BLIND SPOTS

The misguided prevalence of “gut feeling” in medical dogma.

In his follow-up to The Price We Pay (2019), Makary, a public health researcher and professor at Johns Hopkins School of Medicine, elaborates on the enduring misconceptions plaguing modern medicine in terms of research breakthroughs that have been largely underappreciated, overlooked, or simply ignored in a clinical setting. He cites several recent studies to bolster his position, such as a 16,608-woman study on menopausal hormone replacement therapy concluding that it causes breast cancer development. Despite the lack of evidentiary support for this conclusion, the study’s authors continue to tout it to clinicians while overlooking HRT’s considerable benefits. The overuse of prescribed antibiotics for infections is juxtaposed against research citing the microbiome imbalance they cause by obliterating beneficial bacterium. Makary also discusses the medical groupthink about dietary cholesterol, ovarian cancer, silicone breast implants, and complicated childbirths, among others. Presenting a fascinating study on peanut anaphylaxis, Makary rails against the American Academy of Pediatrics’ recommendation that children avoid the nuts altogether instead of considering research indicating that reintroducing small doses of peanuts (in conjunction with powerful immune suppressants) can actually prove curative. He pauses midway through the book to lucidly examine how the mechanisms of the human mind naturally resist innovative ideas and approaches. As a public health advocate, Makary is simultaneously dazzled by the sophistication of modern medicine and alarmed by the medical industry’s stubborn reluctance to adapt and evolve in the midst of supportive research meant to challenge interventional therapies and procedures. The author’s critical eye is well suited to this clinically sound report appealing for closer scrutiny and a redesigning of the medical establishment, and he coaches readers with or without clinical expertise to “ask for the underlying evidence or rationale to support a health recommendation.”

An eye-opening look at how the American medical industry’s rigidity has stunted its reliability.