When Medicine Stopped Asking Questions

In 2022, the world conducted an inadvertent experiment on millions of people. As GLP-1s exploded in popularity for weight loss, a pattern started to reveal itself. Patients' disease markers were getting better across many different unrelated conditions.

Within days of starting treatment, far before patients experienced any weight loss, their diabetes was improving. Within weeks, their blood pressure was dropping. Fatty liver disease, kidney function, cognition in Alzheimer’s, and Parkinson’s tremors, all started seeing improvements.

And it was happening in thin people too. Parkinson's patients at healthy weights saw their tremors improve. Alzheimer's patients showed slower cognitive decline. People struggling with alcohol addiction had far fewer cravings. By 2024, GLP-1s were in clinical trials for over a dozen diseases across nearly every medical specialty: heart disease, liver disease, kidney disease, Parkinson's, Alzheimer's, addiction, even cancer. Like dominoes, one disease after another was responding to this single molecule, hinting at the common upstream cause medicine’s siloed approach couldn’t see.

These were supposed to be completely different diseases with different causes. According to medicine’s framework, kidney disease has nothing to do with Parkinson's. Liver disease with addiction. Alzheimer's with heart disease. Yet one peptide was improving them all; bringing into question everything we thought we knew about disease itself, and providing a clue as to what disease actually is.

To understand why this went against our current understanding, let’s go back to 1847, to a Vienna maternity ward where women were dying at alarming rates. They would come to the hospital healthy, and then within days they would develop what was at the time called childbed fever, which presented initially as fever and pain, and then would invariably, and quite quickly, lead to death. Everyone knew this was happening, but no one knew why or what to do about it. A young doctor named Ignaz Semmelweis was working in a hospital at the time that had two maternity wards. One was staffed by doctors and one by midwives, and he noticed that in the doctor’s ward, 1 in 10 of the women who came in for care was dying, whereas in the ward staffed by midwives only about 1 in 30 was dying. The doctor’s ward was far better resourced, they had more training and superior equipment, so why were their patients dying at three times the rate? Semmelweis became obsessed with figuring out the difference. What were the midwives doing that the doctors weren’t? Or—and this was likely a harder question to ask—what were the doctors doing that was killing their patients?

Then one day one of the doctors from the ward, one of Semmelweis’s good friends, got sick and died. He was performing an autopsy with one of his students, when their hand slipped, cutting him with their scalpel. The doctor then developed the same symptoms as the women with “childbed fever”, and the same rapid decline leading to his death. These doctors were performing autopsies in the morning, and then delivering women’s babies in the afternoon. They must be carrying something from the dead, to the living.

Semmelweis came up with the idea to wash their hands with chlorinated lime before surgery, to see if that would stop them from transferring childbed fever to the patients. The doctors on his ward implemented his protocol, and almost overnight, the death rates fell from 10% to 1%. But he didn't know why it worked, he couldn't explain it scientifically, and so despite these clear and documented outcomes, the medical institution wouldn't take him seriously. Without institutional backing, individual doctors had no reason to believe him over their training. They were outraged at his suggestion that doctors could be unclean. Semmelweis got increasingly desperate, and he started writing angry letters, accusing doctors of killing their patients. Which, to be fair, they were. He couldn't understand why they couldn't see what he saw, why they wouldn't believe what his data clearly showed. And eventually, sick of hearing his wild rants, they drove him from Vienna. He died in an asylum at the age of 47.

By this time, in the mid-1800s, physicians had catalogued a huge number of diseases, each with its own set of symptoms and perceived causes, but their theories couldn’t explain the patterns they were seeing. For patients with festering wounds, for example, a surgeon could perform the same operation on two patients, with the same surgical techniques and pre- and post-op care, and one would heal perfectly, while the other would develop angry red streaks, fever, delirium, and death. They called this outcome "hospital gangrene" or "surgical fever" and had elaborate theories to explain it like bad hospital air, the patient's constitution, and even the weather.

Cholera outbreaks would come on out of nowhere and kill thousands of people. During the 1854 London outbreak, entire neighborhoods were leveled by the disease while others would be left untouched. The belief at the time was that it was the miasma that was causing it, you could smell it, the foul air coming out of the cesspits in the Thames, so of course that was what was killing people. Except some people living in the worst air stayed healthy, and removing patients from the miasma didn't always help.

Medicine had unique theories for every disease, each with their own experts and treatments. Wound infection experts debated whether pus was healthy or dangerous. Cholera specialists mapped outbreaks and argued about miasma versus contagion. For tuberculosis, doctors prescribed rest cures in various climates, endlessly debating which location worked best. Medical knowledge was fragmenting with everyone focused on their specific illness, because specialization seemed like the path to effective treatments. No one thought to connect them all, why would they? A wound infection had nothing to do with cholera. Tuberculosis with childbed fever. They were different problems requiring different explanations.

Then in 1857 a chemist named Louis Pasteur was hired by the French wine industry. Their wine kept spoiling, unpredictably turning to vinegar and ruining entire batches at once. Pasteur looked at the wine under a microscope, and he saw what at the time were called animalcules, tiny organisms living in the wine. He noticed he was seeing one type of animalcule (organism) in the good wine and a different type in the spoiled wine. Maybe, he thought, specific types of microorganisms were causing specific types of fermentation.

Now microorganisms weren't a new concept, people had been observing them under microscopes for almost two centuries, but the thinking at the time was that these tiny life forms spontaneously generated from decay. When mold suddenly appeared on your food, or maggots in your meat, they seemed to arise from nothing; one day it wasn't there, and the next it was. Pasteur was the first to show that life doesn't just come from nothing. Through what is famously known as the swan neck experiment, he showed that broth only spoiled when airborne particles could reach it - proving these organisms were deposited from the air, not spontaneously generated, just needing the right conditions to multiply. Once he understood this, he was able to explain why some batches of wine were going bad and others weren’t, and he was able to come up with a system so that they could prevent it from continuing to happen. If the winemakers heated the wine, that would kill off the bad organisms, thus preventing them from multiplying and ruining their wine.

Pasteur was so successful with the wine problem that in 1865 he was asked to help in another French industry that was experiencing a similar and similarly mysterious issue. Whole crops of silkworms were dying off in large numbers, again, seemingly at random, and causing massive loss for the industry. And as you can probably guess, it turned out to be exactly the same story. Pasteur found that microorganisms were infecting the silkworms, causing disease, and that the disease passed from sick silkworms to healthy ones through the spread of these microorganisms, which led to entire colonies being wiped out almost at once. The same thing that was spoiling wine was killing living creatures.

This is when Pasteur started connecting the dots. If the same thing, microorganisms, was spoiling wine and killing silkworms, passing from one to the next through the air or physical contact, what else could it be doing that we aren’t seeing? Was it possible that this was affecting humans too? That all those various medical conditions like cholera and tuberculosis and childbed fever were also caused by these same microorganisms?

Pasteur had stumbled onto a discovery that had the potential to explain all of those disparate illnesses and even possibly create a unifying theory of disease that medicine had been lacking. But the concept of 'proof' as we know it today didn't exist yet, and without any way to prove his ideas, there was no way to convince doctors to incorporate his thinking. They had rejected Semmelweis even with clear evidence, despite him showing that his new protocol was drastically saving lives. These doctors had been building and debating their protocols and theories for decades, and changing people’s thinking when they’ve invested their lives thinking about things a specific way is not easy. For his idea to overturn centuries of thinking, he would need some way to prove it to them. The challenge was, what kind of proof would convince them? Luckily for medicine, it was around this same time, in the mid 1800s, that the way we thought about proof and what counted as evidence was about to change.

Defining proof

For most of human history, "knowledge" came from a combination of observation and, even more importantly (then and now), authority. For example if Aristotle said something, it was automatically considered true. If you had enough authority, you could observe something, and if you had a good enough explanation for what you were seeing, your educated guess could become accepted truth. The idea of taking those observations and somehow testing them to prove what you thought you were seeing just didn’t really exist. But in the 1600s this system where guesses became truth started to change. Francis Bacon famously argued that you shouldn’t just be able to reason your way to ‘truth’, you should have to test it. He thought you should observe it, conduct an experiment, gather data from that experiment, and then you could draw conclusions. And he wasn’t the only one. René Descartes contributed the idea of systematic doubt, which is that we should question everything, and break each problem down into its component parts, drilling down into smaller and smaller parts and then separating and analyzing them carefully. And by the late 1600s and into the 1700s, scientists had largely adopted this framework, and Newton's work on gravity and motion showed the world how powerful this new approach could be.

This new method of gaining scientific validation, what is now known as the scientific method, worked beautifully well for things like physics and math. Things that behaved predictably, didn’t change or adapt, and could easily be broken down into their component parts and measured or tested in a lab. Planets reliably orbit around the sun on the same path, chemical elements combine in consistent rations, and gases follow precise laws as they relate to pressure, volume, and temperature. Through this new method of testing, sciences like physics and chemistry were transformed from philosophical speculation into rigorous sciences. And through this transformation, a new era of scientific discovery had begun.

Medicine, however, lagged behind. By the mid-1800s, physicians were still relying largely on the old ‘scientific’ methods of tradition, authority, and clinical observation. They would watch patients, catalogue their symptoms, and try treatments to see how they worked, but they weren't designing controlled experiments to test their theories about what caused disease. This meant that medicine at this time was still largely made up of a lot of guessing, very few effective treatments, and minimal clear answers.

The framework is born

Which brings us to 1876, to a makeshift laboratory in a small German town, where a doctor named Robert Koch was trying to figure out what was killing farmers’ livestock. Anthrax, a bacterial disease that had been killing off livestock for centuries, was devastating cattle and sheep across the region. While some animals would get sick and die, others in the same field would remain healthy, and as we have now seen over and over again, no one had any idea why. Now Koch, who was extremely methodical and driven, was determined to figure this out. Building on the work of Pasteur, he knew where to look for the answer, and he spent months isolating bacteria from the diseased animals, growing them in pure cultures, and studying them under a microscope. And what he did during these months of meticulous work was something no one else had ever done before in medicine; he created a systematic way to prove that a specific microorganism caused a specific disease.

His system of proof, which became known as Koch's postulates, is still taught in medical schools today, and consists of four steps: First, find the organism in sick patients - by examining their blood, tissues, or other samples under a microscope. Second, isolate it and grow it in pure culture in the lab. Third, introduce it to a healthy animal and reproduce the disease. Fourth, isolate the same organism again from the newly diseased animal and see if it matches the one you originally found. So in short: find the unique organism, isolate and grow it, put it into a new animal, then pull it out and isolate again. If you could do all four steps, you had proof - not just speculation or observation or theory, but proof - that one specific microorganism caused one disease. It was repeatable and testable. Koch had figured out how to apply the scientific method of the hard sciences to the messy field of biology, and now medicine finally had a way to prove causation.

Once Koch had successfully used his new system to find the specific bacterium that was causing Anthrax in the diseased animals, he moved on to studying disease in humans. He was able to use his new system to find the specific bacterium that caused tuberculosis, which was the leading killer of the time. Then he found the bacterium that caused cholera. For every new discovery he used his postulates, and his method proved effective over and over again. This became the first domino in a series of changes that would lead to what we know of as “evidence based” medicine today. Koch had systematized medical research, and this framework: one cause, one disease, isolated in a laboratory, tested systematically, became THE way to think about disease.

And it worked. Spectacularly. Within decades, scientists had identified the bacteria causing diphtheria, typhoid, tetanus, pneumonia, and the plague. These diseases that had killed millions for millennia suddenly had identifiable causes, and even cures. Antibiotics arrived. Vaccines proliferated. Infant mortality plummeted and life expectancy soared. Medical authority and prestige was on the rise, and it was hard earned; the results from this new way of thinking about disease were incredible. Medicine had officially grown up, from bloodletting and humors, to saving lives on a massive scale. The framework was touted and celebrated, and it deserved it.

Stuck in neutral

The framework was succeeding wildly, but with each victory, it also grew more rigid. Through these successes and saved lives, it had started becoming the only way people were allowed to think about and conceptualize disease. If you couldn't isolate a pathogen in a laboratory, culture it, and reproduce the disease in a controlled experiment, then what you were describing wasn't considered a real disease. Medical education was transformed around this model and research funding started flowing only to studies that fit it. Pharmaceutical companies built empires around it. The infrastructure of modern medicine, now a nearly 5 trillion dollar behemoth, was built on Koch's postulates.

And all the while, as medicine celebrated these victories and organized itself around this new system, chronic disease was becoming the dominant health problem of the developed world. And the framework that had worked so brilliantly for infectious disease just didn't quite work for these new diseases.

Heart disease. Cancer. Diabetes. Autoimmune disease. Alzheimer's. These conditions didn't seem to fit the mold we had trapped ourselves in. Because in an interconnected body, with a condition that affects multiple systems, there is no single pathogen to isolate, no simple cause-and-effect. Researchers were able to find associations, risk factors, and genetic predispositions, but nothing that could cleanly explain what they were seeing. There was nothing in these diseases that worked the way anthrax or tuberculosis had worked. And medicine, instead of questioning whether the framework fit these diseases, or whether perhaps these diseases were something else entirely, doubled down. There MUST be a specific cause: a gene, a protein, a pathway. It had worked so well before, we just haven't found it yet. We must just need more funding, more studies, and more decades of searching.

Medicine threw money and resources at the problem for decades, making little forward progress, but sticking rigidly to the model. While researchers kept searching for the single cause, they ran into two main problems. For the big diseases - cancer, Parkinson's, Alzheimer's, heart disease - the high profile diseases that brought in the funding, they did find things: genetic mutations, protein aggregations, plaques, inflammatory markers. With billions of dollars and decades of research, they could finally point to specific mechanisms. But knowing what was broken wasn’t leading to cures. Cancer treatments remained brutal, often killing healthy cells along with diseased ones. Parkinson's and Alzheimer's medications might slow progression slightly, sometimes helping with symptoms for a while, but they couldn't stop or reverse the damage. Heart disease treatments managed symptoms but didn't address why the disease developed in the first place and didn't actually reverse anything either. The framework had delivered on its promise - it found the specific effects the diseases were causing on the body. But it couldn't deliver what patients actually needed: healing.

And then there were all the other patients. The ones with Chronic Fatigue Syndrome, Fibromyalgia. IBS. Chronic pain. These conditions received little funding due to the stigma that they weren’t ‘real’. The framework's definition of 'real disease' had become completely untethered from patient experience or even biomarkers, the objective physiological measurements that medicine uses to confirm disease and develop treatments. As an example, when The Rome Foundation, the organization that sets IBS diagnostic criteria, updated them in 2016, they didn't use the biomarkers that had been found - which by then had an Area Under the Curve (AUC) of 0.89 which is a standard metric for evaluating diagnostic tests. Which, if it were used, puts these into the good to excellent range for diagnostic testing, and rivals that of the diagnostic accuracy of any of the ‘big’ diseases. Instead, they surveyed about 1665 people from the general population, excluding people who had been diagnosed with IBS, found the 90th percentile of symptom frequency, and declared that the threshold for disease. The top ten percent of bowel issues in this swath of healthy people became the new definition of IBS. And subjective pain became the primary marker, despite clear biomarker evidence. So anyone with severe, constant, debilitating symptoms that weren't specifically pain - daily bloating, distention, and abnormal bowel function - no longer qualified for diagnosis or treatment. The change cut IBS prevalence in half overnight - not because fewer people were sick, but because they no longer met the criteria. Medicine had defined disease by population statistics rather than by whether people were actually sick, and this change got ratified by the same committee that proposed it. No real research necessary. The pattern holds across the other dismissed disorders too, for example Fibromyalgia has biomarkers with around 85% diagnostic accuracy, and Chronic Fatigue Syndrome’s biomarkers diagnose the disease with a whopping 96% accuracy. And without the legitimacy that would come from people paying attention to these biomarkers, funding dried up, and without funding, treatments were never developed. Millions of patients suffered for decades with conditions that had documented biomarkers but no available treatments, leaving millions of patients in limbo.

The framework had a label for these cases: "functional disorders." Not real disease, just the body malfunctioning ‘without a clear structural cause’. Because no one was talking about these biomarkers, and without thinking about the biomarkers, if you couldn't culture it, image it, biopsy it, or see it under a microscope, then by definition it wasn't a disease the framework could recognize. Medical training even has a term for the patients with these conditions: 'heartsink patients'. They are taught in medical school about this subset of patients that keep coming back with symptoms but no findings, and who ultimately become a drain on doctors time and energy. The term ‘heartsink’ was coined to capture how the doctors felt about these patients, as in, the patients who make doctors' hearts sink when they see their name on the schedule. These patients were shuffled between specialists, each finding nothing wrong in their domain, until the labs they took based on outdated knowledge came back unremarkable and they were eventually referred to psychiatry, told their symptoms were psychosomatic, and that they needed to manage their stress.

But the patients in both groups were still sick. And medicine, having built itself entirely around finding specific, visible causes, had no framework for either group. Neither the “real” diseases where finding the mechanism didn't lead to cures, nor the “functional” ones, with biomarkers medicine wasn’t looking for. By the 21st century, chronic diseases were causing 75% of all deaths worldwide, and the framework had failed the majority of medicine's patients.

Yet despite this clear gap in our ability to help patients, medicine was becoming MORE dogmatic, not less. The failures should have prompted questions; the pattern was clear in the data. The framework could identify mechanisms but not produce cures. Millions of patients suffered with no identifiable pathology. Medicine was missing something fundamental, the way it had missed microorganisms for centuries, but this time by being too focused on the microscopic to see the pattern at a different scale.

You would think it would be clear the same pattern was repeating again, but we don't seem to learn from history the way we think we do. In the 1830s, "heroic medicine" was the dominant medical framework. Physicians believed that illness stemmed from imbalances in bodily fluids that needed to be expelled, so they would bleed patients repeatedly, or give them mercury to induce violent diarrhea, all in an attempt to purge the disease. And it was actively killing patients. People could tell the official approach was wrong, so alternatives proliferated: herbal remedies, water cures, dietary reform, the 1800s version of the wellness industrial complex today. Some of these helped somewhat. Some were nonsense. None had the actual mechanism, they just knew the establishment was failing them. It took germ theory to finally explain what was actually happening, and once it did, medicine gained the authority to dismiss the alternatives. But that same victory created a new blindspot: the assumption that all disease must work like infectious disease. Find the pathogen, kill the pathogen. Heroic medicine had the wrong framework for infectious disease. Germ theory has the wrong framework for chronic disease. And medicine, so buoyed by its victory figuring out germ theory, can't see they're repeating the same pattern.

Medicine’s calcification

The success had been too spectacular. Germ theory and Koch's postulates hadn't just cured diseases - they had transformed medicine from educated guessing into a respected science. For the first time in human history, doctors could reliably save lives. That success became medicine's identity, its claim to authority. And instead of questioning whether the framework fit chronic disease, medicine closed ranks. To question the framework was to question whether medicine deserved its hard-won prestige.

And by the mid-20th century, enormous infrastructure had been built on that framework. Medical schools restructured their entire curricula around it - going from two-year apprenticeships to up to fifteen years of rigorous training in identifying pathogens, understanding molecular mechanisms, and finding specific causes. Licensing boards tested whether doctors could think within the framework, and research institutions organized themselves into departments studying specific diseases with specific mechanisms. The money followed the framework too. Pharmaceutical companies built trillion-dollar empires on the principle: one drug, one target, one disease. A pill for every ill, each designed to hit a specific molecular pathway. Research grants flowed to projects that fit the model - isolate a mechanism, develop an intervention, then test it in controlled trials. Entire careers were built on expertise within the framework. Questioning it didn't just threaten ideas; it threatened livelihoods, institutions and industries.

Then there was the public health imperative. Vaccines work. Antibiotics work. When medicine needed people to trust doctors - to get their shots, take their medications, and follow medical advice - "trust the science" became essential messaging. Any hint of uncertainty could be exploited by quacks peddling snake oil, or people spreading dangerous misinformation. Medicine had to project confidence, certainty and authority. To say "we don't actually understand chronic disease very well" would undermine the credibility needed to get people to accept the treatments that DID work. It became a propaganda of sorts, but one with a virtuous goal: make sure people keep taking these life-saving drugs.

So medicine and the industry that surrounded it circled the wagons. The framework that had succeeded spectacularly for infectious disease became the ONLY legitimate way to think about ALL disease. If your illness didn't fit–if it couldn't be cultured, imaged, biopsied, or measured with the tools designed to find what we already knew existed–then either you weren't really sick, or we just hadn't found the mechanism yet. Keep looking. Keep testing. Keep believing the framework will deliver. And anyone who suggested otherwise faced dismissal. Researchers who proposed methods that didn’t follow these strict guidelines struggled to get funding. Doctors who acknowledged the limits of the framework risked being labeled unscientific. Patients who insisted their suffering was real despite normal test results were told it was psychosomatic, that they needed to see a psychiatrist, that perhaps they were catastrophizing their symptoms.

The spiral to dogma is complete

By the 1980s the dogma was well cemented into our society, from the institutional level all the way down to how we talked about our own illnesses. An outbreak in a small Nevada town would soon test just how far medicine was willing to go to defend it. In 1984 in the affluent resort town of Incline Village, Nevada, on the shores of Lake Tahoe, dozens of residents - teachers, professionals, active community members - suddenly fell ill with debilitating fatigue. They experienced cognitive problems and flu-like symptoms that wouldn't resolve. Two local physicians, Daniel Peterson and Paul Cheney, meticulously documented the outbreak. They ran tests and tracked patterns, following every medical protocol they knew.

When they reported their findings to the CDC, investigators were sent to examine the outbreak. When they arrived they found that none of what had been documented fit their framework and so drew the conclusion that this was a case of mass hysteria. They even started calling it the "Yuppie flu." The patients - many of whom were successful, educated, and previously healthy - were dismissed as stressed, anxious, and perhaps subconsciously seeking attention. And the doctors, Peterson and Cheney, were ridiculed for taking it seriously and for continuing to research what would later be recognized as Chronic Fatigue Syndrome.

And Incline Village wasn't an isolated incident. For decades prior, similar cluster outbreaks had been documented - at hospitals, schools, even an entire symphony orchestra. From 1984 to 1992, an unprecedented wave of these clusters was reported across North America. And the CDC systematically dismissed them as mass hysteria. And because of this systematic dismissal, around 1992, the reporting just...stops. The illness didn't disappear, Chronic Fatigue Syndrome (ME/CFS) continued in sporadic individual cases, but the cluster outbreak pattern that had been documented for over 50 years suddenly vanishes from the medical literature. When institutions declare something illegitimate, people stop reporting it. These patients' suffering was real, but because the CDC declared it hysteria, they lacked the funding needed to find the markers that the framework would take seriously. And as you now know, without a pathogen to culture or a lesion to biopsy, the framework left them with no category for their illness except: not real.

But the dogmatism went even deeper than dismissing what didn't fit. Even discoveries that followed the framework's rules perfectly could be rejected if they challenged the wrong beliefs. In 1982, two Australian researchers, Barry Marshall and Robin Warren, discovered that stomach ulcers - long attributed to stress and excess acid - were actually caused by the bacterium Helicobacter pylori, otherwise known as H. Pylori. They followed Koch’s postulates and the framework to the letter. They isolated the organism from diseased tissue, they cultured it, and they even demonstrated causation when Marshall, in an act of desperation to prove his point, drank a culture of H. pylori and gave himself acute gastritis, then cured it with antibiotics. This was Koch's postulates executed flawlessly: a clear bacterial cause for a disease. Exactly what the framework was designed to identify.

But the medical establishment rejected it anyway. For years. In 1983, their abstract was one of only 11 rejected out of 67 submissions to the Australian Gastroenterology Society meeting. Their paper linking the bacteria to ulcers faced extensive delays at The Lancet, one of medicine’s most esteemed journals, ostensibly due to "difficulties finding reviewers." At conferences, the microbiologists in attendance were intrigued enough to start research projects, but gastroenterologists routinely dismissed the theory as "preposterous." Then Marshall discovered something that revealed just how deep the resistance went; when he submitted his first paper to a US journal, it was rejected - not because the science was flawed, but because senior gastroenterologists had made a policy decision that the theory was "too new and radical" and they wouldn't accept papers on it. So they made this decision despite the solid science, because it seemed too…new.

The prevailing wisdom at the time was that bacteria couldn't survive in stomach acid, that ulcers were a stress disease, and that the real treatment was antacids and acid-suppressing drugs. And it’s important to note that Tagamet and Zantac were among the world's biggest-selling prescription drugs at the time, and generated billions in pharmaceutical sales. Marshall called it fighting the "Acid Mafia." It would take a decade before the medical community integrated his findings into treatment protocols, and it would be twenty-three years before he received his Nobel Prize for the discovery.

Even when researchers follow the rules perfectly, even when individual doctors or researchers see the truth clearly, if it challenges the framework, they're dismissed until the evidence becomes undeniable - and sometimes not even then.

Medicine had become unfalsifiable

Chronic fatigue syndrome didn’t fit the framework so it was dismissed. H. Pylori didn’t fit in with current understanding and established knowledge so it was rejected. The spiral to dogma out of control was complete. The “science” of medicine had become unfalsifiable. If it found a mechanism, that proved it worked. If it didn't find a mechanism, that just meant we needed to look harder, develop better tests, search at a different molecular level, or dismiss it as not real. If you look through the medical literature, it’s full of researchers documenting findings that don't fit, calling things "paradoxes," noting things are "surprising" or "novel," saying "mechanisms remain unclear" - and then the papers just... stop. They don't follow the implications. They add the anomaly to the list and move on. There is no observation, no pattern of failure, that can challenge the fundamental assumption: all disease must work the way infectious disease works. When a new framework explains existing anomalies better than the current model, it faces resistance proportional not to the weakness of its evidence, but to how fundamentally it threatens established thinking. It voraciously searches for anything that could question the new idea, and demands the new framework be perfect in every scenario, while giving the old framework infinite grace. Semmelweis had the data. Marshall followed Koch's postulates perfectly. The evidence didn't matter - the framework was more powerful than proof.

But if you know anything about science, you know that it’s supposed to be provisional. "Here's what we know now, subject to revision when we learn more." That's the whole point. We celebrate scientific breakthroughs precisely because they overturn what we thought we knew. But medical science has become something else. It’s become: "This IS how disease works. Questioning it isn't scientific curiosity - it's dangerous anti-science thinking." This system, the very framework that was supposed to help us understand disease, had become the thing preventing us from seeing what we were missing. And this dogmatic institutionalized ‘truth’ became the operating system of modern medicine. For decades, it determined what counted as real disease, what deserved funding, and even which patients deserved belief. An entire generation of physicians was trained to believe the framework was reality itself, not a tool for understanding it.

And then, in 2022, came the drug the framework couldn't explain

Trial after trial showed GLP1s improving a dozen different diseases. The results were being published rapid fire in medical journals, and new uses were getting approved by the FDA. But nobody could explain why it was helping across so many conditions.

And the research money was pouring in. Each new trial revealed another disease responding to the same drug, and each time, the response was: publish the results and move on to the next trial. Never stop to ask the obvious question.

If one peptide improves diabetes, heart disease, liver disease, kidney disease, Parkinson's, Alzheimer's, and addiction, what does that mean about what these "different" diseases actually have in common?

The framework had no answer. Because answering that question would mean admitting the framework was wrong about what chronic disease actually is.

The blind men and the elephant

But it turns out there is an answer, and this answer has been clinically and academically documented across all of medicine. Every single piece of data points to one overarching mechanism, a physiological state that precedes all disease expression, that medicine has been documenting and then overlooking, because they're looking at the pieces instead of the whole.

You've probably heard the parable - of blind men touching different parts of an elephant, each convinced they understand what they're touching. One feels the trunk and thinks it's a snake. One feels the leg and thinks it's a tree. One feels the tail and thinks it's a rope. They're all right about some details of their piece, but they're all wrong about the whole. Medicine has been meticulously documenting every piece of the elephant for over a century, without ever stepping back to see what they're actually looking at.

So let's do what medicine can't. Let's take a look at the pieces across all of medical research. Every medical system, every specialty field. And then we can step back and see the entire elephant that's been hiding in plain sight.

We'll start with one clue in particular - something that's been measured in hundreds of thousands of clinical trials, documented since the 1950s, and dismissed every single time as noise to be subtracted away.