Health
Ideology May Not Be What You Think but How You’re Wired
So sharp are partisan divisions these days that it can seem as if people are experiencing entirely different realities. Maybe they actually are, according to Leor Zmigrod, a neuroscientist and political psychologist at Cambridge University. In a new book, “The Ideological Brain: The Radical Science of Flexible Thinking,” Dr. Zmigrod explores the emerging evidence that brain physiology and biology help explain not just why people are prone to ideology but how they perceive and share information.
This conversation has been edited for clarity and brevity.
What is ideology?
It’s a narrative about how the world works and how it should work. This potentially could be the social world or the natural world. But it’s not just a story: It has really rigid prescriptions for how we should think, how we should act, how we should interact with other people. An ideology condemns any deviation from its prescribed rules.
You write that rigid thinking can be tempting. Why is that?
Ideologies satisfy the need to try to understand the world, to explain it. And they satisfy our need for connection, for community, for just a sense that we belong to something.
There’s also a resource question. Exploring the world is really cognitively expensive, and just exploiting known patterns and rules can seem to be the most efficient strategy. Also, many people argue — and many ideologies will try to tell you — that adhering to rules is the only good way to live and to live morally.
I actually come at it from a different perspective: Ideologies numb our direct experience of the world. They narrow our capacity to adapt to the world, to understand evidence, to distinguish between credible evidence and not credible evidence. Ideologies are rarely, if ever, good.
Q: In the book, you describe research showing that ideological thinkers can be less reliable narrators. Can you explain?
Remarkably, we can observe this effect in children. In the 1940s, Else Frenkel-Brunswik, a psychologist at the University of California, Berkeley, interviewed hundreds of children and tested their levels of prejudice and authoritarianism, like whether they championed conformity and obedience or play and imagination. When children were told a story about new pupils at a fictional school and asked to recount the story later, there were significant differences in what the most prejudiced children remembered, as opposed to the most liberal children.
Liberal children tended to recall more accurately the ratio of desirable and undesirable traits in the characters of the story; their memories possessed greater fidelity to the story as it was originally told. In contrast, children who scored highly on prejudice strayed from the story; they highlighted or invented undesirable traits for the characters from ethnic minority backgrounds.
So, the memories of the most ideologically-minded children incorporated fictions that confirmed their pre-existing biases. At the same time, there was also a tendency to occasionally parrot single phrases and details, rigidly mimicking the storyteller.
So by “liberal” you mean flexible in thought rather than politically liberal, yes?
Right. The work with children is about prejudice rather than conservatism. Ideologues are strong partisans either to the left or right. Psychological rigidity is linked to ideological extremity regardless of the mission of the ideology.
Are people who are prone to ideology taking in less information? Are they processing it differently?
The people most prone to ideological thinking tend to resist change or nuance of any kind. We can test this with visual and linguistic puzzles. For instance, in one test, we ask them to sort playing cards by various rules, like suit or color. But suddenly they apply the rule and it doesn’t work. That’s because, unbeknownst to them, we changed the rule.
The people who tend to resist ideological thinking are adaptable, and so when there’s evidence the rules have changed, they change their behavior. Ideological thinkers, when they encounter the change, they resist it. They try to apply the old rule even though it doesn’t work anymore.
In one study you conducted, you found that ideologues and nonideologues appear to have fundamental differences in their brains’ reward circuitry. Can you describe your findings?
In my experiments I’ve found that the most rigid thinkers have genetic dispositions related to how dopamine is distributed in their brains.
Rigid thinkers tend to have lower levels of dopamine in their prefrontal cortex and higher levels of dopamine in their striatum, a key midbrain structure in our reward system that controls our rapid instincts. So our psychological vulnerabilities to rigid ideologies may be grounded in biological differences.
In fact, we find that people with different ideologies have differences in the physical structure and function of their brains. This is especially pronounced in brain networks responsible for reward, emotion processing, and monitoring when we make errors.
For instance, the size of our amygdala — the almond-shaped structure that governs the processing of emotions, especially negatively tinged emotions such as fear, anger, disgust, danger and threat — is linked to whether we hold more conservative ideologies that justify traditions and the status quo.
What do you make of this?
Some scientists have interpreted these findings as reflecting a natural affinity between the function of the amygdala and the function of conservative ideologies. Both revolve around vigilant reactions to threats and the fear of being overpowered.
But why is the amygdala larger in conservatives? Do people with a larger amygdala gravitate toward more conservative ideologies because their amygdala is already structured in a way that is more receptive to the negative emotions that conservatism elicits? Or can immersion in a certain ideology alter our emotional biochemistry in a way that leads to structural brain changes?
The ambiguity around these results reflects a chicken-and-egg problem: Do our brains determine our politics, or can ideologies change our brains?
If we’re wired a certain way, can we change?
You have agency to choose how passionately you adopt these ideologies or what you reject or what you don’t.
I think we all can shift in terms of our flexibility. It’s obviously harder for people who have genetic or biological vulnerabilities toward rigid thinking, but that doesn’t mean that it’s predetermined or impossible to change.
The opioid overdose reversal medication commercially known as Narcan saves hundreds of thousands of lives a year and is routinely praised by public health experts for contributing to the continuing drop in opioid-related deaths. But the Trump administration plans to terminate a $56 million annual grant program that distributes doses and trains emergency responders in communities across the country to administer them, according to a draft budget proposal.
In the document, which outlines details of the drastic reorganization and shrinking planned for the Department of Health and Human Services, the grant is among many addiction prevention and treatment programs to be zeroed out.
States and local governments have other resources for obtaining doses of Narcan, which is also known by its generic name, naloxone. One of the main sources, a program of block grants for states to use to pay for various measures to combat opioid addiction, does not appear to have been cut.
But addiction specialists are worried about the symbolic as well as practical implications of shutting down a federal grant designated specifically for naloxone training and distribution.
“Reducing the funding for naloxone and overdose prevention sends the message that we would rather people who use drugs die than get the support they need and deserve,” said Dr. Melody Glenn, an addiction medicine physician and assistant professor at the University of Arizona, who monitors such programs along the state’s southern border.
Neither the Department of Health and Human Services nor the White House’s drug policy office responded to requests for comment.
Although budget decisions are not finalized and could be adjusted, Dr. Glenn and others see the fact that the Trump administration has not even opened applications for new grants as another indication that the programs may be eliminated.
Other addiction-related grants on the chopping block include those offering treatment for pregnant and postpartum women; peer support programs typically run by people who are in recovery; a program called the “youth prevention and recovery initiative”; and programs that develop pain management protocols for emergency departments in lieu of opioids.
The federal health secretary, Robert F. Kennedy Jr., has long shown a passionate interest in addressing the drug crisis and has been outspoken about his own recovery from heroin addiction. The proposed elimination of addiction programs seems at odds with that goal. Last year, Mr. Kennedy’s presidential campaign produced a documentary that outlined federally supported pathways out of addiction.
The grants were awarded through the Substance Abuse and Mental Health Services Administration, an agency within the federal health department that would itself be eliminated under the draft budget proposal, though some of its programs would continue under a new entity, the Administration for a Healthy America.
In 2024, recipients of the naloxone grants, including cities, tribes and nonprofit groups, trained 66,000 police officers, fire fighters and emergency medical responders, and distributed over 282,500 naloxone kits, according to a spokesman for the substance abuse agency.
“Narcan has been kind of a godsend as far as opioid epidemics are concerned, and we certainly are in the middle of one now with fentanyl,” said Donald McNamara, who oversees naloxone procurement and training for the Los Angeles County Sheriff’s Department. “We need this funding source because it’s saving lives every day.”
Matthew Cushman, a fire department paramedic in Raytown, Mo., said that through the naloxone grant program, he had trained thousands of police officers, firefighters and emergency medical responders throughout Kansas City and western rural areas. The program provides trainees with pouches of naloxone to administer in the field plus “leave behind” kits with information about detox and treatment clinics.
In 2023, federal figures started to show that national opioid deaths were finally declining, progress that many public health experts attribute in some measure to wider availability of the drug, which the Food and Drug Administration approved for over-the-counter sales that year.
Tennessee reports that between 2017 and 2024, 103,000 lives saved were directly attributable to naloxone. In Kentucky, which trains and supplies emergency medical workers in 68 rural communities, a health department spokeswoman noted that in 2023, overdose fatalities dropped by nearly 10 percent.
And though the focus of the Trump administration’s Office of National Drug Control Policy is weighted toward border policing and drug prosecutions, its priorities, released in an official statement this month, include the goal of expanding access to “lifesaving opioid overdose reversal medications like naloxone.”
“They immediately reference how much they want to support first responders and naloxone distribution,” said Rachel Winograd, director of the addiction science team at the University of Missouri-St. Louis, who oversees the state’s federally funded naloxone program. “Juxtaposing those statements of support with the proposed eliminations is extremely confusing.”
Mr. Cushman, the paramedic in Missouri, said that ending the naloxone grant program would not only cut off a source of the medication to emergency responders but would also stop classes that do significantly more than teach how to administer it.
His cited the insights offered by his co-instructor, Ray Rath, who is in recovery from heroin and is a certified peer support counselor. In training sessions, Mr. Rath recounts how, after a nasal spray of Narcan yanked him back from a heroin overdose, he found himself on the ground, looking up at police officers and emergency medical responders. They were snickering.
“Ah this junkie again, he’s just going to kill himself; we’re out here for no reason,” he recalled them saying.
Mr. Rath said he speaks with trainees about how the individuals they revive are “people that have an illness.”
“And once we start treating them like people, they feel like people,” he continued. “They feel cared about, and they want to make a change.”
He estimated that during the years he used opioids, naloxone revived him from overdoses at least 10 times. He has been in recovery for five years, a training instructor for the last three. He also works in homeless encampments in Kansas, offering services to people who use drugs. The back of his T-shirt reads: “Hope Dealer.”
Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. is urging Americans to dispose of their prescription medications properly. He addressed the issue in a video posted on X, marking National Prescription Drug Take Back Day, which is April 26.
The Drug Enforcement Administration (DEA) has set up free, anonymous drop-off sites across the country where Americans can leave their unused prescription medications.
U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. speaks during a press conference announcing of the U.S. Food and Drug Administration’s (FDA) intent to phase out the use of petroleum-based synthetic dyes in the nation’s food supply, at the Department of Health and Human Services in Washington, D.C., April 22, 2025. (REUTERS/Elizabeth Frantz)
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While some may think that flushing prescriptions down the toilet is a safe alternative to throwing them away and can prevent people from accidentally ingesting it, Kennedy warns that there are dangers to that too. The HHS chief explained that once flushed, the medications will go into the water system, potentially exposing anyone who drinks the water to those substances.
“We don’t fully know the effects of low levels of birth control hormones or antibiotics or chemotherapy agents and so on, in the water, but it’s not good,” Kennedy said in the video.
An image of HHS Secretary nominee RFK Jr. juxtaposed next to a bottle of pills made by drug manufacturers. (iStock/Getty )
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However, there are some medications that are safe to flush. According to the FDA’s “Flush List,” there are several opioid medications that are safe to flush, including Vicodin, OxyContin and Percocet. However, the FDA warns that drugs that do not appear on its Flush List should not be flushed down the toilet.
(PATRICK T. FALLON/AFP via Getty Images)
The DEA sees National Prescription Drug Take Back Day as more than a way for Americans to clear out unwanted or unused medication. On its website advertising the take back day, the DEA frames it as a way to prevent “medication misuse and opioid addiction from ever starting.”
During its most recent take back day in October 2024, the DEA collected 629,953 pounds, or 314 tons, of medication across 4,644 collection sites.
For those who miss National Prescription Drug Take Back Day, there are drug take-back sites open year-round. The FDA provides instructions on how to safely dispose of medications, as well as needles and syringes safely.
David Paton, an idealistic and innovative ophthalmologist who started Project Orbis, converting a United Airlines jet into a flying hospital that took surgeons to developing countries to operate on patients and educate local doctors, died on April 3 at his home in Reno, Nev. He was 94.
His death was confirmed by his son, Townley.
The son of a prominent New York eye surgeon whose patients included the Shah of Iran and the financier J. Pierpont Morgan’s horse, Dr. Paton (pronounced PAY-ton) was teaching at the Wilmer Eye Institute at Johns Hopkins University in the early 1970s when he became discouraged by increasing cases of preventable blindness in far-flung places.
“More eye doctors were needed,” he wrote in his memoir, “Second Sight: Views from an Eye Doctor’s Odyssey” (2011), “but equally important was the need to beef up the existing doctors’ medical education.”
But how?
He considered shipping trunks of equipment — almost the way a circus would — but that presented logistical challenges. He pondered the possibility of using a medical ship like the one that Project Hope, a humanitarian group, sent around the world. That was too slow for him.
“Shortly after the first moon landing in 1969, thinking big was becoming a reality,” Dr. Paton wrote.
And then a moonshot idea struck him: “Could an aircraft be the answer? A large enough aircraft could be converted into an operating theater, a teaching classroom and all the necessary facilities.”
All he needed was a plane. He asked the military to donate one, but that was a nonstarter. He approached several universities for the money to buy one, but administrators turned him down, saying the idea wasn’t feasible.
“David was willing to take risks that others wouldn’t,” Bruce Spivey, the founding president of the American Academy of Ophthalmology, said in an interview. “He was charming. He was inspiring. And he didn’t quit.”
Dr. Paton decided to raise funds on his own. In 1973, he founded Project Orbis with a group of wealthy, well-connected society figures like the Texas oilman Leonard F. McCollum and Betsy Trippe Wainwright, the daughter of the Pan American World Airways founder Juan Trippe.
In 1980, Mr. Trippe helped persuade the United Airlines chief executive Edward Carlson to donate a DC-8 jet. The United States Agency for International Development contributed $1.25 million to convert the plane into a hospital with an operating room, recovery area and a classroom equipped with televisions, so local medical workers could watch surgeries.
Surgeons and nurses volunteered their services, agreeing to spend two to four weeks abroad. The first flight, in 1982, was to Panama. The plane then went to Peru, Jordan, Nepal and beyond. Mother Teresa once visited. So did the Cuban leader Fidel Castro.
In 1999, The Sunday Times of London’s magazine sent a reporter to Cuba to write about the plane, now known as the Flying Eye Hospital. One of the patients who arrived was a 14-year-old girl named Julia.
“In developed nations, Julia’s condition would have been little more than an irritation,” The Sunday Times article said. “It is almost certain she had uveitis, an inflammation inside the eye, which can be cleared with drops. In Britain, even cats are easily treated.”
Her doctor was Edward Holland, a prominent eye surgeon.
“Holland uses tiny knives to make openings that allow him to get his instruments into the eye, and soon he is pulling at Julia’s scar tissue,” The Sunday Times article said. “As the tissue is pulled away, a dark and liquid pupil, unseen for a decade, is revealed. It is an intimate and moving moment; this is medicine’s chamber music. Next, he breaks up and removes the cataract, and implants a lens so that the eye will keep its shape.”
The Cuban ophthalmologists watching in the viewing room applauded.
But after the surgery, Julia still couldn’t see.
“And then a minor miracle begins,” the article said. “As the swelling begins to go down, she makes discoveries about the world around her. Minute by minute she can see something new.”
David Paton was born on Aug. 16, 1930, in Baltimore, and grew up in Manhattan. His father, Richard Townley Paton, specialized in corneal transplants and founded the Eye-Bank for Sight Restoration. His mother, Helen (Meserve) Paton, was an interior designer.
In his memoir, he described growing up “among the fine, intellectually sharp, widely traveled persons of the Establishment.” His father practiced on Park Avenue. His mother threw parties at their home on the Upper East Side.
David attended the Hill School, a boarding school in Pottstown, Pa. There, he met James A. Baker III, a Texan who later became secretary of state for President George H.W. Bush. They were roommates at Princeton University and lifelong best friends.
“David came from a very privileged background, but he was down to earth and just a very likable guy,” Mr. Baker said in an interview. “He had his objectives in life straight. He was a hell of a lot better student than I was.”
After graduating from Princeton in 1952, David earned his medical degree from Johns Hopkins University. He worked in senior positions at the Wilmer Eye Institute and served as chairman of the ophthalmology department at the Baylor College of Medicine in Houston.
In 1979, while still trying to procure a plane for Project Orbis, he became the medical director of the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia.
“Among my duties,” he wrote in his memoir, “was providing eye care for many of the princes and princesses of the kingdom — about 5,000 of each, I was told — and it seemed that all of them insisted on being treated exclusively by the doctor in charge, no matter how minor their complaint.”
Dr. Paton’s marriages to Jane Sterling Treman and Jane Franke ended in divorce. He married Diane Johnston in 1985. She died in 2022.
In addition to his son, he is survived by two granddaughters.
Dr. Paton left his role as medical director of Project Orbis in 1987, after a dispute with the board of directors. That year, President Ronald Reagan awarded him the Presidential Citizens Medal.
Although his official connection with the organization had ended, he occasionally served as an informal adviser.
Now called Orbis International, the organization is on its third plane, an MD-10 donated by Federal Express.
From 2014 to 2023, Orbis performed more than 621,000 surgeries and procedures, according to its most recent annual report, and offered more than 424,000 training sessions to doctors, nurses and other providers.
“The plane is just such a unique venue,” Dr. Hunter Cherwek, the organization’s vice president of clinical services and technologies, said in an interview. “It was just an incredibly bold and visionary idea.”
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