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!
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Posted By: Mark Sisson
This is always a touchy subject. Although I’m not primal (yet), I have been eating healthily for the past decade or so. Most people don’t understand that, and I’m fine with that. I’m not evangelistic at all. If people ask, I offer my opinion, but short of that, I don’t comment on other peoples’ diets and I expect them to not comment on mine.
All I care about is that my fiance likes to eat as healthily as I do, so we have a great time cooking and eating together. That’s the most important part for me, especially moving forward in this journey called life.
I bit of an older story about good health advice being ignored. The book of Leviticus in the Bible was written around 1490 B.C. In Leviticus 15:13 it say to wash in RUNNING WATER! It wasn’t until the late 1800′s that Physicians actually followed that practice. Look at all the lives they cost prior to that. It only took them 3000 YEARS!! to head the advice of someone that connected dirty hands and spreading disease. Lets hope it doesn’t take that long for that advice of primal eating to sink in!!
I run across the same thing you people do here. I have a degree in Exercise science with a minor in nutrition and I am working on a nursing degree. They still act like I don’t know what I’m talking about. They shrug it off like I’m crazy?? I could help change there lives if they would just listen!! They don’t have 3000 years!
Actually the bible says nothing about using a chlorine solution to kill the bacteria. So your little story about a knowledge in the bible is a fraud.
wow, that was unnecessarily snarky. Running water would have helped…but my guess is you were just upset by a biblical reference.
Most water in the time period was simply unsafe to drink. Beer and wine were common because they were safe to drink. Yeah it was snarky but saying you have a degree in science then quoting Leviticus saying it could have saved lives. It just seemed retarded to me.
what’s strange is that some of the people in my life that i thought would be the most receptive seem almost…resentful. and others are so open-minded and interested, people i thought would be totally stuck in their ways. i have an idea that it might be related to people’s ability to step outside a box. some people need more security than others; new thinking truly upsets them. then combine that with how closely tied food is to their culture and family. to some bread is….comfort, tradition, family, good healthy food. to others, bread is something to make a sandwich with. so maybe it depends on how deep the tie is, emotionally. or maybe people who lack the willpower find it easier to ignore what’s in front of them. it’s amazing what people can justify and believe. i like the karma comment, i think i’ll adopt that. and though i’d like to see those closest to me live longer and better (and maybe lose some weight)…I Can’t Change It. i can’t. so hey, that’s more ribs and farm eggs for me.
Love this story Mark.
I am currently just trying to lead by example. My husband is interested and happy to try the PB lifestyle but the rest of my family just thinks that it is another one of those fad diets.
I’ve had the same issue with my own family. These days i keep my mouth shut because i know that one day the results will speak for themselves. Seeing is believing and i see signs that they are very slowly coming around. it does take patience though.
Hey Mark, great article!
I have fallen so hard for this site (and similar sites like WAPF, etc.) that I have decided to change my field of study from Law to Medicine. I’ve decided to become a Naturopathic Doctor (N.D.) so that I can heal people with food. I bet you can guess what kind of diet I will be prescribing for most people, eh?
Grok on!
Right on, Steve! I am really excited for you. Going into primal medicine is one way to make a big, big difference for a lot of people.
My school days are behind me, but reading comments like yours makes me more optimistic for the future! I hope you will share with us at MDA any unique knowledge you may discover.
Timothy,
Thank you for the kind words sir. I plan on doing as much research into low-carb dieting and it’s effects on health as possible. I will even try to conduct “experiments” in a clinical setting. Imagine that, in a few years, Mark could be quoting an actual, full-fledged PRIMAL health study (with me as the author)! That would be brilliant. However, I’ve got a ways to go yet, as I need to finish up this BA before I can apply to med school…. Better get started!
Steve
We need more people like you, Steve. Stay in touch!
I have lost over 140 pounds and kept it off for 5 years now. I was on massive amounts of Insulin to control blood sugars along with many other drugs to control symptoms of a killer disease called Diabetes. I now use no meds no Insulin…
When people ask me what I eat, I tell them I eat a high fat diet. They look at me like I have three heads and 6 eyeballs. I even had a pharmacist tell me I was a liar, that I could never get off Insulin when using massive doses like i was using. But he has not received any money from me for his drugs in a long time. I also have said bye bye to my Diabetes doctor, because I don’t need him anymore.
I know that if I ever went back to eating a low fat/high carb diet, I would be seeing them both in a few short weeks…I think that they have to be mad at me for effecting their income levels. I do spread the message to others and have helped several people get off their Diabetic meds too…I may have a contract put out on my life if I keep this up! Type II Diabetics don’t have to be a slave to meds and Insulin. Spread the word, before it’s too late, but wear a bulletproof vest. LOL
I know somebody above said “No one goes to the doctor to just say hello…” but maybe you should do just that! If only you could drop by and say hello and show him how well you’re doing and that you don’t need him any more.
Hmmm I don’t get it. If my brother/sister/friend/anyone would bombard me more than once with negative comments, I just say a firm and calm STFU. It helps that I don’t talk like that usually. Had to do it sometimes. The common reaction is silence. And yes I still have a large circle of friends and family. This seems to be more a problem of defining borders that of the actual lifestyle.
Set your boundaries. People love to voice their opinions on everything (me included) so if it weren’t that particular lifestyle, it’ll be something else.
Yes I agree.
I believe that we don’t need to get in a discution with other family members or friends. We are mature and as a human being we have the choice to choose.
Why do people like or don’t like Dalai Lama? Because he is cleaver or because he is “peace”. Does he confront or argue with people about his believes?
Why do people believe and listened in theorys and not in hypothesis?
Are you committed with the term “Phenomenologic”? Well the term put emphasis on here and now. It is important to understand each individual’s experiences here and now than to understand how they perceive things in the past. It could be our mother, friend, brothers and sisters who believes what they have learn the right way and it is difficult for them to change their believes in other perspectives.
For example you have culture problems. For example take the latinamericans or russians. They eat everything because of economical issues “money”. So pasta, bread and cornflakes in the morning are good food for them. It makes the stomage happy. It will be sutpid to not do that. If you change that now taking away all that kind of food that they have being eating for years of course you will get answers like”my uncle eats everything and he was healthy” or “Nonsens you can eat everything because then you exercise and everything is gone”.
Food is food and you eat with your pocket, right? But at the end what is really more expencive the sickness, the pharmacology or the food you choose for a better health?
As Mark (2010)says in this blog “Let your success and vitality speak for themselves, but by all means share your secret”.
Sorry for my english.
Juan
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.
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.
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.
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.
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!
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.
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!!!!!!
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.
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.
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.
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?
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.”
Interesting! The community college I attend decided to serve nothing but vegetarian food in the cafeteria today. I heard it was a fiasco.
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!
..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”
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.
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.
this is a very good blog