The first city to really hit this wall was London in 1858. When the river level dropped, the sewage in the Thames remained, resulting in "the great stink". Construction of a proper sewage system began the following year in 1859. In 1865 it was complete enough to begin operation. It wasn't considered complete until a decade later, in 1875.
The role of sewage in spreading cholera was first hypothesized in 1849 by John Snowe. He'd put together a pretty convincing case by 1854, and the actual bacteria was discovered in the same year. But the proof that finally convinced the medical establishment didn't come about until 1883.
If this makes you suspect that the medical establishment had their collective heads up their collective asses, I'm not about to disagree.
Reasoning is hard, and the medical establishment didn't consist of biologists, any more than the computer-programming establishment consists of computer scientists. It still doesn't today.
The main reasoning challenge here is that doctors are slow to accept evidence that what they've always done is not what they should do.
See the prolonged acceptance of bloodletting, resistance to handwashing, and on and on to the slow adoption in the present day of evidence based medicine.
I guess that's plausible, and I have occasionally observed doctors behaving that way, but I don't have enough evidence to independently confirm that it's especially common among doctors.
Also, I've seen people do amazingly dumb things because of disbelieving their doctors, so maybe a certain amount of overconfidence would be protective?
There is a lot of research in psychology on this. ChatGPT will happily refer you to various books written over the decades on how the strong hierarchical structure of medicine makes it particularly prone to cognitive dissonance, with lots of concrete examples of doctors behaving that way.
I asked GPT-5 Mini and it said, in part, "some studies find clinicians update more when evidence is clear and actionable (better calibration), others show clinicians exhibit the same biases as laypeople (e.g., positivity bias, anchoring). Results depend on task design, sample, and how “evidence” is presented. (...) Experimental psychology and related fields show measurable differences in how some doctors update beliefs—many update appropriately to clear, high‑quality evidence and some update better than average—but there is no simple universal claim that all doctors are more willing than the average person to change their minds. The evidence supports a nuanced conclusion: clinicians can be more evidence‑responsive in domain‑relevant tasks, but updating varies widely and is strongly shaped by task framing, institutional context, performance level, and incentives."
But that's because GPT-5 Mini's responses are strongly shaped by task framing and context. You can get it to say just about anything as long as you stay away from taboo areas.
It did refer me to a lot of books, and the ones I looked up did in fact actually exist, but none of them seemed to be relevant.
No worries. I was sort of poking fun at your bringing up ChatGPT as a source (especially in a discussion about epistemic hygiene), but I probably shouldn't have done that.
The first city to really hit this wall was London in 1858. When the river level dropped, the sewage in the Thames remained, resulting in "the great stink". Construction of a proper sewage system began the following year in 1859. In 1865 it was complete enough to begin operation. It wasn't considered complete until a decade later, in 1875.
The role of sewage in spreading cholera was first hypothesized in 1849 by John Snowe. He'd put together a pretty convincing case by 1854, and the actual bacteria was discovered in the same year. But the proof that finally convinced the medical establishment didn't come about until 1883.
If this makes you suspect that the medical establishment had their collective heads up their collective asses, I'm not about to disagree.