Agreed that the system of medical research in the US needs work. However, I’m a huge believer in “Any intuitive change to a complex system will inevitably leave [that system] worse off.” (From the dedication page of a college textbook in the engineering of complex systems that I used 40 years ago, which was in turn quoting an earlier text on urban studies.)
Three thoughts to offer:
First, a story. I’ll keep this short. 20 years ago my family was in a sick house incident. Not just me, but my wife and then 7 and 3 year old children had permanent effects to our health. Mainstream medicine is in denial that such impacts can happen, and has chosen to be useless in these cases.
Second, while this was going on, my then 7 year old son, with previously healthy eating habits, suddenly began overeating when he got home from school. We did not understand why, and had no way to think about what was going on, and quite frankly were more focused on some strange symptoms in other family members. When his health hit crisis, I did talk by phone with my brother in law, a well regarded physician on the other side of the country. He got stuck on my son’s weight and read me the riot act on calories in vs calories out, unable to get past that dogma to ask the “why” which would have been helpful. Our son, now an attorney, was talking to one of the paralegals in the government office where he works earlier this week. She commented that there were days when she couldn’t focus there in the office without (additional, superfluous) eating. He, well aware of the difference between good and ideal air quality in that office, simply asked her if she ever had that problem focusing when outside. He could ask a question that an MD wouldn’t be allowed to, because there is no theory, and certainly no published papers, that relate marginal air quality experienced by specific individuals (not entire populations) to a learned behavior of eating to stabilize the operation of the nervous system enough to get one’s job done.
I would observe that to get a medical license, one must pass one’s practical anatomy (human dissection) class in med school, and then spend 3 years functioning well in hospital air (which is quite toxic in my experience). This means that (save perhaps Sherry Rogers, if you read her “Tired or Toxic”) persons who have such sensitivities are weeded out of the medical profession as underperformers, and the sensitivity’s reality can be denied.
Third, shortly after the sick house incident, I remember a day when the four of us walked into a big box store, one of Costco’s antecedents. Responding to the same environmental stimulus, each of the four of us had a different experience, all nervous system mediated, each something medicine treated more as a symptom cluster than as a well understood disease. And they all cleared when we left. My thought at the time was we were living a Rosetta Stone…but keeping me working and the kids in school and learning to mitigate symptoms were all we could do, so there’s no contemporaneous record.
End note: coming out of the sick house incident, I tried to run the “Lorenzo’s Oil” play, studying books both around medicine and around indoor air quality, looking for a fix for what ailed my family. Failed. However, along the way, as a guy with two degrees in electrical engineering (and actually using the math concepts from that systems engineering textbook mentioned above) one day I stumbled across a question which was obvious to me but had never occurred to “Medicine”: “what is the mechanism by which the human body stabilizes the concentration of Ca++ and other nervous system feedstocks, on a time scale of 10 milliseconds, local to a particular neuron or group of neurons which have just used a lot of the local supply, analogous to a decoupling capacitor on a computer motherboard?”.
The result of this question is a hypothesis about a new disease mechanism, as heretical and out of paradigm as germ theory was before Pasteur. (Yes, I just hypothesized Multiple Chemical Sensitivity is a hapten-centric autoimmune disease of the system of circulating proteins in the bloodstream, but it would take a short book to explain this heretical hypothesis and the reasoning behind it.)
So my challenge for the medical research community is this: Forget me advancing such a hypothesis, with no credentials. How could a research physician advance such a hypothesis without suffering Semmelweiss’ fate?