Dear health establishment, one of my favorite musical genres is the singer-songwriter style of music most popular in the 1960’s and 70’s. Guys like James Taylor and Jim Croce, ladies like Carole King. The soulful meaning of the lyrics, the moral causes and personal crusades coupled with well-performed guitar work or piano instrumentation is a hallmark of this music. The soft sound is juxtaposed against the heavy meaning of many of the lyrics. As I opine here, I want to remind you of a verse from one of my favorite songs of all time. A song about the shifting tides of the exploration and radical shift in the individualistic thinking of the 1960’s.
Come gather ’round people wherever you roam, and admit that the waters around you have grown
And accept it that soon you’ll be drenched to the bone.
If your time to you is worth savin’, then you better start swimmin’ or you’ll sink like a stone.
For the times they are a-changin’.
– Bob Dylan, The Times They Are A-Changin’
I was recently made aware of the situation whereby the Medical Board of Tasmania & the Australian Health Practitioner Regulation Agency (AHPRA) has acted to silence one fo their own, Dr. Gary Fettke. A physician and orthopedic surgeon by trade, he has been outspoken about the evidence which exists that our modern diet (the so-called “Western Diet” or “Standard American Diet”) has led to a rapid and expansive increase both in our waistlines but also in the incidences of Type II diabetes. Additionally, as an orthopedic surgeon, there is a vested interest in his part as it pertains to joint stressors brought on by obesity and a sedentary lifestyle…let alone the complications of diabetes up to and including limb amputation. His very capacity to perform his job to the utmost of his capabilities is now at risk by what is apparently a schoolyard squabble over whether one of the most qualified medical practitioners of surgery in Tasmania (and likely in all of Australia) is competent to tell someone, like Arnold Schwarzenegger, to “Put the Cookie Down!”
What heinous crime did the good doctor commit for which he has been silenced by this board (I should point out that as I understand the process, silenced by an anonymous complaint and until resolution of the case against him)? What did he do to deserve such a harsh rebuke and a depression of the pause button on his ability to benefit the health, wellbeing, and ultimate outcomes of his patients? He said that excessive sugar consumption (specifically with a focus on Fructose) is inherently unhealthy. A man with many years of training, licensure, certification, and credentialing. A man whom the same review board is now adjudicating is the same man who has been trusted to perform a number of surgeries without any evidence of malpractice or poor performance for a number of years. Even being trusted as a senior lecturer to those aspiring to follow in his footsteps.
I want to caution you, medical establishment. I want to point out that the groundswell of support from the educated and enlightened masses has shifted the tides under your feet.
- No longer will we blindly follow public policy handed to you under the guise of evidence-based practices.
- No longer will we willingly be complicit in our own disease and unhealth.
- No longer will we stand idly by while the access and availability of self-testing and open access to medical and health literature tells us what we have long since suspected. Your recommendations don’t work.
You may argue that they work in theory (a statement I would dispute for all but spherical cows in a vacuum), but they don’t work in practice. The world is getting fatter, sicker, and angrier with you – and yet at every turn of the bat (I’m looking at you South Africa…thank you Dr. Noakes for fighting the good fight!) the medical establishment appears to be hell-bent upon proving that if they’re shown to be wrong, the correct answer is not a course correction or a retraction, but instead a going all-in on wrongness in some effort to bluff those of us holding the better hand into folding.
It. Won’t. Happen.
The times they are changing. You cannot appeal to your expertise in the face of a mountain of evidence of your incompetence. And when one of your own dares to point out the emperor has no clothes, the appropriate measure is not censure, it is rejoicing. Dissent is the essence of science and the stuff of breakthrough. You cannot, in the face of decades of peddling advice which has left your patients fatter and less ambulatory, appeal to your own authority when the foundations of that authority are crumbling under the sheer weight of our own fatness and illness.
Let me remind you of the last verse of the song from above.
The line it is drawn, the curse it is cast.
The slow one now will later be fast.
As the present now will later be past; the order is rapidly fadin’.
And the first one now will later be last,
For the times they are a-changin’.
Gary is unfortunately learning a lesson that Voltaire observed when he wrote that, “It is dangerous to be right in matters on which the established authorities are wrong.” Dear health establishment…doctors, nurses, nutritionists, researchers…search both the anecdotal evidence with every presenting patient and your biochemistry textbooks. Search the eyes of a child who has just been diagnosed with Type II diabetes. Search the heart of a mother who, despite all of her efforts at following your advice, has brought her obese child to your facility exasperated and heartbroken. Then search your soul and ask yourself a question that I find myself asking of many of my clients, “Is what I am currently doing working?” Your patients are fatter than ever. Your patients are sicker than ever. The answer is no.
The emperor has no clothes. Dr Fettke hit the nail on the head. He is challenging the status quo. He should be celebrated for raising his hand, not censured to the detriment of his patients. Let’s presuppose, however, that Dr. Fettke is wrong. Perhaps the thousands of people who have improved, managed, or cured conditions such as Multiple Sclerosis, Diabetes, Epilepsy, and Cancer are simply the result of placebo and wishful thinking. Perhaps the hundreds of thousands who have improved the conditions of PCOS, Insulin Resistance, or have overcome obesity…maybe they’re just delusional zealots who starved themselves thin and repaired their metabolism by accident or coincidence. Maybe Dr Fettke is wrong…but if he is, then prove it with sound science, not a swift gavel. Your very response belies the issue of mistrust in the authority you wield and why you have lost the trust of your patients. Your version of evidence-based medicine or nutrition is a form of defensive practice based upon only the science which agrees with your presupposition. There’s a term for that, and it isn’t EBM – it is confirmation bias. I’m guessing you read about that in a research methodology or statistics course at some point in your education.
Admittedly, I realize I’m painting with a broad brush. There are a number of highly competent medical and nutritional practitioners who haven’t yet exchanged their brain for a credential. To those of you who dare to ask questions, challenge presupposition, and demand answers…thank you! This is the foundation of what I learned in the third year of my elementary education when we learned about the “Scientific Method.” Please know that you have the support of the rationally minded who are searching and efforting towards optimum health. I don’t care what the eventual outcome is, whether our approach or someone else’s is proven correct. What I celebrate is that you are willing to ask hard questions, to demand better research, and to utilize the years of training and expertise you have. For that, I applaud you…and I’m guessing many others do as well.