Tag Archives: wellness

Exercise and shibboleths

I’ve been trying to lose weight and gain muscle for years. But despite being in the target Young Male demographic, I never listened to Joe Rogan, or Logan Paul, or any of the exercise/fitness influences. Part of that was that they just didn’t interest me. Part of that was that fitness is filled with a lot of pseudoscience, and as a scientist myself I could see that almost everything said online was tinged with nonsense and falsehood. Everyone is looking for “one weird trick” to get abs of steel and 4% body fat, which leads to a proliferation of voodoo practitioners giving terrible advice and selling you supplements.

I stayed away from online exercise discussions.

But while idly scrolling one day, I found a video by Dr Mike Israetel of Renaissance Periodization. And for the first time in my life, I’m hooked. I’m watching his videos, I’m trying to learn his techniques, I’m putting into practice what he say I should be doing.

I think a large part of this sudden switch is that Dr Mike seems to have legit credentials. A teaching record at Lehman College, a genuine publication history, this guy is clearly doing science, not voodoo. But I think even more than his credentials are his shibboleths.

Put simply, Mike Israetel says all the right words as a scientist to make me (a fellow scientist) believe he knows what he’s saying. There are certain words that started out in science but have reached the mainstream: anyone can talk about carbohydrates and calories. But few people know what a motor unit is, or can accurately talk about the immune system. Dr Mike is saying things that pass the smell test to me (I am a fellow biology but not an exercise scientist specifically), and that helps me believe him when he says things I might otherwise be skeptical of.

And those shibboleths… make me nervous. Because I know I’m not actually doing research, I’m not actually seeking out all sides of the debate and forming my own rational conclusions. There’s hundreds of hucksters selling you on “the best way” to do exercise, so am I trusting Dr Mike for all the wrong reasons? Maybe he knows his biochemistry, but his exercise science is dogshit. I’d never know.

And even if Dr Mike is truly giving me the most accurate, up-to-date information in the scientific literature, that information could be wrong, and I could spend my time following baseless advice and getting less fit than if I’d just trusted the gymbro with a 6-pack and pecs.

I haven’t looked for any advice outside of Dr Mike, because to be honest I don’t have the time or the background necessary to know if he’s *really* got the goods or is a huckster like all the others. I have the background to know he knows his biochemistry, but beyond that I’m lost. But as someone without much time to exercise anyway, I feel like latching on to a charismatic Youtube professor is at least better than latching on to any other charismatic Youtuber, and is hopefully better than flying blind like how I used to exercise.

Time will tell.

Healthcare needs to stop infantilizing its patients

I was once told a family story about one of my great-great aunts, let’s call her Clara. As a young adult, Clara was diagnosed with Lou Gehrig’s disease, or as it was known in those days “turning to stone.” Before Lou Gehrig made it noteworthy, the disease that bears his name was named after its most noticeable symptoms, a progressive atrophy of motor neurons until a person can’t even move at all. They feel like they’ve “turned to stone,” and death follows when the neurons controlling the heart or lungs also atrophy away.

Clara’s doctor told her sister about the diagnosis, but the sister was *adamant* that Clara not be told. “Turning to stone” was a horrific way to go, and conjured ideas of a person being trapped in their own body unable to move or call for help until at last they slowly, agonizingly, died. Clara was never told her diagnosis, and continued to see her doctor while being told lies that she was “improving” and “getting better.” Until at last she died.

And with the fullness of time, I guess she really will “turn to stone,” as will we all.

I don’t know what Clara thought as she was dying. Maybe she never really knew what was happening to her, or maybe she figured it out. Either way, her family probably thought they were doing her a favor by not telling her, and saving her the pain of knowing her inescapable fate.

But were they really saving her? Or did she pass away sad and frustrated that despite her efforts and all the encouragement, she only ever got worse and worse? Maybe knowing would have given her peace of mind, and made it easier for her to understand her condition.

Stories like Clara were common a century ago. It was not uncommon for doctors to hide a diagnosis from a patient, on the assumption that it was better they simply not know. Fortunately now we’re past that, and doctors are willing to treat patients with a lot more respect. Sometimes.

Recently I switched doctors and have been trying to continue taking the medicine I had been prescribed by my old doctor. My condition isn’t immediately life-threatening, but my live is much improved with the medicine. However I have had an absolutely terrible time of it, and have seen first hand how stupid the medical system can be when doctors get it into their heads that the patient is best kept in the dark.

The first thing that happened was that the doctors, with too little information in hand, misdiagnosed me and tried to brush brush off my condition. The medicine I’m taking has some slight psychoactive properties for some (although not for me) and is occasionally used to treat depression or insomnia. I have neither, and I wasn’t taking it for either.

I listed both my condition and the medicine I had been prescribed, and the doctor agreed to set up an appointment with me. But when I arrived for the appointment, the nurse did nothing more than take my weight before telling me that I was in the wrong place, *that* medicine is proscribed by psychiatric care, and I needed to get an appointment with an entirely different department. I made the appointment, but had no idea why I was even doing so.

The medicine isn’t psychiatric, nor is the condition. But because it has alternative affects, someone got it in their stupid thick skull that this was *only* a psychiatric medicine and that I couldn’t possibly be taking it for the *non-psychiatric* reason that I had put in the mandatory intake form. It’s clear neither doctors nor nurses ever read a damn word of the forms they ask you to fill out, because even glancing at mine would have told them what my condition *really* is. And if they *did* think I needed to visit psychiatric, then *they should have told me so before the damn appointment*. They should have realized “oh, this person is in the wrong place” and told me before they wasted my time!

As I said I scheduled the appointment with psychiatric, but after an angry phone call with the original doctor’s office, someone actually realized their mistake and got me a new appointment with someone who could treat my condition.

*Could* though, not *will*. Because see, my condition can also sometimes be treated with lifestyle changes, but I’ve worked on it for years with no luck before I got the medicine, and the medicine is the *only* thing that helped me. But the doctor I spoke to decided to treat me like someone who had never heard of their own condition, the condition *I had to tell these people about*, and started off with the whole lifestyle spiel before I had to cut them off and list off everything I’ve tried before medicine actually getting some help with medicine.

The doctor also decided that I had so *little* understanding of my condition that she had to list all the signs and symptoms, all the ways it will affect my health, even though *I already know all this, which is why I’m here for some god damned treatment*. These people were too stupid to read a form, and now are too stupid to listen to me and understand that I have had this for a while, I know what it’s all about, and I know I both need and want medicine to contain it.

They treated my like a child, quite frankly. They assumed that I was completely lacking in knowledge, that I didn’t know what I needed or wanted, and that I had zero understanding of my own health. I got a prescription but I’ve decided after filling it that I’m unlikely to ever visit this practice again, because for all the horrors of the healthcare system, infantalization of the patient is one thing that should have stayed in the 19th century.