Catch-22
In Catch-22, Joseph Heller’s classic novel about WWII fighter pilots, a pilot could avoid flying dangerous missions only if they were insane. However, anyone who asked to be grounded was by definition sane and therefore had to fly. As Heller wrote:
There was only one catch and that was Catch-22, which specified that a concern for one’s safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn’t, but if he were sane he had to fly them. If he flew them he was crazy and didn’t have to, but if he didn’t want to he was sane and had to.
Sabotaging RFK Jr’s Confirmation Will Increase Vaccine Hesitancy.
With this in mind, we can turn our attention yet again to Dr. Vinay Prasad, who has become a lightening rod during his brief, tumultuous time at the FDA. The drama has never been higher, and trust has never been lower. Back when he was auditioning for his job, Dr. Prasad debased himself by relentlessly fluffing RFK Jr., his future boss, claiming he was more reliable than vaccine-expert Dr. Peter Hotez and that he would be the savior of vaccines. Dwell on that for a moment. In order to gain power, Dr. Prasad was willing to write this article:
Things haven’t worked out that way.
After Vinay left, Marty and Bobby worked very, very, very hard through Susie Wiles, the president’s chief of staff, to tell the president that Vinay was not anti-Trump
Once in office, Dr. Prasad made several controversial decisions about rare diseases that landed him in hot water. However, while the patients affected by these decisions shouldn’t be discounted, this is not what Dr. Prasad should be primarily known for at this moment. Rather, Dr. Prasad should be chiefly known what he isn’t saying. His silence about the dangers of the administration in which he proudly serves affects the entire world.
As a reminder, Dr. Prasad is the country’s chief vaccine regulator and head of Center for Biologics Evaluation and Research, which says its mission is to “Protect and improve public and individual health in the United States and, where feasible, globally.” Moreover, Dr. Prasad markets himself as a guru and protector of EBM against ignoramuses who sometimes act based on less than pristine evidence. Dr. Prasad was not shy about sharing his opinions. “RCT or STFU!” he said to those who tried to limit COVID in any way. He said that anyone who treated death more seriously than than rare, temporary vaccine side-effects “motherfuckers” and “fucking morons”. Dr. Prasad was known for this juvenile vulgarity, not his cautious restraint.
Yet now that he has power and responsibility, Dr. Prasad is quiet and invisible. He has nothing to say as his boss spreads gross antivaccine disinformation and dismantles research in vaccines. Even though RFK Jr.’s disgusting rhetoric inspired fatal violence at the CDC, and RFK Jr. continues to dunk on the people who work there, Dr. Prasad maintains his monk-like silence.
RFK Jr. is the literal chief of the Medical Establishment, and he is a significant threat to the health of American children. Doctors across the country have finally realized this, and they are aligned against him. Dr. Prasad, however, is mute. This quiet acquiescence sends a clear message- If a nuanced master of clinical appraisal like Dr. Prasad doesn’t think RFK Jr. is a problem, then why should anyone else?
From his immaturity to his disinformation, there are countless reasons why Dr. Prasad is unqualified to be a leader at the FDA. However whatever decision he makes about some future biotech drug, it’s all a secondary issue. None of those decisions will be more consequential than the initial one he made by agreeing to work for RFK Jr. in the first place. That by itself is both indefensible and irredeemable.
Moving forward, Dr. Prasad should be known mainly as a doctor who prioritized his fancy job title, even though this required him to nod along politely while his boss took a blowtorch to vaccines and science. Moreover, in order to get his job back, Dr. Prasad had to grovel and prove he was a fan of Trump and everything he is doing right now. According to one news report about his return:
“After Vinay left, Marty and Bobby worked very, very, very hard through Susie Wiles, the president’s chief of staff, to tell the president that Vinay was not anti-Trump,” one of the senior administration officials said. “The MAHA movement is an expansion of the MAGA, sort of, you know, big tent.”
History is full of these sorts of self-interested enablers, and Dr. Prasad can avoid this disgraceful fate only if he is willing to be a responsible leader and simply tell the truth about RFK Jr. It’s quite the Catch-22, but if someone agrees to take a leadership role at the FDA under RFK Jr., that automatically proves that person is fundamentally unfit for the job. And the only way Dr. Prasad can have a successful tenure at the FDA is to be honest about RFK Jr. and get fired again. Until then, the regulatory decisions he makes are inconsequential compared to the fact that he was willing to legitimize and team up with RFK Jr. to begin with. Today, we should all pay attention to what he isn’t saying.
Nothing else about him matters to me, and it shouldn’t matter to you either.