Young v. Rogan: Keep on Rockin' in the 'Fee' World | Opinion

The Neil Young v. Joe Rogan imbroglio has been dissected and analyzed by pundits in more detail than my gross anatomy cadaver in medical school. Spotify, meanwhile, is living the lyrics of Leon Russell's hit song Tight Rope: "I'm up on the tight rope, One side's hate and one is hope."

At first glance it's a virtuous stand by an aging, former anti-establishment rocker who has targeted the world's most popular, young podcaster, initially being castigated for spreading misinformation about COVID-19 and vaccines. True to his roots, Young is the conscientious objector delivering an ultimatum to Spotify: Rogan or me. Spotify took notice, removed Young's music, per his wishes, and instituted links on their site directing users to information on COVID that could be supported with data, unlike some of the misinformation on Rogan's podcast. Rogan issued an Instagram mea culpa, and a promise to do better in the future. Whether altruism, politics, or economic rivalry underlie Young's actions is worthy of debate, especially in a fee-based subscription model that has wreaked economic havoc on musical artists.

As a cardiologist who has first-hand witnessed the human tragedy of COVID-19 during its first wave, and published on its cardiac consequences, let me emphatically state that the benefits of vaccination are not debatable. That does not mean the risk is zero to a given individual; however, the risk of dying of COVID after vaccination on average is 0.0033 percent, comparable to the one year odds of dying in a car accident in 2019 (0.012 percent).

For individuals who have had COVID, the vaccine would provide even greater protection than exposure alone. Vaccinated individuals who come down with COVID, particularly in the Omicron era, are used as an example to discredit vaccines by those who oppose it; however, let's not conflate getting a mild case of COVID with the far greater incidence of serious disease or death in non-vaccinated individuals. Further investigation is still needed to determine the best treatment strategy for previously healthy individuals who experienced a significant early adverse effect from the vaccine such as pericarditis, myocarditis, or significant arrhythmias, which most cardiologists have seen. Scientific discussion on alternative therapies should not be thwarted, particularly because these rare but serious events occur more commonly in younger individuals.

There was no dearth of intolerance to contrarian opinions in politics or science before the COVID era (BCE), but since the COVID era (CE), there is less tolerance for any content considered contrary to the "public good." This is hardly surprising from a psychological perspective given the toll COVID has taken on the world.

We need to be careful not to be too dogmatic in our attempts to "follow the science." Science and scientists have historically demonstrated susceptibility to the foibles of orthodoxy and error. This was eloquently stated by Avi Loeb, former chair of the astronomy department at Harvard University, in his 2021 Scientific American article: "Those who refuse to consider an unconventional idea in science are disturbingly similar to those who refused to look through Galileo's telescope."

The scientific community and policy makers would do well to at least acknowledge the grey zones in COVID treatment such as the presence of moderate immunity in those who have recovered from previous infection, as recently published in The Lancet. We are still unsure as to the longer-term protection from both vaccines and spontaneous infection. There will also be differences in individual susceptibilities as well as risk of recurrence in both the vaccinated and previously infected individuals. The problem is that modern medicine is still not advanced enough to deliver personalized medicine, which would allow us to determine at the individual level who might be more likely to suffer serious disease from COVID or experience serious side effects from vaccines. This would require a much deeper understanding of individual physiology and genetics than we currently have. Honesty and transparency about these matters by the medical community and public policy makers would likely engender more trust and cooperation among skeptics.

Young v. Rogan also highlights another societal change that does not often make headlines. In our new world paradigm of centralized services or fee-based subscription models, as in the retail space, digital-only book publishing or musical streaming, we are ceding complete control of content access to companies like Spotify, Apple or Amazon. If they feel pressured to mollify social media opinions (which may not reflect the majority view), we will lose access to content expressing alternative viewpoints.

In the past, strong protests by organized groups against an author or artist might result in book or record burnings. Recall anti-Beatles protests supported by the KKK for John Lennon's statement taken out of context, "We're more popular than Jesus now," or the Disco Demolition Night, which was racist and homophobic in motive.

While these events could sway public opinion, they could not easily cancel the objects of such protest. We are heading toward a future that facilitates the ability to erase entire content by the flip of a switch and forever become unavailable, since large private company repositories increasingly control world content and distribution. The ultimate cost for the convenience of having fee-based content at our fingertips 24/7 is that we are unknowingly relinquishing our ability to decide what we may be able to read or hear in the future. We don't want to get to the point of having organizations choose between "happiness and high art" for us, as could Mustapha Mond, former scientist and resident world controller of Western Europe, in Aldous Huxley's Brave New World.

Fortunately, for now, Spotify has taken a nuanced response, and for that reason I will continue to be a subscriber. I also don't have to listen to Joe Rogan, which is a more effective way to marginalize him for misinformation and ignominious racial comments.

I just put the LP, Harvest, by Neil Young on my turntable, and gently placed the stylus on side 2, track 1 to hear Old Man. Being analog, it's grittier and not digitally sanitized, showcasing Young's brilliance, enhanced with a few crackles and pops from the well-played vinyl. I also don't need to subscribe to another streaming service to access it. As I hear the lyrics, I can't help but think that both men are iconoclasts, and not always right. Perhaps a reformed Joe Rogan should sing for Neil Young: "Old man, look at my life, I'm a lot like you were."

Raman Mitra MD, PhD (@glamrockmd), is a cardiologist at Northwell Health in New York and a part time rock and roller.

The views expressed in this article are the writer's own.