Running bit
Degenerative Hair
A reframe introduced by guest Amy McDevitt: if we're going to call spinal changes 'degenerative,' we should be consistent and call gray hair 'degenerative' too — and see how patients respond.
In the one-year anniversary episode, Jason recalled a guest — Amy McDevitt — flipping the language of clinical catastrophizing on its head. Clinicians routinely describe normal age-related spinal changes as “degenerative,” often alarming patients with a word that implies something is falling apart. McDevitt’s counter: gray hair is degenerative hair. Degenerative hairlines. Would you like to discuss your degenerative follicular changes?
The joke works because it is also a serious point. “Degenerative” describes normal biological aging in many tissues. Using it selectively in clinical contexts — for spines, discs, joints — implies those changes are more alarming than they are, creates nocebo effects, and can push patients toward passive dependency rather than active recovery.
Jason noted he’d previously heard the version “degeneration is the gray hair of the spine.” He’d never heard it reversed until McDevitt did it. The show’s unofficial policy on clinical language has been moving toward normalization and away from catastrophizing ever since.
First seen in 1 Year of Podcasting… Here’s What Actually Happens (Most Don’t Make It This Far).