Being Healthy Means Thinking Freely

  • For our society to avoid suffering from another contagion, we need big ideas.

  • To mine the best ideas, everyone needs to be free to think independently and express themselves.

  • Currently, free thought is inhibited in our society by forces such as tribalistic thinking.

I was never really supposed to be able to do what I do for a living. Where I grew up, the notion that one could find gainful employment by having ideas and working to develop them in the academic space was close to inconceivable. On the island of Malta, where I am from, during the time I lived there, there were really just three options for the intellectually ambitious: doctor, lawyer, or priest. I initially chose doctor, but, over the decades, this role evolved into a privileged position of being able to work in academic public health, where I get to help inform a conversation about how to build a healthier world. 

The longer I do this work, the more I am struck by how extraordinary it is that anyone gets to do it, let alone me. One is reminded of Maslow’s hierarchy of needs, with the basics of food and shelter at the bottom, and engagement with meaning and ideas located somewhere near the top. For much of human history, it has been all most people could do to satisfy foundational needs, to access the material resources necessary to keep body and soul together. That we now have a society which supports the pursuit of ideas as a viable career path is a rare and fairly recent achievement in the grand scheme of history.

At the heart of this opportunity is the ability to think and speak freely—to feel that one can share ideas, agree or disagree, be challenged, but ultimately know that the exchange of ideas will be respected. In a broad sense, this is an inheritance of the Enlightenment, about which I have previously written. Personally, I have always been drawn to the definition of freedom offered by the Polish revolutionary Rosa Luxemburg, whose 150th birthday was last month. According to her, “Freedom is always and exclusively freedom for the one who thinks differently.” This, I think, covers most of us. Few could say they have never found themselves in a position of thinking differently—a life without such moments would be empty indeed.

Open dialogue leads to the best ideas to support health

In addition to supporting a rich, meaningful life, this freedom is essential to health. Creating a healthy society is a big task requiring big ideas. Such ideas will necessarily spark disagreements. This is good. We should welcome disagreements, and we should be open to them. This exchange of ideas can only develop in a context of maximal freedom of thought.

I would argue we have of late fallen short of supporting such a context. I am raising this point because, as we approach the end of COVID, we are faced with the urgent job of creating a society where contagions can no longer take hold. The next pandemic may well be far worse than COVID, equaling it in infectiousness but surpassing it in its capacity to kill those it infects. Responding, then, will take a robust intellectual climate, informed by the liberty to voice ideas, to make mistakes, and to truly innovate.

With this in mind, I will suggest three key impediments to creating such a climate, in the hope that by acknowledging them, we can reverse course.

Three impediments to free thinking in our society

1. First, we have become less able to distinguish between truth and belief. Years ago, Stephen Colbert coined the word “truthiness” to describe something which feels true even when the facts suggest otherwise. Colbert introduced the word largely as a joke, yet, in 2021, it is arguably the pillar of many a worldview. We have seen it on the right, with “alternative facts,” and we have seen it on the left with the notion of having a “personal truth” which may or may not always correspond with data. The conflation of what is true with what feels true has muddied the waters of thought. 

2. Second, instead of thinking for ourselves, we have at times outsourced to others the business of generating our ideas and opinions. We are living in a media environment full of compelling slogans, charismatic speakers, tribalized division of outlooks and ideologies, and technologies that deliver all this to us at every minute of the day. It can be difficult, amid this, to sort out which of our opinions we formulated through a process of reason, and which we simply absorbed from this cacophony or from other members of our ideological tribe. What is easy, however, is getting swept up in the moment, joining the chorus of prevailing opinion, and, when we find ourselves thinking differently, keeping those thoughts to ourselves.

3. The great irony of this conformity is that the more we borrow thoughts from others, the less likely these thoughts are to reflect what other people have truly concluded for themselves. This speaks to the third impediment to free thinking: preference falsification and the gap between what we might call the performance of ideas and opinions and what people genuinely think. Achieving health relies on a process of persuasion, whereby we cultivate buy-in for a vision of the world that supports health. If we are not honest with each other about what we think, we cannot know where we stand in this process. 

We can each do our part 

It is up to us, as individuals, to do what we can to support a conversation that is worthy of the challenges we face. Creating a world free of contagion will take the very best ideas, and these can only emerge in a context of free and open inquiry.

In my travels, I have seen what cultures look like when they value such a context, and I have seen what they look like when they do not. It is better, by far, when we prize the opportunity to freely inquire, to debate, to even occasionally be wrong in public, on our way to being right. It is only when we are free to think differently that we are free to think at all.    

Sandro Galea, M.D.