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‘Currently the scientific process is doing a major disservice to patients and society.’ That was the conclusion of a paper that popped on my Twitter field today. It’s like the entire universe is conspiring to say something to all of us in this field and I am so here for it. The authors led by Calster et al. (2021) basically stated that ours is an enterprise where the quality of the work we do remains poor. The criticisms remain longstanding. Business as usual is the backbone of the enterprise where most initiatives to address this issue are top-down. I guess I am not alone is all I can say. That and we all need to do better. COVID19 made it painfully clear. According to Calster and colleagues (2021) ‘the focus remains more on the destination (research claims and metrics) than on the journey. And so the problem of poor research persists. The problem is deteriorating further.’

‘Notwithstanding, research should serve society more than the reputation of those involved. Science should not be a game in which we collect credits to reach the next level of our career.’ Which made me decided to keep this today. With research, even with the publications you write, keep being in service to people.

Be in service to people as you study disease prevention, disease management and disease treatment. Be in service to people without focusing on disease too. Be in service to people as you reduce poor quality research, reduce poor design, reduce poor research conduct, or reduce poor reporting. Be in service to people to simply reduce ‘research waste’. Be in service to people with research that has value for patients, research that has value to society. Be in service with research that is simply of value and not harmful.

But of all this, know that research waste remains a persistent problem. Research waste is structural injustice. Research waste is costly and truly harmful to society. Research waste is a function of all of us in academia. We are the problem with research waste. We can also be the solution. And I want to be counted in the number of those working towards a solution.

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Henrietta Lacks is like all of us to the scientific landscape. Nameless, faceless, voiceless, with no power to make decisions with how we are viewed to the field. She didn’t have a say with her own unique cells. No wonder people distrust a paradigm that continues to treat people as if they have no name, no face, no voice, not even power. Until now. The past week has been surreal.

To give a quick background and this is from Yasmin Amer for NPR news: ‘In 1951, a Black woman named Henrietta Lacks walked into Johns Hopkins Hospital in agonizing pain. Doctors diagnosed her with cervical cancer. She died just months later. But what this mother of five never knew was that her cells would outlive her and be used to develop new drugs and vaccines…Her cells were the first known immortal cells. Whereas other cells died in the lab, hers thrived. They multiplied. They gave doctors the ability to do new, innovative research. Names and fortunes were built on them, nicknamed HeLa cells for Henrietta Lacks.’

Watching the Lacks family do their part to put a name, a face, a voice to cells used without permission is soul gratifying. To see the highest health organization in the world, the World Health Organization acknowledge that some injustice occurred in a field that preys on people for what what just is and not for their overall being, is also soul gratifying. Henrietta Lacks is no longer nameless, or faceless or even without voice because some voices, came together to say in harmony together, enough is enough. Enough is enough with treating people as if they were commodities in science. Treating them as if they were indispensable. Enough is enough with being faceless in science too. Enough is also enough with being voices with science. She matters just as everyone else matters as well. Science can no longer pretend as if it’s not in the business of people who have names or faces or voice. They do.

Every single person that interacts with the field has power even beyond science. We in the field are not the only ones that get to decide what has impact or who counts. They public had a critical say to advancing the field. They have a critical say with dictating how we best use our tools to serve them. And if and when we deviate from what is permissible, the public has a say with putting us right back in order. That is what Henrietta Lacks Family did for her this past couple of days. She may be long gone, but forever and ever we will say her name, see her face and know her voice. She was powerful beyond her wildest dreams and will remain so for as long as time permits.

The immortal Henrietta Lacks

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Last week the U.S Surgeon General issued an advisory that declared ‘misinformation as a public health threat.’ In a blue document with massive bold letters in white, he argued that we need to begin the process of confronting misinformation by ‘building a healthy information environment.’ I was intrigued and kept scrolling down the document to understand for myself what he meant by the terms ‘a healthy information environment.’

I also welcomed the invitation to ‘limit the spread of health information as a moral and civic imperative that will require a whole-of society effort.’ His words. The table of contents seemed easy to follow with suggestions on the ‘what’ people can do whether as individuals or educators or journalists or even funders and of course the government. There was even a ‘where do we go from here’ section that increased my curiosity with the report. But from the first page, the background, the report lost me and I am sure the public. None of this centered the ‘public’ in public health.

There is a reason why health misinformation is so rampart these days and it has nothing to do with long backgrounds, even those focused on correct health information. We fail and continue to fail the ‘public’ if the words we use to speak to ‘public’ doesn’t include language or even tools that makes sense to the ‘public.’ I wanted to root for this document because of the seriousness of the topic, because this is literally a life and death matter and people, black and brown lives are dying everyday because of health misinformation.

Then it dawned on me, if I took a camera and walked down the streets of Harlem or Newark, or Augusta, or Pittsburgh, or even went to stores like Sam’s Club or Costco, would people be able to tell me what if anything they remembered from the Surgeon General’s advisory. Would they even know it exists?

There in lies the dilemma with health misinformation. While the public health experts are so focused on what it is or what it is not, the ‘public’ is focused on the why in the forms of stories they pass on to each other, through words and languages and other mediums that make sense to the ‘public.’ There is a reason why social media is widespread and content is viewed as powerful. People are expecting from public health, serious comments about their lives using tools and language that make sense to the ‘public,’ that speak to the ‘why.’ They are not expecting the ‘what.’ They are expecting connections, truths, even art and spoken words that say things important to help them with life, their health. The sooner we understand the ‘why’ of health information, the quicker we can begin to center the ‘public’ in public health. This is what is meant by public health to me these days, a deliberate focus on the public’s health, not by us the experts but by the public first.

We spend too much time focused on the ‘what’ of health that we forget the ‘why’ in public. There is a reason why stories live on long after the storyteller has ended the story. We can start there by bringing back stories to public health. Poetry too. As a tool, whether spoken or listened too, poetry can humanize us, make us whole, both emotionally and intellectually. Art can do the same. Art for and by the public can be intentional and life-sustaining with centering the public in public health. While letters to the public, like a ‘Dear Public Health’ can help the public confront the worst so as to be free to experience the best that is unshakable in public health, the ‘public.’

It is always about the ‘public’ after all. Our future depends on listening, seeing, feeling, daring even to center the ‘public’ in public health. We are all amplified when we center the ‘public’ in public health. That should have been the main crux of the advisory, a foundation through which to dismantle the public health threat that is health misinformation. We have miles to go but if we want to end this war, as it’s a war to, with casualties increasing everyday, the ongoing pandemic being a clear example, then we have got to bring back the ‘public’ in public health.