In this solo monologue, Dr. Aaron Hartman, an assistant clinical professor at the Medical College of Virginia, examines three contemporary "medical blind spots"—areas where mainstream medicine has long held incorrect or incomplete beliefs. He first traces the history of dietary fat guidance, showing how early 20th‑century innovations like Crisco and the 1970s USDA food pyramid demonized fats despite basic biochemistry indicating their essential role, and explains the current shift toward whole‑food, minimally processed fats. He then recounts his personal experience treating Lyme disease in Virginia, highlighting the institutional denial of chronic Lyme, the restrictive Infectious Disease Society of America guidelines, and the recent governmental acknowledgment that Lyme cases now outnumber breast cancer. Finally, he describes the emergence of Long COVID, once dismissed as “crazy” but now recognized as affecting roughly 10 % of COVID survivors, with potential neuro‑degenerative and cardiovascular sequelae. Throughout, Dr. Hartman emphasizes that medical knowledge evolves slowly—often “one funeral at a time”—and urges patients to become informed advocates for their own health, questioning authority, and understanding that past orthodoxy can be wrong. He closes with anecdotes about the Hippocratic Oath, historical medical harm, and his mission‑hospital work in Ecuador, reinforcing the need for humility and patient‑centered care.
Chapters
What are things that our healthcare system has got just plain wrong, not even close to being right, and yet held them to be the truth, the dictum for years, sometimes decades? These are blind spots. These are things that our healthcare system, we get plain wrong, things that we think that are right that are wrong and vice versa. I wanna talk about the fat one just a little bit more because this is pretty recent and talk about two other ones. That you, one you probably know about, one you might not think as much about, that are things we got plain wrong that are in recent memory that should make sense and resonate with you. We will go back and talk about ones more in antiquity, ancient, more ancient, but more distant history. But the point is there's all something we're getting wrong right now. And one of the things I ask myself when I see patients, you know, is what I'm getting ready to do now. What is, is there a blind spot? Is this a thing right now that 5 or 10 years from now we think, Wow. I can't believe I used to do XYZ. And in which case, whatever procedure, maneuver, medication, supplement, intervention I'm doing, they need to be safe. Especially when according to the med— current medical literature, half of all research findings from published clinical research findings are later found to be false. That's a crazy number to think about. So I wanna talk, get back to the fat thing. Now the fat thing is interesting cuz the main thing was heart disease, right? A lot of people don't realize that in 1900, the most common cause of heart disease in our country was actually infection. You might get typhoid, get aneurysm, die from that. You might get strep, get rheumatic heart disease. Acute infectious processes were actually the most common cause for heart disease. Fast forward to 1950, all of a sudden heart disease is going up in our country, but with antibiotics, it's not being caused by infections. Well, what happened about 1908 to 1910, this thing called crystallized cottonseed oil, Crisco, got introduced into our food system. It's actually interesting, the history. Napoleon actually was looking for a butter alternative for his troops, and they actually were able to create this thing, butter alternative, white thing. Eventually Crisco got there. Eventually we got margarine, you know, decades later. But the idea of looking for a fake fat is actually not new. It was an old thing. We just didn't know how bad they were gonna be for us. So 1950s, heart disease is going up. You know, Ancel Keys came in with the Seven Countries Study. 1977, USDA says, look, we're gonna make a food pyramid. Fat's bad at the top. You know, the thing about it is, did everybody get it wrong? This is a concept I also want you to think about with these blind spots and with micro gaslighting is, and even the idea of being a micro feminist, is that there are a group of people who are getting it right. There are people who know that, knew that fat, that knew cholesterol was good. I mean, basic biochemistry, cholesterol is the most important fat molecule in your cell membranes. It actually keeps the shape and structure of your cells. Omega essential, these are called essential fatty acids. Cholesterol. Why are they called essential? Because they are essential, right? Omega-3s, omega-6s, essential fatty acids. These are things we've known we need for health, but yet there's some kind of cognitive dissonance. We know we need these, but We'll make these synthetic things that are partially crystallized, partially plasticized, and we'll talk about that in a second. And they'll be just as good or healthier for us. And that's kind of where the thinking gets a little off. And it, you know, in hindsight you're like, how did we think that? Why did we think taking plastic and putting it into ourselves? I mean, we know what microplastics are, right? Microplastics are small nanoparticles of our plastic world that we inhale, we breathe, that actually get in our cells and cause issues. Strangely enough, actually men with low testosterone many times will actually have microplastics in their testicles. Kind of think about that. Totally different topic here though. This is us taking liquid, whether it's vegetable oil, and making semi-solid into margarine, taking cottonseed oil and crystallizing it into Crisco. And the effect of these things actually are that messes up the cell walls and membranes. So from a basic biochemistry standpoint, it doesn't make sense why we would demonize these, but yet that happened. And there were people saying fat is good. There were people saying we should not remove it. Yet those people were demonized, were ostracized, looked at as being crazy. Even as recent as 5 years ago, to say you need healthy fats, mainstream medicine was not a thing. It's only since the FDA flipped the pyramid upside down that you can be a credible physician, academic. I am, you know, assistant clinical professor at the Medical College of Virginia and talk about this and not get shot down or canceled or whatnot. Half a century. It was actually roughly some— it was actually about 70 years. Um, and from the, the, uh, food pyramid thing over half a century. And yet we got it plain wrong. Now what happens? Okay, we're, we're in this transition right now cuz this is pretty fresh. This is pretty new. Well, the transition usually takes 10 to 20 years for it to take on. Um, it's not gonna be a quick thing. So what's what happens? The information comes out slowly. Yes, good fat. Yada yada. This doesn't mean everybody goes carnivore and starts eating sticks of butter. It means you, when you eat fat, you eat whole fat milk. You don't separate it out. You don't homogenize it. You don't superheat it, ultra-pasteurize it. You don't do all these things to change the chemical structure and you call it healthy. That is unhealthy. You don't strip out the fats from things. You eat them as they occur in nature, minimally processed, minimally processed. And so just think about that for a second. We got this wrong for such a long, long time. And now fat is back and it's gonna be a while before we can have conversations without upset about it without name-calling, but that is how medicine works. There's a saying that medicine progresses one funeral at a time, okay? And we're experiencing this between hormones being flipped around as of last fall and now the fat thing. We're experiencing this in real time. What is something else we're experiencing in real time, a blind spot that we've gotten wrong, that a small group of physicians getting bigger and bigger, providers getting bigger and bigger, have known about? Lyme disease, chronic Lyme disease. So when I moved back to Richmond after getting out of the military in 2007, had my first case of Lyme disease. A patient came in, you know, rashes, et cetera, et cetera. Testing had a lot of these— the Western blot testing was positive, and I'd never treated Lyme disease before. I mean, military, we didn't have it. You don't have it in hospitals, right? It's rare. It's not— it's a rare disease that doesn't exist, right? So called my local infectious disease doctor. And their response was, we don't take care of Lyme disease, we do not take consults for it, and it doesn't exist— it does not exist in Central Virginia. Got off the phone and I thought, with this infectious disease doctor, and thought to myself, how can you say it doesn't exist if you literally refuse to see it? So I called the Medical College of Virginia, the local medical school, trying to get infectious disease department. No return my calls, no return my information for consult. So I was forced to figure it out on my own, used UpToDate, started researching, and took care of this patient. So fast forward, you know, at this point in time, the Infectious Disease Society of America was saying you should only use Anabox for 2 weeks. If you have a tick bite, you only need doxycycline for a day, no more. If you use it more than that, you risk your license. So in the Lyme literate world, we physicians actually have— and I actually have my patients sign pretty thick disclosures. Yes, they realize this is not standard of care. Yes, it's not FDA approved, yada yada yada, before I can actually treat them with the most up-to-date data. But even now, you know, why am I bringing this up? Because Lyme disease, as of last year, the government made a statement that there are more cases of Lyme disease in our country every year than breast cancer. The government's finally recognized it's there. The government actually this past January had an open table forum. They had experts from around the country to talk about Lyme disease, talk about how it's affected patients, how they've worked out. It's now starting to come out in the open, but yet we still have medical boards for states saying if you use too many antibiotics, you might lose your license. We're seeing a transition with this. And most of my patients, most people I talk to know that, you know, I'm in Virginia. Everybody knows there's Lyme disease here now, even though some of the experts still disagree. The average person knows, yeah, it's a tick. I got the red thing. I get my antibiotics. Um, they may not know, however. That they might need the inbox for 4 to 6 weeks, not just 1 to 2 weeks to prevent from getting chronic Lyme disease. But this is another example of a blind spot that we're transitioning through right now. And this is one we'll hit— everybody's going to know about this one. Long COVID. I saw my first Long COVID case, May of 2000. Now at that point in time, this was unrecognized. If you talked about it, you, you might have lost your license. You know, California was doing some really interesting things. If you mentioned it, you were considered crazy, outlandish. Fast forward now, it's all, it's recognized. Long COVID is a thing. Now we're recognizing that there's a significant number of people, 10% of all people who got COVID will probably have long COVID. Now we're realizing that there's a significant number of people that will probably develop some kind of neurodegenerative issues from this, similar to Hong Kong flu, similar to Spanish flu, similar to swine flu, similar to the Russian flu. This is a thing when you see a lot of people getting a similar infection. You tend 8 or 10 years later to see neurological conditions. Now we're also learning with long COVID, it can actually set you up for cardiovascular disease because the impact of the spike protein on your endothelium, which is the lining, it's actually called the glycocalyx for all the nerds out there, but, um, the endothelial glycocalyx. But the point is like now this is accepted. It's being researched, you know, 6 years ago, actually 5. Yeah. Yeah. 6 years ago it didn't exist. If you mentioned it, you were in big trouble with your medical board, with stuff you'd get canceled online. You're considered an anti-scientist. Anti, you're against people, you actually could get in a lot of trouble and lose your job and things over it. So the idea of this blind spots, these things that we think that are just plain wrong, it's not a new idea. It's as old as medicine itself. And, um, next episode I want to talk about something that is pretty crazy to think that we used to believe this and now we know it to not be true. But, and we'll keep on talking about this. The reason I want to talk about these over the next couple of weeks is just so people get an idea in their head that. You have to be an advocate for yourself. You have to be educated, read, to learn your body and know yourself, be engaged with your health. Trusting the experts to do everything for you in today's day and age, in any day and age, you know, it's why is that? Why is the Hippocratic Oath? Here's a good question for you. Actually, two anecdotes and I'll be done with this one. Why is it that the Hippocratic Oath, part of it is you will do no harm. You'll enter a house only for good, not for evil. Because back in the day, you know, what was that? Like 500 BC, whatever, over 2,000 years ago, it was common for doctors to actually hurt and kill people. This was actually a thing. Another anecdote, when I was at a mission hospital in Ecuador, middle of nowhere, we did some really cool work there, helped a lot of people. In that culture, if you went to the hospital and got admitted, it meant you were dying. So we had a mom bring her kid in, maybe 6 years old. And, um, they walked like 3 days from the jungle, came in, he was unconscious, just totally out of it. He had meningitis. So we told mom, we have to admit him to the hospital. And she just, you could hear the wail, this guttural, emotional, like just the most bare emotion of a mom grieving, like someone telling you your child is going to die. And you guys just, those wails, just, I still hear it like now, just kind of makes me emotional. This feels Horrible sound. Horrible. Because for her, that's what that meant. A week later, she, the son left with the mom. Okay. That's good part of the story. But in that culture, getting admitted to the hospital is, it means you're going to die. Right? So the point is, is that the idea of doing no harm first, first and foremost, do no harm is something that's historically been part of medicine in the world. Now we've lost that in the United States because we've become so clean and so sterile and so exacting. We've, we've forgotten that there are dangers. And the part of this is just educating people about those past dangers and some things to think about. Maybe we'll talk later about what are some, what do I think are some blind spots right now? That's where you get controversial. Anyway, hope you all enjoy this series. If so, please like, share, subscribe. Let us know how you're, if wherever you're looking at this, YouTube or on our podcast, let us know what you think about it. We'll keep on doing a few more of these. Depending on the feedback, we might do a bunch of these, but I feel like I want to do this for enough of time so everybody gets the feeling that this is not just Aaron Hartman saying things. This is legit. This is real, and it's part of you becoming an invested individual in your healthcare. Take care, we'll talk to you soon.
