ep.306 featuring Ben Lewin's Inside Science, Brian M., and Dr. Bonati on Whiplash Injury

Welcome to American Medicine Today, I'm Kimberly Benati alongside Ethan Euchre. So for centuries, science has been driven by human intellect, but what will science look like with AIs at its creative center? A new book answers this and many other questions. Joining us to discuss is Benjamin Lewin, the author of Inside Science. Thank you for joining us. Hello. So why don't we start off with a question. How is AI really transforming science? Well, it's both a great promise because it can analyze a lot of data faster and more effectively than a human intuition, but it's also rather worrying because it undercuts one of the principles of science. So science has always worked on the principle that your results have to be reproducible by other people. You have to report them in a way that has all the details that everybody else can understand what you've done, how you did it, and what tools you use to accomplish it so that if necessary, they can repeat the experiments. The problem with AI is that because the program has its own parameters, as it were, you don't really know exactly how it works. So how are you going to reproduce something? AI says to you, this is what the analysis of the data produces, but how are you going to validate it? This threatens to change the whole nature of science. Well, and we've covered AI, especially as of late because it's just become, you know, a classic A. How are we going to move forward with this? And we've also discussed sort of the perils we've had guests on that said, this is a terrible idea. I mean, even some global organizations have said that work in AI have said, we need to hit pause on this because we don't know where we're going with it yet, and yet we're unleashing this technology upon the world. What are your thoughts on all of that? Well, I think of it as being very imaginative AI. Oddly enough, it's very creative, but not necessarily quite so factually based. When I was writing the book, I asked it for a list of references on the subject, and it gave me a really good list, authors who publish in the field, journals that publish in the field and titles that look exactly what I wanted. The problem was that when I went to check those references, none of them existed. So what I worry about is that when it analyzes data in science or medicine, there is a risk that it will use imagination rather than a factual check. I asked Demi Hassabi, who is the creator of a program called AlphaFold that analyzes protein structures by AI, how would we deal with this? He said, well, basically, it's looking downstream. You look at the predictions of the results, and if they're correct, that's fine. If some of those predictions don't stand up, then you have to go back and investigate what went wrong. That's not unlike how science works anyway, of course, but I still think it's a little worrying that we're going to publish papers with analysis, which we can't really understand. You also, you talk about something called the grant game. Can you tell us what that is? Yes. So the way science proceeds these days is scientists apply for grants. They basically outline the project they want to undertake. They say how they're going to do it, and they present some reasons as to why they think it will work. The problem is, it's a catch-22. In order to show reasons why it will work, you have to get some data. In order to get the data, you have to have some funds. So people game the system. When they've got one grant, they use the part of that grant in order to get data, which will basically show that the next grant will work. But they don't present too much of that data because then they're not going to get the money because they've done the work already. It's a very circular process. I would really like to see grants which are basically based on asking what projects are you going to do and how you're going to do it. I'd like to see them replaced by funding people. We should say, if you've done good work for the last five years, we'll fund you for the next five years. The worst that would happen is you run out of ideas, it peters out, and a little bit of money is wasted. It's actually a lot less money than is wasted administering the grant system. You talk about this publish or perish mentality. Can you elaborate on that? Publish or perish is a phrase that goes back to 1942, so it's not that new. But it's got a lot worse in the last 10 or 20 years. Basically the way you get a reputation in science, and certainly the way you get tenure at a university, is you publish lots of papers. So publish or perish is just a description basically saying people are looking at quantity rather than quality. How many papers have you published? Then secondarily, I suppose, you look at what is in each paper. The problem is that the pressure to publish like that means that there's a sense in which people play it safe. So you don't do a project that might take 10 years to come to fruition, because during those 10 years, you won't have enough papers in order to be able to get grants, more money, tenure, whatever. And you don't do projects which are a little bit way out, but which might be very innovative and make great discoveries, because it's too risky. They might not work. So you play it safe. So science is becoming less intellectually interesting, less daring, if you like, and we are making maybe fewer major discoveries because of this need to play it safe. You know, the other thing that stands out to me that you mentioned earlier was the fact that there needed to be certain parameters set up. So who are the ones that are setting the parameters? Because couldn't it give you whatever narrative you want if you hone in, you know, parameters? So who's to say it's really science at that point? Well, there is sometimes a sense of looking where the light is. You go where you can get easy results. Basically, the great strength of science is that if you present results which are not to be correct, somebody else will show that they're not correct. And you will have to defend them or retract them. It's what is called a self-correcting system. Sometimes it's called a self-policing system, which is really wrong. There's no policing effort, but it is self-correcting in the sense that if something's wrong, it will be found out and it will be repudiated. You also talk about how, I guess, politics gets in the way. I remember, you know, just reading, obviously, I wasn't there when these things happen. But, you know, talk about back in the day when, you know, the curies were working on things and Jonas Salk with the, you know, the polio vaccine and things like that. They, at least from what I understand, didn't really have a lot of red tape. They could just do the research and say, this is what I found. It's pretty amazing. Check it out. But I believe you talk about how politics gets involved and can actually hamper things. Is that correct? Well, yes. My sense of it is this. Science is basically an unpredictable activity. And if you attempt to direct it using politics, you say, we think this line of research will be more relevant to human welfare, for example. It's completely counterproductive because you never know which results are going to generate something really interesting down the road. For example, we now have the technique, the CRISPR technique for gene editing. Very powerful technique indeed. Where this comes from, where it originated, is in some work 20 years ago, very arcane work on bacteria, which had a lot of trouble being funded because people said, look, it's a weird system of bacteria. It has no relevance to anything. What's the point of it? It turned out the point of it is we now have CRISPR gene editing. My point is that politics, trying to direct science politically, is not only muddleheaded, it's really counterproductive. I wish we could get legislators to realize that nowadays because they're always pushing their science narrative and it turns out there really isn't the data nowadays to back it up. Trust the science, they love to say, and then it turns out the science wasn't really science or maybe it was, but it was inaccurate. That in a way brings us to the main purpose of Inside Science, the book, which is people who are not scientists very often don't understand very well how science works. There's a sort of caricature of science. It's viewed as a black box that produces results. My position is that if you don't understand how it works, I don't mean understand all the technical details, nobody could do that, but if you don't understand the principles by which science works, how can you assess it? During the COVID epidemic, as you just sort of pointed out, people kept yelling, follow the science, but most of them hadn't the faintest idea what science is about. That's why we had so many silly missteps and errors. It's because people don't look to say, what are the limitations of science? What can we take from this that's correct? I think we need to have a better understanding among the public of how science works. In that connection, of course, it is notable that we have very few people who are scientifically qualified in the political class. They're all lawyers or whatever, but scientists, there are almost none in Congress, none in the Senate, none in the political class of any country. All right. Well, thank you for joining us. Benjamin Lewin, thank you for being on the program. It's a pleasure. Thank you very much. Well, that wraps up this segment. Make sure you stay tuned. We'll have more after the break. Don't be screwed by lesser spine institutes who bait you with minimally invasive procedures. Benati invented the precise tools necessary to minimize surgery, scarring, and asthesian recovery. So successful are the Benati spine procedures, they consistently reflect 98.75% patient satisfaction. Over half our patients have suffered from failed back and neck surgeries at other facilities. Benati succeeds where others fail. My name is Brian Mullen. I'm from Palm Coast, Florida. I'm 67 years old. Work is extensive. I work and work and work, but I own three businesses. So I'm a home builder, and I'm a swimming pool contractor, and I'm a roofer, a roofing contractor. Brian attributes his pain to a lifetime of working in the construction business. I really started to notice the difference about a year and a few months ago, and it just sort of started coming on. I think I can remember sitting in front of the TV, watching maybe a football game, and I'm just like scooting around in my chair just a little bit, and I hear a lot of cracking going on. And I didn't think much of it. It wasn't a pain. It was just like an adjustment, you know? But it kept on. It was consistent, and it was quite a bit. So I recognized I was starting to have a problem, get a little pain, and then it got worse and worse into the point where I could barely get up out of bed, very, very painful. It started right there in the base of my back. I'll say my tailbone, way down in there, and that's where the pain, and then it started to increase a little bit down in my butt, and then that was very heavy, heavy tightness. So then it started going down my legs a little bit in the back, some more tightness. No real zingers, but it was there. It was almost like a rubber band. I'm just like stretched too far. It prevented me from getting into the back of my pickup truck. You know, we have a step back there, and I'll forget that, reaching over the side, picking up anything. I forget it. And certainly my activities after work, you know, boating, can't get up, down, around, turn, that's out. Going to the beach and walking down the beach, just, you know, regular activities that one would expect to be able to do at my age. And that was the point where I know I needed some help. Brian tried conservative treatments to relieve his pain. You know, I take the Tylenol. I tried some ibuprofen, so I was scheduled to do that on a regular basis for my knees and other things. But that was it. I just tried to get my feet up and try to sit in the right position after work, try to minimize certain things. Certainly as a contractor, I'm an older contractor, so I'm not grabbing big things out of the truck. I went to a chiropractor about a year ago. I went to my general practitioner. She prescribed me some ibuprofen. More recently, I saw a doctor, and he was doing injections into my L5, L4 area. I got three injections. The first one worked okay. And then the second one, not so much. And the third one was a disaster. Extreme pain. Helped me for maybe a week. And so I knew I was done. And we took it from there, and it just seemed to go downhill. And then just previously, it really went downhill pretty fast. Brian and his wife learned about the Bonatti Spine Institute while watching TV. He started researching more about the exclusive Bonatti Spine procedures. We see it on the news channels. There's a great advertisement you guys have going on there, and that really interests me. And then I followed up on the internet, and I made that call, and I'm glad I did. After reviewing his imagery, Dr. Bonatti called him personally to discuss the details of his pain and to let him know that he was a candidate for the targeted Bonatti Spine procedures. I spoke to Dr. Bonatti. He made the call to me after I sent in my films here, and he had a chance to review them. And he spoke to me and gave me the confidence that he could help. We came in and got an examination that reviewed, Dr. Wolfe reviewed my records with me, my films. He went over that in detail. Brian required three procedures to relieve his pain. At the Bonatti Spine Institute, surgeries are performed incrementally using conscious IV sedation, where the patient remains awake and communicating with their surgeon to determine the source of their pain is eliminated while they are still on the operating table. That was nice. It was better than I thought it would be. I didn't know what to think. How are you doing? I was talking to my anesthesiologist. She was encouraging me along the way, speaking to me. The first day, I got some relief, and then the second day was the big one, and I got some major relief. And then the third day, it was even more, it seemed, than the second day. It was tough, but, you know, it's done. I'm so glad that I followed through, and I got all three of them done at the same time. I got to tell you, after the third operation, and then now today, I have improved tremendously. I mean, just getting up out of bed, getting up out of a chair like this, where I'd have to practically scream in pain, and had difficulties just sitting up, getting up. Right now, it's gone. After surgery, I was, of course, from the back and not from the front surgery. There was no extreme trauma to any organs or anything like that, so I didn't need any physical therapy right there. I didn't need a wheelchair. I didn't need large bandages or, you know, wrappings of that sort. I mean, who wants to go into a hospital where you never get to sleep, right? They're always in there poking you every 15 minutes, and you're not getting any rest in any hospital, that's for sure. So by having the hotel that we had down the street, it was very convenient for us to just back and forth it. Couldn't imagine anything better. Really, it was quite convenient. After the Bonatti Spine procedures, patients are prescribed walking therapy, about 40 minutes a day to aid their body in the healing process. Just walking a little bit, you know, just getting around and walking maybe five minutes here, five minutes there. Just keep everything moving. Brian highly recommends the Bonatti Spine Institute to anyone suffering with neck or back pain. This place is fantastic. I tell them only to come to Dr. Bonatti and his team. Now pain-free, Brian is looking forward to returning to work and his daily routine. I'm looking forward to getting back to my regular routine, and I'm fortunate enough to be young enough, still young enough, to be able to do all that, and I'm ready. Welcome back to American Medicine Today. With car accidents happening all the time, we hear about whiplash, but really, what is it? Can you define that for everyone that's watching? Well, whiplash injury is an overstated injury, and it's very practically very poorly treated. Imagine that you're traveling in a car, and then suddenly you have an accident. You see a car coming from the back, and you know the car is going to hit you. What you do? Brace for impact. I'm going to tell you what you do, exactly. You brace for the impact. Bad. Bad reaction. Because you tense everything up. Because the first thing that you do is you grab with your hands the wheel. You put your feet on the floor or on the brake, depending. Usually people are saying, I don't want the car to move because I'm going to hit the car in front. They put their foot on the brake. The first thing that happens is your neck is going to move forward, and it's going to go with the whip towards the back. So the cervical spine is going to suffer. At the same time, remember, you're preparing for the bump. So you are grabbing the wheel. You are going to twist your wrist and injure your wrist and your fingers. When you try to brace, you are not going to get your elbows bent. You're going to push your elbows straight and try to hold the distance between you and the driving wheel, because you don't want your chest against the other instrument in the car, in the dashboard. So what you do, you injure your elbow, and you really injure your shoulder. Now you have neck injury. You have wrist injury. You have elbow injury, and you have shoulder injury. What happens when you're driving the newer cars that have the airbags, and then not only do you have the back and forth, but bam, you're now hit by that airbag. That is not really a whiplash, but it's not going to allow you to go farther back and forth. The next problem that is injured is your lumbar spine. If you are with the belt, then it's going to twist you, and major injuries happen with the way that they design that type of a belt that creates a rotation injury in your spine. So you injure immediately three levels to four levels of the lumbar spine. Wow. Now you have lumbar spine, cervical spine, neck, elbow, I mean, shoulder, elbow, and wrist. 90% of the people, they will be able to walk, and they will go, hey, that's not so bad. I don't have such a bad injury. Till they wake up the next day, right? But the problem is they are still under the effect of the tremendous amount of adrenaline. So the body is holding a false impression of what happened to you. The next that happens to you is the next day, you barely can move. And one of the symptoms you have is bad neck pain, bad shoulder pain, bad back pain, and probably bad headaches. Few weeks after, that person is hurting all over. And then an orthopedic surgeon or a neurosurgeon or a family physician is seeing this patient. And here we start with physical therapy, with pain management, usually narcotics. Then we go to some medications for depression, some medications for just relaxation, some muscle relaxants, things like that. All these things start to come in the transition of you being healthy to being unhealthy and now in the hands of doctors. You start to take medications that they are not helping. So you increase now, because of the other serial pains, to narcotics. Unfortunately, the Whiplash injury doesn't go away for around seven months to a year. Wow. And it's a pain constant. But will it remedy itself? When you say that, the most excruciating pains will resolve? Or is there any other intervention? No, you will be massively in pain. You cannot perform. Your shoulders hurt, your hands hurt, your neck hurts, you have headaches. Your back is killing you. You cannot walk. Your knees hurt, your hip is hurting, your foot is hurting. So you practically, you are in walking pain. The narcotics are helping. So you can perform. So you can work the pain, though, and the problems are still compounding then at that point. Yeah, well, the problem is the narcotics coming in your body, and the narcotics for seven months is a real problem, because now you are not only a person with all this Whiplash injury pain, but you are now a drug addict. What do they do at that point? Well, you need to have MRIs immediately. They tell you if the back is OK, or is the back, with herniated discs and problems, that they created the pain. So you need to talk to the patient level by level, and see if that patient is talking to you. If this part of the MRI say that this is a problem, and the clinic say the same problem, you analyze that one as mistreatment. The same thing with the neck. One space at a time, one finding at the same time, and talking to a patient, and the clinic, and the MRI, and the scans, and the x-rays will help you to decide is treating this one. What type of treatment now? Once you decide what type of treatment, usually a general practitioner will send a thing to another specialist. If it is a back and neck, he's going to go to a neurosurgeon, orthopedic surgeon. If it is a knee or hip, he's going to go to an orthopedic surgeon. Well, but always the one that doesn't be treated is the headaches. For the patients, the most important. Yes, because it's hard to function. Because they cannot perform. And then at the very end, this patient goes to a neurologist. And the neurologist go and tells you this medicine, that medicine, this other medicine, and this test, and this other test. The problem is nothing more than simple herniation between five and six vertebrae on the cervical spine. That is where it's a small nerve that goes and touch the dura. And when you touch the dura, you have neck pain and headaches. And if you can correct that, then the headache disappear. And it's like a miracle. Yeah. The headache disappear right there in a couple of minutes, it goes away. Once that goes away, the patient is more acceptable to be treated for the other things. Because the other ones, usually with the motion, the movements, and the things, start to get better every day. The headache doesn't. Right. That's the overpowering pain at that point. That is probably what, in my experience, is whiplash injury. Well, hopefully with the knowledge you've gained here, you're better able to explain what you're going through to your doctors. Thanks for watching American Medicine Today. If you have any comments or questions, contact us at the numbers below. Or you can tweet at Dr. Bonatti using the hashtag AmericanMedicineToday or hashtag AMT. We would like to hear from you.