#being forced to expand her stuff on the fly by a big company who had heavy creative input
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ligbi · 2 months ago
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I'm having Sailor Moon thoughts for the first time in a long time and
The cats.
They're from Planet Mau. We all know this. We also know they existed in the Silver Millenium and Queen Serenity put them into a stasis to wait for Usagi to need them after she's been reborn -She's been re-born before according to Sailor Moon Sailor Stars Musical, but that was an era of peace(?). While we don't know the exact time the cats awoke, it seems to be after Beryl's reincarnation accidentally woke Metallia up at the D Point, so it seems fair to assume the seal on Metallia and on the cats was linked.
Now, Queen Serenity doesn't come from our solar system, and is from another Galaxy (as is Nehellenia), but Pluto/Uranus/Neptune and the Inners seem to have been born in the Galaxy, as was presumably Saturn who slept until she was called upon to destroy the world after the cats were sent away. What we don't know is when the cats came to the Moon from Mau.
Did Queen Serenity take them with her when she fled from her place of origin? Were they ambassadors sent to the our Galaxy? Tin Nyanko recognized Luna and Artemis as Mau residents, but didn't seem to know them personally- it seems like she assumed they escaped when Galaxia came to the planet to murder everyone.
I have obvious opinions on the timeline of Silver Millennium events- Queen Serenity left her home during the early days of the Sailor Wars because it takes Galaxia a while to murder Everyone, Nehellenia's curse summoned a poor clone of Chaos to the sun which created Metallia, the events with Artuka happened while Endymion and the Princess were courting, Beryl did a lot wrong but I forgive her anyway, ect ect, but Why the cats were there in the first place isn't explained and we can't use the same crow logic for them.
Lead Crow knew Phobos and Deimos during the Silver Millennium Era, and that they were chosen to be trained as soldiers- presumably a type of Sailor Senshi- under Mars. Chosen by whom is unclear but Queen Serenity hand picked Mars to be, well, Mars, and we can assume did the same with the other girls, so it seems like a sailor crystal is gifted to you and linked with your star seed- or maybe replaces it?- which makes some sense since Queen Serenity just showed up to this galaxy and took over crystal duties- and appointing a child to guard the door of time and space. Is Pluto the only person in the universe doing that, or are there other doors in other galaxies? Did Queen Serenity have some type of Senshi-adjacent duty before she had to leave?
But the cats don't have sailor crystals and don't seem like they were training to become senshi- one for obvious reasons since even with the Golden Crystal Mamoru is still just...whatever he is, and the other-look PGSM is the best Sailor Moon, but it does Not fit in with the greater canon sorry Sailor Luna with your Candy themed attacks- so let's assume they....what? moved to the Moon to be advisors? Was Queen Serenity a big deal 'elsewhere' and that's what people of Mau who aren't even here to train as senshi are so close to the royal family? Was she taking in refugees from other planets that were destroyed by Galaxia? That could explain the residents of Moon and the castles of the other senshi, and why they just have castles that seem to be rules by the Moon, instead of their own kingdoms.
I know this solar system has great balance for harboring star seeds, which is why it gets to be the specialist place in the universe, and the last one Galaxia attacks, but was it the new ancient magical alien equivalent of the U.N. after the first was was presumably destroyed by Galaxia? That would explain some things, I guess.
I also think Mau was a version of Loveless which explains why human!Diana has a tail but Artemis and Luna don't (th3y hd th4 seggz ~>.<~)
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wrestlingisfake · 5 years ago
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Double or Nothing preview
Kenny Omega vs. Chris Jericho - The winner of this match will face the winner of the Casino Battle Royale at a later date to determine the first AEW world champion.  Interestingly, Jericho is scheduled to challenge for the IWGP heavyweight championship on June 9, and this match may indirectly affect that one.
This is a rematch from Wrestle Kingdom 12, where Jericho began his sudden shift from “I’ll never wrestle anywhere besides WWE” to “I can be the Brock Lesnar of New Japan.”  Neither man has had a match since Wrestle Kingdom 13 earlier this year, where Omega lost the IWGP heavyweight title in the main event, and Jericho lost the IWGP intercontinental title in the semi-main. 
Jericho’s character outside of WWE has been a leathery weirdo brawler, whose services are highly valued by promoters even though he’s totally uncontrollable.  He’s randomly ambushed several top names in New Japan, and he seems to be gunning for Cody Rhodes down the line, but his recurring nemesis is Omega.  The general idea is that Omega entered the “greatest of all time” conversation with his six-star performances in 2017, and that puts a target on him for legends like Jericho that want to make a statement.  Omega defeated Jericho at Wrestle Kingdom 12, then Jericho shockingly attacked him at All In, then Omega’s team defeated Jericho’s team during Jericho’s wrestling cruise, and then Jericho attacked Omega again at AEW’s February 7 media event.
This is basically the biggest match AEW can present at this point.  It’s a rematch from the Tokyo Dome, featuring the biggest current star who’s never been to WWE and the biggest ex-WWE star they could sign.  In some ways it’s a coup they could put this together in a US show, but in other ways I’m disappointed that AEW couldn’t come up with something hotter.  18 months after his first NJPW vignette, the challenge for AEW is to prove Jericho still has mileage as a 48-year-old resident legend, and not just as an occasional special attraction.  Luckily, Jericho is keenly aware of this stuff and pretty good at finding ways to keep himself over, so hopefully this match will set up a good direction for him.
I tend to think Omega should win here, but Jericho is coming in with a pretty shitty win-loss record, considering he’s been set up as the top heel in the company.  A win for Jericho would add momentum to the angle that he thinks he’s singlehandedly put AEW on the map, and set up more matches down the line.  Then again, Omega is the actual ace of the promotion, and needs to be protected as such.  So I’m expecting a creative finish, but I don’t know which guy will win.
Nick Jackson & Matt Jackson vs. Penta El 0M & Rey Fenix - The Young Bucks (Nick and Matt) are defending the AAA tag team championship.  This feud started with the Lucha Bros. showing up at an AEW press conference, taking exception to the Bucks calling themselves the greatest tag team.  This led to the Bucks flying all over the place to ambush the Lucha Bros. at various indie shows.  Finally, when the Lucha Bros. won the AAA tag title at Rey de Reyes, the Bucks suddenly showed up for an impromptu title match and won the belts.
It’s worth noting that a rematch for the title has already been booked for AAA’s Verano de Escándalo on June 16.  So the outcome of this match won’t have much impact on which team ends up with the belts in the long run.  With that in mind, the logical outcome is for the Bucks to win to establish them as the benchmark for the strong tag team division they’ve been promising.  Penta and Fenix aren’t enhancement talent by any means, though, so I could see them scoring a win on the Bucks’ turf.  But until the Lucha Bros. put a ring on it and sign with AEW, it would be risky to put them over.  I’m leaning towards the Bucks retaining.
Cody Rhodes vs. Dustin Rhodes - Dustin, 50, is the son of wrestling legend Dusty Rhodes and his first wife, Sandra; Cody, 33, is Dusty’s son by his second wife, Michelle.  This is virtually a direct follow-up to their match at WWE Fast Lane 2015 (as Stardust and Goldust), which had been the closest they’d come to their dream of doing the match at a Wrestlemania.  A year later, Cody left WWE to begin a meteoric rise in the non-WWE scene, leading to his leadership role in AEW.  Once it became clear Dustin was leaving WWE, it was obvious he would end up here.
Dustin delivered a strong video package about needing to prove he’s still got it, and wanting to settle old scores with Cody.  Cody cut an intense promo likening Dustin and his era with Old Yeller, suggesting he has to put Dustin down because he loves him.  You can debate the wisdom of indulging in this storyline at a pivotal point in AEW’s beginnings, but you cannot argue that both men as fully committed to proving it can work.  Hopefully that results in some killer storytelling and a good match.  I have to think Cody wins here, and the brothers hug and Dustin ends up with a backstage job or something.
PAC vs. Hangman Page - ...already happened, so I guess you can watch that here.  The match on this card had to be cancelled.  The angle is that Page was so hype to fight Pac that he went to an indie show in England to do the match a week early.  Pac intentionally got disqualified and then pillmanized Page’s knee; he claimed he only wanted the Double or Nothing match to injure Page, but since he’d already succeeded with that he wouldn’t be coming to this show.  I suspect this match was intended to determine a participant in the match to crown the first AEW world champion, since Page has been talking about wanting that spot for months. 
As of this writing, AEW hasn’t announced what Page will be doing on this show, or even if he’s kayfabe recovered enough from the knee attack to have a match  This could be trouble, because it leaves fans to imagine all sorts of crazy surprise opponents that the company may not be able to deliver.  Already people have been actively speculating about CM Punk (the Dave Chappelle of wrestling), Jon Moxley (formerly WWE’s Dean Ambrose), and Joey Ryan (who had a farcical feud with Page last year).  How AEW handles this mess will leave a lasting first impression with fans, particularly fans like me who’ve seen all the stupid things WWE would do in this situation.
Britt Baker vs. Nyla Rose vs. Kylie Rae - This is a three-way match, so the first woman to score a fall over either opponent will be declared the winner.  Baker is probably best known as the wrestling dentist from the four-way match at All In last year.  Rose made headlines as the first trans woman signed to a major wrestling company, and I’ve just learned she starred in a Canadian sitcom a few years ago, playing a computer programmer, which is an interesting contrast from her “Native Beast” wrestling persona.  Rae is relatively less known, but she’s a smiley happy character in the vein of Bayley, and she’s from Chicago so I know who I’m rooting for.
Unfortunately I think the big story in this match is whether the live audience will accept Nyla, or if a bunch of jerks try to start transphobic chants or something.  I think the hardcore AEW audience is cool about it, but there’s just no way to know until she goes through the curtain.
Of these three, Baker seems to be the one they’re pushing as the face of the division, which may make her the favorite.  But the fact it’s a three-way with nothing tangible at stake makes this one hard to call.
Christopher Daniels & Scorpio Sky & Frankie Kazarian vs. CIMA & T-Hawk & El Lindaman - Daniels’s team is SoCal Uncensored, which has become something of an underground sensation via their sing-along catchphrases and Being the Elite skits.  Cima’s team represents a faction called Strong Hearts, consisting of the wrestlers who joined him in leaving Dragon Gate to found Oriental Wrestling Entertainment in Shanghai. 
OWE is one of several attempts to expand the wrestling industry into the lucrative Chinese market--AEW is clearly partnering with them to cultivate Chinese talent and a Chinese audience.  Note, however, that Cima, T-Hawk, and Lindaman are Japanese, not Chinese; the Chinese wrestlers they’ve been training will presumably appear in the future.  This match seems to be less about China than about getting OWE over with the AEW audience, and acknowledging the influence Cima has had in the careers of wrestlers like Daniels and the Young Bucks.
If you weren’t paying attention to ROH last year, you might be surprised how hot SCU has become with the kind of fans that’ll be at this show.  When I went to All In I was prepared for the sea of Bullet Club shirts and constant Elite chants, but the response to anything SCU did was far more intense.  They really should win here, although there may be a plan to use them to establish the Strong Hearts as a force to be reckoned with.  It’ll really depend on how often Cima and the OWE guys are planning on flying out to do these shows.
Aja Kong & Yuka Sakazaki & Emi Sakura vs. Hikaru Shida & Riho & Ryo Mizunami - Kong is legendary monster heel, whose career goes back over 30 years.  As for the others, I don’t have much info on them.  My impression is that this match is designed to help introduce joshi (Japanese women’s wrestling) to the west, which would suggest the younger participants in this match (Sakazaki, Shida, Riho, and Mizunami) will be groomed for long-term roles in the company.  From what I’ve heard, Kenny Omega wants AEW to spotlight Japanese women as a unique attraction, similar to how WCW used cruiserweights and luchadors back in the day.  It’s a clever move, since the other US promotions have male Japanese stars, but joshi is still rather obscure in the west.  On Being the Elite they’ve played up Kenny Omega’s history with Riho, so I guess I have to pick her team to win.
Chuck Taylor & Trent Beretta vs. Jack Evans & Angelico - Chuck and Trent are the Best Friends, who were on the verge of breaking up when we last saw them in New Japan.  Evans is one of the original big names from the super-indy days in the early 2000s.  Angelico has been teaming with Evans in AAA, Lucha Underground, PWG, and elsewhere.  The Young Bucks have talked a big game about making the tag team division more important in AEW than in other promotions, but matches like this one will determine if they’re really serious about any tag teams but themselves.  I can’t decide which team should win, but I’ve got a soft spot for the Best Friends so I’m rooting for ‘em.
Casino Battle Royale - This is a 21-person gauntlet battle royal match, scheduled for the pre-show, where the winner will qualify to for a future match to determine the first AEW world champion.  Typically this kind of match starts with two participants in the ring, and each additional participant enters every 90 seconds or so.  The twist here is that five participants will start, and every three minutes another five enter the match.  The final entrant, being “lucky 21,” gets to enter alone, meaning only one person will have that “freshest person in the match” advantage.
The rules for elimination have not been specified, so I assume it’ll be the standard rules for most battle royales.  After entering the match, a participant will be eliminated if they exit the ring over the top rope and both of their feet touch the floor.  Participants can avoid elimination by stalling their entry into the ring, or by exiting the ring under the top rope, or by going over the top and keeping one foot off the floor until they can re-enter.  Eliminations can occur at any point in the match, before and after the last participant has entered.  The last person left in the match after everyone else has been eliminated is declared the winner.
Confirmed entrants for the match include:
Ace Romero (the big fat dude from MLW)
Billy Gunn (he’s an ass man, womp womp)
Brandon Cutler (the Young Bucks’ old buddy from PWG)
Brian Pillman, Jr. (the son of the “loose cannon” from WCW/WWF)
Dustin Thomas (a guy with no legs who impressed everyone at Joey Janela’s Spring Break recently)
Glacier (the Mortal Kombat guy from WCW...yes, that Glacier)
Isiah Kassidy (one half of the tag team Private Party)
Jimmy Havoc (an edgelord from the British indie scene)
Joey Janela (sleazy guy from GCW that does the Spring Break shows)
Jungle Boy (Luke Perry’s son doing a Tarzan gimmick) 
Luchasaurus (a guy who seems to be neither a luchador nor a dinosaur)
Marq Quen (the other half of Private Party)
Michael Nakazawa (Kenny Omega’s old buddy from DDT)
MJF (obnoxious preppie douchebag from MLW)
Shawn Spears (WWE’s Tye Dillinger/Cody’s old buddy from OVW)
Sonny Kiss (formerly XO Lishus in Lucha Underground)
Sunny Daze (scary weird guy that makes Bray Wyatt look like Mr. Rogers...okay, I’ll admit that’s not a very helpful comparison right now, but you get the drift)
???
???
???
???
That leaves four spots remaining as of this writing.  Knowing AEW, those spots could go to some of the guys who are signed but not booked (like Darby Allin or Peter Avalon) or to total unknowns, or to giant surprise stars.  It is entirely possible some women could be added to the match.
Obviously that “lucky 21” spot is perfectly suited for a big surprise entrant to shockingly debut, run wild, and win the whole thing.  However, since this match is for the pre-show, I don’t see them blowing their wad on a really big surprise.  On the other hand, the winner of this match has to be a credible contender for their world championship, so they can’t just give it to Joey Ryan or whoever.  This is where you really start wondering if Jon Moxley is available.
Sammy Guevera vs. Kip Sabian - The opening match, to air on the pre-show.  Guevera is a former AAA crusierweight champion.  Sabian has held the IPW:UK championship, and based on the limited data I can find for that title, he may well still be the champion.  Considering how much of this card consists of wrestlers I literally never heard of until they were booked for this show, it says something that these two are so obscure they’re in the opener.  But that’s to be expected when starting a promotion from scratch.  Hopefully they both give us a reason to care who they are.
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ifleewroteotome · 6 years ago
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#4 - Boss!
Context: Sarcastic, ambitious, slightly aggressive, creative and caffeine-addicted CEO manages her business and falls in love, featuring:
Heroine: Risk-taker, smart enough to hire people to do the things she can’t (or doesn’t want to do), gets sh-- done and done well. Drinks too much coffee and does not know what work-life-balance is.
Barista: Peppy, optimistic, concerned for CEO’s general health and well-being. Chameleon.
PR Lawyer: Not paid nearly enough. Perennially exasperated. All to often CEO’s DD. Responsible.
Chairman of the board: hotshot venture capitalist with an attitude. Super alike to CEO which is why they bang heads a lot. Never smiles--just smirks. A lot.
Flaky model: Hired to promote new product, floating breezily through life like the blessed flower child they are. 
Chef: Grump with a heart of gold, has CEO’s takeout order ready (with extra veggies because girl, vitamins)
Preschool teacher neighbor: Actual hufflepuff, single parent, has the work-life balance stuff figured out.
Personal trainer: Doer of things. Does not judge. 
Supporting cast!: Possibly-evil-but-also-awesome administrative assistant, smarmy parent company vultures, cool-tempered CIO, quick-tempered CFO, ex-beauty pageant marketing employee/ally, ex-girlfriend bartender
The Heroine (MC)
CEO MC: Never gets enough sleep, which makes her sarcastic but is also semi her own fault given the amount of caffeine she consumes. Sort of obsessive about long-term planning, unwaveringly believes that a company’s value comes from its employees and will choose them over shareholder dividends every time. Determined to run an ethical company even if it means it’s not the most profitable company. Super duper Type A – aggressive and fearless because she has to be. Sometimes really just wants a cupcake in her hand and a cat in her lap, but then she’s bored and goes back to business planning. Creative risk-taker, decent negotiator. Smart enough to know where she needs help and hire people who can do the things she can’t (or, more to the point, doesn’t want to do). Gets back up every time. Will definitely fight you. Might feel bad about it later but only if someone reminds her it happened.
Love Interests
The BARISTA: Peppy, optimist (or so MC thinks) but it turns out they actually switch up their personality depending on who they’re serving (sometimes they are the chill, hipster philosopher, sometimes they are the rude New York get-it-done eye roller, etc.) actually somewhere in the middle of it all – but really IS an optimist despite themselves. Kind of slippery and hard to pin down. Big family, used to being what their other siblings/parents need from them. Fairly certain CEO MC is headed for an early heart attack with the amount of espresso she imbibes. Probably an author. Maybe an ex-broadway personjust because. IDK.
The PR LAWYER: Worked-three-jobs-put-self-through-college story. Patience, tact, good at calming people down. Detail oriented, a little fussy about appearances. Perennially exasperated by CEO (Please don’t promise to have a cure for cancer In the next three years with no data to back it up. No, you can’t punch the reporter for being a dick. Look, I know you WANT to donate 100% of proceeds to charity but please pick a friendlier one than ‘punch reporters in the face foundation’ that’s not gonna fly) never gets enough sleep. Has a key to MC’s house so they can come yell at her for making their life difficult at whatever hour of the night she insists on doing so. Is on MC’s speed-dial, which means they also get called to DD, though they’d rather not.
FLAKY MODEL(s?): Trust fund kid? Pretty face? Floats through life? The sort of person who will get on the wrong subway train and then just ride it all day people-watching never mind that they had an appointment six hours ago. Pose with a boa constrictor? Sure, as long as it’s being treated humanely. Tarantula on the face? Awwww, it’s fuzzyyyyy. No filter, no worries. Probably drags CEO MC along on a Caribbean shoot and PR Lawyer has to call and yell because that does not look good, okay? And poor MC is like, I thought we were getting a drink and model is like WE ARE we are getting tropical coconut water from the SOURCE here oh wait I don’t know how to drink out of a coconut…who knows why they are attracted to CEO MC, probably because she’s there and sticks around and no one else does. Human puppy dog.
CHAIRMAN OF THE BOARD: young hotshot venture capitalist, thinks CEO MC is a bleeding heart (your employees do not need that many sick days, lost productivity blah blah blah why do we need a daycare onsite that’s a waste of shareholder money), kind of a math whiz, naturally lucky, doesn’t get along with family (gambling problem in the fam – which manifests in him in investment risks and unresolved issues) butts heads constantly with MC, frequently tries to get her fired – in part because his attempts to do so get her fired up and she does great things, which ultimately is better for the company than when she’s just doing her normal ‘good’ job. She is going to be royally ticked when she figures that out. Manipulative, but relatively benign under it all. The sort of person who smirks instead of smiles. All the time.
CHEF FROM HER FAVORITE RESTAURANT: Also a CEO though on smaller scale, because, running a restaurant IS running a business. Probably under the impression CEO MC is actually like, a graduate student with no money because she tends to get takeout at weird hours. Gruff, grumpy, abrupt, but heart of gold. Basically—will grumble about you coming in late but will add extra veggies to your pasta because you’re looking a little pale and need the nutrients and if you call them on it will snarl that they had to be used up they were going bad and he wasn’t going to waste extra, expensive, PROTEIN on you. (MC asks them out and then realizes the only nice restaurant she knows is the one the chef owns)
PRESCHOOL TEACHER: JUST A DECENTLY NICE PERSON. Checks in to make sure MC has eaten regularly, staying hydrated, needs anything fixed around the house (she can do her own plumbing but doesn’t like the electrical and hey it’s nice to have company). Good with kids. Maybe divorced and wanted them but ex-spouse didn’t? idk. Calm, not easily ruffled, sweet as pie, except when he’s playing video games and suddenly MC understands how he can get through the day without any aggression – he unleashes it on fictional zombies. Blissfully normal, all things considered.
PERSONAL TRAINER: “fine, whatever, EAT THE DANG CHEESE if you’re just going to ignore my nutritional advice we’re doing ten more reps” athletic, happiest when DOING versus saying or reading or sitting. Not as impulsive as you’d guess at first glance, because they tend to use working out as a meditative time to make decisions. Didn’t finish college because they realized they just didn’t enjoy it, but they did enjoy working with student athletes, which is how they got into training. Enviably fit. Wants to expand the gym so wheedles business advice out of MC in exchange for not harassing her about her tendency to drink coffee instead of water (she insists it has water IN it, it should count) not particularly intimidated by her, which is a pleasant change of pace.
Supporting Cast (non LIs)
ADMINISTRATIVE ASSISTANT: Keeps MC sane, has her back, schedules everything. Good at details, even better at smiling at angry people and making them not-angry through sheer force of sunny personality (actually a ruse, MC is convinced she’s actually the most delightfully evil person ever, but like some kind of fairy tale where when you acknowledge the thing it goes away, refuses to ever dive into figuring out). Older than the MC because we need to stop making middle aged women invisible in stories?? Sometimes has to remind MC of how much she does by holding silent protests (in part why MC thinks she is secretly a supervillain in the making) which are always, always successful.
PARENT COMPANY ADMIN ASSISTANT: Bane of MC’s existence. Smarmy, smily pain in the tush.
CFO: We have put in an official request with the company credit card management to start declining purchases at that coffee shop you go to, no this is not negotiable, it’s not in the budget anymore drink so darn water woman. Completely willing to go toe-to-toe with MC, meetings often involve a lot of yelling, but they’re always productive and no hard feelings.
CIO: Serpent-y, but not in a bad way. Just a very cool-tempered person, very contained, very guarded, very introverted. Never happy when she has to do presentations, so super willing to share knowledge with MC so she does it instead (she is not a great teacher, kind of judgey and shows her frustration when MC doesn’t ‘get’ it right away, but very brilliant, and there’s no malice in the judgement, just no filter). Extremely logic-oriented and process-oriented over people-oriented. Picks up and assess tech very quickly, and good at finding affordable, fast solutions.
RANDOM MARKETING EMPLOYEE: Set up to be a villain but is actually like gung-ho on MC’s side. Literally an ex pageant queen, went to college on scholarship from it. Out of the workforce for awhile as a stay at home mom when her kids were young, but picks up the new trends fast. Now a single mother, so will literally fight the chairman if he tries to take away the company daycare. Some days uses the ‘people see a pretty face and assume no brain’ to her advantage, some days it wears her out. Unofficially drinking buddy with MC, even though they both feel weird about it given the fact MC is technically boss’s boss’s boss.
BARTENDER: also an ex-girlfriend maybe? Current best friend? Who she turns to when the barista cuts her off from coffee and the chef’s restaurant is already closed. Sharp-tongued, bristly, generally disgusted with MC’s six inch heels and slacks in her leather-jacket, cigar smoke bar. Like lady, you’re lost. Probably on the mob payroll at some point in her life.
ROUTE PLOTS:
(Chairman route?) MERGER – company has just bought another company, which is a major risk move for CEO (can only be one, so do you keep the old one on as a VP? Do you let them go? Will they be bitter/try to sabotage you?) you have to fend off internal sabotage, get everything running smoothly without either company falling apart in the process.  
(PR Lawyer route?) Parent company did something massively shady and it’s tainting your company’s name too, so you have to scrounge to avoid having to fire half your employees and keep the company alive.
(Model route?) New product launch – hence why models are entering the picture. It’s a new business venture in the sense it’s targeted at a completely new audience your company hasn’t catered to before.
(Personal Trainer route?) Company is in its infancy, hugely risky time, and you’re doing everything you can to ensure it’s a success  (maybe including putting your own salary back into it, which means you can’t afford PT so they agree to work with you as long as you give them business advice)
FROM @han-pan- they keep trying to buy new retail space for the gym and MC keeps buying it instead because it’s SUCH GOOD PROPERTY and they sort of exasperatedly are like ugh fine whatever you owe me since you keep swiping prime spots out from under my nose
See the rest here
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igotmysteriousmessages · 7 years ago
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Pokemon AU: RFA+Mint Eye as Pokemon Trainers
Ok,I’m a sucker for Pokemon almost as much as I am for Mystic Messenger so I had to write this AU... I hope you like it (and sorry to the people in my askbox because this took forever to be made so is the only think I’ve worked on this week)
Credits to shootingstar03 on deviantart for the template for the trainer cards
Warning: This is full of spoilers, like everywhere and from every route
RFA Member Yoosung wants to battle
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Since he is still unsure of what to do with his life I don’t think he has a preferred type on his team despite him having quite a few normal types.
His team is mostly composed of cute and energetic pokemon (Lillipup, Buneary, Ambipom, Pachirisu) but in case of needing they can still give a good fight.
He caught a Rockruff because it was cute and with time it evolved into Lycanroc a Pokemon that is loyal and protective like Yoosung is to MC in his route.
Similar he caught Goomy because it was cute and looked like a slime (he is a gamer kid after all) and as they trained together it evolved into his most powerful and beloved Pokemon.
Pachirisu besides the reasons already given is very protective of its food and it reminded me of Yoosung and his HBC bag  
Lillipup came into his team after Rika’s Herdier died but after Rika dying not too long after he found himself unable to evolve it till he meets MC.  Towards the end of his route it becomes a Stoutland.
RFA Member Zen wants to battle
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I do know beautiful is not a Pokemon type but a contest attribute, the reason I chose is because I firmly believe Zen is a contest trainer therefore he hasn’t got a main type.
His family runs a gym and he was expected to succeed his brother as gym leader but he loved acting, singing and pretty Pokemon so he ran away to become a contest trainer.
Lurantis and Vivillion are Pokemon that look pretty and elegant so I think they’d fit him well
Munna is a Pokemon that protects the dreams of its trainer with its psychic powers so I chose it because of Zen’s psychic dreams
Arcanine, besides being a beautiful Pokemon this big dog is loyal and protective; Much like Zen.
For Gallade I have no much explanation, his ace is a beautiful knight on white armor (he probably owns the mega-stone too)
When he was a kid he caught a Feebas and kept it since he felt identified because everybody said it was weak and ugly. After running away and start winning contests Feebas beauty stat raised to the point it evolved into Milotic.
RFA Member Jaehee wants to battle
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(Confession time: I was very tempted to give her Meloetta because of her love for musicals but I didn’t want to use legendaries so I had to leave it out… maybe in the future I’ll write about RFA and legendary Pokemon)
I hadn’t planned her to have a defined favorite type but as the Pokemon were chosen the flying type became evidently fitting since flying is associated with freedom and her route is about her freeing herself from expectations and finding her happiness.
Throh is the Judo pokemon so it fits her pretty well
Noctowl, owls are known to be smart and this particular one along his pre-evolution is based on clocks as for most her route Jaehee is running against time also is nocturnal and this poor woman never sleeps.
Fletchinder and Altaria are both known for being beautiful and have pretty singing voice which I bet she’d appreciate in her team since she loves Zen’s musicals.
Swanna is partly inspired in the tale of the ugly duckling and it reminded me of Jaehee forcing herself to wear office oufits, short hair and glasses for her job despite her loving long hair and pretty dresses, probably when she met MC she had a ducklett and it evolved with time.
Oricorio Pom-Pom style (Caught by MC) Knowing Jaehee liked musical Pokemon and that this particular one is known for cheering up depressed trainers MC caught one and gave it to her as a gift.
RFA Member Jumin wants to battle
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As you might have imagined this man has mostly cat pokemon
Also his team is not very battle orientated since he is a businessman not a fighter and thought his team can hold a pretty good fight he keeps them mostly as company.
This rational man that is also interested on paranormal stuff screams Psychic type. Thought he only has 1 ghost type I think he might be pretty knowledgeable on the type since he is interested on magic.
Meowstic is the only female on his team (is a white female cat inspired on a domestic cat…so, basically Elizabeth the 3rd)
Alolan Meowth they are the pets of wealthy families so probably Jumin got a Meowth from his father who has a Persian.
Alakazam, since they are incredibly intelligent and with amazing psychic powers I bet Jumin wants one on his team…. Similarly grumping has great psychic power too.
Espeon is cute and thought not exactly a cat is pretty close. I have headcanon that MC suggests him to get and Eevee like hers because they are good friends and could help him open up… he wasn’t trying to evolve it, it just happened.
I already said, this man is interested in magic so a witch inspired pokemon like Mismagius is a need on his team.
It wasn’t on purpose but I couldn’t help but mention most of his team is purple and even in shades similar to his hearts.
RFA member Saeyoung wants to battle
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Since he is a hacker he has electric pokemon related to electronics like Rotom, Magneton and Vikavolt.
By the way he said hackers were like cockroaches so it seems fitting he has electric bug Pokemon as Joltik and Vikavolt (sadly there is no Pokemon inspired on cockroaches)
Beheeyem is an alien with the ability to rewrite people’s memories which is both very fitting with his personality at the beginning of the story and useful for a secret agent.
Vikavolt is inspired on a bug, a battery and an alien so is no wonder is his ace.
Plusle is not in his team at the beginning of the story though he caught it on his childhood. The reason is because is a symbol of the past he is hiding. As he and MC head to rescue Saeran Plusle becomes an important member of the team.
When they were kids Saeyoung and Saeran found the eggs of Plusle and Minun and decided to raise them; hiding them from their mother who didn’t allow them to have pokemon. When Saeyoung joins the agency he keeps Plusle but can have him on his team because is part of the past he supposedly erased but he always keeps it close because it reminds him of Saeran.
RFA leader Jihyun wants to battle
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This man has such a free and creative soul that I don’t think he’d have a main type
I don’t really think I need to explain why Smeargle is his ace; is a painter after all.
Maractus is quite evident too, this man loves his cacti.
Chansey and Audino are both pokemon who main role is to be healers which is what Jihyun wants to do for his friends, heal their pain and keep them safe… also Chansey is related to good luck which Jihyun needs.
I’m going to hell for giving him a Cubone, I know. But Cubone wears it’s mother skull on its head till it evolves into Marowak when is replaced for its own and since one of the biggest traumas Jihyun carries with is his mother dead he’d probably feel very close to this Pokemon.
He adopted Cubone after his mother dead but it didn’t evolve till his 2 year trip after his route.
Braviary is known for protecting its friends without stopping to consider consequences, very similar to Jihyun.
Mint Eye admin Ray wants to battle
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He like plants and beautiful/cute stuff so his specialty would be Grass and Fairy
Roselia, of course flower boy’s ace would be inspired on a rose. Also it has a blue rose (unattainable) and a red rose (love)
Mimikyu hides it’s true self because it wants to be loved and make friends, just like Ray.
His savoir has a Florges so he in his admiration for her, he adopts Flabebé (one with a Blue flower) and raises it to become Floette. He dreams that one day his savoir will acknowledge his hard work and loyalty and will grant him a shiny stone so he can evolve Floette into Florges.
Mareep, it cute and cuddly so he probably would like it, also it produces electricity so it becomes helpful in his job as a hacker; especially on the firsts stages of the building of Magenta when he didn’t have permanent access to electricity (Also sheep are associated with sleeping and this boy needs a nap)
I chose Chespin mostly based on the XY series rather than the game itself. Clemont’s Chespin was really cute and loved sweets which I think suits Ray.
Cherubi, based on the chatroom in which him consideres destroying the stronger branch of his plant to let the weak survive because when Cherubi is ready to evolve the smaller cherry dries up; (Also you know he has no respect for the 4th wall, so Cheritz reference)
Mint Eye admin Saeran wants to battle
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I like the idea of his specialities being somewhat the opposite of Ray’s. Dark is contrary to Fairy (which symbolizes light) and Poison (associated to death) is quite contrary to Grass (Plants are the base of life) but despite that the reason is because of how dark his personality becomes and poison for the elixir.
His team in this case is composed of pokemon known to look scary and aggressive but that tend to be very protective of themselves or their master (since he tries to prove he is the stronger by being aggressive to MC yet he keep obeying his savoir) like Houndoom, Liepard and Mightyena.
The choice of Type:Null is rather similar but I wanted to expand a little here. Type:Null was created by humans as a weapon and it resulted to be too powerful so it has to be contained by that helmet or it might lose control and go against it’s trainer…. Which is exactly what Rika does to him with the elixir… in a minor point is very aesthetically fitting.
(I was rather reluctant to choose this one since it falls in a grey area between being and not being a legendary but it fitted too well to leave it out)
Toxapex is also similar to the others but rather than taking the offensive this pokemon hides on a hard poisonous shell.
Zweilous two heads are in constant conflict and the one that gets more food gets to be in control of the body which reminds of the relationship between Ray and Saeran during this part of his route.
RFA Member Saeran wants to battle
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He said it. He is both Ray and Saeran so he keeps both of his teams aces and since he reached a new stage on his life so do those pokemon.
Roselia evolves through shiny stone. MC gives one to him after escaping Mint Eye since she knew how much he wanted one. But he is now free from Rika’s influence so instead of evolving Floette (which represents he relationship with Rika) he decides to use it on the Pokemon that represents Ray, thus Roselia becomes Roserade.
Type:Null on the other hand evolves through friendship stopping it’s agresive behavior when it meets a partner it fully trust therefore no longer needing the helmet. So basically when Saeran decides to leave Mint Eye and open his heart to love and friendship Type:Null evolves into Silvally
Skiploom, I kind of cheated here because this is based on something we learn about Saeran on the secret endings rather than on his route but I think it stills applies to him. Skiploom is based on a flower and a bulb and likes to float through the wind similar to how Saeran likes to be able to see the sky.
Lillygant, he caught this one the night on the cabin when he leaves to pick the flowers.  Lillygant produces a relaxing smell, gets along with other pokemon pretty easily, is very beautiful and loyal so when he found one he immediately thought of MC and decided to add it to his team.
Swirlix, sweet candy pokemon which reminds of cotton candy and ice cream is perfect for this guy (I know vanillite family is literally ice-cream but somehow I feel swirlix fits Saeran better)
Minun; the same as with Saeyoung. He kept minun with him all time after Saeyoung disappeared but after joining Mint Eye he kept it on its pokeball because the memory of his brother’s betrayal was too painful, yet he didn’t have the heart to get rid of it. When he starts working with the intelligence unit to find Saeyoung Minun becomes part of his team.
Mint Eye Leader Rika wants to battle
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When she was in RFA she was a Fairy type trainer because she wanted to be good and didn’t want anybody to notice the darkness within her but when she embraces her demons she becomes more fond of Dark type (even though there is only 1 dark type pokemon on his team)
Vespiquen, this pokemon is the queen of the hive which is the role the savoir plays at Mint Eye.
Solrock, I don’t need to explain this…you all saw that coming.
Shiinotic, it produces powerful spores that Rika uses to make the elixir.
Florges (Yellow Flower) this is based on the chatroom with V on Ray route in which he talks about the daffodil on his garden, Florges absorbs energy from the surrounding plants.
Absol, they are believed to be a bad omen and bring disgrace which is pretty much how Rika lived as a child so it became her closest friend from the day she caught it when she was a child. When she started going out with V she hide it because she didn’t want him to reject her but when she discovers V sees nothing wrong with her Absol it becomes a permanent member of her team
Herdier (based on Sally) died on battle. It was a very traumatic experience for Rika from which she never got over so the spot on her team was left forever empty.
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bleusarcellewrites · 7 years ago
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That's How You Know
So, happy late bday, Kim, like, a milenial late, but ey, better late than ever, imma right? eeeeey. I love you, tiny. I really really really hope you like this and I don’t break your heart like your first gift.....yeh.
Anyways, Shallura centric with mentions of Klance and Hunay and broganes.
Ps. Sorry for typos, bad grammar or stuff, ya know. Also, Allura and Shiro being awkard af bc I’m all for that shit. 
Ps.2 Read under the cut.
EDIT: i didn’t even tagged you wtf, honestly, @coralreefskim
Disclaimer: Voltron doesn’t belong to me. 
As far as Shiro is concerned: he’s an only child,
Because he’s going to kill his little brother.
Shiro stomps hard against the hall’s floor as he heads towards the last door on the right. He has walked down this hall a lot of times over the last four years, being the place where his squad and him came to have their weekly movie night.
Lance’s apartment has always been their meeting point, but, for half a year now, it had become Lance and Keith’s, seeing how much time his little brother spent at his boyfriend’s apartment rather than their own.
Which is exactly why he’s marching down to Lance’s apartment, because he knows the lil’shit he has of a brother will be there and he’s going to regret deleting the last season of Game of Thrones before Shiro had a chance to see it just to record his crappy 90’s conspiracy theories.
As soon as the familiar mahogany door is in front of him, Shiro holds up his prosthetic and knocks, maybe with a little too much force than usual, and taps his foot against the floor in impatience, grumbling under his breath as he waits for an answer.
He hears the door lock click and as soon as there’s enough space in between, Shiro is quick to raise his hand, finger pointed in accusation at the person behind the door, mouth wide open ready for a screaming match -
“Um?”
When he realizes that it’s neither Lance or Keith who is behind the door and it’s an entirely different person who he’s currently trespassing on their personal bubble, his finger a little too close to the bridge of their nose.
Bright deep blue eyes meet his own gray ones and suddenly Shiro forgets why he came here. Brother? What brother? Game of Thrones? Whatever, everyone dies anyways.
All he can focus on is those big eyes that are staring at him...with a hint of indignation and annoyance, yep, right, okay then, time to apologize.
“Um!” That’s not how one should start with when attempting to apologize, but he’s trying, “I’m sorry! I’m really sorry, I thought you were Klance - I mean! Keith! Or Lance! I thought you were one of them, and I was looking for my brother, but you’re not my brother because, of course, you don’t have a - Oh kay then, yes, so , um, you're not them, and I’m really sorry about that abrupted ...scene I guess? I don’t usually do that, but you see, it was Game of Thrones so he had to pay -”
Shiro has chill, he swears to God he's the chilled one in his family, but no one can blame him when he loses said chill because there's suddenly a Goddess in front of him, okay?
How about if he runs? Would that make this less awkward?
He doesn’t have time to decide because suddenly, the gorgeous stranger in front of him gasps and he swears her eyes sparkle as they focus on his arm prosthetic.
“Is that a prosthetic? That’s a stupid question, of course it is! Oh, my! Look at this detail, this is amazing! I have never seen technology so advanced except in our laboratory, how did you managed to get this prototype? How was the physical therapy sessions? This is quite outstanding.”
Shiro blinks, face still flushed and mouth dry.
“Uh…” he lets out dumbly and it’s enough to make the woman jump in realization, her blue eyes widening.
“Oh, oh my gosh, I’m terribly sorry, I didn’t meant to uh, I just - I’m really sorry! I just - I’m a Doctor and I just started to make a new prototype for a mechanic prosthetic along with my father back at the hospital and - not that I’m excused just for that fact but uh - I just wanted to assured you I’m not a creep or a morbid person and - Oh, quiznak,  I’m - Uh...”
She trails off unsure, lower lip getting caught between her teeth and - Ok, Shiro should really look away now.
...Ok, so, he stares a little bit more.
He doesn’t mind in the least the topic revolving around his prosthetic; it’s been a couple of years since his accident and he has healed and grow since then. His past and disability doesn't define him, he has learn that, and he lived by that.
But it’s not like he’s about to tell her that; his awkwardness had to be shared, okay? He has rights as a human being and letting other people to share the awkwardness was part of those rights.
The silence expands itself and Shiro’s starting to think that this is a good time for space cats to try and invade Earth just so he could get out of this mess.
But then the dark skinned goddess princess in front of him - because, honestly, what else could she be - claps her hands with determination before she moves around him, careful to not touch skin and somehow they end up switching places; Shiro blinks in confusion as his feet hit the wooden floor of the apartment and stares as the still unknown woman shifts on her feet outside the apartment.
“Yeah, ok, so, um, just stay there and - uh, hang on -” She says hurriedly, grabbing the handle of the door to close it carefully before she closes it entirely, leaving Shiro behind with an empty apartment.
Not two seconds later and then there’s a knock on the door. Shiro immediately opens it and then there’s the woman, smiling bright and wide at him and holding out her hand.
“Hi, I’m Allura Altea, I’m Lance’s cousin and I promise not to make this awkward again.”
That’s all it takes for Shiro to think she’s the one.
Their first date took place two weeks later right after Shiro finally got the courage to ask Allura out.
Shiro wants to emphasize that by ‘courage’ he means that his little brother quite literally kicked him in the butt towards Allura during one of Lance’s parties and shouted loud enough about how Shiro wanted to woo Allura with his charm like he wrote in his diary.
It’s a fucking journal, Keith, learn the difference.
At the end, he couldn’t really kill Keith, again, after that scene because Allura had laughed. She laughed and shook her head in disbelief before asking Shiro to expand his idea on his journal and his future plans.
Shiro was more than happy to share.
Now, they stand here: a thursday night on the small but comfortable terrace of Coran’s bakery, the dim lights hanging from the green flora around the walls giving the entire place a more romantic atmosphere.
Allura had complained at first, an embarrassed flush on her cheeks at her Uncle’s tactics and wink when they had arrived, but Shiro had waived the teasing off, offering a wink back to the mustached man and whispering a quick ‘thank you’ before guiding Allura to their table.
It takes a while but then the sun sets, the terrace get brighter and Shiro can only stare fondly as Allura keeps talking, eyes wide with excitement and arms flying around vividly at every word coming out of her mouth.
He’s entranced and he doesn't want to look away but his phone beeps besides him, letting him know it’s a quarter before midnight.
He voices his new discovery and he’s met with a confused arched eyebrow and a soft gasp.
"What? Already?"
Those gotta be his new favorite words.
Shiro chuckles softly, shaking his head in amusement as Allura takes out her own phone to confirm his statement.
"I can't believe five hours have passed already," she muses in wonder, blinking owlishly before flashing him a bright smile. "Time flies, huh?"
With her by his side? He’s starting to realize that.
That’s how Shiro knows she’s the one.
Hunay’s wedding - because apparently now ship names were a thing in their squad and they are never letting him live it down - had been beautiful and Shiro is not afraid to admit that he had been low-key sobbing during the vows.
Shiro lost track of the squad soon after Lance delivered his best man’s speech. He could still see Pidge, though, dancing on the dance floor with her brother, who is also his best friend, laughing as Matt twirls his little sister around with a happy grin, his leg prosthetic doing nothing to prevent him from having fun.
He doesn’t want to even imagine where Lance and Keith are; knowing the two of them, they were probably being teenagers in the backroom instead of two adults with aerodynamic degrees.
“They are actually cuddling,” Allura says calmly suddendly joining him, as if she had read his thoughts, before intertwining their fingers together, her touch warm and secure against his flesh hand, “I passed them just a few minutes ago, both of them laying on the sand with the sunset behind them. Quite romantic, if I say so myself.”
“They are in Hawaii, the least they could do is appreciate the beautiful view of the sunset.” Shiro jokes, and Allura nudging him with her shoulder.
“I believe that seeing one of the people you love the most on this Earth being happy beats watching a sunset in Hawaii, dear.” Allura says playfully but her eyes to meet his and the intensity and emotion in her gaze makes his breath hitch.
‘Maybe so,’ Shiro thinks as he smiles down at her fondly, ‘but I don’t need a sunset when I see my everyday sunrise in you.’
Allura mirrors his smile before she sighs contently, resting her head on his shoulder and staying quiet for a few seconds, just enjoying each other’s company before Shiro drops a kiss on top of her head.
“Hey, dance with me?” He whispers softly before he yelps out in surprise when Allura flashes him a grin and tugs his hand ,running towards the dance floor.
At her smile and the sunset glow around her frame, Shiro decides she’s the one.
It takes him exactly two years and one week to tell her his thoughts.
Not because he was unsure or doubtful about his own beliefs and feelings, far from it; it was because love takes time, and while he had known from the start that he was going to spend the rest of his life with Allura, that didn’t mean he had to rush things.
Falling in love with Allura had been like anything he has experienced before. It had been abrupt and yet soft, fast and yet slow. It had been a rush of emotions quickly followed by a wave of comfort and familiarity that Shiro can’t help but think that this is not the first time living this.
That’s why, as he kneels in front of the woman he loves, the very same woman he had meet two years ago just because he wanted to kill his brother over a silly tv show, he tells her.
He tells her his thoughts, his feelings, his promises and his plans. He whispers his love, his hopes and his desires.
He reassure her, right there, under the stars and on the edge of their city, that there’s no one else in the entire universe for him, no one else out there that can make him smile, laugh or sing at three in the morning while dancing barefoot in their living apartment because -
“You’re the one,” Allura finishes for him out loud, tears falling down her eyes and her free hand, the one that’s not wrapped around Shiro’s, pressed against her chest, “You’re the one, Takashi.”
It might be night around them at the moment, but the moment Allura smiles can’ts help but think,
‘There’s my sunrise.’
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paleorecipecookbook · 7 years ago
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RHR: A Three-Step Plan to Fix Conventional Healthcare
In this episode we discuss:
The patient case that inspired the book
Who is this book for?
The mismatch between our medical paradigm and chronic disease
Drug companies and conflicts of interest
How clinicians can help create a new paradigm
The three core problems and how to solve them
What this new paradigm looks like
How do we pay for this? Is it scalable?
How allied providers are the key
Show notes:
Unconventional Medicine by Chris Kresser
Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.
NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping
[smart_track_player url="http://ift.tt/2yiM0Yd" title="A Three-Step Plan to Fix Conventional Healthcare" artist="Chris Kresser" ]
youtube
Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.
The patient case that inspired the book
Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.
Is a new healthcare paradigm affordable? Scalable? You bet.
His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.
Who is this book for?
Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.
The mismatch between our medical paradigm and chronic disease
Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.
Drug companies and conflicts of interest
Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.
How clinicians can help create a new paradigm
Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.
The three core problems and how to solve them
To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.
What this new paradigm looks like
Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.
How do we pay for this? Is it scalable?
Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.
How allied providers are the key
Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.
Source: http://chriskresser.com November 08, 2017 at 04:12PM
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paralianblue · 8 years ago
Text
The Cockpit
AKA the short story included at the end of special Waterstones copies of Broken Homes, which most of the RoL fandom don’t have access to. I happen to have a copy of that edition, and (seeing as how it’s impossible for the majority of the fandom to access it in any other way) have typed it all up below. Please enjoy, let me know if there are any typos, and note that I do not own copyright etc to the following:
The Cockpit
'It's not easy being a bookseller,' said Warwick Anderson - bookseller. 'Especially in that branch. It's a listed building, so Waterstones can't put in a lift and we have to carry the stock up and down the stairs.'
'So you were tired?' I said.
Warwick took a sip of his coffee. We were in a spare office at Waterstones' gigantic art deco store on Piccadilly that the company had made available to us. We were there because Warwick Anderson refused to go within five hundred metres of his old store in Covent Garden.
He was a white guy in his late twenties with slightly mad blond hair flying up into spikes.
'Well, I already had to do the overnight on my own, so that didn't help,' said Warwick, because the perennial problem for all retailers the world over is the customers. Not only do they clutter up the shop, but they also demand to be reminded of the title of a book they read a review about in the Telegraph, given directions to the Lion King, helped to find a book their mum will like and, occasionally, purchase some actual merchandise. All of this customer-facing activity gets in the way of the shelving, merchandising, stickering, destickering, table pyramiding and stock returning that is necessary for the smooth operation of a modern bookshop. The bigger stores can have whole shifts devoted to coming in early and making sure their shelves are ship-shape, but small stores have to resort of the occasional overnighter.
'You can get a tremendous amount of work done if there are no customers in the way,' said Warwick. 'It's crucial if you have to move a section or something.'
'And you were on your own?' asked Lesley.
'Yes,' said Warwick, who was obviously disturbed by Lesley's face mask. 'Peggy had been with me the night before, but last night it was just me.'
Lesley checked her notebook. 'This would be Peggy Loughliner?' she said.
'That's right,' said Warwick, looking anywhere but at Lesley's face. 'I was in the basement shifting celebrity chefs from one end of the cookery session to the other when a book hit me in the back.'
Warwick had spun around, but found he was still alone. There was a book at his feet. It was Banksy's Wall and Piece. Fortunately it was the paperback version.
'Or else that would have really hurt,' said Warwick.
Spooked, he'd taken the time to check the rest of the shop, including the staff areas and the three entry points, but didn't find any evidence that he wasn't alone. He went back to his shelving and was more annoyed than frightened when he was hit on the back of the head by a soft toy - the kind on offer at till point. He was just about to whirl around and catch the perpetrator red-handed when approximately five shelves of the Art section hit him in the back - including two display shelves of Art Monographs.
'It's not funny,' said Warwick. 'Some of those Taschen books are huge.'
Actually, the CCTV footage was sort of funny, in a cruel YouTube kind of way. Unfortunately, the camera had been positioned to cover a blind spot behind the till so the books were already in mid-flight before they appeared on the screen. Warwick was just visible on the left of the frame being knocked down by the sheer weight of art. Worse than that, a couple had struck him squarely on the back of the head, rendering him semi-conscious.
He'd managed to stagger to the phone at the downstairs till and dial 999 before collapsing. The response team had been forced to break in, adding to the damage. And, having waved Warwick off in an ambulance, they called in the store manager to take care of the door before being called away to deal with a birthday party that was explosively decompressing outside the newly rebuilt Genius Bar in the piazza.
A DS from the CW's PCU, that's the Charing Cross Primary Crime Unit to you, evaluated the case and, since Warwick had suffered only a minor concussion, there didn't seem to have been a break-in prior to the arrival of the police, and nothing appeared to have been stolen, assigned it to his most junior PC with strong hints that it should be cleared, dumped, or passed into oblivion by the end of the day. The PC, who shall forever remain nameless, had been at CW with both me and Lesley and had been following our subsequent careers with the same appalled interest engendered by the early round contestants in Britain's Got Talent so he decided this was just the sort of weird shit that the Special Assessment Unit, aka The Folly, aka those weirdos, had been formed to deal with.
'You know what I reckon,' said Warwick Anderson. 'I reckon it was a poltergeist."
I don't have time to talk about the nature of ghosts here, but let's just say that, like the mentally ill, they almost never pose a danger to the public. And when they do it hardly ever involves throwing physical objects about. However, according to Nightingale, when they do start flinging the furniture it can be very serious. So I arranged for us to spend the night in the, possibly, haunted bookshop.
'And I have to be here because?' asked Lesley.
'So there's corroboration if anything happens,' I said.
'And Toby?' she asked.
'To wake us up if anything happens,' I said.
The shop manager, a short, round, and strangely asymmetrical white man in his mid-thirties, also wanted to know about the dog.
'Don't worry,' I said. 'He's specially trained.'
'Oh, he's special all right,' said Lesley.
The Covent Garden branch of Waterstones had been created by purchasing three shops - one medium sized one on New Row and two small ones on Garrick Street - and then knocking them all together and fitting out the basement. This gave it three entrances, four till points and a very odd shape. Lots of dead space, I noticed, ideal for shoplifting.
I asked the manager about it, and he said I'd be surprised by what got stolen.
'Poetry mainly,' he said.
'Really?' I asked.
'Really,' he said.
I supposed that being right next to the Garrick Club they got a better class of shoplifter.
I'd noticed an interesting windowed dome over the main till on my first visit, but when I did a cursory historical and architectural search online that afternoon I couldn't find any reference to it at all. I got the impression that the central section had once been a hall or a boardroom - somewhere built for display.
The manager would have preferred to have spent the night in the shop with us, but but we suggested that if he was that worried he could always wait in his car outside - he declined.
Once he'd shown us how to lock up and set the alarm, in case we left early, and had a strained telephone conversation with his cluster manager, he departed with many a worried backward glance.
The ground floor was an L-shaped space mage up of obviously quite a large hall, the main entrance, and a similar size section at an angle which contained the main till with the glazed dome above it. The stock room and loading bay were behind the till and at the other end two smaller wings, children's books and travel, ended with doors out onto Garrick Street. A set of central stairs led down into the basement where Art, Self-Help, History, Politics, and the ever-expanding Cookery section lay.
We did what we've come to call an Initial Vestigia Assessment, or IVA - which consisted of wandering around the shop trying to sense if anything occult had happened inside. It wasn't easy, because books have the same effect on vestigia as those egg-shaped boxes of foam have on sound. It was a phenomenon much commented on in the literature, or at least in the literature I'd managed to skim through that afternoon. Most practitioners cite the effect as the reason why it was much easier to have a nap in one of the Folly's libraries than in the smoking room where they were supposed to.
There was definitely something at the main till under the dome on the ground flood. A whiff of the slaughterhouse mingled with shouting, excitement, desire, disappointment and rotting straw. Downstairs, where the 'attack' had taken place, it was just your normal central London background of pain, joy, sweat, tears and the occasional inexplicable horse or sheep.
According to the literature there are basically two types of ghosts, those that only show themselves when people are present and those that only come out when nobody is there. There are Latin tags for both types but I can never remember what they are. So the big question was whether to set up camp where the unfortunate Warwick Anderson was buried in books or to wait in the manager's office and monitor via CCTV. In the end we decided to wait in Art, where the attack had taken place, and if nothing happened after three hours to move to the office - which was closer to the staff room and the coffee in any case.
'Hold on,' said Lesley as we settled into our chairs. 'Didn't the children's section used to be downstairs?'
'I don't remember getting called to a job here' I said.
'I used to buy presents for my nieces and nephews,' she said. 'And the children's section was there.' She pointed to a square alcove whose shelves were currently labelled Street Art, Interiors and Photography. Street Art being graffiti with a dollar value on the international market.
'At least that bit was where Harry Potter and Road Dahl were,' she said. 'Although Tracy preferred Darren Shan to Harry Potter. I used to check the table for new stuff.'
The display table in the alcove was currently sporting a sign which read 'Never Without Art', a category which appeared to consist of big glossy books with tastefully photographed white women on the cover.
I rummaged around in the go bag for the first of the snacks and Toby lay down on his back at our feet and stuck his legs in the air.
At least we had plenty to read.
In three hours I ate two packets of crisps, a ham sandwich, and read sixty pages of Policing With Contempt by Victor Baker, the alleged pen name of a serving police officer in some force up north. Whoever he really was, he really hated paperwork, political correctness and yearned for the simpler days of yore. I reckoned that if his skipper ever worked out who he was, he was going to get a close-up look at the good old days via the application of a telephone directory to the tender parts of his body.
We decided it was time for coffee and a possible shift to the manager's office.
I'd just put the kettle on when Toby started barking.
Me and Lesley looked at each other and then ran for the door. We would have made it back to the Art section faster if we hadn't tripped over each other's feet in the narrow corridor that ran past the manager's office. By the time we got there it was all over.
There were four neat stacks of books lined up in front of our chairs.
'Symmetrical book stacking,' I said. 'Just like the British Library in 1896.'
'You're right, Peter,' said Lesley. 'No human being would stack books like this.'
Having established that some sort of weird shit was going on, step two, in the as-yet completely theoretical Modern Procedure Guide for Supernatural Police Officers, was to try and categorise what it is that you're dealing with. With ghosts, the easiest way was to pump a bit of magic into them and see what form they took.
I conjured a werelight which caused Toby to take refuge behind the till counter - he's a veteran of many of my practice sessions.
Shadows flickered amongst the shelves as the werelight dimmed and took on a crimson hue.
'Definitely something,' said Lesley.
'I can't see a figure,' I said.
Usually a ghost would have manifested by that stage.
'Give it some welly,' said Lesley.
I upped the intensity of the werelight until it practically gave off lens flare. Then suddenly it shrank down to a small sapphire blue star and winked out.
'Uh oh,' said Lesley and we both dived for the safety of the till counter just in time for the shop to explode.
Well, not explode exactly. As far as we could reconstruct it later, fully half the books in the basement shot off their shelves and would have sailed across the shop if they hadn't met the books from the opposite shelves coming the other way, with a rattling sound of collision.
Strangely, some areas were left untouched. Not one Nigella Lawson book left its shelf, but every single copy of Paulo Coelho's The Alchemist was later found jammed into an air conditioning vent.
'That didn't feel like a ghost,' I said.
Toby licked my face, which was disgusting, but there was no way I was sticking my head above the level of the till just yet.
Lesley cautiously took her hands off her head and risked a peep over the counter-top. When nothing bad happened, I joined her.
'What did it feel like?' she asked.
It had felt a bit like the first time I'd met Mama Thames or when Beverly Brook kissed me or the Old Man of the River had turned his gaze upon me. Like the smell of blood and the taste of plasticine, like crossed legs and chicken feathers.
'Definitely not a ghost,' I said. 'I want to check something.'
We tiptoed over the books on the floor and up the stairs, which were fortunately free of books, although a display case full of Dan Brown books had been flung into the travel section.
A drift of brightly coloured volumes for toddlers and early readers stretched out from the Children's section towards the stairwell. I motioned Lesley towards the area under the dome.
'Tell me what you sense,' I said.
Even without her mask on it can be hard to tell what Lesley's thinking. The damage to her face has stripped all the markers that we rely on to read the expressions of others. Still, I was getting better at interpreting what I did see, and what she showed under the dome was puzzlement, then disgust and then recognition.
'Cock-fighting ring,' she said.
'That's what I thought,' I said. 'All that excitement, activity and on top of that the power that gets released at the point of death.'
'Chicken ghost?' said Lesley. 'No, wait, you said it wasn't a ghost.'
'Do you know how gladiator fights got started?' I asked.
Lesley indicated that not only did she not know this interesting historical fact, but that she would like me to impart it some time before old age and death.
'They started as a religious ceremony at grand Roman funerals,' I said.
'And you know this because?'
'Horrible Histories,' I said.
'So you're thinking what?'
I told her.
'You're kidding me,' she said.
'Okay,' I said. 'Say something bad about books.'
'What?'
'Say something disparaging about books and reading.'
'Why me?' asked Lesley.
'Because it will be more convincing coming from you,' I said.
Lesley looked around self-consciously and then said: 'Nobody ever learnt anything from a book.'
I thought I heard a rustle downstairs - and so did Lesley.
'Books are for losers,' she said.
Definitely movement, and it wasn't us. I checked and it wasn't Toby either.
'Oh my god,' said Lesley as we went downstairs.
'Exactly,' I said.
'Yeah, well don't sound so smug,' she said. 'Look at this place. It's a mess.'
'I have a plan for that,' I said and told her.
'Not me again,' she said.
'You've got a better voice,' I said.
Lesley agreed and, after a moment's thought, went upstairs to fetch a book from the Children's section. She waved it at me when she came back down.
'Harry Potter?' I said. 'Really?'
'Since I'm reading,' she said. 'It's my choice.'
I created another werelight, a nice gentle one, and addressed the bookshop at large.
'Hello,' I said in my brightest voice. 'My name's Peter Grant and tonight we're going to play a game called 'put all the books back in order.' And if you're especially good and well-behaved, my friend Lesley's going to read you a story.'
Lesley, the coward, claimed she had a medical appointment and left me to explain it to the manager the next morning.
'There's a god living in my branch,' said the manager when I was finished.
'A Genius Loci,' I said. 'A spirit of place. And it's more accurate to say that it is the shop - in a metaphysical sense. A god or goddess of books and reading.'
'But why here?' he asked plaintively.
'Well, it's a book shop,' I said.
'So what?' asked the manager. 'My last branch didn't have a local god in it. None of the other managers have ever mentioned anything like this - I'm sure I would have remembered. Why here?'
Because, I thought, the cock-fighting ring on your top floor provided a reservoir of vestigia which interacted with all those young minds reading books downstairs, and a spirit of a place formed like a pearl around a bit of grit. Only I wasn't going to tell him that. Because not only could I not prove any of it, it was also a bloody dreadful simile.
Then the Children's section had been moved upstairs and the poor little deity started to feel unloved.
'Just one of those things,' I said.
'But what am I supposed to do about it,' he asked. 'Sacrifice a goat?'
'About once a week somebody has to sit down and read it a book,' I said.
'What kind of book?'
'It's not the book that's important,' I said. 'It's the reading.'  
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ehealthy-diet-plan · 4 years ago
Link
How Gov. Michelle Lujan Grisham’s Massive Guess On COVID-19 Testing Helped Curb The Outbreak In New Mexico
  Michelle Lujan Grisham changed into competent for the coronavirus — or at least as competent as a governor may also be for an as soon as-in-a number of-generations pandemic to ravage each point of life in their state.
the former fitness secretary and U.S. Consultant from New Mexico who took over the state’s highest office in 2019 drew on her event coping with infectious ailments to get out in front of COVID-19. She declared a statewide health emergency on March 11th, when the simplest 4 situations had been verified, and hospitals have been offering free pressure-via testing at hospitals just two days later. As of early June, New Mexico has administered more tests per capita than each state however Rhode Island and big apple, a difference that has helped steer clear of the virus from spiraling out of control in what is not only one of the nation’s poorest states, however, one with an anemic hospital ability.
As an infection rates fell, some corporations in the state have been allowed to reopen with restrictions on might also sixteenth. “We’re going to demand in New Mexico that science ebook every decision we make,” Lujan Grisham observed right through a press briefing wherein she also stressed the magnitude of donning masks. “We don’t are looking to go backward and shut every little thing down.”
just as critical as early trying out turned into Lujan Grisham’s early recognition that she couldn’t rely on the federal govt. “I labored during the Trump administration as a member of Congress and become capable of seeing the things that labored and the issues that completely did not work, including the inconsistencies in getting valid assistance,” she explains over the phone to Rolling Stone. “I had that standpoint.”
The interview turned into one among a collection Rolling Stone carried out with governors throughout the month of can also about the challenges of leading during the pandemic (together with Washington State Governor Jay Inslee and New Jersey Governor Phil Murphy.) 
The interview was during an infrequent slice of free time for Lujan Grisham, automatically after one of her every day at 2 p.M. Coronavirus conferences. The conversation had been rescheduled from the old weekend so that she could see her household for the first time in well over a month. “COVID-19 is 190 percent of what I do daily,” she says. “That’s why these colossal crises are challenging because they’re on top of all of the different things every human has to be paying attention to when it comes to enhancing nice lifestyles and serving your ingredients.”
How was the assembly? I'm — foolishly, some would say — attempting to get these meetings all the way down to a half-hour. However, I maintain adding issues that I am looking to comprehend. They take about two hours. I arise thus far, now not simply on the stuff that we study day by day, however, we shift views. What am I lacking? How would I comprise it differently? How does 7-day versus 14-day modeling examine? What about via county? I need to now analyze commonplace times of restoration through inhabitants segments. Should you’re coping with problem-solving, you are looking to have as a great deal counsel as feasible. 
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In late February and early March, you didn’t have this wealth of statistics, and there have been way more unknowns than there at the moment are. What had been you relying on on again then if you happen to have been imposing lots of these restrictions earlier than the federal executive and lots of the rest of the nation were even acknowledging the severity of the virus? When I was secretary of health, we had a flu vaccine scarcity and some very difficult flu epidemic seasons. So I’m no stranger to the importance of any infectious disorder, and I understand the danger in a pandemic. You take an abundance of warning, even though you don’t comprehend everything that you just should be aware of. If there is no vaccine and no actual medication, then you improved to keep people from being in contact. I made quick and intensely extensive, decisive actions, telling Americans to dwell at home, closing colleges, and narrowing standard agencies. We quarantined Americans coming across borders for 14 days. We have been working on taking the temperatures of truckers coming out and in of the state and doing questionnaires about whether or not they had been symptomatic. We were aggressive on the entrance conclusion, and that I consider, unequivocally, it has paid off in the place the state is today.
Are you involved concerning the diploma to which the protests over the killing of George Floyd have pushed COVID-19 out of the information and should lead individuals to disregard taking the types of precautions you had been stressing for months? Americans standing shoulder-to-shoulder in parks and streets and out of doors public structures throughout the nation, even with rankings of them wearing masks, gifts an indisputable risk. I will be mindful of their anger and applaud their passion for justice. But I fret. We know the way effortlessly this virus can unfold — and we recognize protesters may contract the virus and elevate it unknowingly to their parents, grandparents, and different prone populations. We have to be aware we’re coping with this pressing public fitness disaster even at this second of countrywide reckoning. 
What turned into your response to Trump’s name with governors remaining week? What turned into going via your head as he stressed the deserve to “dominate” demonstrators? All I could think was that he was lifeless wrong and guidance the nation towards additional anger, mayhem, and violence. Dominance? That type of implicit support for escalating force is what received us to this element. Dominance is a police officer’s knee on the neck of a citizen. Batons and tear gas and flash-bangs are not the tools to deflect the anger of peaceable protesters. Legislation enforcement’s role right now is to give protection to the peaceable protesters and stop the small number of agitators from looting and escalating the circumstance. The president’s strategy, that excessive force is the simplest technique to address the anger and pain being expressed about extreme and unjust force, is incorrect.
one of the vital things New Mexico was, in fact, out in entrance of was trying out. Can you describe probably the most methods making trying out extensively accessible early contributed to tamping down the spread of the virus and your capacity to computer screen it? You need to understand where the virus is offering itself so that you can get individuals isolated instantly and in the reduction of basic transmission. Should you reduce transmission, you also in the reduction of what we call the density of prevalence of the virus in a group, and then you could take different moves. In case you can’t do checking out, you’re flying blind. Too many Americans are contaminated by the point you recognize you’ve bought a problem. And notwithstanding no state has adequate health care equipment to cope with a virulent disease, New Mexico, per capita, has half as an awful lot [infrastructure] as another state. If we get this wrong, individuals will die because they couldn't get fitness care. So I was clear about that.
The federal government becomes not clear in regards to the strategies they have been going to undertake, so I grew to become the testing expert. I truly did a listing of lab property. I knew exactly what number of gadgets we had. I learned what it took to get them calibrated to run the COVID look at various. I was clear about which COVID tests had been the most plausible and professional. I went to each brand at once. I called the CEOs and the executive members of the family Americans each day until I bought within the queue to get orders coming into New Mexico. We may hold expanding checking out as a result of I knew where my labs had been, I knew the place the devices have been, I knew what it takes to get it completed, and it put us in a more robust position.
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How has your inability to count on constant federal guide affected your ability to combat the pandemic? I knew it was going to be challenging. Loads of the federal secretaries don't have any govt experience, and a lot of them have no event in the environment that they’re asked to steer. The White House may also be responsive, however, the problem is that it’s hit and miss as a result of they don’t have a powerful federal design. They’ve obtained 50 different things they’re engaged on at a time for 50 diverse governors, which is why constituents aren’t getting what they need. It’s anything they’ve arguably gotten worse on, at a time after we want more facts, extra counsel, and extra self-belief because we are reopening and introducing possibility again into our communities. Here's when the federal executive, in reality, must be constant. The fact that they’re no longer is, in fact, a travesty. Frankly, I don’t see it getting more advantageous each time quickly.
New Mexico is likely one of the poorest states in the nation. To what extent have economic concerns factored into your determination-making? It’s extremely tough stability. The national noise is that you just ought to choose from public health and safety, and the financial system. I don’t trust that. I agree with in prudent determination making, because closing the economic climate can be worse over the lengthy haul. People are determined. Individuals have misplaced their companies and misplaced financial protection. When somebody will text me or name me and say, “Throw a bone to this business and open up a bit early,” that’s a political resolution, and I don’t make any political decisions about this virus. This virus is nonpartisan. It will assault you no matter the place you are or who you are. However people power me, and that I get it. I don’t dismiss that. The manner individuals are all feeling is credible. But I ought to seem on the facts to make these selections. 
The Navajo Nation has been hit in particular difficult. Why has the outbreak been so dangerous there? What are some of the challenges in fighting it from getting worse in these materials of the state you don’t truly have the same variety of jurisdiction over? I haven't any control over a sovereign nation. I don’t consider that I should still. I had a call with every tribal leader in the state in early March after we have been making all of these selections. I obtained on the cellphone and mentioned, “You have to shut down. You need to shut the casinos. You ought to shut your inns.” There’s lots of risk on account of their chapter government with layers of in fact advanced organizational programs. In their families, what is outstanding when it comes to caregiving — guide, pride, and faith — has developed into their Achilles Heel, as a result of they have got assorted generations residing in a single-family unit. There are too many households without operating water or electrical energy. They should travel as a way to get these primary resources. They don’t have enough health care. Their trying out changed into taking weeks to get returned.
I alerted the White condo that the possibility changed into excessive and that they need to do something differently. The federal government is in cost of their testing, in can charge of their elements, in can charge of their hospitals. It’s all federal. [In New Mexico,] 50 p.C and above — depending upon whether you look at mortality charges, of superb [COVID-19] case fees, or clinic quotes — are Native American situations. If you took out the Native American fine instances in New Mexico, we would have the lowest expense of transmission per capita in the country, using some distance. This turned into a complete failure of the federal executive.
what's being achieved to insulate the Navajo Nation and different vulnerable communities during the state in opposition t the results of the pandemic within the long run, above all when you consider that the lack of federal support? We have isolation facilities where we use accessible resources and can circulate you and your family, separate you into resort rooms, and ensure that you simply bought food, water, protection, and health care aid — and stream you if you get ill. What we tell Americans is that you should self-isolate unless you get you to examine effects lower back. In case you live in a city environment, that you could go appropriate home and also you’ve received water and electricity and take care of — the entire issues that you simply want. You’re going to get a solution in 24 hours at the most. In case you’re in Navajo Nation, you may now not get a solution for a week, and you should go out and get different substances. You may have a dialysis appointment or any variety of stuff you need to go to, yet you don’t have any guidance. Neither can we so that it will do the contact tracing. It’s horrific.
but I’ll inform you what: We’re going to come up with it. The Navajo Nation has been miraculous, and we’ve received a speedy response team with one of the crucial ideal scientific and medical docs in the country, all working together to think about how we can include it faster. If the federal executive can step up its online game, that’s splendid. But I have to function as if they’re now not going to. We ought to have all of those issues in the vicinity because we can’t tolerate losing one more lifestyle. Not one. We can’t have one more person get sick. We are able to have a further household be decimated by way of this virus. It is merciless, and unfair, and unjust. And we can do everything in our power to repair this.
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chocolate-brownies · 6 years ago
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Right now, I can feel the tight squeeze of stress in my stomach. This morning, I got a call from a close friend needing support, which prevented me from starting this article. At any moment, I expect one of my coworkers to email me asking for help with a last-minute assignment. And I’m set to leave my desk early for a dentist appointment, after which I’ll rush home to cook a late dinner.
I’m under time pressure—and I know I’m not alone. If you’re a woman, or a single parent, or practically anyone living in today’s go-go-go American society, you probably are, too. When researchers surveyed Americans before 2011, about half said they almost never had time on their hands and two-thirds said they sometimes or always felt rushed (though a more recent study suggests things may be improving a bit).
As researcher Cassie Mogilner and her colleagues write in a 2012 paper, “With waking hours largely consumed by work, precious minutes remain for the daily list of to-dos, including exercise, cleaning, and socializing with friends and family.”
At first glance, the issue seems straightforward. Time pressure comes down to a lack of time, right? Well, partly. It’s the feeling that we don’t have enough time to do what we want to do—but it turns out that feelings and enough and wants are somewhat subjective.
From 1965 to 2003, the average American workweek actually declined by three hours, while leisure time increased. And in many places in the developed world, the workweek has gotten even shorter since then. In one study of more than 7,000 working Australians, researchers declared that time pressure is an “illusion.” They estimated how much time is necessary for basic living—hours of paid work, housework, and personal care—and compared it to how much free time people had in their actual schedules. It turns out there was a big discrepancy, which was most extreme for households without children and smallest for single parents.
“Those who feel most overworked—those who have least ‘free time’—largely do it to themselves,” the researchers wrote. In other words, we could theoretically spend fewer hours making money, vacuuming and washing dishes, or cooking and eating, and we’d get by without getting overwhelmed.
Although you may not want to subsist just above the poverty line or give your kids as little attention as possible, the broader point is important: Tight-squeezy time stress has to do with the things we value and the time we devote to them. And, other research suggests, it also relates to our attitudes and mindsets about time. Rather than always blaming the clock, we can find some roots of the time crunch deep in our own psychology. Here are some scientific insights to help you make a distinction between real stopwatch pressure and the unnecessary pressure you might be putting on yourself.
Four Ways to Take Back Your Time
1. Ask yourself: What makes my time fly?
In a 2004 study of nearly 800 working people in Ohio, researchers were confronted with a puzzle.
When women did more than 10 hours of housework a week, they felt more pressed for time and in turn more depressed. But when men did the same amount of housework, they didn’t. A similar pattern appeared for volunteering: Men who volunteered more were less depressed, but women got time stressed and didn’t seem to experience as much benefit.
The explanation that the researchers came up with, bolstered by people’s accounts of how they spent their time, was that men tend to do more enjoyable housework and volunteering. They cut the grass and coach soccer teams; they get into flow and feel a sense of accomplishment. Women, on the other hand, are often occupied with small, repetitive daily chores and service work: less cheering and high-fiving and more trying not to fall asleep at school meetings.
Unsurprisingly, a day packed with somewhat engaging activities feels less busy and stressful than a day of drudgery. If time flies (in a good way) when you’re having fun, it also seems to fly (in a bad way) when you’re not. This subjective element might have created more of a sense of time pressure in women who participated in the study, even if men’s activities equaled or exceeded theirs in hours.
One study found that people who are more passionate, who aspire to do things that matter to them at work, aren’t as rushed and harried as others.
A similar effect takes place at work. In one study, researchers surveyed more than 2,500 employees at a technology company and a financial services company. They found that people who are more passionate, who aspire to do things that matter to them at work, aren’t as rushed and harried as others.
If you feel short on time, you might simply not be enjoying the activities that fill up your schedule. Life can be like that sometimes, but if you find yourself feeling overwhelmed, it might help to add one more thing to your day—something that keeps you engaged.
2. Stop competing with yourself
Why does passion seem to free up our time? The researchers who observed this phenomenon wanted to discover what was really going on.
They found a clue when they asked employees about how conflicted or aligned their goals were. Employees lacking in passion said that their goals were competing with each other, fighting for time and attention; for example, the drive to do well at work might make it hard to get home for dinner with the family. But passionate employees were different: They saw their goals as supporting each other. After all, healthy home cooking and family bonding might give them more energy and motivation tomorrow.
So, time pressure isn’t just about how enjoyable our activities are, but also how well they fit together in our heads. One study found that people who simply think about conflicting goals—like saving money vs. buying nice things, or being healthy vs. eating tasty foods—feel more stressed and anxious, and in turn shorter on time.
Knox College professor Tim Kasser, an expert on materialism who coauthored a seminal paper on time scarcity, once joked, “If every research project that I’m currently working on right now was a cat living in my house, it would be very clear that I had a problem.” If your to-do list feels like a herd of hungry felines, all in competition for your one can of food, it’s no wonder you’re overwhelmed.
While we may freely choose some tasks on our plate, others are largely the product of our society or culture, says Australian National University professor Lyndall Strazdins, who has spent the last decade trying to show how time scarcity matters for individual and public health. For example, being a good suburban mom today seems to include chauffeuring your kids around the neighborhood to countless sports and hobbies.
“If you don’t do that, then you feel you’re not living up to one set of norms, but if you don’t do [something else], you’re also not living up to another set of norms,” says Strazdins. “You’ve got 24 hours…and you get to a point where you just can’t expand your day.” If you feel a lot of inner conflict about a task, then you might consider just letting it go.
3. Change your calendar view
Often when we’re caught in a time conflict, it’s because of some external obligation: Daycare pickup runs up against an important meeting; your work shift starts at 9, but the bus is late. Time pressure goes hand in hand with feeling you’re not in control of your own schedule.
In one 2007 study, researchers interviewed 35 low-income working mothers who were caring for at least one child. They asked the moms to talk about how they spent the previous day, and how they manage to feed their families when it’s hectic.
The researchers were able to pinpoint different ways of managing time—some of which were more successful than others.
The least successful was the “reactive” style, where mothers didn’t feel in control of their days. All those mothers felt time-scarce, beholden to the clock, unable to accomplish everything they wanted to. In contrast, mothers who had an “active” time-style had some success at scheduling, managing, and structuring their days. They felt slightly more in control of their own time and a bit less time-stressed than the reactive group.
“People often complain of being in a time bind not only because they are objectively busy, but also because they perceive a lack of control over their time,” researcher Ashley V. Whillans and her colleagues write. That perception may be based on our life circumstances—because we have non-negotiable work hours or babies who aren’t fond of sleeping through the night—but it can also be part of our psychology.
According to research, rather than experiencing life as masters of their own fate, some people tend to feel like they’re at the mercy of external forces (and thus less resilient to stress and more depressed). If this describes you, it may be harder for you to seize back a sense of control over your schedule.
In that case, try to keep your eyes on the prize and do what you can to gain a sense of control over your time. Take little steps, like optimizing your to-do list or practicing saying “no” to people who ask for favors.
4. Revalue your down time
One last piece of the time-pressure puzzle is money, and that one is complicated. If you work multiple jobs or can’t pay for a babysitter, you’re bound to feel short on time. But some research has found that people with high incomes feel particularly short on time—and people who get richer become even more harried than they were before. Even just feeling rich—when your savings is on the higher end of the scale on a form you’re filling out—can make you feel more rushed.
“In a society like ours, the go-to answer [for happiness] is make more money, buy more stuff,” says Kasser. “What we’re trying to say is, well, no; what people actually need is more time.”
Why would an abundance of money feel like a scarcity of time? One possibility is that rich people have so much they could do with their money but only a handful of hours outside work to do it, suggest researchers Daniel Hamermesh and Jungmin Lee. So many expensive hobbies to pursue, so little time!
But another possibility is that they simply put more value on their time. If each hour they’re not working is $100 they could have earned, they better use that hour well.
As economists would remind us, when something is scarce, its value goes up—but the opposite is also true. When something is valuable (like time), we perceive it to be scarcer.
As economists would remind us, when something is scarce, its value goes up—but the opposite is also true. When something is valuable (like time), we perceive it to be scarcer. In one experiment, researchers asked 67 students to engage in some mock consulting work, for which they would “charge” $1.50 or $0.15 per minute. The students who were charging $1.50 felt more pressed for time—even though they weren’t actually going to earn that money! In another experiment, when people were asked to calculate their hourly wage, high earners felt even more time-starved.
“Feelings of time pressure are not just a function of individual differences, the quantitative amount of time spent working, or even people’s working conditions, although these factors are obviously important,” write researchers Sanford E. DeVoe and Jeffrey Pfeffer. “Time pressure is at least partly a result of psychological processes and the perception of time’s value.”
This is all good news and bad news. It means that our efforts to optimize and schedule, plan and streamline, might not be getting to the heart of the problem. But it also means that we may have more leverage than we think, even if we can’t manufacture spare hours to call a friend or get to the dentist. Time pressure is the uncomfortable gap between how we wish we spent our time—and how we think that would make us feel—and how we’re spending it and feeling now. With that in mind, we just might be able to find some room to breathe.
This article originally appeared on Greater Good, the online magazine of UC Berkeley’s Greater Good Science Center, one of Mindful’s partners. View the original article.
The post Take Back Your Time appeared first on Mindful.
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pillowsteam8-blog · 6 years ago
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FRUGAL IN ESSEX
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If you are traveling with kids they will get a totally free candy sample at the finish of the trip exactly where you are dropped off correct into the present shop. If my hotel doesnt have a totally free shuttle and it is near to the occasion hotel, occasionally I would consider the occasion hotels totally free shuttle and then stroll to my hotel. Update on the automobile insurance coverage: We did have to get my daughter a policy of her personal because the vehicle is in her title.
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I get every thing I know she will require at that time. I do not know although, I have by no means been to the dermatologist for a facial peel. I will allow you know how it goes. Occasionally it is simple to get drawn into revenue that you did not know about and invest much more than you needed to.
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This one’s simple. Set up automated payments, both via your services companies straight or by way of your bank’s on-line bill-spend, and you will quit getting to be concerned about late fees—plus you will conserve on postage and occasionally even get a little low cost! Get your self a buying checklist on hand prior to going to supermarket.
Looking for stuff to do while on a #budget? Check out our FREE “Budgeteer Weekend Guide.” We share 100 fun things to do while living #frugal, regardless of what stage of life you’re in! #fun #Happiness #living #TuesdayThoughts #winning http://beyondabudget.com/free-downloads/ pic.twitter.com/FRNWUttJDM
— Beyond a Budget (@beyondabudget) April 24, 2018
Lately I was viewing at the nearby park as guys had been flying model planes about and received into a conversation with a guy who knew fairly a great deal about every model plane that went up. But then lifestyle received in the way. It is no way to reside your lifestyle.
The way these function is that the piston consists of a temperature-delicate fluid that expands as it warms and condenses as it cools. Whilst an financial economic downturn can force remain at house mothers to function to offer for the kids, a lack of fuel can force them back house simply because they can't afford to commute to and from childcare and employment. About Living with less is a function at house mom who is usually searching for methods to reduce costs.
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Consider all of your costs and complete them. The 70/thirty Rule merely stated says that you will reside on 70% of your complete month-to-month earnings following tithing and taxes. I have a couple of much more days however till that occurs, so I will wait till the suitable date and contact once more. I’m referring to the disturbing stories of monetary burden imposed on these who have incorrectly distributed money from a retirement fund due to a divorce.
But if you are attempting to alter from dark to light, I would not suggest this, as you might damage it and have to go spend tons of money for a GOBankingRates salon "repair". Simply because you are conscious of your numbers, you are much more inclined to keep track of and track them on a constant basis.
This yr we’re going to re-assess exactly where we are in regards to our objectives on a much more regular basis so we are in a position to make changes as we require to. Individuals my age are obtaining higher blood stress, higher cholesterol, cancer, and other devastating illnesses.
Balloons are festive and inexpensive, particularly if you fill them with air, rather of helium. Not only are these mothers and fathers caught covering the price of a roof overhead, but at occasions also a cell telephone, vehicle payment, vehicle insurance coverage, and well being insurance coverage. Because lodging price can be the most costly element of traveling the highways of America, this easy tip can conserve you tons of cash and disappointment.
Hope winter is treating you all nicely.
It is most likely. Nevertheless, the cash that you can conserve is nicely really worth the work. Hope winter is treating you all nicely. I attempt to store the specials, as well, and I stockpile issues like papergoods, detergent, pet meals, and so on., if I discover particularly great offers. It is most likely great to think about revisiting your spending budget when lifestyle-altering occasions happen, and set intervals to modify for smaller sized things like inflation and modifications in fixed expenses.
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Figure it out cautiously in advance and then to reside inside your spending budget. Consuming out continuously is costly. If you are not and require to purchase cold meals, some crackers and cheese, fruit, salami, infant carrots - these can be a meal and they will be a great deal less expensive than a meal out. Be ready to trim meat rather than purchase meat that has currently been trimmed. Frugal Choice:: I discovered that a big light excess weight blanket worked just as great as a nursing cover, and I usually had it in my diaper bag anyways.
I wore my personal mother's wedding ceremony dress and could not have discovered 1 much more stunning. That is a great quantity to invest on meals when you only have two mouths to feed. We will be donating some of these to the meals pantry. I purchased two trays of Active Lizzie which will brighten up the backyard and hanging baskets, prepared for us to place the home up for sale.
Appear at all your receipts for final month and create it all down. When you are reserving a getaway, appear to travel throughout off-peak months, on off-peak days of the week, and at off-peak occasions of day. It is a fantastic location to have a day picnic. As soon as you have constructed up your web site with fantastic content material, share that content material utilizing social media. Final month I talked about apps to assist conserve cash, and briefly touched on couponing via some of them.
You will invest much less on a vehicle rather of an SUV, for instance, and you can conserve considerably on gasoline, as well. Maintaining appliances in purchase rather of creating them off as broken can conserve you severe bucks. Studying how to restore and reuse your personal products can conserve you 1000's of bucks every and each yr.
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I summarized in the initial five components of this series about what constitutes an emergency and how you can deal with it. · Exposed me to worldly other cultures, languages, dialects, holidays, traditions, individuals, animals, wildlife, and a lot much more. Speak to your family members prior to you begin creating modifications in the direction of a thriftier way of life.
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shapesnnsizes · 7 years ago
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RHR: A Three-Step Plan to Fix Conventional Healthcare
In this episode we discuss:
The patient case that inspired the book
Who is this book for?
The mismatch between our medical paradigm and chronic disease
Drug companies and conflicts of interest
How clinicians can help create a new paradigm
The three core problems and how to solve them
What this new paradigm looks like
How do we pay for this? Is it scalable?
How allied providers are the key
Show notes:
Unconventional Medicine by Chris Kresser
Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.
NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping
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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.
The patient case that inspired the book
Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.
Is a new healthcare paradigm affordable? Scalable? You bet.
His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.
Who is this book for?
Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.
The mismatch between our medical paradigm and chronic disease
Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.
Drug companies and conflicts of interest
Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.
How clinicians can help create a new paradigm
Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.
The three core problems and how to solve them
To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.
What this new paradigm looks like
Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.
How do we pay for this? Is it scalable?
Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.
How allied providers are the key
Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody.
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denisalvney · 7 years ago
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RHR: A Three-Step Plan to Fix Conventional Healthcare
In this episode we discuss:
The patient case that inspired the book
Who is this book for?
The mismatch between our medical paradigm and chronic disease
Drug companies and conflicts of interest
How clinicians can help create a new paradigm
The three core problems and how to solve them
What this new paradigm looks like
How do we pay for this? Is it scalable?
How allied providers are the key
Show notes:
Unconventional Medicine by Chris Kresser
Special offer for RHR podcast listeners - get the audiobook free if you buy the book by November 12th.
NaturalForce.com - use coupon “unconventional” and get $10 plus free shipping
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Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. Today we’re going to do something a little different. I am bringing on a guest host, Tony Federico, he’s the VP of marketing for Natural Force Nutrition, a physiology editor for the Journal of Evolution and Health, and a longtime contributor to Paleo Magazine, and also at Paleo f(x), which is where I met Tony, I think, originally, and I have interacted with him the most. And he’s moderated several panels that I’ve been on and I’ve always been impressed with the way he’s done that, the intelligent questions that he asks and just his balanced perspective on ancestral health and Functional Medicine, and this movement overall. Today is the day that my new book, Unconventional Medicine, comes out. It’s now available on Amazon, and I wanted to ask Tony to come take over the podcast and talk with me about the book because I know he’s really interested in all these topics and he’s read quite a bit of the book himself, and I thought it would be more interesting to have a conversation about it than for me to just sit here and do a monologue. So Tony welcome to the show and thanks for being here. Tony Federico:  Yeah, thanks for inviting me on, Chris. It’s always fun, when we’ve had the chance to chat, as you said. Whether in person or on podcast, I’m always happy to jump in and dish on health with you. Chris:  Fantastic. So, you have read a little bit of the book and we chatted a little bit about it via email, so let’s dive in. Let’s talk a little bit about this book. And for me it was really, it felt like the most important next step that I could take in order to get this message out about ending chronic disease. Tony:  Yeah, I got my copy of Unconventional Medicine a couple days ago. I just so happened to have some time off yesterday, and the next thing I knew I was 80 pages in. Chris:  Nice. Tony:  So, I have to say that, as somebody who’s been in the trenches, I worked as a personal trainer for 10 years, I could really relate to a lot of the things that you were saying in the book, and we’ll get into why a little bit later on in the interview. But you know I just am really impressed with what you put together here, Chris. So let's just, let's get into it, and the first thing that I actually wanted you to maybe tell me a little bit about was how you open the book, which I think is a really great story about a patient named Leo. So I wanted to talk a little bit about Leo and his story and kind of how that inspired you to go down this particular path of unconventional medicine.
The patient case that inspired the book
Chris:  Sure, yeah. So, Leo was an eight-year-old boy that I treated in my clinic a few years back, and I wanted to start with his story because it's, unfortunately, a typical story, much more common than, of course, we would like. And it was powerful for me, it was a powerful experience. It's what actually led to me writing this book. So, like way too many other kids of his age, he was suffering from a number of behavioral issues. He was initially diagnosed on the autism spectrum. Eventually they settled on OCD and sensory processing disorder. He would throw these just crazy tantrums where he'd end up crying or screaming inconsolably, writhing on the floor, and this would happen for seemingly the simplest of reasons. Like trying to get his shoes tied as they were going out the door, not cutting the crust off his sandwich in just the right way or getting a stain on his favorite T-shirt. And he was really rigid around his behavior and its environment, everything had to be just right, just the way he wanted it to be, or else he would fly off the handle.
Is a new healthcare paradigm affordable? Scalable? You bet.
His diet was extremely limited, he only ate a handful of foods, pretty much all of which were processed and refined. So crackers, bread, toaster waffles, that sort of thing, and this is part of the kind of OCD-like tendencies. And any time his parents would try to introduce new food, he would go totally ballistic. And they were worried about nutrient deficiency, but they didn't feel like they ... they were just worn down. Any parent who has a kid like this will understand that. It's just they didn’t feel like they had the resources to battle him at every meal. And they took him to a bunch of doctors locally, and that’s where they got those diagnoses. Initially they were kind of relieved to have those, but then after a while they realized that they were just simply labels for symptoms. And when they asked what the treatment was, you can probably guess the answer: medication. Tony:  Something to do with drugs. Chris:  Something to do with drugs. Yeah. And when they asked how long he would be on that treatment, you can probably also guess the answer. Tony:  The rest of your life. Chris:  Yeah. Shrug of the shoulders, indefinitely, maybe he'll grow out of it, that sort of thing. And they weren't excited about the idea of of medicating their son, but they were also aware of how much he was suffering, and they were suffering, frankly, too. They decided to give them a try, starting with Adderall, and then they progressed to Ritalin and then antidepressants. And certainly the drugs did seem to help with at least some of the symptoms, but there were a couple issues. Number one, they also caused some very intractable side effects like headache, abdominal pain, irritability, and most significantly, severe sleep disruption. And they had a couple of other kids that were younger than Leo. So they were not happy about the sleep disruption. Nobody was because it was brutal for them and also brutal for Leo. Kids need a lot of sleep, and if they’re waking up throughout the night, that’s going to make ... So that was in some ways worse than the original symptoms they were trying to treat. And then Leo's mom had done quite a bit of research on the effects of these medications and she was scared. Particularly for children and adolescents, some of these drugs have some pretty scary side effects and long-term risks. So what really stood out to me, and I mentioned this in the book, is that not once during this entire process of seeing all these different doctors, primary care provider, psychiatrist, eventually behavioral disorder specialists, did anybody even hint at the possibility that something in Leo's diet or some other underlying issue like a gut problem or nutrient deficiency or heavy metal toxicity or something like that could be contributing to his symptoms. It wasn't even broached as a possibility at any time. Fortunately, Leo's mom, one of her friends followed my work and sent her a couple of articles from my blog. One was on the gut–brain–axis, and I think the other one was on the underlying root causes of behavioral disorders. And so that's what led them to bring Leo to see me, and long story short, we were able to ... we did a bunch of testing, found issues that you might guess at. So, disrupted gut microbiome, SIBO, fungal overgrowth, gluten intolerance, but also intolerance of soy and corn and rice and buckwheat, which were major ingredients in a lot of the processed and refined food products that he ate, and arsenic toxicity because rice milk was the only other beverage he would drink aside from water. And we know that rice products can be high in arsenic. So, we, over several months, it definitely wasn't easy to address these problems because of his OCD-like tendencies and his picky eating habits. But after several months he was like a different kid. His teacher even called home and was like, “What have you done with Leo and who’s this kid that you’re sending in?” Because it was a big issue for her. They often had to come to school and pick him up early because of the behavioral problems. And his diet expanded; he was eating foods he would've thrown against the wall just months before, he was more tolerant of disorder, more relaxed in his environment. They were able to travel for the first time in a long time because he wasn't so anxious in unfamiliar environments. His physical symptoms had improved significantly. So they were just over the moon. They couldn't believe it, and toward the end of our treatment together, she said something that really struck me, which was there’s so many kids out there that are like Leo and they’re suffering, they’re not finding help in the conventional system. Tony:  Sure. Chris:  And their doctors and parents are not even thinking about this stuff. Like it’s not even in most people’s consciousness that if a kid has a behavioral disorder that you should look at these physiological issues. It’s not, for 99 percent of people they don't even go there because they don't know. Tony:  Yeah, I mean I think that that was—reading about Leo and reading about a story and certainly there's people that I've known, myself included, who have had very similar experiences—I think it's great to have a narrative like this that you can really connect to because then when you tease it apart, all the pieces really make sense. It makes sense why having doctors treat symptoms has failed, it makes sense why a lack of communication between the health provider network that was supposed to be serving Leo failed. It makes sense why it didn't work when you actually start to tease it out. But then we’re still all, well not all, but most of us are still going down this path and it's an exercise in futility, really. You have an eight-year-old kid who's on powerful stimulant medications, he’s on antidepressants, and it was bad enough for his parents to reach out and to seek those interventions as solutions, and then the side effects are even worse. And that’s just something that just gets you right in the heart. And like you said, he’s not the only one, he’s not the only kid. His parents are not the only parents. And frankly, his doctors are not the only doctors because I can guarantee you that that probably doesn’t really feel good for the practitioner, for the healthcare provider to not get results as well. And they’re working with what they’ve got. Chris:  Absolutely. Tony:  And trying to use the tools they have. Chris:  Yeah, I mean, let’s be clear about this. Everybody is doing the best they can in this situation. The parents are doing the best they can, in the vast majority of situations, parents just love their kids and do everything possible that they can to help their kids thrive. I’m a parent, I know that that’s how I relate to my kid. I know that every parent I know, that’s how they relate to their kids. And I would even, I would say that’s true for doctors too. The vast majority of them are trying to do the best they can with the tools that they have and in the system that they’re working within. And that’s the rub. Tony:  Right. Chris:   It’s like most doctors I’ve seen have been caring and they’ve wanted to do the right thing, but the question is, can they do the right thing in the conventional medical system as it exists today? And, of course, that’s largely what the book is about.
Who is this book for?
Tony:  Yeah, so let’s kind of speak to that specifically. And we’re talking about doctors, we’re talking about medical professionals, we’re talking about patients, and then we didn’t mention it, but where I fit into this formula or potential formula as an allied healthcare provider, as a personal trainer/health coach, is that your audience for this book, do you really see that kind of triad is who you're speaking to here? Chris:  Yeah, definitely. I think if you look at the cover of the book, the subtitle is “join the revolution to reverse chronic disease, reinvent healthcare, and create a practice you love.” So that last bit would suggest that it's mostly for practitioners, but that's not true. It is really for anybody that is interested in the ideas of reinventing healthcare and reversing chronic disease. And, in fact, I would argue that that change is going to be initiated by people, primarily by people that are not practitioners. So it's like a grassroots, bottom-up approach, where a good example is with my training program, my ADAPT training program, now that we've been training practitioners in this approach for the last couple years, we always ask people how they learned about my work or how they learned about the training program. And in a surprising number of cases, the answer is from their patients. So these doctors or other practitioners, their patient brings an article in that I wrote or brings something in, tells them about me, and to their credit they’re open-minded enough to go and check it out. And then they like what they see and they end up taking the next step. So people even who have no intention of ever becoming a healthcare practitioner, I think would really benefit from this book if they're interested in these ideas. And then certainly, as you mentioned, licensed healthcare providers like medical doctors or nurse practitioners or physician assistants that are currently working within the conventional paradigm but have already seen its limitations and want to do something different but don't yet know what that might look like. And then people who are outside of the conventional paradigm but are already practitioners, so acupuncturists, chiropractors, naturopathic physicians, etc., in many cases they’re already well aware of the limitations of conventional medicine, which is why they chose to go down a different path. But speaking personally as an acupuncturist myself, I also saw some limitations in the traditional Chinese medicine approach, or at least some differences in the way that I wanted to practice it. I was looking for something that could incorporate modern diagnostic testing and create a more systematic approach that included ancestral diet and lifestyle and some of the other things we talk about in the book. So, I think many of those practitioners can benefit from the book from that perspective. And then you have the growing and already large number of people like yourself who are personal trainers, health coaches, nutritionists, etc., who I really think are going to play an increasingly important role in this revolution to reinvent healthcare. Tony:  Yeah, it so important now for people to really, for patients to be their own advocate, and I don't think we’re living in a time where I remember with my grandparents—if your doctor said something, it was basically gospel and you didn’t question it and you didn't think about it. Now, the first thing people do when they experience a symptom, it's Dr. Google first. So it's super important to equip and arm patients with good information, which I think this book does. Here's a path, here's a path forward for you as a patient. But then it's respectful of the role of doctors, and you highlight many situations where conventional medicine is great. If you break your arm or get in a car accident or have a heart attack or whatever the case may be, yeah, you need a doctor, and you need to go to an emergency room and you need those types of interventions. But it's really in this kind of gray area, it’s really not gray, it’s actually quite clear. And we could probably specify a little bit more, but there’s this middle zone where somebody’s not acutely injured, they’re not acutely in a disease state. They’re in a chronic disease state, or they’re just unwell. And it’s hard for a system that is all about pharmacological interventions, surgical interventions, to deal with a more subtle approach. And that’s where that whole middle ground and acupuncturists and massage therapists and everybody who's in that middle zone. I had clients constantly when I was actively training, constantly asking me questions where I was like, you know what? This is really something they maybe should be taking to their doctor. But guess what? The doctor only has 15 minutes under pressure to see as many patients as they can. I had a friend who was a physician in France. And he was telling me about their medical model, and he would spend tons of time with his patients. And it was actually incentivized for prevention. And here we see some maybe misplaced incentives, and perhaps you can speak a little bit more about that.
The mismatch between our medical paradigm and chronic disease
Chris:  Yeah, so, going back to your original comments, I think that the most important thing for people to understand is that our medical model, when it comes to our medical paradigm, is that it evolved during a time when acute problems were the biggest issues. So in 1900, the top three causes of death were all infectious diseases, tuberculosis, typhoid, and pneumonia. And the other reasons people would see the doctor were among those you mentioned, like a broken bone or a gallbladder attack or appendicitis. Tony:  War. Chris:  Right, injuries, trauma, etc. And so the treatment for that's pretty straightforward. It wasn't always successful, of course, but it was straightforward. You know, if the bone was broken, you set it in a cast. If the gallbladder was swelling, you would take it out. If someone was having appendicitis, you’d remove the appendix. So that's pretty ... it's one problem, one doctor, one treatment. Pretty straightforward. But you fast-forward to today, it's a totally different healthcare landscape. Seven of the top 10 causes of death are chronic disease rather than acute problems now, and 86 percent of the healthcare dollars we spend go toward treating chronic disease. And unlike acute problems, chronic diseases are expensive, difficult to manage and usually last for a lifetime. They don't lend themselves to that one doctor, one problem, one treatment kind of approach. The average chronic disease patient requires multiple doctors, usually one for every different part of the body in our system, and is taking ... Tony:  Specialists. Chris:  Right, specialists, they’re taking multiple medications in many cases, and they're going to be taking those medications for the rest of their life. So far, it's really, our conventional medical system is amazing for these acute problems. But it's the wrong tool for the job for chronic problems. So that's one issue, and it’s really important to point that out, because we just went through the whole healthcare debate again with the Affordable Care Act and the current administration’s proposal for a replacement, which has not come to fruition. But throughout that entire discussion, it really bothered me that there was an elephant in the room. All the discussion was around insurance. Like, who gets insurance and who doesn’t. And that’s important, it’s important to talk about that. But we have to recognize that health insurance is not the same thing as healthcare. Tony:  Yeah. Chris:  Health insurance is a method of paying for healthcare. And that’s really crucial to get that difference. Because my argument in the book is that there is no method of paying for healthcare, whether it’s the government, corporations, or individuals, that will be adequate and will be sustainable under the pressure of growing prevalence of chronic disease. It will bankrupt all of us. Government, the corporations, individuals, whoever is responsible for paying for the care will not be able to do it unless we can actually prevent and reverse chronic disease instead of just slapping Band-Aids on it. Tony:  I think the analogy you gave in the book was rearranging the deck chairs on the Titanic. “Making a few small tweaks to our current system and expecting that to work is like rearranging the deck furniture on the Titanic as it inexorably sinks into the ocean. Too little, too late.”  Chris:  Yeah, exactly. That’s the argument about insurance. As the whole ship goes under, sinks under. The other problems you mentioned are very real also. So we have a misalignment of incentives, like the insurance industry, for example, doesn't benefit when the cost of care shrinks because they only make more money when the overall expenditures rise. So it's actually not in their best interest necessarily to seek out the most cost-effective solutions.
Drug companies and conflicts of interest
Chris: And then of course, we have drug companies. People are pretty well aware of the conflicts of interest there. It’s in their interest to sell drugs, and even when that’s not in the interests of the general public or the patients or the doctors. In many cases, it’s not in their interest either. So the best example of this is a recent one. We’re in the midst of an opioid crisis, the worst we’ve ever seen by far, and the DEA has been wanting to create new regulations that restrict a pharmacy’s ability to sell opioids in ways that will protect people. So, for example, there was a pharmacy in West Virginia in a town that was tiny. It had like 30,000 people in this town, and they had ordered something like nine million opioid pills in the last year. It was clearly a front, like there’s clearly something shady going on there. There's no way that 30,000 people in that town needed nine million opioid pills, and yet there are no regulations to actually prevent that from happening. And so, the DEA had proposed some regulations to just safely protect people from that kind of thing. And the Big Pharma lobby basically shut that down and they played a big role in writing a law that limits the DEA's ability to do that kind of regulation in the midst of the worse opioid crisis ever. And to put this in perspective, we hear a lot about the gun lobbies and their control. They spend about $10.5 million lobbying Congress, I think, per year. And Big Pharma, they spent $250 million. Tony:  Wow. Chris:  Twenty-five-fold higher. Tony:  It's really tragic. I actually, I don’t think we’ve ever talked about this, but I grew up in South Florida, which was kind of ground zero for the opioid epidemic. And I remember in high school down in Miami and West Palm Beach, and kids would get a hold of a contact or whatever, somebody that had a prescription and basically would end up being a de facto drug dealer vis-à-vis a pill mill, etc. The kid across the street from me died, multiple kids in my high school died, multiple kids went into in-treatment programs, some of them battled addictions for decades. Some of them got out of it. Very few got out of it. Some of them didn't and have continued to be plagued with either switching from pharmaceuticals to street drugs like heroin, etc., and then we can see what's happening there. And that's just one example. If we look at drug consumption in the United States, is it that Americans are just that much sicker and we’re in that much more pain than people in other countries? Because we’re consuming far and away more painkillers than any other country on the planet. And I would venture to guess that you could say the same about antidepressants or ADD medication. It's very much a case of misaligned incentives. And incentives are working in the sense of the pharmaceutical companies are doing very well. Chris:  Yeah. Who are they working for is the question. Tony:  Exactly. Chris:  We’re the only country aside from New Zealand that allows direct-to-consumer drug advertising, and I think that's a big part of the problem. But it's not just Big Pharma. We also have conflicts in medical research that, of course, are related to Big Pharma because they pay for two-thirds of all medical research. We have broken payment models, where there's no real incentive or reward for good performance, and in fact, you could argue it's the other way around because doctors are compensated for, usually based on the number of procedures they order and the number of patients they see. So to your point about the doctor in France who is actually incentivized to prevent, rather than just treat disease, we don't have that at all, it's the opposite. And so there are a lot of deeply entrenched issues that we certainly need to address, and that's not essentially what this book is about. There are other books that cover that material really well, and frankly many of those issues are outside of our individual control as clinicians or practitioners.
How clinicians can help create a new paradigm
Chris: We can work toward addressing them, and I think we should, but the good news is that I think that the bigger changes that we need to focus on individually and collectively are addressing the medical paradigm which we’ve talked about, creating a medical paradigm that’s better suited to tackle chronic disease. Addressing the mismatch between our modern diet and lifestyle, and our genes and our biology, which we've, of course, talked a lot about on the show before. And then creating a new way of delivering healthcare that actually supports this new medical paradigm and this more preventative approach. Because those things are all within our control as clinicians. Tony:  Yeah. I like how you posed the question, and it was kind of a cool little, I think it was, not Hiroshi, but the person who is in charge of cooking at a Buddhist monastery. And basically a young monk comes up to this older man. He’s like, why are you doing the grunt work, basically washing rice out in the courtyard? And he says, it was like, what was it? “If not me, who? And if not now, when?” And I think that that’s really kind of the core of setting all this stuff up. Talking about the problem is really in the service of pivoting to the solution, and I’m a big believer in thinking globally, thinking big, but acting locally, hyper-locally, like yourself. Chris:  Yeah. Tony:  And then the people around you and who you can touch and impact. That’s ultimately where the power comes from. So let’s talk about that. What is in people’s power. And you started to describe some of those pillars of a new model. And you describe it as the ADAPT framework. And I don’t know how much you get into this on your regular podcast episodes, but to just kind of lay it out, ADAPT from a big-picture perspective. How does that actually address some of these systemic issues from an individually empowered stance? Chris:  Yeah, great question, and before I even go into that, I just want to say I agree that I think the change is going to happen on different levels. So, because a lot ... we’ve talked about this stuff at conferences or even some people who’ve already read the book. They say, oh, this is fantastic. I’m so excited. But how are we going to deal with Big Pharma and the insurance industry and these misaligned incentives and all of that? And can we ever deal with that? The answer is we’re not going to deal with that overnight and it’s going to take a while to unwind those things. Tony:  It’s the chronic disease, is what you call... Chris:  Exactly, exactly. And I use that analogy in the book. But the good news is that changes can happen very quickly on an individual and local level. And there’s already a lot of evidence of that happening. So my own clinic, CCFM, tripled in size in the last three years alone. We have Cleveland Clinic Center for Functional Medicine, launched by Dr. Mark Hyman, has just blown up like crazy. I mean they started in this tiny space. Now their 17,000-square-foot space, it takes up the whole second floor of the Glickman Tower at Cleveland Clinic. They've got a waitlist of 2,500 patients from nine countries around the world. This is really exciting! The Cleveland Clinic is always on the forefront of the newest trends in medicine, and the fact that they've invested that much money in this speaks volumes. Then we have groups like Iora Health, an organization based in the Rocky Mountain area that’s reversing diabetes using health coaches. So there are lots of really interesting produced concepts, and there's going to be more and more of these. Like we’re doing a pilot program with the Berkeley Fire Department where we’re working with their new recruits to help, we’re implementing a wellness program. Tony:  That’s awesome. Chris:  To reduce injuries and help with recovery and optimize their performance. And if that goes well, there’s been interest from the wider fire department and in the city of Berkeley as a whole. Robb Wolf’s done some incredible work with Reno that we’ve talked about before. So I think the change is going to happen more quickly on this local grassroots level, and then that's going to start to get the attention of people on a state and federal level. And then it will start to get really interesting.
The three core problems and how to solve them
To answer your question, in my book I basically lay out three core fundamental problems with the healthcare system in the US. And these, I argue, go even deeper than the misaligned incentives and Big Pharma and all of that stuff, although they’re, of course, connected. The first is that there is a profound mismatch between our genes and our biology and our modern diet and lifestyle. And I'm not going to say more about that now because almost everyone listening to this podcast knows exactly what I mean. The second problem is the mismatch between our medical paradigm and chronic disease, which we just talked about. We need a new medical paradigm that is better suited for chronic disease. And then the third is that the way we deliver care in this country is also, it's not set up to support the most important interventions. And we’ve touched on that too, where the average visit with the primary care provider is just actually eight to 12 minutes. Tony, you were talking about 15 minutes. That’s luxurious in our current model. The average amount of time a patient gets to speak before they’re interrupted by the doctor is 12 seconds. Tony:  Wow. Chris:  So I think it’s pretty clear that if a patient has multiple chronic diseases, which one in four Americans now do, one in two has one chronic disease, and they show up to the doctor’s office and they're on multiple medications, and they had been presenting with a whole set of new symptoms, there’s absolutely no way to provide high-quality care in a 10-minute visit. So we have to change our, not only the paradigm, but also the way that care is delivered. So that was my premise. So it follows then that my solution would address, I would hope at least those three points, right? Each of those three deficiencies. So the ADAPT framework combines an ancestral diet and lifestyle, which addresses that mismatch between our genes and biology in our modern diet and lifestyle. And then Functional Medicine is the new paradigm of medicine that is based on addressing the root cause of health problems, so we can prevent and reverse them instead of just suppressing symptoms. And then the third component is what I call a collaborative practice model, which links licensed providers like medical doctors, nurse practitioners, with what I call allied providers, which include folks like yourself, Tony, health coaches, nutritionists, personal trainers, etc., to provide a much, much higher level of care than what doctors are able to provide on their own. So, again, we're not trying to replace doctors in any, or even conventional medicine. We need people to do colonoscopies and remove cancerous tumors and use all of the incredible amount of training and expertise and skill that they’ve acquired over a lifetime of practice and study. We absolutely want that, but we need to add stuff to that that's not available now. Tony:  What that really says to me is, emphasize the importance of community, of connection, of collaboration. We’re social creatures, we’re tribal by nature. That’s another kind of Paleo/ancestral health part of the puzzle. And it would be foolish to think that we can dissect out and silo out all these different aspects of our lives without consequence. I really like this idea of bringing everybody into the fold, and it’s not saying that you can go to just the naturopath, or you can go to just the health coach. Because like I mentioned already, I certainly would’ve been ill-equipped to handle plenty of issues that a client would’ve brought to mind or brought up in conversation during a training session. But it would’ve been really great to say, ah, here's the Functional Medicine practitioner that I recommend you speak with, and to have a good relationship with that person and to be able to, as a health coach, help my clients better by getting them in touch with the right person. And that’s having this network that can really support people throughout their health journey whether it’s just feeling better and more energy, or addressing something like diabetes or hypertension. Which certainly there’s a place for all the players in that kind of scenario.
What this new paradigm looks like
Chris:  Absolutely. And let’s use an example just to bring this to life for people. So, imagine you go to the doctor and they do some blood testing for your annual physical. And they find that your fasting blood sugar is 96 or 97. Your hemoglobin A1c is 5.5, and you’ve got triglycerides that are 110, 120, maybe 130. Currently, what would happen is nothing, usually. Tony:  You’re not sick enough yet. Chris:  Yeah, all of your markers are within the lab range, they say, and that means you’re normal, and so you might get some vague advice about make sure to exercise and follow a good diet. And thank you very much, that’s it. Certainly there are exceptions to the rule, of course. There’s some practitioners who can get a lot more proactive about that. But I can’t tell you how many people, patients I’ve had that have been given that basic line with those kinds of lab results. What could happen is this. The doctor says, “Well, you know, if we think of blood sugar disorders on a spectrum, on the left you’ve got perfect blood sugar. On the right you’ve got full-fledged type 2 diabetes. You’re not on the right yet, you don’t have type 2 diabetes or even technically prediabetes, but you’re progressing along that spectrum. And what we know from a lot of research is that if we don’t intervene now, that you’re going to continue progressing. And in fact, we have studies that show that the average patient who has prediabetes, will progress to full-fledged type 2 diabetes in just five years if it’s not addressed.” So what we want to do is be proactive here. We want to intervene now because it’s much easier to prevent a disease before it occurs than it is to treat it after it’s already occurred. So here’s what we’re going to do. We’re going to set you up with our staff health coach, and they’re going to give you all the support you need to adopt a better diet. They’re actually even going to take you shopping, they’re going to come to your house and clean out your pantry with you, and they're going to give you recipes and meal plans and give you ... totally hold your hand and do everything that they need to to get you on this diet. Because we know that information is not enough. We’ve got lots of studies. I can tell you as a doctor, go eat a healthy diet, and hey, we know that that’s probably not going to happen. Most people know what they should be doing, but they’re not doing it, and it’s not because of lack of information. It’s because they need support, and we’re here to support you. We’ve got this health coach. Furthermore, we've got this great personal trainer named Tony. We’re going to set you up with him and we’re also going to set you up with a gym membership. And the good news is, your insurance is going to pay for all this. They’re going to pay for the health coach, they’re going to pay for the gym membership, they’re going to pay for your sessions with Tony. And in six months’ time, you’re going to come back here and we’re going to retest your blood markers and I can almost guarantee that if you stick with the program, you’re going to have normal blood sugar by that time. And throughout that period you’re going to have weekly check-ins with a health coach, you’re going to have training sessions. And not only will your blood sugar be normal, you’re going to lose weight, your energy levels are going to go up, your sleep’s going to get better, you’re going to feel more confident and empowered because you’re making these changes, and you’re going to feel like a different person. Now that’s totally possible.
How do we pay for this? Is it scalable?
Chris: I can hear some people saying, “Oh, how are we going to pay for that? That’s ridiculous.” Tony:  Is it scalable? Chris:  The question we should be asking is, is treating type 2 diabetes scalable? Because I mentioned this in the book, it costs $14,000 a year to treat a single patient with type 2 diabetes. So let’s imagine that this patient progresses. We don’t intervene, five years later they have type 2 diabetes. All of a sudden the healthcare system is spending $14,000 a year paying for that person’s care. And let’s say that that person gets diagnosed at age 40, which is still reasonable these days. The age of diagnosis is dropping more and more, and then let’s say that they live until they’re 85 years old, which is also possible because of our heroic medical interventions that keep people alive a lot longer than they might have been otherwise. So 45 years living with type 2 diabetes, that’s a cost of almost $650,000 for one patient to the healthcare system. Tony:  And that doesn’t even touch on the lost wages, cost to employers, when someone’s on leave, loss of productivity. And then the cost to the family members. Chris:  Absolutely. Tony:  People that are actually, are helping the patient, their health is going to be going down too. Chris:  Yeah. Nor does it touch on the qualitative aspects. Being immobilized, not being able to play with your grandkids, all of that stuff. But let’s just even forget about that for a second—$650,000, okay? And then the CDC recently came out with statistics saying that 100 million Americans have either prediabetes or diabetes, and 88 percent of people with prediabetes don’t even know that they have it. Which means they're almost certainly going to progress, right? If you do the math and you multiply 100 million people times even $14,000 for one year, you get a number that’s so large, I don’t even know what it is. It’s like a google something. It’s like, it has so many zeros after it, I don’t even know how to characterize it. But then if you multiply 100 million times like 20 or 30 years, it’s more money than there is in the world. It's like it's not going to happen. Tony:  Not sustainable, not scalable. Chris:  Not sustainable, not scalable. So let’s say in our example that we ... the healthcare system spends $10,000, which is way more than would be necessary, but let’s even say we buy the person’s groceries for three months. And their gym membership and their trainer, and their health coach, and those weekly, let’s say we spend $10,000. We’re just super generous and we spend $10,000 for that six-month period. Again, the research and my clinical experience indicates with near certainty that if the person is at that stage of not even prediabetic and we intervene, there’s like almost no chance that it’s not going to, we’re not going to be able to normalize that person’s blood sugar. And if they do that and they stick with it and they are able to do that because they now have support rather than just information, we’ve just saved the healthcare system $640,000 over the course of that patient’s lifetime. And that’s a conservative estimate, as you say. We're not including even the indirect costs. Tony:  Right, right. Chris:  I think that this is not only possible, it's going to become necessary. And whether we get there with a proactive approach where we decide to move in this direction and we make these changes or whether we get there because we absolutely have no choice, we’re going to get there. Tony:  Yeah. I mean it really sounds like we can’t afford to not do this. Chris:  Exactly. Tony:  And if we get to that point where we continue down the reactive path and we wait until there’s a total collapse, it might be too late, just to put it frankly. And it’s going to come out at a huge, not just financial cost, a huge human cost. Chris:  Yeah, it’s going to be, we can use the chronic disease metaphor again, it’s a lot easier to prevent a problem or reverse it at an earlier stage than it is to wait until the patient is essentially on life support or the healthcare system is on life support. It’s harder to reverse it at that time. And that’s of course why I’m writing the book now because I want to get this message out as far and wide as I can. Tony:  Yeah. If not now, when? If not you, who? Go right back to there.
How allied providers are the key
Chris:  Exactly. And one more thing about that is the amazing thing, the beauty of this is that it takes about eight years and hundreds of thousands of dollars to train a doctor. And it takes a certain kind of personality and a certain kind of comfort level with science, and a lot of prerequisites. It’s not for everybody. And there’s a ... already we have a shortage of doctors, and that’s predicted to get worse. I’ve seen estimates that suggest by 2025 we’ll have a shortage of 52,000 primary care physicians. So that’s a big deal. [insert image] So we already don’t have enough doctors, it’s already going to get worse, but if you think of healthcare as like a ... I have something in the book called the healthcare population pyramid. And you were referring to it earlier, Tony, where at the very top of that pyramid you’ve got 5 percent of people who are in really acute situations. So they’re in the hospital or they’re in an intensive outpatient care setting. They need the conventional medicine paradigm as it exists, and it’s fantastic for those situations. Then you’ve got another 25 percent of people in that kind of high middle of the pyramid who are dealing with some pretty serious chronic health challenges. So they require more regular care, but they’re not sick enough to be in the hospital or in any kind of ... they’re living their lives, but they’re struggling a lot. A Functional Medicine practitioner/clinician usually working in concert possibly with the conventional specialist of some kind is a really great option for that 25 percent of the pyramid. But then you’ve got the 70 percent at the bottom. So these are people who do, may have health issues, but they’re more minor, so they might have skin problems, or a little bit of brain fog, some difficulties sleeping, some GI issues. And these can be definitely debilitating and total pain, but they’re not at the level of that 25 percent. My argument is that in many cases these people could be very well served by a health coach or nutritionist with good training. And possibly seeing a Functional Medicine provider once or twice a year, or something like that. And the thing is, we can train people in a year or two without an extensive science background to be very, very objective in this role. Because they’re mostly working with patients on changing their behavior. If you think about it, most of the risk factors for chronic disease come down to the wrong behaviors. Eating the wrong diet, not getting enough sleep, not exercising, or exercising too much, or any number of things that come down to choices that we’re making. And so if a skilled health coach who’s trained in things like motivational interviewing and coaching to strengths and other evidence-based principles of facilitating behavior change which we have a ton of research on, they can be incredibly effective for that 70 percent of the population. That's the majority of the population. So we’re totally underutilizing these practitioners, and my argument is that they’re going to play a huge role in this future of medicine. And that's of course one reason why we're launching an ADAPT Health Coach Training Program next year to complement the practitioner training program that we've been doing. Because I want to create this ecosystem we've been talking about where you have all of these different types of practitioners working to the maximum of their training and ability and scope of practice and supporting each other and therefore providing the highest level of care to patients. Tony:  That certainly kind of perks my ears up hearing about the ADAPT health coach option and something that I’m personally interested in. So who knows? Maybe I can get in on that. We can talk about it again in the future. Chris:  Yeah, for sure. For sure. Tony:  So, for this particular book, for Unconventional Medicine, people are fired up, they’re hearing about it, they’re like, “Okay, this resonates with me. I’m a practitioner, I’m an allied health provider, I’m a patient, I’m ready. Now’s the time. This is it. We’re going to do this.” What’s the best way for people to get their hands on this thing? Chris:  Well not surprisingly, Amazon. They have the best way to get your hands on anything. So it’s available in paperback, Kindle, and audiobook. We’re hoping [the audiobook] is going to be out today, the day this podcast is released. But it might be another two or three days. They’re just taking their sweet time to approve it. I narrated the audiobook myself. So you podcast listeners, I figured you might be into that, since you like to listen. Tony:  They know your voice. Chris:  Yeah, and just listening to something instead of reading it perhaps. So to that end, we have a special offer for podcast listeners, because I appreciate your support and I know many of you are already part of this movement, and some are wanting to get involved. So if you buy that paperback or Kindle version between now and Sunday night, you’ll get some really cool bonuses. The first is a free copy of the audiobook. So again, we wanted to include that for podcast listeners, since we figured you guys and gals are probably interested in audio. But there are two other things that are really, I think, fantastic. And one, they’re both tools to help you be more confident and persuasive and factual when you share your passion for Functional Medicine and an ancestral diet and lifestyle. Because we’ve had a lot of questions from people, both practitioners and non-practitioners alike. They say, “Oh, how do I talk about this stuff to my sister at Thanksgiving?” Tony:  “Isn’t that that caveman diet?” Chris:  Yeah, exactly. All of our ancestors died when they were 30, so why should we even care? How do you respond to those arguments? Or if you start talking about Functional Medicine and maybe one of your conventional medicine colleagues says, “Oh, that’s just, I saw something on Science-based Medicine that said that was all just hooey. There’s nothing to it. How do you respond to that?” So what we wanted to do is give people the ammunition they needed in a respectful way. You know, this isn’t about getting the better of somebody. It’s about responding in a factual and convincing but respectful way. So we’ve got two different, we’re calling these the Power Packs. And one is for practitioners, so clinicians, health coaches, nutritionists, trainers, etc., and these are facts, research that you can reference and persuasive reasons for your clients or patients or colleagues to consider this Functional Medicine and ancestral diet and lifestyle approach. And then we have one for non-practitioners called the Supporter Power Pack. And these are smart answers and compelling comebacks, again respectful, for those common objections that you hear when you start talking about this stuff with your friends and family. So these bonuses are available until Sunday night [November 12, 2017] at 11:59 p.m. Pacific Time. So you’ve got a few days to act on that, and you can go to ... we set up a special link for you to get these and that’s Kresser.co/bonus. That’s Kresser.co/bonus. So head over there to get your Power Packs and your free audiobook, and that’s after you purchase either the paperback or Kindle. There’ll be a place where you enter your order number and we ask for some information just to verify, and I hope you enjoy those and get a lot out of them. Because they were actually really fun to put together. Tony:  Yeah, I think the audiobook is huge. I like to listen to audiobooks when I’m driving around town or outside getting some exercise. Chris:  Yeah. Tony:  So, no excuses when you make it that easy. Chris:  Yeah, yeah. So, Tony, thanks so much for doing this. This has been really fun to talk to you, as it always is. And I appreciate it. Tony:  Actually, I wanted to throw in one extra little special thing, as we mentioned, at the top of the show. I spent 10 years as a personal trainer in the trenches, I was involved with Paleo Magazine for many, many years, going to all the events, and for me kind of an evolution in my professional life was, how do I impact more people? How do I help more people? And at first I was working one on one, and then it was as a facility manager helping other trainers and coaches get better. And then I was able to scale it up that way. And last year I had an opportunity to join the team over at Natural Force, which is all-natural, nutritional products, and I basically said, “You know what? I’m going to go all in on this because if I can touch a million people through really good, high-quality nutrition, that’s me maximizing my impact and really kind of living my purpose.” So one of the things I wanted to do today is put it out there for anyone listening who maybe uses collagen or MCT oil or whey protein. We really bend over backwards to source the best ingredients in the world, no additives, all that stuff. Everything is as clean as we can possibly make it. It takes a lot of work, working with manufacturers. Kind of like what you were saying, how patients have to know how to talk to their doctor. I don’t think people really realize, and I didn’t realize until I got on the inside, how much work it is for a brand to work with their manufacturers to convince them to get outside of the conventional mold. So it’s the kind of unconventional nutrition is really what we’re pushing here. So I set up a discount code for any Revolution Health listeners. Go to NaturalForce.com, use coupon code “unconventional” and get $10 off plus free shipping on your order. So I just want to put that out there as just a little extra bonus for anybody, and I would certainly love to help in that way and really get some good, high-quality nutrition into people’s hands. Chris:  Awesome. Yeah, and there’s so many ways people can help, and I ... at Paleo f(x) we’ve see the growth of companies that are serving this space, and it's amazing. Like the products that are available now. I had breakfast this morning, I had some eggs and kale and parsley and a little bit of bacon in a couple of cassava flour tortillas. Breakfast burritos. Whoever thought I’d be having a breakfast burrito again? Tortillas are made from completely cassava flour. They’re autoimmune friendly and they’re grain-free tortillas. It’s incredible. Tony:  I think I might have some of those in my fridge as well. Chris:  Yeah. I mean there’s so many things. And these people, they’re serving this movement with that kind of work. So it’s great to see. Tony:  It takes a village, man. Chris:  It does. Thanks again, Tony. I really appreciate it. Thank you, everybody. So again, Kresser.co/bonus to pick up your free audiobook and the other bonuses, and I hope you can all join me in this revolution to reinvent healthcare. We need you, whatever your background and goals. Take care, everybody. RHR: A Three-Step Plan to Fix Conventional Healthcare published first on https://chriskresser.com
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twilight-deviant · 8 years ago
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@uglybusiness reblogged your post “Okay, you know what, your tags are a JOY and a highlight of my dash :) Also, it didn't occure to me that Flynn's remark...”
:)
My mistake - I saw @wellwhataboutme’s post and tags after messaging you. But yes, it’s such an great observation. And it makes me happy that the writers put that in there, ‘cause the minor, less obvious details and lines like this are my favorite kind of characterisatoin. I can just trust the writers so much more when they show this level of consistency and subtlety. So I’m very excited, despite even the bitterness of that moment for Flynn and Lucy. (Now, I just hope the writers won’t use these skills they’ve just proven to write something truly aweful for us garcy fans, lol.)
At this point, he as good as blames her for the endurance of Rittenhouse. […] she (in his mind) condemned his family to their deaths all over again.
Ow. The way you pharsed it, it hurts. :( You’re right of course, that’s exactly what he must be feeling. He lost both the hope that this time he’d finally saved his family, AND the hope he’d had a friend in Lucy. (I can’t imagine how lonely he must be. How much he must want someone who understands, who he could share the weight of his mission with.)
But did you notice Lucy’s reaction to his accusations? She looked so upset and distressed, very clearly sorry for him. Like, she knows she absolutely had done the right thing by saving the boy, but this knowledge doesn’t help much when she sees Flynn in so much pain and despair. When, also, another child might have lived, if. Poor Lucy. :(  I guess she’s just had a sneak peek into Flynn’s shades-of-black world, where every action, every choice, even the most humane, inevitably leads to someone getting hurt. :(
On a side note (and since we’re on the topic of hurt Flynn :)), did you spot that when he returns from 1780 and rants about 50 muskets, he’s got a wound on his arm? And he pays it no heed? Someone needs to make a wounded!Flynn gifset, of that moment and of his stitches from the pilot ep. Ahem.  That reminded me of another thing that’s been bothering me, if you don’t mind duscussing it. From what we have been shown, Flynn never shies away from a fight or a shootuot. He seems both competent and fearless. But when he’s telling Wyatt how his family was killed in Watergate episode (“we call them silencers but they’re not that silent”), and Wyatt asks why he didn’t fight back, his reply (and Goran’s delivery) sound almost like a set of… excuses. “It was dark, bullets were flying, there were too many of them”. He covers his face when he says that, too, and then quickly forces the conversation back to Rittenhouse. Am I seeing things, or does this really look a little like Flynn is ashamed or hiding something? What do you think?
They each want the other to be who they want them to be. They’re projecting. But, it should be noted, they are still not devoid of similarities or understanding or even an interest in being in each other’s company. So I am just really looking forward to seeing them both… not “settling”… but accepting each other for who they are instead of what they’ve read or who they wish they were. Sign me up. I want ten seasons.
Yes, exactly! :) I really love how you phrased it. ♥
(Also, sorry this is so long and rambley!)
That’s one of the reasons I love Timeless so much. Like yeah, it’s fun to make up theories. But just expanding upon and drawing attention to what subtleties are already there is super great fun. Many layers to this show. I stand by the belief that the writers still intend to make Flynn and Lucy team up one day. The journal will come true. We’ll get there. Everything along the way is just a bump in the road. Makes for an interesting ride, yeah?
I mean, just when Flynn says, “So my family is still dead. And Rittenhouse survived. And it’s your fault.” And calling it, “the mess you made.” I think right now it makes him feel better to blame someone, and she’s his best target. (Even though he was having his own reservations about it!) Hers is the betrayal he never saw coming. Because he thought he had all the answers and that the journal was indelible. I’m sure he does feel very alone now. You’re so right.
I DID notice her faces as he was berating her!
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She does feel sorry for Flynn. And on some level she feels the guilt Flynn is trying to force on her, but she still knows she made the right choice. She would make it again. (I mean..... I'm pretty sure she would? She was researching where to find John in the future. Under Flynn's orders, of course, but still. She was complying?) She does want Flynn to succeed and bring his family back to life. No doubts there. She just had to draw the line at murdering a child, even if it meant Flynn’s remained dead. But it does beg the very important question of how many other lines in the sand Lucy would let Flynn cross before she intervened. Because she just stood there watching when he killed Rittenhouse. Lucy is constantly weighing Flynn’s goal against what it costs today and trying to decide if it’s worth it. But she does want him to bring his family back. She does. So despite how Flynn might feel right now, Lucy is on his side. She just can’t go as extreme as him, not against her own moral code and not against recorded history. If it was easier, if no one had to die, if history could remain intact, I don’t doubt she would willingly help him. (Can I point out though that one of the main pillars in her argument against killing John, twice used, is that there were other followers and his death ensured nothing? So... I wonder just how different the discussion would go if John’s death was a 100% guarantee towards saving Flynn’s family.)
I did see Flynn’s injury!
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Boo-boo. He got himself hurt. Such a tough guy though. Such a manly man. Doesn't even seem to notice. I'm sure he's had worse. Wyatt's shot to the shoulder (neck? shoulder/neck area?) was worse I think. (And yas. Give me all that hurt Flynn. I want that man to have so many scars. He shot Wyatt in return, didn’t he? lol. They’re scar buddies! Wacky fun.) But I guess that's when he gave up trying to infiltrate Rittenhouse's compound. Got hurt. Cut his losses. Still, man, screw semi-automatics. Go back with fricking full on automatics. I know he has one. He used it on Rittenhouse agents in 1.06. (Old timey one in 1.09. More I’m sure.) Snipe them from the trees. Grenade launcher. Tear gas. The possibilities are almost endless. Can I just say... Can I suggest... A nice touch when they arrived at the house in 1.10 would have been if Arnold commented that security was even tighter than usual and someone replied saying, "We suffered a major assault a few days ago. He's taking no chances." Which would have been Flynn in the beginning of 1.11. It's stuff like that which really makes something pop in the time travel genre. Come on, Timeless.
You do make a point, yeah. Flynn’s delivery in the story of his family’s deaths is a little... hesitant, stilted. Granted, he is giving his very personal story to an adversary, a man who doesn’t even believe him when he says it and is undoubtedly tearing apart every aspect for its credibility.
Flynn has definite survivor's guilt about that night. Severe survivor’s guilt. Super. (If it were a contest, I would submit that his is worse than Wyatt’s, but this is not the sort of thing you hold contests about.) I don't doubt Flynn would give up his own life to bring them back. He already considers his life as it was forfeit. He considers that man to be dead. He has no purpose beyond killing Rittenhouse and righting their wrongs. I really want to see that night played out in a flashback (goodness, for SO many reasons), but I'm not sure what he'd be ashamed of, going off what facts we do have. By the time he became aware enough to get out of bed and fight back, his wife and daughter were already dead. Although, ya know big stab to the heart, it was his actions that caused their deaths, however unintentional and unknowing.
I'm sure Flynn has replayed that night in his head so many times and has identified every little thing he could have done differently. He thinks what would have happened if he got up to check on their daughter instead. But he has to rationalize that they would all three be dead in that instance-- Rittenhouse catching him more unaware without the two gunshots to warn him. And how horrible is it that the sound of his wife and daughter being murdered is the very alarm that kept Flynn alive? They died because of him, and he lived because of them. .....................Let that sink in. Heavy stuff. Painful stuff. That’s twofold survivor’s guilt. He has so many reasons to feel guilty, though none of them are really his fault. And I’d wager if his account about that night sounds like an excuse, it’s probably because he’s had to excuse it to himself. In the past two years, he has, over and over, had to tell himself that he had to make it out that night. Everything had to happen as it did. His wife had to check on their daughter. He had to give up fighting. He had to flee. He had to leave them there. He tries to excuse his actions that night because he knows it’s necessary. He tells himself the entire course of events was necessary. He has to survive so he can bring them back. It’s just really hard to rationalize it though.
And you are right. Flynn doesn’t back down from a fight. He really pushes his recklessness sometimes. But, as commented on above, he seems to know when to cut his losses. Live today, fight tomorrow. Though I’m sure he only did so after he knew for certain that his family was dead. He wouldn’t leave them there otherwise. I like to believe Flynn did fight back at first. Because his first excuse is, “There were too many of them.” He maybe picked off a few before he realized how many there were. They kept coming. And if they saw him, they shot at him. Bullets everywhere. There’s really no telling how accessible guns were in Flynn’s family home, but I’m sure he had at least one near. However, disoriented, unprepared, in the dark, outmanned, lacking firepower, emotionally compromised, Flynn knew they had the advantage. And yet he either stayed long enough to try killing them anyway or there were so many that even in retreat, they almost killed him. Because he barely made it out alive.
Now, what I REALLY want to see is a flashback of Flynn after the battle. I want to know how he escaped. I want to know how badly he was injured. And though it will be the death of me, I want to see him the moment he’s able to stop running, the moment when it all comes slamming into him and he has to acknowledge what just happened and that his family is dead. I’ve seen Goran’s acting so far. I know this one would kill me. Like dead. Just dead. Straight dead. But I’m willing to risk it.
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