Patient readers, what follows was thrown over the transom, doubtless from an ally in the Atlanta area. I don’t know who, and that’s probably a good thing. –lambert
Weekly / September 31, 2023 / 43(7);37124-19.
On September 24, 2023, this report was posted online as an MMWR Satirical Release.
Bud Abbott, PhD1; Louis Costello, MD1; Jacques Tati, MD1; Desiree Armfeldt, PhD1; Fredrik Egerman, MPH1; Emmett Kelly, DVM1; William Kempe, PhD1; Mikhail Nikolayevich Rumyantsev, PhD1; Oliver Hardy, DPT1; Stan Laurel, MD1; John W. Gacy, PhD1; Violent J, MD (VIEW AUTHOR AFFILIATIONS)
What is already known about this topic?
Some diseases attach the pysche and cannot be traced to any physical agent (Herbert, et al.) Among these are brainworms.
What is added by this report?
To prevent epistemologically significant brainworm infestations, persons must understand their risk, take steps to protect themselves and others with careful media consumption and critical thinking, and media fast for ≥5 days if infested.
What are the implications for public health practice?
Epistemologically significant brainworm infestations must be minimized to protect persons at high risk for severe illness. Importantly, it is not only others who may be infested, but one’s self.
A brainworm has been defined as “a persistent delusion or obsession; a deeply-ingrained or unquestioned idea”; brainworms have been compared to earworms (songs or melodies that keep playing inside one’s mind). Each are cases of involuntary cognition; brainworms, however, also affect speech and often behavior (e.g., frequent handwashing, sometimes continuing for a quarter of an hour, while unmasked). The term may have originated in the lyrics of Pink Floyd’s Hey You.
Understanding Risk. Brainworms can be detected in others through behavior (see above) but more importantly through linguistic cues. In a hospital settings, phrases like “it’s just a cold,” “learn to live with it,” “mild,” “endemic,” “follow the science,” “herd immunity,” “we’re all in this together,” “let me see your smile,” and “evidence-based medicine” are all signs of brainworms, especially when cumulative and occurring regularly. Any or all of these phrases, if repeated, can lead to infestation.
Self-Protection. If in a risky environment, you may choose passive measures, either spatially (leave the area) or attentionally (earbuds). You may also address the infestation by expressing critical thinking, but that carries its own risks (ostracism). Finally, you may wish to observe the media consumed by the infested subject, and avoid it.
If Infested. Cure can be difficult. A media fast, at a minimum, is indicated, for at least a working week. If a relapse occurs, consider excercising critical thinking skills in a group setting.
Brainworms Prevention Strategies
We have discussed preventing brainworm infestation in individual persons above, at “Self Protection.” Preventing brainworm infestation at the community level can be more challenging, since superspreading index patients are most likely to occur at the top of social and institutional heirarchies, and not below. It may be individuals protecting each other is the way forward here (“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has”). More research is needed. As for health care systems, remedies can only come externally by alterting incentives, as with regulation, legislation (and in some cases, prosecution).
The social determinants of brainworms are unknown, but are thought to include the accumulation of social and symbolic capital through excessive deference to authority figures in professional settings. More research is needed here as well. Further, one must take great care to ensure that one is not one’s self undergoing an infestation, especially if one is challenging others (in the vulgate: “high on my own supply”). The exercise of critical thinking, ideally in a group setting, is indicated here, along with regular doses of humility.
1 All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.