Why I left the NIH

Summary

Unexplainable Podcast Episode Summary: "Why I Left the NIH"

Introduction

In the June 18, 2025 episode of Unexplainable by Vox, host Noam Hassenfeld engages in a profound conversation with Francis Collins, a towering figure in modern science. Collins, renowned for leading the Human Genome Project and directing the National Institutes of Health (NIH) under three U.S. presidents, shares his experiences and the tumultuous circumstances that led to his resignation from the NIH. The discussion delves into the intersection of science, politics, and public trust, offering deep insights into the current challenges facing scientific institutions in America.

Francis Collins: A Legacy of Scientific Excellence

Noam Hassenfeld ([01:01]) introduces Francis Collins as one of the most influential scientists of recent decades. Collins' leadership in the Human Genome Project earned him the Presidential Medal of Freedom, and his role in developing the COVID-19 vaccine under Trump's administration saved millions of lives. His tenure at the NIH spanned 32 years, during which he navigated the agency through various political landscapes.

The Downfall at the NIH Under the Current Administration

Collins recounts the abrupt and unsettling changes that unfolded at the NIH following the inauguration of the current administration. Noam Hassenfeld ([02:49]) expresses his concerns about the recent chaos, citing cuts, firings, and halted grants. Collins elaborates on the immediate challenges:

"Almost immediately after Inauguration Day... Everybody gets up and we all start talking to each other... It can't be right." ([03:12]—Francis Collins)

An initial email directive halted the commencement of new projects, restricting research to ongoing endeavors. This led to widespread disbelief and anxiety among NIH employees. The situation escalated rapidly, with over 1,000 employees being suddenly terminated. These firings remain contested in court, leaving many researchers unemployed. Additionally, studies on sensitive topics like vaccine hesitancy and the health impacts of wildfires were abruptly forbidden, accompanied by restrictive gag orders that silenced scientists:

"No scientists... were permitted to speak to in any kind of setting... effectively muzzled." ([04:26]—Francis Collins)

Erosion of Public Trust in Science

A significant portion of the discussion focuses on the declining trust in scientific institutions, a trend that intensified during the COVID-19 pandemic. Collins attributes this erosion to the necessity of revising recommendations as new data emerged, which led to public confusion and skepticism:

"Covid did a lot of harm to people's trust in science... Do these guys know what they're talking about?" ([09:02]—Francis Collins)

He highlights the deepening political polarization surrounding scientific issues, noting that vaccine hesitancy was particularly rampant among white evangelical Christians—a demographic he personally identifies with. This internal conflict was heartbreaking for Collins, as it represented a failure to bridge the gap between scientific advancement and community trust.

Challenges in Science Communication

Collins reflects candidly on the shortcomings in science communication during the pandemic. Initially adhering to the "knowledge deficit model," he believed that providing facts would correct misunderstandings. However, this approach proved ineffective, especially amidst a deluge of misinformation and disinformation:

"I was naive about science communication... we need a lot more listening." ([21:18]—Francis Collins)

He emphasizes the importance of embracing uncertainty and storytelling to engage the public more effectively. Rather than solely presenting statistics, Collins advocates for narratives that resonate on a personal level, fostering a deeper understanding and trust in scientific endeavors.

Bridging the Trust Gap: Efforts and Reflections

In an attempt to mend the fractured trust between science and the public, Collins participated in initiatives with organizations like Braver Angels, which facilitate dialogues between opposing viewpoints. His interactions with individuals like Wilk Wilkinson, a critic of COVID lockdowns, provided valuable lessons in empathy and understanding:

"We failed to say... This is the best we can do right now. There's a good chance this is wrong." ([28:01]—Francis Collins)

These conversations underscored the necessity of acknowledging mistakes and uncertainties, fostering a more inclusive and honest discourse. Collins recognizes that admitting ignorance and maintaining humility are crucial steps toward rebuilding credibility and trust.

The Future of Science and Hope for Upcoming Generations

Despite the adversities faced, Collins remains optimistic about the future of biomedical research. He urges young scientists to persevere, highlighting the unprecedented advancements and the strong public support for medical research:

"I don't believe those facts can be suppressed for very long." ([35:07]—Francis Collins)

However, he expresses concern over a potential brain drain, as many international trainees contemplate leaving the U.S. due to the current climate of instability and uncertainty. Collins calls for sustained support and protection of research institutions to ensure that America's legacy in scientific innovation remains unblemished.

Conclusion

This episode of Unexplainable offers a compelling narrative of Francis Collins' departure from the NIH, contextualizing it within the broader challenges of sustaining scientific integrity amidst political turmoil and declining public trust. Collins' reflections serve as both a cautionary tale and a beacon of hope, emphasizing the critical need for improved science communication, institutional support, and community engagement to navigate the complexities of modern scientific endeavors.

Notable Quotes with Timestamps

• Francis Collins ([03:12]): "Almost immediately after Inauguration Day... Everybody gets up and we all start talking to each other... It can't be right."

• Francis Collins ([04:26]): "No scientists... were permitted to speak to in any kind of setting... effectively muzzled."

• Francis Collins ([09:02]): "Covid did a lot of harm to people's trust in science... Do these guys know what they're talking about?"

• Francis Collins ([21:18]): "I was naive about science communication... we need a lot more listening."

• Francis Collins ([28:01]): "We failed to say... This is the best we can do right now. There's a good chance this is wrong."

• Francis Collins ([35:07]): "I don't believe those facts can be suppressed for very long."

Speaker Attribution

• Noam Hassenfeld – Host and interviewer
• Francis Collins – Guest, former NIH Director and prominent scientist

This structured summary captures the essence of the episode, highlighting key discussions, insights, and emotional undertones conveyed by both the host and Francis Collins. It provides a comprehensive overview for listeners who may not have tuned in, ensuring they grasp the critical issues surrounding the deteriorating relationship between science and political forces in the United States.

Transcript

[Francis Collins]

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[Noam Hassenfeld]

Relax.

[Francis Collins]

Responsibly Corona Extra Beer imported by Crown Import, Chicago, IL. Go from game time to having a good time with Corona Premier. It's the only lighter than light beer worthy of being called corona. 90 calories, 2.6 carbs, and an undeniably crisp, refreshing taste that you can't help but share. Because with Corona Premier, the best play happens off the field. Welcome to the premier side of light Corona Premier. Drink responsibly. Corona Premier Beer imported by Crown Imports, Chicago, Illinois. For 12 fluid ounce serving average analysis Cal's 90 carbs, 2.6 grams protein 0. 0.7 grams fat, 0.0 grams.

[Noam Hassenfeld]

1, 2. Okay, good to go. A couple weeks ago, I called up this scientist I've been wanting to talk to for a long time. I've particularly been struck by your writing because it feels like it encapsulates the mission of unexplainable of our show, like we're all about leaning into the things we don't know. You know, the importance of uncertainty and humility in science.

[Francis Collins]

I think you got it right. Science is pursuing the unexplainable, trying to explain it. And sometimes we succeed, and sometimes that hypothesis wasn't right. Let's try something else.

[Noam Hassenfeld]

Francis Collins is easily one of the most important scientists of the last few decades. He led the Human Genome Project, which won him the Presidential Medal of Freedom. He was the director of the National Institutes of health under three presidents, and he led the NIH's work on developing the COVID vaccine, which saved millions of lives. But the reason I wanted to talk to Francis right now is because of the chaos that's been going on at the nih. I've been hearing about cuts, about firings, about grants not getting funded. And I wanted to talk to someone on the inside, someone who's worked under this version of Trump and the previous one.

[Francis Collins]

I was, after all, the NIH director during Trump's presidency. Number one, reported to him in various ways, especially during the really serious tumult of COVID 19 in 2020.

[Noam Hassenfeld]

To be honest, I wasn't sure exactly what he was gonna say. I thought, you know, if he could make the COVID vaccine under Trump's watch five years ago, maybe he knows something I don't about what's really going on.

[Francis Collins]

Well, I had experienced transitions before where things that one administration wanted to do another one did not. And those were bumpy. Sometimes I was kind of used to that. But I didn't expect science to be under this kind of full bore attack, which is really what happened. Almost immediately after Inauguration Day, Francis says.

[Noam Hassenfeld]

It started in his research lab.

[Francis Collins]

I've got a tiny little office there that can barely fit me and one other person.

[Noam Hassenfeld]

When he saw a notification on his.

[Francis Collins]

Computer, it was an email saying, you may not start any new projects. You can only work on things that you were working on before. January 20th, Francis walked out of his.

[Noam Hassenfeld]

Office into the lab and he saw everyone else reading the same thing.

[Francis Collins]

Everybody gets up and we all start talking to each other. Like, I didn't see that one coming. Hopefully that's not going to last more than a few days. Maybe this is still just an idea of the new team trying to figure out what they're doing. They can't possibly mean this. I looked at people around me and we just shook our heads like they were disbelieving. It's like, this is the United States of America. This is the nih. It can't be right.

[Noam Hassenfeld]

But more orders kept coming down. Over 1,000 employees at the NIH were suddenly fired. Those firings are still being challenged in the courts, but as of now, those people are still out of work. Researchers were prevented from studying certain topics like vaccine hesitancy or even things like the health effects of wildfires. And officials rolled out communications, gag orders.

[Francis Collins]

No scientists working for NIH were permitted to speak to in any kind of setting, even a scientific meeting with no press. Or if you felt you had something you had to say, it had to be cleared at the level of the Department of Health and Human Services, which generally was not interested in clearing it. So you were effectively muzzled.

[Noam Hassenfeld]

It seemed like new rules were getting announced almost every day, sometimes on really basic things.

[Francis Collins]

We were told, you can't buy any supplies. And a little while after that, they decided, oh, you can use your purchase card now, but you can't buy anything that costs more than $1, which was an insult. It was clear that this was intended to induce trauma. This was cruel. This was not reasonable. Here's why we're doing it. Don't worry. We love you. The message seemed to be, you are lazy bureaucrats and we are going to do everything we can to make your life miserable.

[Noam Hassenfeld]

Francis wasn't really sure what to do. He wasn't sure what he was allowed to do.

[Francis Collins]

We were all kind of in crisis. I felt some really bad things are happening here, and yet I'm not able to speak about it. I would get lots of press inquiries saying, can you tell us what's really going on? The New York Times, the Washington Post. And I would have to say, I'm sorry, I can't talk to you.

[Noam Hassenfeld]

It got to the point where Francis felt like he just couldn't do his job anymore.

[Francis Collins]

It was feeling increasingly powerless and hopeless and frankly also getting a sense that there might very well be an action taken to get rid of me because I was not seen as friendly to the administration. So I pulled my folks together in a conference room. They didn't know what was coming. And I told them, by tomorrow night, I'm no longer going to be here. And we all cried. I never thought it would end this way. My wife came to pick me up on that last Friday, and I just walked out of the building and got in the car and said, I guess this is it. That's how it ends.

[Noam Hassenfeld]

Most medicines developed in the last few decades, from cancer treatments to vaccines, have relied on NIH research. But the current administration wants to cut its budget almost in half. So how did we get from a world where the NIH was universally recognized as a jewel of scientific research to a world where the government is essentially tearing it down from the inside, from a world where the same scientist who developed a life saving vaccine in Trump's first term is now resigning under pressure in his second? I'm Noam Hassenfeld. And today on Francis Collins on how America lost trust in science and how we might be able to get it back. Francis had been at the NIH for a long time, 32 years, and he'd seen it through all kinds of administrations. He started working on the Human Genome Project under Clinton. He finished it under Bush. He became NIH director under Obama and was still in charge under Trump when he led the NIH work on the COVID vaccine. And in the last few years, he'd moved from NIH director to running a diabetes research lab there. The whole time, he says there was never a question whether scientific research was important.

[Francis Collins]

Yeah, I mean, gosh, when I was NIH director, one of my jobs was to meet with members of Congress. I did that like at least a half a day a week for all 12 years to try to explain science and why it mattered and what we were doing at NIH that might make a difference in terms of people's lives. And support was always just as good on each side of the aisle. It was one of the last remaining bipartisan things, all the way up to.

[Noam Hassenfeld]

About 2020 you know, it feels like during this time there's been a bigger shift, not just in government, but I'm constantly hearing that Americans themselves have lost trust in science.

[Francis Collins]

They have.

[Noam Hassenfeld]

Does it feel like they have? Is that fair to say?

[Francis Collins]

I think it's totally fair. You can look at all the surveys about trust, and let's be clear, Americans have lost trust in almost every institution. But I think it was more than that. I think Covid did a lot of harm to people's trust in science because, well, first of all, it was a huge disastrous experience for the world. There were days where thousands of Americans were dying, and as one of those people who was communicating with the public about what we knew about the virus and what they might do to protect themselves, we were doing the best we could with the information we had, but the information was incomplete. And so we often had to change recommendations over time because we learned more about the virus and about the pandemic. And people began to wonder, do these guys know what they're talking about? So it is a fairly recent development that suddenly this has become about whether science is something that's good for our country or not.

[Noam Hassenfeld]

So your most recent book, the Road to Wisdom, it's all about trust.

[Francis Collins]

Yes.

[Noam Hassenfeld]

If you were telling the story of the loss of trust and everything going on in the science agencies today, how far back would you start? Like, you know, once upon a time. Where is your beginning?

[Francis Collins]

Depends on the particular demographic you're talking about. I'm a person of faith, by the way, and certainly of faith have tended to be among the most skeptical of science. And that goes back 150 years or more to the sense that maybe science is up to something that's trying to do damage to our Christian faith. And that was there certainly well before COVID But I think Covid did something to take what had been maybe a little bit of a tendency for science to be political and turned it into a really big deal. So if you're a Democrat, you're much more likely to get vaccinated than if you're a Republican. Does that make sense? Not in the slightest.

[Noam Hassenfeld]

But that's how it was, the COVID vaccine. That's when Francis really understood just how bad trust in science had gotten, which was ironic because it was one of the highest points of his scientific career. The fastest vaccine development in history.

[Francis Collins]

I thought it was pretty unlikely that this could get done in less than maybe a year and a half, and even that would have been a world record. The fastest one before now was five years.

[Noam Hassenfeld]

Five years okay.

[Francis Collins]

Yeah. But people were dying around us, so we had to try.

[Noam Hassenfeld]

Yeah.

[Francis Collins]

And I also knew that most vaccines fail, or if they succeed, they have sort of modest efficacy, maybe 40% or something. And it was pretty likely that whatever we ended up with in this big push during 2020 was going to be far less satisfying than we would have hoped for.

[Noam Hassenfeld]

Francis still remembers the moment he knew it worked. They'd done this huge trial with 40,000 people. Half of them had gotten the vaccine, half of them had gotten a dummy shot, and no one knew which was which. Not the patients, not the scientists, just to be sure they weren't accidentally influencing anything. Until one evening in November 2020.

[Francis Collins]

I remember holding my breath as they were pulling off the labels and basically revealing the results, because I'd prayed about this a lot that year, and it was astounding. The efficacy to prevent serious disease, hospitalization and death was 90 to 95%. So much better than anybody would have thought possible. This was a stunning result.

[Noam Hassenfeld]

Where were you? Do you remember where you were when you got these results?

[Francis Collins]

It was a zoom call, of course, because we were all wearing masks if we went outside. Remember, it was November 20th, so nobody ever got together in person. But I was supposed to speak to the group then because had the leaders of the effort, including from pharma, on that, and I found I couldn't. I got all choked up, and I had a few tears to shed, and I didn't know what to say. It felt like, we have hope now. Prayers have been answered. Science has triumphed. This is probably the most amazing achievement that science has ever managed to produce to save humanity. I think it'll stand up that way over the course of time to do this in 11 months and to have that kind of result.

[Noam Hassenfeld]

At a certain point, though, it became clear that a lot of people were not getting the vaccine. Yeah. Do you remember when you found out.

[Francis Collins]

It happened over time, this sort of increasing unease. And by the time we got to this sort of April, May, June of 21, there was no reason for somebody to say, well, I just can't get access. And then it was clear. We're talking about more than 50 million Americans who said, no, I don't want this. I didn't see that coming, really. I guess I didn't realize how strong the political polarization was or how strong just our own sort of cognitive biases are. And I don't mean to put down these good, honorable people who made that decision. They were doing the best they can, being barraged with information coming from lots of different directions and having a lot of political messages that tapped into other parts of what they cared about. It was a terrible position to have people put in. But what group was most resistant to accepting the vaccines? It was white evangelical Christians. I'm a white evangelical Christian, so those are my people. But I broke my heart to see how that happened.

[Noam Hassenfeld]

For his part, Francis never really felt this tension between science and religion that so many other Christians have been dealing with. He actually came to Christianity through his work as a doctor.

[Francis Collins]

I know it surprises people, and believe me, it surprised me at the time when it happened. No. I was raised in a home where faith wasn't considered relevant or important. I was an atheist by the time I was in graduate school. And then there I was, sitting at the bedside of people who were facing the end of their lives. And I had a patient who simply asked me one day, what do you believe? And I realized I have spent no time at all on that question. I thought, okay, I'm a scientist. I'm supposed to study all the questions, so I better study this one so that I'll have a better answer the next time about my atheism.

[Noam Hassenfeld]

You're saying, oh, I'm a scientist. I need to consider the possibility of God as a scientist.

[Francis Collins]

Right, Right. And I have never encountered a place where I thought some scientific insight about the universe could not be fitted fairly conveniently with what I know as a Christian. And I lived that during 2020 because I was praying for those vaccines to be successful. But I was also expecting that if God answered those prayers, it would be through the science that we were all deeply engaged in. And that way, I think the laboratory and the cathedral are not all that different. They're both places where you can worship.

[Noam Hassenfeld]

When Francis started seeing this happening, over 50 million people, and particularly these people just like him, white evangelical Christians, rejecting the vaccine, he thought he might be able to bridge the gap in trust.

[Francis Collins]

Does Jesus, for example, have an opinion.

[Noam Hassenfeld]

About how we behave during this pandemic.

[Francis Collins]

And even whether we get vaccines? Do you think that the Bible speaks to these issues? I think the Bible speaks to virtually every issue. And that's where I often go when I'm trying to sort something out that I can't figure out on my own.

[Noam Hassenfeld]

Francis went on TV shows, he went on podcasts. He gave all kinds of interviews, all to show people what the vaccine meant to him as a Christian.

[Francis Collins]

When you see how much time Jesus spent doing healings, and even Jesus sometimes used things like water and mud, well, maybe that was his particular divine way of accomplishing a healing. We humans, as God's children have been given the tools of science to kind of come up with our own way to work through God's grace to provide an opportunity to prevent suffering. And I think that's what vaccines are and have been all along.

[Noam Hassenfeld]

Francis wanted people to know that the vaccine wasn't something in opposition to his faith. It was a culmination of, of everything he believed in.

[Francis Collins]

This is not a threat, but an answer to prayer, a God given gift that is going to save lives. This is truly a love your neighbor moment. And some people will go, well, God will take care of us. Well, God does expect us also to answer the call. And maybe it helped, Maybe it would have been worse without that. But things were so dug in that I guess it wasn't good enough to convince people that this was something they would want for themselves and their family. And a lot of people died.

[Noam Hassenfeld]

The Kaiser Family foundation estimates that vaccine hesitancy costs 234,000 lives. And now I hear Francis looking back, trying to do a sort of autopsy on all of those lives lost. But I also hear him looking ahead to the future, lives we might lose because of what's currently happening at the nih, the cuts and the censorship that led him to leave the institution he led for so long, a place that's supposed to be saving lives.

[Francis Collins]

If you cut out the foundational work that NIH supports, you're not gonna have breakthroughs that otherwise are on the track to be there. But it's more than that. There are people on clinical trials for cancer who suddenly have been told, I'm sorry, the trial was stopped, and that might have been their best hope. So there are casualties here that are absolutely immediate and desperate and put people's lives in jeopardy. Let no one misunderstand that.

[Noam Hassenfeld]

It feels impossible to wrap my head around all of this. The people at risk right now, the treatments that might not be discovered down the line. But I wanted to know if Francis had learned anything from his experience with the vaccine, from all those people turning their backs on a treatment and whether that experience helps him make sense of what's going on now, when it's becoming clear that more than 50 million Americans aren't taking the vaccine. You know, one of the most remarkable scientific achievements in human history. Did that tell you anything about the pursuit of science and how it works?

[Francis Collins]

It certainly woke me up to the fact that we apparently had not done a very good job going back some time in giving people some sense of science literacy about, why can you Both recognize that science is tackling some really hard problems and occasionally gets the wrong answer. But it's going to get self corrected because it's about truth. Science is not just a bunch of people who are coming up with answers that they like. These are answers that aren't going to be sustainable unless they're actually true. And maybe here's also where I began to realize that's another problem that society has that I was unaware of in terms of its severity, the importance of truth, the fact that there is such a thing as objective truth. But not everybody shared that. Well, that might be true for you, but it's not true for me. I would hear people say that about things that were established facts. And that's a road to destruction of a society if it becomes widespread. And unfortunately it seems to be doing so right now.

[Noam Hassenfeld]

It feels like you believed that all you had to do was develop the vaccine, get to the thing that worked, and then people would take it. And there's this whole other piece of convincing people that you or the scientific community at large didn't do.

[Francis Collins]

Yep, I was naive about science communication and how it works. And I was kind of, without knowing to call it this, I was an adherent to the knowledge deficit model.

[Noam Hassenfeld]

What does that mean?

[Francis Collins]

That means that if you're trying to communicate science to get somebody to make a decision, it's because they're missing knowledge and you're gonna provide that. You're gonna fill their deficit and then everything will be fine.

[Noam Hassenfeld]

You just tell them here's a fact.

[Francis Collins]

Yeah, here's a fact.

[Noam Hassenfeld]

Now you believe the fact I'm an.

[Francis Collins]

Expert and then they'll make the right decision. No, it doesn't work that way. Especially when there's already skepticism and distrust. You're seen as an elitist who maybe has an ax to grind or something you're trying to put over on them. And you may even do more harm than good by going after somebody's misunderstandings face on. They'll just gonna dig their heels in more thoroughly. I guess what I've learned is we need to do a lot more listening with the science communication part of this. Really understand where people are coming from and also be prepared to tell stories instead of going down the road with statistics. Yet for a scientist, that sounds like an anecdote. I would never get away with that in the seminar room. Yeah, this is not the seminar room, people. We need to actually find better ways to help people understand what we.

[Noam Hassenfeld]

You might be listening to all of this and thinking, okay, sure, that sounds good. In theory, but it's got to be pretty hard to have these kind of tough conversations that actually change people's minds in the real world, right? In a minute. A tough conversation that actually changes people's minds in the real world. Support for unexplainable comes from 1Password okay, I know you think you take care of your passwords. You add the exclamation point, you put a three instead of an e. All that good stuff. I hate to break it to you though. It's probably not doing much. And honestly, most people in your company probably aren't even that good. But 1Password Extended Access Management makes security simple for everyone. 1Password says their award winning password manager is trusted by millions of users and over 150,000 businesses from IBM to Slack. And they say their extended access management blocks unsecured and unknown devices before they access your company's apps. And that they've got regular third party audits and the industry's largest bug bounty. You can take the first step to better security for your team by securing credentials and pro protecting every application, even unmanaged. Shadow it. You can learn [e-mail] unexplainable that's 1Password.com unexplainable all lowercase support for the show comes from NPR's Planet Money. What do concert tickets, rent prices, and free shipping that might not actually be free all have in common? Money Smackers. The do re mi economics. It's underneath everything we do, just hiding there even when we don't expect it. Ready to just jump out from behind a door when you walk into a room. And for smart, nuanced human stories about how it all works, you can check out Planet Money from npr. Planet Money is a show where the economy actually makes sense. It's where stories take center stage. I'm a huge Planet Money fan. I love the way they explain complicated concepts with these super engaging stories. They're clear. They're fun. They teach me a lot. Everything from the chaos in the economy right now to how the war on drugs somehow got us blueberries. You can turn into Planet Money every week for entertaining stories and insights about how money shapes our world. Stories that can't be found anywhere else. Listen now to Planet Money from npr. Avoiding your unfinished home projects because you're not sure where to start. Thumbtack knows homes so you don't have to. Don't know the difference between matte paint, finish and satin or what that clunking sound from your dryer is. With thumbtack, you don't have to be a home pro, you just have to hire one.

[Francis Collins]

You can hire top rated pros, see price estimates and read reviews all on the app.

[Noam Hassenfeld]

Download today.

[Francis Collins]

Forget the world around you. Forget the people around you.

[Noam Hassenfeld]

You are entering unexplainable, alone with your own thoughts. Too many of us have lost trust in science, in institutions, in each other. So how do we get it back? In 2023, Francis tried something new.

[Francis Collins]

Good evening. Shall we get started?

[Noam Hassenfeld]

He started working with a group called Braver Angels, which brings people together on opposite sides of an issue. So everything from immigration to gun control to public health.

[Francis Collins]

This discussion, of course, is entitled An Elitist and a Deplorable Walk into a Bar. We'll let you decide in the course of the evening who's the elitist and who who just walked into a bar.

[Noam Hassenfeld]

Francis was on stage with Wilk Wilkinson, this outspoken critic of COVID lockdowns who ran a trucking company in rural Minnesota. I am somebody who certainly doesn't have the bona fides of a scientist. I have spent more time in bars in my adult life than I did in a classroom.

[Francis Collins]

The first time I met with him, I thought, well, we're never going to be able to get along here because let's just say he is very articulate and very outspoken.

[Noam Hassenfeld]

So when Braver Angels confronted me with this opportunity to speak with Dr. Francis Collins, first of all, I was like, what? Like me? This doesn't make sense, but I'll talk to anybody.

[Francis Collins]

He was very strong in his views about how the government had trod upon liberties and freedoms and made stupid recommendations.

[Noam Hassenfeld]

There were so many problems with the communication. The science was changing, and that was not ever communicated well by anybody. Francis had gotten criticisms of his communication and his decision making all the time. But having this kind of conversation was different.

[Francis Collins]

I needed to listen, I mean, really listen, to people who were very angry and distrustful of the government's approach and felt it had done them harm.

[Noam Hassenfeld]

And when he really listened to Francis, could see that he agreed with a lot of Wilk's points.

[Francis Collins]

So what we did wrong. What I did wrong, because I had plenty of these moments in television interviews, is we failed to say every time there was a recommendation, this is the best we can do right now. There's a good chance this is wrong. We didn't say that. We wanted to be sure people actually motivated themselves by what we said because we wanted change to happen in case it was right. But we did not admit our ignorance, and that was a profound mistake. And we lost a lot of Credibility along the way. And that one I will not forget.

[Noam Hassenfeld]

Francis had a whole bunch of conversations with Wilk that went way beyond this one on stage. And they made him understand lots of different ways. Public health officials had been kind of narrow minded out of that.

[Francis Collins]

I think I have a better sense of how our one size fits all approach, at least initially to the country, just didn't fit. Feel like it made any sense when people were in various rural communities and wondering, why do I have to close my business? I haven't even seen any cases here yet. I learned about that as a guy living inside the Beltway, feeling this sense of crisis. We weren't really thinking about what that would mean to Wilk and his family in Minnesota, thousand miles away from where the virus was hitting. It also helped me understand something that I maybe hadn't quite understood for myself, which was when I was in the middle of this, my number one goal was to save lives. I'm a physician. I took the Hippocratic oath. I assumed there were other people worrying about the economic effects of this and the effects on children's learning when they were kept out of school. And I didn't feel like that was my thing. My thing was to try to keep people from dying. But it became clear to me that that may have been something I was a little bit wearing blinders about. Maybe those other factors about economic harms and harms to children's learning should have been a bit more front and center to the conversations that I was part of.

[Noam Hassenfeld]

So I understand looking back on it and saying, okay, it would have been better, more accurate to communicate the level of uncertainty, to just say to people, this is evolving. We don't have to, don't know. Do you think that would have led to a different outcome?

[Francis Collins]

I don't know. I wish we could do the experiment and maybe we could figure out a way to do it in some sort of controlled space. But the way in which this failed to land as effectively as I wish it had, I would say 20% of the problem was the less than perfect communication of the science, and 80% of it was the deluge of misinformation and disinformation and that contamination the conversation to the point where a lot of people stopped listening to the actual facts. But there didn't seem to be any penalty for stating something that's absolutely false. And I haven't heard anybody apologize for that.

[Noam Hassenfeld]

You know, when I think about this willingness to have difficult conversations, you know, to accept responsibility for mistakes, it seems like this is something that most People are not doing.

[Francis Collins]

Not doing.

[Noam Hassenfeld]

And I've heard you mention maybe we could have something like a Truth and Reconciliation Commission or a pandemic amnesty on a larger level where people could really be open about their mistakes. Do you think that could have any effect?

[Francis Collins]

You know, I proposed the idea of amnesty in one of these Braver angels, large scale settings, and the audience blew up. They were not there.

[Noam Hassenfeld]

Huh. People are too angry on both sides.

[Francis Collins]

On both sides. They're feeling too hurt. Too much harm has been done to them. So amnesty, I don't think we're there. Truth and reconciliation. People were like, okay, because they can imagine that those other people are going to have to ask for forgiveness for what they did. But right now, we're so dug in, I hope that this truth and reconciliation option is out there right now. It doesn't quite feel like people are ready to go there.

[Noam Hassenfeld]

One of the things that you say, looking back on your time during COVID is that we needed to have more uncertainty. You needed to be communicating uncertainty all the time. It's something that the scientific agencies don't do enough of. And it's clearly now happening in the other way, where RFK is saying things like, we're gonna find out the cause of autism. No uncertainty. It seems to me like what we need is more people embracing uncertainty, more people talking about their mistakes, whether it's people with their friends who they disagree with, or whether it's the highest scientists in our scientific agencies. How do we get there? Cause we weren't there during COVID when we were doing Operation Warp Speed, and we're not there now.

[Francis Collins]

Yeah, we're a long way from there. And I guess when you're in this circumstance where there seems to be a real pitched battle between the various tribes, the idea that anybody would say I might be wrong, the fact that I've been willing to say that has resulted in a lot of attacks, even from people who I thought were my friends. Like, oh, no, you can't show weakness like that. Well, yeah, we really do need to do that, but we need to all do it and not just expect a few people who are then going to get whacked for it. It's hard right now and you don't see a lot of that in our country.

[Noam Hassenfeld]

Yeah, I mean, I don't want to come off as naive here. I don't assume that just emphasizing uncertainty is going to be the thing that saves us from a full frontal assault on science, but I mean, your response was resigning because it doesn't seem like you could do anything. What do we do about this situation?

[Francis Collins]

Well, I didn't resign to go play golf or fishing because I'm not good at either one. I wanted to have a chance to try to do something productive about this circumstance. So that's a lot of what I'm working on right now. I do think the action is basically to build on what maybe is starting to happen. A general sense in the public that medicine is important, that maybe this is not something that should be attacked in this way. There's some signs there. There was a meeting of the full Senate Appropriations Committee, chaired by Republican Susan Collins, and four senators made strong statements about how this is something that is one of the crown jewels of the federal government and should actually be sustained. And if anything, expanded. So there is some, maybe glimmers of support there. But I think our case is so strong, we just have to figure out how to get that message to enough people and we'll get this back on track.

[Noam Hassenfeld]

Francis can find hope in a lot of places, like even in Susan Collins kind of places. But it's clear he's worried about the lives this could be costing right now and about the future of his profession.

[Francis Collins]

Even though I'm not there anymore, I still talk to lots of trainees. And that is the most disturbing part of this talk about unexplainable. How could the talent that we have in this country, much of which is international trainees that have come from other countries. Cause they thought America was the place where you could really pursue your dreams. And now they're losing confidence that there's a path for them. And fully a third of the young scientists I talked to, graduate students or postdocs, are seriously looking at the opportunity to leave the United States and take their science somewhere else. And wondering, is there a hope for me here?

[Noam Hassenfeld]

Yeah. If I were a young scientist and I wasn't sure whether I should stay or whether I should even take this on as a career, what would you say to me?

[Francis Collins]

I would say you're at a really paradoxical time. Because this is the most incredibly exciting moment for biomedical research. So many things are becoming possible that I would not have dreamed would happen in my lifetime. And we're on this exponential curve of gathering insights. So if that's your dream to be part of, don't give it up now. The paradox is right at the moment. There's a lot of negative things happening in the United States that seem to be threats. But the case here is so compelling that I don't believe those facts can be suppressed for very long. You can already look at polls to say when the American public is being asked, are you worried about some of the things that are happening right now? One of the things they say, I don't think they should be harming medical research. That's right there. 77% of Americans raise that point. So that's people on both sides of the aisle. So there's some momentum there. So I wouldn't right now make your plans to move to Australia, although you might want to have that in your back pocket in case it takes longer than I think it will for us to get back on track.

[Noam Hassenfeld]

Before we go, one last thing. This episode was us trying to wrap our heads around the current moment in science. All the changes at places like the nih, the nsf, usaid. We're trying to figure out exactly what's happening. What do all these budget cuts mean for science right now? What do they mean for the future of science in America? And we want to hear from you. Are you a young scientist just starting out, scratching your head about how to build a research career right now? Have your plans or dreams changed? How is all of this affecting you? We want to hear stories from people working in science about what's changing on the ground right now. So if you're up for it, send us a voice memo or an email to unexplainableox.com we'll get back to you as soon as we can. And with your permission, of course, you might be featured in a future episode. This episode was produced by me, Noam Hasenfeld. We had editing from Julia Longoria, mixing and sound design from Christian Ayala, music from me, and fact checking from Melissa Hirsch. Meredith Hadinot runs the show, Jorge Just is our editorial director, and Bird Pinkerton couldn't believe it. She thought the platypus was on her side, but suddenly she saw other platypuses coming out of the grass. She'd been betrayed. Thanks as always to Brian Resnick for co creating the show. And if you have any thoughts about this episode or any episode, send us an email. We're@ unexplainableox.com we love hearing from you. We read all the emails and you can also leave us a review or a rating wherever you listen. It really helps us get in front of new listeners. You can also support this show and all of Vox's journalism by joining our membership program. You can go to Vox.com members and you'll get ad free podcasts as well as a whole bunch of other goodies. Plus you'll be helping keep this place running and you'll make us very happy people. Unexplainable is part of the Vox Media Podcast network and we'll be back next week. Nobody knows your customers better than your.

[Francis Collins]

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[Noam Hassenfeld]

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[Francis Collins]

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[Noam Hassenfeld]

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[Francis Collins]

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[Noam Hassenfeld]

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[Francis Collins]

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