Trust Grandmas Not Doctors

2019-08-31 • health philosophy

Remember when fats were evil?

Remember when we thought we were healthy because we were pouring skim milk over our cocoa puffs?

Imagine having faith in the old USDA food pyramid. You'd avoid fats like the plague and get all your calories from fucking cereal and bread.

And then, ten years later, your hormones are all messed up because your body has been deprived of all kinds of essential nutrients that we've been consuming for forever.

So after months of complete and unexplained exhaustion, sleeping for twelve hours a night yet still struggling to keep your eyes open, you decide to go to the doctor.

You limp into the office and notice the ten foot USDA food pyramid poster in the reception is missing. Weird.

Eventually you get called in and what's the first thing you see? Your doctor, the same guy who told you to switch to margarine ten years ago, is now happily munching on a steak and stirring butter into his coffee.

You say, "What the fuck dude, are you trying to get a heart attack?"

And he says, "Heart attack? Ha! Fats are totally good for you now. Get with the times man,"

"What? I haven't eaten fat in years..."

"Oh SHIT, what? That's not good. No wonder you're here right now. Did no one told you?? You must live under a rock haha how could you not know??"

"Why would I know that? I don't follow diet news or whatever. You want me to make my home page or something? Do all your patients need to listen to nutrition podcasts to stay healthy?"

"Hey relax man. You're just a little hangry. Just take this, hit up a steakhouse or two, and see me in a few weeks."

Your doctor tosses you an avacado and waves you out of the office.

Doctors Are Normal People

I used to revere doctors.

Here were these white-coated super-heros who dropped phrases like 'popliteal fossa', saw under your skin, and cured every infection, snapped limb, and headache.

This respect is ingrained in our culture. And understandably so.

Think about all the times you've heard a sarcastic "*oh, I'm sorry, are you a *DOCTOR?*" in response to health advice. For most people, doctor approval gives any health-related statement truth and credibility.

Disease is painful and opaque and if you don't have faith in something, it can be absolutely terrifying. If you don't believe in God, you gotta put your faith in doctors. It's the only way to keep the inner turmoil and helplessness at bay.

The problem with substituting doctors for God is that doctors aren't that special. Some doctors can be incredible people, sure, but they aren't superhuman.

Doctors are normal people.

Normal people who crammed for their college physio exams hungover in-between weekend benders. Normal people with forgetful memories and cognitive biases. Normal people who dread work on Monday and daydream about where to go out for dinner while glancing at the rash on your face.

And as normal people, they don't have some secret knowledge the rest of us can't see. They know what they're taught in school, augmented somewhat by knowledge gained through practice.

And who do they learn from? Well they learn from more normal people with normal knowledge bounded by normal epistemic limits. People who take constantly shifting theories (e.g. fats are bad for you) and present it as fact.

That's all fine and good. People make mistakes, that's nothing new.

The problem is when doctors and scientists take this half-baked knowledge of the human body and pretend to be experts. And then we, as science-revering intellectuals, throw all skepticism out the door, fill our bodies with whatever pharmaceuticals are in vogue, blindly parrot whatever they say, and viciously suppress any alternative viewpoints as bullshit, unfounded, pseudo-science.

I've heard variants on the following conversation so many times, the one's where people dogmatically argue "rational" viewpoints that they have no understanding of just because someone in a lab coat said it was true.

"Monsanto is putting all kinds of weird chemicals in our food."

"They're all proven safe. Besides, everything is a chemical you idiot."

"I don't know, it just seems sketch to me."

"OH, I didn't know you were a DOCTOR. Please, please, tell me more about how 'sketch' it is!"

"Ah, never mind."

Guess-and-check medicine

If you went to a dermatologist a few years ago, they'd say, with confidence, "acne is caused by a bacterial infection".

And you'd trust them whole-heartedly, because intelligent people trust medical science, and doctors are the arbiters of medical science.

And based on how confident your dermatologist sounded, you'd assume they knew "acne is caused by a bacterial infection", like, for certain, right?

Well they didn't. It was a guess at best. They didn't know shit about acne.

We don't think acne is a result of bacterial infection anymore— we think most acne is linked to general 'inflammation' (which we also barely understand).

But uncertainty wouldn't have stopped your dermatologist from prescribing you a powerful antibiotic long-term.

If you've been keeping up on the latest health research for the last few years, which seems to be the pre-requisite to defending yourself from shitty doctors nowadays, you'd see that long-term antibiotic use could seriously fuck up your gut bacteria, causing all kinds of complex disease.

And this is in addition to the widely acknowledge consequence of (breeding treatment resistant "super bacteria")?

I'm imagining the acne conversation right now:

RESEARCHER 1: "I think acne is a bacterial infection."

RESEARCHER 2: "Ok, I trust you. What kills bacteria?"

RESEARCHER 1: "Antibiotics!"

RESEARCHER 2: "Of course! Let's give people antibiotics! That'll kill the bacteria and stop the acne!"

One month later...

RESEARCHER 1: "Our month long trial is complete— the antibiotics occasionally worked for acne!!! Some people do suffer some strange side-effects, but who knows if they're even related. We'll just fine-print "side effect: upset stomach" on the bottle. Even if there are horrible long-term side-effects we've missed, there are so many confounding factors that no one will be able to link it back to us."

RESEARCHER 2: "Brilliant!"

Note: I know the FDA approval process is more stringent than this, but in general it's not hard to get highly dangerous drugs through the process.

And how many other treatments are based on unsound, poorly researched, guesses?

I'm imagining the same company today.

RESEARCHER 1: "Oh shit, turns out those antibiotics we've been selling are fucking up people's gut bacteria."

RESEARCHER 2: "Damn, we have to pivot."

Researchers rub their temples.

RESEARCHER 2: "I've got it! So arbitrarily killing gut bacteria is bad, right?"

RESEARCHER 1: "Right."

RESEARCHER 2: "So let's do the opposite! We'll throw trillions of arbitrary strains of bacteria into people's stomachs. We'll call it a probiotic!"

RESEARCHER 1: "Isn't that what, like, yogurt does?"

RESEARCHER 2: "It's all about marketing. Yogurt is a grandma remedy. Probiotics are science. We'll just estimate the number of bacteria in yogurt, put ten times the amount in our pills, and then run a study or two. Then we can say probiotics are PROVEN to work. We'll also say that our probiotic has TEN TIMES more bacteria with GREATER DIVERSITY than yogurt or kombucha or any of that Whole Foods bullshit that isn't backed HARD SCIENCE."

Researchers pop champagne.

Epistemic hubris

Attempting to model the trillions of micro-interactions and impulses in our bodies is a noble endeavor that saves lives.

Pretending that these models are correct is not noble and ruins lives.

It's ok to tell patients: "This pill will relax you, but we have no idea what else it'll do to your body. There are a lot of known side effects, and probably way more unknown side-effects that can subtly fuck you up long-term. It's your life, and I'll prescribe you some if you're desperate, but I implore you to explore other solutions."

It's not ok to say: "Anxiety, huh? Let me write you a script for some Xanax. All it does is agonize your GABA receptors. Slows you down a bit. Just try it out and see if it helps. If not, there are a few other drugs we can try out."

How proud, how insane, how deluded do you have to be to throw random chemicals at an INFINITELY COMPLEX system of trillions of cells, bacteria, and electrical signals that you barely understand and act like you know what the outcome will be?

All this confidence based off some fischer-price modeling of a small subset of the cellular interactions (Xanax agonizes GABA receptors) that are taking place.

We have absolutely no idea what else is happening, as evident by the inexplicable side-effects we gloss over.

And the worst part is, these already shitty models of the body are CONSTANTLY CHANGING.

We used to think fats were bad. Now avacados are a superfood.

We used to think the levels of pesticides in our food were safe. Now Monsanto is being sued for billions of dollars.

We used to think inhibiting serotonin re-uptake helped depression. Now we think the whole SSRI thing might be a placebo and horse tranquilizer is the way to go.

I could go on and on, but this kind of stuff is easy to Google.

"Proven safe" means nothing to me anymore.

You sound a little one-sided...

I do think allopathic intervention is justified in life-or-death situations. For example, the defibrillator saves lives each year and I'm happy it exists.

But keep in mind, people have a much higher risk tolerance when they're about to die.

If I'm mid-seizure, I don't give a shit about the side-effects of whatever muscle relaxant I'm injected with. I have bigger problems.

If I have sepsis, then sure, give me some antibiotics. I don't care about my gut microbiome if I'm going to die in a few hours.

Allopathic research is necessary for this kind of high risk but potentially life-saving intervention and I'm grateful for the doctors and scientists who work on that kind of thing.

This rant isn't for them.

This rant is directed towards the hordes of doctors thoughtlessly prescribing invasive medication to patients with chronic and lifestyle diseases, telling them it's "proven safe".

It's directed towards doctors who didn't (and still don't) understand antibiotics and tell patients to take completely unnecessary risks for acne or a cold.

It's directed towards the pediatricians with outdated and disgustingly simple models of the brain giving ninth graders life-time scripts for Prozac.

It's directed towards the doctors who don't realize how little they know. The doctors who tell patients that a synthetic pill that fucks with brain signaling mechanisms we barely understand, a pill developed by a purely for-profit company that could care less about what happens to you as long as they aren't sued, should be the first line of treatment for a fourteen-year old kid.

Ok Karthik so doctors don't know shit and the medical system is fucked. I threw out my Ambien. But now what?

How am I supposed to fix my insomnia?

Trust tradition.

Why Trust Tradition

  1. Tradition is smarter than you are

This article, which is actually a TL;DR of this book, brilliantly explains why.

The TL;DR of the TL;DR is:

Cassava root is poisonous if prepared incorrectly.

The indigenous Tukanoans somehow developed a complex multi-day preparation method that made it safe to eat.

They figured out this method without knowing what cyanide was or how the small intestine worked.

Henrich argues that the preparation methods were "not primarily the products of individuals applying causal models, rational thinking, or cost-benefit analyses" but they arose from "faith in cultural inheritance—in the accumulated wisdom implicit in the practices and beliefs derived from their forbearer."

Basically, they trusted their parents, not science or "first principles".

And if a European "intellectual" intervened in the Cassava preparation process and said, "you indigenous people are so inefficient, I will use my mental models of how the world works to streamline this process. Y'all don't even have a reason for why you're doing all this extra unnecessary shit", this would happen:

"At the beginning of the seventeenth century, the Portuguese transported manioc from South America to West Africa for the first time. They did not, however, transport the age-old indigenous processing protocols or the underlying commitment to using those techniques. Because it is easy to plant and provides high yields in infertile or drought-prone areas, manioc spread rapidly across Africa and became a staple food for many populations. The processing techniques, however, were not readily or consistently regenerated. Even after hundreds of years, chronic cyanide poisoning remains a serious health problem in Africa... In some places, there’s no processing at all, or sometimes the processing actually increases the cyanogenic content."

Consider the above in the context of doctors prescribing probiotics.

What hidden effects are we missing? What qualities of fermented foods don't exist in probiotics? How significant could this be? Why are we trying to outsmart the cultural wisdom of eating yogurt after your meal in the first place?

2. We all have an intuitive sense for what our bodies need. Obtuse nutritional science just gets in the way.

How do animals survive with no food pyramids, no Healthline, and no concept of vitamins, minerals, or saturated fats?

How do chimpanzees, with no doctors, no models of bacteria, pathogens, or the gut, know to eat clay when they have an upset stomach?

How did the indigenous Tukanoans know to go through that elaborate preparation process for the Cassava root?

How did cavemen know what to eat?

Natural intelligence.

Somewhere deep in our primal archetypes is an intuitive sense for what our bodies need.

Most people don't realize this.

They don't realize this, because our subconscious intuition is masked by conscious concepts about what's good or bad. These concepts are instilled in us by a misguided society that profits off of selling us new, poorly substantiated, dietary fads ("I'm really craving a warm, soupy, meal right now, but I have to stick to my 30-day raw foods challenge...") and supplements. And on top of that, our natural signaling is all fucked up by foods like French Fries and Sour Patch Kids designed to trick us into cravings and addiction.

Traditional medicine systems get in touch with our brilliant intuition.

Take acid reflux, for example.

When that disgusting acid-vomit hits your throat, it feels hot and sharp.

Your body is trying to tell you that you have too much heat and sharpness in your body. Don't laugh yet.

Your body is trying to tell you to eat cooling foods, like aloe vera (also used for sunburn), and dulling foods, like oats (dull is harder to visualize). Obviously if you have this disgusting hot acid in the back of your throat, you're probably going to want to avoid hot and spicy foods as well.

Sounds too simple? This protocol is basically what Harvard recommends for acid reflux. They just don't point out the intuitive nature of it all.

Even if you don't understand what 'dull' means in this case, just think about what foods would make you feel better. Definitely not a spicy curry. Oatmeal with bananas and some coconut water might sound good though.

Traditional medicine systems formalize our natural intuition, unclouded by the limited conscious mind, and that's why they're so powerful.

The Western approach looks at blobs of cells under a microscope and guesses at what they could be doing. We then notice new patterns and links between our guesses and build unsound theories on top of them.

Rather than try tackle the insurmountable task of modeling, in minute detail, every cell, pump, and impulse in the body and trying to understand then nature of reality with magnets and microscopes, traditional medicine takes the phenemological route, searching inward rather than outward, using a deep understanding of the self as a guide.

3. Even if you disagree with everything else I've said (please let me know if you do), medical science is slowly catching up and validating traditional remedies. Why continue to wait?

"...if something comes from the West it becomes science; if it comes from the East it becomes superstition. Many of the things that your grandmothers would have once told you, are today being discovered in top scientific laboratories as “great” discoveries about human nature. Everything that they are saying after billion-dollar research studies, we have already said in our culture, because this is not a culture which has evolved out of compulsions of living. This is a culture which was evolved consciously by sages and saints, seeing how you should sit, how you should stand, and how you should eat. It was designed for what is best for human wellbeing, and there is immense scientific value in it.” - Sadhguru Jaggi Vasudev

Ten years ago, if I told you meditation helped irritable bowel syndrome, you would've called me a quack.

Ten years ago, if I told you to take turmeric for arthritis, you would've called me a quack.

But today, if I tell you acupuncture helps with liver disease, you'd still call me a quack, because there "aren't enough studies".

Are you fucking kidding me?

You think ALL THIS BULLSHIT is "rigorous" and "trustworthy", but a well-tolerated treatment used for thousands of years with incredible success is a "potentially dangerous placebo"?

Here's your fucking study, not that it even matters, because even when there are studies that say traditional remedies are safer and more effective alternatives to pharmaceutical bullshit, we dismiss it. We don't want to admit that we've vastly over-complicated problems with existing and elegant solutions.

Oil pulling (swishing oil around your mouth) is proven (in the Western framework) to be at least as effective as mouthwash for dental hygiene.

This is over-complication at it's finest.

Could you imagine dedicating your entire life to a mouthwash business?

All the years spent in a lab working on R&D, the thousands of people coming together to formulate the chemicals and manage supply channels and handle marketing and brand vision and HR.

Only to realize a bottle of sesame oil from Trader's Joe's does the job better in every way?

Well the British Dental Journal can't, so despite acknowledging this study, they still say oil pulling is "suspicious" and "reeks of pseudoscience quackery".

Life isn't long enough to wait for the fifty more studies needed to convince British dentists that Crest Pro-Health Multiprotection Rinse is more expensive, more toxic, and less effective than swishing sesame oil around your mouth.

These ancient healers knew something, and they knew it without all the crazy medical equipment we have today. That's worth something.

Trust them.