Salvato in:
| Autori principali: | , , |
|---|---|
| Natura: | Recurso digital |
| Lingua: | inglese |
| Pubblicazione: |
Zenodo
2026
|
| Soggetti: | |
| Accesso online: | https://doi.org/10.5281/zenodo.19360140 |
| Tags: |
Aggiungi Tag
Nessun Tag, puoi essere il primo ad aggiungerne!!
|
Sommario:
- <p><strong>Episode summary:</strong> In this episode of My Weird Prompts, Herman and Corn dive into the "humility of the present" to address a listener's concern about the fallibility of modern medicine. From the Nobel Prize-winning history of lobotomies to the modern-day prevalence of gallbladder removals, the brothers discuss how evidence-based practice can sometimes lead us astray. They explore tools like the "Number Needed to Treat" and the "Lindy Effect" to help navigate medical decisions today. Looking ahead to the year 2100, they speculate on which current "gold standards"—like chemotherapy and orthopedic surgery—might one day be viewed as barbaric relics of the past. It's a fascinating look at the "half-life of facts" and why the most advanced treatments of today are often just the first steps toward a better future.</p> <h3>Show Notes</h3> <p>In the latest episode of *My Weird Prompts*, hosts Herman and Corn Poppleberry tackle a question that sits uncomfortably at the back of many patients' minds: How do we trust modern medicine when history is littered with "scientific" certainties that turned out to be disastrous? Inspired by a prompt from their housemate Daniel, the discussion navigates the precarious balance between respecting current evidence and acknowledging the "humility of the present."</p> <p>### The Ghost of Medical Consensus The conversation begins with a look back at the 1940s, an era when the prefrontal lobotomy was not a fringe experiment but a Nobel Prize-winning breakthrough. Herman explains that the procedure's creator, Antonio Egas Moniz, was celebrated because the "weight of evidence" at the time suggested it was a viable solution for overcrowded psychiatric wards. However, the tragedy of the lobotomy highlights a massive flaw in historical methodology: a lack of long-term, rigorous follow-up and the absence of double-blind, randomized controlled trials.</p> <p>Herman points out that medicine often relied on "clinical observation"—a doctor tries something, it seems to work for a few patients, and it becomes the standard of care. This lack of statistical rigor also allowed tobacco companies to use doctors in advertisements for decades. While there was an intuition that smoking was harmful, a significant "lag" existed between that intuition and the hard data required to change public policy.</p> <p>### The Case of the "Disposable" Organ The brothers then pivot to a more contemporary concern: the cholecystectomy, or gallbladder removal. Daniel, the listener who prompted the episode, shared his own negative experience with the surgery, questioning if the medical community is currently too flippant about removing organs.</p> <p>Herman confirms that this is a very real debate in modern surgical practice. With roughly 700,000 gallbladders removed annually in the U.S., it is often treated as a "disposable" organ. Yet, Herman cites research showing that 10% to 40% of patients suffer from "post-cholecystectomy syndrome," experiencing symptoms like chronic pain and digestive issues after the surgery. The discussion highlights a systemic tendency to favor mechanical fixes—removing the part with the stone—while overlooking the complex role the gallbladder plays in the gut microbiome and bile acid signaling.</p> <p>### Tools for the Informed Patient For those feeling overwhelmed by conflicting medical advice, Herman offers practical statistical tools to move from being a passive recipient of care to an active participant. He introduces the "Number Needed to Treat" (NNT) and the "Number Needed to Harm" (NNH).</p> <p>The NNT tells a patient how many people must receive a treatment for one person to see the intended benefit. If a doctor recommends surgery, asking for the NNT can reveal whether the procedure is a "definitive fix" or a statistical long shot. Similarly, the NNH helps quantify the risk profile. Herman argues that these metrics move the conversation away from anecdotes and toward a more honest assessment of reality.</p> <p>He also introduces the "Lindy Effect," the idea that the longer an idea or practice has survived, the longer it is likely to persist. In medicine, a treatment that has been the standard of care for fifty years is often a safer bet than a "flashy" new treatment that was introduced only three years ago.</p> <p>### The Half-Life of Facts A central theme of the episode is the "half-life of facts," a concept coined by Samuel Arbesman. In many fields, particularly medicine, about half of what is considered "true" today will be proven wrong or significantly modified within 45 years. While this can be terrifying for someone facing surgery today, Herman views it as a sign that science is working—it is a process of constant pruning and revision.</p> <p>### Looking Toward 2100: The Future's "Bloodletting" The episode concludes with a provocative look into the future. Herman and Corn speculate on which of today's standard practices will look "barbaric" to doctors in the year 2100.</p> <p>1. **Systemic Chemotherapy:** Herman describes current chemo as a "blunt, violent instrument" that poisons the entire body to kill cancer cells. He predicts that future generations will look back on the collateral damage of chemotherapy—loss of hair and immune destruction—as a dark age, eventually replaced by hyper-targeted nanotherapies. 2. **Orthopedic Surgery:** The hosts discuss the "Fidelity trial," which showed that for certain knee issues, "placebo surgeries" (where only incisions are made) were just as effective as the real procedure. They suggest that many current surgeries will eventually be replaced by biological signaling and regenerative medicine. 3. **Broad-Spectrum Antibiotics:** Corn highlights the "nuking" of our internal ecosystems. Future medicine will likely view our current flippant use of antibiotics as a reckless destruction of a "secondary organ"—the microbiome—which we are only beginning to understand.</p> <p>Ultimately, the episode serves as a reminder that while we must act on the best evidence we have today, we should do so with an awareness that we are merely on a "winding staircase" of knowledge. Progress requires the courage to treat, but also the humility to admit that our current "gold standards" are often just the best guesses of the present moment.</p> <p>Listen online: <a href="https://myweirdprompts.com/episode/evolution-of-medical-truth">https://myweirdprompts.com/episode/evolution-of-medical-truth</a></p>