Pride, Epistemic Humility, and the Lessons We’re Still Not Learning

On September 17, 2020, I drove myself to the emergency department at Colorado Mountain Medical in Avon, Colorado. That morning, I experienced a sudden headache and vomiting, and did what any physician might do: I promptly pulled up Medscape on my iPad and worked through the differential diagnosis in a 60-something male. I sought care that same afternoon, but the center was closed. COVID protocols. I went home and slept. By the next morning, the headache had not relented, and I took a second drive – straight to the hospital. I got a CT, climbed off the table, eyed the monitor, and diagnosed my own dural sinus thrombosis. From there, I was transferred to Swedish Hospital in Denver for a catheter thrombectomy. Ironically, I found myself on the receiving end of a procedure I have performed on others during my years of neurointerventional practice.

I was lucky. A 24-hour delay in a condition like that can mean the difference between full recovery and permanent deficit. Or death.

I tell that story not to relitigate the COVID policy debates, but because it illustrates something that rarely appears in official tallies: the cost of confident policy falling on patients who had nothing to do with the disease those policies were designed to fight.

Francis Collins is one of the most accomplished scientists of our time: a former NIH director who led the Human Genome Project, a committed Christian, and a man of evident moral seriousness. He wrote The Road to Wisdom: On Truth, Science, Faith, and Trust as a kind of civic appeal — a call for Americans to recover the epistemic virtues that make democratic life possible. His diagnosis of the problem is largely correct. His prescription is largely insufficient. And in at least one noteworthy passage, he models precisely the failure he warns against.

Collins defines wisdom as something that “includes experience, common sense, and insight” alongside “sober judgment about how to discern truth.” Few would argue. He’s right that we are living through an epistemological crisis — a collapse in shared standards of evidence, an epidemic of motivated reasoning, and tribalized media ecosystems that reward outrage over accuracy.

What he doesn’t ask, with sufficient rigor, is why.

The answer has been hiding in plain sight for three thousand years. Ancient theologians named it superbia — pride — and placed it first among the seven deadly sins. Not lust, not greed, not sloth. Pride. C.S. Lewis put it memorably: “It was through pride that the devil became the devil. Pride leads to every other vice. It is the complete anti-God state of mind.”[1] Jonathan Edwards, writing three centuries ago, called pride “the first sin that ever entered into the universe, and the last that is rooted out.”[2]

In my own work on this subject, I contend that pride operates primarily as a cognitive distortion — not merely a moral failure but an epistemological one.

In Superbia, I observed, “Excessive confidence in our own opinions may be the subtlest yet most pervasive manifestation of sinful pride.”[3] False beliefs are harmful enough. The far greater danger is the union of error with certainty: “when we are wrong but sure that we are right.”[4]

Collins circles this territory. He acknowledges cognitive biases, endorses epistemic humility, and insists that we assess the “integrity, competence, humility, and aligned values” of sources before trusting them. Good counsel. But he frames these primarily as civic virtues — tools for restoring public trust — rather than as spiritual disciplines rooted in a theological model of human nature. The result is a prescription that is clinically sound but therapeutically weak. Telling proud people to be more humble, without accounting for why pride is so resistant to correction, is a little like treating my sagittal sinus thrombosis with aspirin.

Collins is not wrong that misinformation is dangerous. He cites well-known empirical data suggesting that vaccine hesitancy cost tens of thousands of lives. He is right that both political poles have been susceptible to epistemological failure.

But his treatment has a conspicuous blind spot. He devotes considerable energy to cases where conservative-leaning communities resisted official guidance — on vaccines, on masks, on the severity of COVID itself. He is far less interested in cases where progressives, the institutions he led, or the consensus he represented, got things badly wrong.

A few examples worth naming honestly:

The infection fatality rate. Early modeling projected COVID mortality at 1-3% of cases or higher, a figure that drove enormous policy decisions. John Ioannidis of Stanford argued publicly, beginning in March 2020, that this figure was a severe overestimate derived by dividing deaths by confirmed cases at a moment when testing was nearly nonexistent. He was widely ridiculed. Ioannidis subsequently published a seroprevalence analysis in the Bulletin of the World Health Organization placing the overall IFR at 0.23–0.27% — a figure the WHO saw fit to publish in its own journal. Ioannidis was largely vindicated. The individuals and institutions that vilified him never said so.

Vaccine transmission prevention. The mRNA vaccines were extraordinary achievements — highly effective against severe disease and death from the original strain. By late 2021, however, the data clearly showed that they did not meaningfully prevent transmission of Omicron. On December 20, 2021, my wife and I attended a live performance at which proof of vaccination was required for all adults [“to prevent transmission,” you know]. We contracted Omicron. The policy had outlived its evidence base. Public health messaging was slow to acknowledge this.

Indirect mortality. My dural sinus thrombosis was not in any COVID database. But patients like me — with cardiac conditions, cancers, neurological emergencies — who faced delayed or denied care during lockdowns did not vanish from the actuarial tables. They appear in excess mortality statistics attributed to other causes. The costs of confident policy were real and distributed broadly, but they were largely invisible to those making the confident policy.

Collins mentions none of this. That silence is not a minor editorial choice. It is the shape of the argument.

The most revealing passage in the book concerns the Great Barrington Declaration (GBD) — the October 2020 statement signed by epidemiologists Martin Kulldorff (Harvard), Sunetra Gupta (Oxford), and Jay Bhattacharya (Stanford), along with thousands of other medical professionals. I was among them. The declaration argued that lockdown policies were causing serious collateral harm and proposed an alternative: focused protection of the elderly and vulnerable, with less restriction on the low-risk population.

Collins’s response was visceral. He called the proposal “lethally wrong” and “dangerous,” coordinated with Anthony Fauci on a “quick and devastating takedown,” and — writing now, years later — maintains he has “no regrets for the point,” only for his choice of words.[5] He associates the GBD’s authors with Trump, Scott Atlas, and political opportunists, without engaging their core epidemiological argument. He cites the Swedish experience as a cautionary tale, noting Sweden’s elevated mortality relative to its Nordic neighbors — while omitting that Sweden’s cumulative excess mortality through 2022 was comparable to or lower than most of Western Europe, and significantly lower than the United States.

What Collins exhibits here is something distinct from simple error. He apologizes for how he fought the argument. He doesn’t reconsider the argument.

I want to be careful here. Collins is a brilliant man who bore enormous responsibility during a genuine crisis, made decisions under conditions of radical uncertainty, and got many things right that mattered enormously — including the accelerated vaccine development that almost certainly saved millions of lives globally. The cognitive distortions visible in his GBD analysis do not invalidate his broader contributions.

But that’s precisely the point. Pride doesn’t require malicious intent. It doesn’t require stupidity. It operates most effectively in the minds of the intelligent, the accomplished, and the morally serious — because they have the most to lose by being wrong, and the most cognitive firepower to deploy in their own defense. As I wrote in Superbia: “In the mansions of our minds, the windows are grand and clear, while the mirrors are safely locked in the basement.”[6]

Collins tends to frame epistemological failure as a problem of disinformation — bad actors, social media algorithms, politically motivated denial. These are real. But they are downstream of something more fundamental: the disposition of the human heart toward self-justifying certainty. Disinformation can only take hold in minds already organized around tribal identity and defensive reasoning. The cure is not better media literacy, though media literacy helps. The cure is the kind of deep epistemic humility that flows from genuine theological conviction — from understanding, at the level of lived belief, that we are fallen creatures whose reasoning is systematically distorted by self-interest, that our certainties are often projections of our pride, and that revision is not weakness but wisdom.

Collins comes close to this when he includes “humility” among his criteria for a trustworthy source. His version of humility is essentially consumer-facing: evaluate your sources for humility, then trust the humble ones. The problem is that this outsources the epistemic work to the very cognitive apparatus that pride has already compromised. A proud person will reliably perceive humility in sources that confirm their priors and arrogance in sources that challenge them. Collins’s framework, applied by a proud mind, produces exactly the same result as no framework at all.

Personal humility — the kind that requires you to hold your own conclusions loosely, regardless of source quality — is structurally different. It doesn’t depend on accurately reading others. It disciplines the reader, not just the reading list. The wisdom tradition Collins’s title invokes locates humility there. “When pride comes, then comes shame; but with the humble is wisdom” (Proverbs 11:2, NKJV). The road to wisdom begins not with finding humble sources but with becoming a humble seeker. Thomas Aquinas put it plainly eight centuries ago: “A swollen mind is an obstacle to truth, for the swelling shuts out the light.”[7] Epistemic humility is the cure for the ailments that Collins diagnoses, with accumulating evidence that it leads to clearer thinking and less political hostility.

Physicians are among those most prone to the particular failure Collins illustrates. We enter medicine through a selection process that rewards confidence. We are trained to project certainty — patients need it, systems demand it. We accrue status through demonstrated expertise. The resulting culture, in many specialties, is one where uncertainty is experienced as professional embarrassment and revision is experienced as defeat. These are structural accelerants of exactly the epistemic pride that drove the worst moments of COVID-era institutional behavior — on all sides.

None of us is exempt. I signed the Great Barrington Declaration, and I believe that decision was defensible on the evidence. But I am aware that my personal experience of the lockdown’s costs is not a neutral lens. Intellectual honesty requires acknowledging that. Collins would benefit from the same acknowledgment. So would we all.

The Road to Wisdom ends with a pledge — a personal commitment to civil dialogue, charitable listening, and responsible information hygiene. It’s a fine pledge, as far as it goes. But the road to wisdom described in the biblical tradition runs much steeper. It passes through genuine self-examination. It requires what the Proverbs call “the fear of the Lord” — a reckoning with the insufficiency of our own judgment that only a prior reckoning with God can produce.

The epistemological crisis Collins rightly diagnoses is, at its root, a spiritual one. Pride distorts belief. Humility corrects it. Processes are secondary.

We are not of one mind on these questions — even within a community like CMDA, bound by shared faith and shared profession. That’s not a problem to be managed. It’s an invitation to the kind of humble inquiry that wisdom actually requires.

[1] Lewis, C.S. Mere Christianity. New York: Harper One, 2001

[2] Edwards, Jonathan. Thoughts on the Revival of Religion in New England. IV.1, 1735

[3] Willing, Steven. Superbia: The Perils of Pride. The Power of Humility. Amazon, 2022. P. 39

[4] Superbia, p. 63

[5] Collins, Francis. The Road to Wisdom: On Truth, Science, Faith, and Trust. New York: Little, Brown and Company, 2024. pp. 110-111.

[6] Superbia, p. 14

[7] Gregory the Great, as quoted by Thomas Aquinas, Summa Theologica, 162.3