American Medicine’s Major Assumption
How a single belief shapes research, medicine, and how patients view themselves
Over the past few months, I’ve paid more attention to scientific research and discussion than I have since studying neuroscience in college. In addition to Covid-19, which has made topics like inflammation and viral load part of everyday conversation, I’ve dug into chronic illness and Lyme disease research on my own. After reading through many articles on both conditions and sitting in on discussions with friends and researchers, I’ve noticed a surprising trend. While the content of discussion sometimes changes- new pharmaceuticals, oxygen therapies, new viral behaviors- many of the same phrases have appeared over and over: “The immune system gets confused…” “cells make mistakes…” “the body overreacts…”
In between the basic facts, I heard interpretations which often boil down to the same, profound assumption:
The body makes mistakes (and therefore cannot be trusted)
To be clear, we all recognize that our bodies change over time. They get sick, age, and eventually die. But there are at least two ways to interpret these same events: either your body makes an increasing number of mistakes over time OR your body performs optimally with the resources it is given (e.g. food, water, sleep) in dealing with the stressors is faces. In the first interpretation, the body is compared to a machine that loses reliability over time and becomes faulty; in the second, it is likened to a dynamic system that is attempting to heal faster than it is being harmed.
I’ve noticed over time that most Americans- physicians, researchers, and citizens- don’t just prefer the former interpretation; their entire thinking is based on it. And while the idea that the body makes mistakes may sound like a small, or even rational, assumption, it leads to dramatically different questions and conclusions. When researchers and physicians believe the body makes mistakes, they focus on fixing those mistakes through pharmaceuticals and complex interventions to the detriment of lifestyle changes and longer-term solutions such as better nutrition and stress reduction. What does that look like?
Spontaneous Breakdown: From Researcher to Patient
One of my first long-term research positions began in college, when I worked in a lab studying the role of protein misfolding in neurodegenerative diseases like Alzheimer’s and ALS. At the time, neurodegenerative disease research was largely shaped by the “Amyloid Hypothesis” that emerged through Alzheimer’s research- the idea that protein plaques in the brain were the main cause of disease progression. The way we imagined these diseases, a set of proteins in the brain spontaneously misfolded into an ineffective and dangerous shape, leading other proteins to do the same. We envisioned the situation as similar to a zombie horror movie. Our goal was to use other proteins to “fix” those that had “gone rogue” and bring them back to their normal shape.
But over time, something began to bother me. In biochemistry courses, we learned that protein shape was largely determined by temperature and pH. So why did we not ask, Is there any change in the ambient environment that would favor such a change? As I looked at our research, it seemed that by assuming spontaneous misfolding, we had created an arbitrary starting point to our work. When I brought this point up in our lab, I was neither refuted nor supported, mostly just ignored. By the time I graduated, the Amyloid hypothesis was on very shaky ground and yet most research labs pressed on in the same direction.
A few years later, I found myself viewing disease from a different angle: as a chronic Lyme patient. Sitting across from a highly respected (and incredibly expensive) doctor, I listened as he told me about the aggressiveness of the Lyme spirochetes and coinfections. “These things can be spirochetes, cysts, or intracellular forms, so you have to be incredible clever to get attach them with antibiotics.” And then a few minutes later, he said made a fascinating offhand remark: “If I were to test most people in CT, I’m guessing a huge number would test positive for Lyme, but they would be able to suppress the symptoms.” Just like a few years prior, I noticed a strange dissonance between the two pieces of information: If these infections were so aggressive, how were most people able to suppress them? And what prevented me from doing so?
After meeting a great nutritionist, I learned about my food sensitivities, changed my diet, and began to rebuild my gut. As I removed foods from my diet that were triggering inflammation and supplemented my diet with a few vitamins, my health improved dramatically within weeks. On my final visit to my expensive physician, I shared my lifestyle changes and dramatic progress. He responded, “Food won’t make a huge difference. How did the antibiotics work?”
Whether in a research lab, in the doctor’s office, or in the casual conversation, I’ve almost always encountered the same perspective on the human body: it just “messes up” sometimes! This view is reflected in the most common metaphor we use for the body: the machine. We speak of a body “breaking down” or “falling apart” as if the body were purely mechanical, despite the fact that none of our cells are more than ten years old.
Since this idea is so foundational to conventional medicine and research, it is rarely acknowledged how limiting it is. Over the past forty years, billions of dollars have been spent on developing targeted chemotherapies for cancer and prospective drugs for Alzheimer’s patients. In return, we’ve seen an increasing number of cases and negligible returns on lifespan. In all this time, very little attention has been given to fundamental questions such as, “What stressors could lead the body to naturally adopt these states? What is the body responding to?”
Finally, the worst damage is to individuals and patients. When a person believes that her body just “makes mistakes,” he stops trusting it. He stops listening to important signals and cues like pain, that provide a huge amount of value and information. Most importantly, he stops believing he can make a difference by changing his diet, his environment, or his stress level and surrenders control of the healing process to a physician or pharmaceutical company. His focus switches from understanding nature to fearing or trying to outsmart it.