Pierre Kory’s Medical Musings
The Historic Suppression of Scientific Debate in COVID
Never before in modern history have entire topics in Medicine been actively prevented from discussion in public forums. As a result most of the world only heard one-sided narratives.
Pierre Kory, MD, MPA
I started reading about the definition, history, and legal background of censorship. The entry on Wikipedia (ugh) was quite revealing:
Censorship is the suppression of speech, public communication, or other information. This may be done on the basis that such material is considered objectionable, harmful, or sensitive. Censorship can be conducted by governments, private institutions and other controlling bodies.
But get this, look at the examples of topics that have traditionally been censored:
General censorship occurs for a variety of claimed reasons including national security, to control obscenity, pornography, and hate speech, to protect children or other vulnerable groups, to promote or restrict political or religious views, and to prevent slander and libel.
Note that “scientific opinion” is not on there. Because scientific data nor interpretations of that data, should ever be considered offensive. You can argue that wrong interpretations of data can be harmful, but debate is how you resolve that, not censorship! Science literally rests on open debate and the sharing of data and exchanging of interpretations amongst not only experts, but the wider public.
Now, also from Wikipedia:
Censorship has been criticized throughout history for being unfair and hindering progress. Censorship is counterproductive as it prevents the censored topic from being discussed. Those who impose censorship must consider what they censor to be true, as individuals believing themselves to be correct would welcome the opportunity to disprove those with opposing views (just ask Steve Kirsch).
But again, science is not on there as a category of discourse to censor. Although history is replete with attempts to censor individuals with scientific views contrary to established orthodoxy, in all the instances I can think of, the person being censored was eventually proven correct! Galileo (earth is round), Seimelwess (importance of handwashing), Scopes (teaching of evolutionary theory) etc.
Yet, in the last 2 years we have undergone a massive censorship of the discussion and sharing of scientific data in public forums. I believe this was the proximate cause of what can now only be viewed as humanitarian catastrophes resulting from 1) the suppression of knowledge of early treatment with effective repurposed drugs and 2) the suppression of data showing the toxicity, lethality, and ineffectiveness of the vaccines.
This period should serve as one of the most damning arguments against censorship.
We were not allowed to openly discuss our data or our interpretations and applications of that scientific data (i.e. scientific opinions) in major media or social media. The journalist Matt Taibbi called me “the ghost of the internet” because whenever I had a scientific discussions with folks who are now dear friends and colleagues, their content and podcasts were de-platformed or demonetized (as in the case of my dear friend Dr. Been), and/or they immediately founds their posted videos of those discussions taken down, like immediately (the speed in which I “disappeared” was astonishingly fast at times). All because we had a scientific discussion where I had shared data and interpretations of that data. I was honored with the opportunity to make my case in front of some truly expert and deep thinkers. Folks who could challenge me, ask questions, express concerns or offer alternative interpretations or hypotheses. I would say that the only problem with those discussions is that the data in support of ivermectin was just so overwhelming. It is a drug with proven efficacy in COVID. Note that conclusion is shared by some of the most highly published doctors in the history of our specialty (the FLCCC) as well as by a group of some of the top evidence-based medicine researchers in the world (Tess Lawrie, Andrew Bryant, Edmund Fordham et al. of EBMc2).
And therein lay the problem. The data could not be debated because any other interpretation than ivermectin being effective was pretty much indefensible in the face of a mountain of repeatedly and almost universally supportive data from myriad sources. So, instead, such discussions were banned from wider public view. Strong move. I think the only thing that saved a good portion of humanity was that individual and organizational websites (like the FLCCC’s, AAPS, c19early.com, and others) were largely secure and not taken down or booted off of hosting servers. But I imagine they could have been.
So, in COVID, Big Pharma and Big Government literally got media companies to shut down debate and discussion on certain topics like HCQ and IVM and vaccine toxicity and ineffectiveness. See YouTube’s community guidelines, which are so absurd, I literally turn purple with rage every time I read it. But it is also sort of comical because they literally put it in writing, right out in the open, plain to see, essentially saying “thou shalt not discuss these medicines on our platform.” And they did it while their efficacy was still being debated. In a global pandemic with thousands dying each day. Safe medicines.
Check it out:
Insane. Crazy town. Clown world. Now, keep in mind that these “guidelines” restricting any discussion of the efficacy, even potential efficacy during a global pandemic, were employed by every major media company in the world with few exceptions, like Trial Site News (although massively impactful, not yet “major media”) and maybe on a few occasions Fox News or some conservative radio hosts.
But all was not lost. Independent podcasters and some radio hosts saved the day, contributing to the dissemination of life-saving information to millions of people in this country and world. Folks like Bret Weinstein, Joe Rogan, John Campbell, Dr. Been, Dr. Mercola, Greg Hunter, Vicki McKenna (hi Vicki!) and countless others. But the print and TV media giants did not have that policy written and made public for all to see (and laugh at). It was under the table, understood by all media that ivermectin should instead only be referred to as a horse dewormer. Not subtle. Alex Berenson’s recent sharing of evidence that the White House was behind his Twitter de-platforming shows how high up the censorship was coming from.
So you literally had the government and Pharma pressuring all the media and social media giants (all of them – Facebook, Linked in, Instagram, Twitter etc) to outlaw, yes, outlaw discussion of even the possibility these medications were effective. Never, ever forget this. Note how YouTube wrote that their guidelines were based on WHO recommendations. Control the top, you control everything beneath it. Read my detailed deep dive uncovering the corruption of ivermectin at the WHO here and here.
Now, one of the reasons Paul Marik was such a famous critical care doctor is that he had long been successful at debunking prevailing orthodoxy supporting standard of care practices in our specialty. He did it via lecturing and debating at national conferences and in publications within medical journals. It was how he and I met, when he congratulated me on an editorial I wrote in a major journal, where I argued against using ultrasound to measure the size of the inferior vena cava to estimate central venous pressure (CVP), largely drawing on the science and rationale he had compiled and published.
Talking to Paul this morning, he told me he is most proud of his work (note he accomplished this feat on his own) in teaching a global generation of critical care doctors that measuring the CVP to estimate the fluid needs of a patient was useless outside of a very narrow set of circumstances like hemorrhage (in those circumstances though, you don’t need the CVP to estimate fluid needs as the patients vitals and clinical presentation will tell you all you need to do.
You have to understand that the CVP was used for decades by critical care doctors in ICU patients who were in states of shock (dangerously low blood pressure). It was the standard of care in ICU’s. Paul did a deep dive into the published literature and especially into the complex physiology of the factors which influence CVP and wrote pretty much the coolest and most impactful paper ever called “Does Central Venous Pressure Predict Fluid Responsiveness?: A Systematic Review of the Literature and the Tale of Seven Mares.” The papers most memorable sentence was “the only study we could find demonstrating the utility of CVP in predicting volume status was performed in seven standing, awake mares undergoing controlled hemorrhage.” Brilliant. Funny.
His paper triggered fierce and I mean, fierce debate in critical care… for years. Reversing established orthodoxy in medicine (and anywhere really) is nearly impossible. But Paul singlehandedly pulled it off with his papers and lectures (helped by a lot of folks like me who followed his work closely). I would argue that today, the obsession with using the CVP to guide fluid resuscitation has largely (but never completely) been abandoned. Wow.
But, again, back then, you could have “debates” on controversial topics, in fact, such topics demanded them! I remember when the United Hospital Fund used to put on this terrific conference in Manhattan where they invited experts in the field to debate “controversies” in critical care (like CVP). Each speaker was given ten minutes and were assigned the pro side or the con side of a topic, but the assigned debaters could not choose the side to argue! After both speakers were heard, the audience voted on which conclusion was based on the more compelling data and argument. I was invited several years in a row and sometimes had to argue the side I was not on intellectually. Which made it even more enlightening an exercise – imagine getting Berenson to have to argue in support of ivermectin? It just might happen that he learns something important. Also, it was a “hard” ten minutes they gave you. So much so, I remember one year I got the whole room laughing because I did not shut up when the big timer hit ten minutes and the big red stoplight turned on, so a close colleague of mine ran up to the podium, put me in a headlock and started to drag me away from the podium as I was still yelling my final points. That was fun. Now, not so much.
More trips down the memory lane of debates. One of the first “corruptions” by Pharma that I experienced in my career was when Eli Lilly invented a national campaign called “Surviving Sepsis” in an attempt to create guidelines supporting optimal care practices. They involved all the professional societies in critical care to participate. Leaders in the field all with a seat at the table.
Yep, you guessed it, it turned out to be cover for their efforts in making a $5,000 harmful drug (Xygris) the standard of care in sepsis. Every single one of those committee members got money. The entire campaign and strategy was developed by a PR firm. Recall that Disinformation tactics were first invented by a PR firm in the 1950’s working for the Tobacco Industry at a time when their products were starting to look bad in the scientific literature.
I would argue that Pharma is the most skilled practitioner of Disinformation amongst all industries. I mean 20 years ago already, the entire country’s critical care doctors gave a very expensive, harmful drug to every septic patient for years based on a manipulated trial with the tiniest of mortality benefits amidst a splashy “public health” campaign concocted by a PR firm working for a pharmaceutical company.
When Xygris was eventually shown to be harmful it was abandoned. But that decision occurred on the back of fierce debates and constant re-analysis and discussion of the accumulating data. Hmm, I wonder when that will happen to Remdesivir? Fun fact: during my fellowship training in pulmonary and critical care, my mentors, Dr. Paul Mayo and Dr. Samual Acquah essentially forbade the use of Xygris at a time when every other fellow in training was using it like water. I never once ordered it for any patient.
But there were other controversial aspects of the sepsis guidelines that Paul was a beast in demolishing at national conferences. He was so good, his take on the data so expert and compelling that his lectures were always packed, like standing room only type packed. For a medical lecture.
The most debated aspect of sepsis treatment (and yes, it was debated repeatedly at national conferences) was called “early goal directed therapy” (EGDT) which required that you resuscitate patients using fluids and vasopressors to a target central venous pressure (CVP) and a target central venous oxygen saturation (SCV02), but to monitor the latter continuously, you had to insert a special catheter into the large neck veins to do it. I will not go into the detailed physiology of those parameters but the need to measure them was nonsense.
I knew it (even as a fellow), my mentors knew it, Paul knew it, yet EGDT was widely adopted across the country and world. The protocol was based on a single center study whose Principal Investigator Manny Rivers held the patent on that catheter (unknown by most at the time). Further, information later came out that the data were manipulated. That information was leaked by a whistleblower who was a fellow of Rivers at the time. The fellow was threatened by the hospital with the ending of his career if he were to continue to speak publicly about it. They even apparently threatened to “kill his kids.”
But the point is, the debates were fierce, in the open, and at conferences and hospital auditoriums across the country and world. They were data driven arguments by experts with decades of scientific inquiry and clinical expertise who reviewed the physiology and published literature. And sometimes led to conflicting interpretations. Yes, we all had biases when interpreting the data (all humans do), but we debated. It was not outlawed to say that SCV02 and IVC were unnecessary. Or to say they were critical. And you were not forced to use all aspects of EGDT in the care of patients back then as they were just “guidelines,” not rigid protocols supported by Federal government funded bonuses in every patient you used it in like we have now with Remdesivir.
Interestingly, widespread EGDT adoption actually showed consistent impacts in reducing mortality, but we knew it was not from the targeting of those parameters but instead just from the early recognition and resuscitation of sepsis. Might even be the one instance in history where a corrupt action by Big Pharma actually led to a benefit in public health. Anyway, eventually studies showed that targeting those parameters versus simply using clinical judgement led to the same outcomes and the practice was abandoned. Paul was right again.
Another aspect of the U.S resuscitation guidelines that Paul was absolutely brilliant in debunking was the decision to target a reduction in lactate as a resuscitation endpoint. This was another fiction like the CVP. Again, almost all of emergency and critical care medicine had been indoctrinated with the physiologic concept that lactate is a marker of hypo-perfusion (reduction in blood flow to organs). Now, in certain, specific clinical instances (ischemic bowel etc), a rise in lactate can reflect hypo-perfusion. But in most septic patients it is simply a marker of illness and stress. It is not harmful, in fact, if anything, lactate is better utilized by organs to maintain function and energy. However, doctors were taught to target lactate as a resuscitation endpoint instead of simply interpreting it as a marker of disease severity.
But, in this instance, that practice and belief was not the result of corruption. No-one as far as I can tell was making money off of dumb doctors and nurses being forced to check lactates repeatedly. It simply stemmed from ignorance and established practice, with leading “experts” (dotards) arrogantly teaching that it was important to target (because they were taught that and did not critically think about it). Paul’s research revealed that targeting lactate was the result of a gross misunderstanding of lactic acid physiology. It was again one of the most masterful papers I have read. He marshaled tons of physiologic knowledge and logically presented the concepts and data which defined the cause and purpose of lactic acid production.
Just like with his teachings on CVP, again you had one man arguing against an entire generation of doctors who believed that reducing lactate was important in the general septic patient. I totally agreed with Paul’s papers and conclusions. Which made my life difficult because I tried in vain to disseminate this knowledge among my trainees, trying to stop what I saw as the pervasive “lacto-bolo reflex” they were all exhibiting. Paul actually invented the term, and it was brilliant: “bolo” refers to a bolus of fluids, and the “reflex” was the ordering of an infusion of a half liter or liter of fluids every time a high lactate was measured.
Lacto-bolo reflexes unfortunately led to what he also brilliantly coined as “salt water drowning,” i.e the receipt of excessive amounts of saline fluids by patients. Every time a doctor or nurse received a report of a high lactate… the doc ordered fluids. Lacto-bolo reflex. What is crazy is that the excess fluid administration that resulted paradoxically worsened kidney function and led to more kidney failure despite the fact the doctors were trying to preserve kidney function with fluid infusions! It was insane and I knew it because of Paul’s research and teaching. I also tried for years to fight the lacto-bolo reflex in my trainees and colleagues with little success except for when I was physically present in the ICU. When I went home for the night though, my fellows and residents all continued with their lacto-bolo reflexes. When the cat’s away the mice will play.
However, in this instance, despite Paul’s papers and lectures on the topic, the unthinkable became true. “Experts” (dotards) eventually established the checking of repeated lactate as a national quality of care standard. Those standards are what hospitals are judged on which affects their reimbursement and accreditation.
So, doctors across the country are now literally mandated to repeatedly check and respond to lactates in septic patients. Again, another example of an orthodoxy based on fiction. Despite all of Pauls efforts in teaching, lecturing, and publishing on the topic, this time, he was unsuccessful in changing orthodoxy. He may have been if his career didn’t end but History marches on. I would argue that his efforts in singlehandedly trying to reverse orthodoxies unfounded by “the science” led to a widespread respect, admiration, and reverence for the deep knowledge and scientific acumen he consistently displayed. But not so much anymore it seems.
And that is solely because Paul’s final effort in academic medicine was in trying to reverse the fiction that ivermectin was ineffective in COVID. That effort ended his career because for the first time, unrealized by him at the time, instead of fighting ignorant knowledge of physiology, he was poking The Bear, i.e tackling a subject that threatened Big Pharma. In a big, big way. Thus, that effort ended his career. But let’s be specific about that – his former hospital (SENTARA GENERAL IN NORFOLK, VIRGINA) was the one who actually ended his career.
Now, how they ended it is pretty interesting, as my last job was ended in the same way. They did it by using a process that hospitals have long employed when a physician “doesn’t toe the line.” In COVID, Paul was a clinical leader in a major hospital and was employing a highly effective protocol using a combination of repurposed drugs and not using Remdesivir. And he was vocal about it. And he was teaching the doctors in training about the harms of Remdesivir and all of the data supporting “unapproved therapies.” So, they invoked a process called “sham peer review” to get rid of him. What the heck is “sham peer review?”
From a seminal paper on the topic:
In 1986, the United States Congress enacted the Healthcare Quality Improvement Act (HCQIA). which granted immunity to hospitals and reviewers participating in “good faith” peer review of physicians and dentists. These reviews were envisioned to be vehicles by which it could be determined if any actions or recommendations against a physician should become necessary on the measures of incompetence, unprofessional conduct, or behaviors that impact the doctors’ clinical privileges. However, of late, HCQIA has resulted in many unforeseen consequences, not the least of which is the rise of ‘sham peer reviews’ —and the consignment of guiltless, lifesaving, pre-eminent physicians into obscurity.
What is “Sham” Peer Review?
Sham peer review is an adverse action taken in bad faith by a hospital for purposes other than the furtherance of quality health care. It is a process that is disguised to look like legitimate peer review. But sham peer review is not objectively reasonable, precisely because it is not performed to advance the quality of health care (violation of safe harbor provision).
A sham peer review happens when the hospital invents some pretext on which to attack the physician and acts to disguise the adverse action against the targeted physician by conducting a such a review—where the truth and the facts do not matter, because the process is contrived to be rigged, and the outcome is predetermined.
Over the years, sham peer reviews have unfortunately become fairly well-known. Hospitals in the United States have mounted these proceedings for at least four decades to rid themselves of physicians who “get in their way.” Often, they are doctors who don’t ”follow the party line” and whom they consider “disruptive.” Hospital officials are resistant to physicians who bring patient safety or care quality concerns to their attention. Some hospitals retaliate against these whistleblowers, by instigating these sham peer reviews.
How Sham Peer Review works
Hospitals that use sham peer review bring trumped up, fabricated, and thoroughly false charges against the targeted physician. Although no court of law would permit depriving an accused person of files or records needed to defend himself, as it is fundamentally unfair and in violation of due process, hospitals that employ sham peer review frequently refuse to provide records required to the physician under review. Based on these totally erroneous and phony charges the physician’s hospital privileges are summarily suspended. The physician is usually given 14 days to respond in writing to the sham charges. The charges and the physician’s response are then supposedly shared with the Medical Executive Committee (MEC). The physician then meets with the Medical Executive Committee. The physician is usually denied legal representation (which is unlawful), and the meeting takes the form of a Kangaroo court.
And the above, is EXACTLY what happened to Paul. Like.. to the T. Most importantly, he had no rights during the process. No ability to bring a lawyer in to help defend him. No ability to discover the identity of the complainant or exact documentation of the complaint. That is how they can just make shit up.
I won’t go into the details because the above explains everything that happened to Paul but his was particularly egregious (mine was short and simple). They generated at least 8 anonymous, invented complaints by other providers, nurses and employees inventing things he said or did and characterizing his behavior as “disruptive.” He had never gotten a single complaint from a patient or colleague in his entire career. They even accused him of malpractice for treating a patient for severe COVID who had tested negative for COVID. I saw the patient’s films and labs, heard his history, and presentation. The guy had COVID, period. Plus, the guy was super sick, on a ventilator, and Paul saved him with his protocol. No small feat for a COVID patient on a ventilator. The patient survived yet the hospital used the case as a mark against him. Insane.
Everything was right out of the sham peer review playbook. And it resulted in the ending of his career.
My “sham peer review” was different given that I was working as an independent contractor running an ICU for a hospital in central Wisconsin. The hospital administration had been asking my partners who hired me to get rid of me as soon as they heard I had been hired, likely due to my public profile (ya think?). My partners refused as we got along great and they deeply appreciated my skills, contributions, COVID expertise and protocols. They told the administration “if he goes, we go.” And this was a hospital with a long track record of difficulty recruiting physicians. Yet, my partners were continually harassed by the administration who kept sending them “hit pieces” they found about me in newspapers and magazines.
Six months later, in November 2021, the Chief Medical Officer of the hospital knew I was not vaccinated and that a mandate was about to start. So he called me and asked if I was going to be vaccinated because he had to plan for contingencies. I asked him for a couple of days to think about it. I decided I would just get a vaccine card instead. Not proud of that plan but I knew the vaccines were built on unconscionable lies. He called me two days later, and I told him I would get vaccinated.
The next morning after my shift, my lead partner called and told me “they didn’t need me anymore.” I asked what happened (I knew they needed me, badly). He explained that I had told some ER patient to not get vaccinated and that their practice believed in vaccination so could not be associated with someone who was not. One catch – I had not been in the ER for two weeks. I defended myself, to no avail. My partner knew I was telling the truth, but I knew he was likely under an ultimatum. He apologized and said, “I am so sorry, but there is a war going on and you are unfortunately a casualty of that.” We said pleasant goodbyes and wished each other well. Pretty quick sham peer review because I was not an employee so they had the right to cancel my contract at anytime. Done. Gone.
So, as you can see from the above, COVID is not our first rodeo battling ignorance and corruption in Medicine. But we battled with debate using data, published literature, and deep knowledge of physiology. Now, no more.
Steve Kirsch has been offering 1-2 million dollars for anyone in academia or the agencies to participate in a public or even privately recorded, moderated debate of the evidence to support vaccine safety and efficacy. No-one took him up on it.
An organization in Kansas City asked me, Peter McCullough and two other experts to participate in a debate with the clinical leaders at KU. They refused to show. Their table sat empty on the stage while we debated the public statements they had made with a local TV program instead. They literally told the TV presenter that “we do not debate in public forums, only in journal clubs amongst fellow doctors.” Note he said this on TV then went on to support their policies citing what we know are corrupt and easily disprovable evidence-free narratives. What a farce.
Just as sad as the above is that Paul had long been invited every year by a medical education organization to lecture to anesthesiologists as he was a perennial favorite lecturer. This past year, he gave a masterful lecture on the data supporting the use of ivermectin in COVID. Soon after, he was told that he will never again be invited to give lectures.
He also gave the same lecture to the Anesthesia Department at Mass General (Harvard). The evaluations by attendees all complained that his lecture was full of mis-information. He will never be invited back.
Twitter, which describes itself as a “public square” has de-platformed many of my colleagues (multiple times) for sharing newly emerging data supporting the efficacy of ivermectin. Hey Juan Chamie, how many times have you been Twitterwhacked? One of life’s greatest mysteries (slight overstatement) is how I am still alive on Twitter, although to be accurate, I am only half-alive as they severely shadow ban me on that platform.
I guess we just have to accept the fact that two new commandments have come down from the mountaintop:
Thou shalt not share favorable ivermectin data in any public media sphere
Thou shalt not present analyses of the scientific data supporting ivermectin in lectures to physicians
The world has gone mad.
Next post, I will delve more specifically into the tactics Pharma deployed in pulling off their massive Disinformation campaign against ivermectin using propaganda as well as censorship of the FLCCC .
I just want to say how much I appreciate all the subscribers to my Substack, and especially the paid ones! Your support is so greatly appreciated.
P.S. I opened a tele-health clinic providing care not only in the prevention and treatment of acute COVID, but with a specialized focus on the study and treatment of both Long-Haul and Post-Vaccination injury syndromes. If anyone needs our help, feel free to visit our website at www.drpierrekory.com.
P.P.S. I am getting professional help (hah!) to write a book about what I have personally witnessed and learned during Pharma’s historic Disinformation war on ivermectin. Pre-order here for: