Thought as a dysfunctional system

How we idealise thought! We say we need to think things through. We say we need time to think about things. We want to think things to their logical conclusions. But when you are lost, an early move is to admit you don’t know where you are. When you are digging a hole, pausing is no bad thing.

I want to emphasise the extremely empathic humanity of David Bohm because there is another sort of more aggressive challenge that we associate with the legal system and certain business techniques like Red Teams, where the aim is to destroy the credibility of your opponents and their thinking. I want to claim that such adversarial systems often cover up the flaws that are truly systemic and which may infect both pro and con arguments simultaneously. Nothing says that, because one person is wrong, the other person is necessarily right. There is a world of difference between mutually seeking the truth and trying to attribute error.

I have a friend who was a senior EU civil servant / scientist looking at things biological. I needed to explain to him about my keto diet and his immediate reaction was: “but that is a whole different biochemistry”. That is, you can say very little about a keto diet from the perspective of human microbiology, because human biochemistry, as practiced and studied, excludes all the processes that make a keto diet work.

I tasked Prof Trish Greenhalgh at Oxford with this in an email. She agrees that this is a whole other biochemistry, and she was taken with the idea that she might give a lecture on what change in thinking would be maximally disruptive for medical knowledge as we know it. But I have not had her admit that the evaluations she does, as to whether this policy or that treatment in the health sphere are cost effective, are also invalidated by these systemic flaws. Of course, everyone knows that it is difficult to learn something when your job depends on not learning it.

Let’s step gradually closer to this. The medical condition we have used before and which I know about first-hand is diabetes. Diabetes is known in the medical world as a progressive disease that there is no escape from. You can manage it first with lifestyle and then with medication to prolong life and quality of life (avoiding amputations!) but that is what medicine can do for you. This belief is true and corresponds with GP and consultant experience and observation.

The buried assumption is that it is glucose metabolism that is the basis of life and energy. We live by burning glucose. This is awkward because it is precisely glucose that diabetics cannot deal with. But there is another biochemistry! We can also metabolise ketones, thus sidestepping the whole question of needing starches in the diet. To your average doctor this is dangerous nonsense, but statistically it is turning out over the years that people who put themselves on a keto diet almost all do better than people receiving conventional treatment.

As it turns out a keto diet works wonders for all sorts of health conditions. In evolutionary terms we used to be in ketosis most of the time and our bodies seem to need to be ketosis at least occasionally. This corresponds to the feast and famine life of hunter-gatherers and the diet high in animal fat that sustains them. And we can look closer to home, as it seems that breast-fed babies are in ketosis most of the time: this is clearly a natural state and one beneficial for development.

While we are there, we can note that elite athletes in many disciplines put themselves on keto diets for performance reasons. And we can see why this might be a good idea. A hunter cannot outrun an antelope, but he has the stamina to pursue him all day until the antelope is exhausted. Without eating gels full of glucose!

If we review this now, we see a medical science and epidemiology based on a totally flawed assumption that gives advice that kills people by the million. And it is simply not visible from within medical science. Thought as a system indeed. We cannot study, for instance, whether a new drug works for dementia, because 99% of elderly people in our study set are on a diet that promotes dementia. It might be interesting to know whether an approach works for elderly people on a diet that makes their condition worse, but it doesn’t really advance medical, biochemical knowledge.

Many studies of low carb diets use definitions of low carb that are not ketogenic. Studies have used definitions such as “less than 40% of calories from carbohydrates”. The buried assumption here is that carbohydrates have a simple dose response function. It is assumed that fewer carbs must be better if the low carb hypothesis is true.

That of course is pure laziness of thinking. Insulin is a hormone and insulin resistance is at the centre of these biochemical questions. It seems that for a range of individuals, there is a tipping point or switch somewhere between 20g and 50g of carbohydrate per day. At those levels the biochemistry is switched from metabolising ketones to metabolising glucose and trying to store the excess glucose as fat. I keep my carbohydrate intake to below 30g most days: no bread, pasta, rice, potatoes, pastry, fruit, root veg. An apple a day would keep the doctor in attendance.

It is the existence of this switch that invalidates almost all medical research. The ability of the body to move between two different biochemistries means that no stable, valid conclusions can be drawn without specifying which biochemistry they apply to.

As an example, I saw a paper that said that lactate is an important intermediate step in cancer formation. Lactate is a product of glucose metabolism by muscle cells: it is what gives athletes pain in their muscles at very high work rates. We have already pointed out that on a keto diet, in a keto-adapted athlete this does not occur. While not claiming any athletic prowess in my 60s, I know that I do not get sore or stiff the way I used to. It is at least conceivable that the pain given by lactate build-up in the muscles is a valid body warning that you are doing it wrong.

Apparently, conclusions about diet drawn from epidemiology are much more wrong than right. At least 80% are, with hindsight, not only unsupported by the evidence but contradicted by it. Which doesn’t stop people, and perhaps especially the popular press and academics paid to corrupt the science, from drawing epidemiological conclusions all the time.

Just imagine for a moment epidemiology in the realm or oral health. Focus on all that tooth brushing and fluoride and gum disease and caries. Focus on stopping kids sucking sweets and drinking fizzy drinks. I don’t know what proportion of people in the UK don’t have caries because of the care with which they brush of floss, but…

People on a keto diet do not have gum disease or (new) caries. There is a perspective that says that the mouth is an early warning system for our general health. If something ferments in our mouths and gives us inflamed gums, we should not be eating it. How easy is that? But the whole of dentistry and the epidemiology of oral health is consumed by prevention and treatment options that should never be necessary in the first place.

There is no, and can be no, statistical basis for the epidemiology of oral health until this changes. It is not just sweets and fizzy drinks that a dentist might currently advise against. It is wholemeal bread and crisps and chips and indeed rice with your curry. It is the Healthy eating plate advised by Public Health England. The norm is in a place where we cannot learn.

I have heard of marketing meetings inside an oral health company where what was being discussed was what they could claim a toothbrush could do for oral health. Like clean the inside of the cheeks and the tongue. I have heard recently of a poor soul marketing Nutella and being in brainstorming meetings to find ways of describing sugar that might confuse consumers. The might of these corporates is trained on making us ill, and it does. But the scale of deception is such that the norm changes and we don’t any longer have a basis for understanding what products do to our health.

One more example is the gut microbiome. Researchers say that they cannot find a gut biome that represents primal health, one that has not been damaged. So, they have no reference point for what a gut biome ought to consist of. Where is the person who has never taken an antibiotic? Who has never consumed processed food with trans fats? Where is the person whose meat consumption is only from pasture fed animals?

What I hope to establish with this case is that thought can be a dysfunctional system. I have seen high powered Cambridge academics with a role in advising the government on health matters being unable to fight their way out of this wet paper bag. They put their confidence in “science” as a progressive discovery machine that must be rigorously applied and end up talking drivel. They claim that only highly trained scientists can discover the truth and end up with ad hominem insults to people who have outflanked them without having their credentials.

It is worth returning to an image of Bohmian Dialogue and understanding just how far these people are from being able to examine their assumptions. Their assumptions are buried in and buttressed by what they can get research money to investigate. They are buried in their promotion prospects and indeed in severe sanction if they dare to challenge the Public Health England lies. How liberating would it be for these asphyxiated beings to dialogue together without prejudice? What brilliant productivity for public research money might follow?

When we say that a system of thought is dysfunctional, we are saying that because of flaws in the system, and an inability to look for those flaws, no logical result of thinking can be relied upon. We are not talking about localised and localisable errors that need to be locally corrected. We are talking about the corruption of a system of thought so that it tends to give wrong answers that are believed to be logically correct. We cannot park the sense that an assumption may be wrong and may need to be challenged: we cannot in practice do useful work until we are prepared to accept that, and indeed to find others to accept it with.

It is hard enough thinking things through. It is ten times harder to think how they might be different if some of our assumptions changed. It is ten times harder again to find people who also want to uncover the dysfunctions. But thinking in a dysfunctional system in not just a waste of time and effort; it further pollutes the water for those around us.

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