Blind Spots

Why is it that modern medicine can cure previously deadly diseases in hours and provide us with artificial limbs, but then the top experts disagree on whether we should have toast or eggs for breakfast? And it's not like we are told that it doesn't matter which one we eat. We are told that the respective wrong thing will kill you a slow painful death after a life of diminishing fitness and mounting obesity.

Marty Makary presents a fascinating discussion of ten such blind spots in modern medicine in his new book aptly named "Blind Spots". Aside from the eggs vs toast conundrum, he talks about topics like the microbiome (don't carpet bomb it with antibiotics), hormone replacement therapy (it is beneficial after all), peanut allergy (prevent it by giving children peanuts), blood transfusions (should be checked for infectious diseases) providing a well-research but also objective analysis of where things have gone badly wrong in medicine.

What makes this book so powerful is that it comes from a top doctor coming straight from the establishment. Many of us have grown used to flat-earth-adjacent critics chastising modern medicine. But it's hard to them seriously when, in the next sentence, they tell you that gravity is not a thing. So, it's great to see an analysis from someone who understands the medical establishment. In this sense, the book illustrates the way forward for health decisions relating to our own life. You don't always have blindly trust the establishment, but "doing your own research" on X doesn't work either. What you can do is find an expert on the topic who you trust to not have substantial conflicts of interest, and then follow that person's advice.

An interesting point Marty Markary makes is that challenging the conventional wisdom in medicince can be more damaging to your career than flat out academic fraud. This is true especially in politically charged areas, such as the medical treatment of trans people. If what you do doesn't get past journal editors and review boards, then your career is over.

Are the physical sciences different? The advantage of the physical sciences is that feedback is more immediate. You build a solar cell and test its efficiency, rather than having to wait for decades to see if the cohort you are studying has a slightly higher risk of getting a specific disease. Only, I guess, String Theory might be a bit like the latter case where you only know after decades of research if you are on the right track.

Also paradoxically, it is easier to admit mistakes if the stakes are not so high. If you've been using an inappropriate basis set in your computations, then you might still be able to repent and change your ways. But how could anyone admit to themselves that their actions and advice might have harmed millions?