Nothing shook my faith in the medical system more than having kids.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
> Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
> Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence".
It was Molière (<1622 - 1673), who wrote a play that featured an apothecary (explaining the functioning of opium to laymen), but no examinations.
My sister wouldn't sleep. The doctor constantly gave the "sigh, you're an idiot, you just do X and Y and they sleep" talk to my mother because nothing came up on their screening, even though my mother almost wanted to scream that something was clearly wrong and abnormal. Turns out, different doctor, serious vitamin deficiency.
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
It’s especially a problem with women and minorities. Doctors just don’t believe them. I’m neither of those and I had to convince my doctor that I had Lyme disease. I had the bullseye right where the tick had bit me. It was clearly Lyme disease. He assumed it couldn’t be because it took 8 weeks for the bullseye to show up (it’s usually a matter of days in America). He did not know that European Lyme disease takes much longer for the bullseye to appear. He at least had the tact to call me later and apologize after he did more research
> unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
Maternal milk is better than formula in every possible way and there is a perfect scientific consensus around this. Formula is the least worst substitute to maternal milk but going around and screaming that formula is perfectly fine, as if it was as good (or even better!) than maternal milk is denying some very well-established piece of science for likely ideological reasons.
Formula is adequate as far as macronutrients go, but it lacks sugars present (at varying levels-about 20% of the population are FUT2 non-secretors and cannot produce the α1,2-fucosyltransferase enzyme that is used to make human milk oligosaccharides), stem cells and bacteria present in breast milk. Women in the US are often deficient in the strain that can metabolize the human milk oligosaccharides, b. infantis, and it's not clear afaik to what extent bacteria gets passed vertically in breastmilk. The microRNA present in breastmilk can modulate gene expression, but the extent and effects are unclear.
B. infantis and human milk oligosaccharides create a feedback loop that encourages the formation of a robust immune system during a critical period [1]. Some formulas contain b. infantis, and some contain 2'FL, the HMO present in breastmilk. The most robust strain is EVC001, which has been shown to be present at a year after 21 days of supplementation. In an observational study, it reduced the diagnosis of necrotizing enterocolitis in very low birth rate infants by 73% [2].
I wish this was common knowledge, but most formulas do not contain these (often they contain other pre and probiotics) and babies are missing out on the specific sugars and bacteria that we know impact the development of the immune system.
Our twins were put into my wife's arms, and we were wheeled into a room to stay for 48 hrs, being woken up every 2 hours by a nurse, which would wake up our kids, making the whole thing a living nightmare. I have no idea how I drove home.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
Same experience. The medical system is a reflection of pop parenting culture or vice versa. Everyone was so gung ho on breastfeeding, but when the milk didn’t come in and our son wasn’t interested in a dry breast the only advice given was “keep trying”. Then the shock and surprise when baby is losing weight. We had to demand formula, which was given grudgingly, and left the hospital a day later. If we have another we will do breast plus formula from the get go.
> The medical system is a reflection of pop parenting culture
Indeed. And not just in relation to parenting. The average doctor is constantly trying to emulate TV doctors, just like the average police detective is influenced by what they see on CSI, and every archaeologist wants to be Indiana Jones or Lara Croft. It would be hilarious, if it didn't have such disastrous consequences for regular people every day.
After 5 kids in 10 years, you come to realize that the standards aren't agreed upon, and best practices/recommendations change YEAR TO YEAR without fail.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
There are a lot of really good benefits to breastfeeding but it's not going to work for everybody or in every situation. I wouldn't fault a doctor for recommending it, but they shouldn't make someone feel bad if it isn't working out.
I want recommendations and best practices to change as our understanding of things improve though. The alternative would mean that either no more research is being done, or doctors are just ignoring anything they didn't learn while in school.
My partner is a GP who has been doing early childhood screening. One thing she learnt after doing a special training is that advice on proper breastfeeding is very difficult to find. She found that with many mothers that had problems, some small adjustments could often make a huge difference (often causing a kind of hallelujah moment for the mothers). The issue is much of the advice given at the hospital is wrong or insufficient.
The training the she did is the possums program from Australia, if somebody wants to look it up I think some resources are available for free.
The worst encounters I have had with nurses have been with older ones filtering information and using out of date practices because they think they have seen it all and now know best.
The justice system does the best it can with the information it has. It is far from perfect. It makes horrible mistakes all the time. The problem, of course, is improving it without knock-on effects making it worse.
There are huge swaths of people doing the work required to make it better, every day. It's not as easy as turning a dial from "bad" to "good"
No. When it comes to evaluating forensic evidence lawyers are, by training, too process oriented to solve the problems.
Ask a prosecutor what the error rate is for fingerprints or DNA evidence and you’ll get a blank stare. They don’t even try to measure it.
A lot of doctors are process oriented as well. Which is fine most of the time. But I was similarly disturbed when a specialist had zero clue what the approx half life of one of the primary drugs they use was. There was a situation that didn’t fit the book and i just looked it up for them on the spot. They didn’t like me.
You're telling me no defense lawyer thinks about arguing the evidence is unreliable or are you just saying the prosecution throws everything they can find at their side of the case? The former seems extremely hard to believe (lest you're about to become the greatest defense lawmaker of all time due to wisdom shared in a short HN comment) and the latter seems to be evidence of the system working both well and as designed, not evidence it's badly faulty.
There are also huge swaths of people actively trying to make it worse, that's what the FBI did (does?) for years when it knowingly pushed junk forensics.
Or what basically every prosecution does, when it knows that the science behind some things isn't airtight but still presents it in the best possible light to get a conviction.
It's not a justice system, it's a Law and Order system: It's not designed to deliver justice, it's designed to resolve disputes relatively cheaply, while allowing for spending more money to get better results.
> A system that does not incarcerate anyone for any reason would be much preferable
surely you don't actually believe that? I don't think the result of this is just 0 false positives. The result of that is a lot more crime, and a lot more injustice.
to be replaced with what? i'm all for making changes that are an improvement, but just burning it to the ground for the sake of it with no end game is not an improvement
The justice system is doing what the doctors tell them. Broadly speaking If a medical professional testifies that this is the only way, what qualifications does a DA have to question him? Medicine is a profession; thus the professional body ought to be addressing this and, if the guidance changes, be advocating and lobbying to Congress that people start being released.
> If a medical professional testifies that this is the only way, what qualifications does a DA have to question him?
Questioning witnesses is literally the DA's job. That doesn't magically stop being the case just because the witness is an expert. The DA is indeed qualified for this. You could even say it's one of the main reasons the DA exists.
Got it. So the DA is supposed to not only be an expert in the law, but enough of an expert in medicine such that he can flaunt widely acknowledged medical standards while cross-examining expert witnesses on why they're wrong.
The author of this post admitted that it took him countless hours to discover that medicine basically has this issue wrong and only after being particularly motivated to do so. If the DA has so much medical expertise that they know better than the doctors, then what exactly is he doing being a DA?
The idea that the main purpose of the DA is to know better than doctors is ludicrous.
Nothing shook my faith in the medical system more than having kids.
Holy cow is modern medicine still as smugly wrong as it’s always been. Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
And as a result you get unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
> Every generation laughs at all the stupid stuff the previous generations believed, and then acts so confident that they’ve got it right this time.
Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence". This is a bit like saying that things with an essence of gravity fall towards the earth, whereas things with an essence of levity float towards the sky. The examiner proudly accepts that answer and bestows upon the student the title of doctor.
This was very funny to anyone educated in the time Voltaire was writing, since they would have known that morphine puts people to sleep because... it has round molecules with no sharp edges...
Edit: correction below, thank you thaumasiotes.
> Voltaire (1694-1778) wrote a satirical account of a medieval university's oral examination on medicine: the examiner asks why morphine puts people to sleep, and the student confidently replies that morphine has a "dormative essence".
It was Molière (<1622 - 1673), who wrote a play that featured an apothecary (explaining the functioning of opium to laymen), but no examinations.
https://en.wikipedia.org/wiki/The_Imaginary_Invalid
I used to enjoy this blog written by a person who hated US medical school:
https://web.archive.org/web/20101218031844/http://www.medsch...
People will probably find it offensive but it does explain a lot about why the stuff being taught is almost always not questioned.
This post in particular:
https://web.archive.org/web/20101211180021/http://www.medsch...
My sister wouldn't sleep. The doctor constantly gave the "sigh, you're an idiot, you just do X and Y and they sleep" talk to my mother because nothing came up on their screening, even though my mother almost wanted to scream that something was clearly wrong and abnormal. Turns out, different doctor, serious vitamin deficiency.
And medical incompetence by staff, not doctors, is also awful. My brother hated reading. He got glasses, still hated reading, my mother wondered why he could be so disobedient in that regard. They said, well, the prescription is right, he can clearly see fine. Turns out two years later that the lenses were installed on opposite sides. Right lens on left eye, left lens on right eye. A simple mistake, but the consequences...
It’s especially a problem with women and minorities. Doctors just don’t believe them. I’m neither of those and I had to convince my doctor that I had Lyme disease. I had the bullseye right where the tick had bit me. It was clearly Lyme disease. He assumed it couldn’t be because it took 8 weeks for the bullseye to show up (it’s usually a matter of days in America). He did not know that European Lyme disease takes much longer for the bullseye to appear. He at least had the tact to call me later and apologize after he did more research
I do find it bizarre they don't verify you can see with your actual glasses.
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[dead]
> unworthy nurses making moms feel intense shame for not “trying hard enough” to somehow magically produce milk.
Stay away from mommy blogs/forums. Those are the most toxic cesspools I've ever witnessed. Things are changing, some of the newer ones are not nearly as bad, but man the judgement is super real.
Nurses are one thing, but personally, the worst is family members who think they know better and don't understand the data and that times have changed.
FORMULA IS PERFECTLY FINE.
Maternal milk is better than formula in every possible way and there is a perfect scientific consensus around this. Formula is the least worst substitute to maternal milk but going around and screaming that formula is perfectly fine, as if it was as good (or even better!) than maternal milk is denying some very well-established piece of science for likely ideological reasons.
6 replies →
Formula is adequate as far as macronutrients go, but it lacks sugars present (at varying levels-about 20% of the population are FUT2 non-secretors and cannot produce the α1,2-fucosyltransferase enzyme that is used to make human milk oligosaccharides), stem cells and bacteria present in breast milk. Women in the US are often deficient in the strain that can metabolize the human milk oligosaccharides, b. infantis, and it's not clear afaik to what extent bacteria gets passed vertically in breastmilk. The microRNA present in breastmilk can modulate gene expression, but the extent and effects are unclear.
B. infantis and human milk oligosaccharides create a feedback loop that encourages the formation of a robust immune system during a critical period [1]. Some formulas contain b. infantis, and some contain 2'FL, the HMO present in breastmilk. The most robust strain is EVC001, which has been shown to be present at a year after 21 days of supplementation. In an observational study, it reduced the diagnosis of necrotizing enterocolitis in very low birth rate infants by 73% [2].
I wish this was common knowledge, but most formulas do not contain these (often they contain other pre and probiotics) and babies are missing out on the specific sugars and bacteria that we know impact the development of the immune system.
1. https://www.cell.com/cell/fulltext/S0092-8674(21)00660-7 2. https://pubmed.ncbi.nlm.nih.gov/35032555/
5 replies →
What are some good mom blogs?
1 reply →
Our twins were put into my wife's arms, and we were wheeled into a room to stay for 48 hrs, being woken up every 2 hours by a nurse, which would wake up our kids, making the whole thing a living nightmare. I have no idea how I drove home.
They had no care for my wife's ability to heal, rest, or anything, just subjecting us to the worst kind of institutionalized checklist torture. The medical system cares for nothing other than preventing lawsuits and providing a place for doctors to do their 1 hr of work on their 18 patients a day.
Same experience. The medical system is a reflection of pop parenting culture or vice versa. Everyone was so gung ho on breastfeeding, but when the milk didn’t come in and our son wasn’t interested in a dry breast the only advice given was “keep trying”. Then the shock and surprise when baby is losing weight. We had to demand formula, which was given grudgingly, and left the hospital a day later. If we have another we will do breast plus formula from the get go.
> We had to demand formula
I don’t understand. You can’t just go to the store and buy infant formula?
4 replies →
> The medical system is a reflection of pop parenting culture
Indeed. And not just in relation to parenting. The average doctor is constantly trying to emulate TV doctors, just like the average police detective is influenced by what they see on CSI, and every archaeologist wants to be Indiana Jones or Lara Croft. It would be hilarious, if it didn't have such disastrous consequences for regular people every day.
2 replies →
After 5 kids in 10 years, you come to realize that the standards aren't agreed upon, and best practices/recommendations change YEAR TO YEAR without fail.
Breastfeeding is one of the worst things hoisted upon mothers who are told "you must try no matter what" - seemingly ignoring the mental and physical health of the mother and the father all the while.
There are a lot of really good benefits to breastfeeding but it's not going to work for everybody or in every situation. I wouldn't fault a doctor for recommending it, but they shouldn't make someone feel bad if it isn't working out.
I want recommendations and best practices to change as our understanding of things improve though. The alternative would mean that either no more research is being done, or doctors are just ignoring anything they didn't learn while in school.
2 replies →
My partner is a GP who has been doing early childhood screening. One thing she learnt after doing a special training is that advice on proper breastfeeding is very difficult to find. She found that with many mothers that had problems, some small adjustments could often make a huge difference (often causing a kind of hallelujah moment for the mothers). The issue is much of the advice given at the hospital is wrong or insufficient.
The training the she did is the possums program from Australia, if somebody wants to look it up I think some resources are available for free.
2 replies →
Older nurses are the best. They've seen it all.
The worst encounters I have had with nurses have been with older ones filtering information and using out of date practices because they think they have seen it all and now know best.
The justice system does the best it can with the information it has. It is far from perfect. It makes horrible mistakes all the time. The problem, of course, is improving it without knock-on effects making it worse.
There are huge swaths of people doing the work required to make it better, every day. It's not as easy as turning a dial from "bad" to "good"
No. When it comes to evaluating forensic evidence lawyers are, by training, too process oriented to solve the problems. Ask a prosecutor what the error rate is for fingerprints or DNA evidence and you’ll get a blank stare. They don’t even try to measure it.
A lot of doctors are process oriented as well. Which is fine most of the time. But I was similarly disturbed when a specialist had zero clue what the approx half life of one of the primary drugs they use was. There was a situation that didn’t fit the book and i just looked it up for them on the spot. They didn’t like me.
You're telling me no defense lawyer thinks about arguing the evidence is unreliable or are you just saying the prosecution throws everything they can find at their side of the case? The former seems extremely hard to believe (lest you're about to become the greatest defense lawmaker of all time due to wisdom shared in a short HN comment) and the latter seems to be evidence of the system working both well and as designed, not evidence it's badly faulty.
5 replies →
There are also huge swaths of people actively trying to make it worse, that's what the FBI did (does?) for years when it knowingly pushed junk forensics.
Or what basically every prosecution does, when it knows that the science behind some things isn't airtight but still presents it in the best possible light to get a conviction.
> junk forensics
Fiber analysis (e.g. carpets)
It's not a justice system, it's a Law and Order system: It's not designed to deliver justice, it's designed to resolve disputes relatively cheaply, while allowing for spending more money to get better results.
If the current functioning is it doing "the best it can", the whole thing should be burnt to the ground.
> A system that does not incarcerate anyone for any reason would be much preferable
surely you don't actually believe that? I don't think the result of this is just 0 false positives. The result of that is a lot more crime, and a lot more injustice.
3 replies →
to be replaced with what? i'm all for making changes that are an improvement, but just burning it to the ground for the sake of it with no end game is not an improvement
13 replies →
If you burnt to the ground everything doing the best it can probably 75% of the public and every instution would spontaneously combust.
and none as effective as this one person
too many cooks in the kitchen
The justice system is doing what the doctors tell them. Broadly speaking If a medical professional testifies that this is the only way, what qualifications does a DA have to question him? Medicine is a profession; thus the professional body ought to be addressing this and, if the guidance changes, be advocating and lobbying to Congress that people start being released.
> If a medical professional testifies that this is the only way, what qualifications does a DA have to question him?
Questioning witnesses is literally the DA's job. That doesn't magically stop being the case just because the witness is an expert. The DA is indeed qualified for this. You could even say it's one of the main reasons the DA exists.
Got it. So the DA is supposed to not only be an expert in the law, but enough of an expert in medicine such that he can flaunt widely acknowledged medical standards while cross-examining expert witnesses on why they're wrong.
The author of this post admitted that it took him countless hours to discover that medicine basically has this issue wrong and only after being particularly motivated to do so. If the DA has so much medical expertise that they know better than the doctors, then what exactly is he doing being a DA?
The idea that the main purpose of the DA is to know better than doctors is ludicrous.
2 replies →