Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
8 Mar

Dear Mark: The Semmelweis Reflex

Sometimes the path of Primal transformation includes a series of upendings. It’s in part a process of uprooting daily habits that don’t serve your well-being. Maybe it’s a re-envisioning of your identity from an unhealthy, tired, or otherwise plagued person to that of a strong, fit, confident individual. More than likely, it’s about overturning oft-taught if not long held conventional thinking about healthy living. When we embark on our Primal path, we likely anticipate at least some of these changes, but what about the conflict prompted by other people’s grappling with the Primal Blueprint as we reflect it? What is it about our Primal process that upsets other people’s apple carts and provokes sometimes exaggerated resistance? See what reader Evan has to say.

Dear Mark,

I’ve been following the PB for a year and a half now and am proud to consider myself a diehard. I’m stronger, fitter, leaner, and for the first time in years feel energized throughout the day. My problem is this: I have a brother who’s an MD and seems to take my bucking of conventional wisdom personally. Whether it’s dogging my diet or my workout, he’s never got a shortage of offhand comments every time we get together with the family. I stopped arguing with him a few months ago because it just seemed useless and I frankly don’t want to make tensions worse for my family. Care to show up at one of these dinners to take on my brother’s resentments? Barring that, do you have any advice for getting him off my back? Thanks and Grok on!

In early 19th century Vienna, one of the world’s largest and most well-known clinics in the world was among the worst institutions plagued by a widespread and puzzling “childbed fever” epidemic. The aggressive disease at one point killed 1 in 6 delivering mothers in his clinic. Pregnant women came in perfectly healthy but following childbirth were dead within a few days or less. For decades, the pandemic panicked women and eluded hospital staff, who responded to the continuing scourge by increasing ventilation and treating patients with practices like blood letting, leeching and mercury tonics (the discovery of germs not having been made yet).

Finally, an obstetrician and assistant administrator of the hospital, Ignac Semmelweis, made a startling connection. The proverbial light bulb went off when a colleague at the clinic died with the same fever symptoms after cutting himself while performing an autopsy. Semmelweis theorized that the professor’s cut was invaded by harmful “particles” from the corpse and eventually died from their effects. He then made the connection that medical students participated in autopsies the same days they helped deliver babies in the clinic. From there, he examined the rates of the adjoining midwife clinic, where the staff didn’t conduct postmortem examinations. The mortality rate in the midwife clinic was only a third of the mortality rate in the medical student wing. Upon investigating his theory with the implementation of new sanitation requirements, the mortality rate in the medical student clinic fell to that of the other clinic in only a month’s time. Clearly, hand washing and sanitization with a chlorine solution was the key to preventing the spread of disease. The discovery instilled a sense of relief but also the shocking revelation that doctors themselves had unwittingly caused so many patients’ deaths.

However, what happened afterward was the most surprising. A head administrator, Johann Klein, took Semmelweis’s discovery personally and renounced his findings. Klein believed Semmelweis’s argument was an attack on him, since he had instituted medical students’ participation in autopsies and had changed vaginal examination guidelines for obstetric patients. Semmelweis, a man whose efforts and scientific scrutiny had in essence discovered germ theory in its rudimentary parts and saved thousands of women’s lives, was discredited and pushed out of the clinic. His career continued for a time in Pest, Hungary, but never fully rebounded.

Semmelweis, for his part, had done relatively little to publicize his discovery. Although he and his students sent letters to well known obstetricians throughout much of Europe, he didn’t publish his findings until years later and only then attached to scathing personal criticisms of particular physicians and administrators. Victim to developing psychosis in his later years, Semmelweis was eventually institutionalized through his wife’s efforts and died from physical trauma after being beaten to death in the asylum.

It’s a dramatic story, to be sure, but an instructive one I think. This man had statistical evidence, scientifically sound support on his side, but the politics of the situation stalled progress. The threat of questioning authority and compromising professional reputations was finally too much to swallow. Semmelweis’s findings not only diminished the stature of the hospital administration, it brought down to earth the position – and astuteness – of physicians themselves. History has frequently revealed a sacrificial pattern when one person’s discovery takes on accepted wisdom. In short, it’s a game of kill the messenger.

In this reader’s case, I imagine it’s a similar phenomenon. Clearly, his brother has invested countless hours, thousands of dollars and invaluable credibility in his conventional medical education. He’s personally invested in the standard mindset of the medical establishment. Whether it’s a conscious realization or not, his professional integrity and authority are being questioned by his brother’s example – by his success, by his willingness to discern and embrace a health philosophy that diverges from conventional teaching.

My advice to Evan and all of us who meet with this kind of resistance is this: have patience and don’t take the bait. We don’t have to take the tension as personally as the other person does. Understand that our success upends their thinking, their lifelong efforts and maybe their sense of professional or personal expertise.

That said, let’s not make the same mistake as Semmelweis did in being overly modest in publicizing our genuine health discovery. There’s a difference in arguing to protect one’s own turf or pride and illuminating and sharing practices that can mean better health and well-being for people we know and love. Let your success and vitality speak for themselves, but by all means share your secret.

How do all of you share the love, so to speak? Tell your stories and offer your advice for Evan and others in the same boat. As always, thanks for the great questions and comments and keep ‘em coming!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I don´t argue with people. My family is full with MD`s and they all are experts. If someone asks I give some answers but only hesitantly. I can´t stand people advising me how to eat. They are also blind for any kind of health improvements I made. Actually they expect some collapse in my health in order to emphasize how right they were. Well, I´m a small/thin woman and it looks too bizarre for most people if I eat my good sized steaks and dipping it in butter.

    Tamara wrote on March 9th, 2010
  2. Evan: My advice would be read, read, read. The more research and and learn about topics that buck conventional wisdom, the better off you’ll be. You have to be better prepared for conversations because others have CW to ‘back them up’. Most of us here @ MDS know that fats, saturated fats, and cholesterol DO NOT cause heart disease. It’s the processed, refined foods that spike glucose, insulin and damge our intricate systems that lead to heart disease, obesity, diabetes and the like. Grains? They’re are getting recommended everyday as proper nutrition. Gimme a break! And we wonder why obese, diabetic patients are not getting better OR getting worse? Just do a word search of grains on MDA.

    Sterling wrote on March 9th, 2010
  3. Keep in mind, after a few months of good constant blood sugar its hard to remember what the blood sugar roller coaster is like. As I reflect its really sad how much my mood/attitude would swing depending on my card intake. I would find my self arguing just to argue. Maybe that explains the resistance you are seeing.

    “First they ignore you, then they laugh at you, then they fight you, then you win.”

    Mahatma Gandhi

    The good news is you have almost completed your victory. The better you look and feel the harder it will be for anyone to disagree with you.

    With that said I still have a mean streak and would probably call the md a carb’a’whore and ask him to explain triglycerides’s. Ask him if they are good for you then challenge him to blood test. That way by his own standard you are healthier than the almighty.

    Matt wrote on March 9th, 2010
  4. All these people are smart and right to be skeptical about Primal eating, why shouldn’t they be… it does go against all CW and does sound like a fad diet. (I’m sure Vegans feel the same way when they are trying to convince you…that you are defensive and just won’t step outside the box.)

    St. Francis said “preach the gospel always and everywhere…use words if you have to.” (paraphrase) Same thing here: results will speak for themselves, then communicating the “why” for those results can come later.

    Marie wrote on March 9th, 2010
  5. I’ve been steady on this Primal lifestyle for a little over a month now and have seen DRAMATIC results. My family and coworkers and friends and such have all noticed and complimented me on the weight loss and muscle gain. However, when they hear that I’m not eating bread, rice, processed sugars and the like, they tell me I’m crazy, and that they don’t know why I’d put myself through all of that. I guess they’ll never know till they experience it for themselves.

    I think that this type of reaction is more a self-preservation technique for the lifestyle they choose to live, rather than interest in my own well-being. All we can do is continue to live strong and healthy lives and lead by example. Maybe the rest will catch on one of these days!

    JoshTheMonkey wrote on March 9th, 2010
  6. About a year ago my DH had lost 40 lbs on a similar diet to PB. His cardiologist was surprised to see the weight loss but said, “I don’t want to know how you did it. Don’t tell me.”

    This same guy refused to order a fasting insulin test because he didn’t “do” diabetes(!) What an idiot! A rich idiot of course, fully committed to not discovering anything that would threaten his income.

    My 2c worth: let the MD brother rant. He’ll get tired of it eventually. And you’ll have the best revenge: good health.

    ColoGrassFed wrote on March 9th, 2010
  7. My 2c worth: All you can do is say “hey, this worked for me and I have seen awesome results.” if they choose to listen great, if not, you did your part. I am only 2 weeks into going Primal and I love it!!!!!!

    Andy wrote on March 9th, 2010
  8. I actually went Primal without telling my wife and that was a big mistake. I apparently didnt take her point of view into consideration before drastically changing our lifestyles. Fast forward a few months and we are both living mostly primally. I eat completely primally but do a mix of Crossfit/crossfit football and max effort black box. Needless to say the results have been fantastic.

    My point of view as far as dealing with skeptics is focus on the immune response. Forget the fat loss and muscle building qualities which we all love, the fact is there are plenty of unhealthy ways to get ripped. There is however no way to consistently avoid getting sick unless all systems are running efficiently. Ive been living in NYC now for 5 years and living primally for the past year or so. It is sure a big coincidence that I got sick at least twice a year for the first 4 years and havent had anything more than a little sniffle for the past year. That in conjunction with consistent energy levels, effortless and consistent sleep, and being more powerful are usually enough to convince everyone thats not a member of the “Flat earth society” that living primally works.

    alan wrote on March 9th, 2010
  9. I’d also like to say that I completely agree AppalacianMatt’s above comment about how living primally is preventive medicine where as living conventionally simply treats what is already screwed up.

    alan wrote on March 9th, 2010
  10. As a medical doctor, I think the only thing I should worry about is using the scientific method to learn as much as I can to try to give the best to my patient – when he asks me.

    I don’t give opinions to anybody who don’t ask them to me, and I let people decide what they do – including helping me decide which drugs and treatments they will do.

    Usually my patients are interested in the fact that I prescript drugs, yes, but also exercising, social events, friendship, good nutrition, all that.

    Griping to the things I learned in the university isn’t going to do anybody any good – some of them aren’t even taught there, anymore.

    Emmanuel wrote on March 9th, 2010
  11. I run into “well,PB doesn’t REVERSE heart disease” Like Ornish/Fuhrman-
    and honestly, I don’t know how to rebut that…To my knowledge,there haven’t been studies showing Paleo/PB can reverse CV disease… have there?

    pat557 wrote on March 9th, 2010
    • According to Dr. Atkins, who was a cardiologist, his clinic has (as of his 1999 book) demonstrated REVERSAL of heart disease SYMPTOMS “in over 85% of overweight coronary patients who have diligently followed our program consisting of the lipolytic diet, nutritional supplements, and chelation therapy.” He went on to say, “…my heart patients (on a high-fat, low carbohydrate diet) almost always show a dramatic improvement, as manifested by their ability to exercise longer and more vigorously without symptoms and to discontinue medications that were previously necessary.”

      Marylou wrote on March 10th, 2010
  12. Interesting! The community college I attend decided to serve nothing but vegetarian food in the cafeteria today. I heard it was a fiasco.

    p14175 wrote on March 9th, 2010
  13. I’ve been on the primal diet/plan for a whole 3 days now, and am having a good time with it. I happened to run into my personal trainer at the Fedex store this morning, and told him what I was up to. I could see the skepticism in his eyes, and the first thing out of his mouth when I told him the diet was basically meat and veg was “well, make sure you’re eating really lean meat so you don’t raise your cholesterol!”. I smiled and said “well, actually you’re supposed to eat fatty meat, and no carbs”. He kind of shook his head disparagingly and said “oh, don’t talk to me about that. REAL science says otherwise”…to which I said, “well, “real” science contradicts itself all the time. My naturopathic doctor, who is in effect, a scientist, is a HUGE proponent of the paleo/primal diet”. An uncomfortable silence ensued. I said “well, let me send you some links and let me know what you think”. I’ll be curious to see if he responds!

    Jeremy wrote on March 10th, 2010
  14. ..or the gent could, if his Bro is really being an arse/bully about this trot out the fat tailed power-law (unknown) quip from Richard Burton..purchaser of large diamonds, actor and famed Welsh boozer ” Dr’s are like actors, one gets a few good ones and the rest are rubbish”

    Justin De Quim wrote on March 11th, 2010
  15. Just a small addendum to the story of Ignac Semmelweis: despite being in fact an ehtnic Hungarian, his theory on disinfection to avoid “childbed fever” was rejected by Hungarians in Pest (which later joined with Buda to become Budapest) either. His death was quite ugly too (revealed by autopsy to be blood poisoning, via a gangrenous wound, inflicted during the beatings he got when he was “admitted” to the asylum). Despite of his revolutionary findings, hardly any Austrian or Hungarian newspapers gave news of his death and the official obituary of the Hungarian Association of Physicians and Natural Scientists did not even mention his death (despite having rules ordering to deliver a commemorative address in honor of all of their members that have deceased the year before).
    Ironically the most prestigious medical school of Hungary is named after him: the Semmelweis University (of Medicine) in Budapest.

    CoolKoon wrote on March 14th, 2010
  16. Psychologists have a term to explain this kind of resistance to change. It is called “Cognitive Dissonance.” It is a defense mechanism that causes us to defend ideas we are heavily invested in in spite of evidence to the contrary. Most of us a guilty of it in some aspect of or lives.

    P.W. Lester wrote on March 13th, 2011
  17. this is a very good blog

    Burberry Outlet wrote on July 20th, 2011

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