Authority and Expertise
And the obstacles to overcoming vaccine hesitancy
Designed by vectorjuice / Freepik
I had a conversation over the weekend with a doorman in my building, in which I asked him whether he’d finally gotten an appointment to get the COVID-19 vaccine. He’d been trying for some time to secure appointments for himself and his mother, had been having trouble finding one for a time when he wasn’t working, and I’d offered a couple of times to assist him if he needed it.
Our conversation from there went something like this:
So I tell him that I’ve never heard anything of the kind, remind him that there is a huge amount of misinformation out there on the internet, and that he shouldn’t rely on rumors, and then I promise him that I’ll talk to my wife, who is a doctor, and find out whether there’s any reason for him to be concerned (knowing of course that there wasn’t).
I spoke to her, she spoke to him, and he was, by all reports, relieved to hear that his sister-in-law’s fears were unfounded. But as I tweeted yesterday, I doubt that will be the end of it.
The reason, in part, has something to do with the yawning chasm in our lives where authority used to be, or that’s my intuition. Why, after all, is my doorman talking to his sister-in-law about the vaccine rather than his doctor? Probably because he doesn’t have a doctor in the sense of someone he can casually consult, or who would naturally be communicating with him about important matters of public health without even being asked. Even if he has health insurance (which I believe he does, through his union), whoever is listed as his primary physician is unlikely to be someone he has a longstanding relationship with, because that’s rarely the way people relate to their doctors these days. It’s become an expensive luxury.
So why doesn’t he just listen to the CDC? It might be that he doesn’t realize he can — but it’s also the fact that the CDC is a distant and faceless bureaucracy, whereas his sister-in-law is someone he knows, someone he has a relationship with. And that is an essential component of authority, part of what distinguishes it from mere power. That’s the one reason I have some hope we might have some influence; my wife is both a doctor and someone he knows personally. But she’s not his doctor, and so she can’t possibly carry as much weight.
This whole question — of the relational aspect of authority — made me think of two moments from Shakespeare’s King Lear, which follow quickly one upon the other. The first bit is part of Lear’s dialogue with the blinded Gloucester:
KING LEAR: Thou hast seen a farmer's dog bark at a beggar?
GLOUCESTER: Ay, sir.
KING LEAR: And the creature run from the cur? There thou mightst behold the great image of authority: a dog's obeyed in office.
A dog’s obeyed in office: it is the office that confers authority, and the meaning of “authority” is authorized violence: The beggar flees because he fears the dog may bite him. Note that there’s nothing illegitimate about this authority: The dog is owned by the farmer, and is charged with protecting his property; this is the dog’s proper job. But the “office” that the dog holds implies no relationship between him and the beggar.
A few moments later, a few men working for Lear’s daughter, Cordelia, arrive, looking for Lear. Having no way of knowing that they’ve come on a mission of mercy, and having already heard the bark and felt the bite of his older daughters’ authority, Lear expects that these men have come to do him mischief. And so he faces them:
KING LEAR: I will die bravely, like a bridegroom. What!
I will be jovial: come, come; I am a king,
My masters, know you that.GENTLEMAN: You are a royal one, and we obey you.
KING LEAR: Then there's life in't. Nay, if you get it, you shall get it with running. Sa, sa, sa, sa.
Exit running; Attendants follow
“There’s life in’t” — what’s the “it” that there is life in? What Kent, back when he first meets Lear in disguise, says he recognizes in Lear: Authority. This is not the authority of the dog in office — Lear has shed his office and its powers, retaining only the title. But neither is his authority a matter of Lear’s natural faculties. Back when Lear had recognized authority, he exercised it capriciously and tyrannically, and in his retirement he behaved appallingly, abusing servants, carousing at all hours — Goneril had a perfectly legitimate bill of complaints to lodge against him.
What the attendants do is recognize Lear. They know who he is, that he is a king, and they treat him differently because of that. Inasmuch as Lear has authority still, even without power, it’s because of that relationship. That’s pretty much the opposite of what the farmer’s dog has.
But what do our official authorities have? What they have, primarily, is expertise. That’s why we’re supposed to listen to them on matters like vaccination — because they know what they’re talking about. They don’t always, of course; the CDC took forever to acknowledge basic facts about the COVID-19 virus and its transmission that could be discerned from early in the pandemic:
The CDC, like any bureaucracy might, appears to have fallen into a “not invented here” mentality that kept them from acknowledging information that contradicted their prior commitments (to the notion that COVID-19 spread similarly to other diseases, like H1N1, for which they had established protocols), and then were reluctant to change course in part because changing would undermine their authority. But that fact just goes to illustrate what their authority was based on. It wasn’t based on a trust rooted in a relationship. It was rooted in the aura of infallibility that expertise strives to exude.
I want to be clear about something: I’m not knocking expertise. The scientists at the CDC really do know a great deal — vastly more than most people. And the bureaucrats there know more about the science than your average person as well — far more than journalists often appear to do:
Nor do I have a romanticized idea of how good trusted, local authority rooted in personal relationships was or would be. As I put it in the above tweet thread: your local sheriff could be on the take; your family doctor could be a quack; your parish priest could be a pedophile. Trust can be abused at any level — and when that abuse occurs in the context of a personal relationship, it can hurt far more deeply (sharper than a serpent’s tooth, even).
I’m just pointing out that there’s still something lost when these relationships decay and there’s an absence of known, trusted, local authority. That gap is filled in all sorts of ways. If you’re like me, and have a lot of time and inclination to do so, you wind up following someone like Zeynep Tufekci who — though she lacks the credentials in the field of epidemiology — has demonstrated both the intelligence and the wisdom to be a good guide through the pandemic. Those other virtues ultimately matter more than expertise, because they are required to do the job of evaluating what experts say. I’ve come to trust her, and to know her in a sense, from reading her work — but it’s to some degree a pseudo-relationship rather than a real one, because it isn’t bi-lateral; she doesn’t know me. And if I were a different person, I might have that kind of pseudo-relationship with Andrew Cuomo — or, worse, with Jenny McCarthy — which would leave me in a much worse position to know what I should believe.
A major obstacle to getting to herd immunity through vaccination, then, and thereby ending the pandemic, is filling that gap somehow, and convincing millions of vaccine-hesitant individuals that they shouldn’t listen to their sisters-in-law, who they know, but should listen to someone else. I suspect that “someone else” will do a whole lot better if they have a real relationship rather than a pseudo-relationship with the hesitant individuals. I wish I were sure we had enough of them, or that we had any kind of commitment to build them back up where they have decayed.
In their absence, we’ll wind up relying on force — legal or workplace-enforced requirements to get vaccinated. That will probably work, and it is in fact what we should do — but it will work the way a barking farmer’s dog scares a beggar into moving on. A government of the people, by the people, and for the people ought to at least aim to do better.