05Intermezzo: The Formula of Madness

Here, I’d like to pause.

We’ve made it through three chapters. A Neolithic surgeon with a scraper. An exorcist with a crucifix. A gynecologist with a scalpel, cutting out healthy ovaries. Three eras, three continents, three vocabularies. You would think—three entirely different stories.

But you’ve probably already sensed it: this is one story. It keeps repeating. It has a signature.

And before we go any further, I want to name this handwriting. Because later—across the twenty-odd chapters of this book—you’ll encounter it again and again. In university clinics and Baku apartments. In Nobel Prize lectures and Instagram livestreams. I want you to recognize it yourself—before I even point it out.

I call it the formula of madness. It has five steps.

STEP ONE. A PINCH OF TRUTH. Lies are almost never based on pure fabrication. They’re rooted in observation — small, genuine, sometimes even precise. An epileptic convulses and speaks in a stranger’s voice — that’s true, that’s what a seizure looks like. After a high fever, a syphilis patient sometimes grows quiet — that’s true too; we’ll see why later. The observation itself is honest. The trouble begins with the next step.

Step two. Overgeneralization. From a pinch of truth — a universal conclusion. Click! The trap snaps shut. “A strange voice”? So there’s a foreign spirit in the body. “Went quiet after the fever”? So fever cures madness. “A woman suffers”? So it’s her female organ that suffers. An observation that holds true at exactly one point gets stretched over everything: all diseases, all people, all cases. The blood drains from your face when you grasp the scale of it: one tiny spark set a whole universe of dogma ablaze. But the real horror lies elsewhere. Nobody asks questions. Did we actually test this? What would have happened without our intervention? How many cases did we simply not notice because they didn’t confirm the guess? Silence. The dead give no testimony.

Step three. Method. From hypothesis — bypassing verification — practice is born instantly. If the spirit is inside, drill an exit. If the womb wanders, cut it out. If fever heals, apply heat. Between “I think” and “I do this to people” not a single barrier rises. This is the decisive step. This is where the hypothesis stops being innocent.

Step four. Industry. The method grows a school, authority, students, fees. It acquires its own masters, its own certificates, its own degrees of initiation, its own conferences or its own congregations, its own departments, its own wards. Who are these people whose names are stamped on the certificates? Those who believed, or those who smelled blood? Now the method has what the timid hypothesis never had: people who live off it, whose survival depends on it. From this moment the method no longer needs to work. It no longer needs to heal. It only needs to sell.

Step five. The victims. It is always the same people who pay — those who suffer the most. The sick. Their families. Those who had no choice, and those who did, but wanted too badly to believe. Their suffering is either ignored, written off as an “inevitable price,” or — worst of all — credited to the method as a virtue: if they endure it, the treatment must be working.

The formula has one built-in property that makes it almost immortal: it cannot hear refutations. If the patient got better — the method works. If not — the patient was “too far gone,” “resisting,” “didn’t believe enough,” or “was brought in too late.” The formula is constructed so that it cannot lose. Every outcome confirms it.

Now I can finally give the definition this entire book was written to provide.

Insanity in the clinical sense is an illness: a disorder that severs a person’s connection with reality against their will. That was the insanity suffered by the patient in the ward with whom this book began. It isn’t chosen. It cannot be bought. It is treated—to the extent medicine knows how.

But madness can be something else too — far broader. That is what this book is about. It’s about the systematic, persistent, incorrigible denial of reality that wounds — both the one who carries it and everyone around. Think about it. It has no hallucinations. It has a method. It doesn’t lie in a hospital bed. It stands at the patient’s bedside. With a trepan. With a crucifix. With a scalpel. Later — with a syringe. With an ice pick. With figurines for systemic constellations. And with a payment link in the profile description.

The five steps of the formula—that is the anatomy of this kind of madness.

Notice what this definition leaves out. It contains no mention of stupidity — people of brilliant intellect were infected by the formula, and we shall meet them yet. It contains no mention of villainy — most carriers of the formula are sincere; sincerity proves nothing, after all, except sincerity. And it contains no mention of the past.

Does humanity have an antidote? It does. It’s boring, slow, and can’t be sold from a podium. It’s called verification. Take your guess — and try to refute it. Compare those who were treated with those who weren’t. Count failures as honestly as successes. Show the data to hostile eyes. Admit defeat when it comes — and discard the method.

What sets science apart from the formula of madness isn’t that it never gets things wrong. It gets things wrong all the time — the entire second half of this book is about exactly that, and it won’t be an easy read. Science differs in one respect: it has a mechanism for correction. The formula is wrong forever — because within itself, it is never wrong at all.

Moving forward, this book is structured as an investigation. Each chapter will present its own “case”: the observation that sparked it all, the place where it was amplified, the method it morphed into, the industry that thrived on it, and the bill that patients ultimately paid. At times, I will explicitly outline these five steps in a separate analysis. More often, you’ll spot them before I do.

And now, for the most uncomfortable part.

Until now, the formula has been wielded by individuals without medical training: priests, exorcists, folk healers. Their ignorance could be excused by the times they lived in. In the next part, the formula will don a white coat. It will earn a diploma, a professorship, a peer-reviewed journal—and even a Nobel Prize. And we will see that a degree does not cure one of the formula. The only remedy is scrutiny.

Let’s go have a look.