The truth ― at least as it pertains to lifestyle, diet, and health ― is, literally, my business; or more accurately, my vocation ― as my most direct service to it is not-for-profit. After nearly 30 years in the trenches of clinical care and public health practice, I am entirely convinced that fundamental truths are the greatest asset and most luminous promise we know for advancing the human condition. All forces of perpetual doubt, perennial distrust, and persistent confusion – generally for profit and personal gain ― are the shadows that douse the light of hope. They are the enemy to public health. They are my enemy. They are the common enemy.

Accordingly, I look across the expanse of scorched truth imparted to us by our presidential campaign and its aftermath with great foreboding.

If all of the campaign rhetoric was genuine- something we always knew to be unlikely, and now know to be renounced ― the outcome would make very few happy. The unapologetically racist, sexist, xenophobic among us must be- surely- just a rounding error, and only they win if all that we heard was true.

Most, I suspect, are just hoping that some of it was true. Some voted a particular way because they prioritized the implications for their personal finances, not because they don’t mind which part of their daughters’ anatomy is up for random grabs. Others voted that way because they favored a particular position on the Second Amendment, not because they believe climate change is a hoax.

We have seen the neo-Nazis and extremists crawl out of whatever rodent holes hid them from the common view, and our presidential election was their invitation. But most who voted a particular way had reasons unrelated to support for that radical fringe. Most who voted their particular convictions did it in spite of that affinity, not because of it.

Most of us- the reasonable and the decent in all of our political, social, and fiscal diversity – can only hope that some, or even most of what we heard was not true. There will be no wall around Mexico. Hillary Clinton is not going to jail. And apparently the claim that climate change was a Chinese hoax was, instead, a hoax played on West Virginian coal miners until their votes were counted.

Of course, campaigns and elections always involve hyperbole, spin, and even honest error. But this experience was to spin what a Tomahawk missile is to a paper cut. Precedent, and propriety, have been blown to smithereens.  Spin takes a basic truth and aims it at questionable implications. Hyperbole takes a basic truth and exaggerates its meaning. Error is inadvertent. Only lies are lies. Only lies involve saying what you know you don’t mean even as it crosses your lips.

So what now? We have been invited to enter the post-truth era, and maybe we have no choice. We have evidence that an election can be won by out-and-out lies. That is the stuff of an arms race. If one candidate promises a wall around Mexico, with no hope of delivery and no need ever to apologize for failing- why shouldn’t the other just go ahead and promise free ferry service to Mars? Lost in this mix is any hope of ever addressing actual approaches to actual problems down here at home.

This problem is insidious and self-perpetuating, until or unless truth is valued. If one candidate plays the game of lies, and the other doesn’t- the bolder liar wins by default. If both play, it invites escalation that degrades the already dubious processes of political campaigning into genuine absurdity. No voter has any hope of knowing what any candidate will ever actually do. This election seemingly executed a whole new contract: “tell us whatever we want to hear, and we’ll believe it long enough to vote for you.” We have met the enemy, and it is us- in our gullible multitudes.

The dilemma of this post-truth world is rather acute in this moment.

If we hold Trump fully accountable for the positions he espoused, there can be no accommodation. The positions he espoused, in the aggregate, are the very rhetoric goading fascists into the open, for thinking they are now welcome there. Any reconciliation comes at the cost of decency itself, and leaves character in tatters.

But if we offer no accommodation, and he didn’t mean what he said- do we leave him nowhere to turn for support but to the very radical elements that most threaten us all? Do we drive him into an embrace of policies he privately derided even as he spouted them?

We might, instead, hold Trump to the standard of his deeds, rather than his obviously insincere words. We could, then, potentially reconcile- but at a dreadful cost. We would be saying, in essence: lie with utter abandon to get elected, and we’ll forgive you afterward if you do the right thing then.

But if there is no cost to lying, what hope is there for truth? We will have killed it- in the company of expertise. That’s ominous, no matter one’s politics. It is certainly an acute threat to all that matters most to the health of people and planet alike.

So here we are, between a rock and Trump place; damned if we do, and damned if we don’t. Invidious outrage to the left, the renunciation of truth to the right. Only the fascists among us will win if Trump meant all that he said when he said it. But if he was lying, as seems more evident every day, then they lose- but so do we all. We have all looked on not only as truth was killed, but as its remains were publicly desecrated.

We, the people, can fix this henceforth by choosing not just to trust, but also to verify. We can choose to make truth matter more than being told lies we like. We, and only we, can establish the accountability that paves the fast track to the post, post-truth era- where truth matters.

But in this moment, we are here- where it has not.

I keep running into the idea, propounded by friend and foe alike, that those who cast votes for the losing cause need to get over it. Ordinarily, I would agree. But this is not an election of normal wins and losses. For everyone loses when lies trump truth.


David L. Katz

Director, Yale University Prevention Research Center; Griffin Hospital