I think it could be made better, but it’s your project and your decision.” Those are different approaches.

Each approach has its merits. There are many successful people who are disciplined, have a plan, like to be the boss, and still manage mentorship. It is not one is better than the other, or right or wrong, but I see myself more in the collaboration and team creation side of the spectrum.

2. Jacobsen: I will dig a little deeper, but connect this to mentors and students. What differentiates a good teacher or educator from the bad one, and the good student from the bad one?

Guyatt: There are different styles. A good teacher has to be enthusiastic, love what they’re doing, deeply care about what they’re doing, place a high value on sparking the excitement, response, interest, and engagement of the learner. Ideally, or to some extent a necessity, being a good at explaining, clarifying, simplifying, finding ways to communicate concepts so the light goes on in the learner. The bad teacher will be the opposite. Not terribly excited, not a high level of enthusiasm.

Also, not caring about whether the message gets through or not, and simply wants to teach the course and move on, not very good at communicating concepts, and so on, it would be the absence of the positive characteristics. Good students, it is nice if they are smart. It is nice if they are well organized. I have students who are limited in those ways. Fortunately, even those folks are committed, hardworking, most are good listeners, they take direction well.

If lucky, the best learners are imaginative, pick up ideas fast, start using the concepts themselves, start coming up with great ideas I would never have thought, which is the imagination, energetic, and enthusiastic. Occasionally, somebody comes along. A few people come along who have everything. I have had the opportunity to mentor them. It is wonderful. Most of the people in this huge slew of these PhD students only have one or more of the characteristics. Most care, are committed and hardworking, but there is tremendous variability.

3. Jacobsen: You earned the McMaster University “President’s Award for Excellence in Teaching” (Course or Resource Design), short-list for the “British Medical Journal Lifetime Achievement Award,” as well as the positions of Fellow of the Canadian Academy of Health Sciences, Distinguished University Professor at McMaster University, Officer of the Order of Canada, Fellow of the Ryan Society of Canada, and a member of the Canadian Medical Hall of Fame.[5] These mean weight to professional work, lifetime achievement, and expressed opinions by you. What do these recognitions mean to you?

Guyatt: Two mean the most to me. One is the Order of Canada or Officer of the Order of Canada because of the recognition outside of science and medicine. It is a recognition of contribution to the wider society. The other called the – the Canadian Institutes of Health is the leading academic granting body in the country, the premier, the most prestigious grants, and they have an award called – Canada’s Health Researcher of the Year (CHR), which doesn’t mean great job for the year. It is a career award. It is saying, “Who is the top researcher in the country to whom we haven’t already given an award?” There is a competition for research dollars among basic scientists, test-tube physiology-oriented scientists, and folks like me who are clinical researchers.

The basic researchers dominate the CHR. That is, the clinical epidemiology researchers see those guys get more of the money than us. There is a competition between groups. Most people would agree that the senior leadership in CHR is basic science. Anyway, several years ago, they gave me Canada’s Health Researcher of the Year award. It was nice. They were saying, “You’re the best researcher in the country, leaving aside all of those that have already won the award.” I earned the award as a clinical research, not as a basic researcher.

That was the recognition. On the one hand, with the Order of Canada, I was recognized for making a social contribution important to the society as a whole beyond my field; on the other hand, they chose me as the top researcher in the country. That was nice in terms of recognition.

4. Jacobsen: Associated with this. You have numerous representations in the media. What responsibilities to the public, and the medical, public policy, and scientific community?

Guyatt: To behave with integrity, the main responsibility when you disseminate is accuracy. Another specific concern is conflict of interest. Many people within the medical community who take public stances are conflicted. They get lots of money from industry. It is hard for that not to influence you. We have intellectual conflicts of interest. Every researcher prefers their research. If their findings contradict somebody else’s, then they are right. The other person’s findings must be wrong. This is a universal phenomenon.

There is a responsibility to be aware of one’s conflict of interest. When there are conflicts of interest, it is crucial to make the conflicts clear. Also, there is responsibility to attempt to minimize the conflicts of interest, and the presentation and interpretation of things. There is a responsibility to listen and be open to other perspectives. Other people’s points of views.

5. Jacobsen: You spoke in many, many venues and gave many, many other lectures. What makes a good speaker, and a great presentation on medicine and public policy?

Guyatt: There are the same pieces if you’re talking about medicine and public policy, or whether you’re talking about basic clin-epi. We will talk about large group presentations. [Laughing] I run a course on how to teach evidence-based healthcare. One of the things is the students often see what we hope is the best lectures. These group are small groups, but lectures are done well. They see a few lectures. Then we say, “What’s made this lecture good?” As much as we’d like to think we put on good lectures, there are issues.

First, the person must be enthusiastic. They must give the impression that they believe that what they’re talking about is interesting, energetic, and that manifests itself in various ways. I never speak from behind a podium. I give a roving mic. I come out in front of the audience getting or becoming immediate with the audience. As one of my colleagues has said, “Just talk to them.” Which means, be calm, relaxed, and conversational, and look around, and talk to the people in front of you, you should make eye contact.

With a 1,000 people, you can make eye contact all over the place. Well-organized, very knowledgeable about what you’re talking about, we have a rule: “Tell’em what you’re going to say, say it, and then tell’em what you’ve said.” An organization includes, “Okay, folks, here are the major points I’m going to make.” You do it. At the end, you say, “Okay, folks, what might you want to take away from this, what major points have we made.” That structure is a crucial thing.

Humor if you can manage it. Oh! Examples, tell stories, the way to communicate things if you’re speaking in public, my talks are mostly story after story after story of illustrating things. You need to engage people by telling stories. One thing, I have done this stuff for so long. It comes naturally. I have to be careful. If I am not careful, I will be talking at the same time in – not quite a monotone, but a very even tone.

“Point one. Now, point two. Now, point three,” as opposed to, “Point one. Now, point three, which is much more important! Point three. Point four!” The modulation of tone and affect rather than an even tone and affect. That’s one thing. That’s a bunch of stuff. I could probably think of some more.

References

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  15. Kolata, G. (2016, August 3). Why ‘Useless’ Surgery Is Still Popular. Retrieved from https://www.nytimes.com/2016/08/04/upshot/the-right-to-know-that-an-operation-is-next-to-useless.html?_r=0.
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  21. O’Dowd, A. (2016, July 21). Exercise could be as effective as surgery for knee damage. Retrieved from https://www.onmedica.com/newsArticle.aspx?id=e13a0a94-5e96-43b9-86b7-7de237630beb.
  22. Palmer, K. & Guyatt, G. (2014, December 16). New funding model a leap of faith for Canadian hospitals. Retrieved from http://www.theglobeandmail.com/opinion/why-new-funding-model-a-leap-of-faith-for-canadian-hospitals/article22100796/.
  23. Park, A. (2012, February 7). No Clots in Coach? Debunking ‘Economy Class Syndrome’. Retrieved from http://healthland.time.com/2012/02/07/no-clots-in-coach-debunking-economy-class-syndrome/.
  24. Picard, A. (2015, May 25). David Sackett: The father of evidence-based medicine. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/health/david-sackett-the-father-of-evidence-based-medicine/article24607930/.
  25. Priest, L. (2012, June 17). What you should know about doctors and self-referral fees. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/ask-a-health-expert/what-you-should-know-about-doctors-and-self-referral-fees/article4267688/.
  26. Rege, A. (2015, August 5). Why medically unnecessary surgeries still happen. Retrieved from http://www.beckershospitalreview.com/population-health/why-medically-unnecessary-surgeries-still-happen.html.
  27. Science Daily. (2016, October 26). Ultrasound after tibial fracture surgery does not speed up healing or improve function. Retrieved from https://www.sciencedaily.com/releases/2016/10/161026141643.htm.
  28. Spears, T. (2016, July 7). Agriculture Canada challenged WHO’s cancer warnings on meat: newly-released documents. Retrieved from http://news.nationalpost.com/news/canada/agriculture-canada-challenged-whos-cancer-warnings-on-meat-according-to-newly-released-documents.
  29. Tomsic, M. (2015, February 10). Dying. It’s Tough To Discuss, But Doesn’t Have To Be. Retrieved from http://wfae.org/post/dying-its-tough-discuss-doesnt-have-be.
  30. Webometrics. (2010). 1040 Highly Cited Researchers (h>100) according to their Google Scholar Citations public profiles. Retrieved from http://www.webometrics.info/en/node/58.

Appendix I: Footnotes

[1] Distinguished University Professor, Health Research Methods, Evidence and Impact, McMaster University.

[2] Individual Publication Date: May 8, 2017 at http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Credit: McMaster University.

[5] Clarity Research. (2016). Clinical Advances Through Research and Information Translation. Retrieved from http://www.clarityresearch.ca/gordon-guyatt/.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two) [Online].May 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, May 8). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two)Retrieved from http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two). In-Sight: Independent Interview-Based Journal. 14.A, May. 2017. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two).” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two).” In-Sight: Independent Interview-Based Journal. 14.A (May 2017). http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two.

Harvard: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two)In-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two)In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two).” In-Sight: Independent Interview-Based Journal 14.A (2017):May. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part Two) [Internet]. (2017, May; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-two.

License and Copyright

License

In-Sight Publishing and In-Sight: Independent Interview-Based Journal by Scott Douglas Jacobsen is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.in-sightjournal.com.

Copyright

© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)

oInterviewer: Scott Douglas Jacobsen

Numbering: Issue 14.A, Idea: Outliers & Outsiders (Part Nine)

Place of Publication: Langley, British Columbia, Canada

Title: In-Sight: Independent Interview-Based Journal

Web Domain: http://www.in-sightjournal.com

Individual Publication Date: May 1, 2017

Issue Publication Date: September 1, 2017

Name of Publisher: In-Sight Publishing

Frequency: Three Times Per Year

Words: 2,922

ISSN 2369-6885

Gordon Guyatt

Abstract

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC. He discusses: his geographic, cultural, and linguistic personal and familial background; influence on development; influences and pivotal moments in major cross-sections of early life; interests in epidemiology and biostatistics; the importance of mentors for research; tasks and responsibilities as the Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact at McMaster University; and what informs pedagogy.

Keywords: biostatistics, epidemiology, Gordon Guyatt, McMaster University, Mentor.

An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)[1],[2],[3],[4]

*Footnotes in & after the interview, & citation style listing after the interview.*

*This interview has been edited for clarity and readability.*

1. Scott Douglas Jacobsen: In terms of geography, culture, and language, where does your personal and familial background reside?

Professor Gordan Guyatt: [Laughing] My dad is a Canadian of 5 or 6 generations. Our family moved to an area around Hamilton called Binbrook in the 1820s. They had a farm. The road that runs by the farm is called Guyatt road because they had the farm there. Those Guyatts were farmers, and the Guyatts in the region are descended in this region from them. My mother was a Czech Jew, who grew up in a little village in what is now the Czech Republic. Eventually, she moved to Prague.

She was at Prague when Hitler gained control of the Czech Republic. She ended up in a concentration camp with an extensive family. Everyone died in the Death Camps. Except her mother and her, they escaped to North America. She married a British soldier, who drove a tank into Belson. She was there at the end of the war. Upon arrival to Canada, they broke up. She met my dad in Canada. He came from an extremely different background. They managed to meet and stay together. They lived in Hamilton. I was born there. I grew up there. Now, I am still here.

2. Jacobsen: How did this influence development?

Guyatt: Through my mother’s background, I have a strong social conscience. I want to contribute as much as possible to society. I strongly identify with the less fortunate. It led to firm left-wing politics. I ran for the NDP 4 times, federally. I mercifully lost on each occasion. I have been active in politics. I started a group called the Medical Reform Group, which has been superseded by Canadian Doctors for Medicare.

I have a deep commitment for equitable, high-quality medical care for all Canadians without restrictions on the ability to pay. My academic career links with the political career. Even if you take the academic career alone, there are strong elements of belief in social cohesiveness and patients getting what they want rather than what doctors think patients want.

 3. Jacobsen: What about influences and pivotal moments in major cross-sections of early life including kindergarten, elementary school, junior high school, high school, undergraduate, and graduate studies?

Guyatt: [Laughing] Sadly, my memory of early life is sketchy. My mom said some things that influenced me. Her attitude: it would happen to the Jews again. However, she said, “Not to my kids.” My dad was from a strong Baptist family. His dad was a doctor, but qualified as a Baptist minister. He left ministerial work and became a doctor. He was a deacon on the Baptist church. It might have contributed to my values. My mother went to the Baptist church.

However, at some level, her heart was not there. She grew up as a Jew in Czechoslovakia. She went along with my dad’s world. Yet she was skeptical about his perspectives on the world. Baptists did not like drinking, dancing, or singing. They were puritanical. Also, my father was Right-wing. He had passionate Right-wing feelings. My negative characterization of some Right-wing folks is an upbringing of privilege, but even so, they manage to feel hard-done by.

Jacobsen: [Laughing].

Guyatt: [Laughing] I remember dad walking into the house every July for a few years, and saying, “For the rest of the year, I will be working for the government.” Because he was in the 50%+ percent tax bracket. He felt resentful. My mom said, “Well, that’s not the only way to look at the world.” I think skepticism, but some positive things from dad too. My dad is an extremely self-disciplined individual. On a 1-100, he is 99.5 on the self-discipline scale. He was model of true self-discipline. I turned out very self-disciplined.

Also, he loved the English language and precision in speech. As an academic, it helped me. Those are specific events, but streams of influence from childhood too. Then a clear  influence, when I was a resident in internal medicine, I loved the academic environment. I loved to teach. However, I had no interest in research. The chair of the department of medicine, who was a leader  in thrombosis research, Jack Hirsh, had a mission. He took bright young people and turned them into researchers.

He called me to his office. I described personal plans. He said, “Gordon, that’s fine, for now, but, in ten years, you’ll be bored. So, you should really think about research.” I knew one thing. I had zero interest in basic research. I was obedient and understood, “If the boss tells me, then I will do it.” I spent the second year of sub-specialty training in clinical epidemiology. Someone picked up: I am a bright guy. They thought, “We have this bright guy. Let’s lead them in the directions preferred by us.”

Hirsh sent me to the chair of the Department in Clinical Epidemiology, Peter Tugwell. Peter did a preliminary interview. This was not the interview for the program. He guided me, in the right direction. He said, “How much of your time in the long run do you want to be spending on research?” At the time, the real answer was zero. However, that answer would have been rude. I said, “25%.” He looked concerned and said, “Oh, well, if you say that in the interview, they won’t let you into the program.”

I went into the interview for the program. This time, I said, “50%.” I was allowed into the program. Lo and behold, I found, “This is great stuff! This is really interesting!” As I progressed through the program, I did not know, but, as it turned out, I am great at research. It is interesting. The more I went on, the more exciting it became. Then the same theme, I was directed. I continued to think, “I am a real doctor.” I wanted to be a real doctor. So I am with the Department of Medicine, not this Department of Clinical Epidemiology.

For some reason, the chair of Medicine, and the chair of Clinical Epidemiology, wanted my primary appointment in clinical epidemiology. I said, “Okay, I’m a real doctor. But if you want that as my primary appointment with these eggheads, then I’ll do it.” Quickly, in my training, I picked this up. Then I found myself in the best department in the world for this area, where I stumbled into it.  I was surrounded by brilliant people.

Those who taught me had a profound belief in collegiality and caring about one another, and mentoring junior people. Here I found myself not only doing interesting stuff, but with the world’s greatest mentors. Jack Hirsh continued to mentor me, and Dave Sackett, who was probably one of the leading lights. Those guys were mentors for me, but I had other senior folks in the department. They helped me too.

Now, I am in this spectacular environment. Now, I start writing grants and – lo and behold – the grants earn funding. I realized, “I’m surrounded by all of these smart people, and I find that I’m in the same league, and I actually talk to these people as equals and sometimes come up with ideas now.” Then over the next few years, I found, “Wow! This is exciting and great stuff, and I’m good at it.” There is the story of personal evolution.

4. Jacobsen: Two questions come from that. One has to do with epidemiology, biostatistics, and medicine. The medicine one as the natural inclination for you. The epidemiology and biostatistics, at least within research, as an unwilling participant. Any other interest in those disciplines – biostatistics, epidemiology?

Guyatt: No, as an undergraduate, I took the usual pathetic statistics course, which, as far as I can tell, could not be better designed to make people think that statistics is boring and uninteresting. It had the natural effect on me. As it turns out, another thing was peculiar about in contrast to other doctors about me. I never did science training. I never did biology or chemistry. Any of it. As it turns out, there was one medical school in the country for people without a science background: McMaster University. So I got into McMaster without a science background.

Once in the program, I was interested in physiologic reasoning. I went into internal medicine because it is the most interesting and challenging branch of medicine. Nothing specific to epidemiology or biostatistics, but an interest in an academic approach. This was the reason for the interest in an academic environment and in being an academic teacher. A major interest in an academic approach to the practice of medicine, which is clinical epidemiology. Clinical epidemiology, and making the medicine practical, became evidence-based medicine (EBM).

5. Jacobsen: In the previous responses, you talked about mentors. What is the importance of mentors for research – especially if they didn’t even know they had an interest or a talent in it?

Guyatt: Oh! Crucial, these folks directed me. I would never would have done these things myself. My colleague David Sackett wrote a book about mentorship. He talked about the importance of it, and the aspects of a good mentor. Dave died 2 years ago. The Journal of Clinical Epidemiology produced a series with one section of a recent issue was a review of Sackett’s life. He mentored me. He mentored tons of people. They were nice enough to ask me to do it.

A big aspect is Dave’s brilliance as a mentor. He influenced so many people. I am enormously lucky for the mentorship. It was crucial. If you are left alone, it is much more difficult. If you have the right mentorship environment, even somebody on the mediocre side, you can do well with the right support.

6. Jacobsen: You work as the Distinguished University Professor in the Department of Health Research Methods, Evidence and Impact.[5] What tasks and responsibilities come with these positions?

Guyatt: Basically, they let me do what I want. Fortunately, my preferred work keeps with the university’s mission. I do enough clinical work to stay competent. I teach at the undergraduate, residency, and post-graduate levels. I do a lot of research. For me, a wonderful marriage of research and teaching responsibilities. In the last decade, under research and teaching responsibilities, I supervise 5 or 6 PhDs at any point in time. I get credit for, as my major education credit, supervising the PhDs, but the PhDs are the ones doing research for us.

Again, I have been extremely fortunate in a series of ways from the beginning to the end in my academic career. Now, I work with young people. I enjoy it. I enjoy getting people connected. So I have educational responsibilities, which are teaching undergraduate, and some teaching at the graduate level. My main educational activity is supervising these senior trainees. You need research associated with it. By university standards, I am extremely productive, where it counts. Since I am productive, I feel that’s why they let me work on what I want.

7. Jacobsen: What informs pedagogy for you?

Guyatt: In terms of communicating concepts: clarity, keeping things as simple as possible, using examples of everything, using paradigmatic or extreme examples to illustrate concepts, ensuring that people really understand the idea, and then gradually introducing increased levels of sophistication. Tons of feedback for people, always trying to keep it as positive as possible, while making it clear where improvements are needed, creating a facilitative environment of learning where the people feel supported and valued. They get enough positive reinforcement to them keep them going while conveying a top priority on rigour and doing work at the highest possible level.

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Appendix I: Footnotes

[1] Distinguished University Professor, Health Research Methods, Evidence and Impact, McMaster University.

[2] Individual Publication Date: May 1, 2017 at www.in-sightjournal.com; Full Issue Publication Date: September 1, 2017 at https://in-sightjournal.com/insight-issues/.

[3] B.Sc., University of Toronto; M.D., General Internist, McMaster University Medical School; M.Sc., Design, Management, and Evaluation, McMaster University.

[4] Courtesy of Gordan Guyatt.

[5] McMaster University. (2016). Gordon Guyatt. Retrieved from http://fhs.mcmaster.ca/ceb/faculty_member_guyatt.htm.

Appendix II: Citation Style Listing

American Medical Association (AMA): Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One) [Online].May 2017; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

American Psychological Association (APA, 6th Edition, 2010): Jacobsen, S.D. (2017, May 1). An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)Retrieved from http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Brazilian National Standards (ABNT): JACOBSEN, S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One). In-Sight: Independent Interview-Based Journal. 14.A, May. 2017. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one>.

Chicago/Turabian, Author-Date (16th Edition): Jacobsen, Scott. 2017. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One).” In-Sight: Independent Interview-Based Journal. 14.A. http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Chicago/Turabian, Humanities (16th Edition): Jacobsen, Scott “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One).” In-Sight: Independent Interview-Based Journal. 14.A (May 2017). http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Harvard: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)In-Sight: Independent Interview-Based Journal, vol. 14.A. Available from: <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one>.

Harvard, Australian: Jacobsen, S. 2017, ‘An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One)In-Sight: Independent Interview-Based Journal, vol. 14.A., http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

Modern Language Association (MLA, 7th Edition, 2009): Scott D. Jacobsen. “An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One).” In-Sight: Independent Interview-Based Journal 14.A (2017):May. 2017. Web. <http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one>.

Vancouver/ICMJE: Jacobsen S. An Interview with Distinguished University Professor Gordon Guyatt, OC, FRSC (Part One) [Internet]. (2017, May; 14(A). Available from: http://www.in-sightjournal.com/an-interview-with-distinguished-university-professor-gordon-guyatt-oc-frsc-part-one.

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© Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal 2012-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Scott Douglas Jacobsen, and In-Sight Publishing and In-Sight: Independent Interview-Based Journal with appropriate and specific direction to the original content.  All interviewees co-copyright their interview material and may disseminate for their independent purposes.

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