The Trust Crisis in Medicine & How MAHA Became Possible

We trace the real reasons so many Americans distrust doctors and vaccines, from profit incentives and broken access to the chaos of COVID messaging. We also dig into the specific history and lived experience that shape Black communities’ relationship with modern medicine, and why trusting nerds matters more than ever.

Transcript

Why “Healthy Again” Rings Hollow

SPEAKER_00 0:00

Welcome back to Pit 2 Punchlines, everybody. On this episode today, we are talking about what some people consider a controversial topic. We're talking about make America healthy again. All right, guys. First of all, America is not healthy to begin with, but we're going to talk about this quote unquote movement because this slogan does not really represent, I think, what's happening here. And as an ER doc, we just know that regardless of what happens, we always deal with the downstream effects of what the policymakers make. So uh we're just gonna talk about what's been going on, just because essentially, I don't know, I'll be honest, I know what's happening right now is essentially gonna make people much sicker. And we already deal with a lot of sick people in the emergency department, and let alone dealing with the usually guys who experiment with sticking things up their butt. So essentially we're gonna have to deal with more sick people. But I should say that this episode is not actually about the Maha movement or RFK or the current president. This episode is actually about the idea of how we can get here as a nation where people are distrusting doctors and not sure about vaccines and what the current climate is. So, not about anything in terms of that political conversation, more about how we got here to begin with. All right. All right, so let me give you a little timeline how I'm gonna talk about this essentially. I'm gonna talk about uh kind of five different major topics leading to how I think we got to kind of distrusting modern medicine in many ways. Um, go off on little tangents and we're gonna have a good time. You guys ready? All right, cool.

Big Pharma And The Purdue Example

SPEAKER_00 1:49

Let's go. All right, guys. Um, I think the first major topic that we have to discuss is the idea of big pharma in this country. Pharmaceutical companies kind of run the show in many ways when it comes to new drugs and discovery. And essentially at the same time, they are companies, they're for-profit companies that the goal is profit. So essentially it's money, money, money, money, money. So essentially they need that they need to make money. That is the goal. If there's no profit, there's no purpose for them. And I think for a lot of people, just at the very get-go, if a company's goal is to make money, sometimes people have this thought that if their sole purpose is to make money, then they may cut corners to get there. And I think a good way to start off this particular conversation about big pharma is by talking about Purdue Pharma. And if people don't know what I mean by saying that, if you've seen the painkiller Netflix movie, you may have a better idea that Purdue Pharma was the pharmaceutical company that was in charge of getting OxyContin into the market and the terrible things that it did to America and contributing heavily to our current uh opioid epidemic. Um, to go into that a little bit more, obviously OxyContin is an opioid medication. Uh Purdue Pharma was, you could say, maybe in bed, or they were very entangled with the FDO at getting this improved, uh getting this medication approved. And by getting it approved, they did much more than just that. They got it approved. It's an opioid medication. All of them have addictive potential, but they somehow, somehow got the FDA to say it was okay to say and market this being less addictive. Essentially, this you could already see is a problem. But what is very interesting and very disturbing is that when you look about the when you look at the pharmaceutical company, when you look at how studies are done and how they essentially get approval, they will do studies to study the safety and efficacy of drugs. But the study is being conducted and paid for by the same people who are marketing and want to sell the drug. So essentially Purdue Pharma, you know, from different studies, and I think this letter to the editor that was in around the time when they're getting approved, that they gave to the FDA, that is how they were able to get the FDA to say it's okay to say this particular opioid was less addictive when it's an opioid in general. It is baseline addictive. What's even more frustrating is when you found out later on, and none of this is a secret, you can look this all up. One of the senior FDA officials that was at the FDA at the time, a government organization, ended up taking a job later with Purdue Pharma, right? When I say they were in bed, they were literally entangled with the senior FDA official. And it's just very frustrating, right? Because essentially the same people who are trying to make profit or the same people trying to sell you this drug that say it's gonna save your life or significantly, significantly enhance your life. I can understand how people are frustrated by that, right? It doesn't make any sense.

Insurance Gaps And Skipped Care

SPEAKER_00 5:11

Now, the next idea I want to talk about, though, is the lack of health insurance. And let me rephrase that the lack of health insurance and great health insurance for people. Uh the truth is in this country, there's about 8% of people who are uninsured. So it's about 26 million people. And in this country as well, there's about a fourth of Americans who are ununderinsured. Meaning they have insurance, but it's not that great because they're still paying high out-of-pocket expenses to pay for their health care. Now, if you think about if we loop these two groups of people together, or rather lump them together into the same people, I would define them as people who don't have as great of access maybe to medical care in some ways. And for these people, uh, if you don't have access to great health care, you may try to skimp out on healthcare in certain ways. Therefore, you may not have access to doctors or different health professionals who can actually give you advice or give you perspective of how to improve your health. So at baseline, you may not be as healthy because you don't have access in general to health professionals. That is a huge issue because what that leads to is people going to other sources for their health if they don't have access to professionals, which leads to the next thing I want to talk about, which is information that is not great, or rather misinformation that tells people the things

Influencers And Health Misinformation

SPEAKER_00 6:37

that are not great, essentially. When I think about this, I'm specifically referring to influencers, which I guess some people could say it's uh kind of ironic. So I guess me doing this podcast, essentially maybe I'm trying to become an influencer. But essentially, when I say influencers, I'm talking about influencers who may not have knowledge in what they are talking about. Now, the truth is that influencers is how we are right now, it's how things are functioning right now. Like a lot of people go to influencers for advice. When influencers like, yo, I heard from a friend, from another friend, that drinking a little bit of bleach is gonna cleanse you and make you all better for everything. People may actually believe these things, but they have no scientific basis and just nonsense. But when people don't have access to professionals, they're gonna listen to people who they trust. And if they trust these influencers, psh, that's what's gonna happen. And yes, there are health care or rather medical influencers, but to be honest, uh sometimes you could say they also have a marketing issue in terms of being able to relate to people. Uh, but you know, it is what it is. Influencers are here to stay.

COVID Messaging And Vaccine Confusion

SPEAKER_00 7:42

I will say COVID, which I want to talk about, was a huge issue for being able to get people to trust the medical community. COVID was not that long ago. The pandemic was not that long ago. And it was a crazy time of death and chaos and people just not being sure what to do. And I would say the government, and of course, like a health professional, whether the CDC or other places, did not do a good job at guiding the people about what to do based on their fears. Like, remember, it was a time where people were like, oh, mask or don't mask. And you know, people were talking about different medications and things they thought that could help. Uh, and unfortunately, some of those people were also health professionals, talking about hydrochloroquine or ivermectin. And unfortunately, we did not have a unified message for people until a bit later. But by that point, people were frustrated. So I think the COVID pandemic also showed how perhaps disjointed the medical community is about certain things. And different people, like I said, even different doctors were saying different things, and people were just all sorts of confused. Now, those are four different topics to kind of think about from big pharma, misinformation, lack of health insurance, and also COVID. But there is another subsect of, I think, people within the American community that I want to talk about.

Why Black Patients Distrust Medicine

SPEAKER_00 9:08

Um, and I actually want to talk about African Americans and why, particularly amongst all Americans, and I'm just gonna say black Americans moving forward for the most part. But the reason why a lot of black Americans don't necessarily trust the medical community in the US and medical professionals is because of a history of unfortunately exploitation and unfortunately um harassment. You could also say just like um poor treatment by the medical community. Um, maybe harassment is too much, but you know, you can make that determination of yourself. So I want to talk about three different topics when we talk about why the black community doesn't trust modern medicine nowadays, and particularly also in the past. I don't know if you guys know about the Tuskegee syphilis experiments in the past. Uh, for those who don't know, the Tuskegee syphilis experiment was the study that was done in nine between 1932 and 1972 in rural Alabama. It was a study in which there were 600 black men that were recruited, of which 400 of these black men had syphilis. The unfortunate and very difficult thing about this topic is that in 1940, penicillin, which is the, well, it is the cure for syphilis, was discovered. But all the people who had syphilis in the study were not told about the cure for this study, which is ethically wrong. However, it wasn't until whistleblower came out and revealed this in 1972 that they actually revealed this to these men. Because essentially the scientists who were, you could call it, studying this, experimenting with this, because essentially they were using these people as like guinea pigs, they wanted to see what the long-term effects for syphilis was. But ethically, it is wrong. If there is something you don't have a cure for, but you discover it, you have to tell the people. But because they were black people who was who were in this study, they refused to do so. Um, and this is something that is huge and something that's talked about within the medical ethics literature. Another nerdy point that also really highlights the issue and why perhaps black people don't trust the medical community, um, is the case of Gila cells, which are cells that have been used to study so many different advances in medicine from um vaccines against polio to chemotherapeutic effect to even vitro fertilization, right? Um these cells are laid or named after who they were discovered or rather procured from. Um the there's uh the woman, a black woman named Henrietta Lax, who lived between 1920 and 1951. Unfortunately, she died because of cervical cancer. And uh, in the process of her death, there's some scientists who took her tumor cells without her consent and studied them. And by studying them, they saw that these cells continue to divide, but they never died despite multiple, multiple, multiple divisions. When most other cells that they study would usually die after dividing after a few times. Therefore, they're the ideal type of cells to study uh these different um essentially study for these different effects that you're trying to discover different medications and or other things for. If you think about it, like her uh cells were used to create so many different things, and the actual intrinsic nature of it gives a new definition to black girl magic, right? Like she her cells were able to create these amazing things. However, ethically, it was wrong what these scientists did. They, one, did not inform this woman they were taking her cells to be able to do these studies. And two, they never informed her family until it was discovered much later. And three, whether or not you think it's right or not, they never compensated her family for any of these things. So, once again, doing things to black people that are unfair. Now, this is in the past, like perhaps decades ago. But more recently, there are things that are super important to talk about why black people may distrust the medical community. One of the things that we, at least in medicine, we talk about is black maternal death. Um, unfortunately, there is a significantly increased um mortality for black women who are giving birth in this country compared to any other women from white women, Hispanic women, or Asian women. Essentially, the way they look at black maternal death is by looking at the number of deaths per 100,000 live births. And for black women, unfortunately, it's 50.3 uh maternal deaths per 100,000 lives compared to white women, which are 14.5 deaths, compared to Asian women, which are about 10.7 deaths. I bring this up because not too long ago, Serena Williams, the legendary tennis player, almost died while giving birth. And part of the reason why this became relevant is because the doctors and the nurses who were in the hospital where she was being cared for didn't listen to her about her own past medical history. So the story is that she had a postpartum pulmonary embolism. Um, right after she gave birth, it's a very high, was right rather, it's a very uh significant time because you actually have a higher history of essentially throwing a blood clot. And Serena Williams already had a history of a blood clot even before she gave birth. So she already knew she was at a higher risk for that. So after she gave birth, soon after that, she started feeling very short of breath. And she told the nurses and the doctors or this hospital. And they're like, oh, you know, calm down. Maybe it's your pain medication, maybe you're a little delirious and whatever, whatever, whatever. But she persisted and she was like, I have a history of blood clots. I need a CT scan. Because she remembered when she had a blood clot in her lungs from before she needed a CT scan to make sure or confirm whether it was there or not. And sure enough, after they did the CT scan, she had some blood clots in her lungs and they put her on the blood thinners to thin her blood and prevent her from dying. But Serena Williams is a huge celebrity. And the only reason I mentioned that is because she felt emboldened and she spoke up for what she needed, and these people eventually listened to her. But imagine all the other black women who may not have been as privileged in some ways, and people may not have listened to them in other ways, or maybe they were at a hospital that was not as well off, and people just ignore them and then they died. Like these are part of the things that often black women, um, and maybe we can even extrapolate to like black people in general complain about within the medical care that they receive in the US. And another reason why them, or rather, us as a subgroup complain uh uh about the medical um community in the US and how it's so it's so is essentially distrust in the medical community. So essentially, you know, it's it's not necessarily that great. And I think like these issues will continue because the mistrust will only kind of continue.

ChatGPT Symptoms And The Steve Jobs Effect

SPEAKER_00 16:21

And I don't think the current things we have, like ChatGPT, will make it any better. Because I think like for me right now, when I think about um how people feel about their health, um, what I see happening right now is often people will go to ChatGPT if they're having something. They'll type in their symptoms and ChatGPT will spit out a bunch of different ideas of what it could be. And then they'll come to the emergency department being like, Chat GPT says I have this, please test me for this. And medicine doesn't necessarily work that way because it's you know back and forth. You listen to people, you hear the symptoms, you look at their virus, and then be together with that, you try to determine what's going on. But if people say ChatGPT, which apparently, of course, like takes a bunch of like knowledge from different things, says something, people are less likely to believe that their doctor may know what he or she is talking about. On the other hand, or rather perhaps not on the other hand, but on the same, in the same vein, um, it's kind of easy to see to a certain extent, like if people are trusting doctors less, they can easily believe RFK when he's like, oh, vaccines lead to autism, or you should not be getting as many vaccines because people in Denmark, or wherever the hell he is getting his ideas from, don't take as many vaccines when there's a lot of research and studies to go into which vaccines are needed within certain demographics, whether in the US or other places. But if there's already some mistrust in doctors, then why the hell will people even listen to them at all? Right, when the people are trying to dis or rather discredit this person who's not in medicine at all. Uh ultimately, I think medicine is losing its credibility and people are losing trust not just in doctors, but also scientists and people who make the medical community. And experts aren't really much of a thing anymore, if you think about it. Uh, or rather, people just don't really care about what experts have to say, which is kind of sad, honestly. And I think this ongoing phenomenon is very, very dangerous. And I I call it the Steve Jobs effect. And this may seem kind of crazy, but I'm gonna explain it to you guys. Um, because the truth is that diseases and death does not discriminate anybody. Whether you're rich or poor, disease and death will come for you. That's the kind of thing that we all kind of share. We are not immune from it. And the reason why I call this a Steve Jobs effect, not to diss Steve Jobs, who, for those who don't know, was one of the founders of Apple, he did not necessarily fully trust Western medicine. And, you know, I could argue in some ways, you can't necessarily always blame him. Uh, but there are a lot of things that modern medicine knows really, really well. And to describe why I call it the Steve Jobs effect, I want to kind of describe his um his story with unfortunate pancreatic cancer. So Steve Jobs was diagnosed with pancreatic cancer in October 2023. He got lucky. Uh, when I say he got lucky, he got lucky because of the type of diagnosis he was diagnosed with. He was not diagnosed with the more aggressive form of pancreatic cancer, which is a pancreatic adenocarcinoma. He was diagnosed with pancreatic neuroendocrine tumor, which is less aggressive. And if caught very early on and taken out right away, people live for years and years and years because it is something that is less aggressive, therefore it metastasizes less quickly. So if you're lucky, like he was, to have discovered pretty early on, you usually have good outcomes. However, when Steve Jobs was diagnosed, uh he decided not to go down the route of just getting a surgery called the Whipple to get it removed. He delayed it by nine months and he tried alternative medicines. What I mean by that, he did, he changed his diet, he tried acupuncture, did different supplements and other things until nine months later when he finally decided to get the surgery. Unfortunately, he was too late by this point. Um, even though the surgery went well two years later, the cancer recurred. It had metastasized slash spread to other areas of his body, and he ended up dying years later. And the frustrating thing for me is that he had an opportunity to get this taken on. Maybe he would still be with us today. Nobody knows because no one knows if maybe the cancer had already spread at that point. But usually if they find it early on, people have good outcomes. That's what medicine or literature has shown.

Integrative Medicine And Trusting Research

SPEAKER_00 20:49

And I will say that Western medicine does a bad job of kind of hating on integrative medicine. But I actually think the best of both worlds is to combine both of them. Like, don't knock Western medicine, but also don't knock the potential benefits of integrative medicine, like acupuncture and other things, which studies now have shown that does a great job in relieving people of pain and various other ailments. Because at the end of the day, diseases are the diseases, right? Diseases are diseases. And for us, the way we discover how to navigate them is by researching them. Whether it is more conventional Western medicine or if is it, or if it's integrated medicine, which people often, I guess, call Eastern medicine, we have to research it, but we have to do the research. We have to be very nerdy about this. We have to be nerdy about this and actually answer the question does this work or does it not work? But we have to be willing to live with the conclusions of the studies. Now, in kind of wrapping this up and concluding this episode, what I will say is that, you know, people aren't really sure what to do. At the end of the day, with all of this information and misinformation. And what I will say, if you're looking for a source of guidance when it comes to medical literature and also medical advice, trust the nerds. Like, trust the nerds. What I mean by that is that okay, there are a lot of people, like graduate students and other people who are really into kind of getting into the weeds and answering the question: do these different remedies or other things work? They'll do very, very rigorous research, not just to prove their own point, but sometimes to disprove other people's point. And I'm not saying people shouldn't do research on their own, but the thing is that within the world of medical literature, you have to know how to tell even if a study is a good study or not. But also what's great about nerds and people who love this is that they'll go into it, they'll see something, and even though someone uh even though someone gets to a certain um uh conclusion, they will try to see if they can replicate the study and get to the same conclusion. That's how we confirm or deny certain things. That's how these things work to be able to kind of get to a point where we're actually showing what things work or don't work. And people who dedicate their lives to this. So, like, find your nerdy influencer if you prefer to go through uh social media, or find a good friend who is uh someone who's pretty learned in this topic. What I will say though is do not trust either the politicians or perhaps influencers who may not have the the expertise knowledge in this. What I do love are influencers who get people who have this expert knowledge who come on their podcasts or their Instagram and talk about these topics. So go after that because at the end of the day, diseases are diseases. It's gonna come after all of us. So let's make the right decisions and try to make ourselves healthy at the end of the day. All right, guys, it's been Pit the Punchlines. Uh, I will see you guys next time. Peace.