Latest / Truth in Motion with Dr. Jocelyn / What Two Thousand Years of Watching Knows

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What Two Thousand Years of Watching Knows · Truth in Motion with Dr. Jocelyn

0:02
SPEAKER_00: Welcome to Truth in Motion with Dr.
0:05
SPEAKER_00: Jocelyn, where insight, clarity, and wisdom help you thrive.
0:09
SPEAKER_00: Welcome back.
0:11
SPEAKER_00: I want to start today by offering you my apology.
0:15
SPEAKER_00: This episode was meant to reach you on Friday, and it didn't.
0:19
SPEAKER_00: And I want to tell you why.
0:21
SPEAKER_00: It turned out to be harder and more emotional than I ever expected.
0:25
SPEAKER_00: I didn't think talking about science would stir up so much in me, but as I worked on it, I felt sad.
0:31
SPEAKER_00: I felt angry and I felt disillusioned with the system we have and with the way science is too often done today.
0:39
SPEAKER_00: I understand the pressures of the world we live in, and still I expect better.
0:44
SPEAKER_00: I want better.
0:45
SPEAKER_00: I also noticed something else in myself, pride.
0:49
SPEAKER_00: Pride in East Asian medicine.
0:51
SPEAKER_00: And I think that's good in some respects.
0:53
SPEAKER_00: We should be proud of what we practice.
0:56
SPEAKER_00: I mean, why would anybody choose to practice something other than what they believe is the best?
1:01
SPEAKER_00: But this show is called Truth in Motion, and telling the truth matters deeply to me.
1:06
SPEAKER_00: And that means being honest about my own bias.
1:09
SPEAKER_00: It means being honest about the strengths and the weaknesses of the medicine that I practice and of my own work in the healing arts, and of how all of it compares with everything else that's out there.
1:24
SPEAKER_00: Here's what I believe.
1:26
SPEAKER_00: Power comes from our ability to choose, and real empowerment widens our choices.
1:32
SPEAKER_00: That's why I've spent these weeks laying a foundation in science.
1:36
SPEAKER_00: Partly for me, so I keep thinking for myself and keep asking questions, partly to keep my oath, to honor those who came before me and the advances medicine keeps making, and mostly for you.
1:50
SPEAKER_00: So you can understand the claims of medicine, scientific and otherwise, and make the choices that are right for you.
1:57
SPEAKER_00: So you can be a real participant in your own care, and so you can stand strong when you're making decisions for someone you love.
2:06
SPEAKER_00: I wish we lived in a world where every motive was pure, but we don't.
2:11
SPEAKER_00: I'm thankful that grace and mercy show up even here, in our everyday lives, in our work, and even in science.
2:19
SPEAKER_00: It isn't perfect and we can still learn from it, grow from it, and benefit from it.
2:24
SPEAKER_00: While we challenge ourselves and each other to be more ethically rigorous along the way.
2:30
SPEAKER_00: So with that long and honest introduction, let's step into today's topic, empiricism, and the real challenges in research.
2:41
SPEAKER_00: In 1999, a new pain reliever came to the market in the United States.
2:46
SPEAKER_00: It was called Viax.
2:48
SPEAKER_00: It had passed its trials, it was approved, and millions of people took it for arthritis and everyday pain.
2:56
SPEAKER_00: Five years later, in September of 2004, it was pulled from the market.
3:02
SPEAKER_00: A study published in the Lancet the following year estimated that Viax had caused between 88,000 and 140,000 cases of serious heart disease in the United States.
3:16
SPEAKER_00: The trials had looked good, but the trials were short, and some harms only show up with time.
3:23
SPEAKER_00: Now, go back 2,000 years.
3:26
SPEAKER_00: In China, a book of herbal medicine was being written.
3:29
SPEAKER_00: The Shen Nang Ben Sau Jing.
3:32
SPEAKER_00: It lists 365 medicinal substances and it sorts them into three groups.
3:39
SPEAKER_00: The first group, 120 of them, are described as harmless.
3:43
SPEAKER_00: The second is to be used with care.
3:46
SPEAKER_00: And the third group is strong in action and often poisonous.
3:51
SPEAKER_00: Think about how anyone could know that.
3:54
SPEAKER_00: Only one way, by watching, generation after generation of healers, watching what happened to real people over months, over years, and over whole lifetimes, and writing it down.
4:08
SPEAKER_00: That's what today is about, the kind of knowing that only time can give.
4:14
SPEAKER_00: As always, why does this matter?
4:17
SPEAKER_00: Because many of us are tired.
4:19
SPEAKER_00: We're tired of fixing one problem only to be handed another, a medication for this some symptom, and then another one for the side effect.
4:28
SPEAKER_00: And a quiet worry about what all of this is doing to us years from now.
4:35
SPEAKER_00: Today we'll see the oldest form of evidence in medicine.
4:39
SPEAKER_00: Long careful observation of whole people, hold something the newest trial can't.
4:46
SPEAKER_00: Time.
4:47
SPEAKER_00: And with time comes the one thing we most want to know about any treatment.
4:52
SPEAKER_00: Not does it work, but what happens to me 10 years from now?
4:58
SPEAKER_00: My bias.
4:59
SPEAKER_00: I promise to be honest about my bias, and here it is plainly.
5:04
SPEAKER_00: I believe medicine should actually practice medicine.
5:07
SPEAKER_00: That means finding the cause of the problem and resolving it, not masking it.
5:13
SPEAKER_00: I believe the least invasive, safest options should come first, and we should take on more risk only as the safer options fail.
5:22
SPEAKER_00: Drugs and surgery are the riskier steps, and too often they come first.
5:29
SPEAKER_00: Think about it.
5:30
SPEAKER_00: How would we handle anything else we love?
5:33
SPEAKER_00: We wouldn't take a sledgehammer to a squeaky door before we tried a little oil.
5:38
SPEAKER_00: Yet in medicine, the strongest intervention is often the first thing offered, and the gentler ones are treated as extras if they're mentioned at all.
5:49
SPEAKER_00: That's my bias.
5:50
SPEAKER_00: And this week has shown me why it's well founded.
5:54
SPEAKER_00: So let's stand on that ladder that we've been talking about and look at it one more time.
6:01
SPEAKER_00: Every rung is empirical.
6:03
SPEAKER_00: It learns from watching what actually happens.
6:06
SPEAKER_00: On Tuesday, we looked back, Dalin Hill asked patients in 20 London hospitals about their past.
6:14
SPEAKER_00: On Wednesday, we followed forward.
6:17
SPEAKER_00: 40,000 doctors tracked for 50 years.
6:21
SPEAKER_00: And on Thursday, we met the FAIR test, the randomized trial, where chance decides who gets the treatment.
6:28
SPEAKER_00: Each rung is real evidence, but notice something about every one of them.
6:34
SPEAKER_00: Who gets to do the observing?
6:37
SPEAKER_00: Researchers, data analysts, journal editors.
6:42
SPEAKER_00: The rest of us see the summary, the abstract, the headline.
6:46
SPEAKER_00: We're asked to trust that the observing was done honestly, and that trust isn't always earned.
6:53
SPEAKER_00: Back in episode seven, we said that science rests on what's observable and repeatable.
6:59
SPEAKER_00: So here's the question I want to ask today.
7:02
SPEAKER_00: Observable by whom?
7:05
SPEAKER_00: A randomized trial asks one narrow question about one group over a set number of weeks or months.
7:13
SPEAKER_00: It's fair and it's powerful, but it's short.
7:17
SPEAKER_00: And it watches one number.
7:19
SPEAKER_00: East Asian medicine asks a different question over a far longer span.
7:25
SPEAKER_00: What happens to this whole person and to people like them across a lifetime and across generations?
7:34
SPEAKER_00: Here's how modern drugs are tested before approval.
7:38
SPEAKER_00: According to the FDA, the largest stage of testing called phase three involves between 300 and 3,000 people and lasts one to four years.
7:49
SPEAKER_00: 3,000 people sounds like a lot, but when millions of people take a drug, a side effect that strikes one person in 10,000 will never show up in the trial.
8:02
SPEAKER_00: And a harm that takes 10 years to appear can't show up in a four-year study.
8:08
SPEAKER_00: So what happens after approval?
8:11
SPEAKER_00: In 2017, researchers looked at every new drug the FDA approved over 10 years, from 2001 to 2010.
8:21
SPEAKER_00: There were 222.
8:24
SPEAKER_00: Nearly one in three, that's 32%, later had a major safety event, a boxed warning, a safety announcement, or withdrawal from the market.
8:37
SPEAKER_00: And on average, those problems surfaced more than four years after the drug was approved.
8:43
SPEAKER_00: Now let's look at what East Asian medicine had that no trial can buy.
8:48
SPEAKER_00: It had time.
8:50
SPEAKER_00: This is one of the oldest medicines still practiced today, with a written record going back more than 2,000 years.
8:58
SPEAKER_00: It had whole people, not one number, but the whole picture.
9:03
SPEAKER_00: How a person sleeps, how they digest, their energy, their mood, their pulse, their tongue, the season they were born into and the season they're living in, and how all of it moves together.
9:15
SPEAKER_00: And it had generations.
9:17
SPEAKER_00: A healer watched a patient for years, then taught a student, who watched for decades more.
9:25
SPEAKER_00: What helped was kept.
9:27
SPEAKER_00: What harmed was recorded and warned against.
9:30
SPEAKER_00: The record was refined, corrected, and passed down for 2,000 years.
9:36
SPEAKER_00: That's a kind of evidence about long-term safety that no four-year study can match.
9:42
SPEAKER_00: And notice what this kind of medicine aims to do.
9:45
SPEAKER_00: It doesn't try to force one number down while the rest of the body pays for it.
9:50
SPEAKER_00: It looks for the pattern underneath and works to bring the whole person back into balance.
9:57
SPEAKER_00: So the body can do what it was designed to do.
10:01
SPEAKER_00: Heal.
10:03
SPEAKER_00: Here's what I find most beautiful about the evidence of East Asian medicine.
10:08
SPEAKER_00: It's observable by everyone, including the patient.
10:13
SPEAKER_00: A pulse isn't hidden in a lab.
10:16
SPEAKER_00: You can feel it at your own wrist right now.
10:19
SPEAKER_00: Is it fast or slow?
10:21
SPEAKER_00: Strong or faint?
10:22
SPEAKER_00: Steady or does it skip?
10:25
SPEAKER_00: A tongue isn't locked in a database.
10:28
SPEAKER_00: You can look at your own in the mirror tomorrow morning.
10:31
SPEAKER_00: Its color, its coding, its shape, whether it looks the same after a good night's sleep as after a hard week.
10:39
SPEAKER_00: That's what generations of healers build their knowledge on.
10:42
SPEAKER_00: Not on data only a few people could see, but on signs that the practitioner, the patient, and the family could all witness together.
10:51
SPEAKER_00: And when your evidence is your own body, no one can ghost write it.
10:57
SPEAKER_00: No one can bury the bad results.
11:00
SPEAKER_00: You're there for every observation.
11:03
SPEAKER_00: That's empirical evidence at its most honest.
11:06
SPEAKER_00: Observable, repeatable, and shared.
11:10
SPEAKER_00: When the old record meets the modern test, and when this old knowledge is put to the modern test, it holds up.
11:18
SPEAKER_00: A line written around the year 340 telling healers to soak sweet wormwood rather than boil it led to yo-yo to the malaria drug Artemisian.
11:31
SPEAKER_00: It has saved millions of lives.
11:33
SPEAKER_00: And in 2015, it won her the Nobel Prize.
11:37
SPEAKER_00: Acupuncture has been put to the test too.
11:40
SPEAKER_00: A pooled analysis of 39 trials and more than 20,000 people with chronic pain found it better than both sham acupuncture and no acupuncture, and most of the benefit was still there a year later.
11:54
SPEAKER_00: What the old texts recorded, the modern trials keep finding.
11:59
SPEAKER_00: What about safety?
12:01
SPEAKER_00: And now the question that matters most to many of us: what does it cost the body?
12:06
SPEAKER_00: In Germany, researchers followed more than 229,000 people who received acupuncture.
12:13
SPEAKER_00: About nine out of a hundred reported any side effect at all.
12:18
SPEAKER_00: The most common by far was a small bruise or a little bleeding where a needle went in.
12:24
SPEAKER_00: Serious problems were extremely rare.
12:26
SPEAKER_00: Compare that with a list of possible side effects in any drug commercial.
12:31
SPEAKER_00: Acupuncture works with the body's own healing.
12:35
SPEAKER_00: It doesn't add a foreign chemical that has to be cleared, and it doesn't trade one problem for another.
12:43
SPEAKER_00: What does it feel like to be cared for this way?
12:47
SPEAKER_00: So what does it feel like to be cared for by a medicine built on watching?
12:52
SPEAKER_00: It means being seen as a whole person, not a lab value, not a diagnosis code, a person with a story, a body, and a season of life.
13:02
SPEAKER_00: And it means a practitioner who has trained their own senses, their fingers on the pulse, their eyes on the tongue, the color of the face, the way you move into the room.
13:14
SPEAKER_00: And it means the patient's own experience counts.
13:18
SPEAKER_00: How you sleep, how you feel, whether you're getting your life back.
13:24
SPEAKER_00: Is this medicine?
13:25
SPEAKER_00: That's not a side note.
13:27
SPEAKER_00: That's the evidence.
13:30
SPEAKER_00: So the next time we hear there's no evidence for that, we can ask a better question.
13:36
SPEAKER_00: What kind of evidence?
13:38
SPEAKER_00: A few months and a trial?
13:40
SPEAKER_00: Or 2,000 years of watching whole people live, heal, and grow old?
13:46
SPEAKER_00: And when we choose care, we can ask four things.
13:49
SPEAKER_00: Does it find the cause or only quiet the symptoms?
13:53
SPEAKER_00: Is there a gentler option to try first?
13:57
SPEAKER_00: What does it cost my body?
14:00
SPEAKER_00: And what happens to me 10 years from now?
14:04
SPEAKER_00: Here's today's practice, and it puts the evidence in your own hands.
14:09
SPEAKER_00: For the next week, each morning, before coffee or tea, look at your tongue in the mirror.
14:15
SPEAKER_00: Then rest two fingers on the inside of your wrist and feel your pulse for a minute.
14:20
SPEAKER_00: Write down what you notice, and one line about how you slept and how you feel.
14:25
SPEAKER_00: By the end of the week, you'll start to see patterns.
14:29
SPEAKER_00: How your body answers a late night, a heavy meal, a stressful day, or a peaceful one.
14:35
SPEAKER_00: That's you, becoming the observer of your own evidence.
14:40
SPEAKER_00: And no one can take that knowledge away from you.
14:44
SPEAKER_00: This week we asked how we know what we know.
14:47
SPEAKER_00: We climbed the ladder one rung at a time, and today we asked who gets to do the observing.
14:52
SPEAKER_00: We saw a drug that passed its trials and was pulled five years later.
14:57
SPEAKER_00: And we saw that a medicine built on watching whole people with evidence anyone can see still holds up under the modern test and works with the body instead of against it.
15:08
SPEAKER_00: When we honor what time has taught, we don't have to choose between science and wisdom.
15:14
SPEAKER_00: We can choose care that finds the cause, starts gentle, and still serves us years from now.
15:22
SPEAKER_00: That's the truth as I see it.
15:24
SPEAKER_00: And telling it is how I choose to be part of the team.
15:28
SPEAKER_00: Next week, we look at the numbers themselves.
15:31
SPEAKER_00: This week we heard percentages, risks, and trial results.
15:35
SPEAKER_00: But the same numbers can be arranged to tell very different stories.
15:40
SPEAKER_00: So next week we ask, how can numbers be used to mislead us?
15:45
SPEAKER_00: And how do we see through them?
15:48
SPEAKER_00: Thank you for joining me.
15:49
SPEAKER_00: Meet me tomorrow.
15:51
SPEAKER_00: I will look forward to seeing you there.
15:54
SPEAKER_00: Keep the conversation going.
15:56
SPEAKER_00: Find your next steps in Notes from a Fellow Traveler, my blog.