I'm deeply concerned about the entire Midwestern Doctor and his influence. His writing is a textbook of recurring techniques seen across manipulative movements and demagogic figures in history.
I am not a medical person but have a strong compass to seeing when someone is very invested in manipulation. I also have spent a long time studying tactics of persuasion, mind priming, and harms of manipulative rhetoric/speech/behaviour much of which I see in his articles.
All of his articles use the same tactic.
Anger, fear, and betrayal are triggered first; reasoning comes later, when the reader is already biased toward his side. Every totalitarian and cultic movement has used that sequencing.
He's selectively using some studies (which without through fact checking might be compelling) to create some conflict or outrage. He will present lots of individual studies, historical anecdotes, lesser-known trials, or border cases that appear to support his narrative. But typically, he does not show counter-evidence, show the full context, or deal with contrary data in depth. People unfamiliar with the domain can be swayed by that. In fact, he offers an overload of selective evidence.
He floods readers with citations, half-truths, and anecdotes—more data than a non-expert can check — so the sheer quantity feels like proof. It’s an old propaganda trick: bury the falsehoods under an avalanche of seemingly relevant "facts" or half-truths. Let people see how smart I am.
Claims like “this is the forgotten side of medicine,” that the establishment is actively suppressing truths, or that “they” are conspiring to hide safer alternatives. This frames the writer as a brave truth-teller under attack, which is a powerful persuasion hook. He presents himself as a saviour bringing THE truth to people while not even signing his real name. Like many authoritarian-populist speakers in our history he casts himself as the lone honest insider — persecuted yet brave — rescuing ordinary people from deception. That archetype (truth-teller versus the system) is a magnet for disillusioned audiences.
Even when he uses scientific sounding language, often the connections are leaps: e.g. arguing Tylenol causes autism by chaining together intermediate points that individually might be true or ambiguous, but the overall inference is not justified. That’s the same patter that I noticed in the few articles I read: individual segments felt solid, even enlightening, but the whole argument didn’t cohere. Mind you, I didn't fact check the "solid-seeming" anecdotes he presented, which I think might have holes in them too.
To all his articles he slides (now subtly still in the phase of priming) the "miracle cure DMSO" that in itself is completely without enough strong evidence and with dangerous side effects). A saviour comes to the rescue!
Any refutation is reinterpreted as “evidence” of the conspiracy: if scientists disagree, it’s because they’re controlled. That structure is unfalsifiable—a hallmark of manipulative ideology, not science.
His views aligned and defending the current highly uneducated US government—like clockwork providing claims and big rhetoric that farther their conspiracy theories even in the most critical minds through the use of emotions, eroding trust in medicine. By aligning with RFK Jr., conspiracy narratives, anti-pharma rhetoric, distrust of institutions, he builds a shared worldview with readers who already have skepticism of “corporations / elites / governments.” That alignment helps bypass critical filters: if you already distrust pharma or big corporations, then a messenger who echoes your distrust feels more credible.
Important to say that I don't have much trust either in corporations, big pharma or the model of medicine today, but still am not buying into this "lets all connect against the enemy". With interest I read a couple of his articles about psych meds, but the more I read the more things were not adding up. And my BS radar started blaring to actually take a step back and anaylyse what he was doing.
Bottom line, he mostly appeals to emotions that people already have - fear worry, distrust, anger, capitalising on them to push his own narrative moulding people to even defend his flamboyant theories as they become so invested in THEIR side (seen in the replied/comments below). It's yet another attempt to turn people against one another.
It's a simple indoctrination! These patterns resemble what’s found in fascist, cultic, and extremist rhetoric: the exploitation of grievance and mistrust to consolidate psychological dependence on a single “truth-revealer.”
I believe his work is to prime people to offer them on his cures or any other method, choices once they're fully enchanted by his rhetoric. Many lunatics in our history use similar rhetoric to make people do harmful things to themselves and to others.
It would be much less cowardice to sign with his true name and credentials. And people should stop believing everything they read or hear becasye they can suffer.
Anyone who intends to read AMD, I suggest learn more about core characteristics of propaganda speech, from books like Ur-Fascism. Soon you will find out what AMD is playing.
One thing I know is I will trust Midwestern Doctor much more than whomever this joker is. Go prescribe some more pimple cream and delude yourself into thinking that you do anything useful for society.
since i am now in my mid 80s and grew up trusting doctors, guess i will have to rethink what i do now. i live in mexico sohave plenty of sun and no hulging veins
People like Audrey Hepbun wear sunglasses as a fashion statement- the bigger the better. Sunglasses can hide bloodshot eyes and droopy eyelids. Not everything is worn or taken for medical reasons - sometime it is just for glamour.
One more thing, I actually did have stage 3 melanoma 30 years ago, and my dermatologist said flat out, stay away from birth control pills as there may be a link.
Just to set the record straight, Pierre Kory is not the anonymous writer of A Midwestern Doctors' substack. Pierre Kory has interviewed this doctor, who has chosen to remain such beginning with being outspoken on COVID failed policies, which as you know, Dr. Kory never has done the same.
Did I miss something here? Did AMD have a guest-post on Sensible Medicine or was the Sensible Med platform simply extended to Dr Ortel to rebut an AMD post? I only recently have become aware of and reading AMD posts, so I don't have any framework to offer opinions as to his/her identity nor to have a full sense for how much I agree with their observations.
What I see here: the main point I got from the AMD post was that the most deadly form of skin cancer, ie melanoma, does not have direct correlation to sun exposure. This has been an extremely difficult concept for me to wrap my head around! Dr Ortel's rebuttal actually seems to support this point in his statement "we do not understand the exact interactions of solar exposure with ... steps in melanoma development." Really?! This is not what the messaging of the medical establishment is seeming to push. Does he think mothers are slathering their children from head to toe with sunscreen because they think they are limiting their risk for basal cell and squamous cell cancers down the road?? No, they feel they are saving their lives from deadly melanoma! Unfortunately, his "clarification" here did not clarify anything - it actually seems to support one of the main claims AMD makes. And I still find this quite shocking - the focus and strength of constant advice to cover yourself from any sun exposure seems to be telling us with great certainty that we are decreasing our risk of dying from "skin cancer" - the strength of these recommendations does not suggest there is anything we "still don't understand the exact interactions of"!
And was a rebuttal even necessary for the "bulging veins" comment? This was not a "Doctor's" veins bulge comment. This was a childhood/"youthful" observation that AMD had, which later caused them to question things. All of us use observations to some extent. My brain thinks in pattern-recognition. During the lifetime I've had, my brain has observed and filed away all kinds of things. When I see or hear something that contradicts the patterns I've observed, it makes me question what that thing purports. On further investigation, I might find I do agree. But I often find it only opens the door to more questions and critical review. People who just accept "facts" from others and don't question more often get led astray. AMD is obviously someone who uses their own observations to question medical dogma.
Dr Ortel's comments about sunlight and mental health are quite misleading! I don't imagine any doctor who recommends sunlight to a patient to help with depression/SAD is suggesting they "spend a long afternoon asleep in the sun". Thirty minutes of natural light in the morning is very different than that and does play a potential role in mood improvement and likely has less side effects than SSRIs.
The main sense I seem to get out of this post is an attempt to limit or call out MISINFORMATION. We have a recent focus on "those of us who know better" feeling the need to stamp out things they deem untrue. I do not think adults need protection from "misinformation". An adult possesses the intelligence and ability to review information and decide where it does or doesn't fit into their already held views. I do understand that physicians have a particular role of authority and need to consider that role. But - medicine is not as cut and dried as some (even doctors) think. There are many examples where mainstream medicine recommended something strongly that turns out to be completely wrong (peanut allergy comes to mind). Physicians need to remain humble in that regard. We are using our expertise to give advice and that advice can have its limitations. People are free to take our advice - or not.
I think it is reasonable for another doctor to counter claims made that he/she might not agree with. Unfortunately, this rebuttal by Dr Ortel did not clarify much for me and seems odd that it appeared here on Sensible Med.
Dr Ortel's final line generally negates any rebuttal he was making anyway - "the dose makes the poison". Current admonitions from medicine/dermatology to sunscreen constantly, even if inside on a cloudy day, may not have as much science as they suggest. Maybe a more nuanced recommendation would actually make more sense. (the rebuttal did not clarify this for me).
This message could have been delivered without the ad hominem tilt, the snark, and the attempt (missed) to dox AMD. If so, its persuasiveness would have increased exponentially. Still, a second opinion regardless of how it was delivered was warranted.
Agreed. The problem with doctors and other experts using snark and ad hominem attacks is it allows fair turn-around back to them when they aren't correct on every detail. It is also a big part of why trust in medicine, "science", and doctors seemed to decrease during the pandemic. Humility in the true limits of what you are saying goes a long way to counter that. As does the acknowledgment that adult humans can form rational and reasonable conclusions taking many different inputs into account. Paternalism doesn't play well in current society (at least to many people). A simple point of view statement would have been better.
Continuous exposure and intermittent is old. Previous century. My melanoma prepared when young then one beach exposure at fifty detected v. soon after. Has the ozone hole produced much melanoma? I’ve had at least five cancers since the melanoma. Moved from Palo Alto to Santa Barbara with many sunburns in 5th grade.
Fairly certain AMD is NOT Pierre Kory. If memory serves I think AMD has mentioned somewhere that he’s in Michigan? So not even the same practice state. Starting off with a faulty assumption and zero things to confirm this isn’t a great opening
According to this dermatologist, among AMD claims that are so ridiculous they "could have been headlines from the National Enquirer" is this: "Health benefits of sun and ultraviolet radiation exposure."
How do the mainstream docs manage to consistently be this dumb???
Dermatologists and neurologists and cosmetic surgeons and endocrinologists are the least trustworthy of the Medical Industrial Complex. If we let the MIC rule our lives, we'd all live in "safe and secure" bubbles, never go outside, and live a couple of years longer, like caged animals in zoos.
blood vessels under the skin dilating in sunlight - wouldn't that be because the body increases blood flow to cool down the slowly(or quickly) warming skin surface?
I'm deeply concerned about the entire Midwestern Doctor and his influence. His writing is a textbook of recurring techniques seen across manipulative movements and demagogic figures in history.
I am not a medical person but have a strong compass to seeing when someone is very invested in manipulation. I also have spent a long time studying tactics of persuasion, mind priming, and harms of manipulative rhetoric/speech/behaviour much of which I see in his articles.
All of his articles use the same tactic.
Anger, fear, and betrayal are triggered first; reasoning comes later, when the reader is already biased toward his side. Every totalitarian and cultic movement has used that sequencing.
He's selectively using some studies (which without through fact checking might be compelling) to create some conflict or outrage. He will present lots of individual studies, historical anecdotes, lesser-known trials, or border cases that appear to support his narrative. But typically, he does not show counter-evidence, show the full context, or deal with contrary data in depth. People unfamiliar with the domain can be swayed by that. In fact, he offers an overload of selective evidence.
He floods readers with citations, half-truths, and anecdotes—more data than a non-expert can check — so the sheer quantity feels like proof. It’s an old propaganda trick: bury the falsehoods under an avalanche of seemingly relevant "facts" or half-truths. Let people see how smart I am.
Claims like “this is the forgotten side of medicine,” that the establishment is actively suppressing truths, or that “they” are conspiring to hide safer alternatives. This frames the writer as a brave truth-teller under attack, which is a powerful persuasion hook. He presents himself as a saviour bringing THE truth to people while not even signing his real name. Like many authoritarian-populist speakers in our history he casts himself as the lone honest insider — persecuted yet brave — rescuing ordinary people from deception. That archetype (truth-teller versus the system) is a magnet for disillusioned audiences.
Even when he uses scientific sounding language, often the connections are leaps: e.g. arguing Tylenol causes autism by chaining together intermediate points that individually might be true or ambiguous, but the overall inference is not justified. That’s the same patter that I noticed in the few articles I read: individual segments felt solid, even enlightening, but the whole argument didn’t cohere. Mind you, I didn't fact check the "solid-seeming" anecdotes he presented, which I think might have holes in them too.
To all his articles he slides (now subtly still in the phase of priming) the "miracle cure DMSO" that in itself is completely without enough strong evidence and with dangerous side effects). A saviour comes to the rescue!
Any refutation is reinterpreted as “evidence” of the conspiracy: if scientists disagree, it’s because they’re controlled. That structure is unfalsifiable—a hallmark of manipulative ideology, not science.
His views aligned and defending the current highly uneducated US government—like clockwork providing claims and big rhetoric that farther their conspiracy theories even in the most critical minds through the use of emotions, eroding trust in medicine. By aligning with RFK Jr., conspiracy narratives, anti-pharma rhetoric, distrust of institutions, he builds a shared worldview with readers who already have skepticism of “corporations / elites / governments.” That alignment helps bypass critical filters: if you already distrust pharma or big corporations, then a messenger who echoes your distrust feels more credible.
Important to say that I don't have much trust either in corporations, big pharma or the model of medicine today, but still am not buying into this "lets all connect against the enemy". With interest I read a couple of his articles about psych meds, but the more I read the more things were not adding up. And my BS radar started blaring to actually take a step back and anaylyse what he was doing.
Bottom line, he mostly appeals to emotions that people already have - fear worry, distrust, anger, capitalising on them to push his own narrative moulding people to even defend his flamboyant theories as they become so invested in THEIR side (seen in the replied/comments below). It's yet another attempt to turn people against one another.
It's a simple indoctrination! These patterns resemble what’s found in fascist, cultic, and extremist rhetoric: the exploitation of grievance and mistrust to consolidate psychological dependence on a single “truth-revealer.”
I believe his work is to prime people to offer them on his cures or any other method, choices once they're fully enchanted by his rhetoric. Many lunatics in our history use similar rhetoric to make people do harmful things to themselves and to others.
It would be much less cowardice to sign with his true name and credentials. And people should stop believing everything they read or hear becasye they can suffer.
Anyone who intends to read AMD, I suggest learn more about core characteristics of propaganda speech, from books like Ur-Fascism. Soon you will find out what AMD is playing.
One thing I know is I will trust Midwestern Doctor much more than whomever this joker is. Go prescribe some more pimple cream and delude yourself into thinking that you do anything useful for society.
since i am now in my mid 80s and grew up trusting doctors, guess i will have to rethink what i do now. i live in mexico sohave plenty of sun and no hulging veins
People like Audrey Hepbun wear sunglasses as a fashion statement- the bigger the better. Sunglasses can hide bloodshot eyes and droopy eyelids. Not everything is worn or taken for medical reasons - sometime it is just for glamour.
One more thing, I actually did have stage 3 melanoma 30 years ago, and my dermatologist said flat out, stay away from birth control pills as there may be a link.
Just to set the record straight, Pierre Kory is not the anonymous writer of A Midwestern Doctors' substack. Pierre Kory has interviewed this doctor, who has chosen to remain such beginning with being outspoken on COVID failed policies, which as you know, Dr. Kory never has done the same.
Did I miss something here? Did AMD have a guest-post on Sensible Medicine or was the Sensible Med platform simply extended to Dr Ortel to rebut an AMD post? I only recently have become aware of and reading AMD posts, so I don't have any framework to offer opinions as to his/her identity nor to have a full sense for how much I agree with their observations.
What I see here: the main point I got from the AMD post was that the most deadly form of skin cancer, ie melanoma, does not have direct correlation to sun exposure. This has been an extremely difficult concept for me to wrap my head around! Dr Ortel's rebuttal actually seems to support this point in his statement "we do not understand the exact interactions of solar exposure with ... steps in melanoma development." Really?! This is not what the messaging of the medical establishment is seeming to push. Does he think mothers are slathering their children from head to toe with sunscreen because they think they are limiting their risk for basal cell and squamous cell cancers down the road?? No, they feel they are saving their lives from deadly melanoma! Unfortunately, his "clarification" here did not clarify anything - it actually seems to support one of the main claims AMD makes. And I still find this quite shocking - the focus and strength of constant advice to cover yourself from any sun exposure seems to be telling us with great certainty that we are decreasing our risk of dying from "skin cancer" - the strength of these recommendations does not suggest there is anything we "still don't understand the exact interactions of"!
And was a rebuttal even necessary for the "bulging veins" comment? This was not a "Doctor's" veins bulge comment. This was a childhood/"youthful" observation that AMD had, which later caused them to question things. All of us use observations to some extent. My brain thinks in pattern-recognition. During the lifetime I've had, my brain has observed and filed away all kinds of things. When I see or hear something that contradicts the patterns I've observed, it makes me question what that thing purports. On further investigation, I might find I do agree. But I often find it only opens the door to more questions and critical review. People who just accept "facts" from others and don't question more often get led astray. AMD is obviously someone who uses their own observations to question medical dogma.
Dr Ortel's comments about sunlight and mental health are quite misleading! I don't imagine any doctor who recommends sunlight to a patient to help with depression/SAD is suggesting they "spend a long afternoon asleep in the sun". Thirty minutes of natural light in the morning is very different than that and does play a potential role in mood improvement and likely has less side effects than SSRIs.
The main sense I seem to get out of this post is an attempt to limit or call out MISINFORMATION. We have a recent focus on "those of us who know better" feeling the need to stamp out things they deem untrue. I do not think adults need protection from "misinformation". An adult possesses the intelligence and ability to review information and decide where it does or doesn't fit into their already held views. I do understand that physicians have a particular role of authority and need to consider that role. But - medicine is not as cut and dried as some (even doctors) think. There are many examples where mainstream medicine recommended something strongly that turns out to be completely wrong (peanut allergy comes to mind). Physicians need to remain humble in that regard. We are using our expertise to give advice and that advice can have its limitations. People are free to take our advice - or not.
I think it is reasonable for another doctor to counter claims made that he/she might not agree with. Unfortunately, this rebuttal by Dr Ortel did not clarify much for me and seems odd that it appeared here on Sensible Med.
Dr Ortel's final line generally negates any rebuttal he was making anyway - "the dose makes the poison". Current admonitions from medicine/dermatology to sunscreen constantly, even if inside on a cloudy day, may not have as much science as they suggest. Maybe a more nuanced recommendation would actually make more sense. (the rebuttal did not clarify this for me).
This message could have been delivered without the ad hominem tilt, the snark, and the attempt (missed) to dox AMD. If so, its persuasiveness would have increased exponentially. Still, a second opinion regardless of how it was delivered was warranted.
Agreed. The problem with doctors and other experts using snark and ad hominem attacks is it allows fair turn-around back to them when they aren't correct on every detail. It is also a big part of why trust in medicine, "science", and doctors seemed to decrease during the pandemic. Humility in the true limits of what you are saying goes a long way to counter that. As does the acknowledgment that adult humans can form rational and reasonable conclusions taking many different inputs into account. Paternalism doesn't play well in current society (at least to many people). A simple point of view statement would have been better.
Continuous exposure and intermittent is old. Previous century. My melanoma prepared when young then one beach exposure at fifty detected v. soon after. Has the ozone hole produced much melanoma? I’ve had at least five cancers since the melanoma. Moved from Palo Alto to Santa Barbara with many sunburns in 5th grade.
Fairly certain AMD is NOT Pierre Kory. If memory serves I think AMD has mentioned somewhere that he’s in Michigan? So not even the same practice state. Starting off with a faulty assumption and zero things to confirm this isn’t a great opening
Moderation in all things.
Yes; generally remains true.
I guess this is called being ratioed
Too snarky, imo.
I’m more concerned with the ingredients of things we put on and in our bodies than what the sun may or may not do…
According to this dermatologist, among AMD claims that are so ridiculous they "could have been headlines from the National Enquirer" is this: "Health benefits of sun and ultraviolet radiation exposure."
How do the mainstream docs manage to consistently be this dumb???
Dermatologists and neurologists and cosmetic surgeons and endocrinologists are the least trustworthy of the Medical Industrial Complex. If we let the MIC rule our lives, we'd all live in "safe and secure" bubbles, never go outside, and live a couple of years longer, like caged animals in zoos.
blood vessels under the skin dilating in sunlight - wouldn't that be because the body increases blood flow to cool down the slowly(or quickly) warming skin surface?
Correct. It's just heat.