- @Tough Cookie: "Stop calling the symptoms
of more than half the population "atypical."
(jazzy bass beat music)
Last week, not only did I give you two videos
that were quite deep in terms of their topics,
but they were quite long as well.
So I appreciate you watching them,
and leaving your feedback.
In today's video, I'd like to address
some of the most common critiques and criticisms
from those videos,
in addition to responding to comments as I usually do.
Let's get started.
Peewoop!
"STOP calling the symptoms
of more than half the population 'atypical.'"
I got this comment a lot, and I totally understand why
The tricky part about recognizing heart attack symptoms
in female patients is that they are often masked
and they often present atypically.
It sounds like I'm calling the symptoms
of a heart attack atypical
because they happen in the female population.
That's not the case.
The majority of all people, men and women,
experience heart attacks with chest pain.
Now, if you're having jaw pain, stomach pain,
nausea, fatigue and you're having a heart attack,
that is an atypical presentation,
whether you're a male or a female.
What I was trying to say in the video
is that if you're a woman,
you're more likely to have these atypical symptoms,
not that all women experience atypical symptoms
and men experience classical symptoms.
That's not how that works.
@Bella24NJ: "You mentioned women use a more narrative
style of talking and that makes doctors have more errors.
Isn't that a form of victim blaming?"
Bella, I can see how you can get there.
What I think the study was trying to accomplish
was to figure out reasons why women
were being misdiagnosed when it comes to the way
they present their illnesses.
Now, this is not saying that it's the woman's fault
for having this narrative style.
This study is identifying that this is the cause
and then we can further address it
by educating doctors to be better suited
to accept a type of presentation.
Some advice that I give to all my patients,
irrespective of their sex,
is that they should not be afraid to be outspoken.
If a doctor's doing something
that they're not comfortable with
or they feel that the doctor is missing something,
they should speak up.
If that doctor is not willing to listen and communicate,
get a second opinion.
That's not always feasible in a given moment.
But it's important to advocate for your own health.
This is not to excuse bad doctors' habits.
This is simply a practical solution
for a problem that I see occurring quite often.
@JonsLana: "I hear you but to be perfectly honest,
you sound like you are justifying and making excuses.
I understand you are a medical provider,
but please try and see this from a patient's perspective.
It would be more helpful."
@JonsLana, I'm sorry you feel that way.
I really do and try and see all of these situations
from a patient's perspective.
Not only have I been a patient,
but my family have been patients.
I lost my mom to cancer,
and I spend a lot of time in hospitals.
So I do know how the system works intimately
from a professional perspective and a patient's perspective.
That being said, the purpose
of me doing the reaction video to this
was not to defend doctors.
It was simply to take a 360 look at the issue
and really point out that while bias and discrimination
definitely occur, we need to talk about it,
I also didn't want to lose focus
and see that there's a lot of other issues
that are contributing to these disparities
that weren't discussed on this bit.
@JDela10: "I liked Haidt's book, but I can't help
but see a bit of contradiction here
because he says kids are antifragile
so don't overprotect them, but yet he wants them
to be kept away from social media altogether."
Jonathan Haidt made a really good point
that we had to edit out simply for time's sake
because this was 100-plus-minute interview
and we did only show you 48 minutes.
So I'll let him say his take.
But I have a slightly different opinion on the matter.
- Okay, Haidt, you're saying that we need
to let kids out more and not supervise them
and kids have to climb trees
and they have to get injured.
But then you're saying
we shouldn't let them on social media.
Aren't you coddling them and overprotecting them
from social media?
And I say, well yeah, logically that's a good point.
But let's see if it's the same kind of learning.
When you climb a tree and you get in trouble,
you get scared or you fall or hurt yourself,
you learn, you don't avoid trees.
You actually climb trees better the next time.
But when you're shamed on social media, what happens?
And I always ask, say, everybody who's in Gen Z,
how many of you have been on it
since you were 10 or 11 years old?
A lot of hands go up.
I say, okay, do you think that being on social media early
and being shamed and being attacked,
do you think that overall that's made you tougher
and more independent because I've been shamed
and attacked so many times, I don't care,
or do you think it's made you more hesitant,
it's made you more self-censoring,
it's made you more careful about what you say?
And the overwhelming consensus,
it's a large majority say it's the former,
that they, no, no, the latter, I'm sorry.
- Yes.
- The large majority say
- Yes.
- That it's that they're more
- Protective.
- They're more self-censoring, basically more cowardly.
- In my opinion, we don't want to expose children
to unnecessary chronic stress or chronic trauma.
And I think social media falls into that category.
If my child goes to school and gets called a name
and comes home upset about it,
that's good, that's an acute stress.
They're gonna learn how to deal with that.
But now if they're being called that name
every single day at school, being bullied,
then they come home and they're being bullied
on social media and it never stops,
that now crosses a line into chronic stress/trauma
where I need to step in.
My second point on social media
is that it really functions like a drug
because of the way that it affects our minds.
The likes create a dopamine hit,
much like vape pens do, cigarette smoking, alcohol use does.
And we don't let young children use those
because they haven't quite developed the frontal cortex,
the decision-making part of their brain.
So exposing them to social media earlier on
can really affect the way they mature
and their circuits form.
So I think keeping children away from social media
until they're mature,
and that line is different for everybody,
is not a bad idea.
"This is the first time I've turned off one of your videos.
The implication that children shouldn't be protected
from bullying, or emotional abuse, is ridiculous.
It doesn't make children stronger.
But it does make many of them suicidal, including me."
Now Sarah, I'm incredibly sad to hear that
and I'm sorry you had that experience watching our video.
The type of conversation that Jonathan Haidt are having
is really fraught with nuance because it's really important
that we don't just say, "Oh, all children
should be bullied and they'll become stronger
and that's all good."
That's not what we're saying.
And it's really important
that we pay attention to that bit of nuance.
What we're saying is that acute stress,
small amounts of struggle,
challenges are good for children.
What we don't want to see happen
is children exposed to serious traumatic events,
chronic abuse or bullying
because in that case it changes from a healthy challenge
to an unhealthy challenge.
Now, that line is different for every child,
based on how they've developed maturity,
based on what experiences they've had in their lives,
based on their parents even.
And that's really up to the parent
to decide where that line lies.
Both too much and too little intervention
can have adverse effects.
@fero: "mike: I am a real doctor.
Also mike: I don't know my blood type."
Oh, my God, there were so many comments about this.
It is perfectly normal to not know your blood type.
For example, if I have a patient come into the office
and I order them a complete blood count,
a complete metabolic panel, vitamin test,
cholesterol panel, thyroid panel, whatever it is,
it doesn't automatically come in
to tell me their blood type.
That's a special test that I have to order.
And guess what, your insurance is gonna say,
"Well, why did you need to know that?
Why are we paying for it?
If it's not of medical necessity,
you have to pay for it."
The one time that your insurance will pay for it
that will apply to a lot of people
is in a preoperative setting.
So if you come to me and you're about to go for surgery
and you need clearance,
I'm the one that's gonna be doing that clearance,
I may order a blood test just to make sure
that if something happens during the operation,
we have your blood type ready to go and save your life.
@Panda Red: "My health economy teacher told me
to always be positive but never HIV-positive."
If you're HIV-positive, that's okay too.
We can figure it out.
In fact, the control for HIV has gotten so good
that the life expectancy for someone
who takes treatment carefully and properly and appropriately
for HIV is essentially the same life expectancy
as for the average person of that same sex and age.
@Kim Carpenter: "I have epilepsy and I was wondering
what goes on in my brain whilst that happens."
Kim, that's a really great question.
Now, I'm not a neurologist.
But I'll sort of give you
a very basic explanation of what happens.
In one part of your brain,
there happens to be an area of over-excitation,
almost like an electric storm.
And then, that starts spreading throughout your entire brain
and that's how you can develop epilepsy
and go into a full-on seizure
where you're shaking, you're feeling things,
seeing things or confused
because it activates all different parts of your brain.
Interestingly enough, if patients fail medical therapy,
meaning taking all these types
of medications for their seizures,
one of the possible treatments
is surgical intervention,
literally taking out the part of the brain
where we've isolated the beginning
of that seizure activity to that pinpoint part of the brain.
@Regan RN: "Dr. Mike, where is the difference
between an MD and a DO and which is better?"
You've phrased your question in the exact title
that I have a video already existing.
And that video just hit a million views.
I'm gonna link it down below in the description.
It's called, "What is the difference between an MD and a DO
and which is better?"
I'm very passionate about this subject.
I've actually partnered
with the American Osteopathic Association,
which represents well over 100,000 practicing DOs
and we're gonna be giving all sorts of little tidbits
about the differences and what makes a DO special.
So stay tuned for that.
@Carolyn Byce: "Video idea: Can you do a video
about surgery anxiety/what to expect?
I'm having surgery for the first time
and I am really nervous."
Caroline, this is such a good idea.
Part of my job as a family medicine doctor
is to do pre-surgical clearances,
which means that right before a patient
gets to go under the knife,
they come to me first to make sure
that they're healthy enough to go for surgery
or at least optimized well enough
to go for surgery.
During this process, I have really in-depth conversations
about their fears,
about what they need to be doing beforehand.
And I think that can make for a really good quality video.
I know what questions most people have.
And I know what language I need to use
to explain that to them.
If you want that type of video,
someone's gotta be the leader here
and put a really good comment down below this video
and up-vote that bad boy.
Let's make the limit for it 5,000 up-votes.
If you get that, dedicated video to presurgical anxiety.
@Addy Paul: "Question: What happens if you stay upside down
for an extremely long time?"
You're gonna get a headache
because gravity is gonna change the amount of blood
that's going to your head.
And you're gonna get a lot more blood pooling there.
Now, your legs are used to this
because obviously you're standing and upright
for the majority of the day.
In fact, the veins in your legs
have natural valves that as each time your heart pumps,
those valves open and then close
to make sure that the blood doesn't automatically fall
and pool to the bottom of your legs.
You may see this in some people as they get older,
when those valves become incompetent
or they have damage to their veins
and you see that their legs are constantly swollen all day.
That's because blood is pooling down there
and their venous system is a little bit abnormal.
@Luckzle: "Health question why can't I see
when I close my eyes?"
Because you have eyelids
and they're not transparent.
There's actually some animals I know
that have transparent eyelids
and then a regular eyelid so they can see underwater.
If you know what kind of animal that is,
drop it down below in the comments
because I need a refresher.
I think it's a toad or a snake.
Oh, alligators.
Whatever.
@Jennifer Saunders: "This man really just pulled out nuts
out of his dishwasher, put them in a drinking glass."
There are way too many jokes
to be made about that entire situation.
Man, like I was so tired and delirious
when I was filming that.
Yes, I store my nuts in my dishwasher
and I put them in a drinking glass.
Deal with it.
@Jocelyn Raj: "Dr. Mike: 'I love nuts.'
Fans: start mailing all kinda nuts to him."
Actually, if you want to send me some interesting nuts,
I'm down.
I've gotta be careful when I say things like that.
I feel like I'm gonna go to my P.O. Box
and be unpleasantly surprised.
- What's in the box!
- I know many of you were scared off
by the 48-minute mark on my latest anxiety video.
But I urge you, make the time.
Check out this video.
Leave me your comments because I'm still very active
in that comments section.
And as always, stay happy and healthy.
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