Nina Shapiro MD - Hype: A Doctor’s Guide to Medical Myths, Exaggerated Claims, and Bad Advice - How to Tell What’s Real and What’s Not

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For EA, who suffers no hype

D OES SUGAR FEED CANCER CELLS ?

W HEN CAN NATUROPATHIC MEDICINE HAVE MERIT ?

S HOULD YOU BE WORRIED ABOUT GENETICALLY MODIFIED FOODS ?

C AN VACCINES TRIGGER BRAIN DISORDERS SUCH AS AUTISM ?

At least a couple of times a week, I encounter misinformed patients whose ideas about whats good for themor a family memberare totally wrong. Or they ask questions about what theyve heard about in the media or read online and are surprised by my answers, which often contradict conventional public wisdom. Some examples: My child stopped eating dairy and he doesnt get sick anymore. I only get the flu when I get a flu shot. Did you know that throat lozenges can cure strep throat? I read that in the newspaper.

In my work at UCLA as a surgeon, and as someone who has had her feet firmly planted in both clinical and academic medicine for more than twenty years, I help patients and their families make decisions every day about their health. I find myself dispelling a lot of myths. We live in times filled with suspicion: Every day the media delivers swarms of health-related information that can swiftly trigger fear or inspire us to change our habits overnight. From the headlines about brain-eating amoebas in freshwater lakes to the alleged ills of gluten, sugar, vaccines, foods from genetically modified organisms (GMO), and the chance of getting cancer from tap water, the onslaught of news can be downright overwhelmingand is potentially harmful . One day coffee is good for you and protective against dementia, the next day its declared a potential carcinogen.

Claims that routinely circulate are frequently overblown, misleading, based on shoddy research, or completely false. Some of the ideas are hocus-pocus, created to prey on the vulnerable. Common offenses include exaggerating the benefits of many vitamins, herbs, supplements, homeopathy, skin creams, antiaging schemes, cold remedies, and unconventional anticancer programs. Talented scammers know how to lead the public into believing in causation when there is none, building hype for everything from arnica to zinc.

Unfortunately, many individuals dont know where to turn for unbiased, trustworthy advice, and the ease with which misinformation is propagated on the internet leaves peoples heads spinning. Hence the purpose of this book .

I started this book several years ago. After the 2011 publication of Take a Deep Breath, which spoke to parents who have children with breathing problems, I realized I needed to write a much broader book that speaks to people about their health decisions on a wide array of issues. I would argue that more hype and misinformation exists in medicine and health circles than in any other area. I say this not just as a physician, but also as a mom, wife, sibling, daughter, and someones friend. I am fortunate to live in a world surrounded by so many smart people who are successful in a multitude of ways. Some are talented actors, directors, or producers; some are innovative entrepreneurs; many are far better organized and far more engaged parents than I could ever hope to be. But what I notice so often is a huge disconnect. Hypocrisy might be too strong a word, but I wouldnt rule it out.

When it comes to health, well-being, nutrition, and medical choices, well-educated people can have some pretty funny ways of thinking. No doubt personalities and emotions come into play, especially when such decisions are being made for ones own body or for a spouse, parent, or child. Health choices can be downright bizarre. At my kids school, for instance, I would frequently hear parents concerned, to the point of obsession, about hand washing. Yes, this is important, dont get me wrong. Yet these same parents dont immunize their children and rally to ban any Styrofoam or plastic while driving a gas-guzzling SUV. Some people worry about eating inorganic foods with dyes and artificial colorings but will text and drive and skip the seat belt on occasion.

Surgeons have a unique way of thinkingdifferent, even, from that of doctors in other specialties. Every decision we make involves risks and benefits, and our decisions often have to be made in an instant. We think and do almost simultaneously. As the saying goes, a good surgeon knows how to operate; a great surgeon knows when not to. One choice is not necessarily more aggressive than the other. We see how bodies work in live, real time. We see the internal damage that no physical exam, blood test, or highest-level X-ray can replicate.

We think and act fast. Many view surgeons as erratic and impulsive. In many ways, this is true. If the sh*t is hitting the fan, our impulses kick in, and we act on impulse to save a patient, stop the bleeding, open an airway, clamp a vein. Were not always polite when a patient is, as we call it, circling the drain, crashing, or trying to die. Accept our apology.

Were not just butchers. We know how the human body works, metabolizes, absorbs, digests, just as much as nonsurgeons do. We know that rubbing cream on your skin will rarely have a direct effect on other organs. We know that drinking a juice marketed to boost your immune system will not do that. We know that the liver is a great detox center, the kidneys are a terrific filter, and the brain is the most powerful organ. We are so keenly tuned in to the ins and outs of the body that when a patient of a certain age, weight, and medical status has a specific operation for a specific length of time and will not be eating or drinking for a certain period afterward, we can calculate to the drop of watermilliequivalent of each electrolyteand milligram of protein how much that patients body will need via intravenous fluids to keep the patient in perfect fluid and electrolyte balance indefinitely. Undergoing abdominal surgery is more taxing on the body than running a marathon, climbing a mountain, or sweating through a day of hot yoga, yet we can get it right when it comes to ideal fluid and electrolyte balance.

Sports drinks, protein boosts, and energy bars are all guesswork. They go through the gastrointestinal tract and may not be absorbed in the right amount by the right organ. Just as postsurgical patients cant by drinking liquids maintain their fluid/electrolyte balance, people ingesting supplements, drinks, powders, and bars oftentimes get no benefits because of where those substances end up. (Hint: Check your pee and poop.) When one receives intravenous fluids, the contents directly enter the vascular system, going from the veins through the heart, to the arteries, and then to the organs of the body, where absorption of fluid and electrolytes takes place. Some vessels go to the kidneys, which filter out the unnecessary fluid and electrolytes, so we can pee them out. When you eat something, the contents go from the mouth to the esophagus to the stomach, and then the intestines. After this, some of the contents get pooped out. Which of these make it past the intestines, the liver, and the kidneys is much more guesswork than in the absorption of intravenous fluid contents.