This is a very different post than the one I initially conceived, but sometimes as I write, words pour out and take on a different trajectory.
Kelly Brogan, M.D.
I’ve been a fan of Dr. Kelly Brogan and her work for years, and so I was happy to find that she was a recent guest on the Adulting podcast in an episode that they called, “Is Medication Bullsh*t? A Non-Conventional Approach to Mental Health.”
Why am I a fan?
First of all, podcast titles such as that one.
Secondly, Dr. Brogan challenges the existing system in ways that would intimidate me if I did it publicly. We live in a world where people think in black & white, for & against. We get shamed if we agree with something that a disagreeable politician says. It’s expected that we be for or against entire categories of issues rather than allowing room for nuance, or agreeing with some aspects of that issue but not others.
It’s not uncommon to see Facebook posts that say, “If you don’t agree [with me on this issue] then unfriend me now.”
We seem to have lost our ability to respectfully disagree and also to have conversations that might change the way we think. People are afraid to change the way they think.
Take that podcast episode title, for example. It’s slightly clickbait, but it’s accurate. It’s the discussion topic. The idea that medication might be bullshit is enough to trigger people – anger them, put them on the defensive, and make them stand firm.
Professionals such as Dr. Brogan are constantly slandered.
Thirdly, her full title is Dr. Kelly Brogan, MD.
Brogan is an Ivy League trained conventional psychiatrist. She worked in Emergency rooms. She believed so much in the pharma model that her specialty was medicating pregnant and breastfeeding women.
Through her own health challenges, she researched beyond the medical model and what she found surprised her. For nearly 10 years she’s been recovering people from depression without medication.
This includes recovering people from suicidal bipolar disorder, from “treatment resistant” schizophrenia, from OCD and more. Recovering people. None of her patients have killed themselves (as long as she’s honest and aware, which I think she is).
I would never tell someone on medication that medication is bullshit. I’m also not qualified as a doctor. Dr. Brogan is.
Beyond the Classic Model. Are We Broken?
I appreciate it so much when a medical doctor looks beyond the classic medical model. These are the experts I trust most because they’ve got an expanded worldview rather than the narrower one given to them in their training. They’re not being bought by pharmaceutical reps. They’re open to healing people, regardless of what that looks like.
I’ll go into this more in a subsequent post and then link to it here, as this post has taken a different turn than originally intended (I often love it when I get curious during the writing process and deviate from the original intent).
Credentials + Evidence
Science is imperfect. Hypotheses lead to experiments. How do researchers choose hypotheses? Often, from anecdotal evidence. It always bothers me that people dismiss particular beliefs as bullshit until they’re proven in a study. Here’s the thing: Something didn’t go from being false to being true because adequately funded research provided the “right” evidence. It was true all along.
Yes, people believe all sorts of weird shit, but that doesn’t mean that it’s false. There was a time when electricity seemed like a “woo woo” concept. Lasers remained in the world of science fiction. However, the world evolves.
I state this because Dr. Brogan shares both scientific evidence and anecdotal. Her team is in the process of making more of their research publicly available, as so much of what’s available is based on the pharmaceutical industry-funded model. Not that “big pharma” is all bad, but their results, motives and advertising should always be questioned. You might need to rely on them for some things. Modern medicine is amazing and saves lives.
So much of what Dr. Brogan says resonates with me. And with her medical degree and her experience, I have tremendous respect for her and I although I do read the footnotes in her books and articles, I tend to believe what I read when I read it.
But, people believe whatever supports their worldview, and this supports my worldview. It’s not that I don’t believe the people who say that meds make them feel better, it’s that I think that it’s possible that with a different protocol they wouldn’t need meds at all. Note that I say “possible” because I don’t know. Maybe another protocol wouldn’t work for them. Evidence says that it’s worth a shot.
There are other medical doctors that I put in her category who question the system, do research, write books, and get results for patients either without medication or with medication supplemented by nutritional therapies and lifestyle changes. Some of my favourite medical doctor experts include Dr. Mark Hyman and Dr. Hyla Cass (she’s my aunt, so I’m clearly biased).
Then there are “doctors” that I trust such as Dr. Deanna Minich who has a Ph.D. and Master of Science. Dr. Minich’s doctoral (Ph.D.) research focused on essential fatty acid absorption and metabolism, and her Master of Science degree (M.S.) allowed her to explore the health benefits of colourful, plant-based carotenoids. Not a medical doctor, but still university educated in science and health.
Still, I tend to refer to footnotes, and I don’t take them at face value.
Last year, while reading a book by one prominent non-MD doctor, a Functional Medicine practitioner and Certified Clinical Nutritionist with a few sets of letters beside his name – I was interested in a specific connection he made. I was initially satisfied that there was a study referred to in the footnotes. Upon further reflection, however, I noticed that I’d only looked superficially. When I read that study – or its abstract – online I saw that it referred to something else.
The author had inferred something broadly and used that study as evidence of his statement. The truth was, his “evidence” in the form of a study noted in the footnotes wasn’t evidence at all. He was reaching and interpreting. Meh. I took some real and relevant information from the book, but as I do, I questioned much of it.
Letters beside one’s name are often present for the illusion of credibility and for vanity but can be confusing. More on that later.
A few days after I listened to the Adulting podcast that featured Dr. Brogan I read an article in Men’s Health about Dave Asprey. It’s this article that inspired the direction that this blog post you’re reading ultimately took. (Brogan’s articles generally get the wheels in my head turning and at first, this was going to go in another direction that a subsequent article will go in.)
Why do I trust some experts over others, even when they say similar things?
Dave Asprey calls himself a “biohacker”. He started the Bulletproof Coffee concept.
He’s not a doctor, though his wife is. He’s a researcher. What has struck me about Asprey for years is that he’s a marketer. He’s one hell of a storyteller. The whole Bulletproof Coffee phenomenon was built from an experience that Asprey had that he turned into a story. That story became his core narrative; his origin story. Every entrepreneur – and superhero needs one. That, and an elevator pitch, which can be a version of the origin story.
Like many superheroes (think Bruce Wayne, Tony Stark), having the financial means helps further the fight against evil.
I say this without any adverse judgment, just observation: He’s basically a rich kid who can afford toys to play with, to make himself a health guinea pig. These are the opening words from Asprey’s book The Bulletproof Diet published in 2014, and which I own:
Nearly 2 decades ago, I was a young, brand-new multi-millionaire entrepreneur in Silicon Valley.
I can’t speak about Asprey’s childhood because I don’t have that information (it’s refreshing to not be able to find that information on Google), but as far as I know, Asprey didn’t get bitten by a radioactive spider. He’s not a mutant. I’m guessing that he wasn’t stranded on a desert isle after a shipwreck sent him overboard nor forced to build weapons of mass destruction (yeah, I read graphic novels and watch movies).
In The Bulletproof Diet, Asprey shared that he came from a family of scientists (his grandparents met on The Manhattan Project, his grandmother was an award-winning nuclear scientist) and in the late 90s/early 00s was a hacker who taught engineers how to manage the internet, so hey, you never know.
The Health Story
In his book mentioned above, Asprey explains that two decades earlier he weighed nearly 300 pounds and was diagnosed with rapid onset of thrombin-induced platelet aggregation, which his doctor said put him as high risk of stroke or heart attack. It’s not Captain America’s polio, but it’s dangerous.
So that’s his story as I know it: He took health matters into his own hands, as many of us do.
The Trust factor
I don’t wholly trust Asprey. I read The Bulletproof Diet, which I own and went back to while writing this, I have read and continue to read his articles. I listen to interviews in which he’s the expert. I often do research to look for evidence to back up his claims.
While I was writing this blog post, I started to examine my own biases, and as I wrote this, I went somewhat deep with that – though I’m sure I could have gone deeper. I tend to psychoanalyze myself.
Why do I trust Max Lugavere, a health and science journalist and documentary filmmaker, over Asprey? Why are Diane Sanfilippo’s cookbooks about paleo, sugar-free and now keto lifestyles the only ones I keep in my kitchen (the rest live on a bookshelf in the basement)? She's not a medical doctor. Sanfilippo’s website describes her as, “Owner & Founder of Balanced Bites; Certified Nutrition Consultant; New York Times bestselling author… serial entrepreneur; business and marketing badass.”
The answer, I think:
Fewer wild claims. Less perceived hubris. Also, affinity.
I read Lugavere’s 2018 book Genius Foods because two of my favourite topics – especially combined – are brain health and nutrition. I went to Lugavere’s talk and book signing in Toronto and adored him. (I wanted to be his friend/big sister.)
I feel connected to Sanfilippo because she feels familiar.
Max and Diane are relatable and have relatable stories. Along with the superhero origin story, relatability and authenticity are big attractors, I think. I think that this is why people like when health coaches have a “How I healed myself” story and trust that more than a medical doctor who only has clinical experience.
Clinical knowledge, experience and an open mind
The experts I trust most have medical or dietician training/degrees but have deviated into the natural sector. When evaluating an expert, I also use my own intuition and try not to believe something solely because someone says it’s true.
I don’t trust dieticians on their own at all (unless they don’t believe what they’ve been taught) and I don’t fully trust doctors on their own. Dieticians get taught that canola oil and margarine are healthy and accept financial incentives to do so.
Doctors get paid to fix the sick and broken with medication, not promote wellness. Often what they consider “broken” is a matter of perspective or the result of a collection of symptoms that can have different meanings and root causes. Doctors often observe the symptoms without digging into the reasons for these symptoms, and they don't always reach the correct conclusion. Misdiagnoses happen. Incorrectly prescribed medication is one of the leading causes of death in the U.S. (also, improperly taken medication). The same set of symptoms can apply to many ailments, and sometimes it’s a simpler, more treatable ailment than the one diagnosed.
In the cases of many of these “experts”, money is a motivator.
Not that money as a motivator is terrible in itself but there’s money with integrity, and there’s money without.
People believe whatever supports their worldview.
Why trust me?
I’ve been thinking about my own experiences and knowledge recently. Aside from any residual imposter syndrome that I experience, I’ve asked myself, “Why should people trust me?”
I’m not sure you should, but I hope you do, and I hope you question what I tell you but not let what you thought you knew previously bias you too much.
Years ago I spoke to a trained nutritionist that I know who told me that I don’t really need certification to write. Some years later, another certified nutritionist friend – a very successful one who has helped thousands of people worldwide – told me, “You know that a lot of these certification programs aren’t recognized and are ultimately meaningless, right?”
Both of these amazing women are book authors with large followings. One has been training others for several years in various wellness issues and also to be coaches themselves, and the other recently started her own training program. The certification programs they took were in classrooms. They had hands-on experiences, exams and practicums, required for graduation. This was similar to my non-related college experience at a government-recognized institution. It was proper academic schooling, as far as I’m concerned, though I’ve noticed that one of them doesn’t refer to it publicly anymore.
My certification? Online, and it didn’t match the experience I’d expected.
Honestly, my reason for pursuing nutrition education was to have letters beside my name for credibility when I published writing, but I knew that I didn’t have the money for full-time studies and part-time studies would require evenings and weekends. My brain does not function well academically after 6 p.m. Furthermore, the local nutrition school that I was interested in was a far commute, and the closer one didn’t seem right for me. If I went with a local school, I wanted one that was recognized by certain Canadian and international organizations in the field.
I wanted a program that was convenient, and that would give me tools and resources for life. I wanted a nutritionist or health coaching program that would provide foundational information, business skills and coaching education, in case I decided to coach. Helping through teaching has always been my interest, primarily through writing.
The certification I chose ended up being taught by one person (despite having a “faculty”), with voiceovers to Powerpoint presentations and multiple choice quizzes at the end of the modules. After a while, I started trying the quizzes without watching the training videos, and I noticed that from years of research, I already knew many of the answers.
When I registered, I loved what I saw on the website (good marketing copy), and the phone call I had with their student representative in charge of guiding people to register was also encouraging. I wasn’t 100% certain, but I wanted to make a decision, and so I took a leap of faith. I signed up with the monthly payment plan. I got “certified”.
So, whether or not letters beside my name add credibility to my expertise or not is in the eye of the beholder.
My certification, which I've recently removed mention of from some places, isn't meaningful. The people who advised me of this before I pursued it were right.
At schools, the knowledge that teachers share is based on curriculum, what they’ve been taught and their own research. I can do research.
Max, Diane and others are successful, bestselling authors. Writing at least one book is on my bucket list.