12 ms·

I was an MIT educated neurosurgeon – now I'm alone in the mountains [video]

125 points by carabiner 2y ago

expertsturgeon 2y ago
I (non-US, non-neurosurgeon) work with a lot of neurosurgeons in my daily practice and here’s my two cents on this. Dude is a neurosurgeon. There are lots of other options for neurosurgeon, and some of them are really rewarding. You don’t like spine surgery because of all the aforementioned reasons? Why not try neuro-vascular surgery, where you cure stroke? Or neurosurgical oncology, where you cure cancer? Or neurosurgical trauma, where you are literally putting people’s head back together. Dude has a huge dysphoria problem with his job, probably burn-out or something, I don’t know, but throwing away years of educations is kinda wasteful.
hilbert42 2y ago
A remarkable video, I'm so glad I watched it. I can't explain why except to say you'll know after you watch it.
- xtracto 2y ago
  I got to half of it so far (will deffo watch it later). One thing that struck me was the mention of what I call the "destructive" paradigm of medicine. If we look at most current medical procedures, they are barbaric. Chopping stuff mainly. How do you fix a fissure in the anus? LIS: Chop a bit of the sphincter and hope it heals back. How do you fix GERD? Make a knot in the esophagus. How do you fix Crohns? Chop the bowel and open a hole in the stomack . Dont get me wrong, I applaud all the stuff current medicine helps with. And I'm far from a radical anti medicine . . But those things make me think that in 500 years, people will turn back and see these sort of procedures the same way we see now how our ancestors treated bacterial infections: intentional bleeding, using leeches and other similar medieval procedures. We as a society should start puahibg for more constructive or generative medicine. As the Guy in the video says, fixing the problem instead of alleviating the symptom.
  - hilbert42 2y ago
    "If we look at most current medical procedures, they are barbaric. Chopping stuff mainly." One has to agree with your view, at least partially. I've heard it said that surgeons are akin to carpenters—some are skilled craftsmen who craft fine furniture, others like builders whose skills are pretty much limited to joining bits of 2x4s but none of whom know the underlying mechanism of how trees grow or how they produce wood. Nevertheless, with the fusion of modern chemistry, a refined understanding of biological processes, and advanced computing and specialist manufacturing techniques (micro sensors etc.) we're just now beginning to see the end of some of the 'chopping'—or at least how in the future we might end it. I've been around for quite some decades so I'm unlikely to benefit from any new technique—they being too immature for deployment—but on current evidence those who are around in 50+ years are very likely to do so.
  - etrautmann 2y ago
    I haven’t watched yet but this seems highly selective. There’s so much creative building in medicine, from what’s done in orthopedics with rebuilding joints (often using a patients existing tissue with new hardware) or with reconstructive surgery, etc. if you consider medicine more broadly to include pharmacology or therapy then there’s more room for constructive creativity.
    - randerson 2y ago
      Brain surgery might be particularly skewed toward feeling barbaric. They are cutting a hole in someone’s head and digging around in brain tissue, often permanently removing tissue or skull. In 500 years time I assume they’ll give you a small drink of nanobots which find their way to the problem and solve it at the microscopic level. Until then, pass the bone saw.
  - metabagel 2y ago
    Reminds me of Star Trek IV where Bones cures a woman’s kidney disease in the 80s and rhetorically asks if it’s the “Dark Ages”. https://youtu.be/_R_WbAhKyAk?si=KSnC6OYJArhnKe0W https://youtu.be/_R_WbAhKyAk?si=KSnC6OYJArhnKe0W
  - 2y ago
epicureanideal 2y ago
Not a fan of anywhere with that many mosquitos.
- adamthegoalie 2y ago
  Yeah that’s when I started questioning his life decision
- ainiriand 2y ago
  I am not sure what would happen to the ecosystem if we remove the mosquitos but god damn I am in favor of taking the risk.
- aleph_naught 2y ago
  I have some minor PTSD from prior insect bites, and the start of that video was giving me anxiety.
carabiner 2y ago
I was pretty moved by this. It wasn't what I expected. It's his personal experience working as a neurosurgeon for 9 years, his critiques of US healthcare, his recognizance of burnout, and his escape from it all. What comes across most, especially on youtube, is his sincerity and lack of presentation or preaching. It's so personal and ends up kind of inspiring. He talks slowly and you can watch at 1.5x. Edit: Why is this flagged?
- isoprophlex 2y ago
  I vouched for it so it's temporarily back up, but I'm afraid it won't be for long. Downvoters/flaggers, please explain yourself. I've found this very thoughtful and worthy of the front page... quite long though, I'll grant you that, but the guy has something honest and genuine to say
  - rgrieselhuber 2y ago
    Downvoters and flaggers generally don't explain themselves. They lack the ability to articulate their position and simply prefer the easy buttons.
  - somenameforme 2y ago
    There's an oddly related video here. [1] It's an interview between two doctors and YouTubers, both named Mike. One is a practicing medical doctor, the other has a doctorate in sports science and provides generally provides excellent nutrition, lifting, and other advice related to body building. The reason it's relevant is because the medical doctor in that video also expresses similar views to the video from this article, yet the sports science Mike expresses radically different views. And his views are ones that even crop up on this site on occasion, so I expect it's a sort of bubble that you or I may not have even really been aware of. They get into a topic about half way through on the future. Lifting Mike thinks that by the early 2030s medical science will have made breakthroughs such that basically every disease will be cured, people will be approaching living forever, and so on. This is paired alongside a general blind faith in all things tech - that the LLMs we have today will be imminently super-geniuses surpassing human intelligence with scales of exponential growth on the orders of magnitude, every other year, and so on. Medical Mike is far more bearish on the future (and the present), though like a good host he doesn't really try to go to war with his guest, so much as just picking his brain and seeing how he responds to basic counter-points. And lifting Mike's responses are mostly to say "that's a very valid point" and then completely ignore them. In my opinion the singularity types are starting to gradually coalesce into something like a secular religion, because I don't think he really believes what he's saying, but he wants to believe it - because the thought of dying sucks. And this video (from this topic) is yet another medical doctor speaking about the questionable path we're currently on and how not only are we not making this exponential progress many seem to want to believe we are, but that the motivations involved in a lot of things like medicine today are quite broken. This isn't going to be responded to well with people who have the faith that in a decade or two we're all going to be living forever. ---------- Okay, cripes this post ended up wayyyy longer than expected. But I also want to add that once you know about this sort of divide, it's almost enlightening to read threads like this [2] (currently on the front page: "Scientists discover a cause of lupus, possible way to reverse it") and watch how the views shape people's responses. There's [fortunately] no real signaling or whatever, but just people having extremely different views on what has happened in the past and present, and even more so about what will happen in the future. [1] - https://www.youtube.com/watch?v=UrzF-rhJtOs https://www.youtube.com/watch?v=UrzF-rhJtOs [2] - https://news.ycombinator.com/item?id=40931636 https://news.ycombinator.com/item?id=40931636
threatofrain 2y ago
A dentist can fix cavities. But what was the root cause? Lifestyle. What can a dentist do about it? Largely nothing. Of course there's going to be advice to brush your teeth and avoid sugary drinks, but such advice is given to children many times over before a dentist sees a cavity. So is it myopic for a dentist to focus on fixing cavities? Is the dentist missing something big? The dental industry also experiences a problem that if everyone started brushing well then the industry would largely crash. Does that stop dentists from telling people to brush? No.
- leoh 2y ago
  You are missing the forest for the trees here
- narrator 2y ago
  The root cause is Streptococcus mutans and other bacteria in the mouth. Dentists would be out of business, except for trauma injuries, if these bacteria were eliminated.
  - Mathnerd314 2y ago
    Ellie Phillips has this triple mouthwash system, in her book "Kiss your dentist goodbye". Apparently she hasn't had her teeth cleaned in 40 years. I have been using it and it seems to work, in that my dentist says I have the best teeth out of all his patients despite me brushing my teeth maybe once a week. The motivation for the mouthwash is simply that mechanical brushing isn't sufficient to kill the bacteria, whereas mouthwash is if you can disrupt all of the biofilms. And then the other two mouthwashes are for pH and fluoride.
    - jpcookie 2y ago
      And the peer reviewed science for this being true is where? Sorry personal anecdotes don't count
      - Mathnerd314 2y ago
Hnrobert42 2y ago
I have taken career breaks. I don't call myself unemployed. To me, unemployed means that you are not working but you want to be. It seems like the terms "unemployed" and "alone in the mountains" are just being used to dramatic effect. Am I wrong?
- carabiner 2y ago
  On my sabbaticals I told people frankly that I was unemployed. Some people I know said they were "funemployed." I don't think this semantic difference is something to get worked up over.
- oskarkk 2y ago
  > To me, unemployed means that you are not working but you want to be. In economics, exactly that is the definition of unemployment: > Unemployment, according to the OECD (Organisation for Economic Co-operation and Development), is people above a specified age (usually 15) not being in paid employment or self-employment but currently available for work during the reference period. https://en.wikipedia.org/wiki/Unemployment https://en.wikipedia.org/wiki/Unemployment
- tasuki 2y ago
  > To me, unemployed means that you are not working but you want to be. To me, it does not mean that. In the very same way that "unforgettable" does not mean "I remember but want to forget".
goethes_kind 2y ago
DISCLAIMER: If you have back/spine problems and you delay surgery because you hope the problem would go away on its own, with healthy living, you might end up with damaged/dead nerves which is irreparable damage, which even a delayed surgery cannot fix. With regards to for-profit medicine, this is why I hate all market based health insurance systems. Even if you are rich and get treated like a king, you still have to question whether your doctor/surgeon is trying to sell you a procedure. The only system that does not suffer from this issue is the NHS (e.g. UK) where the incentive is lacking. The debate about health care systems tends to focus on availability and coverage, but this for-profit perverse incentive is orthogonal to all that.
- trilbyglens 2y ago
  Classic anglophonic world view. Seems like people forget that literally all of Europe has universal healthcare, with many working far better than the NHS.
- ulnarkressty 2y ago
  This is not really true unless there's something _really_ wrong with your back. For run of the mill disk hernia the patient satisfaction scores at 1 year for surgery and conservative treatment are pretty much the same [0][1]. [0] - https://bmjopen.bmj.com/content/6/12/e012938.short https://bmjopen.bmj.com/content/6/12/e012938.short [1] - https://link.springer.com/article/10.1007/s00586-010-1603-7 https://link.springer.com/article/10.1007/s00586-010-1603-7
  - wesapien 2y ago
    I've dealt with lower back issues for a long time. The worst of it was long behind me and I've been diligent enough to not have crippling events. My lower back hasn't felt as good and pain free as of today.I don't know if it was all the walking I've been doing (vacation) and the bag on my back (weird right). The biggest change was the level of stress after vacation. I haven't been on one for over 7 years. I feel much more relaxed these days but I can also tell that everyday this "stress bucket" is slowly getting filled by daily life and I have to dump it all out by doing something other than the ordinary. I'm not a super healthy eater but I'm conscientious about it. I'm not a gym goer or even home exerciser. Once in a while, I'd use my weights and do somebody weight exercises.I don't eat fruits and vegetables as much as one should. I also know that there is great variability in humans. I'm also much more aware of my body and what it needs as far as physical therapy exercises. I've a lot of time watching videos on physical therapy and back pain. I spend the most of my time at home walking on a treadmill while watching something on the TV.
kehphin 2y ago
Very poignant and from the heart! Thank you for sharing. But oh man, when that mosquito was on his cheek, I got so anxious about whether or not he'd slap it away...
DataDive 2y ago
The channel contains 10-hour-long videos of natural sounds. Maybe the post is less about what is right or wrong in medicine and more about the author having gone into the wrong field, which is opposite to what they enjoy in life. Perhaps all along, the author misunderstood what modern medicine is about and how life really works. There is no miracle cure that would restore the neural system. There is a miracle prevention however, be active, exercise, eat well, sleep well, enjoy life, contribute to society. That will help your back more than surgery once things go bad.
- jpcookie 2y ago
  Yeah "positive thinking and going with the flow will fix disease". Tell me: why didn't everyone 1000 years ago live to be a hundred everywhere? Oh that's right: because it's not that simple.
  - sethammons 2y ago
    People long ago seem to all have great, straight teeth, and strong bones. Also a lot of them were killed by a rock to the head. Give and take, I guess
    - trilbyglens 2y ago
      Lol. Or dead in childbirth at 14, or dead from gangrene from a small cut, or dead from diabetes or asthma or simple nearsightedness.
    - willsmith72 2y ago
      You think more people used to die from fighting in ancient than in modern times?
      - sethammons 2y ago
        Absolutely. We live in the most peaceful and least violent age of all recorded human history. https://towardsdatascience.com/has-global-violence-declined-a-look-at-the-data-5af708f47fba https://towardsdatascience.com/has-global-violence-declined-...
deleted 2y ago
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Narhem 2y ago
Super cool project.
spacetimeuser5 2y ago
He could have tried injecting senolytics into the weared disks to remove senescent inflammatory phenotypes, as there is some research in senolytics (dasatinib+quercetin) improving arthritic knee joints by removal of senescent inflammatory cells which allows the new cartilage to grow.
- rozap 2y ago
  I'm actually laughing quite hard at this. This may be the most HN take I think I've ever seen. "20 year career in neurology, but there's this one weird trick that will fix everything"
zerof1l 2y ago
I suggest watching the whole video, I found it very interesting. Here's my attempt to summarize the key points. An MIT-educated neurosurgeon quit his job after realizing surgeries weren’t addressing the root cause of patients’ problems. He observed that the outcome of surgeries would vary greatly: for some it would help, for others a bit and for others, it would not help at all even though he performed them perfectly every time. Some patients even called before the surgery to say that they were okay and no longer needed surgery. So he started asking patients questions and after 9 years he concluded that patients who got better and healed did the following (at 19:42 in the video): low salt diet; mostly plant-based diet; did things that would cause sweat: exercise, sauna, or living in hot weather; did not smoke; drank little to no alcohol; had good social support: family, friends, etc; slept 8 hours a day; were not stressed or managed to release it back, e.g. meditate. Then he talks about the moral dilemma. If he helps patients to truly heal by sharing what he has learned, he and the hospital would not make money.
- kazinator 2y ago
  The combination of low salt intake and {exercise/sauna/hot weather} is poor advice. If your salt intake is low, and you start sweating due to hot weather, exercise or a new-found interest in saunas, you probably need to bump that up.
  - careless_lisper 2y ago
    Google tells me that Americans consume on average 3.5g of salt, while the recommended intake is 2.3g. Quite some room there to decrease salt consumption.
- omnimus 2y ago
  So he concluded that we should destroy capitalism?
  - samiru 2y ago
    No. The way we have built our healthcare system on top of private actors (at least here in Finland) has very little to do with capitalism. Successful lobbying, if not straight corruption, would be closer to the current situation.
DoingIsLearning 2y ago
This part resonated: ".. When you let go of something you are holding too tightly, even though it's hurting you. When you let go of it, then you are able to pick up something else that is hopefully better for you." Despite all the post-rationalization on the why's of medicine, it does feel like he is someone bouncing back from Burnout. The risk being that he may fall into the opposite end of the pendulum swing. As the saying goes: "A ship in harbour is safe, but that is not what ships are built for." In the end there is a balance to everything, I hope he finds his.
deleted 2y ago
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O1111OOO 2y ago
When he isn't talking about medicine, I get very strong Chris McCandless vibes. That need to be free, away from modern life, the demands, the unnecessary stress. Maybe get away from people too (which is harder to admit to... people directly). I haven't come across a video yet but I'm sure he's better prepared for outdoor living than some others that have done similar. There's a large sub-community of Van Lifers doing similar. With a little planning and preparation, it's a great life. Especially for those that clearly need to get away from it all. I can't imagine how difficult the decision was. He basically said that his entire 9 year career was emotionally difficult. That is a heavy burden to bear for so long. I'm certain that his upbringing, his years of preparation, the expectations of the world... made the decision to walk away (without a plan) seem overwhelming. Still... he broke free from all of that! Honestly... I feel so happy for him. To be able to make the decision and implement it. To be at a point where he can begin talking about it, freely. To be connected to civilization on his terms. To live his life in a way that makes him happy.
vehicles2b 2y ago
I'm wondering, does anyone know what are the chances for returning to neurosurgery after an extended hiatus? Person in the video practiced for a decade (edit: nearly a decade of practice, and two decades total including training), I'm sure burnout is common in the field, but I wonder if people that left ever make their way back.
- moneywoes 2y ago
  why not? isn't their a shortage
- silverquiet 2y ago
  I'm more curious if he could re-specialize in a surgery that he finds more rewarding. I'd think orthopedics could provide very clear and quick resolutions for patients; hip replacement is known as the "surgery of the [previous] century" for having such clear quality of life improvement.
  - chubot 2y ago
    Yeah that was partly my reaction too ... Why not steer your career -- i.e. accept a temporary setback -- instead of walking away from the whole thing? But it sounds like he already did that once. The first part of the video talked about how he wanted to specialize in brain-machine interfaces, and then he came to the belief that the approach would never work. It did feel like he had very high expectations for himself. Almost a bit of a hero complex. But I don't think that's a bad thing. I think we need people like this to tell us the truth sometimes! It's not the whole truth, but what he's saying is definitely part of the truth. --- As a particular example, I have noticed that doctors and dentists don't talk to each other ... It's not overstating it to say "the system" essentially discourages that. But your body doesn't know anything about these divisions, and I agree with the observation that the mouth is one of the two main openings in the body and is central to health !! i.e. the condition of your teeth are a good indicator of general health, not just dental health This relates to the part of the video where he says: "if your body heals, it doesn't just heal the spine -- it heals everything" It is comforting to know that people can see with what I think of as "blank mind" -- see and think from first principles -- rather than falling back on all the technical jargon that we use to justify ourselves and our jobs
2-3-7-43-1807 2y ago
netflix special ... when?

125 points by carabiner 2y ago

I (non-US, non-neurosurgeon) work with a lot of neurosurgeons in my daily practice and here’s my two cents on this. Dude is a neurosurgeon. There are lots of other options for neurosurgeon, and some of them are really rewarding. You don’t like spine surgery because of all the aforementioned reasons? Why not try neuro-vascular surgery, where you cure stroke? Or neurosurgical oncology, where you cure cancer? Or neurosurgical trauma, where you are literally putting people’s head back together. Dude has a huge dysphoria problem with his job, probably burn-out or something, I don’t know, but throwing away years of educations is kinda wasteful.

hilbert42 2y ago

A remarkable video, I'm so glad I watched it. I can't explain why except to say you'll know after you watch it.

xtracto 2y ago
I got to half of it so far (will deffo watch it later). One thing that struck me was the mention of what I call the "destructive" paradigm of medicine. If we look at most current medical procedures, they are barbaric. Chopping stuff mainly. How do you fix a fissure in the anus? LIS: Chop a bit of the sphincter and hope it heals back. How do you fix GERD? Make a knot in the esophagus. How do you fix Crohns? Chop the bowel and open a hole in the stomack . Dont get me wrong, I applaud all the stuff current medicine helps with. And I'm far from a radical anti medicine . . But those things make me think that in 500 years, people will turn back and see these sort of procedures the same way we see now how our ancestors treated bacterial infections: intentional bleeding, using leeches and other similar medieval procedures. We as a society should start puahibg for more constructive or generative medicine. As the Guy in the video says, fixing the problem instead of alleviating the symptom.
- hilbert42 2y ago
  "If we look at most current medical procedures, they are barbaric. Chopping stuff mainly." One has to agree with your view, at least partially. I've heard it said that surgeons are akin to carpenters—some are skilled craftsmen who craft fine furniture, others like builders whose skills are pretty much limited to joining bits of 2x4s but none of whom know the underlying mechanism of how trees grow or how they produce wood. Nevertheless, with the fusion of modern chemistry, a refined understanding of biological processes, and advanced computing and specialist manufacturing techniques (micro sensors etc.) we're just now beginning to see the end of some of the 'chopping'—or at least how in the future we might end it. I've been around for quite some decades so I'm unlikely to benefit from any new technique—they being too immature for deployment—but on current evidence those who are around in 50+ years are very likely to do so.
- etrautmann 2y ago
  I haven’t watched yet but this seems highly selective. There’s so much creative building in medicine, from what’s done in orthopedics with rebuilding joints (often using a patients existing tissue with new hardware) or with reconstructive surgery, etc. if you consider medicine more broadly to include pharmacology or therapy then there’s more room for constructive creativity.
  - randerson 2y ago
    Brain surgery might be particularly skewed toward feeling barbaric. They are cutting a hole in someone’s head and digging around in brain tissue, often permanently removing tissue or skull. In 500 years time I assume they’ll give you a small drink of nanobots which find their way to the problem and solve it at the microscopic level. Until then, pass the bone saw.
- metabagel 2y ago
  Reminds me of Star Trek IV where Bones cures a woman’s kidney disease in the 80s and rhetorically asks if it’s the “Dark Ages”. https://youtu.be/_R_WbAhKyAk?si=KSnC6OYJArhnKe0W https://youtu.be/_R_WbAhKyAk?si=KSnC6OYJArhnKe0W
- 2y ago

epicureanideal 2y ago

Not a fan of anywhere with that many mosquitos.

adamthegoalie 2y ago
Yeah that’s when I started questioning his life decision
ainiriand 2y ago
I am not sure what would happen to the ecosystem if we remove the mosquitos but god damn I am in favor of taking the risk.
aleph_naught 2y ago
I have some minor PTSD from prior insect bites, and the start of that video was giving me anxiety.

carabiner 2y ago

I was pretty moved by this. It wasn't what I expected. It's his personal experience working as a neurosurgeon for 9 years, his critiques of US healthcare, his recognizance of burnout, and his escape from it all. What comes across most, especially on youtube, is his sincerity and lack of presentation or preaching. It's so personal and ends up kind of inspiring. He talks slowly and you can watch at 1.5x. Edit: Why is this flagged?

isoprophlex 2y ago
I vouched for it so it's temporarily back up, but I'm afraid it won't be for long. Downvoters/flaggers, please explain yourself. I've found this very thoughtful and worthy of the front page... quite long though, I'll grant you that, but the guy has something honest and genuine to say
- rgrieselhuber 2y ago
  Downvoters and flaggers generally don't explain themselves. They lack the ability to articulate their position and simply prefer the easy buttons.
- somenameforme 2y ago
  There's an oddly related video here. [1] It's an interview between two doctors and YouTubers, both named Mike. One is a practicing medical doctor, the other has a doctorate in sports science and provides generally provides excellent nutrition, lifting, and other advice related to body building. The reason it's relevant is because the medical doctor in that video also expresses similar views to the video from this article, yet the sports science Mike expresses radically different views. And his views are ones that even crop up on this site on occasion, so I expect it's a sort of bubble that you or I may not have even really been aware of. They get into a topic about half way through on the future. Lifting Mike thinks that by the early 2030s medical science will have made breakthroughs such that basically every disease will be cured, people will be approaching living forever, and so on. This is paired alongside a general blind faith in all things tech - that the LLMs we have today will be imminently super-geniuses surpassing human intelligence with scales of exponential growth on the orders of magnitude, every other year, and so on. Medical Mike is far more bearish on the future (and the present), though like a good host he doesn't really try to go to war with his guest, so much as just picking his brain and seeing how he responds to basic counter-points. And lifting Mike's responses are mostly to say "that's a very valid point" and then completely ignore them. In my opinion the singularity types are starting to gradually coalesce into something like a secular religion, because I don't think he really believes what he's saying, but he wants to believe it - because the thought of dying sucks. And this video (from this topic) is yet another medical doctor speaking about the questionable path we're currently on and how not only are we not making this exponential progress many seem to want to believe we are, but that the motivations involved in a lot of things like medicine today are quite broken. This isn't going to be responded to well with people who have the faith that in a decade or two we're all going to be living forever. ---------- Okay, cripes this post ended up wayyyy longer than expected. But I also want to add that once you know about this sort of divide, it's almost enlightening to read threads like this [2] (currently on the front page: "Scientists discover a cause of lupus, possible way to reverse it") and watch how the views shape people's responses. There's [fortunately] no real signaling or whatever, but just people having extremely different views on what has happened in the past and present, and even more so about what will happen in the future. [1] - https://www.youtube.com/watch?v=UrzF-rhJtOs https://www.youtube.com/watch?v=UrzF-rhJtOs [2] - https://news.ycombinator.com/item?id=40931636 https://news.ycombinator.com/item?id=40931636

threatofrain 2y ago

A dentist can fix cavities. But what was the root cause? Lifestyle. What can a dentist do about it? Largely nothing. Of course there's going to be advice to brush your teeth and avoid sugary drinks, but such advice is given to children many times over before a dentist sees a cavity. So is it myopic for a dentist to focus on fixing cavities? Is the dentist missing something big? The dental industry also experiences a problem that if everyone started brushing well then the industry would largely crash. Does that stop dentists from telling people to brush? No.

leoh 2y ago
You are missing the forest for the trees here
narrator 2y ago
The root cause is Streptococcus mutans and other bacteria in the mouth. Dentists would be out of business, except for trauma injuries, if these bacteria were eliminated.
- Mathnerd314 2y ago
  Ellie Phillips has this triple mouthwash system, in her book "Kiss your dentist goodbye". Apparently she hasn't had her teeth cleaned in 40 years. I have been using it and it seems to work, in that my dentist says I have the best teeth out of all his patients despite me brushing my teeth maybe once a week. The motivation for the mouthwash is simply that mechanical brushing isn't sufficient to kill the bacteria, whereas mouthwash is if you can disrupt all of the biofilms. And then the other two mouthwashes are for pH and fluoride.
  - jpcookie 2y ago
    And the peer reviewed science for this being true is where? Sorry personal anecdotes don't count
    - Mathnerd314 2y ago

Hnrobert42 2y ago

I have taken career breaks. I don't call myself unemployed. To me, unemployed means that you are not working but you want to be. It seems like the terms "unemployed" and "alone in the mountains" are just being used to dramatic effect. Am I wrong?

carabiner 2y ago
On my sabbaticals I told people frankly that I was unemployed. Some people I know said they were "funemployed." I don't think this semantic difference is something to get worked up over.
oskarkk 2y ago
> To me, unemployed means that you are not working but you want to be. In economics, exactly that is the definition of unemployment: > Unemployment, according to the OECD (Organisation for Economic Co-operation and Development), is people above a specified age (usually 15) not being in paid employment or self-employment but currently available for work during the reference period. https://en.wikipedia.org/wiki/Unemployment https://en.wikipedia.org/wiki/Unemployment
tasuki 2y ago
> To me, unemployed means that you are not working but you want to be. To me, it does not mean that. In the very same way that "unforgettable" does not mean "I remember but want to forget".

goethes_kind 2y ago

DISCLAIMER: If you have back/spine problems and you delay surgery because you hope the problem would go away on its own, with healthy living, you might end up with damaged/dead nerves which is irreparable damage, which even a delayed surgery cannot fix. With regards to for-profit medicine, this is why I hate all market based health insurance systems. Even if you are rich and get treated like a king, you still have to question whether your doctor/surgeon is trying to sell you a procedure. The only system that does not suffer from this issue is the NHS (e.g. UK) where the incentive is lacking. The debate about health care systems tends to focus on availability and coverage, but this for-profit perverse incentive is orthogonal to all that.

trilbyglens 2y ago
Classic anglophonic world view. Seems like people forget that literally all of Europe has universal healthcare, with many working far better than the NHS.
ulnarkressty 2y ago
This is not really true unless there's something _really_ wrong with your back. For run of the mill disk hernia the patient satisfaction scores at 1 year for surgery and conservative treatment are pretty much the same [0][1]. [0] - https://bmjopen.bmj.com/content/6/12/e012938.short https://bmjopen.bmj.com/content/6/12/e012938.short [1] - https://link.springer.com/article/10.1007/s00586-010-1603-7 https://link.springer.com/article/10.1007/s00586-010-1603-7
- wesapien 2y ago
  I've dealt with lower back issues for a long time. The worst of it was long behind me and I've been diligent enough to not have crippling events. My lower back hasn't felt as good and pain free as of today.I don't know if it was all the walking I've been doing (vacation) and the bag on my back (weird right). The biggest change was the level of stress after vacation. I haven't been on one for over 7 years. I feel much more relaxed these days but I can also tell that everyday this "stress bucket" is slowly getting filled by daily life and I have to dump it all out by doing something other than the ordinary. I'm not a super healthy eater but I'm conscientious about it. I'm not a gym goer or even home exerciser. Once in a while, I'd use my weights and do somebody weight exercises.I don't eat fruits and vegetables as much as one should. I also know that there is great variability in humans. I'm also much more aware of my body and what it needs as far as physical therapy exercises. I've a lot of time watching videos on physical therapy and back pain. I spend the most of my time at home walking on a treadmill while watching something on the TV.

kehphin 2y ago

Very poignant and from the heart! Thank you for sharing. But oh man, when that mosquito was on his cheek, I got so anxious about whether or not he'd slap it away...

DataDive 2y ago

The channel contains 10-hour-long videos of natural sounds. Maybe the post is less about what is right or wrong in medicine and more about the author having gone into the wrong field, which is opposite to what they enjoy in life. Perhaps all along, the author misunderstood what modern medicine is about and how life really works. There is no miracle cure that would restore the neural system. There is a miracle prevention however, be active, exercise, eat well, sleep well, enjoy life, contribute to society. That will help your back more than surgery once things go bad.

jpcookie 2y ago
Yeah "positive thinking and going with the flow will fix disease". Tell me: why didn't everyone 1000 years ago live to be a hundred everywhere? Oh that's right: because it's not that simple.
- sethammons 2y ago
  People long ago seem to all have great, straight teeth, and strong bones. Also a lot of them were killed by a rock to the head. Give and take, I guess
  - trilbyglens 2y ago
    Lol. Or dead in childbirth at 14, or dead from gangrene from a small cut, or dead from diabetes or asthma or simple nearsightedness.
  - willsmith72 2y ago
    You think more people used to die from fighting in ancient than in modern times?
    - sethammons 2y ago
      Absolutely. We live in the most peaceful and least violent age of all recorded human history. https://towardsdatascience.com/has-global-violence-declined-a-look-at-the-data-5af708f47fba https://towardsdatascience.com/has-global-violence-declined-...

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Narhem 2y ago

Super cool project.

spacetimeuser5 2y ago

He could have tried injecting senolytics into the weared disks to remove senescent inflammatory phenotypes, as there is some research in senolytics (dasatinib+quercetin) improving arthritic knee joints by removal of senescent inflammatory cells which allows the new cartilage to grow.

rozap 2y ago
I'm actually laughing quite hard at this. This may be the most HN take I think I've ever seen. "20 year career in neurology, but there's this one weird trick that will fix everything"

zerof1l 2y ago

I suggest watching the whole video, I found it very interesting. Here's my attempt to summarize the key points. An MIT-educated neurosurgeon quit his job after realizing surgeries weren’t addressing the root cause of patients’ problems. He observed that the outcome of surgeries would vary greatly: for some it would help, for others a bit and for others, it would not help at all even though he performed them perfectly every time. Some patients even called before the surgery to say that they were okay and no longer needed surgery. So he started asking patients questions and after 9 years he concluded that patients who got better and healed did the following (at 19:42 in the video): low salt diet; mostly plant-based diet; did things that would cause sweat: exercise, sauna, or living in hot weather; did not smoke; drank little to no alcohol; had good social support: family, friends, etc; slept 8 hours a day; were not stressed or managed to release it back, e.g. meditate. Then he talks about the moral dilemma. If he helps patients to truly heal by sharing what he has learned, he and the hospital would not make money.

kazinator 2y ago
The combination of low salt intake and {exercise/sauna/hot weather} is poor advice. If your salt intake is low, and you start sweating due to hot weather, exercise or a new-found interest in saunas, you probably need to bump that up.
- careless_lisper 2y ago
  Google tells me that Americans consume on average 3.5g of salt, while the recommended intake is 2.3g. Quite some room there to decrease salt consumption.
omnimus 2y ago
So he concluded that we should destroy capitalism?
- samiru 2y ago
  No. The way we have built our healthcare system on top of private actors (at least here in Finland) has very little to do with capitalism. Successful lobbying, if not straight corruption, would be closer to the current situation.

DoingIsLearning 2y ago

This part resonated: ".. When you let go of something you are holding too tightly, even though it's hurting you. When you let go of it, then you are able to pick up something else that is hopefully better for you." Despite all the post-rationalization on the why's of medicine, it does feel like he is someone bouncing back from Burnout. The risk being that he may fall into the opposite end of the pendulum swing. As the saying goes: "A ship in harbour is safe, but that is not what ships are built for." In the end there is a balance to everything, I hope he finds his.

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O1111OOO 2y ago

When he isn't talking about medicine, I get very strong Chris McCandless vibes. That need to be free, away from modern life, the demands, the unnecessary stress. Maybe get away from people too (which is harder to admit to... people directly). I haven't come across a video yet but I'm sure he's better prepared for outdoor living than some others that have done similar. There's a large sub-community of Van Lifers doing similar. With a little planning and preparation, it's a great life. Especially for those that clearly need to get away from it all. I can't imagine how difficult the decision was. He basically said that his entire 9 year career was emotionally difficult. That is a heavy burden to bear for so long. I'm certain that his upbringing, his years of preparation, the expectations of the world... made the decision to walk away (without a plan) seem overwhelming. Still... he broke free from all of that! Honestly... I feel so happy for him. To be able to make the decision and implement it. To be at a point where he can begin talking about it, freely. To be connected to civilization on his terms. To live his life in a way that makes him happy.

vehicles2b 2y ago

I'm wondering, does anyone know what are the chances for returning to neurosurgery after an extended hiatus? Person in the video practiced for a decade (edit: nearly a decade of practice, and two decades total including training), I'm sure burnout is common in the field, but I wonder if people that left ever make their way back.

moneywoes 2y ago
why not? isn't their a shortage
silverquiet 2y ago
I'm more curious if he could re-specialize in a surgery that he finds more rewarding. I'd think orthopedics could provide very clear and quick resolutions for patients; hip replacement is known as the "surgery of the [previous] century" for having such clear quality of life improvement.
- chubot 2y ago
  Yeah that was partly my reaction too ... Why not steer your career -- i.e. accept a temporary setback -- instead of walking away from the whole thing? But it sounds like he already did that once. The first part of the video talked about how he wanted to specialize in brain-machine interfaces, and then he came to the belief that the approach would never work. It did feel like he had very high expectations for himself. Almost a bit of a hero complex. But I don't think that's a bad thing. I think we need people like this to tell us the truth sometimes! It's not the whole truth, but what he's saying is definitely part of the truth. --- As a particular example, I have noticed that doctors and dentists don't talk to each other ... It's not overstating it to say "the system" essentially discourages that. But your body doesn't know anything about these divisions, and I agree with the observation that the mouth is one of the two main openings in the body and is central to health !! i.e. the condition of your teeth are a good indicator of general health, not just dental health This relates to the part of the video where he says: "if your body heals, it doesn't just heal the spine -- it heals everything" It is comforting to know that people can see with what I think of as "blank mind" -- see and think from first principles -- rather than falling back on all the technical jargon that we use to justify ourselves and our jobs

2-3-7-43-1807 2y ago

netflix special ... when?