"Blind Spots" by Dr. Marty Makary

Dr. Marty Makary's book, Blind Spots, was available September 17 of this year and now shows up as #14 on the NY Times non-fiction best sellers list.  The subtitle is, "When Medicine Gets It Wrong, and What It Means for Our Health."  I have skimmed it and am now reading it.  The book takes a rather critical view of the approach medicine has taken to a number of health issues, pointing out that incorrect ideas propagate in the medical community and are not challenged until many people have been hurt.

The book attracted my attention because I hoped it would address how medicine has focused on a pharmaceutical approach to Alzheimer's disease as opposed to taking lifestyle head on.  That's not outside of the scope of the book, but he doesn't really spend time there.  

In Beating the Dementia Monster, we mentioned that Dr. Dale Bredesen had encouraged post-menopausal women who had stopped taking hormone replacement therapy to resume it.  Makary has the same assertion.  Women were discouraged from taking it, after a study connected the therapy with an increased risk of breast cancer.

Makary cites this as a major fail of medical science.  He cites studies that failed to support the connection with cancer, and he says the benefits of the therapy far outweigh the risks.  He specifically cites some significant statistical evidence that women taking hormone replacement therapy have a very much reduced probability of developing Alzheimer's disease.

Makary cites other conditions he believes represent failures on modern medicine, including:

-- Promotion of nut allergies in children by preventing their early exposure to nuts

-- Abuse of antibiotics

-- Demonization of dietary cholesterol and red meat

-- Origins of the opioid crisis

and more.

Makary focuses on the phenomenon of "group think."  A chunk of my engineering career was taken up with accident investigation.  I investigated serious industrial accidents as well as nuclear facility events and accidents.  The goal was always to find the root cause, a cause that could be corrected to prevent recurrence.  And quite often, we identified group think as a cause.  In group think, a consensus on a process or solution to a problem arises in the group.  Being consensus grants a proposed process or solution special authority, and so bad ideas are not easily challenged.  When the idea arises in the medical community and propagates in the culture that peanut allergies can be prevented by keeping peanuts away from young children, we get an epidemic of peanut allergies.  Even though evidence arises to contradict this belief, it remains embedded in the thinking society in general and doctors in particular. 

When I bought the book, I was hoping for more focus on chronic diseases (like Alzheimer's disease).  He seems to have some thoughts there, but they don't come out so much in this book other than in hormone replacement therapy.

Robert F. Kennedy, Jr. has some serious thoughts on chronic diseases.  While I definitely don't want to get into any political discussion on this blog, I was impressed to hear the focus he wants to bring to chronic disease.  I heard him speak on the subject.  He wants to make changes to the food supply and otherwise discourage the lifestyle habits that lead to many chronic diseases.  Alzheimer's disease would, of course, be a prime target for such an effort.