**“The alternative to blind belief is not simply unbelief but a different kind of belief – one that embraces uncertainty.“**

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— “What Derrida Really Meant” by Marc C. Taylor, OP/ED NY Times 10.14.04

This article looks at how do we stay accurate when dealing with complex systems under uncertainty?

How might we improve our accuracy when dealing with complex systems like the human body, and our group thinking in society?

In my last article I shared a story about an unexpected car repair.

That story highlighted

 How we solve problems is closely related to how we perceive them. 

Add to that that many problems happen amid ambiguity.

And you can see why it can be tough to have a clear picture of what is going on.

As we'll see, our thoughts and feelings can make us reach for familiar and easy answers.

But life is complex.   

Spotting what is important, and what isn’t, is one of the hardest parts of coming up with a solution to a problem.

This is made even a bit trickier because

Sometimes important possibilities are outside our current model.

When we deal with complex systems, including the body, ignoring unseen possibilities can have big impacts in our lives and the world around us.

A few weeks ago two things happened that made me stop and think.

The first was a singing coach of mine published a thoughtful video on YouTube sharing some experiences of seeking medical care, and then finding himself in an upsetting and difficult situation that played out over many years.

In the video, he spoke about how these experiences impacted him, his family and his perspectives.

(You need to listen past the first minute to hear the specifics.)

The second thing that happened, near in time, was two physicians who are very involved in the fitness world sent out a report on the current use of testosterone in men.

Please note: their report states it's for information and educational purposes only.

The same is true for the articles I write.

A Learning Process

You can see how an ER doctor thinks about this process of contending with the unknown HERE.

And you can see how an Oncologist and Professor of Oncology thinks about the importance of thinking for yourself HERE.‍ ‍

One of the questions he raises is essentially: are we actually describing what's happening in real peoples' lives accurately?

An Example of Messy and Complex Realities

Now, don't worry, this isn't an article about Testosterone Replacement Therapy, so if you like you can skip this next part.

And for context, this is a complex area for many reasons.

Testosterone, the primary male sex hormone made by the body, and used in Testosterone Replacement Therapy (TRT) is known for its use in medicine , but increasingly has been used in fitness and wellness.

What began as a treatment for a specific type of endocrinological disease, more recently has expanded into lifestyle optimization use by people seeking energy, muscle, virility and other benefits.

This has expanded the number of people using testosterone.

TRT gets used by men seeking health, fitness, or even aesthetic benefits.

For example, Alan Ritchson, the actor who plays Reacher in the popular Prime streaming series of the same name, has used it at times to help maintain his super hero like physique.

The physicians point out that a quarter of men treated with testosterone do not even have a blood draw before treatment begins to determine if their testosterone level is low.

The report also notes testosterone clinics "have nearly quadrupled their U.S. prescription volume over the past two decades."

So if you assume that more testosterone is always better, and delivers better health and physiques, you can read the report HERE and see what you think.

Another large percentage of men who show low levels of testosterone on an initial blood draw, show normal levels if a second draw is performed at a later time - even when treatment is never initiated. (MA Male Aging Study 1987 - 2004)

Our bodies are shifting events, not static things.

And they operate in complex ways.

The report goes in depth into the physiological reasons why augmenting testosterone may or may not make sense for a given individual.

What's the Connection?

What do these two things have in common?

a YouTube video about the personal consequences of being caught in a medical model that doesn't fit, and
a report on the complexity of thinking about testosterone use in men published by two physicians, which shows why thinking about the body can be intellectually challenging

How it Feels: A Big Part of the Process

When issues about one's well being is on the line, for many, it brings up feelings of:

worry
uncertainty
and other strong emotions

Videos and reports can sound clear and definitive.

But people and practitioners, often have to make decisions in the midst of uncertainty.

The process of working with issues of the human body often involves going over ambiguous territory again and again to try to figure out what may be accurate.

What Can We Learn?

If reality is complex, and full of unseen possibilities

How, then, do we advise people?

And how do we think for ourselves?

How can we try to be accurate and effective even when we are uncertain?

That is a GREAT question to ask.

There’s an old tale.

A foreigner travels to a distant land in search of a sage said to be one of the wisest people alive.

He hacks his way through dense forests, wades through swamps, and climbs high snow-covered mountains to find the sage.

Finally, cold, hungry and exhausted he arrives at the summit of a final mountain peak.

There, inside a cave, in front of a fire, the sage sits quietly.

Overcome, the traveler rushes forward and shouts:|

“Tell me. Tell me, in one sentence! All the wisdom you have learned!”

The sage pauses for a moment, considers, and then replies:

“Know what is happening.”

The Benefit of Noticing Patterns & The Cost of Models that Resist Unseen Possibilities

Sometimes a single experience looks like an isolated incident: a bad experience, a failed product, or a one-off mistake.

But when similar occurrences show up in many different people and settings, and unfold in a similar way, it can sometimes be a warning sign that a broader pattern is starting to come to light.

Below I’ve outlined three examples from US history.

But there are many more examples out there.

For example:

Boeing 737 MAX Crashes
Volkswagen Emissions Scandal
Me Too Movement

Ford Explorer & Bridgestone Firestone Tire Failure

Imagine that in the late 1990s, a driver in the United States was traveling in a Ford Explorer when the vehicle suddenly became uncontrollable.

The cause, it turned out, was a tire that had blown out at speed.

Car problems happen every day.

Most are quickly forgotten.

But in this case what the driver probably did not know was that, elsewhere in the country, another Ford Explorer owner had just experienced something strikingly similar.

And then another.

At first, these incidents were scattered.

Yet over time, a different picture began to form.

As reports accumulated across regions and drivers, engineers and regulators started to see repetition.

It grew clearer that the issue was not a single faulty tire, or a single unlucky vehicle, but a shared failure model embedded in a system.

What had first appeared as a series of individual experiences and near-misses eventually became one of the largest automotive recalls in U.S. history.

The point was not that each incident was unusual.

It was that they were not isolated at all

2008 Financial Crisis

In the years leading up to the 2008 Financial Crisis in the USA, a lot of things seemed like business as usual.

That was until stress began to appear in the U.S. housing market.

Individual borrowers started defaulting on mortgages.

At the individual level, these looked like ordinary financial struggles, local problems tied to specific loans, households, and regions.

But behind these individual cases was a system that had become deeply interconnected.

And it was operating on an incentive structure that would come close to collapsing the US economy.

Why did the complexity impact so many?

Mortgages were being issued by lenders to large numbers of borrowers, often with little regard for long-term repayment.

But then those mortgages were bundled together by investment banks, and turned into financial products.

These products were then sold en masse to investors around the world.

Meanwhile, credit rating agencies assigned many of these products high safety ratings, making them appear far more stable than the underlying loans actually were.

Everyone was making money and things looked good.

Until they didn’t.

Most people did not look deeper to understand the complexities.

However, a small number of people began to suspect that something was wrong.

One of them was Michael Burry, a fund manager who dug deep to look at the actual details.

Because of that, Burry noticed a concentration of risky borrowing hidden inside products that had been labeled safe.

Yet, when he tried to explain his view, he was ignored and ridiculed.

Though his fund would go on to make over 700 million on his observations, no one appreciated what he had to say.

It was difficult for others to accept, because most of the system still looked stable from their vantage point.

And no one thought the level of detail Burry was considering was worth their time.

From most perspectives inside the system, nothing looked obviously wrong until it was almost crashing down on top of everyone.

Institutions often protect coherence before accuracy.

Accuracy is Harder Due to Moral Complexity

Another issue is that **medicine is practiced in the midst of moral complexity,** and this impacts doctors as well as patients.

There are a myriad of ways to think about this, but you can **read about one real world impact** in this powerful and impactful ***article*** form **Medscape**, ***Why Dedicated Doctors Quit Medicine.***

Moral complexity is where we find an overlap of:

intentions
consequences
choices

Medicine as it exists today is full of these.

A simple fictional example exists in the movie The Big Sick (based on a true story):

At one point a man who has been dating a woman (who later becomes his wife) has broken up with her on difficult terms, when she is suddenly overcome by an infection.

A friend of the woman's calls him and tells him no one else can go to the hospital, so he goes.

No one yet knows this will become life threatening.

Then quickly things go downhill, the doctors need to immediately put her in a medically induced coma.

She is unconscious and they ask if the ex-boyfriend is her husband, and if he can authorize it - right now!

None of her family is present or knows about the situation, and they live in a different city. He doesn't know her family, and he's the only one there.

Should he wait and take time to try to contact people he does not know, or should he sign the forms the doctors need?

This is of course a dramatic invention, not perhaps even the exact details as they unfolded, nor is this how things would likely unfold in real life, yet the fictional version works well enough to raise the interesting questions of moral complexity:‍ ‍

What is the right thing to do? (if these were real circumstances)

If he waits and she dies, did he do the right thing?

If he signs the forms, then contacts her parents, and she lives, did he do the right thing?

This fiction highlights how people must make difficult choices under great uncertainty.

Let's take a look at how that can play out in real life in the next example!

Opioid Crisis

In the late 1990s and early 2000s in the United States, doctors began prescribing powerful opioid painkillers at large scale for both acute and chronic pain.

Patients were given prescriptions after surgeries, injuries, and for ongoing pain conditions.

At the individual level, it looked like standard medical care: a doctor treating pain in a routine way.

At the same time, doctors were being told, through medical messaging, pharmaceutical marketing, and changing clinical guidelines, that pain was being undertreated and that they should be more aggressive in prescribing pain medication.

Over time, prescriptions expanded dramatically.

And across communities, rates of dependence, addiction, and overdose began to rise sharply.

What initially appeared as individual cases of misuse or unfortunate outcomes, including overdose, became a widespread pattern of harm.

By the 2010s, the scale of the crisis had become impossible to ignore.

Major legal action began to unfold.

States, cities, and counties across the U.S., eventually numbering in the dozens, filed lawsuits against pharmaceutical companies, distributors, and pharmacy chains.

By the late 2010s and early 2020s, total legal settlements related to the opioid crisis reached into the tens of billions of dollars.

What had begun as routine pain treatment in everyday medical practice had, over time, become one of the largest public health crises in modern U.S. history, marked by mass addiction, widespread overdose deaths, and major criminal and civil accountability across the industry.

Opioid Crisis Insight: The more common a treatment becomes, the easier it is to treat the protocol as the answer. Convenience, routine and incentives can begin to outweigh individual needs and long-term consequences.

This Sounds Familiar. Is it Unique? Or is it a Pattern?

The story Chris shared was news to me. And it rang a bell in my mind.

It sounded like part of a pattern I had heard before.

So I went back to look at the evidence I have seen over time.

Here are some of the things I considered:

CEO of Home Health Care Company & Medicine Stacking in Older Adults

One of my first job’s after college started in an office building with six people trying to build a new type of home health care company into what a few years later would be 750 people working in 12 health centers, 2 pharmacies and an ambulance service.

When I met with the CEO at the start and asked him why he wanted to build the company, he shared with me a number of reasons.

I still remember him speaking about older patients being prescribed medications, one after another, until it was difficult to tell what medication was doing what.

Over treatment and ineffective treatment was certainly key considerations for what he was trying to do.

Podcast with Physician in Metabolic Medicine

It wasn’t just the CEO who told me a lot of medications were prescribed and it got difficult to tell what was doing what.

The same idea was shared with me, years later, on my podcast by a primary care physician who ran her own practice in metabolic medicine.

Using a focus on diet and movement she helped people with significant weight challenges learn new lifestyle habits along with her regular medical practice.

During our interview she shared her frustration from the time she was working in large health care providers, and how multiple medications were often prescribed for patients, and that she felt there were often ways to reduce or eliminate them, but that this avenue was ignored, and that any type of education was minimal.

What’s worth noticing is that here you have a physician herself describing, not an individual case, but recurring patterns.

Movement Teacher's Rationale for Her Work

In 2025, when I created and hosted the Excellence in Exercise and Movement Summit, one of the guests shared her story of what motivated her to create her style of movement education.

She shared a story about her father, who had been a robust and active man, and how during later years she watched him undergo multiple surgeries for back issues, and multiple medications, which she saw led to a decline in his health.

Similar to Chris, she shared that at the time she was not well informed, and couldn’t make the decisions and distinctions that she can today.

She underwent a personal learning from suffering which inspired her to look for a better way.

Whether it’s the use of testosterone, opioids, or other substances or procedures, it's hard to avoid seeing the same story recur over and over.

More was used than was necessary.

It didn’t help.

In some cases it created mental, emotional and physical harm.

When you listen to people speak about what it was like to live through these experiences over many years, you can hear how disruptive and upsetting it was,

When you consider the costs of things like the opioid crisis

You start to wonder:

How can we do better?

If Only Life Were Simple

Of course it would be a simple matter, if this was always the case.

But it’s not.

At the Excellence in Exercise and Movement Summit, we had another guest, who had suffered through five years of a very serious and aggressive form of cancer that looked to be incurable.

After trying many treatments, at the last moment, she was prescribed a drug that was not even intended for her condition, but which she had access to through a compassionate care program, and it saved her life.

It’s reasonable to assume that she is alive today because of that medication.

It could be easy to conclude from some of these stories that a certain approach or tool is bad, and that it should not be used.

And often that is where the energy, emotion and conversations go.

This is right. That is wrong.

This is good. That is bad.

However, I think there is a larger and perhaps, sometimes, more useful thing to realize from all of these stories.

A Way of Thinking about Accuracy & Effectiveness

Anyone who has spent much time working with the human body encounters its complexity and the fact that answers are not always cut and dry, nor clear.

People who work with the body are constantly dealing with levels of uncertainty.

They don’t have a static possession of truth.

Medicine specifically derives its authority from a claim to superior accuracy in understanding the body.

Not perfection
Not certainty.

But a meaningfully higher capacity to correctly interpret what is happening in the body and respond proportionately.

Medicine’s claim to accuracy is only meaningful if it stays tied to ongoing correction of interpretation based on unfolding reality in specific cases (as Dr Bishal Gyawal points out).

When accuracy degrades in medicine, overprescription of medications and procedures often appears as one clear external signal.

But the problem is not medication or procedures themselves.

Clearly medicine used well saves and improves lives.

But for who?

Who should take testosterone? And who should not?

Too often we turn issues of the body, or medicine, into arguing about the right answer.

But in complex human systems, being right once matters less than staying in contact with reality and revising.

People who regularly work with and try to understand the human body, often come to see that:

Accuracy takes iteration

That means repeating a process or a set of steps over and over, usually to get closer to a desired result or improve something.

That’s what most body based professionals are engaged with.

Being in the mess long enough to have some orientation to where the exit may be.

Like having hiked a mountain or a swamp long enough to have a feel for it.

Accuracy is not handed down oracle like!

It’s surprising how often solutions are the result of an off handed comment or observation that is not intentional.

Penicillin was discovered in such a manner - by accident and observation.

Something important that I’ve also learned is that accuracy is not connected to things that humans often interpret as accuracy.

For example none of the following guarantee accuracy:

Tone of voice
Presence or absence of emotion
Who you like or trust
Who cares about you
A professional's title
Area of expertise

As people we tend to judge how something is presented, and who presents it, more than we double check whether what is presented is correct.

Careful thinking, observation and double checking are key to not missing unseen possibilities.

Complexity

Even when observations are accurate, bodies remain variable systems.

Many of our systems of measurement are imperfect and context dependent.

And all methods of working with the body, including medicine, are learnable and improvable forms of thinking.

Accuracy, therefore, has to be an ongoing process.

Not one and done.

It’s easy to think that accuracy is a fixed thing inside of someone’s head that they can give you.

That can be the case, but not that often.

Medicine like so many things having to do with the body is called: a practice.

Everyone who works with the body has their own understanding and practice with which they work with ambiguity to find a process for arriving at answers.

Complex problems take time to figure out, and require a period of problem solving and drafting possible organizations and solutions.

Think figuring out a difficult crossword puzzle not flipping a card over to see the answer in the game Trivial Pursuit.

Shared Reality Changes

Accuracy takes iteration because in human society when something becomes “settled” inside a group (even informally), the group often starts to protect the shared version of reality more strongly than it updates it in response to a correction in the moment.

Chris ran into people who were sure what the solution looked like for him, but sometimes he found that those solutions made things worse, not better.

It matters to actually look carefully.

Accuracy is not a property of a person, but of a process.

There are domains where reality is messy, decisions have real consequences, and yet people still want clean certainty.

But when certainty gets treated as if it’s available as a one time thing for everyone, and not situation specific, systems drift, sometimes into overuse, sometimes into blind spots, sometimes into harm.

Summary

"Know what is happening" is not the same as:

* Be certain.

* Be right.

* Have the answer.

* Follow the expert.

* Trust your intuition.

It's a surprisingly humble instruction.

But difficult to do.

“The alternative to blind belief is not simply unbelief but a different kind of belief – one that embraces uncertainty . . . "

Nathan Schechter, ACSM CPT, writes about the mechanics of experience - how people learn, change, connect, and perform under real conditions.

Disclaimer:
The information and content provided by Mind Body Literacy and in this article is general information and is intended for educational purposes only. Individual situations vary. This content is not intended as, nor should it be used as a substitute for, professional medical or psychological advice, diagnosis or treatment. No guarantee or warranties are made with respect to the accuracy, applicability, fitness, or completeness of the content. This article reflects personal observations, interpretations, and opinions.

Accuracy and the Body