“Question Authority” Returns

In the 1960s, Timothy Leary, a well-known figure of the counterculture,  popularized many catchphrases like the one above.  It’s message was meant to raise doubts about the Vietnam War among other issues. In 2024, according to Marty Markary, M.D. we need to once again reexamine our assumptions about some medical beliefs.

In his most recent book, Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, Markary urges government, patients, doctors, and the medical/research establishment to take a closer look at either outdated or harmful practices.

What Markary, a noted surgeon and researcher, found by looking deeper into his profession is that groupthink and blind spots too often impact our healthcare system. He provides numerous examples and opens with the infamous “peanut allergy.”

In the year 2000, the American Academy of Pediatrics (AAP) “nutritionists” recommended, just to be safe, that parents avoid introducing peanuts into their children’s diet until the child was at least age three. This decision was based on an extremely flawed study, without consulting immunologists or allergists.

As it turns out, too late for an entire generation, the best way to prevent an allergy is to gradually introduce a food, like a tiny amount of peanut butter mixed with breast milk or formula, to a child two-to-three months old. And yet, to this day, the WIC program (Special Supplemental Nutrition Program for Women, Infants, and Children) excludes peanut butter from the list of foods covered for infants. You can read the entire story at the Harvard Gazette’s website: https://news.harvard.edu/gazette/story/2024/10/excerpt-from-blind-spots-by-marty-makary/

Given how flawed our access to government directives and well-researched information has become, consumers and patients might want to maintain a healthy skepticism about “assumed science and practices.” From Markary’s website, the list of topics he covers in his book are examples of groupthink and whether you’re a new parent, an aging male or female, or trying to achieve a good diet, there are good reasons for everyone to question authority.

Dr. Markary is the newly confirmed Director of the FDA

One of the most disturbing topics in the book describes U.S. blood bank policies when HIV/ AIDS was devastating the population of gay men and IV drug users. In an effort to protect the sanctity of the Red Cross’s project and to avoid scaring people away from donating blood, gay men and IV drug users, often financially desperate, were allowed to regularly donate blood. All major medical associations promised the public that there was only an extremely low risk of contracting HIV/AIDS from donated blood. This “extremely low risk” groupthink killed nearly an entire generation of innocent people with severe hemophilia, who relied on frequent blood transfers for survival.

Here’s another blind spot at the FDA: “Ironically, OxyContin was approved by the FDA for chronic use based on a 14-day clinical trial, and would not be challenged until 2017 when the medical field was humbled by a study that was embarrassingly simple. “Researchers looking at pharmacy filling records found that 1 in 16 patients who were given opioids after surgery were still taking them 3 to 6 months later.”

In the last chapter of the book entitled “Imagine,” Markary suggests major health recommendations may prove to be wrong in the future, once adequate and transparent research has been conducted. Here are a few examples:

• Fluoride in drinking water. While it might address polluted water and lower cavities by killing bacteria in the mouth, fluoride is also killing good bacteria in the gut (microbiome) and appears to have a deleterious effect on children’s IQs.
• Marijuana is harmless and not a gateway drug for youth. “Compared to the 1970s, marijuana includes ten times as much of the psychoactive component, known as THC, and is more harmful to youth than to adults. Some studies found that 1 in 10 young people who used marijuana would develop psychotic symptoms later in life.”
• Mass use of Tylenol for fever. This common practice has been proven to make infections last longer by interfering with the body’s ability to heal itself. Most medications should be prescribed on an individual basis and not as a universal remedy. A daily aspirin for seniors is another example of not being good for everyone.
• Tongue-tied newborns. “Increasingly, lactation consultants, dentists, and pediatricians are recommending cutting the base of the tongue of infants for a condition called ‘tongue-tie’ meant to help with suckling and breast-feeding. There’s no good evidence to support the procedure, but regardless it’s become a new cottage industry in America.”

Markary concludes this list: “With a $4.54 trillion health care system in the U.S., answering simple but important clinical questions is rarely on anyone’s funding radar.”

The point of the book and a gift to readers and medical professionals is to have an open mind, because those in charge of medical journals and foundations have been historically close-minded. This human tendency has led to massive mistakes and exclusion of differing research. Markary points out that this is also true at professional conferences – the group decides who can present. More recently, those who have challenged groupthink and identified blind spots as a result of the pandemic’s devastating tole, have suffered financially and professionally. And when research funding is denied in order to maintain the status quo – groupthink wins.

There are more than a few reasons not to see what is right in front of you. It’s human to want to hold on to what you believe is true despite disturbing evidence to the contrary. Groupthink gives comfort to those who find the curious, like Markary, a professional pain. However, he believes that questioning authority is essential if we want to avoid making medical mistakes and prohibiting new ideas and new professionals from challenging what is promoted as the truth.

“The physician must be able to tell the antecedents, know the present, and foretell the future — must mediate these things, and have two special objects in view with regard to disease, namely, to do good or to do no harm.” Hippocrates

Photo credits: Peanuts – thomas-franke.