Medicine
Ask a programmer how much work he can do in a day, and you will often hear the same answer: “I can focus for one or two hours. Then I do my emails, read documentation, read the news, review pull requests.” Nobody seemed to find this puzzling, or to be able to answer the question that bothered me: what is the difference between a brain that can focus and a fatigued brain? What changes between those two states, and how can we extend the time a brain can stay focused?
Under the guidance of a wise mentor, I began to investigate this and many other questions:
- Why do so many modern children seem cripplingly sick, but mostly subclinically?
- Why do doctors and parents so often act as though this is normal?
- Why do bodybuilders understand the practical effects of hormones better than endocrinologists?
- Why do crooked teeth and tooth decay seem so much more common today than in the past, or among wild animals?
- How can we extend not only lifespan, but quality of life?
- Why are some people addicted to doom scrolling but some are not? Is doom scrolling perhaps a symptom?
- Why is everyone “lazy”, and why are all the American businessmen I meet on modafinil?
- Why is everyone in Poland fat now, while twenty years ago nobody was?
These questions are right in front of us, yet they rarely seem to provoke much curiosity. Consider Elon Musk, Donald Trump, Xi Jinping, and Recep Tayyip Erdoğan. What do they have in common? Extraordinary wealth or power, extensive networks, and access to medical care that most people can only dream of. What strikes me is that even at this level of wealth and influence, being visibly overweight is hardly unusual. If access to doctors were enough, why would this be so?
Jeffrey Epstein, another man with extraordinary means, had doctors arranging prescriptions for medication used to treat erectile dysfunction. His correspondence with doctors is another reminder of how ordinary physical concerns persist even among people with extraordinary access.
Ancient people prayed for fertility and followed rituals and diets intended to promote it. These practices remind us that fertility is a luxury that can be painfully hard to obtain. Modern people still suffer from infertility, despite all our wealth and medical technology. Obviously, infertility is not a genetically passed trait.
Many wealthy and famous people have children with autism or ADHD. Why are we seeing so many more children with these conditions than forty years ago, even in families with extraordinary means?
The Chinese military has trouble recruiting young men who meet its health and fitness standards, with poor eyesight and obesity among the reasons for rejection. Chinese people also suffer from poor health, much like the more visibly sick Americans.
What changed, and how much of it can we control? Are there bubbles of people who understand what is happening, while the knowledge is too taboo, or the solutions too expensive, to become widely available?
It turns out that yes, there are bubbles of people with answers to the questions I was asking. The solutions I have encountered are very expensive. Understanding the problem requires both an open mind and a willingness to be contrarian, and the subject is full of taboo landmines. Together, these barriers keep this field of study largely untouched.
Axioms
These are the starting points on which I build my medical theory.
1. An abundance of one nutrient cannot compensate for the absence of another.
Botanists know this as Liebig's law of the minimum: plant growth is limited by the essential nutrient in shortest supply relative to need. Adding more of an abundant nutrient does not remove a deficiency in another. Crop growth, leaf changes, and nutrient measurements make this principle visible. I take it as a starting principle for investigating human nutrition.
2. Repeated cultivation can exhaust the soil.
In the shifting agriculture described by the FAO, farmers cleared and burned woodland, cultivated the land for 2–5 years, then moved on when yields declined. The old field was left fallow for 5–15 years so its fertility could recover. The exact cycle varied with the soil and vegetation, but the practical lesson was clear: a field could lose its ability to nourish crops, and that ability had to be restored.
3. Growing a crop and nourishing a person are different goals.
Fertilizer programs are largely built around yield and cost, with nitrogen, phosphorus, and potassium at their centre. Agronomy recognises micronutrients such as molybdenum, but a crop's nutritional requirements are not identical to ours. Iodine is essential to humans, and enriching crops with it requires attention to human nutrition beyond the requirements of crop production.
4. Substantial declines in food's nutrient content have been measured.
A comparison of 43 US crops between 1950 and 1999 found reliable declines in six of thirteen nutrients, with median decreases of 6–38%. A UK comparison between 1940 and 2019 reported declines of roughly half in iron and copper in the fruit and vegetables studied. The pattern varies by nutrient and food, and changes in crop varieties and yields are among the possible causes. Nutrient density deserves direct investigation.
5. A shared deficiency can make disease the norm across a population.
Before salt iodization, almost every schoolchild in certain Swiss regions had a large goitre. Severe iodine deficiency also caused endemic cretinism, with profound developmental impairment. After iodization, no new cases of endemic cretinism were identified in children born after 1930. A community can become accustomed to widespread illness while the underlying cause remains a missing nutrient.
6. The entire population can be poisoned by the same toxin.
From the 1920s, lead was added to gasoline to improve engine performance. Vehicle exhaust spread it into the air, soil, and dust, exposing people far beyond the workers handling it. Lead damages the nervous system, especially in developing children. As lead was removed from gasoline and other sources, the US population's average blood lead level fell by 78% between the 1976–1980 and 1988–1991 surveys. A harmful exposure can become part of ordinary life across a population, making it difficult to recognise how much healthier that population could be without it.
7. Food quality is not distributed equally.
China's special-supply system has provided senior officials with food from specially controlled farms, including organic produce, with food safety as the stated concern. The leadership has treated control over its food supply as a privilege worth securing. Ordinary consumers do not have the same access to those safeguards. It is physically impossible to feed the world population with organic food.
8. Throughout recorded human history, mainstream medicine has always been wrong about mostly everything.
Mainstream medicine describes itself as evidence-based medicine. While noble in principle, the methodology is designed more for risk avoidance and cost management by lawyers and politicians than for solving medical problems.
History is full of cases in which accepted opinion was wrong about something fundamental. Galileo was condemned for defending the Earth's motion around the Sun. Ignaz Semmelweis showed that disinfecting doctors' hands in maternity wards could prevent mothers from dying, yet his findings took decades to win broad acceptance. It is conceivable that exactly this kind of collective error is happening now, and that possibility deserves serious consideration.
9. Studying veterinary textbooks is a valuable way to study human medicine.
Humans are naturally constrained by taboos that make certain questions difficult even to ask. Racehorses and breeding dogs are too big a business for taboos to take priority over health, fertility, and performance. I may therefore extract insights from veterinary textbooks that are unavailable in human medical books, especially on nutrition, hormones, reproduction, and development.
10. Humans aren't inferior dysgenic mistakes.
Genetic diseases exist, but my starting premise is that they are not the main limiting factor for a healthy life in the average person. “Some people just develop ADHD” is not an intellectually satisfying statement. Modern medicine devises impressive, high-tech solutions to problems that should not exist in the first place. My focus is entirely on preventing imperfections from arising, beginning before conception, rather than waiting until they require treatment or symptom management.
Mainstream doctor: “High cholesterol? Take these statins to lower it.”
My paradigm: “High cholesterol? Could the body be responding to another problem? If the rise is compensatory, what is it trying to accomplish, and what else might change when we suppress it? Lowering cholesterol does not by itself tell us why it was high. Is the body producing more of it, clearing less of it, or responding to another condition? I want to investigate the cause and address it.”
Ahead of the curve
I do not expect this approach to gain widespread adoption any time soon. Consider the requirements and put rough odds against each one. These numbers are illustrative guesses, not measured statistics; each percentage applies to the people who have already met the preceding requirements.
- Have the money and be willing to spend it: 10%. The expense is beyond most household budgets. Even among those who can afford it, many will have other priorities.
- Dedicate vast amounts of time: 10% of those remaining. Investigating problems, working through possible causes, and determining the best course of action can become a substantial part of your life. Paying for it does not remove the need to do the work.
- Exhibit very high discipline: 10% of those remaining. The daily work must continue through boredom, inconvenience, and competing demands, often for months or years. Initial enthusiasm is easy; following through consistently requires much more.
- Have a strong command of English: 50% of those remaining. For the approach described here, you need to work through textbooks, research papers, and technical discussions yourself. Conversational English is not enough.
- Be willing to admit that everyone around you is wrong: 10% of those remaining. That includes respected professionals, people you trust, and the consensus you have relied on yourself. You must be willing to reach an uncomfortable conclusion and examine it seriously.
- Carry the responsibility: 10% of those remaining. You must take ownership of investigating and addressing the health problems in your family, including your children's. That means learning, making difficult decisions, following the results, and changing course when necessary. You cannot hand over the entire burden and assume that someone else will solve it.
Multiply those estimates: 10% × 10% × 10% × 50% × 10% × 10% = 0.0005%, or one person in 200,000. The percentages are guesses, and the conditions may be correlated rather than independent. This illustrates the barriers to adoption; it is not a reliable prediction.
The money, time, and discipline are difficult enough to find. Questioning the judgement of people you have always trusted, then accepting responsibility for what happens next, asks considerably more. Few people will take on all of it.
The three foundational pillars of health
Liebig's law
Provide the necessary nutrients. An abundance of one cannot compensate for the absence of another.
Reduce harmful exposures
Reduce exposure to deleterious toxins and endocrine-disrupting substances.
I propose the following predictions of this paradigm:
- Children breathe through the nose, have straight teeth and symmetrical bodies.
- There are no issues with fertility.
- Family members find doom scrolling intellectually unsatisfying and take pleasure in solving challenging problems.
- The family spends the majority of its time in creative rather than survival emotions.
Consistent failure to produce these outcomes would count against the theory and require me to reconsider it.