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Thoughts on Medicine 2.0 vs. 3.0
Plus a Progress Report from the 'Kill Phase' of the Gut Repair Protocol
Recent Thoughts on Medicine 2.0 vs. 3.0
Sometimes you read a book and there’s so much new information, you focus on absorbing all of it. Other times, you might know 80% of the content already, but for some reason (perhaps the virtues of the author) the book helps to crystallize the information so you can see the big picture.
In the past month, I revisited the audiobook of The UltraMind Solution by Dr. Mark Hyman, and it helped snap a bunch of things into place for me.
One of the ideas the book dispels is the notion that a single intervention of any kind, be it exercise or a pill, could ever result in human flourishing and health. Health involves many spheres of life—from the personal to the environmental and cultural, from what we choose to eat, to how farmers choose to grow the food, etc., etc.
For the past 140 years or so, we’ve been in an era of medicine that Dr. Peter Attia calls Medicine 2.0, which we’re only now beginning to transition out of.
You might say this era of medicine began in 1880 when Burroughs Wellcome & Company was founded in London by the American pharmacists Henry Wellcome and Silas Burroughs.
It’s hard to believe there was ever a time before pills, but these guys invented the “tabloid” which they later renamed the “tablet.” This was the beginning of an era defined by the idea that a pill could cure just about any ill. Burroughs Wellcome & Company later became GlaxoSmithKline.
When it comes to history, context is everything. Imagine the world that Wellcome and Burroughs came from and worked in. A time when:
Slavery was a living memory in America and segragation the reality.
In the UK and US, women were typically not allowed to attend university or do most jobs (Cambridge didn’t award degrees to women until 1948) and women could not vote.
London and other cities were filled with coal-burning power plants; People burned coal at home daily for heat.
The Industrial Revolution moved people off farms and into cities where their health deteriorated for many reasons—people who once ate relatively healthy foods as farmers now ate highly processed boxed and canned foods, etc.
In large swaths of cities, people lived in squalor, with many people crammed into one room with little access to clean water, etc.
The poor were sent to workhouses where families were divided and treated like work machines or slaves (Charlie Chaplin’s family amongst them, which helps explain his films The Kid and Modern Times).
For the houseless, one could pay a small daily sum to “sleep” seated in a chair with your torso draped over a rope for “support” — in the morning the rope was dropped and everyone fell to the floor.
The River Thames was an open sewer and a water supply.
Should one suffer an injury, death or amputation was common.
There was no NHS.
Labourers who were injured were either dismissed or sent to company doctors who had a vested interest in protecting their employers from claims.
An astonishing percentage of children died before reaching the age of 5.
There were industrial-scale orphanages.
Insane asylums were like zoos where anyone could pay an admissions fee.
The Seductive Idea of a Pill
The list above should suffice to say: Within this context, the idea that pharmacists Wellcome and Burroughs could manufacture any tablet that suddenly counteracted all these horrors and made people happy and healthy is an obvious absurdity.
However, the idea that a conventient little pill could offset the pain and downstream health effects of society’s horrors was an incredibly seductive notion.
If you as an individual (patient or doctor) were largely powerless to do anything about this list of horrors, how easy would it be to put all your hope in a pill? At least a pill gives you some sense of agency in all this, right?
This context helps explains the 100+ years that follow—right up to the present day.
Unsurprisingly, it’s been an era where patients were (and still are) blamed for their problems: women are “hysterical,” medications don’t work for women because they’re women, poor people have bad health because they’re poor, workers who have lingering symptoms after a workplace concussion really just have pyschological problems, etc.
There’s little question that Medicine 2.0 (and science generally) helped solve some of the problems we faced back then. Medicine prevented or decreased certain forms of acute disease and death, but the solutions could simultaneously set the stage for mental illness and chronic disease.
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1880 vs. Today
Today, the world is both better and worse than it was in 1880. Consider:
Where our work hours were once fairly circumscribed, we can now find ourselves working at nearly any time of day or night.
Modern life routinley disrupts the circadian rhythm that health depends on.
Many of us now work in largely disembodied ways, looking at screens nearly all day every day. And often in isolation.
Individual families often live far away from extended families, or they live in otherwise “atomized” ways without family, village, or community.
People in the middle class are often living and working under tremendous strain in almost every sphere of life. The stakes for making any mistake in any area of life (including school or career or even being in an accident) are incredibly high.
The fortunes of many families now hinge on having two professional incomes in order to compete with other two-income households. And whilst women have added the professional sphere to their lives, men have resisted adding the domestic sphere to theirs, resulting in a sitation where women often do vastly more overall, and suffer the resulting stress, which degrades their health and happiness. Families may outsource the domestic sphere at great expense, but this is also a catch-22.
To become or to remain a “have” (instead of a “have-not”) one is required (and encouraged) to work constantly in a state of anxiety about how bad things might be if one didn’t or couldn’t work ceaselessly. And the rewards for hard work (such as buying a house) are often out of reach.
In much of the world, young people feel hopeless about the prospect of ever owning the house they live in and thus having the feeling (or reality) of security and the health-promoting benefits of security.
Both our water and food supplies are contaminated with pesticides invented in recent decades, petrochemical fertilizers, pharmaceuticals and hormones, which flood our bodies and brains with toxins and deprive us of essential nutrients and fill us with empty calories that further degrade our health.
The natural world itself has suffered many losses over the past century.
As in 1880, the question remains: What can medicine do about all this other than mitigate disease and pain? And what can we do about it when our health declines to the point where it can no longer be ignored?
During the Medicine 2.0 era, the common practice has been to test new drugs on populations of animals or men (only in recent years have women been included in such studies). If enough subjects appear to benefit, the drug is approved for use. But little to no effort is made to ascertain why a drug didn’t work for some individuals, which might offer guidance to their wise application. The data only flows one way. It’s a top-down, command and control approach.
Typically, little evidence is gathered from you personally. Case in point, I’ve had access to my genetic information for several years now, but no MD has asked to review it or based any decision about my care on that information. I am left to read websites that address my genetic variants and surmise the implications, etc.
Transitioning to Medicine 3.0
It seems to me that we’ve reached a breaking point where medicine can no longer mitigate all of the downstream effects of the kinds of forces I listed above. The levels of metabolic disease and deaths of despair are unprecedented. And Medicine 2.0 also created some of these downstream effects, in part because the focus has been on treating diseases rather than people. “Diagnose and Adios.”
Can we shift away from the mentality that any single intervention will fix everything? Can we face the totality of the changes that are needed for us to be healthy and live in a society that promotes and prioritizes health and happiness?
Our own health and the health of our families may be the pivotal leverage point for these social and even global changes.
Believe it or not, I’ve never been more optimistic about our ability to meet these challenges. Personally, I feel like I finally have the right framework for increasing health instead of mitigating illness.
Progress Report from the 'Kill Phase' of the Gut Repair Protocol
Here’s where the “rubber meets the road” for me personally at the moment.
A few months ago, I did a test called GI360 from Doctor’s Data. That test revealed that of the 6 categories of healthy gut flora, 2 were far too high and 4 were too low. The 2 that are too high prevent the other 4 from gaining ground or existing in proper balance.
This state of affairs might have happened for any number of reasons, including taking antibiotics in the past.
But no matter how it began, the result is that I now have dysbiosis and a compromised gut barrier, which may or may not be contributing to a compromised brain barrier (those barriers are one cell thick and it’s the same type of cell).
The lab does a second step: they determine which things will kill off the overgrown bacteria and what they’re resistant to. Those results are different for different people.
In my last update, I was nearing the end of the first phase of the gut repair protocol. That phase was called the Biofilm-Busting Phase. It involved taking things that lowered the defences (the biofilms) of the 2 categories of overgrown bacteria in my gut.
I am now nearing the end of the “Kill Phase.” During this phase, I’ve taken the things that kill the overgrown bacteria. These are taken with meals and this phase typically lasts 4 to 6 weeks.
I’m reluctant to say what these substances are because I’m wary of people trying to cowboy this on their own without information that is specific to them or their gut flora. But I will say that these aren’t medications or antibiotics. Antibiotics can be necessary for people who have bacteria in their gut that shouldn’t be there, but in my case, the bacteria should be there, they’re just out of balance.
In both the Biofilm-Busting Phase and the Kill Phase, you feel worse before you feel better. The first phase had some psychological low points for sure, but after about two weeks, I turned the corner. The same has been true for the Kill Phase, although the down feeling is more physical than psychological.
In a few weeks I’ll begin the third phase of this process, which is the Repopulation Phase. I’ll take probiotics that elevate all 6 categories of gut flora in a balanced way. That process will take 1 to 3 months.
Along the way, I’m also making lifestyle and diet changes. I’ve recognized my own enchantment with the idea that a single intervention will solve everything. The things that promote and sustain human health have to be “re-upped” every day, including sleep, hydration, light, nutrients, enjoyment and relationships. In other words, I don’t expect this gut repair to be a panacea, but I do hope it’s a fresh start.
I’ll report back when I’m in the next phase of the process.
Brainwave is a newsletter about brain health, a blog about my own journey, and an informational resource for people whose symptoms haven’t resolved after a concussion or mTBI. I aim to present this information in a clear and concise way, spelling out what’s backed by science and what remains unknown. Nothing here is meant as a substitute for professional medical advice, diagnosis, or treatment. I am not a physician or a healthcare practitioner of any kind; I’ve had a lot of sports-related head trauma and had to learn this stuff the hard way. If you found this information helpful or know someone who might benefit from it, please share and subscribe to Brainwave.
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