I was an MIT educated neurosurgeon – now I'm alone in the mountains [video]
youtube.com
youtube.com
An MIT-educated neurosurgeon quit his job after realizing surgeries weren’t addressing the root cause of patients’ problems. He observed that the outcome of surgeries would vary greatly: for some it would help, for others a bit and for others, it would not help at all even though he performed them perfectly every time. Some patients even called before the surgery to say that they were okay and no longer needed surgery.
So he started asking patients questions and after 9 years he concluded that patients who got better and healed did the following (at 19:42 in the video): low salt diet; mostly plant-based diet; did things that would cause sweat: exercise, sauna, or living in hot weather; did not smoke; drank little to no alcohol; had good social support: family, friends, etc; slept 8 hours a day; were not stressed or managed to release it back, e.g. meditate.
Then he talks about the moral dilemma. If he helps patients to truly heal by sharing what he has learned, he and the hospital would not make money.
Successful lobbying, if not straight corruption, would be closer to the current situation.
If your salt intake is low, and you start sweating due to hot weather, exercise or a new-found interest in saunas, you probably need to bump that up.
With regards to for-profit medicine, this is why I hate all market based health insurance systems. Even if you are rich and get treated like a king, you still have to question whether your doctor/surgeon is trying to sell you a procedure. The only system that does not suffer from this issue is the NHS (e.g. UK) where the incentive is lacking. The debate about health care systems tends to focus on availability and coverage, but this for-profit perverse incentive is orthogonal to all that.
Is that a joke? With NHS you have to wait to get GP appointments, wait several weeks for examination by specialists, more waiting in waiting list for surgery... The backlog for everything is huge!
In NHS you can literally wait years for non life threatening surgeries.
There is a long history (20 years) of people who gave up, did their surgeries in France, and sued NHS for reimbursement. More recent stories are from EU, when NHS was part of unified health system (they should pay for medical procedures done in other EU countries to UK citizens).
Dealing with NHS if you need surgery, is basically full time job. You have to navigate Kafka like administrative labyrinth. Sometimes you have to drive 10 hours, to other side of country, because the only specialist who takes new patients is in Scotland.
NHS is doing everything it can, not to pay! If you have any problems and can do so, save your mental health, and just do medical tourism to Turkey, Malaysia or Thailand!
how is this different from NHS?
Three weeks. I am told to wait three weeks. The doc wants it last week. We are having to call around and mess with coverage questions. Similar for my dad and a specialist. Waiting a month while having breathing issues.
People wait already for emergency medical situations, but we pay a premium. And I am still not sure what my 20% shared cost is gonna be for the ambulance and hospital stay. And yes, that factored into my decision to even be treated, which, had I stayed home, may have killed me.
Fuck our system. Medical should not be for profit. It should cost money to run because it should be a service.
In UK we had to wait 10 hours in ER before talking to doctors. Only passing out would get us some attention! Getting MRI was impossible in system. We had to pay privately for MRI, as part of building up case to get surgery approved.
And we also pay good money to NHS.
I still need an MRI. Haven't had one. It has been over a week and I am still waiting on a back up option to open up next week. Meanwhile, nobody knows what my heart is doing aside from EKGs that a nurse can run that say something aint right yet.
Our system is broken.
My experience of healthcare in capitalist America is exactly the same in that regard. I have a mole I want examined, and one of the dermatology practices I called (part of a major local health system) was taking appointments for March 2025! I usually have to wait 3 or 4 weeks to see my primary care doctor (though I suppose I could settle for a rando doctor with an opening or a nurse practitioner and be seen sooner, but whenever I've done that there have been other issues).
Why not mentionning France? It's pretty awesome in that regard
[0] - https://bmjopen.bmj.com/content/6/12/e012938.short
[1] - https://link.springer.com/article/10.1007/s00586-010-1603-7
I feel much more relaxed these days but I can also tell that everyday this "stress bucket" is slowly getting filled by daily life and I have to dump it all out by doing something other than the ordinary. I'm not a super healthy eater but I'm conscientious about it. I'm not a gym goer or even home exerciser. Once in a while, I'd use my weights and do somebody weight exercises.I don't eat fruits and vegetables as much as one should. I also know that there is great variability in humans.
I'm also much more aware of my body and what it needs as far as physical therapy exercises. I've a lot of time watching videos on physical therapy and back pain. I spend the most of my time at home walking on a treadmill while watching something on the TV.
He talks slowly and you can watch at 1.5x.
Edit: Why is this flagged?
Downvoters/flaggers, please explain yourself. I've found this very thoughtful and worthy of the front page... quite long though, I'll grant you that, but the guy has something honest and genuine to say
They get into a topic about half way through on the future. Lifting Mike thinks that by the early 2030s medical science will have made breakthroughs such that basically every disease will be cured, people will be approaching living forever, and so on. This is paired alongside a general blind faith in all things tech - that the LLMs we have today will be imminently super-geniuses surpassing human intelligence with scales of exponential growth on the orders of magnitude, every other year, and so on.
Medical Mike is far more bearish on the future (and the present), though like a good host he doesn't really try to go to war with his guest, so much as just picking his brain and seeing how he responds to basic counter-points. And lifting Mike's responses are mostly to say "that's a very valid point" and then completely ignore them. In my opinion the singularity types are starting to gradually coalesce into something like a secular religion, because I don't think he really believes what he's saying, but he wants to believe it - because the thought of dying sucks.
And this video (from this topic) is yet another medical doctor speaking about the questionable path we're currently on and how not only are we not making this exponential progress many seem to want to believe we are, but that the motivations involved in a lot of things like medicine today are quite broken. This isn't going to be responded to well with people who have the faith that in a decade or two we're all going to be living forever.
----------
Okay, cripes this post ended up wayyyy longer than expected. But I also want to add that once you know about this sort of divide, it's almost enlightening to read threads like this [2] (currently on the front page: "Scientists discover a cause of lupus, possible way to reverse it") and watch how the views shape people's responses. There's [fortunately] no real signaling or whatever, but just people having extremely different views on what has happened in the past and present, and even more so about what will happen in the future.
But if you start doing some straight-line projections, things simply do not look so rosy. I see a similar situation at play with climate change; we are faced with an existential crisis and many respond that "technology will save us" in a way that feels interchangeable with "god will save us".
In general find I the simulation hypothesis a much more desirable replacement for religion. It lacks the various logical flaws or assumptions or singularity types, has a pretty sound basis in reality, and also keeps the extrinsic 'better-be-good' factors of religion, given that the simulation could be for any reason - entertainment, education, or even something like rehabilitation or training. And I think that extrinsic pressure is generally good after seeing what societies without any sort of guiding light seem to trend towards - pseudo-nihilism paired with hedonism is not a path to a fulfilling existence, or perhaps even a sustainable civilization.
Maybe the post is less about what is right or wrong in medicine and more about the author having gone into the wrong field, which is opposite to what they enjoy in life.
Perhaps all along, the author misunderstood what modern medicine is about and how life really works. There is no miracle cure that would restore the neural system.
There is a miracle prevention however, be active, exercise, eat well, sleep well, enjoy life, contribute to society. That will help your back more than surgery once things go bad.
Or dead in childbirth at 14, or dead from gangrene from a small cut, or dead from diabetes or asthma or simple nearsightedness.
https://towardsdatascience.com/has-global-violence-declined-...
I don't think this semantic difference is something to get worked up over.
To me, it does not mean that. In the very same way that "unforgettable" does not mean "I remember but want to forget".
In economics, exactly that is the definition of unemployment:
> Unemployment, according to the OECD (Organisation for Economic Co-operation and Development), is people above a specified age (usually 15) not being in paid employment or self-employment but currently available for work during the reference period.
".. When you let go of something you are holding too tightly, even though it's hurting you. When you let go of it, then you are able to pick up something else that is hopefully better for you."
Despite all the post-rationalization on the why's of medicine, it does feel like he is someone bouncing back from Burnout.
The risk being that he may fall into the opposite end of the pendulum swing. As the saying goes: "A ship in harbour is safe, but that is not what ships are built for."
In the end there is a balance to everything, I hope he finds his.
I haven't come across a video yet but I'm sure he's better prepared for outdoor living than some others that have done similar. There's a large sub-community of Van Lifers doing similar. With a little planning and preparation, it's a great life. Especially for those that clearly need to get away from it all.
I can't imagine how difficult the decision was. He basically said that his entire 9 year career was emotionally difficult. That is a heavy burden to bear for so long. I'm certain that his upbringing, his years of preparation, the expectations of the world... made the decision to walk away (without a plan) seem overwhelming.
Still... he broke free from all of that!
Honestly... I feel so happy for him. To be able to make the decision and implement it. To be at a point where he can begin talking about it, freely. To be connected to civilization on his terms. To live his life in a way that makes him happy.
But it sounds like he already did that once. The first part of the video talked about how he wanted to specialize in brain-machine interfaces, and then he came to the belief that the approach would never work.
It did feel like he had very high expectations for himself. Almost a bit of a hero complex.
But I don't think that's a bad thing. I think we need people like this to tell us the truth sometimes!
It's not the whole truth, but what he's saying is definitely part of the truth.
---
As a particular example, I have noticed that doctors and dentists don't talk to each other ... It's not overstating it to say "the system" essentially discourages that. But your body doesn't know anything about these divisions, and I agree with the observation that the mouth is one of the two main openings in the body and is central to health !!
i.e. the condition of your teeth are a good indicator of general health, not just dental health
This relates to the part of the video where he says: "if your body heals, it doesn't just heal the spine -- it heals everything"
It is comforting to know that people can see with what I think of as "blank mind" -- see and think from first principles -- rather than falling back on all the technical jargon that we use to justify ourselves and our jobs
One thing that struck me was the mention of what I call the "destructive" paradigm of medicine.
If we look at most current medical procedures, they are barbaric. Chopping stuff mainly.
How do you fix a fissure in the anus? LIS: Chop a bit of the sphincter and hope it heals back.
How do you fix GERD? Make a knot in the esophagus.
How do you fix Crohns? Chop the bowel and open a hole in the stomack .
Dont get me wrong, I applaud all the stuff current medicine helps with. And I'm far from a radical anti medicine . .
But those things make me think that in 500 years, people will turn back and see these sort of procedures the same way we see now how our ancestors treated bacterial infections: intentional bleeding, using leeches and other similar medieval procedures.
We as a society should start puahibg for more constructive or generative medicine. As the Guy in the video says, fixing the problem instead of alleviating the symptom.
A: Rectal Glyceryl trinitrate
How do you fix GERD?
A: For the majority of people weight loss and dietary changes will do the job
How do you fix Crohns?
A: You don’t ’fix’ Crohn’s per se as there is no cure. But most people with Crohn’s can be have their disease managed well with -mab medications
In all those conditions you named surgical management is very much at the end of the list and for a minority of patients who do not respond to the above. The first line management in all of these conditions very much does look at ‘fixing the problem’ contrary to what your espousing.
One has to agree with your view, at least partially. I've heard it said that surgeons are akin to carpenters—some are skilled craftsmen who craft fine furniture, others like builders whose skills are pretty much limited to joining bits of 2x4s but none of whom know the underlying mechanism of how trees grow or how they produce wood.
Nevertheless, with the fusion of modern chemistry, a refined understanding of biological processes, and advanced computing and specialist manufacturing techniques (micro sensors etc.) we're just now beginning to see the end of some of the 'chopping'—or at least how in the future we might end it.
I've been around for quite some decades so I'm unlikely to benefit from any new technique—they being too immature for deployment—but on current evidence those who are around in 50+ years are very likely to do so.
Dude is a neurosurgeon. There are lots of other options for neurosurgeon, and some of them are really rewarding. You don’t like spine surgery because of all the aforementioned reasons? Why not try neuro-vascular surgery, where you cure stroke? Or neurosurgical oncology, where you cure cancer? Or neurosurgical trauma, where you are literally putting people’s head back together.
Dude has a huge dysphoria problem with his job, probably burn-out or something, I don’t know, but throwing away years of educations is kinda wasteful.
"20 year career in neurology, but there's this one weird trick that will fix everything"
So is it myopic for a dentist to focus on fixing cavities? Is the dentist missing something big? The dental industry also experiences a problem that if everyone started brushing well then the industry would largely crash. Does that stop dentists from telling people to brush? No.
Edit: If dentistry as an industry cares, so, so much about dental care then why are they not lobbying for less sugar in our food? Is providing care and regular advice the most effective way to fix the problem?
Ellie Phillips is a big fan of xylitol though. The science on that is a lot less clear, e.g. how much xylitol is necessary in gum (she of course advocates huge amounts), and then she also sells mints which have little effect on plaque. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791908/) I sort of ignore that, just because she has to make money doesn't mean the rest of her advice is not evidence-based.
We give adults way too much sugar as well. Every goddamn drink has shittons of sugar. Even a goddamn bread loaf has added sugar these days. A cup of many brands of flavored yogurt have half the sugar as a coke, and they try to pass yogurt off as the "healthy" alternative to ice cream. It's the same if it has the same amount of sugar. The coffee shop near my place sells 5 types of flavored lattes. They all have added sugar. The Japanese, Chinese, and western bakeries near me have added sugar in every pastry and every drink. It's fucking insane.
There is absolutely no need for this. It desensitizes everyone to sugar AND makes them addicted so that you can sell them more junk with even more sugar.
But sugar is not the only problem. Why do ancient skeletons all (mostly) have great, straight teeth and strong jaws? That is not sugar. I suspect it is soft foods.