The Perception of Reality

The Perception of Reality
by Russ Gonnering at Brownstone Institute

Ten years ago, the internet was completely captured by “The Dress.”

A photo of a dress was displayed. Was it Blue and Black? Was it White and Gold? Everybody had an opinion, and it was definite.

This is distinct from other optical illusions, such as The Rubin Vase, which can be easily reversed by most people:

The Dress launched a flurry of scientific inquiries in an attempt to explain the science behind this. The Journal of Vision, a respected academic ophthalmology journal, launched an open-access special edition in an attempt to explain these curious findings on the basis of multiple objective measurements of luminosity, color saturation, assumptions on illumination with natural or artificial light, and prior exposure to long or short wavelengths.

Perhaps the most interesting explanation, and one that is more easily understood by a lay audience, is contained in an issue of Wired magazine:

So, when context varies, so will people’s visual perception. “Most people will see the blue on the white background as blue,” Conway says. “But on the black background some might see it as white.” He even speculated, perhaps jokingly, that the white-gold prejudice favors the idea of seeing the dress under strong daylight. “I bet night owls are more likely to see it as blue-black,” Conway says.

Importantly, it made no difference if it was known by the viewer of the photo that the real dress was blue and black…

Is there a larger lesson that can be learned from this? If illumination and context of a representation of reality of a physical object form perception of that reality, can the same be true of other, less tangible things, such as ideas? I believe so.

The last decade has seen a profound and deepening divide on multiple issues. Consider the recent heated exchanges during the meeting of the Advisory Committee on Immunization Practices (ACIP) of the CDC. Unless one took the time to watch the two days of the meeting, only a summary, most often as a news report, is available. One sees a representation of the actual meeting. 

Just as when looking at a photo of The Dress, perception will be greatly influenced by the context and the illumination of the representation. However, this time it is not only the context and illumination of the viewer, but also that of the producer of the news.

Herein lies the problem. How can we ever arrive at a true representation of reality? During the Great Covid Disaster, I kept thinking that if only the actual unbiased data could be shared with those who insisted the virus evolved naturally, or those who believed early treatment was impossible, or those who insisted the mRNA agents were “safe and effective,” the impasse could be broken. Alas, that never happened because the source of illumination had been altered from what it was in the past.

With the advent of Postmodernism, the literal definition of truth itself has changed. The truth has been replaced by my truth and your truth. Truth has become an opinion, no more important than whether you like your steak rare or medium.

In the past, we relied on ethical medical science to lead the way to find the truth, but is that even possible now? In current medical studies, it seems that the conclusions are now made first, then the study is designed to fit those conclusions. A recently published study on a trial of a new drug to treat hypertension had this statement appended to the end:

The sponsor designed and conducted the study, including collection, management, analysis, and interpretation of the data. The sponsor was involved in the preparation, review, and approval of the manuscript and decision to submit the manuscript for publication in collaboration with all authors. The final decision on content was exclusively retained by the authors.

I realize that drug companies are interested in proving their products indeed help people, but if the drug manufacturer “designs and conducts the study, including collection, management, analysis, and interpretation of the data,” does it not give one pause? Is it appropriate for the drug manufacturer to have this degree of control?

Even worse is the situation where a study on puberty-blocking drugs in children was done, but not published because the results did not fit the investigator’s bias. It is unclear if this study received taxpayer funding, but a previous publication of the author on this subject did indeed acknowledge federal support. Should such federal support entail oversight?

Consider this article by Carlton Gyles in the Canadian Veterinary Journal published in 2015. Interestingly enough, that is the same year as The Dress and five years before The Great Covid Disaster with its attendant problems with bias in publishing. In it, Gyles references the statements of editors of two of the most renowned medical journals in the English language and bemoans the state of medical publications.

The following is a quote (Published in JAMA in 2008 and not NEJM) from Marcia Angell, former Editor-in-Chief of the New England Journal of Medicine:

Over the past 2 decades, the pharmaceutical industry has gained unprecedented control over the evaluation of its own products. Drug companies now finance most clinical research on prescription drugs, and there is mounting evidence that they often skew the research they sponsor to make their drugs look better and safer. Two recent articles underscore the problem: one showed that many publications concerning Merck’s rofecoxib that were attributed primarily or solely to academic investigators were actually written by Merck employees or medical publishing companies hired by Merck¹; the other showed that the company manipulated the data analysis in 2 clinical trials to minimize the increased mortality associated with rofecoxib.² Bias in the way industry-sponsored research is conducted and reported is not unusual and by no means limited to Merck.³

In his 2015 Commentary, Richard Horton, the Editor-in-Chief of The Lancet, wrote:

The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.

So much for “trusting in the science.” If the Editors-in-Chief of the two most respected English-language medical journals lacked trust in the literature as far back as 2008, why on earth should we do so now?

Is there a remedy? Ten years ago, Richard Horton remarked in his commentary reference above: 1) there was no incentive to be “right,” but instead to be productive and innovative; 2) nobody was ready to take the first step to fix the problem.

That may have changed. On August 15, 2025, Jay Bhattacharya, the new Director of the National Institutes of Health (NIH), published his vision of a unified strategy to redirect the priorities of the NIH in order to restore confidence in “the science:”

• NIH training programs should allow trainees to design and conduct the highest quality scientific studies. Importantly, these programs should be based on merit, follow civil rights law, and not discriminate against anyone. NIH and the institutions we support must also uphold safe, equal, and healthy working and learning conditions conducive to high-quality research and free inquiry.
• Replicable, reproducible, and generalizable research must serve as the basis for truth in biomedical science. The “publish or perish” culture favors the promotion of only favorable results, and replication work is little valued or rewarded. NIH is prioritizing research that produces robust, reproducible results.
• NIH is establishing a robust and secure national infrastructure to integrate and link data from various real-world sources consistent with a deep respect for individual privacy rights. This new Real-World Data Platform will provide advanced computational analysis resources for investigators across numerous research areas, including neurodevelopmental disorders and chronic diseases.
• Artificial intelligence breakthroughs provide exciting new possibilities for science and medicine, but require careful, rigorous research to fulfill their promise. The NIH will develop an AI Strategic Plan to enhance transparency in AI models, develop replication standards for AI use in research, and expedite the research, development, and translation of AI discoveries to benefit patients.
• NIH will champion initiatives rigorously exploring the role of poor diets in causing common chronic conditions and the identification of healthy diets that can prevent and better manage these conditions. We will prioritize projects focusing on the role of maternal and infant dietary exposures on health outcomes across the lifespan. NIH will also work to initiate long-term studies to understand the impacts of certain foods and diets on obesity and insulin resistance in children.
• NIH is supporting initiatives to understand the etiology and the treatment and care needs of the broad spectrum of people with autism. The new autism data science initiative will support investigators in identifying and addressing data gaps in scientific understanding of the etiology of autism and commonly co-occurring conditions.
• NIH will continue to support research that advances the health of all Americans, regardless of their age, race, ethnicity, sex, sexual orientation, or other characteristics. To conduct meaningful biomedical research, scientists must consider both individual and external factors that influence health outcomes, guided by the needs of the specific research question…However, broad or subjective claims—such as attributing worse health outcomes in a particular population to poorly measured factors like systemic racism—should not be presented as established background facts without clearly defining measurable variables that are part of the research question.
• NIH has invested substantially in health disparities research, focusing mainly on identifying and documenting worse health outcomes for minority populations. The field has made significant progress in mapping the breadth and depth of differences in health outcomes across populations, but this research has not always translated into measurable improvements in health for minority populations.
• Going forward, the NIH will prioritize research that goes beyond measuring health disparities to focusing on solution-oriented approaches. This includes actively testing, advancing, scaling, and implementing innovative evidence-based interventions and treatments that address poor health outcomes.
• The NIH will continue to support research collaborations with institutions and scientists outside the U.S. Many critical breakthroughs that improve the health of Americans have resulted from global partnerships, so foreign scientific research collaborations often have clear scientific value. However, we must take action to ensure better oversight of our funding abroad. All NIH institutes, centers, and offices should consider whether there is a scientific justification for conducting a research program at a foreign site rather than a domestic one. The NIH should prefer the latter over the former when scientifically justified. We should also consider whether each project involving foreign collaboration will likely lead to better health for Americans, since American taxpayers fund NIH research.
• The state of the scientific literature regarding optimal care and support approaches for children and teenagers identifying as transgender and those diagnosed with gender dysphoria is described in the recent HHS review of treatment for pediatric gender dysphoria. In accordance with these data, there are clearly more promising avenues of research that can be taken to improve the health of these populations than to conduct studies that involve the use of puberty suppression, hormone therapy, or surgical intervention to treat gender dysphoria, gender identity disorder, or gender incongruence in minors. By contrast, research that aims to identify and treat the harms these therapies and procedures have potentially caused to minors diagnosed with gender dysphoria, gender identity disorder, or gender incongruence, and how to best address the needs of individuals so that they may live long, healthy lives is more promising.
• Ending the HIV epidemic in the United States remains a key priority. For more than 40 years, NIH support has enabled significant advances in antiretroviral therapies, transforming the landscape of care and prevention approaches. Recent breakthroughs in simpler-to-take treatments and long-acting prophylactics, and many other recent breakthroughs, provide us with the technological tools needed to finally win this long battle. To take advantage of this opportunity, the NIH will support implementation science and other research directions to improve the uptake of and access to existing medical and behavioral interventions that can significantly limit and eventually eradicate HIV infection from the United States. Research on HIV/AIDS prevention, treatment, and cure will continue as needed to support this goal.

Unfortunately, the response from researchers, politicians, and Big Pharma to these common-sense research guidelines has been to dig in and fight change, as observed decades ago by John Kenneth Galbraith:

Although Dr. Bhattacharya has both stepped up to do something to revert to honest science and supplied the incentive to truth in research, we are still left with a significant problem. We the people must demand that the illumination of The Truth be ignited, and Postmodernism be banished, if not completely, then at least from science. Science must be objective and follow The Truth and not Subjective Opinions of Truth. While some things will remain nuanced, many will not. The boundary between the two must be clear and not blurred as they have been in the past. 

Only the collective efforts and the demand of society will accomplish this noble and much-needed goal.

The Perception of Reality
by Russ Gonnering at Brownstone Institute – Daily Economics, Policy, Public Health, Society