The American Health Binary
Yelling at each other rather than solving our problems
Just as in our politics, Americans have been drawn to extremes when it comes to our health. What will it take to make America as healthy as it can be?
“We do not use Traditional Chinese Medicine to treat cancer. We use it to help with the side effects of cancer treatments.”1
Years ago when I was a parenting and education writer, I interviewed a provider of Traditional Chinese Medicine (TCM) who worked with children. Her career path was one other immigrants might recognize: She was a pediatrician in China, but when she came to the U.S. her training and experience counted for nothing. So she ended up specializing in TCM for kids.
One piece of advice she said she was often asked by American parents was whether she would treat a child’s serious disease with TCM. She told me this only after the interview had concluded, when she was sure what she said would not be on record.
“I don’t understand why Americans think that ancient wisdom is better than modern science. They are two different ways.”
She was shocked that Americans would think that she could use acupuncture to treat infection or cancer. I wasn’t so shocked.
All or nothing Americans
What is it that leads our culture to embrace black-and-white thinking? By the time I interviewed this doctor, I was already seeing the bizarre trend of well-off, educated women seeking “alternative” treatments for their children because they had come to distrust establishment science. I was homeschooling my children and found almost immediately that those of us who believed in science-based thinking would have to use code with each other. I remember a conversation where another mother exclaimed with relief when I made it clear that my children were vaccinated.
I have had my own differences with establishment medicine. I, like many of the MAHA moms out there, had a sweet, charming baby who seemed to take a turn as a toddler. My family navigated years of bouncing between standard of care (including the psychiatrist who wanted to put a five-year-old on antipsychotic drugs) and alternative providers full of promises (such as the ‘psychologist’ who ‘prescribed’ a homeopathic remedy while warning that it would only ‘work’ if we used his parenting methods).
During this time, I watched parents around me getting sucked into what has now become the MAHA movement. Instead of seeking out more thoughtful, more curious medical providers as I did, they just rejected the entire field.
Reason drowns in the din of social media
I was parenting my kids just as social media was ramping up. Parents looking for alternatives were still seeking out actually educated people like the TCM practitioner I interviewed. And those educated people could talk the parents off the cliff, or maybe even talk them out of even approaching the cliff.
But once the misinformation started spreading through social media, once people found comfort in their echo chambers, they simply stopped listening to experts. As a parent, I feel like I skated blithely through a time when the information hoarding of the past was broken, but the information glutting era of the future was just developing. Had I been parenting ten years earlier, I would have had less access to divergent thinkers who gave me new paradigms for parenting an unusual child. Had my child been born ten years later, I’d be facing a bewildering landscape of thoughtfully divergent thinkers swimming like lost tadpoles in a pond full of money-hungry piranhas.
The American binary reasserts and realigns
When my child was small, I read about a fringe group of parents of autistic kids who were pressing the medical establishment to research a radical idea: that there was a connection between gut health and the brain. Mainstream medicine mocked the idea, falling back on the simplicity of concepts like the blood-brain barrier. How could what you eat affect how you think? That’s preposterous!
These days, thanks to parents and researchers who were willing to stick their necks out to push a radical idea, the gut-brain connection has been firmly established.2 Mainstream medicine has come onboard and—I can only hope—children like mine aren’t immediately offered antipsychotic drugs3 (otherwise known as Mommy’s Little Helper4 ).
But just as American establishment medicine is moving in the right direction in so many areas, American public sentiment has moved way off the path, feeding a movement’s need to rebel rather than humanity’s need to embrace open scientific inquiry and advancement.
Sidenote: The American way of birth is an enduring exception
This week’s upcoming episode of The Babblery features a deep dive into the American birth industry with doula educator Anne Wallen. Anne has a fascinating life story as well as a clear and evidence-based approach to healthy birth practices. Birth is one area where the mainstream establishment seems stuck on the traditional side of the binary. As Anne says, “No OB wakes up in the morning and says, I want to ruin someone’s birth today. Whose birth can I wreck today? That’s just not how they got into this job.” Yet that’s what has happened: despite all evidence that our birth practices are leading to shockingly bad outcomes,5 we stick with them.6 The episode comes out Wednesday!
While Americans are stuck on the binary…
Sometimes I wonder whether the American political binary causes our polarized thinking or whether our polarized thinking led to the American political binary. Certainly, the founders didn’t envision a country with two parties that continually play The Opposite Game.7 They envisioned a culture of debate and compromise, a culture that seems foreign in modern-day America.
Make America Healthy Again is a case in point. MAHA seems to believe that there is an absolute answer to every nuanced problem. Autism, one of the great mysteries of modern biological science, is reduced to Tylenol. Public health, a complex and constantly shifting area of research, is reduced to Survival of the Fittest. The health of the most precious resource any country has, our children, is reduced to a battle between us and them.
…Reality is stuck on the spectrum
The truth of health and the truth of science is a constantly shifting target. Our pursuit of understanding the human organism is not served by either side of the binary:
Radicals who reject rigorous science in favor of solutions that “feel right” or feed their preconceived ideas are pulling us in one wrong direction, while
Institutionalists who insist on gatekeeping science and protecting their standards at all cost resist change and send desperate parents and patients to the radical fringe for answers.
We need to find a new balance, where the scientific establishment is committed to openness at the same time as rigor, and our culture is recommitted to trusting science. Despite the herky-jerky nature of scientific progress, we all need to share share a commitment toward progress.
Let’s make America healthier again, rather than yelling at each other across the binary void.
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This is a quote from memory. I found my notes from this interview, but the doctor was only willing to speak about crazy Americans off-record. She didn’t want to drive away business!
This is a fascinating area of research. Here’s a start.
Just a note that I am not against using drugs in extreme cases, but it is clear that the only ethical choice when treating children with behavioral issues is to exhaust all other areas of remedy before resorting to drugs. The potential for catastrophic lifetime effects is just too high.
The psychiatrist actually did say that antipsychotic drugs “can offer relief to parents,” as if our comfort was more important than our child’s health.
Really, it’s truly unbelievable that Americans have doubled down on a system that leads to preventable death. More on that in another piece.
It’s interesting to me that birth is one area where MAHA hasn’t gone full-on crazy. In fact, I’ve hardly heard a peep from them about childbirth, focused as they are on encouraging fertile women to use “natural” family planning methods. (Reminds me of the old doctor joke: “You know what I call people who use natural contraception? Parents!”) Aside from the small number of women who Anne tells me are into “free birth”—women who insist on giving birth alone, with no attendants (yikes!)—the anti-science radicals seem silent on the travesty that is the American hospital birth system. Please leave links in the comments if you have seen MAHA interest in alternative birth practices.
My kids loved The Opposite Game. The rules are as follows: no matter what your opponent says, you find a way to oppose it! Luckily, they grew out of it… mostly!
As a parent of an adult with autism, I fell in that middle too. I remember hearing about the gut and looking it up. There was no science behind it at the time. Now there is. We also researched vaccines as my second child was born. That science hasn't changed. But it's not always binary. We saw a DO for years. She put me on folic acid and flax seed oil instead of a statin. That has controlled my cholesterol for twenty years. I may yet need a statin (thinks menopause), but I'm happy to have avoided one and the potential side effects for so long. A real key is person-centered care.