The hobby has made me recognize a couple of things about country music: it is the kind of music that proposes something about the human condition. It means something. It has revealed something, to me, about happiness (and how perilous that condition of contentment is).

The first thing such music has unfolded for me is, in fact, that something is wrong with me. Something is wrong with you. Something about this world is wrong. It is a bit of a cliché at this point: dogs die, trucks break down, and relationships end. But listen for a moment to Miranda Lambert’s “Tinman.” Or Carly Pierce’s recent “Fault Line.” Or Willy Nelson’s “Can I Sleep in Your Arms.” Broken hearts rip you apart, such that you would be willing to trade it all to be made of heartless tinman. Love leads to suffering, the kind where once solid relationships become sources of violence. A red-headed stranger may be able to kill you at a moment’s notice, but what he longs for most is to spend the night in the arms of a woman: “Don’t know why, but the one I love left me / Left me lonely and cold and so weak / And I need someone’s arms to hold me / ’Til I’m strong enough to get back on my feet.”

The wrongness of the world is often tinted with the kind of violence more appropriate to a Flannery O’Connor short story than popular music. The murder ballad, “Knoxville Girl,” sung in the haunting blood harmony of the Louvin Brothers, narrates the senseless murder of a young woman. The tale is recounted by the murderer himself, who confesses the deed. There is never a reason described for the murder. He kills, and he pays the price, spending the rest of his life in jail.

Such violence is also addressed by singers who have a definite reason to kill. The erstwhile Dixie Chicks gleefully tell us why Earl must die. More recently, Ashley McBryde speaks to Martha Divine, her father’s mistress: “Honor thy father. Honor thy mother. But the Bible doesn’t say a damn thing about your daddy’s lover.” So, the singer kills Martha Divine—if she is caught, she willl say the devil made her do it. In his “Wait in the Truck,” Hardy describes a murder of an abused woman’s partner. The singer faces the consequences of his murder, spending the rest of his life in jail.

There is something like a gothic sensibility to country music. Violence is lauded not because it is a good, but because the reality is that in this broken world where dogs indeed die, where love does not last forever, there is also the violence of the human heart. There is a genuine tragedy defining the human condition. The only thing to do is to sing about it.

All of this seems to go against any sense of what constitutes naïve happiness (more appropriate to the bubble gum pop of the late nineties). That naïve sense is dreadful: the beginning of happiness is recognizing that you are broken. That you long for something more. Dolly Parton’s “The Grass Is Blue” reveals to anyone who listens to it the terrible irony of heartache. The world is so beautiful, so wonderful. But guess what, you are still going to cry. “The Tennessee Waltz” is beautiful and haunting at once: your sweetheart can be taken from you in a moment’s notice.

How can something so terrifying be sung in such a beautiful way? Rainbows and bunnies are not how country music thinks about reality. Even if the genre employs a stock series of archetypes (the adulterous spouse, the violent lover, the fragility of all relationships), it forces the listener to reckon with the truth that we all eventually figure out: something is wrong. And coming to terms with that wrongness is part of the beauty of human life.

“Much of what the public is told about health is medical dogma — an idea or practice given incontrovertible authority because someone decreed it to be true based on a gut feeling,” Makary writes.

Makary’s assertions are supported by hundreds of footnotes as he builds each indictment, but that doesn’t mean all physicians and researchers are nodding in agreement. One example: When a research team analyzed 13 studies comparing antibiotics to appendectomy, it found almost a third of the patients initially treated with antibiotics had an appendectomy within the year. Although the other two-thirds did not, the researchers called the evidence that antibiotics are better “very uncertain.” So surgeons who choose to operate immediately are not necessarily doing something wrong.

Makary, one of medicine’s most prolific iconoclasts, has been poking at America’s health care system since at least 1998 when, as a medical student, his article calling on hospitals, medical schools, and health insurance companies to divest their tobacco stocks was published in the prestigious Journal of the American Medical Association.

A few years later, ignoring criticism from his colleagues, Makary created a checklist to improve surgery safety; after proving that safe surgery checklists reduced surgical errors and deaths, they are now used in most operating rooms around the world. His 2012 book, “Unaccountable,” demanded that hospitals reveal their infection rates and medical errors. A few years later, Medicare began requiring public reporting of those and other indicators of health care quality. His 2019 book, “The Price We Pay,” documented hospitals’ price-gouging practices and called for all hospitals to post cash prices for certain services — which is now required by law. […]

He does not call the medical establishment nefarious; rather, he accuses it of frequently embracing a narrative — that stress causes ulcers, for instance — without evidence, ignoring scientific findings that do not support the idea, and blackballing those who question their position.