Blind Spots

there’s no denying that the medical field has made incredible advancements. however, many widespread health practices remain rooted in outdated or unproven theories. for years, medical professionals have issued recommendations that later turned out to be based on shaky evidence, creating a disconnect between what we believe to be true and what science actually supports. from nutritional guidelines to everyday medical treatments, the risk of relying on outdated information has serious consequences for public health. how did so many well-meaning ideas go so far off course?

in this chapter, you’ll uncover key areas where modern medicine may still be falling short. you’ll explore the rise of peanut allergies and the role that misguided advice played in their increase, as well as the potential dangers of overprescribing antibiotics. you’ll also learn about the persistence of myths surrounding cholesterol and heart disease, and how outdated childbirth practices might still affect mother and baby health today. lastly, you’ll see how a media-driven panic over breast implants overshadowed the growing opioid crisis.

let’s begin with the alarming rise of peanut allergies.

in the late 1990s, peanut allergies were rare, with only about 0.6 percent of us children affected. but by 2004, something had changed. schools were banning peanuts, and emergency room visits for life-threatening peanut reactions were on the rise. a question lingered: why were peanut allergies exploding in the us but still virtually nonexistent in other parts of the world, like africa and the middle east?

in 2000, the american academy of pediatrics – aap for short – recommended that young children avoid peanuts until age three, believing this would reduce the risk of allergies. however, this well-intentioned advice was based on weak evidence and went against known immunological principles. experts like dr. rebecca buckley understood that early exposure to allergens, including peanuts, could actually prevent allergies by helping the immune system develop tolerance. yet the aap’s guidance dominated, and pediatricians across the country adopted the mantra: no peanuts for babies.

meanwhile, in rural tennessee, pediatrician dr. stephen combs, following dr. buckley’s teachings, was advising the opposite – introducing peanuts to infants early. his patients were thriving, with no peanut allergies reported, while peanut allergies soared among children elsewhere. immunologists like dr. gideon lack further challenged the peanut avoidance guideline, observing that israeli children who consumed peanut-based snacks had dramatically lower rates of allergies than their british counterparts. his 2015 clinical trial confirmed it: early exposure to peanuts reduced the risk of developing allergies by a staggering 86 percent.

despite this breakthrough, the damage from the aap’s initial recommendation had already been done. peanut allergies skyrocketed, affecting an entire generation of children and burdening families with fear and anxiety. for many children who developed a severe peanut allergy, daily life became a battle against accidental exposure and the threat of anaphylaxis. even after the aap reversed its guidance, many parents continued to avoid peanuts, unaware that the recommendation had changed.

if you’re a parent, it’s essential to stay informed and critically assess health recommendations. early introduction of common allergens like peanuts may help protect your child from developing life-threatening allergies. the lesson here is clear: always question medical advice, especially when it lacks solid evidence, and trust the science that evolves with better understanding.

when chris, a teenager with chronic abdominal pain, visited the hospital, no doctor could pinpoint the cause of his misery. his medical history, however, revealed the likely culprit: his microbiome had been severely disrupted. over time, chris had been given multiple courses of antibiotics, which wiped out the beneficial bacteria in his gut, leaving him vulnerable to inflammation and bacterial imbalances. this story exemplifies a widespread issue with antibiotics. often seen as harmless, antibiotics can wreak havoc on the body’s microbiome, which is critical for digestion, immune health, and even mental well-being.

the overprescription of antibiotics is a significant problem. studies estimate that about half of the antibiotics prescribed in the us are unnecessary, often given for viral infections that they don’t treat. this careless use not only contributes to antibiotic resistance but also causes immediate harm by killing the beneficial bacteria that keep the body in balance. doctors have long reassured patients that there are no downsides to antibiotics, but that’s far from the truth. in fact, research shows that 20 percent of hospitalized patients treated with antibiotics experience adverse effects, from kidney damage to more severe conditions.

more alarmingly, antibiotics can have long-term consequences, especially in children. research conducted at the mayo clinic followed over 14,000 children and found that those who took antibiotics before the age of two had significantly higher risks of developing chronic conditions such as obesity, asthma, and learning disabilities. the more antibiotics a child took, the greater their risk of developing these issues, indicating a strong link between early antibiotic exposure and long-term health problems.

antibiotic use is essential in certain cases, but you should be aware of the risks and avoid unnecessary prescriptions. overusing antibiotics not only damages your microbiome but contributes to the growing problem of antibiotic resistance. always weigh the benefits against potential harm, and don’t be afraid to question whether antibiotics are truly necessary for you or your family.

uncle sam, a 93-year-old man, lived much of his life avoiding his favorite food: eggs. when he moved to the us in the 1970s, doctors warned him that eggs were filled with cholesterol that would clog his arteries and shorten his life. for decades, he reluctantly followed this advice, believing it would help him live longer. his story reflects a widespread myth that has shaped public health for decades: the belief that dietary cholesterol leads to heart disease. however, modern research shows that this connection was never supported by solid evidence.

for years, the medical establishment promoted the idea that avoiding dietary cholesterol and saturated fat would prevent heart disease, based largely on the work of dr. ancel keys. his influential, but flawed, “seven countries study” suggested that fat consumption was directly linked to heart disease. this theory dominated public health messaging, government guidelines, and even the food industry, leading to low-fat diets and cholesterol restrictions.

yet multiple large studies have since debunked this myth. research, such as the 2020 study involving 177,000 people, showed that eating eggs and other foods high in cholesterol does not significantly impact blood cholesterol levels or increase the risk of cardiovascular disease. in fact, cholesterol is essential for the body, playing a critical role in building cell membranes and producing important hormones.

despite this evidence, the low-fat, low-cholesterol message has persisted in popular culture and healthcare, influencing millions of people like uncle sam. today, we understand that inflammation, not dietary fat, plays a more significant role in heart disease. refined carbohydrates and sugars, not saturated fat, are major drivers of inflammation in the arteries.

if you’ve been advised to avoid cholesterol or fat, it’s worth reconsidering that advice. focus on whole foods, portion control, and minimizing refined carbohydrates for better heart health. uncle sam, now back to enjoying his eggs, is living proof that challenging outdated medical dogma can lead to a happier, healthier life.

in the mid-twentieth century, the medical field developed a highly clinical, intervention-heavy approach to childbirth, often removing newborns from their mothers immediately after birth. this approach reflected the broader belief in medical authority and technology over natural processes. for years, doctors prioritized rapid cord clamping, separating newborns from their mothers, and routine interventions, believing they were essential for the baby’s health. but modern research shows these practices can do more harm than good.

take the example of delayed cord clamping, which involves allowing the umbilical cord to continue delivering oxygenated blood, stem cells, and essential nutrients to the baby for a minute or two after birth. this practice, long overlooked, has been shown to reduce the need for blood transfusions in premature babies, improve oxygenation, and even support better neurological outcomes later in life. delayed cord clamping is now more common in us hospitals, but for decades, the immediate rush to clamp the cord was standard.

another key shift has been in promoting skin-to-skin contact between mothers and newborns right after birth. for decades, hospitals routinely separated mothers and babies, keeping newborns in sterile nurseries. however, studies and clinical practice have shown that keeping babies with their mothers – particularly through skin-to-skin contact – helps regulate the baby’s heart rate, body temperature, and stress hormones, and significantly improves breastfeeding rates. this natural bonding time also reduces the incidence of postpartum depression in mothers.

dr. arpitha chiruvolu, a neonatologist at baylor university medical center, has been at the forefront of pushing these changes in neonatal care. her advocacy for delayed cord clamping and skin-to-skin contact has significantly improved outcomes for newborns and their mothers. her studies have shown that these simple, natural practices lead to shorter nicu stays, fewer medical interventions, and healthier babies overall.

the over-medicalization of childbirth often overshadowed common-sense practices that align with the body’s natural rhythms. by returning to these approaches, the medical field is finding a balance between necessary interventions and allowing the natural bonding process to unfold. this shift offers a gentler, healthier way to welcome new life into the world.

in 1990, connie chung’s television report on breast implants sparked a national health panic. her segment featured women who claimed their silicone implants had caused debilitating symptoms such as pain, fatigue, and autoimmune disorders. although scientific evidence was scarce, the story captured public attention and generated widespread fear, which escalated into what some saw as a manufactured health crisis. silicone breast implants became the subject of mass litigation, and their use was banned by the fda in 1992. women rushed to have their implants removed, often at great emotional and financial cost.

fda commissioner dr. david kessler’s decision to ban silicone implants, despite limited evidence, reflected a broader cultural fear of cosmetic surgery. this regulatory move was fueled by anecdotal reports rather than robust scientific data, raising questions about how health risks are communicated and regulated. for years, debates raged between doctors, patients, and the legal system about whether silicone implants truly caused autoimmune diseases or cancer.

amid this debate, studies began to emerge disproving the link between silicone implants and autoimmune disorders. by the late 1990s, independent research by the mayo clinic and the institute of medicine found no evidence that silicone caused the array of diseases being attributed to it. these findings led to the eventual lifting of the fda ban in 2006, but by then, the damage had been done. companies like dow corning were bankrupted by the flood of lawsuits, and the cultural perception of breast implants had been irreversibly altered.

interestingly, while the fda heavily scrutinized breast implants, it failed to apply the same rigor to opioids. during the same period, oxycontin was approved with minimal oversight, leading to an opioid epidemic that has since claimed over a million lives. this stark contrast illustrates the dangers of misplaced regulatory focus, where an unsubstantiated health scare overshadows a genuine public-health crisis.

today, silicone implants are considered safe, but the legacy of the controversy reminds us of the power of media-driven narratives and the importance of evidence-based medicine.

a few decades ago, doctors wrongly believed that melanoma – a deadly form of skin cancer – did not affect black people. tragically, this misconception contributed to the early death of bob marley at 36, when his melanoma went undiagnosed. this case highlights a dangerous truth about modern medicine: even widely accepted ideas can be wrong. it also raises the question: what else are we getting wrong today?

fluoride in drinking water is one area worth reconsidering. for years, fluoride has been praised for reducing cavities, but new research suggests potential downsides. a 2019 study found that higher maternal exposure to fluoride was linked to lower iqs in children. additionally, the original research supporting fluoride’s effectiveness is outdated, mostly conducted before 1975. countries that do not fluoridate their water, like many in europe, have seen similar declines in cavity rates, suggesting fluoride’s benefits might not be as strong as once thought. with fluoride potentially affecting the microbiome and even brain function, we need to question whether it remains a public health win or poses more harm than good.

another area to challenge is the widespread belief that marijuana is harmless. today’s marijuana contains much higher levels of thc, the psychoactive component, than the marijuana of previous decades. studies indicate significant risks for adolescents, including an increased likelihood of developing schizophrenia and a higher risk of depression and suicidal thoughts. marijuana use also raises the risk of heart attacks and strokes, leading us to question whether we should still consider it a safe, recreational drug.

in hospitals, treating fevers with tylenol is another practice that warrants reevaluation. fevers are the body’s natural way of fighting infections, yet they are often immediately suppressed with medication. research shows that treating fevers can prolong illnesses, meaning that we might need to rethink the automatic use of fever-reducing drugs and instead consider whether a fever might be beneficial in some cases.

these examples reflect the broader issue of medical dogma – when opinions masquerade as facts. as science evolves, we must remain open to challenging long-held practices to prevent further medical missteps and ensure that recommendations are genuinely evidence-based.

the main takeaway of this chapter to blind spots by marty makary is that…

many accepted medical practices are rooted in outdated or poorly supported evidence, often leading to unintended consequences. from the surge in peanut allergies to the overuse of antibiotics and persistent myths about cholesterol, these examples highlight the importance of questioning medical advice and seeking out evidence-based solutions. by staying informed and open to evolving science, we can better protect our health and avoid falling victim to harmful medical dogma. ultimately, it’s about empowering yourself to make more informed health decisions.

okay, that’s it for this chapter. we hope you enjoyed it. if you can, please take the time to leave us a rating – we always appreciate your feedback. see you in the next chapter.