Getting to the Heart of the Facts

I hesitatingly call this post my ‘triumphant return’ to blogging. The extent of this triumph will be determined by how consistent I am with my posts. However, I miss writing regularly, and I think this space offers me a good opportunity to consistently get out ideas for a limited audience. So, on this sunny morning in February, I’ll begin by returning to a guest blog post I was thrilled to have published back in July 2014. In this post, I discussed my skepticism toward many health books and articles published for the general public. Such publications often misconstrue scientific evidence and distort the facts in order to promote a narrow view of a specific topic — such as dieting, food selection, and risk factors for heart disease.

I mentioned personal experience in this post: the fact that back in 2013 I learned I had high cholesterol. Not many people learn they have high cholesterol while in their 20s, and largely that’s because medical guidelines have not encouraged people to get their cholesterol checked until they’re much older — perhaps in their 40s or 50s. Women, specifically, have traditionally been viewed as having a low risk for heart disease, and young women are often considered the least susceptible.

My experience dispelled those long-entrenched assumptions, and those who know me have heard me talk about cholesterol and food choices quite often. It’s hard not to discuss something I feel so passionately about, especially when I see books published to a national audience that explicitly contradict evidence that I know, from medical research and personal diet modification, to be true.

While my focus in that post was on health information aimed at the general public, it’s equally important to examine the clinical side of things. In other words, what happens when someone needs to seek medical guidance not from a published book or a website, but from a doctor or or other medical professional? One would assume that seeking such help would lead to the proper diagnoses, treatments, and lifestyle modifications.

However, my attention has increasingly been drawn to research that discusses the problems inherent within our healthcare system, particularly in relation to gender. I want to share an article on gender bias in women that I came across this past week. A lengthy, revealing read, this article explores some of the ways that women’s legitimate health concerns have been dismissed by medical professionals because of biases and faulty assumptions about women’s health.

I know from my own research on heart disease that women complaining of symptoms such as chest discomfort, shortness of breath, and nausea, have been sent home by doctors who told them to take some antacids or just to relax.

That’s the thing — women are seen as simply complaining. Often our symptoms go without the proper medical attention or treatment because, essentially, we are being told that our own knowledge of our bodies is not sufficient or authoritative enough to warrant the proper medical intervention.

Campaigns like the AHA’s Go Red For Women initiative have sought for over a decade to reverse these attitudes and inform both medical professionals and the general public of the facts concerning heart disease — namely that women can and do acquire heart disease at rates comparable to those of men, and further than young women are often susceptible as well. These public health efforts have also sought to empower women to “speak up” to their doctors and convince them that there is in fact something wrong. Women are encouraged to “know their bodies” and intuitively recognize that something is wrong, and in turn, to use this intuitive embodied knowledge to fight back against doctors who do not give them the needed treatment or care.

The article on gender bias argues, quite convincingly, that efforts to empower women in such ways are problematic. The author concludes, with a healthy dose of sarcasm, that it’s easier to empower women “to recognize their symptoms and seek help without fear of judgment. But that’s just a way of saying that individual women need to compensate for the health care system’s biases: that they should know their risk of heart disease better than their doctors do, should be able to identify the symptoms of a heart attack more readily than their doctors can, and should demand care—and be prepared to fight for it—in spite of their doctors’ tendency to dismiss them. Call me crazy—hysterical, even—but I don’t think you should have to feel that empowered just to receive proper medical treatment.”

This passage calls attention to the ways in which empowering women to “speak up” to their doctors may help treat the symptoms of systemic gender bias but in fact does not address the cause. We can spend endless time and money encouraging each woman to advocate for herself, but until we do more to address “lack of access to preventive care, the gender bias in medical research and education, the psychologization of women’s ailments”, those efforts may not be as effective as we’d like.

Of course, the solutions to these problems require a concerted effort among many stakeholders, including medical schools, health insurance companies, and the general public. But the confluence of misinformation circulating among the general public combined with persistent gender bias leads me to conclude that the one strategy that will help address — if not solve — these issues involves a collapse of the boundaries between specialized knowledge and non-specialized knowledge.

recent controversy surrounding access to scientific papers reveals the problems inherent within this division. This article opens with the provocative question, “Can anyone actually own knowledge?” While few would argue that we should ban the sale of books and instead make every text freely accessible to everyone at any time, the fact remains that there is a distinct division between academic knowledge — articles and publications generated by professors and advanced researchers — and general knowledge dispersed among the average person. Why is this the case? Partly, it’s because academic knowledge is often jargon-heavy, and these articles require both a specialized working vocabulary as well as a hefty math and science background.

But partly, it’s also because it’s so much easier to read a news soundbite (“Researchers now show that you can AND SHOULD eat beef every day!”) than to engage with scientific abstracts. We’re always on the lookout for that easy, digestible nugget of information that we can quickly dismiss if needed or else store away in our minds for future use. We’re so overloaded with facts, or myths masquerading as facts, that our tolerance for sustained interaction with any one of these ideas is often quite low unless it directly and immediately relates to our lives.

In my 2014 guest blog post, I argued for careful scrutiny of the claims made about health and disease in public discourse. Now, though, I want to go further and argue for a sustained engagement with specialized knowledge that allows us to bypass the soundbites and instead directly assess medical and scientific information on its own merits. In practice, this means that we should seek out texts that are written not for the general reading public but instead for other healthcare professionals. Yes, some may be incomprehensible, but others are actually quite accessible with a little more time and effort.

I know this is a huge proposition, especially since we often do not have time to even finish that book we’ve wanted to read for months (or years). But I’m not suggesting that we all race to the library to read biology textbooks or start frantically downloading PDFs of medical research articles. Rather, I think we should all try to build more specialized texts into our general reading practices. We should also become fact-checkers and never take a news story at face value. More broadly, we as a society should evaluate the boundaries between academic knowledge and general knowledge, and push toward greater public access to leading research in the areas of health and medicine, in particular. By promoting educated dialogue, perhaps ultimately we can debunk inaccurate health claims and dispel pernicious biases that threaten to undermine our health.



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