Dr. Aaron Hartman examines three major errors in pediatric medicine: antibiotics' disruption of the gut microbiome linked to obesity and autoimmune disease, the false "refrigerator mom" theory blaming mothers for autism, and how treating pain as a vital sign drove the opioid epidemic.
Chapters
Welcome back once again, everybody, to our series on medical gaslighting, medical blind spots, and what does it mean to become a medical feminist. And actually don't want to leave anybody out. So I want to make sure we get kids in here as well. This happens to everybody. So is there an example of something we've done with kids that we said was helpful and good that we now know is harmful and we actually know we shouldn't be doing anymore and we're still doing it? Antibiotic usage, antibiotic overusage. So early in my career, I was told antibiotics were 100% safe. They only kill bacteria, don't hurt people, don't hurt anybody, super safe. Don't need to worry about anything. So then we start learning about antibiotic resistance. Well, we, we can create new antibiotics to fix that. Um, there are some cases of people getting, you know, C. diff colitis from antibiotics, antibiotic diarrhea. But overall, antibiotics are safe and we'll use safer ones, et cetera, et cetera. And this mainly affects kids. They're the ones who get it from adults versus kids. They get a lot more antibiotics than adults. So what do we know now about antibiotic usage? Well, the first thing is if kids get antibiotic usage early in life, this is birth to like 2 years of age, they're more prone to, for obesity, they're more prone to allergies, eczema, atopy, which is just like a atopic can be skin allergic dermatitis, asthma, respiratory tract issues. Um, also more likely to have autoimmune issues and even IBS, irritable bowel syndrome. So all of a sudden antibiotics aren't as safe as we thought, but how was that happen? Antibiotics aren't supposed to hurt humans. Well, now we know there's this thing called the human microbiome. Many of my listeners already know what that is. It's the bacteria in your gut and on your body, about 100 trillion bacteria. You have about 30 million cells in your body, so you're more bacteria than human. Your DNA-wise, you might have like 23,000 genes in your DNA. There's over a million bacterial DNA genes in, on your body. And we know that the bacteria in your gut help modulate your immune system. 90% of your immune system is around your GI tract. So all of a sudden, all these bacteria are supposed to educate your immune system. A well-functioning human adult immune system is supposed to ignore 99.999% of everything. So ignore dust, ignore pollen, ignore strep, ignore staph, et cetera, et cetera. Antibiotic usage actually impacts through killing gut bacteria that you want a very diverse, almost like a, a jungle of different kinds of bacteria. And antibiotics make it less diverse. And so you have less training less options to train it on things to ignore. And so you tend to see more autoimmune issues, more inflammation, et cetera, et cetera, induced by antibiotic usage because impact on your gut microbiome. When I was in medical school, we had no idea what the human microbiome was. We had no idea about all these gene things, but yet there are people who had concerns. Why, why would people have concerns without that information? Because we knew since the 1950s We've been putting in most, about 80% of all antibiotic usage in our country is actually in the agribusiness. It's used for animal feed. It's, you know, they spray tetracycline and other antibiotics on trees to help keep fungi and stuff down. And so it was, and that's just one of the ways we actually get chickens and cows and pigs to get fatter quicker is we put antibiotics in their feed and they actually get fatter quicker. So the question is, well, those are, you know, pigs and cows are mammals. Um, we put antibiotics in the feed, they get fatter. So wouldn't it do the same thing in humans? There's no data on that. There's no randomized double-blind placebo-controlled trials, right? That's the way we tend to approach things. Now we know, and now, now's a big push to cut back on antibiotic usage, but that's something we got wrong for half a century maybe. And it helped, uh, and it hurt kids and ultimately hurt adults. And then this is like a mixture. This concept is a mixture. Between both the blind spot and the medical gaslighting and really need to be a medical feminist. I don't know if any of you ever heard of the idea of a refrigerator mom. Refrigerator mom back in the '60s and '70s was a mom with a, a kid, a little quirky, a little off. We would now call it an autistic kid before we knew what autism was. And the moms are blamed that you're a refrigerator mom. And I remember when I joined my practice, the first time I actually heard that term was actually when I joined my practice from one of the older physicians who trained up in Canada, been practicing for decades. And we kind of joked about it, you know, but it's one of those things that the idea that he was, it was more like, can you believe we used to do that? And it's one of those things like I'm at this stage of life now. I can't, I can't believe we could do just about anything because we've done a lot of crazy things, but we literally blame moms for their kids being autistic. And oh my gosh, how does that make a mom feel? Like the doctor, the expert is telling her it's her fault that her kid has sensory issues or integration issues or speech issues. Now we know that actually neurodivergence does tend to go through families and a neurodivergent mom might be more productive with neurodivergent kids. So that's more of the genetic component, but it's not the mom not being loving and caring, which literally are the experts in healthcare system were saying that. Point being is that this idea of gaslighting, medical gaslighting is not a new concept. It's quite old. The last topic I wanted to, which is a little diverse here in this, this Friday session is the opioids. Again, these are all things that many of us that I'm talking to right now, remember, literally remember these in our, in our lifetime. But I remember my training early on in the hospital, you have little happy faces, you know, pain is the fifth vital sign. We need to treat pain. And doctors were judged on liberal use of opioids for patients. Hospitals by JACO, the Joint National Commission, were judged on how well they used opioids for patients for pain. The result was we started giving it like candy and we have this opioid epidemic. Now that's where it's not, that was partly driven by the system because physicians were very hesitant before that to give out lots of opioids. But the system said, now we're going to call this the fifth vital sign. If you don't do it, you get bad grades. And we all like good grades. And the result was this opioid epidemic. And oh, by the way, did you know opioids are not addictive? That's what we told people. That's where, that's where we're taught. That's what we told patients. Now we know the exact opposite. They're very addictive, and actually they're not that great for pain. They're great, you know, for one, one week, maybe two weeks, but actually over time opioids can actually make pain worse. They actually can sensitize your central nervous system to pain and actually make you more prone to weird fibromyalgia pain syndromes, et cetera, et cetera. Point being is we got that so wrong for such a long time. The result was a lot of people were hurt, a lot of addiction issues. Um, point being this idea, medical blind spots, things that we thought to be right that are just plain wrong, leading to medical gaslighting. And we need to be advocates for our health and realize this does affect, you know, women more than men. It affects us all though. And so we need to be advocates for appropriate diagnosis, appropriate treatment. And how could you avoid a lot of this? By empowering patients, by giving patients autonomy to make the choices, not saying, well, you do what I say because I'm the expert, but giving them autonomy. Educating people and like you're doing here, getting educated. This can help end this medical gaslighting and these blind spots. I'm going to stop the major topics here for this Friday. I'm probably going to go into a couple— I have like pages and pages and pages of like different topics on the medical gaslighting thing. And we might talk about later on, but this series was helpful. Let me know, share with friends, but also let me know if there's anything else you'd like to learn about on this stage. You'd like to learn about as far as topics you'd like me to do deep dives in, and that can be those on this Friday podcast. Take care. Talk to you soon.
