#but he ended up being pretty knowledgeable. we talked about prescriptions I’d tried before. he worked with my concerns.

[floral-hex]

wowwy wawawa. was worried about seeing a new psychiatrist, but any doc that gives me a month of ativan is okay in my book.

so anyway, I got that and also starting something called remeron after the weekend is over (going out of town for my brother’s 2 day chess tournament and don’t want to deal with side effects during it). Let’s be hopeful.

[surveys-at-your-service]

Survey #474

“nothing flashed before my eyes  /  no pretty angels, no bright lights  /  all i saw was the devil’s soul, & it looked a hell a lot like my own”

Who are you most nervous about introducing potential significant others to? My dad. He can be a challenge. He says whatever comes to his mind the moment he thinks it, and it's not always nice. What is the most exciting thing about your life right now? My relationship, honestly. It feels like the one thing that's going right, but I'm concerned if I don't take care of the things that aren't going so well, that they will creep into my relationship and start breaking it down, ex. not having a job. What was the most important non-academic thing you learned in high school? To just keep pushing and not give up on life, and that it is full of phases, be them good, bad, or bland. Have you ever had a job that deeply affected your personal life? How so and do you still work there? No. Do you have a “one who got away”? I don't feel like that anymore. If you were in a supoerhero movie, would you be the hero or the villain? Because I like to help people, I'd like to be the hero, BUT villains are waaaay cooler. If you found a mouse in your house, would you be frightened? Frightened, no. I LOVE mice. I'd of course be startled and concerned about it getting into food, but I'd just calmly find a way to get it outside. Have you ever tried to perform magic tricks? I used to LOVE getting those little magic kits when the Scholastic fair came around! I had I want to say three and was pretty good at a lot of tricks in them. Can you do more with a yo-yo than just "go up and down"? No. What is one form of technology that you wouldn't be able to live without? The Internet for sure. Did you get an allowance, growing up? Why or why not? No. An allowance for three daughters was something my parents couldn't afford. Would you rather go to a water park or an amusement park? Why? An amusement park. They're more exciting to me, and somehow water parks seem dirtier with all the little kids and just alksdjlfa;wjke What is one instrument you wouldn't mind learning how to play? The violin. What's the longest amount of time you've had to wait in line for something? Probably something at Disney World as a kid, idr. What is something that you would like to learn more about? I ALWAYS want to learn more and more about meerkats. What is something that one of your family member collects? Mom collects owl stuff. Have you ever moved to a new school before? If so, how did it feel? No, except obviously when transferring from certain age ranges, like elementary to middle school. Have you ever legitimately forgotten to do homework? Yes, at least once in middle school. I felt SO awful and had to go outside of the classroom to do it while they were reviewing the work. Do you enjoy autumn leaves or spring flowers more? Why? I really, really like both. Each are just very pretty in their own right. Depending on where you live, why might a day of school get canceled? Hurricanes or like the mere chance of a centimeter of snow. At least once, we've even had such a severe heat advisory that school was called off. If you could meet any fictional character from a book, who would it be? Can dragons be real? 'Cuz then I wanna meet Clay from Wings of Fire if we could talk, lol. He's so wise and I'm sure would have great knowledge to share about looking at my life from new perspectives. What are some common places that people tour when they come to your city? Um, people do NOT tour this city. It's trash. What's one food that you did not enjoy as a child, but do as an adult? I'm not sure. How would having no electricity affect your daily routine? Everything would change, given I'm always on the computer. Would you rather have a mermaid tail, a fairy's wings or a unicorn's horn? Fairy wings, for sure. What is an animal that you'd like to have as a pet but it's not allowed? I wish SO badly that opossums were domesticated animals, alsdkjfkaljwe. I say enough that I do want to rescue/foster one, though, but I would obviously need a license for that. I would absolutely never just snag one from the wild. What are some things that you do to make the world a better place? We recycle here, don't dare to litter, and I always try to be a decent person that spreads love and hope to other people. Has the last person you had sex with ever had sex with someone besides you? Yes. What’s your favorite store at your mall? rue21, I suppose. We have a small mall. Have you ever done a workout DVD? Oh my actual god, this is a THROWBACK. When we were really little, my sister had a BARBIE workout DVD that we watched sometimes. Who usually takes out the trash in your family? Usually Mom, but sometimes me. What song are you currently obsessed with? Absolutely "Bath Salts" by Highly Suspect, ahhhhh- When you go fishing, do you make someone else get the fish off the hook? When I used to go fishing, my dad would always unhook the fish. Do you take any prescription meds? A lot. What happens if you don’t take them? I very rarely forget to take my medicine, but when I do, I experience anxiety and my tremors get worse. Who was the last person you dreamt about? I don't remember. Do you prefer your tea sweetened or unsweetened? I hate tea in any way. How often do you honk your horn? I don't really drive, so. I'd be very hesitant to though because I wouldn't wanna piss someone off. Do you have any children? If so, names and ages? That's a hard pass from me, bro. Have your parents ever witnessed you doing something inappropriate? What? No. Did you get babysat a lot as a kid? I don't remember how frequently, but we did have a babysitter. Both my parents had jobs. If you were the principal of a school, what would you do differently? Actually pay fucking attention to bullying and do shit about it. Are you doing anything fun tomorrow? "Fun?" Don't know her. What is something you'd like to receive as a housewarming gift? I dunno. How old were you when you first experienced the effects of puberty? I don't remember. What is your least favorite holiday, and why? St. Patrick's Day because I worry about getting pinched, lol. Pinching even very lightly is surprisingly painful for me. What were some outdoor games you played as a child? Hide-and-seek was my favorite, then my sisters and I made games for on the trampoline and in the pool, etc. Did you accompany your parents on "Take Your Child to Work" Day? I never remember doing that, no. Are cemeteries peaceful to you, or do they freak you out? They're humbling, more than anything. A reminder of how equal we are and that we all end up the same. It's a nudge to cherish life while you have it. Which ancient civilization would you be interested in learning more about? My favorite is Ancient Egyptian. Do you have better long-term memory or short-term memory? Long-term. My short-term memory is absolutely frighteningly horrid. What was the last situation that made you cry? Describe. I was very frustrated with just life in general and how horribly I'm failing at it. Which forest animal would you be most afraid to encounter? A bear, probably. Do you believe in anything supernatural? (ie: spirits, etc) Yeah, like said spirits. Has anyone close to you ever gone to war? No. Have you ever experienced altitude sickness? No. Is there anything, any event, you wish you could remember more clearly? I don't know right now. Have you ever rubbed anyone’s feet? EW you couldn't pay me to. If you had to get advice from someone of the opposite sex, who would you go to? My boyfriend. What was the last new food/drink that you tried? I recently tried jalapeno-stuffed grilled chicken, and a couple days ago I tried this orange/strawberry V8 my mom bought. It was noooot good, which I figured it wouldn't be. That's not a good mix. Have you had a good day today or was yesterday better? Today was fucking awful, and yesterday wasn't exactly peachy either. Have you ever played Sudoku? Yeah, I enjoy it well enough. Do you ever take surveys for money? No; I once signed up for a site like that though because my mom used to do that, but I literally qualified for no surveys with how inexperienced I was and still am with grown-up stuff. Do you like Barbie or Bratz better? I don't have an opinion, and I didn't really as a kid, either. Do you prefer purple or green grapes? I go back and forth, but either way, it has to be a crisp grape or it's just gross. Who was the last person that made you laugh? I was watching a John Wolfe video. Where does your best friend live? Illinois. Who did you last confide in? Girt. Does your car have an alarm? Mom's doesn't. Where was your mom born? New York. What can always make you feel better no matter what? If I'm being completely realistic, nothing. Not every single tactic is fail-proof, especially these days. What is something you’ll never eat again? Why? Crab legs came to mind first. They are SO mushy and just gross. What is currently happening that is scaring you? My life, bro. Have you ever found a stranger’s note somewhere? If so, what did it say? I mean maybe at some point accidentally? I don't remember a specific occurrence.

[amour-de-tous]

Finally, the update on my health

TW: lots and lots and lots of talk about health, and bad health, in particular, below.  So I know I never really updated everyone on What Was (is) Going On With My Health. It’s been a huge mess, and I run out of spoons every day just trying to eat meals at the right times to take my meds.  Shortest version possible (believe it or not): at the end of May last year, 2019, pretty much all my joints and extremities swelled up unbelievably. Like I couldn’t put my feet on the floor because they were so swollen it felt like the skin would split open. I had to sit in a chair all day with my feet elevated on a stool and pillows just to keep them from continuing to swell, and I had to sleep with pillows under my feet to keep them from swelling more during the night. I say “sleep” loosely, because I was getting about an hour to two hours of very interrupted sleep every night. The swelling was so bad that just to leave my chair where my feet were elevated, and go sit at the table to eat meals, my feet would swell so bad it was hard for me to walk from the table back to my chair. Then my hands started going numb and tingly, but not in a “my hands are asleep” kind of way, but more an “this is excruciatingly painful but I still can’t feel my hands” kind of way. I couldn’t close my hands into a fist, and I couldn’t open my hands either, they were frozen in a sort of half curled position. There were several weeks where I couldn’t hold a fork or spoon to feed myself. There were months upon months were I couldn’t brush or wash my hair by myself. I spent months with my hands/wrists/feet/ankles packed in ice every 20 minutes to try to control the swelling. I also had this awful brain fog situation where I couldn’t focus on anything. Even if I had been able to hold a book, tablet, or phone (which I couldn’t, because my hands were so bad), I couldn’t read because I had absolutely zero concentration or focus or comprehension. Even watching TV was almost impossible because I would zone out and come back to awareness and so much time had passed I’d have no idea what was going on. I literally spent three or four months just sitting in that chair in pain, staring at the ceiling, crying on and off. So, so much more below the cut.

I could barely attend my niece and nephews baptism. We were there for as long as it took for the actual service to happen, and while I tried to stay for the meal and gifts and such, I was in such excruciating pain--and using a cane to even be able to walk--that we had to leave early.  My niece’s 4th birthday was a few weeks later, in late June, and again I was there with a cane and in excruciating pain. I’m my niece’s favourite person and having to tell her Auntie couldn’t get down and play with her, or hold her, was terrible. By the end of June, my PCP had run enough tests to be outside his area of knowledge and referred me out to a rheumatologist. The earliest the one I wanted to see could see me was January. This was the first week of July. So I looked around for whoever could see me first and chose them. The soonest someone could see me was, unfortunately, on my birthday last year, July 15th. So I spent my birthday seeing the rheumatologist, being diagnosed with carpal tunnel, tendinitis, and what he suspected was rheumatoid arthritis. Once I left his office, I spent my birthday getting bloodwork (8 vials, yikes, which continued monthly for the remainder of 2019), and then getting fitted for a set of wrist braces that I would have to sleep in for maybe the rest of my life, and wear during the day when the pain was so bad. The rheumatologist literally said to me “well, none of your labwork confirms this and we don’t really know, but we’re gonna treat you as if you had rheumatoid arthritis”. Although he kept running tests to try to confirm the RA, he didn’t look anywhere else to try and figure out what I actually have. So they started me on medication(s), and referred me to occupational therapy and physical therapy. I was so bad when I started going that my PT consisted of sitting in a chair and (trying) to flex my ankles in different directions, and then a lymph massage to try to reduce swelling. My occupational therapy, when I started, consisted of trying to pick up pieces of sponges and put them in a cup. I was so bad that was actually almost impossible for me. They also referred me out to have a nerve conduction test, where they stuck needles all through my arms and electrified them. It was the worst thing ever, let me tell you. Then I got referred to a hand surgeon (who is lovely, actually) for surgery. He decided to hold off on surgery and see if steroid shots would help (they did, to an extent, and I am so grateful for that). Fast forwards through months and months of testing and bloodwork and physical and occupational therapies and medications, and the swelling had reduced enough that I could stand up or walk to the bathroom or eat dinner without swelling up so bad anymore. Being at PT and OT still meant I came home and had to pack my feet and wrists in ice and elevate to take care of the extra swelling, but it was better. Not good, not right, but better. Fast forward more, still, and it’s December. At that point I could stand long enough to help cook dinner, or even run an errand or two before I was in too much pain and had to sit and elevate again. In mid-March they released me from PT and OT. Not because I was better--I still couldn’t (and can’t, now) bend my wrists at all--but because the prescription had run out. I’d basically used all the allotted amount I had. This ended up being alright in the long run, since aside from one trip to the lab for bloodwork, I haven’t left my house since my last day of OT on March 13th, due to Covid. Turns out having an auto-immune disease and being on immunosuppresants makes you REAL high risk for Covid, and I’m just not playing that game. At the beginning of April, I finally got to see the rheumatologist I WANTED to see all along (via video visit! Didn’t even have to leave my house and be exposed!). She’s awesome and is really set on finding an ACTUAL diagnosis for me and not just saying “we don’t know”. Had 9 vials taken from me in her first round of bloodwork, and then she said it looked like it could be Lupus and did more tests. She’s now pretty certain I DON’T have Lupus OR rheumatoid arthritis. I had an appointment with her at the very end of July (video, again), and it turns out she thinks I have something called sarcoidosis. This is going to require a CT scan, for my lungs and heart, to see if the disease is in them. Evidently with this particular auto-immune disease, your body overreacts and encapsulates what it thinks are dangerous foreign bodies (but really are just part of your own immune system) and creates “granulomas” around them. Basically think of an oyster creating a pearl around an invading body, except in this case instead of pearls, I have lumps of stuff that hurts me.  Horrifying to know I have to walk into a hospital at this point in time, of my own free will. Like I said before, aside from one set of bloodwork, I haven’t been exposed or been out where I could be exposed at ALL. All that goes out the window once I walk into a hospital for a CT scan. :\ After the CT scan, depending on the results, there’s other tests I’ll need. Chest x-rays, EKGs, pulmonary function tests, lung biopsies (YIKES) and others. She seems fairly confident that this is the correct diagnosis for me, but wants confirmation and also to see progression of disease.  At any rate, she’ll be changing my medication. Which sucks for so many reasons, not the least of which is I just picked up 360 tablets of it that I now won’t be taking. :| Also the fact that now I get to try a new medication and do the “am I having side effects or am I just anxious” song and dance. She’s also talking about needing to put me on steroids which I am REALLY unhappy about. I suppose it’s better to go on steroids than to die, but I’m still really unhappy about it. In other, related news, I’ve developed hypercalcemia. Which means there’s too much calcium in my blood, which can cause a HOST of other problems. So I’ve been put on a no-dairy, low calcium diet. Do you know how many items have calcium in them? Almost everything, that’s what. Also, they fortify all the non-dairy “milk” products with calcium. They all have as much or MORE calcium than dairy milk. It’s been a NIGHTMARE, to the point where I’m actually afraid of food now. I’m obsessively reading labels and doing research online. “How much calcium is in 81 grams of kiwi, after all?”. Nightmare. Dairy was my #1 love and foodgroup, and having to suddenly figure out all new things to eat and ways to cook while simultaneously being in pain and *exhausted* 24/7 because auto-immune is not. fun. at. all. It’s already all my energy every day to help make, eat, and clean up a meal. I literally have to sit in my chair after a meal with my feet elevated to recover. Now having to spend all this energy on a whole new diet plan is a nightmare. Basically this whole thing has been a MESS. It’s been 15 months, I’ve been being treated for the wrong disease for 14 months, the news I’m getting now is worse than the news that flattened my emotional response all those months ago, I still can’t function, and I can’t work. Oh, yeah. I haven’t played an instrument since May 2019. My whole life revolved around my music, and now I can’t even play to make myself feel better, because my hands don’t work. I’ve also been out of work since then, too: my last concert was April 2019. I haven’t made any money since. But I have had co-pays out the wazoo! Which reminds me that they raised the price on two of my meds, because of course they did. Thanks, congress. This has been really, really hard. My anxiety has skyrocketed through this, and my depression isn’t doing much better. Although physically I’m not as bad as I was, I’m nowhere near normal, and I don’t think I’ll ever be able to go back to my normal again, either. The best I’m hoping for at this point is to be able to eat calcium again someday, to not have my organs eaten up by this disease, and to continue existing. It’s been exhausting. It really, really has.  That’s not to mention the added stress and anxiety over Covid, and the fact that neither mom nor I can even go to a grocery store because of my high-risk status. We’re averaging getting groceries about once a month right now. It’s super fun now because I have to read the label on EVERYTHING but Aldi doesn’t post their nutrition labels online and!!! That means I have to either guess or not get things! Great!  All this to say that I miss being on tumblr. I miss all my friends here. I miss talking to you all and being able to laugh with you and geek out. Things have been really hard for me (and there are multitudes I haven’t included in here; even if my hands would allow that much typing, I’d probably hit a character limit. Just: I miss you all. I love you. I’ve been a wreck, but I think of you all often. <3

[eltanin-malfoy]

Get A Grip III - Epilogue

pairing : draco/fem-y/n 

word count : 3.3k

warning(s) : mentions of healing/PTSD/war/sex, lots of fluff.

requested : sort of??

a/n : i just wrote this in one sitting! lol. i hope this is satisfying?? i know a lot of my stuff ends on cliffhangers so I decided not to do that for this one. give me some feedback pls! love u! hopefully this doesn’t come off as rushed??

tag list : @kaibie​  @acciodracoo​  @drawlfoy​  @war-sword​  @socontagiousimagines​

Part I II

Y/N’s life as a healer was nothing short of tedious on paper. But she still loved it.

After having received specialised training for treating those impacted by war, trauma and violence post her basic healing certification, her schedule remained full, full, full, thanks to the Second Wizarding War, of course. Everyone and their mother was impacted and gravely so. Thanks to the Ministry’s work towards spreading awareness about the mental implications of war and trauma, everyone had been encouraged to seek support. 

Her ward at St. Mungo’s remained constantly occupied, with the people who were permanently disabled as a result of the violence of the war taking up beds and pretty much being forced to spend the rest of their lives there. It was heartbreaking, but she had to keep her head up high and help them move on. She’d been lucky enough to be able to cool down the impacts the war had had on her in time enough to complete her schooling and be able to work towards achieving the goal she had desired ever since her seventh year at Hogwarts.

Her clinic times were full as well, with her having to both counsel and treat afflicted patients. There were some familiar faces here and there, old friends and teachers and classmates from Hogwarts. And also, the others who’d been in the cellar along with her. Sure, a hospital wasn’t an ideal destination for her to meet others, but it was the only place she seemed to have time for. The little time she got off, she’d stay home, reading up and attempting to expand her knowledge of post traumatic stress disorder based on Muggle research. (Someone had to put in the effort for the rest of the Wizarding World, right?) Romance wasn’t something she put effort into anymore. Sure, she’d had a few affairs, but.. she wasn’t actively looking for something, not when she was so busy. 

But sometimes, the best things come when you least expect them to. 

Y/N was sitting at her desk, writing off yet another prescription of Potion for Dreamless Sleep (something that was so greatly helpful to those suffering with mental illness, you’d never have thought!) for a previous patient. She soon finished writing notes about the frequence of the dosage they were permitted and charmed the parchment to go to the patient’s hand. 

She checked her list and almost froze as she read the name of her next patient. 

Malfoy, Draco. 

Age : 27. (D.O.B. : 5th June, 1980.)

Blood Status : Pureblood. 

Nationality : British.

Ailments : 

Diagnosed with PTSD at 18. Now mostly recovered. 

Suffered severe physical damage and faced Cruciatus curse at a young age, has some sensitivity to loud noises, flashing lights, etc.

Suffered dark magic curse at 16, left with minor scarring on abdomen. No other permanent effects.

Hereditary concerns : skin hypersensitivity, family history of osteoporosis.

Prescriptions : 

Potion for Dreamless Sleep. (Taking regularly for 10 years.)

There was a name she hadn’t seen in years. She’d thought about him, sure. But they hadn’t stayed in contact at all. She usually learned the most about him through the Daily Prophet, where she’d recently learnt he’d been seen talking to a woman at a party. Huh. There really wasn’t much to report about anymore, it seemed. Maybe that was something to be grateful about?

Most of what was on his sheet was expected, when she’d last seen him, at Hogwarts, during their 8th year, which most of the others in their year had chosen to forego, she remembered he was still taking the potion. The only oddity was his continued prescription.. most patients would basically be ‘weaned’ off of it by their fourth or fifth year of treatment.. why had Draco been taking it for twice that long?

Either way, she kept staring at her door a bit nervously, awaiting his entry. There was a soft knock at the door and she bit down on her lip. “Come in.” And then.. He.. walked in. 

She offered him a smile and ushered him over to the chair in front of her desk.

 “Hello, Draco.” 

He was wearing dark robes, his height still prominent as he stepped into the room. His hair seemed to be a bit longer than she remembered it, a few pale strands covering his forehead but still styled meticulously. He seemed obviously more mature, and a bit less skinny than the boy she remembered. There were slight wrinkles on his face, under his eyes, which could again be traced back to the stresses of war, most likely.  

“Good afternoon, Y/N.” He looked at her with an eyebrow raised. “I.. I recognised your name but I didn’t know whether it was really you. I should’ve brou-” For some reason, she forced out a slight giggle. “That’s no-no problem at all, really. I was a bit surprised when I saw your name too.”

“I usually have my check ups with uh.. Healer Bole? I thought it was him again, but the name on the door confused me.” “He’s taken some time off these past few days. That’s why they must have assigned you to me instead.” “I suppose…”

Y/N looked straight into his eyes as an awkward silence rose into the room. His grey pupils stared right back at hers, blinking very slowly. What were you supposed to talk about with someone you’d been close to ten years prior? 

Oh, right, she was supposed to be healing him. Thank god there was no need for any actual small talk between them. 

“So, what brings you here today? If you need counselling or anything, I probably shouldn’t do it since we know each other personally an-” “Oh, oh, no. I just needed to refill my prescription.” “For Potion of Dreamless Sleep?” “Yes.” “Right.. Before I do that, could I ask you about it..?” “Um, sure?”

“Well.. I wanted to know.. how come you’ve been taking it for so long? I don’t know if you know, but patients are only recommended to take it regularly for a maximum of five years.”

“I.. I need it. I can’t sleep without it. The nightmares are still awful.” “But you’ve been.. taking it regularly ever since th-”

“I have.” “So.. how do you know the nightmares are just as bad?” “Well.. um.. I’ve tried sleeping without it, it didn’t work out well for me.” “For a night?” “Yes.” “Well, I’d like for you to try it again, for a few nights. We can send in a nurse for you, if you want.”

He looked at her with a slightly pained, irritated expression.

“Must I..? Bole would give me the prescriptions just fine.” She hesitated for a second, then thought through what he’d just said. “Bole was.. making a mistake, I think. Did he know you’d been taking it for that long?” “I’ve been seeing him all along.” “You’re kidding!” “I’m not..”

Wow, had she just discovered her colleague had been engaging in medical malpractice? Taking the easy way out of a complicated situation? Surely, there had to be more to this, right?

“Did he never ask you to try..?” “He did, but after I told him it didn’t go well the first time he seemed fine with just continuing to prescribe it to me.” “I see..” Hmm. Bole had definitely not done the right thing. It sounded terribly lazy. He was risking Draco developing an addiction just so that he wouldn’t have to put in actual effort to heal him. When dealing with a case as such, patients were often kept in the ward for observation, but obviously Bole hadn’t even brought up the possibility of the same to Draco. A complaint was going to have to be filed, it seemed.

“I hate to inform you of this, but I feel Bole might have done the wrong thing in this case.”

“Oh..?” “Yes, I will again insist you try to forego potion for a few nights. There are major potential implications of using it for as long as you have, and we can avoid any actual damage if we can have you give it up soon.”

“But.. Y/N.. I..” “Come on.. “ She bit at the inside of her cheek. “Like I said before, we can have a nurse come in for you and observe. And also.. It’s Healer Y/L/N to you, Mr. Malfoy.” He smirked at this and set his hands on his lap, taking a deep breath. 

“You know what, Healer Y/L/N? I might be willing to try.. but.. I don’t want a nurse to come in. I want you to.”

Her eyes widened and she reached for the quill on her desk, fiddling with its fibres. When an ex challenged you as such, were you supposed to take it? The feelings he used to stir inside of her had long faded and she was sure the both of them had moved on as much as the other had, it was a mutual break up, in the end. Was this supposed to be related to that..? Was he.. Actually interested? Or was he just playing games? 

Did it even matter? Life was getting a little boring. Something a little out of the ordinary for her would be fun, for sure.

“You know what? Sure.”

***

It was seven o’clock on Friday evening when she finally finished up with all her work at St. Mungo’s and headed home, ready for the night that lay ahead of her. 

She slipped out of the lime green uniform robes she wore to work and went through her wardrobe, confused. What the hell was she supposed to wear? Definitely not something inappropriate, not something overly casual, and not something too fancy either. In the end, she was going over to his place to watch him sleep, and hopefully manage to sleep herself, not to sleep with him. (She was quite tired, admittedly.)

In the end, she decided to wear a pair of pyjamas (white with purple stripes!) just out of spite. Would it be a turn off? Huh, possibly. Would it be funny? For sure. Would it be embarrassing? ..maybe, but hopefully not.

And so she did exactly that and apparated to his home. One she’d only visited years and years ago. 

It was just as grand as it was then. Probably a bit more wellkept now. Obviously so, since it had been 10 years since the war had struck.. since she’d been trapped inside that very cellar. And for a second, she just stood there, processing her memories. She was not going to let the sight of this house cause her to relapse, absolutely not. It had been years. Many years since then. She’d gotten over it. She didn’t need to think about it. 

Slowly but steadily, she made her way through the gate and into the estate. The hedges were gorgeous, trimmed to perfection and even with the sun down, the lamps set every few steps along made everything look even more.. perfect. Draco really did live in the lap of luxury. He always had.

She walked to the door and used the snake-shaped door knocker (Christ!) a couple times, staring up at the tall hardwood door as it suddenly opened. 

And of course, it was him. Him. In a blue cotton button up shirt and silky pyjamas. Cute.

“Good evening, Healer Y/L/N. Do come in. Nice outfit.” He took a step back and held the door open. “Good evening, Mr. Malfoy.” She stepped in, looking around curiously. 

It was all different. Draco had switched up the layout considerably. Gone was the dark and gloomy aesthetic that had presided over the interior of the house before. Everything was white now. Off-white, perhaps, like the color you’d call marble. The palatial chandeliers still hung from the ceilings, but that was all that remained the same. Everything else was brighter. She was glad to see it was so.

“Having a look around, are we?”

“Well, what do you expect, Draco? It’s been.. so many years.. It looks beautiful, by the way.” “Thank you, interior design by yours truly.” “I thought as much.. your taste has improved a bit, I’d say.” She smiled up at him.

The change was definitely helpful towards her not feeling panicked at the sight of the place. It actually looked.. inviting, to some extent. 

“Glad to hear you think so, Healer.” “Right, so, were you going to get to bed?” “This early? I thought we were going to have dinner first.” “I.. had some dinner at work. Quite a bit, actually.” “That’s too bad.. I just had Golby set out the table for us. Nice food too.”

“You can have it, if you like. I’m just here for work, am I not?” “.. Y/N..” He rolled his eyes. “No formalities between us, please.” “It’s not a formality. It’s protocol.”

He set his hand on her shoulder and she almost winced. “Please? For me?” “Ugh.. fine.”

***

Sitting beside him on the table brought back memories. Pleasant ones. Of all the times they had together. The first true ‘moment’ they had between them wasn’t one she liked looking back at all that much. It was unpleasant and could still trigger an anxiety attack. 

But everything after..

She could remember the joy that had filled her upon seeing Draco stumble into Shell Cottage that same day. He was wounded, badly, but he was alive. He could be healed. She’d helped Fleur as much as she could with all the healing after that point, and she took up a mattress right next to where Draco had been put to sleep, and she took care of him, personally. He was beyond grateful, as he’d told her a few days later.

And she was beyond grateful to Harry and Ron. They’d actually listened to her when it would have been so easy to just ignore her. She knew they’d hated him like anything at school, and it had truly elated her to see Draco again, actually alive. 

They’d spoken to Draco and he was actually willing to help them. He told them of the plans he knew the Death Eaters were working on. It wasn’t quite a lot to go off of, since apparently, You-Know-Who had begun to distrust the Malfoy family, but it was still helpful. Draco even told her he basically saved their lives by lying for them, and they’d basically returned the favour. She wasn’t sure about the specifics, really. All she knew was that they’d somehow balanced out what they owed each other. 

They’d spent a while at Shell Cottage before being moved over to a different safe house. Draco was the Death Eater’s biggest target at that point, and he had grown very, very scared. For some reason, it was decided that the two of them would go to the Tonks’ house. To Andromeda’s house. To Draco’s estranged aunt’s house. He felt even more afraid.

She’d been shunned out of their family! All because she’d eloped with a muggle born. He was afraid she wouldn’t take much of a liking to him, but.. it was completely different to what he’d anticipated. She welcomed with open arms, treated him like her own son. Everything was just fine. Or at least that’s what it seemed like.

The ‘Battle of Hogwarts’ came to fruition before them and the two of them stayed far from it, the lack of wands rendering them useless in such chaos. Obviously, after the conflict, they were off in search of their families. Draco’s was glad to have him back alive, as was hers. They’d apparently fled from the country the instant they realised she’d been kidnapped by the Death Eaters. 

But.. of course.. she was then forced to spend quite a lot of time at St. Mungo’s. PTSD. Thankfully, she was far from alone. Practically every other person even partly involved with the conflict was also undergoing some sort of treatment post war. And right after a particular therapy session, when Draco’d asked her to join him for a pint at the Leaky Cauldron, was when repressed feelings came out into the open and she kissed him. 

And that was that, really. 

They were inseparable for the next year. The ‘eighth years’ at Hogwarts, which consisted of several students looking to get the NEWT’s they’d missed out in the year prior, were banded together most of the time, and Draco and Y/N seemed to be joined at the hip. Well, until they weren’t anymore.

It was a mutual agreement. Neither of them were treating it very seriously and they had things to focus on. It ended on a positive note, with a little giggle between them and a hug. They were teenagers, after all.

But now, ten years later, she wasn’t sure why all those feelings were coming right back. Making her blush when he spoke to her. Goddammit. Why did Draco have to get cuter as he got older?

Soon enough, it was time for bed. They’d chatted for nearly an hour just at the dinner table and Y/N suggested he try sleeping earlier than usual, just for observation’s sake. And so he led her into his bedroom, shutting his door behind the two of them.

“Should I.. get you a mattress?”

“That would be nice.” “Actually.. wait... I..” She stared up at him curiously, smoothing back her hair. All of a sudden he grabbed ahold of both of her hands and pulled her forward, closer to him. 

“Draco, I-”

“No, I have a confession to make…” He took a deep breath. “I might have had.. intentions.. calling you over here. Doing all of this, really.” “You.. what?” “I asked them to schedule my appointment with you instead. I kind of.. missed you.” “..Oh?” “I totally get it if you don’t want anything.. romantic with me. I’m fine just being friends. I.. I don’t think you’re in a relationship, but of course, I could be wrong.. I just.. I.. we were so good together, you know?” “We were.” “We just.. got each other. You were so kind to me. Why did we even.. end us..?”

“It was a mutual thing, remember?” “I know but.. I like you, you know?” That made her cheeks flush more than she’d care to admit.

“You do?” “I do. I.. didn’t really need the potion when we’d.. sleep together. You’d just.. I don’t know how you did it.. But I’d feel calm with you. Around you. There’s no better candidate for a healer, really. I was thinking that you’d be very, very good.. and I was right, you were. You.. did the right thing, didn’t you?” 

This was so out of nowhere. She should be more shocked, shouldn’t she? But why was she feeling like she was on cloud nine?

“I like you too.” was all she could manage out. He looked at her for a second before giving her a wide, wide grin. 

“I can’t believe you pretended you didn’t know it was me! Was that just because you couldn’t be arsed to get me chocolates or something?”

“Uh.. well.. Maybe.” He laughed and she did too, playfully hitting the side of his arm. “I’ll get you some if you want them so badly. I have.. better gifts to offer you.” He winked.

“Draco!” She shook her head. 

“Fine. As you wish, Healer.” She just rolled her eyes at him and stared at him with the most sincere smile she could manage. He pulled her even closer towards him, bringing a hand up and setting it on her cheek. His eyes were suddenly on hers and she leaned up towards him, puckering her lips. 

And then their lips met. It was the most familiar feeling in the world and yet the most electrifying. Everything was soft and sweet and perfect. All their wounds were healed and they knew anything that still hurt would only get better. 

All was well.

[hookedontaronfics]

Aber Girl series - Sunday

Title: Aber Girl - Sunday Part 3 of 3. Find Friday’s adventure HERE. Find Saturday’s tale HERE. Rating: T Pairing: Taron x OC Warnings: Cursing and alcohol use A/N: Will Morgan finally let her walls crumble away as Taron tries to show her the best parts of Aberystwyth - and himself? There is so much sweet, adorable fluff in this final chapter it will make your heart ache! Please enjoy the sweetness! x

I awoke straight out of sleep far too early, as it was still pre-dawn dark outside my window. I squinted at my phone and groaned when it read just after 7 a.m. No one had a right to be up this early on their day off, but then I remembered I was to spend the day with Taron and there was going to be no going back to sleep for me. I felt a definite mix of anxious and excited as I sat up in bed, propping myself up a bit and doing what anyone would do; I started scrolling through Google search results. The truth was that even though Taron had always been on my periphery, I hadn’t kept up with what he’d been doing all these years.

I knew he’d gone to RADA after leaving Aberystwyth, and I’d even seen the Kingsman movies because my friends were obsessed. But after that my knowledge was a bit sketchy, so I tried to catch myself back up and found he’d done a bunch of different projects, not always as a headliner, but always seeming to make the most of his roles. I switched over to the images tab, scrolling through photos, most of them from some premiere or film event or the other, although some personal photos had made it onto the internet also, of course; nothing was sacred online. Taron had indeed grown very handsome; I couldn’t deny it anymore. I wasn’t exactly breathless over him, but he had a certain charm about him.

Just then, a text notification popped up from Taron, no less. <Hope you’re ready for today! Dress in layers - We’ll be outside for parts of the day and I want you to stay warm.> I wondered what he had planned; there were a few iconic places in Aber that I’d already spent plenty of time at over the years. I wondered if being there with Taron would make them feel different somehow.

I eventually got myself out of bed and worked on getting dressed, a little bit more successfully than the day before, being ever-careful of my arm. I’d pulled on a pair of warm tights under my jeans and piled on a sweater and zip-up hoodie over my shirt. I swallowed another of the prescription painkillers, hoping it’d keep the pain to a dull ache so I could enjoy my day, and, in a decent mood, I started making breakfast for my parents who weren’t up yet.

I’d got some sausages and eggs in the frypan and set some toast out on the table when my parents came down, still in their robes and pajamas and rubbing the sleep from their eyes.

“Morning,” I said cheerily, carefully sliding food onto plates for them both with my one good arm.

“You’re in a pleasant mood,” my mum remarked, accepting a plate.

“Mmm, yeah, why wouldn’t I be?” I laughed at that, as my parents exchanged glances. “Okay, okay, I have a bit of a date today,” I grinned at them both.

“With who?” my parents both managed to ask at the same time.

“An old school friend,” I said as casually as possible.

“Well that’s wonderful, honey,” my father said. “I hope you have fun!”

I just grinned at that and wolfed down my breakfast. Taron said he’d pick me up at 10 a.m. sharp, and the clock had nearly arrived at that. I felt stupidly nervous as I waited, making small talk with my parents until I saw his car pull up to the house. I got up quickly and pulled my coat on around me, trying to button the toggles as quickly as possible.

“Oh, is that him? Invite him inside!” my mother said, trying to get a peek through the curtain as I pulled my Wellies on over thick socks.

“Yeah, no… Let’s at least wait for the second date? Or like, 30th?” I said as I grabbed my purse and smiled at them. “I’ll be back later, love you!” I shouted as I bounced out the door, letting the screen door slam as I usually did.

Taron had obnoxiously decided to be chivalrous and got out to open the car door for me; I thanked him and slid into the seat quickly, willing him to get back in the car in case my mom was trying to look out the window again. The less questions I had to answer about all of that, the better. We’d been blessed with a warmer day, thought it was still cold enough for the snow on the ground to stay, and there were only a few clouds scudding across the sky.

“Morning, love,” Taron grinned in that eternally cheerful way of his.

“Morning,” I couldn’t help but grin back. “So I am yours for the day. Thrill me.”

Taron raised an eyebrow at that and grinned. “So I think the first thing we should do is go up the Cliff. I’ve spent a lot of time up there, and I always find it peaceful.”

“You take all of your girls up there?” I teased.

“Ouch, do you always think I’m so predictable?” he said, pretending to be hurt.

“Mmmm,” I just responded, making him chuckle, and I found I rather enjoyed that sound. We made the quick drive over to the railway, and I insisted on buying our fare for this. I knew he’d probably be paying for most of the day, and besides that, I had also always loved going up the cliff. Taron had brought a pack with him and sat so close to me on the way up that his thigh was against mine, distracting me slightly. But I also couldn’t help staring out the window as we rode; the views were always stunning from 430 feet up.

Despite the cold air, it was surprisingly busy, but then I remembered that the railway was only operating on special hours at the moment because of the influx of people for the holidays. One of my favorite places to spend time, the Camera Obscura, wasn’t open either, but Taron cutely took my hand and led me over to some benches overlooking the city and sat the pack down at his feet, producing two tin mugs and a thermos of hot chocolate to keep us warmed up. We sat there in our mutually content silence, sipping the warm sweet drink and eventually I laid my head on his shoulder.

“Do you miss this when you’re off in London?” I asked.

“All the time, of course. Aber is the center of my universe,” Taron replied. “I don’t regret making the move, but London doesn’t have my heart. Plus, if I don’t visit often enough, my sisters turn into completely different people. They grow up so fast.”

“I used to hold such a grudge that you left,” I admitted. “That you still claimed to be Welsh when you’d left all of us behind, made a name for yourself in Britain. I suppose that wasn’t very fair of me,” I said, as Taron just listened to me ramble. “I guess part of it was that I wanted nothing more than to leave myself, and felt like it was going to be impossible to do. I felt stuck and resented you for my own fortunes. Everyone here considers you such a hero. I never saw what was so special, and it didn’t help that we had all of that history behind us that I blamed you for exclusively.”

“But you think differently now?” he asked.

“It’s why we’re here, now. I want to give you a chance to prove that you still care about this place, its people. That you aren’t too good for it.”

“I don’t think that. I’ve never thought that. I hope I’ve never acted in a manner that would constitute that. I live in London because that’s where it’s easiest to access what I need. Do you honestly think it was easy to say good-bye to my mam, my sisters, everything I grew up with here?” he asked, his gaze searching my face.

“I don’t know, Taron. I feel like I’ve had to literally confront everything I thought I knew about you and found that I’ve been so, so wrong. I suppose I should apologize, it’s a bit shaming, really,” I said, my face growing red.

“Hey, you’ve been misguided, but I can forgive, and you should forgive yourself for that as well, yeah? It’s not so bad, we have this day to make amends and begin again. And maybe, just maybe, we’ll find some magic in it too,” he said, the way he looked at me so softly making my heart skip a few times.

“Maybe,” I said, stumbling a bit over the word and trying to remember how to breathe.

“Right, shall we head back down? I figured we could walk through the National Library to get warm and then grab a bite for lunch at one of my favorite spots.”

“Sounds good,” I nodded, watching as he wiped out our glasses and packed everything back up before sweetly taking my hand in his and swinging our arms between us as we ventured back to the platform. We took the rail back down, chatting about lighter-hearted subjects, and I was really enjoying his company.

We made the drive over to the Library and walked inside its hallowed walls; I’d spent so many hours here, studying for school or just being transported somewhere else through a book. We wandered through an exhibition related to Wales’ musical tradition, actually spending a fair bit of time there together. Taron always took a particular interest in music, and credited his own voice to growing up in a place that fostered music wherever you went.

Once we’d both grown rather hungry, Taron drove us over to Sophie’s. The brunch and lunch spot was busy but we were thankfully able to grab a table. We both ordered burgers and shared a chip stack, loaded with cheese and bacon and sour cream. It turned out that despite Taron’s pretty built physique, he was quite a foodie, and I loved that there was no shame to it. We ended up laughing and talking a lot, and a few times he’d just wind up staring at me with an expression I couldn’t quite decipher.

“You’re clearly thinking something,” I said softly once we’d finished our food and were just waiting for the tab.

“You’d think me bloody crazy,” he chuckled.

“No I wouldn’t, promise!” I smiled at that, placing my chin in my hand and gazing at him a bit.

“Just thinking how I never thought I’d be lucky enough to have a chance with you. You were always the girl that got away from me, mostly because I never took a chance. That’s dogged me for years, you know,” he sighed a bit wistfully.

“You’ve really thought about me for years?” I asked, a bit incredulously.

“Ahh Morgan, I’ve had my share of breakups and lonely nights. It always left me wondering what could have been,” he said, running his fingers through his hair.

I looked away for a second, almost ashamed by the fact that I’d been on his mind at all and had spent that time just fuming away. It was very nearly comical.

“Hey, don’t be embarrassed,” he said, misreading my reaction.

“I’m not embarrassed, just ashamed of myself, really. I know you’re not mad at me, but I just feel like this could have happened a lot sooner if I had, I don’t know, just tried a little harder. To see all sides of the story. I just assumed I knew what had happened. I talked to my brother before I texted you yesterday, you know. He said you got blamed for everything, that you took the fall for it. Why?”

“I had amends to make, Morgan. And I was protective of my friends, too. I knew I could handle being hated by your brother. I just didn’t realize I couldn’t handle being hated by you,” he said in nearly a whisper. I could feel the vestiges of the walls I’d built up around myself beginning to crumble slowly.

“I don’t know what to say,” I said quietly as Taron reached over and took my hand in his.

“You don’t have to say anything at all. But I’ve felt like this for years, and being able to finally put it in words, and to be honest with you about it, has been such a relief. I don’t want to place expectations on this. I’m just willing to see where it could lead,” he smiled, the corners of his eyes crinkling up as he did so. That was something I had never noticed about him before; when he smiled, it lit up his entire face. He was incredibly expressive and I’m sure that’s what made him such a brilliant actor. You could read what he was thinking without a word being said, and we were having a conversation right then and there by the way he was looking at me. To be the subject of that gaze left me completely breathless.

“So, shall we head out to the next thing?” Taron asked after a moment, and I could only nod in agreement, having to figure out how to put my thoughts back together. I felt undone somehow, but it wasn’t in a bad way; it was just that unnerving feeling that things I thought I had known, about Taron, and about myself, felt completely stripped away.

We got up from our table but Taron was pulled aside for a selfie from someone who recognized him. At least they had waited until we’d finished our meal to ask, so Taron obliged her while I stood awkwardly nearby, feeling somehow like the third wheel. But I wasn’t even a girlfriend, not really, so there was no reason for Taron to acknowledge me in his sphere of actor and fan. Still, he politely excused himself from that conversation as quickly as possible and followed me out the door.

“That’s happening more and more,” he said with a bit of an anxious chuckle.

“So are you big leagues now or what?” I teased him, but he only shook his head.

“Frankly it overwhelms me a bit,” he admitted.

“I imagine so. I mean, I wouldn’t know because I’m just a pleb,” I smirked, making Taron laugh.

“Embrace it,” he smiled. “I wouldn’t give up acting for the world, but celebrity is such a weird thing to me.”

“Well, you’re just Taron to me,” I said with a cute shrug, making him grin.

“Well, just Morgan, shall we go to the castle then?” he grinned, offering his arm to me, which I took.

“Carry on, my fine escort,” I said with a giggle, getting an eyebrow raise for that. God, that eyebrow was classic. I wanted to run my fingers over it, but I decided that might require a beer or two first so I shoved that urge down deep.

The castle was only about an nine-minute walk away, so we decided to leave Taron’s car parked where it was. I promised that just because I was down to one workable arm didn’t mean I didn’t have workable legs, and with the sun shining I was almost too warm under my sweater and hoodie and coat. We strolled down the street, just enjoying the bustle of the city, people running into stores to make their last-minute holiday purchases, and eventually came upon the old castle ruins.

“I’ve spent so many childhood days here,” I grinned as we walked under the north tower gateway.

“As did I,” Taron grinned back as we climbed our way through ruins we both knew so well, Taron taking my hand sweetly to help steady me when there was a large step, since I couldn’t use my other arm to steady myself. Eventually we made it to the topmost point, looking out over the sea. The wind was somehow colder up here, and I pulled my jacket in close about me.

“My parents would bring my brother and me up here to burn off some energy when we were younger. And likely driving them crazy,” I laughed. “We always pretended that this was our castle back in medieval times. Only I wanted to be the knight, and Declan would always be a dragon. Sometimes he would defeat me, sometimes I would slay him. Sometimes we would just rule together and be best friends. Trust me, I was no princess,” I laughed at the memories.

“I mostly just came up here with other schoolmates. Probably did things I shouldn’t’ve,” he chuckled. “Your story is much cuter than mine,” he grinned as I huddled in the corner where two partial stone walls met, trying to seek solace from the bite of the wind. There was a bit of a keyhole window, and I got caught up staring out at the choppy waves for a moment, traveling through my thoughts a bit and unaware that Taron had taken his phone out and snapped a photo of me. “Morgan,” he said to get my attention. I turned to face him, a mix of thoughtfulness and curiosity on my face, and he must have snapped that photo too.

“What are you doing?” I said with a laugh, shaking my head at him.

“Only making sure I don’t forget how you look right now,” he said, a bit of an odd timbre to his voice, almost like he was a bit choked up.

“That’s… Taron,” I said. “Why do you say these things to me? Such pretty things?”

“Because you should know how beautiful you really are. You cover up your insecurities with all this sarcasm and sharp wit but confidence is knowing your own worth. I wanted to show you how I see you,” he said, turning the phone around, and I had to gasp a little bit. Staring back at me was a girl who was both me and not me. There I was, framed by the window, the light streaming about me and almost giving me a bit of a halo, a few strands of hair having blown across my face. But what was most captivating was the soulfulness of my own eyes, the way they seemed to be looking into the universe. The photo was in black and white, but that seemed to enhance the very real vulnerability of it, as if I’d been pared back to nothing but my essence. As Taron had said, not hiding underneath the humor and self-deprecation I used to brush away my insecurities. 

“Wow,” I said, unable to tear my gaze away from myself. “How did you do that?”

“Do what?” he asked, tilting his head slightly.

“Make me look like that?” I asked.

“This is you, Morgan. You’re incredibly introspective, and smart, curious about the world around you, protective of your family and fiercely loyal to your friends, and full of empathy. You’ve got a high spirit but it means you won’t take anyone’s bullshit. But you’ve put these walls up so high because you’re scared of the world seeing you for who you really are. But I have, I always have,” he said, taking a step closer to me. I shivered, but not because of the wind.

“Taron, I don’t know what to say,” I replied, feeling my breath catching as he took another step closer.

“Let me take those walls down, Morgan. Let me in, please,” he pleaded, and with one more step he was in my space, reaching out to touch my cheek gently, his fingers whispering over my skin as he tilted my chin up slightly. “May I?” he asked, and I gave a slight nod.

Taron leaned in, and I found myself holding my breath as we stared at each other, before he gently pressed his lips to mine as I closed my eyes on instinct. That kiss was so achingly sweet and I never wanted it to end, but all too soon he’d pulled away. I cracked an eye open at him, just to catch him looking totally unnerved, overwhelmed, maybe even a little anxious.

“Are you okay?” I asked, suddenly feeling insecure. Had it really been that bad for him? I thought.

“What? No, of course I’m okay. Better than okay,” he laughed. “Can I kiss you again?” he asked.

“Come here,” I grinned back, grabbing a fistful of Taron’s jacket and pulling him into me, kissing him a lot more forcefully than he had done, suddenly needing so much more of him. He pressed his hands against the wall on either side of me, enveloping me and making me feel safe in that space we had created for ourselves as we continued to kiss, his eyelashes sometimes brushing my cheeks.

When we finally broke apart, giggling and breathless, I felt like the entire world had finally shifted, like I’d found my center and things made sense, why I was here in this place. Everything had led me up to this moment, and being with Taron very much felt like a place I wanted to belong.

“I can’t feel my fingers anymore,” I laughed suddenly. 

Taron quickly covered my hand with both of his. “My days, you’re ice cold. We should get back inside, warm ourselves up again,” he said, and I nodded in agreement because despite the flush in my cheeks, I was cold. As we made our way out of the castle grounds, my lips were still tingling and I couldn’t help but brush my fingers over them every so often, marveling a bit at how kissing Taron had made me feel. Almost as if I’d grabbed onto a live wire, feeling every emotion with so much more clarity and depth than before.

How had he gotten so under my skin? I wondered. And made me feel so alive?

We made it back to the car and I held my hands up to the heater vents as Taron put the air on full blast. I couldn’t help shivering a bit as we both tried to get warmed up again. He drove around Aber a bit aimlessly before finally pulling into the Waterstones lot. We went in and just browsed a little bit; I was curious to see what his interests were and had to laugh at the fact that I ended up in bookstores even on my days off. The obsession with books was a bit too real.

We ended up poking around a few other shops, including Coastal Vintage and Siop y Pethe, or Shop of Things, which was one of my personal favorite places to just kill some time. It had such an eclectic mix of books and gifts. Taron had been inspecting something on a display and called me over, holding up a necklace with a heart pendant that read werth y byd, or essentially you mean the world.

“Was thinking of getting this for a girl I know,” he said with a cute wink.

“I’m sure your mam would appreciate it,” I teased, making Taron throw back his head with a lovely laugh.

“That’s good,” he said, his eyes sparkling at me. “But I had a different girl in mind,” he grinned, undoing the clasp and then fastening it around my neck.

“Taron, this is just too much,” I said, but I couldn’t stop smiling.

“You just have never been treated right, that’s all,” he said, pulling me in close and kissing me lightly on the forehead, traveling down my nose before capturing my lips in another one of those breath-stealing kisses I was going to have to get used to.

Taron paid for the necklace and we headed out again, deciding to take a chilly but sweet stroll along the Prom. We had it mostly to ourselves at that point, and the few people we passed greeted us warmly as was the Aber custom but kept walking on by. The sun at this point had sunk low toward the horizon, painting the tops of the sea’s choppy waves with oranges and pinks. In a sudden burst of insanity, I took off across the snowy beach with a shriek, not looking back to see Taron’s surprised but amused expression. I was careful to not wipe out on the slippery pebbles under the wet snow as I squelched my way to the very edge of the water, the waves breaking against the toes of my Wellies as I closed my eyes, threw my arms out wide and breathed in the salty air.

“The sea calls me and I must go!” I said as dramatically as possible when I heard Taron approach.

“Not without me, you won’t,” he said sweetly, making my heart beat faster in my chest as I turned around to face him.

“This is always where I’ve found my peace. As much as I’ve always wanted to leave Aber, I don’t know if I could ever live in a place without the sea,” I confessed. “I’ve never felt so big and so small at the same time anywhere else.”

“It is beautiful here,” Taron agreed, as I noticed that his eyes were much the same color as the sea at the moment, almost a slate grey.

“It’s not London,” I replied. “And you’ll have to go back after the holidays, right?”

“Sadly yes, but, we can figure this out,” he said softly. “Besides, it doesn’t help us to think about that right now. Our day together isn’t quite over yet.”

“You’re right. You still have a little time left to convince me,” I joked, bending over to scoop up some snow and tossing it at Taron, hitting him square in the chest as I took off running across the beach again, giggling. Taron gave chase, managing to scoop some snow up of his own. My Wellies were struggling to keep balance more so than Taron’s shoes, so he caught up to me quickly, lobbing his snowball and hitting me in the back before wrapping his arms around me and hugging me to him, making me squeal with laughter.

“C’mere you,” he grinned as I turned around in his embrace to face him.

“I was kidding you know,” I grinned. “I just wanted you to kiss me again.”

“That can be arranged,” he said, his voice a bit gravelly as he leaned in again and kissed me some more until I could feel the heat rising in my chest. Unfortunately for me, the creeping twilight chill and our growing hunger would soon chase us off the beach, seeking warmth and food again.

We ended up at a restaurant/bar called Baravin right there on the Prom, with a table by the windows so we could still see the sea and also the twinkling Christmas lights on the houses and store fronts. I always loved this part of the year. The food was excellent and I was beginning to think I had never felt this comfortable with someone.

“This has truly been one of the best days I’ve ever had,” I said after we’d filled ourselves up on the chocolate and honeycomb sweet pizza for dessert.

“I’m grateful I could be a part of that,” Taron smiled, his chin in his hand as he gazed at me.

“You’re more than just a part of it. You’re the whole reason for it,” I replied, toying with the necklace a bit absent-mindedly.

“Well that’s very kind of you but I don’t think you would have said the same two days ago when I tripped you in the store,” he said with a bit of a smirk.

“Oh God,” I said, covering my face with my hands. “I was such an arse to you,” I sighed.

“Well it’s all been forgiven, yeah?” he smiled.

“You of me, and me of you,” I nodded at that, my phone lighting up with a text from Andreyah.

<I’ve tried so hard to wait to hear from you all day but I MUST know, how is it going?!> she had sent.

<Um, very well indeed> I texted back, attaching one of our many selfies that we’d taken together. It hadn’t even been a good picture, because I’d said something that made Taron laugh, so his eyes were squeezed shut and his mouth was hanging wide open and he was a bit blurry, but I still loved it because it just felt so genuine in that moment. I loved the sound of his laugh, and knowing I was the reason for it made me feel really good.

<OMG that’s soooo cute! You look really happy!> she texted back right away.

<That’s because I am> I wrote back, while Taron also checked his own phone briefly. <Who would have thought it? But everything’s changed. I can tell you more later, promise.>

<You’d better> she texted back before I stowed my phone away in my purse.

“We can’t sit at this table for forever, but I really don’t want this evening to be over yet,” I laughed softly after a moment.

“Oh, I’ve got an idea,” he grinned a bit mischievously. “We’ve got a bit of time to kill but… You should call your friends, I’ll call mine, and we can all meet up at the Pier’s nightclub for a little bit. Wouldn’t that be a bit nostalgic?” he asked.

“Oh my god, yes! I haven’t been there since college days. Once I graduated my mates and I felt we were all too grown up so we’ve stuck to the pubs but we should totally do it for old kicks’ sake!” I laughed.

So that’s exactly what we did. We gathered a group of our friends and, after admittedly killing time by talking and making out in Taron’s car, we entered the old nightclub I had such fond memories of. They had refurbished the inside of it, so it looked a lot nicer than I remembered, but the music was just as loud and neon lights just as blinding. We all got some drinks and after some introductions between us all, we spent the last bit of the night dancing away. None of my friends even gave me any shit for doing a complete 180 on Taron, but I think Andreyah had filled them in on our reconciliation.

When a slow song came on I wrapped my arms around Taron’s neck and swayed with him. It’d gotten hot in the club so we’d all ditched our coats and jackets. Taron looked so cozy in his sweater, and I was just so thrilled to be there with him. He had his hands loosely at my waist as we just got lost in that moment together. He slowly slid his hands down and around, his fingers gently squeezing my bottom as he asked “Is this okay?” in my ear. It sent a thrill running all through my body, and it was the first time I really understood that this could go so much further. I wasn’t in any way ready to take it that far yet; I had too much past shit to work through. But suddenly I wondered what he’d looked like naked, and I was grateful for the darkness of the club because I was blushing hard at that.

“Want to step outside for a moment? I’m a bit sweaty,” he said against my ear so he could be heard over the music. I nodded and we both went to grab our coats and beers and stepped out onto the pier into the night air. I wrapped my arms around Taron under his coat, laying my head against his chest; his heart was beating rather fast, I noticed. He took a long pull of his beer and had a far-off look in his face, staring out at Cardigan Bay.

“What are you thinking?” I asked softly.

“Things I shouldn’t be, in all honesty,” Taron said, his voice a bit deep, a rough edge to it.

“And in all honesty, I probably am too,” I whispered.

We weren’t alone on the pier, but no one else was paying us any mind, busy with their own conversations and probably as buzzed as we were. Taron stepped me backwards until my back hit the wall of the building, and we were now partially hidden by shadows. He leaned in and kissed me, his hands roaming under my coat and sweater and finding the skin at my waist, setting my nerves aflame. His kisses traveled along my jaw and then down my neck, leaving trails of fire where his lips touched. With the effects of the alcohol our inhibitions had lowered quite a bit, but I was still hesitant, and when Taron realized it he backed off, just resting his forehead against mine as we tried to recover our breaths.

“To be continued,” he smirked lightly at me.

“Definitely,” I laughed softly, biting my lip almost shyly.

Eventually we rejoined our friends, but it had gotten quite late and I had an early shift the next morning, so I decided that it was probably best to head home. I was tired, my arm was beginning to throb yet again, and as much as I would have loved to just dance until the sun came up, I was no longer that college kid with few responsibilities. We said our good-byes and packed ourselves back in the car, happy and worn out. Taron drove me through the quiet streets of Aber, a place he had somehow managed to make feel special all over again.

He parked the car when we pulled up to my house and we both sat there in silence for a few minutes, unsure of what to say or unwilling to end the night.

“Thank you, for today, for everything,” I finally said.

“Yeah, of course, of course,” he said, smiling over at me. “I’m in town for a little while longer, and I’d love to see you again.”

“Now that is a given,” I grinned tiredly at him.

“You should go sleep,” he laughed gently at my sleepy expression.

“Nope, just gonna bunk down right here,” I giggled, patting the car seat and pretending to snuggle in.

“You’re ridiculous,” he chuckled at that. 

“But you like it,” I replied, as Taron reached over and brushed my hair away from my face, caressing my cheeks sweetly and then lingering over my lips, so I placed a kiss right there on his fingertips. “Alright, I should go or we’ll be here all night and morning,” I said, both of us getting out of the car and Taron actually walking me up to my door. I thought that only happened in the movies, I giggled slightly deliriously at the thought.

“Today was fun. Let’s do this again soon,” he said, hugging me tightly.

“It was so fun!” I said from somewhere in his arms. “And we will, hang out again, that is. I guess you sort of won me over. Lucky you,” I said teasingly, but Taron just pulled away to gaze at me for a long moment.

“You have no idea just how lucky I feel right now,” he said, making my heart feel like it was growing three sizes in my chest. “And you know, you’ll always be my Aber girl,” he added. If I wasn’t already swept off my feet, that sentiment definitely did me in.

“Oh Taron,” I breathed softly, standing up on my toes to kiss him again. We finally managed to say our good-byes; I’m not really sure how but eventually he was back in his car and waving cutely to me as I hung in the doorway, watching as he pulled out of the drive and waiting until the darkness swallowed the tail lights.

I must have fairly floated upstairs; my head was full of reliving the day as I brushed my teeth and changed into my pajamas. While I laid on my bed, scrolling through the photos we’d taken, I paused on the photo Taron had taken of me at the castle. He had shown me so much more than just a good time; he had somehow helped me find the person behind all the walls. I felt more at peace with myself then I had in such a long time, and being able to let go of those long-held grievances was liberating.

I set my alarm and then put my phone on the nightstand, snuggling under my covers and closing my eyes, ready to sleep after the events of the day. But oh, what a day it had truly been. Not only was Taron just so thoughtful and kind and handsome to boot, but he had never once judged me for anything I’d felt or had to go through. 

I touched the necklace still hanging around my neck, feeling the weight of its significance. Taron had promised to give me the world, but he had also truly come to mean the world to me. I slipped into the sweetest sleep, a smile on my face. True happiness didn’t come from things; it came from forgiveness, from discovering yourself, from knowing your worth, and maybe even from finding love.

[the-ash0]

surviving paradise ch 23- for science

Hi there. Can I get your attention for one moment? Yes, I know we don't really talk. I know you’re here to listen to the ravings of my mentally unbalanced house-guest. That’s fine. As much as I am aware that people usually refer to me as a narcissistic know-it-all, that is highly over exaggerated. I mean, I love myself; how could I not? I’m Bulma Briefs. The most intelligent and beautiful creature on the planet. And, now that I’ve seen a bit of space, quite possibly in the galaxy. That said, I have quite the problem on my hands here.

That problem is scowling down at me right now. Yes, Vegeta, Prince of all Saiyans.  All two. Damn, that has to sting, right? Well, he does seem angry enough. Despite my best efforts to mollify him. And I’ve certainly tried. Why just today, I let him train -lightly- without complaint, fed him a meal fit for kings (and their extended families), and skilfully convinced him to take a relaxing shower to top it off.

Now I’ve invited him to our nice, cozy living room to overview my findings. I’m even setting a good example: made myself comfortable on the living room couch with my notes spread out  on the low table in front of me. None of it seems to make a difference though. The man is as high-strung as ever. I’m beginning to think that I am somehow offensive to him. In the spirit of another peace offering, I smile and push my notes out. "I have most of the data I need to help you out right here."

The tells are there is you know what to look for. That half-baring of teeth before he snaps his jaws together. The twitch as he just barely stops his hands from balling into fists. Just my voice is apparently enough to dispel any wholesome effects today might have had; all tension is back in full force.

"Hn,"  Vegeta crosses his arms, straightens up as he stares down at the papers. "What do you mean, 'most'?"

Oh yes; I am definitely part of the problem. Or at least, me being nice to him is. But he’s making an effort as well, I now realise and nearly snort in amusement. I have been walking on eggshells with him, giving him everything he could need before he even asks for it. It seemed safest, with the hair trigger he has. Now it seems he’s doing the same with me. How absurd. Absurd, but convenient.

I click my tongue then pick up a paper and hold it up, a little to the side, in a silent invitation for him to join me on the couch and read along with me. "Well, I talked to Goku. Talked to Krillin also, and got some very insightful statements from Gohan here…”

He snatches the paper from me instead, and I blink in surprise. Can he read our language? I was pretty sure he could not, before. The way that he scans the sheet and then quickly becomes confused suggests he had thought he could, but is failing. Of course he is; it’s my handwriting, which is more messy than a doctor’s prescription. But his reaction could not be faked.

Oh, the sneaky bastard. I’m not sure how or when he picked it up, but this explains a lot about our GR mishap. I’ve been blaming myself, figuring I must have turned off the safeties by mistake, but him purposefully messing with my system makes a lot more sense. Just learning this nugget of information would have made this whole exercise worth my while, but I’m digging for a bit more.

Ah, you thought I was just helping out? I am! Yet to be any help, I need information. I am a scientist, after all. The more I know about him, the better I’ll do. And yes, I like knowledge in and of itself; I want as much of it as I can get. And this is the perfect opportunity to milk him for all I can.

When he gives up on my handwriting, eyes returning to me in silent question, I continue. “I really could use your take on things, mostly on Saiyan culture and the myth around the Super Saiyan. I'm afraid Goku had absolutely no clues there, so I'm drawing blanks on that front."

I don't miss the way he crumples the paper in his hand at my best friend's name, but he seems to find some measure of satisfaction in my words.  "It figures that idiot is useless."  With a flippant air, he discards the paper and makes a spinning motion with his now free hand to prompt me on. "Tell me what you've learned, woman."

Disguising what would have been my teeth grinding I smile once more. He thinks he can push me around? Hell no! But it would not do to lose my temper in the midst of researching his. We’re working two fronts here, you see. Yes, I mean to get answers for my questions, but the most important thing is his emotional response. I’ve moved into undefined territory now and I’m going to do a little research into what triggers my houseguest. What sets him off. Between Goku's return and his request for help, I feel safe enough to try and find out.

"Okay." Carefully now, I first promise good things to come. "Well, Goku’s transformation was tied to Krillin's death, and I have two possible theories as to why exactly.” Then butter him up a little more, blinking my eyes alluringly for better effect. “But I need your input before I can make any conclusions—” Now, finally, my own set of demands. Just one little push to see what happens. “—I have some questions for you to answer.”

He huffs. “Fine, what would you like to ask?”

I cannot help that bubble of annoyance. Control freak! He demands, but apparently I make requests. Who does he think he’s talking to? Regardless, I remain pleasant. At least he agrees to listen. "Well, I'd like to know about Saiyan friendships and family. Did you guys form strong bonds with your teammates? Like family?"

This is important, you see. And not just or my Super Saiyan research. I thought I had Vegeta’s needs covered well enough. I thought I’d had him... well...not reformed, obviously, but at least neutralized. I gave the guy a place to sleep, food, and a way to get his anger out. It had worked, or so I thought. On the average day you’d hardly know he lives here. Has been living here for close to a year now. Yes, it took a little planning to stay ahead of his demands. Yet the way he gets so confused and flustered when I show up with what he just realized he needed is so amusing I can hardly consider it a task.

An easy job that I thought I had well under control. I know how reforming works; I have a long list of enemies-turned-friends to prove this: Tien, Yamcha, Piccolo... to name a few. All former bad guys that have become assets to our team, just by having a chance to change. To that end I've been nice, understanding, and yes...patient.

How did Vegeta repay me? That's right. He went and blew himself up.

It turns out that when you leave a confused Saiyan Prince to his own devices, he will turn his anger in on himself. Who knew? Guess there is still a little something missing, and my money is on companionship. The best way to drive a man insane is isolate him, after all. And this guy seems pretty lonely to me.

He blinks a few times and frowns at me like I’ve grown an extra head before finally returning to his all-favourite scowl.  "Tch!" he huffs, as if offended by the question, and turns his gaze off to the side. "We were warriors. We didn't need or want family, they would only hold us back."

It is my turn to be confused, because that just does not compute. Humans and Saiyans are close genetically, and us humans? We’re all about friends and family. I mean, I checked us against Nameks and we genetically have more in common with a banana; despite this, Nameks still live in villages and form ties like we do. But Saiyans? We're very close. Keep this under wraps: it’s about a 99.3 % match.

How do I know this? Saiyans like to bleed. Goku does. Vegeta’s practically addicted to it. Cleaning up after themselves is not their thing... I’m good with scraping up samples and putting them under a microscope. Yeah, fuck consent. I know. I’m a bad, bad girl. But I did it for science. “So... no ties to teammates or family. None at all?”

I get another scowl for my trouble before he starts into a weak laugh. “Did you miss the part where I murdered Nappa, my last unit member?” His laugh picks up in an alarming way when he makes a few gestures depicting Nappa’s last moments in this realm. My face must have shown disgust, because with one last look at me he throws his head back roaring, then suddenly stops. “No.”

So, I think he’s full of shit. Mammals are mammals, and there’s one thing we have in common: we care for each other. Specifically our young. Families must have happened. What, do you think a baby Saiyan is so strong it won't die out alone in the wild? Take a look at how much food they need to survive. Goku had his grandfather to help him as a babe, and I’m sure his appetite kept the old man busy enough. Also, Earth, I’m reasonably sure, is one of the most fertile planets around. Besides, like I said, we’re genetically almost identical. Saiyans cared for their young at some point. It's what mammals do.

“So you never knew your parents? Or what, they didn't stay in touch? How does that even work?”

"I am a Prince. My father was the King. Everybody knew who he was. But we were bred in gestation chambers. What does any of that have to do with becoming a Super Saiyan?"

My pleasant expression slips, but I cannot help it. "Super Saiyan is an emotional response. There should be a way to unlock it by finding the right triggers. The strongest triggers  humans have are related to family, and protecting one's family..." It was such an elegant theory. We all know the story of the mother cat that will fight a pack of dogs to protect her young. Would it not make perfect sense that such a transformation would be linked to protecting your own for Saiyans as well? But with Vegeta’s input, I admit the chances for my first and favourite theory are looking slim right now, and I’m very, very disappointed. "So... no other Saiyans knew their parents?”

"If they did they never talked about them, or at least not to me." He rolls his shoulders dismissively, answering a little too lightly.

I tap my finger on the table. There's more here, but I can sense we are reaching a limit to his patience. Perhaps I should simply move on to theory number two.

“...except for Raditz,” he continues.

“What?”

It's so odd for him to offer information willingly like this that I am caught off guard. Apparently, so is Vegeta. His statement is not connected with any positive mood changes though. After a restless fidget, he balls his fists and starts to pace. “Raditz talked about his old man a lot. But he doesn't count.”

Raditz. He was the one that came looking for his brother, for Goku. That trip must have taken him months, if not years. This does not sound like something a man who did not care about his family would do. And, whatever the reason, Vegeta kept tabs on him to the point that he found out right away when he died. “Why doesn’t he count?”

Something changes in the air. I think I can actually see his ki, and my papers start to flutter. “Because he was fucking weak. And fucking crazy.”

Ok. I think this is as far as I want to test the waters. I don't want my head blown off, so I agree. “You're right. He doesn't matter.”

The lie placates him enough for my papers to still, and he vigorously nods his head. He’s right about one thing though: Goku’s brother seemed totally unhinged. But then, Vegeta seemed pretty off his rocker to me as well. And Nappa? That big guy? I’m kind of glad he’s dead, sorry. Total maniac. I wonder why Raditz was supposedly worse.

I’ll put my first theory on ice for now though, and move on to number two. It will suit my needs better anyway. “Then it’s got to be a sudden spike of anger.”

“No.”

No? Now he’s just insulting me. But I breathe in, and try for reason. He was on the verge of losing it just a moment ago, and although I might want to test his temper, I do not need him to break my fragile neck. “Gohan and I discussed this at length. Goku was having a great time, until Frieza killed you. Then he completely lost it when Krillin was killed. It’s obvious that—”

"The half-breed brat can’t understand." His temper is still there, thinly veiled behind large gestures. "If anger was the trigger, I would have achieved that form as a child!"

Don't you dare insult Gohan! Seriously, he’s the only mature Saiyan in existence, between your drama and Goku’s complete lack of responsibility. Poor kid. So smart and talented. I wouldn’t mind having a kid like that myself, but I'm more of a career girl. I’m in love with science.

Once more, I bite down on my words. Vegeta is upset enough as it is, and I’d hate for him have a little melt down and revert to his old ways, especially when I am within arms reach. “I didn't say it was anger, per se. Goku described it as something breaking. So, I’d say you have to go from being happy to extremely angry very quickly.”

"That's it? You're a genius and all you can come up with is 'getting really pissed off? Some genius! I'm pissed off RIGHT NOW and I'm not transforming!"

“You are focusing on the end product and not the method. Goku is usually very laid back and happy. If you were to relax first, like he does, and then—”

"Kakarot is a feeble minded IDIOT who has betrayed his heritage!" Vegeta’s temper and ki flare, and the Prince of Saiyans loses his control. For a moment, I think he will end me. Then his first crashes through my hardwood table. Notes and wood chips scatter; I am lucky not to be hit, because I didn't even have time to turn my head. "Do not compare him to me!"

Damn. Guess that was pushing too hard. Lucky for me, the cavalry arrives in the form of my mother. Perhaps I should have warned her earlier. But as usual, my good old mother knew something was up and was prepared. She prances in with her trademark clueless expression, and sometimes I wonder if she’s fooling anyone. The sputtering nightmare in front of me seems to fall for it though.

Mom puts her one free hand to her face, the other laden with a tray of meat-buns. "Oh my. Did that old table finally give up the ghost? I knew I should have had it replaced sooner. Anyone care to try my new recipe?"

Vegeta rounds on her, teeth bared. For a moment I fear that I am going to make my father a widower, but when he does a double take upon seeing the remains of the table, I breathe a sigh of relief. He takes a deliberate whiff, grabs three of the buns, and perches on the couch armrest.

He’s on his third bite before I realise he’s distracting himself, frowning down at the buns. He’s not an idiot; not like Goku. I’d have been dead if he’d made up his mind to kill me, but he knows that would not be beneficial. That temper of his is a problem, but at least he was willing to take the out my mother provided.

I give him some time to compose himself, and when he finally speaks around a last mouthful of meat bun, I cannot help but smile. "You'd better have something else to suggest, woman."

My grin grows, because I know I’ve already won. "I’ve given you two options. There’s only two areas where Goku can beat you hands down: friends, and relaxing. Which do you suggest trying?"

He stops chewing for a moment, one eyelid twitches as he sideeyes me. He thinks it's a trap. In some ways, perhaps it is. When he sighs, resigned, my heart crows victory. “Don't worry,”I assure him, “I am an expert in relaxing.”

[paleorecipecookbook]

RHR: Bringing Functional Medicine to the Masses – with Dr. Rangan Chatterjee

In this episode, we discuss:

Introduction and background of Dr. Rangan Chatterjee

WNL: We’re not looking

Raising public awareness of functional and progressive medicine through the mainstream media

The impact of the show Doctor in the House among colleagues and across the UK

Changing the expectation among medical professionals to a more collaborative care method

Chatterjee’s new book, How to Make Disease Disappear, and the 4 Pillar Plan

Communication is the biggest skill for healthcare professionals

Small changes tend to make the biggest impact

Show notes:

Rangan Chatterjee on YouTube

Prescribing Lifestyle Medicine Course

Chatterjee’s new book: How to Make Disease Disappear

[smart_track_player url="https://ift.tt/2jlMsPC" title="RHR: Bringing Functional Medicine to the Masses – with Dr. Rangan Chatterjee" artist="Chris Kresser]

Chris Kresser: Rangan Chatterjee, it's such a pleasure to have you on the show. I'm really looking forward to this.

Dr. Rangan Chatterjee: Chris, the pleasure is mine. Thanks very much for inviting me.

Chris: We met when I came over to the UK last year, I think that was. It’s all such a blur.

Dr. Chatterjee: Yeah, someone said we need to speak, so we went out for a lovely dinner, actually.

Chris: Yes. I really enjoyed that. Mark Hyman introduced us via email before we came over and said, “Hey, you guys should know each other,” and he was definitely right. We hit it off immediately, in large part because we share not only a passion for reinventing healthcare and the future of medicine, but also a pretty similar perspective on how we should go about doing that. That's what I'd love to dive into today, and I want to start by talking maybe a little bit about just your background, how you came to Functional Medicine, and this perspective that we share on reinventing healthcare and medicine, and then I want to talk a little bit about your experience with the TV show, because here in the US we don't have access to it. And so while that's a pretty well-known show and people have had a lot of exposure to it in the UK, some of my US listeners might not be as familiar with what's going on. I think it's a really interesting portal to how Functional Medicine can get a wider adoption and exposure.

Introduction and background of Dr. Rangan Chatterjee

Dr. Chatterjee: Yes. Well, Chris, first of all, just a bit of background and a sense of my journey and how I've got to where I am today in terms of my perspective. I've been seeing patients now as a medical doctor for almost pretty much 17 years, actually, and my career has gone through various evolutions during that time, because the reality is, you leave medical school and you think that you have been given all the tools that you need to get your patients better. That's ultimately why you end up at medical school, is to how to do that way, and it's not so obvious, but when I reflect back on my career, I think there was a discontentment in the way that I'd been taught to practice medicine. It was probably there right from the start, so I don't think I quite realized it because I start off in the acute medical setting, so I was training in hospitals dealing with a lot of emergencies. I remember running the cardiac arrest team for the hospital for a period of time and doing all the things that you think modern medicine is with the defib and all that kind of crazy stuff which you see on television. As a young guy in their 20s, I think, “This is medicine,” right?

The biggest skill for a healthcare professional may not actually be scientific knowledge, but how they connect and communicate with the person in front of them. Every patient wants to be as healthy as they can. They don't want to struggle. They want to live their life!

Chris: Right.

Dr. Chatterjee: I went through my training, I was going to be a specialist, so I got my exams. Certainly in the UK, we call it the MRCP, Member of the Royal College of Physicians, a very tough set of exams to certify in internal medicine, and I was planning to do nephrology, or kidney medicine. I just started to get a little bit frustrated, month on month, sort of year on year, I was getting a little bit frustrated. It's the sort of thing that I don’t really want to spend the rest of my career just seeing kidneys and kidney problems. I thought that I'm going to move to general practice. To put this in perspective, I come from a medical family, and my dad was a consultant in genitourinary medicine. I think he was a bit flabbergasted that his son was going to leave the hallowed turf of being a specialist to become a generalist. But I really had this calling from inside me saying, “Look, I want to see everything. I want to see how everything interacts with everything else.” That's why I moved to general practice. I did my exams, and then I started working and I loved it, but a few years in, I honestly sat back at the end of the day and I thought, “How many people have I really helped today?” I came up with a figure, 20 percent. I thought, 82 percent of the people that had come in, I wasn't convinced I'd actually done that much for them. Sure I may have given them a prescription, a pill to suppress their symptoms, but I really didn't feel that I had actually helped them understand what was going on. I don't think I knew what was going on in terms of what was driving their ailments. I think the difficulty is, Chris, I'm sure you’ve heard this before from people, it's very hard to know what to do with that. You know, all your training, your whole career, everything is shaped around the system the way it currently is. And then for me, as many people have an experience with illness either in themselves or with a family member, that really changes everything. For me it was when my son, who is now seven years old, but he was six months old at the time … My wife and I, we went on holiday, it was just past Christmas, it was around 27th of December. I remember it so clearly. We went to Chamonix in France for a holiday, and my son stopped moving. His arms went back. He had a convulsion, and really I panicked because I thought he might be choking. My wife had called out to me and I knew that he had a lot of mucus and phlegm throughout the day. I tried to turn him over and slap him on the back and clear his airway and nothing was happening. The truth is, in that moment, I wasn't a highly qualified medical doctor, I was a worried father.

Chris: Absolutely. It must have been terrifying.

Dr. Chatterjee: Even now I think back to it, and it was horrible. It really was horrible, and my wife said, “Come on, we've got to go now. We got to get to hospital.” And we rushed into the car. I nearly killed us all. It’s just snowed there and we went on a steep road down to the main roads and the car skidded, but ultimately we got to a hospital, and many of your listeners might be familiar that a six-month-old having a convulsion is not that uncommon if there is a fever there. It’s what we here call a febrile convulsion, but he didn't have a fever. His temperature was absolutely normal, and you could see the admitting doctors and nurses were incredibly worried because, “Why has this boy stopped moving? Why is he having a convulsion without a fever?” We were in a small hospital. He had to be blue-lighted in an ambulance down to the main hospital, down the valley through the mountains.

A few hours later, some of the preliminary blood started coming back. Now in this time frame, he already had two lumbar punctures. We are a health-conscious family. My wife had breastfed for six months as this sort of public health guidance. We’re pretty switched on, we thought, with respect to our health, and then the blood results come back, and the doctor said he's had a seizure because his calcium levels were too low in his body. He had a hypocalcemic convulsion. To put it in perspective, the normal range for serum calcium in that hospital is the same as in the UK, which is 2.2 to 2.6. His calcium level was 0.97, frankly, barely compatible with actually life, in many ways. Everyone was scratching their head—why has he got such a low calcium level? What's been going on there? And then again, you had to wait a bit later on, because in this time frame, initially we thought he might have meningitis. The doctors were very worried, and we were panicked, in a foreign hospital trying to figure out what the hell was going on, and it turns out that his vitamin D level was almost nonexistent.

To cut a long story short, ultimately a fully preventable vitamin D deficiency caused him to have a low calcium level in his blood, which caused him to have a convulsion. That was incredibly challenging to get my head around. I mean, of course, I was delighted that we found out what the problem was and that modern medicine saved his life. He had an intravenous calcium infusion, right? Great. Superb. You bring the calcium level back up into the normal range. That was fantastic, but nobody that taught me or told me what are the consequences of the fact that your son may have been deficient, or certainly suboptimal levels, of vitamin D potentially for the last six months, arguably in the utero as well.

What are the consequences of that? How can you go about potentially repairing some of those? My son had pretty bad eczema at that time and obviously we know now, I wish many doctors knew about then, that it's pretty clear that vitamin D is a critical nutrient immune system. Eczema is in some way dysfunction of the immune system. Could the two be linked? Of course they could be. For me, Chris, really what happened in that moment was, yes, I'd been frustrated, but in that moment, it was like, I, by conventional measures, am highly qualified, double-board certified medical doctor, yet my son nearly died from a preventable vitamin deficiency, and suddenly it was like a switch changing me. In that moment, I'm going to find out why this happened, how this happens, and I'm going to get my son back to full optimal health. I'm going to try as if nothing of this has ever happened. That was the challenge that I set to myself.

In the age of the internet, Chris, you can spend three, four hours a day researching, and that's exactly what I did. Week after week, month after month, year after year, the more I learned, the more I put into practice with him, the more I put into practice with my family and myself. I can see that the immense benefits for my son, I felt the benefits for myself, started applying the same principles with my patients, I was like, this is the sort of medicine I wish I'd learned in medical school. Understanding root causes of ill health. I'm figuring out how you can help people, not only improve their symptoms, but certainly, in many cases, reverse that illness, and it’s just transformed my career, Chris. It has transformed the way I look at health. It has, in many ways, shaped what I've done in the media for the past four or five years. I reflect back and think, had this not happened to my son, would I be doing what I'm doing? I don't know. I can't answer that. Potentially I would have found—maybe the frustration would have gotten the better of me in another way, but this really forced my hand. I'm pleased to say that my son is a thriving, healthy, eczema-free seven-year-old boy who I think is incredibly well and arguably healthier than many kids around him who maybe have not had this problem. It’s a slightly long-winded story, Chris, but that in a nutshell is why I do what I do.

Chris: It's so great. It got very real and very personal for you in a way that it did for me, a slightly different way, but that's what, really, I think at the end of the day, almost everybody who's doing this work that we talk about, Mark Hyman and many of us thought leaders and influencers, have a similar story because when it affects you personally or a family member personally, there's just no other motivation that's quite as urgent.

Dr. Chatterjee: Yes, absolutely, but Chris, we need to … we started talking months before … at the moment I find that the people who are trying to adopt this approach to chronic disease, the thought leaders, but all the thousands of practitioners around the world who are also trying to do this, pretty much all of them behind that have got a personal story. I get that because I'm one of those, but we need to move beyond that. We need to move like what you're doing with the Kresser Institute. We need this education to be that—all healthcare professionals, basically, not just those who have had a personal experience.

WNL: We’re not looking

Chris: Absolutely, yes. Your story with your son is really, I think, revealing because it points to this principle of “we're not looking,” or that's my version of WNL. In medicine we think of WNL as “within normal limits,” if you do a lab test and it’s within the normal limits. But I have another way of looking at WNL, which is “we’re not looking.” Your story with your son, like the vitamin D thing, was easy to detect and easy to correct, but it wasn't part of the standard thought process of what you should be looking for early on in his life. I had a patient last week in her late 70s who came in, and she had some of the typical complaints you might expect of someone of that age. She had kind of a mild tremor. She was having some cognitive decline and brain fog, difficulty concentrating, and her GP had just written it off as, “You're getting older. And you're in your late 70s. What do you expect? This is standard.” And yet when we tested, did a full comprehensive blood panel on her, we found out that she had very severe B12 and folate deficiency and very high homocysteine, and she had again a very easily correctable, at least if it had been detected in time, nutrient deficiency that was misdiagnosed as dementia and early mild Parkinson's. There's really no excuse for missing and not correcting that, and yet we're not looking.

Dr. Chatterjee: Absolutely, Chris, and I'm sure you've got countless more stories like that from seeing patients, as I have. One thing to add there with my son’s story as I'm sure many people listening might be thinking, “It’s so obvious, why wasn't he just giving his son vitamin D from birth?” I think it's a reasonable question because the guidelines in this country actually do state that you should be doing that. The problem is, nobody knows those guidelines.

Chris: Yes.

Dr. Chatterjee: And they're not being followed. As the same with all my patients, I didn’t know that. But I tell you this, I have replayed this over in my head so many times, three weeks before we got on that plane at the start of December, so son's maybe 5 to 5 1/2 months old. I had been coming across a bit more research on vitamin D, and we had a protocol in our surgery in a different sort of part of the UK where I would start to prescribe a lot of vitamin D to certain patients. I started to think, “I think my son should be on this.” Now it's drilled into us in the UK by the GMC, the General Medical Council, that we should not be making those kind of decisions on our own family. It is very much frowned upon here to do anything treatment-wise for your own family. I did what I thought I should do back then, and so I crossed off the protocol and I phoned my wife up and I said to her, “Hey, babe, can you just go make an appointment to the GP? Just go and ask him what he thinks about this. I think that our son should probably be on vitamin D.” And so she prints it off, she goes to see a doctor, and the doctor knows that I'm also a fellow healthcare professional, and he laughed at her and he said, “Look, this is just complete rubbish. You could have just printed this off yourself and typed it up on Word and given it to me. Look, you're breastfeeding; you're doing a great thing. There's nothing more you need to give your son.” And she was a bit upset with the way it went down because I didn't think he was compassionate, and when she reported this back to me, I thought, “Okay, fine. All right, let me do a bit more research. Let me look into this. I’ll figure it out,” not realizing the urgency of the situation. I often think back, could I, should I just put my foot down then, and it’s not a nice emotion as a dad when you get these things. Having said that, Chris, he could well have been deficient for months prior to that.

Chris: Absolutely.

Dr. Chatterjee: And arguably, have I supplemented then, supplementing just before this happens with a very low dose, let’s say, 400 IU of vitamin D or something like that or 800, arguably, it may not change anything, or it could have gone undetected for a lot longer. At least this way, and again, I wish this had never happened, certainly for my son’s sake, but by having it happen with that sort of magnitude, I was forced to confront some very difficult questions and uncomfortable realities, and I felt compelled to fix them. I do kind of believe that things happen for a reason. Maybe as humans we have to believe that in order to get through, but I had a lot of guilt for a number of years. That actually drove me to learn more and help as many people as possible, but I know you're a father as well, Chris. I'm learning now to let go of that guilt.

Chris: Yes. I mean, we can always second guess ourselves, and there's so many situations like that that I can think of myself with my daughter, things I wish I would have done differently. But I think this is more what you were saying before—it's about getting this knowledge and these guidelines and this understanding out on a wider scale because it is true. There's a saying that a doctor who treats himself has a fool for a patient, and you could possibly extend that to family members, because sometimes we're too close to really be able to tell. But what if there had been guidelines that not only should babies be tested, but pregnant women should be tested for their vitamin D levels because guess where kids are supposed to get it? From breast milk, and if a woman is deficient in pregnancy, then her breast milk is not going to be a sufficient source of it, and I always test my pregnant women patients for that now, but that's not something that's really widespread now, at least in our in this country. I don’t know how it is in the UK.

Dr. Chatterjee: One of the biggest frustrations for me about the way medicine currently operates—I should say conventional or allopathic medicine, whatever you want to call it—it's very much a black-or-white situation. You've either got an abnormal result or it's normal.

Chris: Right.

Dr. Chatterjee: There has been no or very little recognition as optimal, and there is this huge gray area in between overtly abnormal and disease and deficiency versus what is an optimal level for this human being to be functioning as well as they can. A little bit like Dale Bredesen, a professor, who is sort of showing how in some cases you can reverse cognitive decline, certainly in early cases of Alzheimer’s disease. He's managed to demonstrate that, but I love his approach, which is you've got to treat that person like a Formula One car. You’ve got to optimize every single parameter that you can. I love that because that really isn't how we do things here, certainly the UK, and I know it's the same in the US. Even if you talk about blood sugar, you talk about a common condition, type 2 diabetes, we’ve got slightly different ranges from you guys, so an HbA1c, the average blood sugar marker, is 6.5 and above, and in this country is, I think the same as you, is a diagnosis of type 2 diabetes. Our prediabetic range starts at 6, so 6 to 6.4 is what we call prediabetic, whereas with you guys, it's 5.7.

Chris: It’s a little lower, yes.

Dr. Chatterjee: A little lower, and you know these are just arbitrary figures that we could argue about all the day. One of the practices I would tap recently, patients who come in and get their blood sugar checked, if it comes back at 5.9, I know doctors who are still reporting that as normal. What's happening is that patient phones at reception to say, “Hey, you know what, my bloods are okay.” The receptionist will report back saying, “Yes, doc said absolutely normal, nothing to worry about.” That patient then who has come, maybe they come in for a medical or for a checkup just to see where does their health look like at the moment, in that opportunity we are reporting an HbA1c of 5.9 as normal, which is madness. I just don’t know how we got so far off track in medicine where we can call that a normal blood sugar.

Chris: Right. Just because it hasn't reached the arbitrary … as if something magical happens when it goes one-tenth of a point higher, then all of a sudden you have diabetes, whereas it was perfectly normal before that.

Dr. Chatterjee: Yes. And even if all we did in conventional medicine, even if we did not adopt a full kind of Functional Medicine approach, is if we simply recognize that as an optimal range, and then there’s a deficiency range, and we should be striving to get our patients in those optimal ranges—just to say, with blood sugar, for example, we could start maybe once the HbA1c is 5.2 or 5.3, start to get people back in and say, “Hey, look, you're not prediabetic yet. You don’t have type 2 diabetes yet, but actually your blood sugar is not as good as it could be. Can I show you some things that we can do to help optimize that?” So many members of the public would welcome that, and they’ll go, “I didn’t realize it. Yes. Tell me what I can do.” Rather than waiting until it has crossed that 6.5 to 6.6 type 2 diabetes threshold, when yes, sure you can still turn it around sometimes, but it’s going to be suboptimal to be getting involved then.

Raising public awareness of functional and progressive medicine through  mainstream media

Chris: Absolutely. Speaking of this, we're talking about raising awareness of Functional Medicine and preventative medicine and what you call progressive medicine. I think arguably you've had a bigger impact in terms of raising the public awareness of these concepts than just about anybody else because you've been doing a mainstream TV show about Functional Medicine in the UK for the last several years. I mean, we don't have anything like that still here in the US, and I've really enjoyed following that and hearing more about the impact, and I think our listeners here would love to hear a little bit more about your experience with that show, how it got started, and then what kind of impact you feel like that's had.

Dr. Chatterjee: Yes, Chris, thanks for asking me. That really has been … I'm incredibly fortunate and lucky to have the experience that I've had, and I’ll explain to you why I say that. I think the first thing to say is I never got approached to do that show because of my approach to medicine. I think it was just quite fatuousness, how it all happened. I was on my journey of learning. I was going out to America at regular med schools. I was going through all these Functional Medicine conferences, and I was literally just sucking up knowledge. One conference had finished, and I couldn't wait to book on to the next one and buy my flight and come straight back to learn more. It’s a story with many people who once they got their head gets switched on to this way of thinking … but what happened while I was doing or was training, I'm still in my sort of conventional practice, and the practice manager sent out a group email to all their MDs in the practice saying the BBC are looking for a new doctor. They've got a new concept called Doctor in the House, which is what happens when you have more than 10 minutes with your patients. I remember seeing the email and thinking, “If you have more than 10 minutes, then you could do so much.” I had no ambition, Chris, to be a TV doctor. In fact, I can't stand that term. You're no longer a doctor, you're a “TV doctor,” and I prefer a “doctor who also is on TV,” but that’s a minor point.

I phoned up the number thinking, what’s this about? Anyway, I ended up having like a 40-minute interview with the studio, and that turned into three months of basically interviews and tests. They’d film me with families, and they take you around an empty house and say what kind of things would you be looking for, what sort of clues would you be picking up, and it …  what’s interesting to me is I didn’t prepare for a single one of those interviews, around eight of them over three months, because I wasn't really desperate to be on television. I just thought, if these guys like me who I am, great. If they don't, fine, get someone else who might want to say … what the right things to say in order to get on television. So I just went and did my thing. Three months later, I heard they went for about 1,500 doctors, and somehow I get picked to make the series. Just to make one show actually, but the show went so well that they made a decision for me to do a whole series, and that was a big decision for me because I thought, “Wow. This is a lot of exposure.” BBC is our main channel that gets the biggest viewing, and it is a primetime show. And I thought, “Wow, this is a lot of exposure.” But I thought, what an opportunity here to see … can I get various conditions, various families who've been struggling with their health for years, who’ve already been under GPs, specialists, other healthcare professionals and they still can't get better, can I get these guys better on television? I didn't know what it would entail at the time. Like all the things, you just you jump in the deep end and you kind of sink or swim.

Chris: Right.

Dr. Chatterjee: If I'm honest, Chris, to actually go into families' houses and spend all this time with them, you get to … for example, we talk about nutrition. This is not what people tell you they eat in your surgery, in your practice. You're actually watching what they do eat, what they got in their fridge, what they got in their cupboards. When they're snacking, what are they snacking on? Because everyone filters in front of their healthcare professional. People tend to have a little filter in terms of what do you eat on a typical day. Are they going to tell you, Chris, what they eat on their best day, when they follow the principles in your book? Or when it’s Christmas holidays and they're actually feeling emotionally vulnerable and that's what they're eating then? I got to see the few hours before bed what the family dynamic is like, what are those interactions. Those sorts of things actually would never probably come up in my surgery. And not only would they not come up, even if I asked about them, I suspect that they just wouldn't come up in the same way. I was just seeing all kinds of things. I thought, “Wow, these are all playing a role in that person's health.” And now that I can see that, I can actually potentially influence those things in a different way, and what's interesting to me, Chris, is that a typical Functional Medicine doctor will probably have a lot longer than some 10 or 15 minutes. You may have an hour or 45 minutes or an hour and a half with the patient, and we all want more time. I potentially got too much time because the other problem I had, Chris, is that when you know absolutely everything and you see it all, it's almost too much information because you can then literally … you don’t have the security of your surgery and your consultation room walls. You're seeing people in their own setting. You feel quite exposed, actually, so it was an incredible experience, the results I managed to demonstrate for those families, but also in front of five million UK viewers a week, and probably the proudest results of my career because I had some of my most difficult cases on that show. As my best friend, who is not a doctor tells me, he’s like, “You've got five million people watching you do your job.” I'm like, “Yeah.” He told me this a few weeks before the show came out. ... I was pretty nervous anyway, but now ...

Chris: Thanks a lot.

Dr. Chatterjee: We can dive into a bit of the detail, but essentially I got to see different sides of people from what I see in my consultation, and that has changed me, not only what I did on the series, but I'm a different doctor now than before I filmed the TV show.

Chris: Yes. For the folks who are listening, although you can't yet watch the full series, I think there are quite a few YouTube clips of the show.

Dr. Chatterjee: I found that there is quite a few on YouTube, and I put them all together on my YouTube channel so people can watch at least eight of those episodes free of charge on the internet.

Chris: Oh, cool. Yes. Yeah. I really recommend doing that. It's really great to see these concepts on primetime television going out to people who are totally unfamiliar with them. I'm just curious—there are so many things we could talk about related to that show, but I'm mostly curious in this context—what was the feedback that you received from professional colleagues and also just from the general public in terms of being exposed to these concepts? What kind of impact do you think it's had in the UK, and how has it changed the conversation?

The impact of the show Doctor in the House among colleagues and across the UK

Dr. Chatterjee: Yes, Chris. Look, I think it's had a huge impact. I mean I get invited by the NHS to come and talk about how we implement the strategies, the things that they saw on television. How do we get that into the National Health Service and make that widespread? Clearly, having a doctor in your house for four to six weeks is not a rational or actionable national strategy. It’s a reverse from the chronic disease trajectory, but what can we learn from that human emotion as we focus on the negatives? If I get 99 with the collaborative and inspirational plus the feedback, and then one in a hundred sort of say, “What was that you were doing? There’s no evidence behind that,” etc., your mind tends to focus on that one person. Although I had learnt over the last years to get a lot better at that, but generally the responses have been very, very good.

It's the first series to actually demonstrate on a primetime show that type 2 diabetes was a reversible condition and something that can be done in some cases, well, I'm not saying it has to be, within 30 days is really quite remarkable. I think that was very much ahead of its time because now, NICE, the National Institute for Health and Clinical Excellence in the UK is now accepting that we can code in people's SNPs that type 2 diabetes can be put into remission, but it was very, very controversial for years here. When my show came out, it was the third episode in the first series, where I helped a lady reverse her type 2 diabetes in 30 days. The BDA, the British Dietetic Association, released the statements about criticizing the care that was given, and there are very alarmist statements advising people not to adopt the strategies they saw and go discuss with the doctor. That was a hugely … it was quite a challenging time for me because I didn't do this to fight with people. I'm not interested in having fights with other people. I think I've found a better way than I used to look out to people. I managed to show that on television, and I just want to get that message out to as many people as possible, to people that agree with me, fine, but I didn’t necessarily want to fight this. I found that quite hard, actually. The thing I found the hardest was, I would have preferred the BDA to say, “Look, that isn't the person we take. We recognize the fantastic results you’ve got. Can we get together and discuss? There’s something interesting there.” That approach wasn't taken because I wasn't sort of being down on dieticians; I wasn't criticizing other people's approaches or anything like that. I was simply going, “Okay, you’ve got this problem. I'm going to give you the best advice I can with all the experience and all the knowledge I have, and worst-case scenario is you're no better after four weeks. Best-case scenario, I've revolutionized your health.” That was the only really negativity I've got in the first series, was the dieticians.

But from so many medical doctors around the country, from nurses, from pharmacists, from nutritional therapists, from other dietitians, I got so much warm feedback saying, “Look, just incredible to see those results. We’d love to learn more.” I got so many emails from medical students, Chris, and this made me incredibly excited. A lot of medical students contact me saying, “Look, Dr. Chatterjee, I love what I saw there, but I'm in final year now of medical school. I'm not learning about this. How can I learn more? Because that was incredible!” I think it's been highly significant here. It’s changing the conversation here. I think a lot of people now are embracing lifestyle not only as a way of preventing getting ill, but also as a therapeutic tool to treat people when they are ill.

I recently lectured for the Royal College of GPs at a Wellbeing conference as to how can doctors look after their health, and this GP came up to me afterwards—and it really touched me—he said, “Look, I've just got to thank you.” I said, “What’s happening?” He said, “Look, the work that you’ve done, it set the stage for me to be able to do what I do. People give me a lot more credibility. I can now talk about these concepts in a way that I couldn't do four years ago because of the work you do. I just want to thank you.” It was great to me to hear that because yes, I'm doing it to help the public. I want to empower the public or as many people as possible to understand that actually, no matter what your health problem is, some simple changes to your lifestyle can have a profound impact. But it's also nice when other healthcare professionals or when other medical doctors say, “Look, I love that. I'm now using this approach with my patients and I'm getting great results. Thank you.”

And I think the culmination of that for me, Chris, was in January this year, where I sort of created with a colleague the first what's called Prescribing Lifestyle Medicine Course that the Royal College of GPs have credited. That's our main institution here. They have credited that course with seven CBD points, and we had nearly 200 doctors come in January and we have GPs, we had gastroenterologists, rheumatologists, oncologists all coming, learning from me and a colleague in terms of how you can apply these principles, and it was just incredible. The feedback is 95 percent of them have said they would highly recommend this course to their colleagues, 85 percent of them have already said this has significantly impacted the way that they are practicing medicine. We didn’t go the whole hog. We didn’t go in as much detail as you offer, Chris, in the Kresser Institute. This is trying to shift people from one to two rather than one to ten because I feel very passionate that … your training exists, that is very good training out there for that really detailed, in-depth look at reversing chronic disease, but I thought, “Okay, look, the public has bought into this. A lot of the profession has seen those results, but probably don’t have the time, energy, or inclination to go on and do this in depth, to dive into Functional Medicine. What are the core principles, and what can I actually teach them in one day to shift them from one to two or one to three?” The feedback has been incredible, so, Chris, what has been the impact? Well, I can tell you, four or five years ago, we weren’t having Royal College of General Practitioners-accredited courses in lifestyle medicine; in 2018 we now are. That gives me a lot of hope.

Changing the expectation among medical professionals to a more collaborative care method

Chris: Absolutely, and that's exactly the change we need to see. I think we all know when we're shifting our paradigm, we expect resistance, but almost by definition, if we don't get resistance, we're not doing our job. We're not really changing the conversation, and of course, we've seen similar things here. We're seeing a lot right now about how the dietetics organizations are fighting health coaches because they want to be the sole providers of nutritional information, and they're arguing that nobody other than a registered dietitian should be able to offer nutrition advice, which I personally think is just crazy. Unfortunately, this stuff, it's not just about logic and what’s the best direction from an evidence-based perspective. We have to deal with all the messy human stuff that comes along with it, and that's fine. We'll get there one way or the other.

Dr. Chatterjee: We will get there, Chris. You mentioned this about dietetics in the US. It was literally last week where a big story came out on the BBC website, a new radio documentary that they did, or was featured in talking about how doctors don't learn about nutrition at medical school or very much in this country, and my quotes were heavily featured in that BBC article. I haven’t read it. I didn't know it was out, actually. My friends texted me and said, “Hey, look, this is out.” I thought, “Wow, this is going to pick up a lot of noise.” There was quite a lot of what I call abuse … No, I won't quite call it abuse, but there was a lot of interaction on Twitter from dieticians. I said, “Look, we're not getting enough.” One of the ways I have tried to make a change here is with this Prescribing Lifestyle Medicine course, which is just a one-day masterclass to teach other healthcare professionals, in particular, medical doctors how they can start to apply these principles in their current system, and this is why there is no dietician teaching that.

I very respectfully interacted back, and I said, “Look, guys, I absolutely respect your expertise. We're teaching in a system, a framework, a new set of principles for people to apply. Everything that we taught was well within our expertise levels to teach.” And no one was responding to that. They just kept saying, “Dieticians are the only people who can give nutritional advice on medical problems. No, this is not serious because there's no dietician there.” And I thought, when you take a step back and you set the emotion out there, I find it remarkable. What I would expect some prefer is, “Hey, look, that is great. You're trying to make a difference here. I’ll tell you what, I've got some interesting things and I can answer that. Can we get together? Can I actually suggest what I'm up to add to that course?” I’d be very open to that. I don’t really understand the assumption that our course is no good when you haven’t attended it, whereas everyone who attended thought it was superb, and I thought that really just shows what we're finding out there, which is a lot of ego, frankly, which there's really no place for that in healthcare because ego is getting in the way of getting people better, and this is not just about one organization fighting with another. We've got a serious problem, Chris. Any disease you want, I mean, type 2 diabetes is one that often gets spoken about, in 2012, so that’s six years ago, we think that type 2 diabetes was costing the UK in direct and indirect costs £20 billion a year. What’s that, about $26 billion a year?

Chris: Incomprehensible.

Dr. Chatterjee: An obscene amount for a condition that by and large is an environmental illness. This is driven by our lifestyle and our environment.

Chris: That number is $250 billion in the US, by the way. This is the population differential.

Dr. Chatterjee: And instead of fighting in terms of who has got the authority to give the right advice, let's just be more collaborative and go, “Hey, look, that's great. That's working or this is working. What can we do together?” Because patients get incredibly frustrated, the public gets incredibly frustrated, because they don’t know who to trust, and I think like you, Chris, I've just decided to just focus on doing what I do. I normally stay out those fights on Twitter, and the reason I got involved last week was because I was really trying to extend a hand of collaboration. And I would go, “Look, this is great. Let’s get together. Let’s meet for the greater good.” And I've learned that Twitter is not the best environment to actually try and change people's opinion.

Chris: Yes.

Dr. Chatterjee: I think things are changing, that's for sure, Chris. There's no question here that things are changing and I can't comment on how impactful my show has been, but I get told by a lot people that the show has been game-changing here.

Chris: Yes. I've definitely heard from lots of people and when I was over there in the UK I heard from lots of people who were turned on to these concepts from watching your show, both professionals and consumers. I think that you have had a big impact.

Dr. Chatterjee: I would say to people who do, if you do provide the links to the shows and they watch them, just to say, look this was edited for a mainstream audience. I think some viewers who may watch it might go, well, what happened there or what testing was done, you got to remember that actually this was a 9 p.m. primetime slot, so a lot of the things I did got very simplified. The narrative got quite simplified, but it was definitely a true narrative. It was definitely not inaccurate, but I would have preferred a lot more detail. But Chris, I've also learned, being in the media, that there are two sides to this. The show that I would want to make with all the detail in there, with all the science, we’ve probably had a hundred people watch that show, whereas the TV studios know how to edit and show in a way that actually engages the viewer, and so we have five million watching it. Initially I was frustrated that not all of my ideas and principles came across. Then I think, “Well, you know what? If 70 percent of your ideas came across to that many people, that's better than 100 percent to 50 people.”

Chris: That's right, absolutely. TV is that kind of medium. We're not talking about a book here. We're talking about a primetime TV, show so you have to customize accordingly, and I think you did a great job, from the episodes that I've seen.

Dr. Chatterjee: Thank you.

Dr. Chatterjee’s new book, How to Make Disease Disappear, and the 4 Pillar Plan

Chris: Speaking of books, let's talk a little bit about your new book, How to Make Disease Disappear. It's actually available in the US now. It was published in the UK as the 4 Pillar Plan, I believe, right?

Dr. Chatterjee: Yes, absolutely.

Chris: At the beginning of the show I mentioned that you and I not only share a passion for reinventing healthcare; we also share a similar perspective on the most important way to do that, and in your book you talk about these four pillars, and they are actually identical to the four pillars that I mentioned in my 14Four online program. Tell us what they are and why you think they're so important for turning our health around.

Dr. Chatterjee: I'm just going to just back up a little bit just to say that on the two series of Doctor in the House I've done so far, I treated a wide variety of different conditions, whether it was type 2 diabetes, whether it was panic attacks and anxiety, whether it was insomnia, whether it was fibromyalgia, chronic back pain, irritable bowel syndrome, cluster headaches, all kinds of different things. And as I reflected, I thought, 80 percent of what I have done with every single family, no matter what their label is, no matter what we call that disease, 80 percent of it in its core was the same. I've been on an evolution of the past years, as I'm sure you have, Chris, as you've got more and more into this area that I love, doing all the fancy testing, and I love finding that little pathway that's not working and giving supplements as much as anyone.

But we often forget the low-hanging fruits and those four key areas of health which I call relaxation, food, movement, and sleep. When we make small changes in each of those four areas, it completely changes our biology in such a powerful way that many people don't realize. We’re always jumping for what's there, you know—what’s that something that we need? What is that test that I need? And more and more, Chris, I'm realizing that actually these four areas for me are the core pillars of health, and we would get so far off the way there with many of us if we just start applying these principles. Food and movement, of course, everyone has been talking about for years, but I think relaxation, which is the whole stress piece, and sleep is very much undervalued. This book came out in January in the UK and is doing incredibly well, and I think the reason it says press is because I've taken the pressure off people. I have said that there are four pillars, there are four core areas to this book, 25 percent of the book is literally on each of those pillars, and in each pillar there are five chapters, and each chapter is a suggestion. That was not prescription, it's a suggestion. That means there's 20 possible suggestions that you can do from the entire book. Now, I don't think anyone's going to manage 20 in the modern world. I think it’s going to be incredibly challenging, but say, “You don’t have to do 20.” Most of my patients tend to need to do about three in each, but I don't know for that individual, in the concepts of their life, in the concepts of their job, how many they will need to do. Some might get away with less, but the whole point of this book is about saying, “Look, you don’t need to be perfect in one area. You don’t need the perfect diet. If your diet is good enough, you're going to get more benefit from shifting over to another pillar and going to be bed one hour earlier or actually switching off for 20 minutes each day and do a bit of meditation.”

I've got many patients, Chris, who come to see me who actually, they have read a lot of blogs and their diet is pretty good by the time they come to see me. And I tell you, I had this type 2 diabetic patient recently, his diet was frankly outstanding. In fact, I would argue he was almost too aggressive with his carbohydrate intake, and he was stressing himself out because he could not get his blood sugars under control. And I remember seeing him and I said to him, “I don't think your diet is the issue here. I think the fact that you are chronically under stress and that you are a busy executive and you never have any downtime, I think these are the levers we need to turn to get your blood sugars under control.” And he was shocked because he thought it was all about carbs. He read it on the internet, he says, “No, no. I must be getting carbs from somewhere that I'm not realizing.” I said, “Look, honestly …” and I drew him this diagram—and I talk about this in the How to Make Disease Disappear book, I sort of go and say, “Look, if there are four possible things that could be playing a role and you have maxed out on your diet, if these other factors are driving your blood sugar now and you don't tackle them, it doesn't matter what you do with your diet since—” I won't get into the whole detail of the story, Chris, but essentially I got him to eat more carbs, but he started to prioritize relaxation, and I just traded with him. I made a deal with him, I said, “Just five minutes a day.” He said, “I can't do it.” I said, “Okay, what can you commit to?” And he came up with five minutes a day, we downloaded the Calm app, the meditation app in my clinic, and so he did that. He went for a 15-minute walk every day, and he had a relaxing practice before he went to bed. I'm not kidding you, Chris, but he came back maybe six or eight weeks later. He was eating more carbs and his blood sugar had come down back into the normal range.

I think even in the health sphere, a lot of us talk a lot about diets, and diet clearly is very important. I'm a huge advocate for changing one's diet, but it's not everything. I think we can over-obsess; we could hit a certain ceiling and forget those other big leaves that we could be turning. That's really where my approach comes from. The approach really comes from what I've learned from my patients both on the TV series, but also in 17 years of practice, which is anyone could go on a seven-day or ten-day diet and lose weight or feel better. The question is, can they still be following that in two months, in six months, and in 12 months?

The approach that I sort of lay out in my book is very simple. I think it's achievable for pretty much everyone, and I think it takes the pressure off people because I say quite clearly, “Look, I don’t expect you to get all of these things, and actually, if you read one of these chapters and you don’t like the suggestion I make, don’t do it. Choose one that does fit with your belief system and your lifestyle,” because there was a lot of crossover there and I think certainly for me, I think that's where the magic is here, which is that if you do about two in each, two sustainable ones in each, I think you're going to get really profound results.

And Chris, sometimes, I don’t know how you feel, but sometimes I feel very burnt out. We’re trying to go around the country and spread this message as far and wide as possible. A few weeks ago, I was really lucky. Jamie Oldman advised me to come out and have lunch with him to talk about can we really start to make an impact with the obesity epidemic in children. It was a great meeting. It went on quite a way. I'd been in London for two or three days, and I don't live in London. I was on the train back home in the evening. I was exhausted. I got over to the station, and my wife, I texted her, she replied that she’s asleep, the kids were asleep, so I asked the cab to stop in a supermarket and I thought to kind of nip in very quickly and buy some food. I walked in, and three people suddenly stopped and turned around, and the lady said, “Oh, my God.” I was like, “What’s happening?” And she said, “Oh, my God, doctor. We’ve just been talking about your book. I literally bought this book six weeks ago. I've been ill for ten years. I had to give up work with fibromyalgia, and I've spent all my savings on private treatment, and all I've done is apply the principles in your book, and I've never been this good. I've been to the gym four times this week, sleeping eight hours a night, I've got more energy.” And her husband came and gave me a big hug, and I thought, this is why I'm doing what I'm doing, is because just for that one moment alone, it was worth the months it took me to write the book. And there's many more moments like that.

But as you would’ve experienced, Chris, no doubt many times in your career that the point is that she hadn't taken any supplements. Again, I'm not saying supplements don’t have a value. If she was my patient, I may well have given her some things to support her mitochondria, but even that taught me that, wow, just by applying those lifestyle principles, the low-hanging fruit, actually, we can go a long way to where we need to, and that's really what I set out. I'm so proud it's coming out in America because your country's health outcomes, I think, are worse than ours.

Communication is the biggest skill for a healthcare professionals

Chris: Yes. We hold that distinction. We're ahead of the pack with far of that goes. We’re behind on many measures of healthcare safety and efficacy.

Dr. Chatterjee: There's a story I got, why I started the book. This is actually before I knew the in-depth Functional Medicine knowledge that I know now, Chris. I remember it was earlier on in my days as a GP. I was in a busy Monday afternoon surgery. I had three people waiting outside. This was years ago. I was trying to sort of catch up, and a 16-year-old boy comes in with his mother and ultimately, basically, there's a letter that he basically tried to harm himself on a Saturday and he ended up in the ER. He was discharged from the ER. They thought he was safe to be discharged, but there was a letter for him to come and see me on Monday and for me to start him on antidepressants. Now, I didn't know as much as I know today, but something intuitively did not feel right to me at all. I don’t know what's going on here. This family seems to be, with me, well balanced. I can't quite figure out what's been going on here. I spent a little bit of time talking, and I said, “Guys, look, can you guys come about tomorrow at the end of my morning surgery, and I'll spend a bit longer with you?” And they said, “Okay, fine.” I, of course, made sure he was safe to send home that night, and that's no sort of immediate issue.

He comes back the next day and the end of it, at the end of our sort of 20 to 25 minutes of chatting, I started to feel, could it be an issue with his use of social media? Because I was really worried how much he used it and what his feelings were like after he was using it. I said to him, “Look, I'm not sure that the way you're using social media is helping you. Would you be interested in me helping you to reduce that?” He said, “What do you think is going to help, doc?” I said, “Well, look, honestly, I don't know, but before we put you on these antidepressants, if you're interested, let me help you do this.” What we did, we said, can you one hour before bed switch off your smartphone? And he goes, “Do you think it’s going to help?” I said, “Look, why don’t we try it?”

He goes away and he does that for a week, and seven days later he comes back in—and just to be clear, this is within the realms of conventional ten-minute appointments. He comes back to see me,  and I said, “How are you feeling?” He said, “I started to feel great. I'm sleeping better. I'm less up and down through the day. Something has changed.” Now Chris, don’t get me wrong, the guy is still not doing very well at all, not to make a small improvement. But now I've got buy-in that there's something here he might be able to impact. Over the course of the next few weeks, we move it to two hours where he doesn’t go on his devices or his phone for two hours in the evening, and he's getting better and better. He’s still not great, but he’s improving each time.

And then I was reading some research about how our diets can influence our mental health, and so I asked him, “What are you eating?” And it was a classic teenager’s diet of sugary, processed junk food, a blood sugar roller coaster all day, and I explained to him, I drew him out a sort of picture and said, “Hey, don’t you realize actually, maybe two hours at your breakfast when your blood sugar is falling rapidly, that is a stress response to your body, and it's not just the blood sugar issue. It's not just that you need to eat a bit more for concentration that is impacting your cortisol levels, your adrenaline levels, and all your mood hormones.” He said, “Really?” I said, “Yeah. The foods you're eating I think are also impacting this.” And so, I drew him a picture and I said, “A few more healthy fats throughout the day …”

In the interest of time, I won't get into the whole case, Chris, but essentially, I helped him make some simple changes to his diet, not full-on perfection, just simple changes, and he started to improve, and I don’t see him for six months. I go into my surgery, and I got a letter waiting for me, and it’s basically his mother. It said, “Dear Dr. Chatterjee, I just want to thank you. You’ve completely changed Evan’s life. He’s like a different boy. He’s happy at school. He is interacting with his friends. He joins clubs at the weekends. I just want to thank you.”

But really, that case has taught me so much, that just simple lifestyle changes, when explained clearly, when explained in a way that actually resonates with the person in front of you, can have a profound impact. I'm not claiming this happens in every case, Chris, absolutely not. But that taught me a lot how … those simple things. And a lot of people say, “Yeah, a 16-year-old will never listen to you.” I disagree. If you connect with that person and actually, we’ve spoken about that, Chris, and something I'm very passionate about is that actually I think the biggest skill for a healthcare professional is actually not scientific knowledge, but can we connect to communicate with the person in front of us? Because I find every patient wants to be as healthy as they can. They don't want to be struggling. They don’t want to be on your waiting list or on my waiting list. Actually they want to be living their life. We assume, and certainly in my profession in the UK, we assume a lot of the patients don't do what we tell them today. I don't really buy into that. I just think if we can connect with them and we can it make achievable for them, they do want to make those changes. And that's essentially what I do in my book, Chris. I make these changes seem achievable for everybody, and I think that's why so many people are resonating with the message.

Small changes tend to make the biggest impact

Chris: And they are. I'm in exactly the same place as you, Rangan, because after many years of doing very … sometimes going down the Functional Medicine rabbit hole, which as you know, can take you pretty deep, I'm more convinced than ever, as you are, that in many cases the basics are what matter most. And I would also say, and this is very consistent with your book, that we often make the mistake of assuming that big problems require big interventions to make a difference. What I've found is actually it's a series of small changes that tends to make the biggest impact, instead of these hugely dramatic interventions. I think that's really the message with your book as well.

Dr. Chatterjee: And I think, Chris, we've all got … one thing I've recognized, we all got our own personal bias, because when I changed my diet, that's such a profound impact to the way I feel that I then was assuming that it all starts with food. That's that key intervention. Now I'm saying that isn't the case, but I've learnt, I see those four pillars as like, they all feed into each other in a circle. You can get on wherever you want, but it will all feed around. If you want to start with food, that is fine. I started with food, but I had a patient we see with a mental health problem who frankly was not interested in changing his diet, but I could persuade him to become more physically active and as we ramped up his physical activity, he then wanted to start eating better, which then had an impact on his sleep, etc., etc., etc., so I kind of learnt over the 17 years of seeing patients, just do not assume anything about your patients. They may not want to start what you want to start, and that really has helped me define that very simplistic … I think the structure of my book, Chris, is actually deceptively simple because the chapter titles are actually quite a simple intervention. I sort of walk people through the science, but then bring it back to say, actually, the lifestyle intervention at the end of all that science is relatively straightforward. I don’t think we realize … I've got this phrase I use quite a lot now, which is, “Consciously make changes to your lifestyle to unconsciously change your biology,” and that in a nutshell is the approach I take to these things.

Chris: Well, this has been fantastic. I'm so glad you could take time out of your busy schedule to join us, and as I mentioned, How to Make Disease Disappear is out today in the US. I definitely recommend checking it out. As I said, I believe that a series of these small changes, even for people who are, and this is a key point, who are really knowledgeable about this stuff … I mean, my patients are some of the most informed, knowledgeable patients that you're ever going to find. I mean, they are people who have been reading these books and following the blog post, and in many cases they're healthcare professionals themselves, and yet in my work with them I often find that the biggest difference comes from making some of these changes like implementing a digital detox or tech Sabbath one day a week, or starting a stress management practice, or incorporating more time for leisure and pleasure in their life. These things might seem insignificant compared to doing thousands of dollars of lab testing and treatment, but frankly, in many cases they end up making a bigger difference.

[Crosstalk]

Chris: Yes, exactly. How could that be more powerful than—

Dr. Chatterjee: ___ real medicine. This is fine. I know about that, but is this real medicine, that’s the nub of the matter.

Chris: Absolutely. I've been beating this drum for many months now. I think it's just really become even more clear to me, and it's one of the reasons we're launching a health coach training program. Actually, by the time this is out, enrollment will already be open for it because I so deeply believe that diet, lifestyle, and behavior change are the key, and the problem is that it sounds almost trite. We said that so many times, people are like, “Yeah, yeah. Tell me something I don't already know.” But we don't already know it because if we did, we’d be acting and behaving differently.

Even myself, I mean, this is something that I continually have to come back to. For example, whereas I am about the effects of technology and I do a pretty good job of limiting my use over the last several months, I'd started to slip, and so we drew a hard line in the sand, and we've gone back to Sunday as being absolutely completely technology-free. We just put our iPads and computers in a drawer. We don't interact with technology at all, and it's been absolutely transformative to go back to that, and now we're planning a vacation soon where we're going to have another experience where we've done every year where we're completely off the grid. No technology for eight or nine days, and I can tell you that that has as big of an impact on my health as just about anything else.

Dr. Chatterjee: Chris, just before we went live in February of this year, I've just been … the book came out in the UK in January, and obviously today it's out of the US, which is just fantastic, but I was burnt out from all the book promo, speaking to hundreds of people. I've been all around the country. You’ve experienced this before, Chris, the irony of promoting a health book is what you do to your own health once you're doing that. And we booked a very last-minute holiday to … we went to a place called Dubai, and I made a big deal of it on my Facebook and my Instagram. I said, “Guys, you will not be getting anything from any of my channels over the next nine or ten days.” Not only did I say that, I managed to do it. We got to the hotel, and I put my laptop and my phone in the safe, and they stayed there. I tell you, that holiday was probably the best holiday I've ever had because I don’t think we realize how much noise technology constantly, it just nags away at you and it just drains your mental energy day after day after day.

I love tech as much as the next guy. Like you, Chris, I go through an ebb and flow. Sometimes I slip into bad habits, and we all need constant reminders. I mean, just because we are sort of preaching this stuff, it doesn't mean we are perfect by any stretch of the imagination. It’s a constant challenge, and I think that collaboration with health coaches is absolutely the way forward, and I'm delighted to hear about that. But if you have not … some people might say, “I can't do a whole eight or nine days without tech.” Okay, fine. Try it on a Sunday morning. Try going to the park with your kids and don’t take your phone with you. It is a different experience. As soon as I come back, I feel like I've got a holiday just when I'm not on my phone for four hours. It’s just incredible.

Chris: Yes. We don't recognize how much it influences us until we get that break, and I definitely recommend starting tomorrow night. Like you said, don't start with nine days—that's probably going to be too difficult—but start with half a day and or even an hour and see what kind of impact it makes.

Dr. Chatterjee: I've always taken with myself … not always with myself, actually, I am sort of pretty strict with myself, and I’ve got myself into trouble sometimes trying to really stick to some really hard-core health regime. What I learnt what is sustainable are these small changes that are achievable because … let’s say, for example, one of the things I recommend—I talk a lot about strength training, as you do, Chris. It's very much undervalued, when we talk about movement and exercise, people often undervalue how important lean muscle mass is. A few years ago I was telling my patients, I was saying, “Hey, guys, once you go past 30, you can lose up to 5 percent of your muscle mass every 10 years. Your muscle mass is one of the biggest indicators of your health as you get older.” And so you got to join the gym and do some…” A few weeks later they come back, and I say, “How are you getting on?” “Oh, you know, doc, I can't manage it. It’s too far.”

I've always thought, okay, I'm giving advice that they are not able to follow. I never felt that actually, you know what? These guys are not doing what I'm telling them to do. I go, okay, clearly the advice I'm giving them doesn't resonate with them in the context of their life, so I came up with a saying in my book, and I actually did it on one of the shows in Doctor in the House, sort of five-minute kitchen workouts, which is basically a very simple bodyweight workout that anybody can do of any age. I've literally got patients in their 20s doing it, patients in their 70s doing it. You don't need any equipment and you can get a really good strength workout doing it. You don’t have to join the gym. You don’t need to get changed, and I've always looked at, how can I make these things practical for people? And what I found is when they say they don’t have time, then I say, “Well, can you give me five minutes twice a week?” “Yeah, of course I can.” You start off slow, and they do this five minutes twice a week. They start to feel the benefits, and before you know it, they're doing it six times a week.

I talked about this in the book. There’s a couple in their 60s who I taught the five-minute kitchen workout in my clinic room, and they thought I was mad, and they were a little bit skeptical. And they said, “Okay, doc, we'll give it a go here.” And they started it off, and they enjoyed it so much, when they came back to me see me four weeks later, they said, “Look, when we run our evening bath upstairs, on the landing we both do it for about seven minutes now, five nights a week.”

Chris: That’s great.

Dr. Chatterjee: Yes. It's incredible. Wow. Can we really make a difference? When you set the bar low, people achieve it, then they want to do more. If you set the bar too high, people don’t achieve it, they just give up. This approach, I think, is quite different from what I've seen five or six years ago. And like you, Chris, I listen to my patients, I learn from my patients, and this is the approach I think works for the vast majority of people.

Chris: That’s fundamentally a coaching approach. I mean, there's a concept in coaching called “shrink the change,” which means you take a big change you want to make, and you have to break it into smaller, more actionable steps, which is exactly what you did there. I mean, that's why I'm so excited about the coaching program because we assume that people, when they don't change, it's because they don't have enough information. We just need to give them more information, and then they'll change, but really, that's actually not the case. People don't change because they don't know how to change, and we as practitioners don't know how to support them in making that change. Just learning about how human beings actually do change and incorporating some of that into our work can make a huge difference.

Dr. Chatterjee: Yes, absolutely. Chris, before we go, I just want to say how much I respect the work that you have done over the past few years. I think very few people have done as much as you to raise awareness of ancestral approaches, Functional Medicine approaches, lifestyle medicine approaches, and yes, I just want to give a lot of gratitude to you. I think your blog is fantastic, and I'm very much in awe of the work that you’ve done.

Chris: Oh, thank you, Rangan, I appreciate that. Everybody, How to Make Disease Disappear is available today on Amazon and elsewhere. Do check it out. We'll put a link in the show notes to your YouTube channel, Rangan, where people can watch some of the episodes of the show. I think that would be a great thing for everybody to see, and I look forward to seeing you again next time when our paths cross, Rangan, and good luck with the book and everything else.

Dr. Chatterjee: Thanks, Chris. I’ll see you soon.

Chris: All right. Great.

The post RHR: Bringing Functional Medicine to the Masses – with Dr. Rangan Chatterjee appeared first on Chris Kresser.

Source: http://chriskresser.com May 01, 2018 at 06:03PM

[common-mushroom]

Aahhhhh I think a cute fic would between a farmer who's a trans boy with Harvey? They go to Harvey asking to get testosterone since their prescription ran out and ZuZu City is far away, making Harvey curious as to how a healthy boy would need it. After some explanation, Harvey seriously studies trans medical practices like HRS and talking to the farmer about what he should know and how to better cater to their needs since he's never had a transgender patient before??

This prompt is awesome!! Video games totally need more representation for trans people. This might actually be a good candidate for a full-length multi chapter fanfic in the future! Anyway here ya go:

Summer was a slow time of year for Harvey at the clinic. Although he needed the money from taking care of patients, he was more than okay with less of it knowing that the people of Pelican Town were healthy. This is why he was shocked to see the farmer appear at his door.

“He’s just doing a drop-in. Hope that’s okay with you, Harvey.” Maru called from the waiting room.

“No problem. Come in, MC.” 

The farmer came in. Harvey was still amazed at how far he’d come since he’d first came to the town only a month ago. MC was pale, skinny, and reeked of the city at the time of his arrival. Now, he had built muscle and acquired a healthy tan, and somehow permanently smelled like freshly-cut grass. Harvey wondered what the farmer was doing in his office at all.

“I’m sorry to drop by at the last minute. I wouldn’t be here if it wasn’t important. I just...I miscalculated how much I had left of my prescription. I thought I’d have enough to last me until I went back to visit my family in Zuzu City at the end of August, but it looks like I’m a bit short.” The farmer’s face, for some strange reason, flushed a dark pink. Harvey was curious.

“You would like me to refill your prescription?”

“I’d owe you so much. Please, Harvey. I’ll do anything. It’s just a real pain in the ass to go all the way to the city, you know?” The boy looked Harvey in the face with pleading eyes. Harvey’s heart leapt in his chest. He looked down at his paperwork awkwardly, lest his gaze accidentally linger too long. 

“Well, depending on the medication, we can usually just fill it right here in the office. But it’ll depend if we have it in stock,” Harvey sighed. “What is it you need?”

The farmer hesitated. Suddenly, a million thoughts began to race through Harvey’s head. Did the farmer have a terminal illness? Was he in trouble? What could be so embarrassing that MC, who was always friendly and loud, suddenly clams up?

“Testosterone injections.”

Harvey’s pen froze mid-word. Testosterone? He looked up from his paper, slowly. He gave the farmer a once-over. What in the hell would he need that for? The farmer handed him a nearly-empty bottle with his name inscribed on the tag.  

Harvey realized that his silence could be taken for hostility, and he shook his head quickly.

“Sorry. You caught me a bit off-guard there. Testosterone, no problem. We’ve got that.” He blushed and wrote out the prescription. “What’s your normal dosage?”

“300 milligrams.”

Harvey continued to write, struggling not to look at the farmer again. The last thing he wanted was to embarrass the boy. 

“Okay. We can have that ready for you in a couple of days. Is that fast enough for you?”

The farmer let out a sigh of relief.

“Yeah, definitely,” without warning, the farmer raced over to Harvey and gave him a tight hug. Harvey’s heart dropped into his stomach. “Thank you so much, Doctor. You have no idea how much this means to me.”

“Oh! No problem, MC. That’s what I’m here for.”

The farmer pulled away and looked Harvey in the eye. 

“This is probably going to come as a shock to you, but...I’m actually transgender. I need those hormones so my body functions the way I want it to. That’s why this is so important to me.”

Harvey paled. Transgender?

“Oh. I’ve never met a transgender person before.” He said, lamely.

“Well, now you have,” MC smiled stiffly. “Thanks, Doctor.” The farmer waved and left the room, giving him a skeptical glance over the shoulder before closing the door.

Harvey slumped down into his seat. MC was born...wow. He couldn’t believe it. But...he looked so...masculine. Harvey quickly booted up his dinosaur computer. It was time to do some more research.

A few days later, the boy was back in Harvey’s office. Harvey prayed that he wouldn’t bring up the awkwardness at the end of their last interaction. He hung his head in shame.

“Hi, Harvey,” the farmer sat down in the chair across from the doctor’s desk. “I just wanted to say thanks again for helping me out.” Harvey smiled and handed the boy his prescription. 

“No problem, MC. I actually wanted to talk to you, if you have the time.” Harvey blushed and stared at his hands. 

“What’s up?”

“I wanted to apologize for the other day. It was completely unprofessional for me to be so reactive.” The farmer chuckled nervously.

“I’m pretty used to it. I know you probably didn’t mean it in a transphobic kind of way.” Harvey’s eyes widened.

“Oh, God, no! I hope it didn’t come off that way. I just...I’ve never had a transgender patient before. I didn’t quite know what to say. I’ve read about it in the past but I’ve never practiced care for it before.”

The farmer and Harvey made eye contact. Harvey smiled shyly.

“I’m sorry.”

“Don’t be.”

“Well, since you asked me for a favor, I wanted to ask you for one, too.” Harvey said. He raked a hand through his hair anxiously.

“What is it?” The farmer grinned.

“I’ve been practicing medicine for years, but I am still in the dark about...your situation,” Harvey gulped. “I want you to tell me everything you know about being transgender.” The farmer blushed and nodded.

“For that, I have all the time in the world.”

~~Hope you enjoyed! I don’t have a ton of knowledge about the medical side of trans issues but I tried my best to be accurate. If there’s anything I should fix let me know! This is just a lil sample :) 

[canaryatlaw]

well today was alright. I tried to go to bed a bit early last night and I woke up feeling slightly less exhausted so I suppose that’s good (I say as it’s 11:52 pm and I’m just starting this). Got up, got dressed, got on the train you know the drill. I was shadowing the newest attorney in court today, although shadowing might not be the right word since it was more like assisting, lol. he’s the only one who’s been hired after me so far, but he took the bar in February so he’s already sworn in (though more on swearing in later) and can actually step up in court, so I was basically just helping him manage cases and courtrooms and such. the call wasn’t too crazy, some days there will be like 3 of us staked out in different courtrooms updating our people about what case they’re up to so they can run from one to the next while we fill out the orders for them, lol, so this was relatively calm which was nice. We finished at about 11 and as I was heading back to the office for some reason I really wanted grilled cheese, and I figured I could take an early lunch if I stopped by the Starbucks in the pedway underneath the courthouse. there’s the grilled cheese place on that walk as well but they generally take a little longer to make them and I didn’t want to waste time so I just went to Starbucks and picked up one of their grilled cheeses since they’re doing that now (they’re pretty good!) and my latest drink pick, which has been a berry hibiscus refresher made with lemonade instead of water. I suppose it’s something other people have ordered because they didn’t even bat an eye when I said it. It wasn’t actually my idea, when we were at the airport Starbucks the other day I ordered a refresher and the person was like “do you want lemonade with that?” and I was like ?? sure??? I didn’t know that was an option??? lol, but it’s quite good so I’m satisfied with that. Got that and took the train back to the office. I found out the deposition was supposed to sit in on had got switched to a different lawyer (they do that a lot) and been moved to by phone, so I didn't have to observe anymore because a lot of the point of having people sit in on them is having them observe their demeanor and how they would come off to a jury, so doing that by phone is kinda pointless. I was fine with this because it meant I’d have more time to work on the project that’s due tomorrow and I didn't know if I could finish in time if a deposition took a while. So I went back to my office and started tackling that. the underlying legal process is complicated so I won’t really go into it, but basically their cases of under-insured motorists where the person at fault’s car insurance limit isn’t enough to fully compensate the injured person, so the injured person then goes to their own insurance company, which usually fights them every step of the way because insurance companies are garbage, so basically we were just filling out a form assessing the state of the cases, but that requires going through like 100 or so documents per case with details scattered throughout, so you had to read every line. thankfully they’re digital at least so I didn’t have to deal with piles of paperwork (one of the things I did not appreciate while working for the government). So I ended up doing that for pretty much the rest of the day, I finished around 4 or so but didn’t email them in yet because the lady who assigned the task just re-assigned some to another guy and I didn’t want to get assigned more, lol. I ended up talking to one of the boss guys (I don’t know who the hell is my actual boss, everyone’s kinda my boss at this point, except the assistants at least, but this was the boss guy who likes me a lot and was one of the ones who interviewed me) about the blog post I wrote about the mass tort situation effecting a Chicago suburb right now (if you’re curious google “sterigenics willowbrook” but I’ll warn ya, it’s not pretty) and he read it and then said he thought it was excellent and that he was gonna talk to one of the head head people (one of the people who have the last name that the firm is named for, there’s a few of them, 3 I think? brothers) so I was pleased to hear that because I somehow get super self-conscious about my writing all the time even when I know I’ve been doing this shit for my dad since I was 12 and could practically write this stuff in my sleep, I feel like I lose perspective and I think if it wasn’t too difficult for me it must not be that good, but that’s not what’s ended up being true. so that was nice at least. I had to sort and count the folders for court in the morning which was fine, then I headed home. I got off the train at the stop by Target to pick up the prescriptions I dropped off yesterday since I don’t really have the time for Target trips during the week, getting on and off the train tends to be more practical. got the meds, and on my walk back to the train I ran into one of the lawyers who works at the domestic violence legal clinic that I haven’t seen in a few months so that was cool, I told her that I passed the bar and was at least employed (not where I want to be, but it’s money, and with the job market right now being what it is makes it even harder to get a public interest job) so she was very happy to hear that which was nice. I really did love working for their office, I found the work so fulfilling and I honestly used it as a way to talk about my skills and experience during a lot of interviews when it came to things like communicating with clients in tough situations who need your help but also your compassion, and I mean there aren’t many other situations where it’s just a law student and the client up in court, you’re the only emotional support they’ve got there, and if something goes wrong as it sometimes did, it was up to you to fix it, and I honestly feel like I gained so much knowledge from working those cases, and while I’m sure many would find the work depressing I always found it incredibly fulfilling and I was always itching to get back to working there when there was a new year or semester. but yeah, that was nice. I took the train the rest of the way home and from there changed into comfy clothing and got some dinner, then set up to watch the good place after chatting with my roommate for a bit about this past weekend in NY, shows and such. the good place continues to be hilarious, I laughed out loud for a solid 10 seconds when Eleanor called jury duty a “pointless group activity” because I mean?? she ain’t wrong lol. so that’s always enjoyable. when that was over I switched over to Iron Fist because I guess I’m this invested in season 2 already I might as well finish it. it’s not bad?? definitely better than the first season, though that’s not saying much, but also just not quite reaching the level you would expect it to be at which is disappointing. I’m currently living for Colleen and Misty teaming up and kicking ass, so as long as I get my awesome ladies I can deal with manboychild and his manboychild pain. After like an episode and a half (I had left off with half an episode left) I decided I wanted to do some kitchen organizing since I bought a lot of groceries this week in preparation for making more meals during the week, but since I wasn’t using anything right away I wanted to make sure it didn’t go bad, and I also accidentally got a 3 pound thing of ground turkey instead of a 1 lb thing (the perils of grocery shopping online) so I wanted to use my food scale to separate that into 1 lb portions, stick them in ziplock freezer bags and freeze them. so I did that, then I wanted to do the same with the frozen chicken I had bought (one bag of chicken breasts and one bag of chicken thighs because I’m trying to shake it up a bit) so I measured those out to roughly 1 lb portions which worked out pretty well, I had a bit left over from each bag that put together made about 1 lb, so I can figure out some way to use that. But yeah, did that, then went on my computer for a bit before getting ready for bed and here I am. oh, I said I was gonna take about swearing in. so I got the final all clear email today regarding the character and fitness committee thing for the bar that got dragged out way too long because the one person who still works at DCFS legal and could verify my employment there 1L summer was now on maternity leave, so I had to frantically message the woman who ran the family law center my first year (who now coincidentally works for the DV legal clinic) since she had knowledge of my internship and ask if she’d email her verifying it, which she very graciously did and I am eternally grateful, lol. but all of that to say that since that’s cleared I was able to pay the $50 licensing fee (leave it to Illinois to squeeze yet some more money out of you for the privilege of getting to practice law) and one of the bosses said today that as soon as we pay that we can go over to the appellate court and get sworn in, so that could happen like, next week??? there’s still like the formal ceremony and everything in the beginning of November that my parents are coming out for but this would just let me be able to practice until then so that’s like super exciting!! and scary haha but mostly exciting. okay, it’s 12:29 am, clearly time for me to go to bed so I will be doing that now. Goodnight dearies. Happy Friday.

[denisalvney]

RHR: Bringing Functional Medicine to the Masses – with Dr. Rangan Chatterjee

In this episode, we discuss:

Introduction and background of Dr. Rangan Chatterjee

WNL: We’re not looking

Raising public awareness of functional and progressive medicine through the mainstream media

The impact of the show Doctor in the House among colleagues and across the UK

Changing the expectation among medical professionals to a more collaborative care method

Chatterjee’s new book, How to Make Disease Disappear, and the 4 Pillar Plan

Communication is the biggest skill for healthcare professionals

Small changes tend to make the biggest impact

Show notes:

Rangan Chatterjee on YouTube

Prescribing Lifestyle Medicine Course

Chatterjee’s new book: How to Make Disease Disappear

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Chris Kresser: Rangan Chatterjee, it's such a pleasure to have you on the show. I'm really looking forward to this.

Dr. Rangan Chatterjee: Chris, the pleasure is mine. Thanks very much for inviting me.

Chris: We met when I came over to the UK last year, I think that was. It’s all such a blur.

Dr. Chatterjee: Yeah, someone said we need to speak, so we went out for a lovely dinner, actually.

Chris: Yes. I really enjoyed that. Mark Hyman introduced us via email before we came over and said, “Hey, you guys should know each other,” and he was definitely right. We hit it off immediately, in large part because we share not only a passion for reinventing healthcare and the future of medicine, but also a pretty similar perspective on how we should go about doing that. That's what I'd love to dive into today, and I want to start by talking maybe a little bit about just your background, how you came to Functional Medicine, and this perspective that we share on reinventing healthcare and medicine, and then I want to talk a little bit about your experience with the TV show, because here in the US we don't have access to it. And so while that's a pretty well-known show and people have had a lot of exposure to it in the UK, some of my US listeners might not be as familiar with what's going on. I think it's a really interesting portal to how Functional Medicine can get a wider adoption and exposure.

Introduction and background of Dr. Rangan Chatterjee

Dr. Chatterjee: Yes. Well, Chris, first of all, just a bit of background and a sense of my journey and how I've got to where I am today in terms of my perspective. I've been seeing patients now as a medical doctor for almost pretty much 17 years, actually, and my career has gone through various evolutions during that time, because the reality is, you leave medical school and you think that you have been given all the tools that you need to get your patients better. That's ultimately why you end up at medical school, is to how to do that way, and it's not so obvious, but when I reflect back on my career, I think there was a discontentment in the way that I'd been taught to practice medicine. It was probably there right from the start, so I don't think I quite realized it because I start off in the acute medical setting, so I was training in hospitals dealing with a lot of emergencies. I remember running the cardiac arrest team for the hospital for a period of time and doing all the things that you think modern medicine is with the defib and all that kind of crazy stuff which you see on television. As a young guy in their 20s, I think, “This is medicine,” right?

The biggest skill for a healthcare professional may not actually be scientific knowledge, but how they connect and communicate with the person in front of them. Every patient wants to be as healthy as they can. They don't want to struggle. They want to live their life!

Chris: Right.

Dr. Chatterjee: I went through my training, I was going to be a specialist, so I got my exams. Certainly in the UK, we call it the MRCP, Member of the Royal College of Physicians, a very tough set of exams to certify in internal medicine, and I was planning to do nephrology, or kidney medicine. I just started to get a little bit frustrated, month on month, sort of year on year, I was getting a little bit frustrated. It's the sort of thing that I don’t really want to spend the rest of my career just seeing kidneys and kidney problems. I thought that I'm going to move to general practice. To put this in perspective, I come from a medical family, and my dad was a consultant in genitourinary medicine. I think he was a bit flabbergasted that his son was going to leave the hallowed turf of being a specialist to become a generalist. But I really had this calling from inside me saying, “Look, I want to see everything. I want to see how everything interacts with everything else.” That's why I moved to general practice. I did my exams, and then I started working and I loved it, but a few years in, I honestly sat back at the end of the day and I thought, “How many people have I really helped today?” I came up with a figure, 20 percent. I thought, 82 percent of the people that had come in, I wasn't convinced I'd actually done that much for them. Sure I may have given them a prescription, a pill to suppress their symptoms, but I really didn't feel that I had actually helped them understand what was going on. I don't think I knew what was going on in terms of what was driving their ailments. I think the difficulty is, Chris, I'm sure you’ve heard this before from people, it's very hard to know what to do with that. You know, all your training, your whole career, everything is shaped around the system the way it currently is. And then for me, as many people have an experience with illness either in themselves or with a family member, that really changes everything. For me it was when my son, who is now seven years old, but he was six months old at the time … My wife and I, we went on holiday, it was just past Christmas, it was around 27th of December. I remember it so clearly. We went to Chamonix in France for a holiday, and my son stopped moving. His arms went back. He had a convulsion, and really I panicked because I thought he might be choking. My wife had called out to me and I knew that he had a lot of mucus and phlegm throughout the day. I tried to turn him over and slap him on the back and clear his airway and nothing was happening. The truth is, in that moment, I wasn't a highly qualified medical doctor, I was a worried father.

Chris: Absolutely. It must have been terrifying.

Dr. Chatterjee: Even now I think back to it, and it was horrible. It really was horrible, and my wife said, “Come on, we've got to go now. We got to get to hospital.” And we rushed into the car. I nearly killed us all. It’s just snowed there and we went on a steep road down to the main roads and the car skidded, but ultimately we got to a hospital, and many of your listeners might be familiar that a six-month-old having a convulsion is not that uncommon if there is a fever there. It’s what we here call a febrile convulsion, but he didn't have a fever. His temperature was absolutely normal, and you could see the admitting doctors and nurses were incredibly worried because, “Why has this boy stopped moving? Why is he having a convulsion without a fever?” We were in a small hospital. He had to be blue-lighted in an ambulance down to the main hospital, down the valley through the mountains.

A few hours later, some of the preliminary blood started coming back. Now in this time frame, he already had two lumbar punctures. We are a health-conscious family. My wife had breastfed for six months as this sort of public health guidance. We’re pretty switched on, we thought, with respect to our health, and then the blood results come back, and the doctor said he's had a seizure because his calcium levels were too low in his body. He had a hypocalcemic convulsion. To put it in perspective, the normal range for serum calcium in that hospital is the same as in the UK, which is 2.2 to 2.6. His calcium level was 0.97, frankly, barely compatible with actually life, in many ways. Everyone was scratching their head—why has he got such a low calcium level? What's been going on there? And then again, you had to wait a bit later on, because in this time frame, initially we thought he might have meningitis. The doctors were very worried, and we were panicked, in a foreign hospital trying to figure out what the hell was going on, and it turns out that his vitamin D level was almost nonexistent.

To cut a long story short, ultimately a fully preventable vitamin D deficiency caused him to have a low calcium level in his blood, which caused him to have a convulsion. That was incredibly challenging to get my head around. I mean, of course, I was delighted that we found out what the problem was and that modern medicine saved his life. He had an intravenous calcium infusion, right? Great. Superb. You bring the calcium level back up into the normal range. That was fantastic, but nobody that taught me or told me what are the consequences of the fact that your son may have been deficient, or certainly suboptimal levels, of vitamin D potentially for the last six months, arguably in the utero as well.

What are the consequences of that? How can you go about potentially repairing some of those? My son had pretty bad eczema at that time and obviously we know now, I wish many doctors knew about then, that it's pretty clear that vitamin D is a critical nutrient immune system. Eczema is in some way dysfunction of the immune system. Could the two be linked? Of course they could be. For me, Chris, really what happened in that moment was, yes, I'd been frustrated, but in that moment, it was like, I, by conventional measures, am highly qualified, double-board certified medical doctor, yet my son nearly died from a preventable vitamin deficiency, and suddenly it was like a switch changing me. In that moment, I'm going to find out why this happened, how this happens, and I'm going to get my son back to full optimal health. I'm going to try as if nothing of this has ever happened. That was the challenge that I set to myself.

In the age of the internet, Chris, you can spend three, four hours a day researching, and that's exactly what I did. Week after week, month after month, year after year, the more I learned, the more I put into practice with him, the more I put into practice with my family and myself. I can see that the immense benefits for my son, I felt the benefits for myself, started applying the same principles with my patients, I was like, this is the sort of medicine I wish I'd learned in medical school. Understanding root causes of ill health. I'm figuring out how you can help people, not only improve their symptoms, but certainly, in many cases, reverse that illness, and it’s just transformed my career, Chris. It has transformed the way I look at health. It has, in many ways, shaped what I've done in the media for the past four or five years. I reflect back and think, had this not happened to my son, would I be doing what I'm doing? I don't know. I can't answer that. Potentially I would have found—maybe the frustration would have gotten the better of me in another way, but this really forced my hand. I'm pleased to say that my son is a thriving, healthy, eczema-free seven-year-old boy who I think is incredibly well and arguably healthier than many kids around him who maybe have not had this problem. It’s a slightly long-winded story, Chris, but that in a nutshell is why I do what I do.

Chris: It's so great. It got very real and very personal for you in a way that it did for me, a slightly different way, but that's what, really, I think at the end of the day, almost everybody who's doing this work that we talk about, Mark Hyman and many of us thought leaders and influencers, have a similar story because when it affects you personally or a family member personally, there's just no other motivation that's quite as urgent.

Dr. Chatterjee: Yes, absolutely, but Chris, we need to … we started talking months before … at the moment I find that the people who are trying to adopt this approach to chronic disease, the thought leaders, but all the thousands of practitioners around the world who are also trying to do this, pretty much all of them behind that have got a personal story. I get that because I'm one of those, but we need to move beyond that. We need to move like what you're doing with the Kresser Institute. We need this education to be that—all healthcare professionals, basically, not just those who have had a personal experience.

WNL: We’re not looking

Chris: Absolutely, yes. Your story with your son is really, I think, revealing because it points to this principle of “we're not looking,” or that's my version of WNL. In medicine we think of WNL as “within normal limits,” if you do a lab test and it’s within the normal limits. But I have another way of looking at WNL, which is “we’re not looking.” Your story with your son, like the vitamin D thing, was easy to detect and easy to correct, but it wasn't part of the standard thought process of what you should be looking for early on in his life. I had a patient last week in her late 70s who came in, and she had some of the typical complaints you might expect of someone of that age. She had kind of a mild tremor. She was having some cognitive decline and brain fog, difficulty concentrating, and her GP had just written it off as, “You're getting older. And you're in your late 70s. What do you expect? This is standard.” And yet when we tested, did a full comprehensive blood panel on her, we found out that she had very severe B12 and folate deficiency and very high homocysteine, and she had again a very easily correctable, at least if it had been detected in time, nutrient deficiency that was misdiagnosed as dementia and early mild Parkinson's. There's really no excuse for missing and not correcting that, and yet we're not looking.

Dr. Chatterjee: Absolutely, Chris, and I'm sure you've got countless more stories like that from seeing patients, as I have. One thing to add there with my son’s story as I'm sure many people listening might be thinking, “It’s so obvious, why wasn't he just giving his son vitamin D from birth?” I think it's a reasonable question because the guidelines in this country actually do state that you should be doing that. The problem is, nobody knows those guidelines.

Chris: Yes.

Dr. Chatterjee: And they're not being followed. As the same with all my patients, I didn’t know that. But I tell you this, I have replayed this over in my head so many times, three weeks before we got on that plane at the start of December, so son's maybe 5 to 5 1/2 months old. I had been coming across a bit more research on vitamin D, and we had a protocol in our surgery in a different sort of part of the UK where I would start to prescribe a lot of vitamin D to certain patients. I started to think, “I think my son should be on this.” Now it's drilled into us in the UK by the GMC, the General Medical Council, that we should not be making those kind of decisions on our own family. It is very much frowned upon here to do anything treatment-wise for your own family. I did what I thought I should do back then, and so I crossed off the protocol and I phoned my wife up and I said to her, “Hey, babe, can you just go make an appointment to the GP? Just go and ask him what he thinks about this. I think that our son should probably be on vitamin D.” And so she prints it off, she goes to see a doctor, and the doctor knows that I'm also a fellow healthcare professional, and he laughed at her and he said, “Look, this is just complete rubbish. You could have just printed this off yourself and typed it up on Word and given it to me. Look, you're breastfeeding; you're doing a great thing. There's nothing more you need to give your son.” And she was a bit upset with the way it went down because I didn't think he was compassionate, and when she reported this back to me, I thought, “Okay, fine. All right, let me do a bit more research. Let me look into this. I’ll figure it out,” not realizing the urgency of the situation. I often think back, could I, should I just put my foot down then, and it’s not a nice emotion as a dad when you get these things. Having said that, Chris, he could well have been deficient for months prior to that.

Chris: Absolutely.

Dr. Chatterjee: And arguably, have I supplemented then, supplementing just before this happens with a very low dose, let’s say, 400 IU of vitamin D or something like that or 800, arguably, it may not change anything, or it could have gone undetected for a lot longer. At least this way, and again, I wish this had never happened, certainly for my son’s sake, but by having it happen with that sort of magnitude, I was forced to confront some very difficult questions and uncomfortable realities, and I felt compelled to fix them. I do kind of believe that things happen for a reason. Maybe as humans we have to believe that in order to get through, but I had a lot of guilt for a number of years. That actually drove me to learn more and help as many people as possible, but I know you're a father as well, Chris. I'm learning now to let go of that guilt.

Chris: Yes. I mean, we can always second guess ourselves, and there's so many situations like that that I can think of myself with my daughter, things I wish I would have done differently. But I think this is more what you were saying before—it's about getting this knowledge and these guidelines and this understanding out on a wider scale because it is true. There's a saying that a doctor who treats himself has a fool for a patient, and you could possibly extend that to family members, because sometimes we're too close to really be able to tell. But what if there had been guidelines that not only should babies be tested, but pregnant women should be tested for their vitamin D levels because guess where kids are supposed to get it? From breast milk, and if a woman is deficient in pregnancy, then her breast milk is not going to be a sufficient source of it, and I always test my pregnant women patients for that now, but that's not something that's really widespread now, at least in our in this country. I don’t know how it is in the UK.

Dr. Chatterjee: One of the biggest frustrations for me about the way medicine currently operates—I should say conventional or allopathic medicine, whatever you want to call it—it's very much a black-or-white situation. You've either got an abnormal result or it's normal.

Chris: Right.

Dr. Chatterjee: There has been no or very little recognition as optimal, and there is this huge gray area in between overtly abnormal and disease and deficiency versus what is an optimal level for this human being to be functioning as well as they can. A little bit like Dale Bredesen, a professor, who is sort of showing how in some cases you can reverse cognitive decline, certainly in early cases of Alzheimer’s disease. He's managed to demonstrate that, but I love his approach, which is you've got to treat that person like a Formula One car. You’ve got to optimize every single parameter that you can. I love that because that really isn't how we do things here, certainly the UK, and I know it's the same in the US. Even if you talk about blood sugar, you talk about a common condition, type 2 diabetes, we’ve got slightly different ranges from you guys, so an HbA1c, the average blood sugar marker, is 6.5 and above, and in this country is, I think the same as you, is a diagnosis of type 2 diabetes. Our prediabetic range starts at 6, so 6 to 6.4 is what we call prediabetic, whereas with you guys, it's 5.7.

Chris: It’s a little lower, yes.

Dr. Chatterjee: A little lower, and you know these are just arbitrary figures that we could argue about all the day. One of the practices I would tap recently, patients who come in and get their blood sugar checked, if it comes back at 5.9, I know doctors who are still reporting that as normal. What's happening is that patient phones at reception to say, “Hey, you know what, my bloods are okay.” The receptionist will report back saying, “Yes, doc said absolutely normal, nothing to worry about.” That patient then who has come, maybe they come in for a medical or for a checkup just to see where does their health look like at the moment, in that opportunity we are reporting an HbA1c of 5.9 as normal, which is madness. I just don’t know how we got so far off track in medicine where we can call that a normal blood sugar.

Chris: Right. Just because it hasn't reached the arbitrary … as if something magical happens when it goes one-tenth of a point higher, then all of a sudden you have diabetes, whereas it was perfectly normal before that.

Dr. Chatterjee: Yes. And even if all we did in conventional medicine, even if we did not adopt a full kind of Functional Medicine approach, is if we simply recognize that as an optimal range, and then there’s a deficiency range, and we should be striving to get our patients in those optimal ranges—just to say, with blood sugar, for example, we could start maybe once the HbA1c is 5.2 or 5.3, start to get people back in and say, “Hey, look, you're not prediabetic yet. You don’t have type 2 diabetes yet, but actually your blood sugar is not as good as it could be. Can I show you some things that we can do to help optimize that?” So many members of the public would welcome that, and they’ll go, “I didn’t realize it. Yes. Tell me what I can do.” Rather than waiting until it has crossed that 6.5 to 6.6 type 2 diabetes threshold, when yes, sure you can still turn it around sometimes, but it’s going to be suboptimal to be getting involved then.

Raising public awareness of functional and progressive medicine through  mainstream media

Chris: Absolutely. Speaking of this, we're talking about raising awareness of Functional Medicine and preventative medicine and what you call progressive medicine. I think arguably you've had a bigger impact in terms of raising the public awareness of these concepts than just about anybody else because you've been doing a mainstream TV show about Functional Medicine in the UK for the last several years. I mean, we don't have anything like that still here in the US, and I've really enjoyed following that and hearing more about the impact, and I think our listeners here would love to hear a little bit more about your experience with that show, how it got started, and then what kind of impact you feel like that's had.

Dr. Chatterjee: Yes, Chris, thanks for asking me. That really has been … I'm incredibly fortunate and lucky to have the experience that I've had, and I’ll explain to you why I say that. I think the first thing to say is I never got approached to do that show because of my approach to medicine. I think it was just quite fatuousness, how it all happened. I was on my journey of learning. I was going out to America at regular med schools. I was going through all these Functional Medicine conferences, and I was literally just sucking up knowledge. One conference had finished, and I couldn't wait to book on to the next one and buy my flight and come straight back to learn more. It’s a story with many people who once they got their head gets switched on to this way of thinking … but what happened while I was doing or was training, I'm still in my sort of conventional practice, and the practice manager sent out a group email to all their MDs in the practice saying the BBC are looking for a new doctor. They've got a new concept called Doctor in the House, which is what happens when you have more than 10 minutes with your patients. I remember seeing the email and thinking, “If you have more than 10 minutes, then you could do so much.” I had no ambition, Chris, to be a TV doctor. In fact, I can't stand that term. You're no longer a doctor, you're a “TV doctor,” and I prefer a “doctor who also is on TV,” but that’s a minor point.

I phoned up the number thinking, what’s this about? Anyway, I ended up having like a 40-minute interview with the studio, and that turned into three months of basically interviews and tests. They’d film me with families, and they take you around an empty house and say what kind of things would you be looking for, what sort of clues would you be picking up, and it …  what’s interesting to me is I didn’t prepare for a single one of those interviews, around eight of them over three months, because I wasn't really desperate to be on television. I just thought, if these guys like me who I am, great. If they don't, fine, get someone else who might want to say … what the right things to say in order to get on television. So I just went and did my thing. Three months later, I heard they went for about 1,500 doctors, and somehow I get picked to make the series. Just to make one show actually, but the show went so well that they made a decision for me to do a whole series, and that was a big decision for me because I thought, “Wow. This is a lot of exposure.” BBC is our main channel that gets the biggest viewing, and it is a primetime show. And I thought, “Wow, this is a lot of exposure.” But I thought, what an opportunity here to see … can I get various conditions, various families who've been struggling with their health for years, who’ve already been under GPs, specialists, other healthcare professionals and they still can't get better, can I get these guys better on television? I didn't know what it would entail at the time. Like all the things, you just you jump in the deep end and you kind of sink or swim.

Chris: Right.

Dr. Chatterjee: If I'm honest, Chris, to actually go into families' houses and spend all this time with them, you get to … for example, we talk about nutrition. This is not what people tell you they eat in your surgery, in your practice. You're actually watching what they do eat, what they got in their fridge, what they got in their cupboards. When they're snacking, what are they snacking on? Because everyone filters in front of their healthcare professional. People tend to have a little filter in terms of what do you eat on a typical day. Are they going to tell you, Chris, what they eat on their best day, when they follow the principles in your book? Or when it’s Christmas holidays and they're actually feeling emotionally vulnerable and that's what they're eating then? I got to see the few hours before bed what the family dynamic is like, what are those interactions. Those sorts of things actually would never probably come up in my surgery. And not only would they not come up, even if I asked about them, I suspect that they just wouldn't come up in the same way. I was just seeing all kinds of things. I thought, “Wow, these are all playing a role in that person's health.” And now that I can see that, I can actually potentially influence those things in a different way, and what's interesting to me, Chris, is that a typical Functional Medicine doctor will probably have a lot longer than some 10 or 15 minutes. You may have an hour or 45 minutes or an hour and a half with the patient, and we all want more time. I potentially got too much time because the other problem I had, Chris, is that when you know absolutely everything and you see it all, it's almost too much information because you can then literally … you don’t have the security of your surgery and your consultation room walls. You're seeing people in their own setting. You feel quite exposed, actually, so it was an incredible experience, the results I managed to demonstrate for those families, but also in front of five million UK viewers a week, and probably the proudest results of my career because I had some of my most difficult cases on that show. As my best friend, who is not a doctor tells me, he’s like, “You've got five million people watching you do your job.” I'm like, “Yeah.” He told me this a few weeks before the show came out. ... I was pretty nervous anyway, but now ...

Chris: Thanks a lot.

Dr. Chatterjee: We can dive into a bit of the detail, but essentially I got to see different sides of people from what I see in my consultation, and that has changed me, not only what I did on the series, but I'm a different doctor now than before I filmed the TV show.

Chris: Yes. For the folks who are listening, although you can't yet watch the full series, I think there are quite a few YouTube clips of the show.

Dr. Chatterjee: I found that there is quite a few on YouTube, and I put them all together on my YouTube channel so people can watch at least eight of those episodes free of charge on the internet.

Chris: Oh, cool. Yes. Yeah. I really recommend doing that. It's really great to see these concepts on primetime television going out to people who are totally unfamiliar with them. I'm just curious—there are so many things we could talk about related to that show, but I'm mostly curious in this context—what was the feedback that you received from professional colleagues and also just from the general public in terms of being exposed to these concepts? What kind of impact do you think it's had in the UK, and how has it changed the conversation?

The impact of the show Doctor in the House among colleagues and across the UK

Dr. Chatterjee: Yes, Chris. Look, I think it's had a huge impact. I mean I get invited by the NHS to come and talk about how we implement the strategies, the things that they saw on television. How do we get that into the National Health Service and make that widespread? Clearly, having a doctor in your house for four to six weeks is not a rational or actionable national strategy. It’s a reverse from the chronic disease trajectory, but what can we learn from that human emotion as we focus on the negatives? If I get 99 with the collaborative and inspirational plus the feedback, and then one in a hundred sort of say, “What was that you were doing? There’s no evidence behind that,” etc., your mind tends to focus on that one person. Although I had learnt over the last years to get a lot better at that, but generally the responses have been very, very good.

It's the first series to actually demonstrate on a primetime show that type 2 diabetes was a reversible condition and something that can be done in some cases, well, I'm not saying it has to be, within 30 days is really quite remarkable. I think that was very much ahead of its time because now, NICE, the National Institute for Health and Clinical Excellence in the UK is now accepting that we can code in people's SNPs that type 2 diabetes can be put into remission, but it was very, very controversial for years here. When my show came out, it was the third episode in the first series, where I helped a lady reverse her type 2 diabetes in 30 days. The BDA, the British Dietetic Association, released the statements about criticizing the care that was given, and there are very alarmist statements advising people not to adopt the strategies they saw and go discuss with the doctor. That was a hugely … it was quite a challenging time for me because I didn't do this to fight with people. I'm not interested in having fights with other people. I think I've found a better way than I used to look out to people. I managed to show that on television, and I just want to get that message out to as many people as possible, to people that agree with me, fine, but I didn’t necessarily want to fight this. I found that quite hard, actually. The thing I found the hardest was, I would have preferred the BDA to say, “Look, that isn't the person we take. We recognize the fantastic results you’ve got. Can we get together and discuss? There’s something interesting there.” That approach wasn't taken because I wasn't sort of being down on dieticians; I wasn't criticizing other people's approaches or anything like that. I was simply going, “Okay, you’ve got this problem. I'm going to give you the best advice I can with all the experience and all the knowledge I have, and worst-case scenario is you're no better after four weeks. Best-case scenario, I've revolutionized your health.” That was the only really negativity I've got in the first series, was the dieticians.

But from so many medical doctors around the country, from nurses, from pharmacists, from nutritional therapists, from other dietitians, I got so much warm feedback saying, “Look, just incredible to see those results. We’d love to learn more.” I got so many emails from medical students, Chris, and this made me incredibly excited. A lot of medical students contact me saying, “Look, Dr. Chatterjee, I love what I saw there, but I'm in final year now of medical school. I'm not learning about this. How can I learn more? Because that was incredible!” I think it's been highly significant here. It’s changing the conversation here. I think a lot of people now are embracing lifestyle not only as a way of preventing getting ill, but also as a therapeutic tool to treat people when they are ill.

I recently lectured for the Royal College of GPs at a Wellbeing conference as to how can doctors look after their health, and this GP came up to me afterwards—and it really touched me—he said, “Look, I've just got to thank you.” I said, “What’s happening?” He said, “Look, the work that you’ve done, it set the stage for me to be able to do what I do. People give me a lot more credibility. I can now talk about these concepts in a way that I couldn't do four years ago because of the work you do. I just want to thank you.” It was great to me to hear that because yes, I'm doing it to help the public. I want to empower the public or as many people as possible to understand that actually, no matter what your health problem is, some simple changes to your lifestyle can have a profound impact. But it's also nice when other healthcare professionals or when other medical doctors say, “Look, I love that. I'm now using this approach with my patients and I'm getting great results. Thank you.”

And I think the culmination of that for me, Chris, was in January this year, where I sort of created with a colleague the first what's called Prescribing Lifestyle Medicine Course that the Royal College of GPs have credited. That's our main institution here. They have credited that course with seven CBD points, and we had nearly 200 doctors come in January and we have GPs, we had gastroenterologists, rheumatologists, oncologists all coming, learning from me and a colleague in terms of how you can apply these principles, and it was just incredible. The feedback is 95 percent of them have said they would highly recommend this course to their colleagues, 85 percent of them have already said this has significantly impacted the way that they are practicing medicine. We didn’t go the whole hog. We didn’t go in as much detail as you offer, Chris, in the Kresser Institute. This is trying to shift people from one to two rather than one to ten because I feel very passionate that … your training exists, that is very good training out there for that really detailed, in-depth look at reversing chronic disease, but I thought, “Okay, look, the public has bought into this. A lot of the profession has seen those results, but probably don’t have the time, energy, or inclination to go on and do this in depth, to dive into Functional Medicine. What are the core principles, and what can I actually teach them in one day to shift them from one to two or one to three?” The feedback has been incredible, so, Chris, what has been the impact? Well, I can tell you, four or five years ago, we weren’t having Royal College of General Practitioners-accredited courses in lifestyle medicine; in 2018 we now are. That gives me a lot of hope.

Changing the expectation among medical professionals to a more collaborative care method

Chris: Absolutely, and that's exactly the change we need to see. I think we all know when we're shifting our paradigm, we expect resistance, but almost by definition, if we don't get resistance, we're not doing our job. We're not really changing the conversation, and of course, we've seen similar things here. We're seeing a lot right now about how the dietetics organizations are fighting health coaches because they want to be the sole providers of nutritional information, and they're arguing that nobody other than a registered dietitian should be able to offer nutrition advice, which I personally think is just crazy. Unfortunately, this stuff, it's not just about logic and what’s the best direction from an evidence-based perspective. We have to deal with all the messy human stuff that comes along with it, and that's fine. We'll get there one way or the other.

Dr. Chatterjee: We will get there, Chris. You mentioned this about dietetics in the US. It was literally last week where a big story came out on the BBC website, a new radio documentary that they did, or was featured in talking about how doctors don't learn about nutrition at medical school or very much in this country, and my quotes were heavily featured in that BBC article. I haven’t read it. I didn't know it was out, actually. My friends texted me and said, “Hey, look, this is out.” I thought, “Wow, this is going to pick up a lot of noise.” There was quite a lot of what I call abuse … No, I won't quite call it abuse, but there was a lot of interaction on Twitter from dieticians. I said, “Look, we're not getting enough.” One of the ways I have tried to make a change here is with this Prescribing Lifestyle Medicine course, which is just a one-day masterclass to teach other healthcare professionals, in particular, medical doctors how they can start to apply these principles in their current system, and this is why there is no dietician teaching that.

I very respectfully interacted back, and I said, “Look, guys, I absolutely respect your expertise. We're teaching in a system, a framework, a new set of principles for people to apply. Everything that we taught was well within our expertise levels to teach.” And no one was responding to that. They just kept saying, “Dieticians are the only people who can give nutritional advice on medical problems. No, this is not serious because there's no dietician there.” And I thought, when you take a step back and you set the emotion out there, I find it remarkable. What I would expect some prefer is, “Hey, look, that is great. You're trying to make a difference here. I’ll tell you what, I've got some interesting things and I can answer that. Can we get together? Can I actually suggest what I'm up to add to that course?” I’d be very open to that. I don’t really understand the assumption that our course is no good when you haven’t attended it, whereas everyone who attended thought it was superb, and I thought that really just shows what we're finding out there, which is a lot of ego, frankly, which there's really no place for that in healthcare because ego is getting in the way of getting people better, and this is not just about one organization fighting with another. We've got a serious problem, Chris. Any disease you want, I mean, type 2 diabetes is one that often gets spoken about, in 2012, so that’s six years ago, we think that type 2 diabetes was costing the UK in direct and indirect costs £20 billion a year. What’s that, about $26 billion a year?

Chris: Incomprehensible.

Dr. Chatterjee: An obscene amount for a condition that by and large is an environmental illness. This is driven by our lifestyle and our environment.

Chris: That number is $250 billion in the US, by the way. This is the population differential.

Dr. Chatterjee: And instead of fighting in terms of who has got the authority to give the right advice, let's just be more collaborative and go, “Hey, look, that's great. That's working or this is working. What can we do together?” Because patients get incredibly frustrated, the public gets incredibly frustrated, because they don’t know who to trust, and I think like you, Chris, I've just decided to just focus on doing what I do. I normally stay out those fights on Twitter, and the reason I got involved last week was because I was really trying to extend a hand of collaboration. And I would go, “Look, this is great. Let’s get together. Let’s meet for the greater good.” And I've learned that Twitter is not the best environment to actually try and change people's opinion.

Chris: Yes.

Dr. Chatterjee: I think things are changing, that's for sure, Chris. There's no question here that things are changing and I can't comment on how impactful my show has been, but I get told by a lot people that the show has been game-changing here.

Chris: Yes. I've definitely heard from lots of people and when I was over there in the UK I heard from lots of people who were turned on to these concepts from watching your show, both professionals and consumers. I think that you have had a big impact.

Dr. Chatterjee: I would say to people who do, if you do provide the links to the shows and they watch them, just to say, look this was edited for a mainstream audience. I think some viewers who may watch it might go, well, what happened there or what testing was done, you got to remember that actually this was a 9 p.m. primetime slot, so a lot of the things I did got very simplified. The narrative got quite simplified, but it was definitely a true narrative. It was definitely not inaccurate, but I would have preferred a lot more detail. But Chris, I've also learned, being in the media, that there are two sides to this. The show that I would want to make with all the detail in there, with all the science, we’ve probably had a hundred people watch that show, whereas the TV studios know how to edit and show in a way that actually engages the viewer, and so we have five million watching it. Initially I was frustrated that not all of my ideas and principles came across. Then I think, “Well, you know what? If 70 percent of your ideas came across to that many people, that's better than 100 percent to 50 people.”

Chris: That's right, absolutely. TV is that kind of medium. We're not talking about a book here. We're talking about a primetime TV, show so you have to customize accordingly, and I think you did a great job, from the episodes that I've seen.

Dr. Chatterjee: Thank you.

Dr. Chatterjee’s new book, How to Make Disease Disappear, and the 4 Pillar Plan

Chris: Speaking of books, let's talk a little bit about your new book, How to Make Disease Disappear. It's actually available in the US now. It was published in the UK as the 4 Pillar Plan, I believe, right?

Dr. Chatterjee: Yes, absolutely.

Chris: At the beginning of the show I mentioned that you and I not only share a passion for reinventing healthcare; we also share a similar perspective on the most important way to do that, and in your book you talk about these four pillars, and they are actually identical to the four pillars that I mentioned in my 14Four online program. Tell us what they are and why you think they're so important for turning our health around.

Dr. Chatterjee: I'm just going to just back up a little bit just to say that on the two series of Doctor in the House I've done so far, I treated a wide variety of different conditions, whether it was type 2 diabetes, whether it was panic attacks and anxiety, whether it was insomnia, whether it was fibromyalgia, chronic back pain, irritable bowel syndrome, cluster headaches, all kinds of different things. And as I reflected, I thought, 80 percent of what I have done with every single family, no matter what their label is, no matter what we call that disease, 80 percent of it in its core was the same. I've been on an evolution of the past years, as I'm sure you have, Chris, as you've got more and more into this area that I love, doing all the fancy testing, and I love finding that little pathway that's not working and giving supplements as much as anyone.

But we often forget the low-hanging fruits and those four key areas of health which I call relaxation, food, movement, and sleep. When we make small changes in each of those four areas, it completely changes our biology in such a powerful way that many people don't realize. We’re always jumping for what's there, you know—what’s that something that we need? What is that test that I need? And more and more, Chris, I'm realizing that actually these four areas for me are the core pillars of health, and we would get so far off the way there with many of us if we just start applying these principles. Food and movement, of course, everyone has been talking about for years, but I think relaxation, which is the whole stress piece, and sleep is very much undervalued. This book came out in January in the UK and is doing incredibly well, and I think the reason it says press is because I've taken the pressure off people. I have said that there are four pillars, there are four core areas to this book, 25 percent of the book is literally on each of those pillars, and in each pillar there are five chapters, and each chapter is a suggestion. That was not prescription, it's a suggestion. That means there's 20 possible suggestions that you can do from the entire book. Now, I don't think anyone's going to manage 20 in the modern world. I think it’s going to be incredibly challenging, but say, “You don’t have to do 20.” Most of my patients tend to need to do about three in each, but I don't know for that individual, in the concepts of their life, in the concepts of their job, how many they will need to do. Some might get away with less, but the whole point of this book is about saying, “Look, you don’t need to be perfect in one area. You don’t need the perfect diet. If your diet is good enough, you're going to get more benefit from shifting over to another pillar and going to be bed one hour earlier or actually switching off for 20 minutes each day and do a bit of meditation.”

I've got many patients, Chris, who come to see me who actually, they have read a lot of blogs and their diet is pretty good by the time they come to see me. And I tell you, I had this type 2 diabetic patient recently, his diet was frankly outstanding. In fact, I would argue he was almost too aggressive with his carbohydrate intake, and he was stressing himself out because he could not get his blood sugars under control. And I remember seeing him and I said to him, “I don't think your diet is the issue here. I think the fact that you are chronically under stress and that you are a busy executive and you never have any downtime, I think these are the levers we need to turn to get your blood sugars under control.” And he was shocked because he thought it was all about carbs. He read it on the internet, he says, “No, no. I must be getting carbs from somewhere that I'm not realizing.” I said, “Look, honestly …” and I drew him this diagram—and I talk about this in the How to Make Disease Disappear book, I sort of go and say, “Look, if there are four possible things that could be playing a role and you have maxed out on your diet, if these other factors are driving your blood sugar now and you don't tackle them, it doesn't matter what you do with your diet since—” I won't get into the whole detail of the story, Chris, but essentially I got him to eat more carbs, but he started to prioritize relaxation, and I just traded with him. I made a deal with him, I said, “Just five minutes a day.” He said, “I can't do it.” I said, “Okay, what can you commit to?” And he came up with five minutes a day, we downloaded the Calm app, the meditation app in my clinic, and so he did that. He went for a 15-minute walk every day, and he had a relaxing practice before he went to bed. I'm not kidding you, Chris, but he came back maybe six or eight weeks later. He was eating more carbs and his blood sugar had come down back into the normal range.

I think even in the health sphere, a lot of us talk a lot about diets, and diet clearly is very important. I'm a huge advocate for changing one's diet, but it's not everything. I think we can over-obsess; we could hit a certain ceiling and forget those other big leaves that we could be turning. That's really where my approach comes from. The approach really comes from what I've learned from my patients both on the TV series, but also in 17 years of practice, which is anyone could go on a seven-day or ten-day diet and lose weight or feel better. The question is, can they still be following that in two months, in six months, and in 12 months?

The approach that I sort of lay out in my book is very simple. I think it's achievable for pretty much everyone, and I think it takes the pressure off people because I say quite clearly, “Look, I don’t expect you to get all of these things, and actually, if you read one of these chapters and you don’t like the suggestion I make, don’t do it. Choose one that does fit with your belief system and your lifestyle,” because there was a lot of crossover there and I think certainly for me, I think that's where the magic is here, which is that if you do about two in each, two sustainable ones in each, I think you're going to get really profound results.

And Chris, sometimes, I don’t know how you feel, but sometimes I feel very burnt out. We’re trying to go around the country and spread this message as far and wide as possible. A few weeks ago, I was really lucky. Jamie Oldman advised me to come out and have lunch with him to talk about can we really start to make an impact with the obesity epidemic in children. It was a great meeting. It went on quite a way. I'd been in London for two or three days, and I don't live in London. I was on the train back home in the evening. I was exhausted. I got over to the station, and my wife, I texted her, she replied that she’s asleep, the kids were asleep, so I asked the cab to stop in a supermarket and I thought to kind of nip in very quickly and buy some food. I walked in, and three people suddenly stopped and turned around, and the lady said, “Oh, my God.” I was like, “What’s happening?” And she said, “Oh, my God, doctor. We’ve just been talking about your book. I literally bought this book six weeks ago. I've been ill for ten years. I had to give up work with fibromyalgia, and I've spent all my savings on private treatment, and all I've done is apply the principles in your book, and I've never been this good. I've been to the gym four times this week, sleeping eight hours a night, I've got more energy.” And her husband came and gave me a big hug, and I thought, this is why I'm doing what I'm doing, is because just for that one moment alone, it was worth the months it took me to write the book. And there's many more moments like that.

But as you would’ve experienced, Chris, no doubt many times in your career that the point is that she hadn't taken any supplements. Again, I'm not saying supplements don’t have a value. If she was my patient, I may well have given her some things to support her mitochondria, but even that taught me that, wow, just by applying those lifestyle principles, the low-hanging fruit, actually, we can go a long way to where we need to, and that's really what I set out. I'm so proud it's coming out in America because your country's health outcomes, I think, are worse than ours.

Communication is the biggest skill for a healthcare professionals

Chris: Yes. We hold that distinction. We're ahead of the pack with far of that goes. We’re behind on many measures of healthcare safety and efficacy.

Dr. Chatterjee: There's a story I got, why I started the book. This is actually before I knew the in-depth Functional Medicine knowledge that I know now, Chris. I remember it was earlier on in my days as a GP. I was in a busy Monday afternoon surgery. I had three people waiting outside. This was years ago. I was trying to sort of catch up, and a 16-year-old boy comes in with his mother and ultimately, basically, there's a letter that he basically tried to harm himself on a Saturday and he ended up in the ER. He was discharged from the ER. They thought he was safe to be discharged, but there was a letter for him to come and see me on Monday and for me to start him on antidepressants. Now, I didn't know as much as I know today, but something intuitively did not feel right to me at all. I don’t know what's going on here. This family seems to be, with me, well balanced. I can't quite figure out what's been going on here. I spent a little bit of time talking, and I said, “Guys, look, can you guys come about tomorrow at the end of my morning surgery, and I'll spend a bit longer with you?” And they said, “Okay, fine.” I, of course, made sure he was safe to send home that night, and that's no sort of immediate issue.

He comes back the next day and the end of it, at the end of our sort of 20 to 25 minutes of chatting, I started to feel, could it be an issue with his use of social media? Because I was really worried how much he used it and what his feelings were like after he was using it. I said to him, “Look, I'm not sure that the way you're using social media is helping you. Would you be interested in me helping you to reduce that?” He said, “What do you think is going to help, doc?” I said, “Well, look, honestly, I don't know, but before we put you on these antidepressants, if you're interested, let me help you do this.” What we did, we said, can you one hour before bed switch off your smartphone? And he goes, “Do you think it’s going to help?” I said, “Look, why don’t we try it?”

He goes away and he does that for a week, and seven days later he comes back in—and just to be clear, this is within the realms of conventional ten-minute appointments. He comes back to see me,  and I said, “How are you feeling?” He said, “I started to feel great. I'm sleeping better. I'm less up and down through the day. Something has changed.” Now Chris, don’t get me wrong, the guy is still not doing very well at all, not to make a small improvement. But now I've got buy-in that there's something here he might be able to impact. Over the course of the next few weeks, we move it to two hours where he doesn’t go on his devices or his phone for two hours in the evening, and he's getting better and better. He’s still not great, but he’s improving each time.

And then I was reading some research about how our diets can influence our mental health, and so I asked him, “What are you eating?” And it was a classic teenager’s diet of sugary, processed junk food, a blood sugar roller coaster all day, and I explained to him, I drew him out a sort of picture and said, “Hey, don’t you realize actually, maybe two hours at your breakfast when your blood sugar is falling rapidly, that is a stress response to your body, and it's not just the blood sugar issue. It's not just that you need to eat a bit more for concentration that is impacting your cortisol levels, your adrenaline levels, and all your mood hormones.” He said, “Really?” I said, “Yeah. The foods you're eating I think are also impacting this.” And so, I drew him a picture and I said, “A few more healthy fats throughout the day …”

In the interest of time, I won't get into the whole case, Chris, but essentially, I helped him make some simple changes to his diet, not full-on perfection, just simple changes, and he started to improve, and I don’t see him for six months. I go into my surgery, and I got a letter waiting for me, and it’s basically his mother. It said, “Dear Dr. Chatterjee, I just want to thank you. You’ve completely changed Evan’s life. He’s like a different boy. He’s happy at school. He is interacting with his friends. He joins clubs at the weekends. I just want to thank you.”

But really, that case has taught me so much, that just simple lifestyle changes, when explained clearly, when explained in a way that actually resonates with the person in front of you, can have a profound impact. I'm not claiming this happens in every case, Chris, absolutely not. But that taught me a lot how … those simple things. And a lot of people say, “Yeah, a 16-year-old will never listen to you.” I disagree. If you connect with that person and actually, we’ve spoken about that, Chris, and something I'm very passionate about is that actually I think the biggest skill for a healthcare professional is actually not scientific knowledge, but can we connect to communicate with the person in front of us? Because I find every patient wants to be as healthy as they can. They don't want to be struggling. They don’t want to be on your waiting list or on my waiting list. Actually they want to be living their life. We assume, and certainly in my profession in the UK, we assume a lot of the patients don't do what we tell them today. I don't really buy into that. I just think if we can connect with them and we can it make achievable for them, they do want to make those changes. And that's essentially what I do in my book, Chris. I make these changes seem achievable for everybody, and I think that's why so many people are resonating with the message.

Small changes tend to make the biggest impact

Chris: And they are. I'm in exactly the same place as you, Rangan, because after many years of doing very … sometimes going down the Functional Medicine rabbit hole, which as you know, can take you pretty deep, I'm more convinced than ever, as you are, that in many cases the basics are what matter most. And I would also say, and this is very consistent with your book, that we often make the mistake of assuming that big problems require big interventions to make a difference. What I've found is actually it's a series of small changes that tends to make the biggest impact, instead of these hugely dramatic interventions. I think that's really the message with your book as well.

Dr. Chatterjee: And I think, Chris, we've all got … one thing I've recognized, we all got our own personal bias, because when I changed my diet, that's such a profound impact to the way I feel that I then was assuming that it all starts with food. That's that key intervention. Now I'm saying that isn't the case, but I've learnt, I see those four pillars as like, they all feed into each other in a circle. You can get on wherever you want, but it will all feed around. If you want to start with food, that is fine. I started with food, but I had a patient we see with a mental health problem who frankly was not interested in changing his diet, but I could persuade him to become more physically active and as we ramped up his physical activity, he then wanted to start eating better, which then had an impact on his sleep, etc., etc., etc., so I kind of learnt over the 17 years of seeing patients, just do not assume anything about your patients. They may not want to start what you want to start, and that really has helped me define that very simplistic … I think the structure of my book, Chris, is actually deceptively simple because the chapter titles are actually quite a simple intervention. I sort of walk people through the science, but then bring it back to say, actually, the lifestyle intervention at the end of all that science is relatively straightforward. I don’t think we realize … I've got this phrase I use quite a lot now, which is, “Consciously make changes to your lifestyle to unconsciously change your biology,” and that in a nutshell is the approach I take to these things.

Chris: Well, this has been fantastic. I'm so glad you could take time out of your busy schedule to join us, and as I mentioned, How to Make Disease Disappear is out today in the US. I definitely recommend checking it out. As I said, I believe that a series of these small changes, even for people who are, and this is a key point, who are really knowledgeable about this stuff … I mean, my patients are some of the most informed, knowledgeable patients that you're ever going to find. I mean, they are people who have been reading these books and following the blog post, and in many cases they're healthcare professionals themselves, and yet in my work with them I often find that the biggest difference comes from making some of these changes like implementing a digital detox or tech Sabbath one day a week, or starting a stress management practice, or incorporating more time for leisure and pleasure in their life. These things might seem insignificant compared to doing thousands of dollars of lab testing and treatment, but frankly, in many cases they end up making a bigger difference.

[Crosstalk]

Chris: Yes, exactly. How could that be more powerful than—

Dr. Chatterjee: ___ real medicine. This is fine. I know about that, but is this real medicine, that’s the nub of the matter.

Chris: Absolutely. I've been beating this drum for many months now. I think it's just really become even more clear to me, and it's one of the reasons we're launching a health coach training program. Actually, by the time this is out, enrollment will already be open for it because I so deeply believe that diet, lifestyle, and behavior change are the key, and the problem is that it sounds almost trite. We said that so many times, people are like, “Yeah, yeah. Tell me something I don't already know.” But we don't already know it because if we did, we’d be acting and behaving differently.

Even myself, I mean, this is something that I continually have to come back to. For example, whereas I am about the effects of technology and I do a pretty good job of limiting my use over the last several months, I'd started to slip, and so we drew a hard line in the sand, and we've gone back to Sunday as being absolutely completely technology-free. We just put our iPads and computers in a drawer. We don't interact with technology at all, and it's been absolutely transformative to go back to that, and now we're planning a vacation soon where we're going to have another experience where we've done every year where we're completely off the grid. No technology for eight or nine days, and I can tell you that that has as big of an impact on my health as just about anything else.

Dr. Chatterjee: Chris, just before we went live in February of this year, I've just been … the book came out in the UK in January, and obviously today it's out of the US, which is just fantastic, but I was burnt out from all the book promo, speaking to hundreds of people. I've been all around the country. You’ve experienced this before, Chris, the irony of promoting a health book is what you do to your own health once you're doing that. And we booked a very last-minute holiday to … we went to a place called Dubai, and I made a big deal of it on my Facebook and my Instagram. I said, “Guys, you will not be getting anything from any of my channels over the next nine or ten days.” Not only did I say that, I managed to do it. We got to the hotel, and I put my laptop and my phone in the safe, and they stayed there. I tell you, that holiday was probably the best holiday I've ever had because I don’t think we realize how much noise technology constantly, it just nags away at you and it just drains your mental energy day after day after day.

I love tech as much as the next guy. Like you, Chris, I go through an ebb and flow. Sometimes I slip into bad habits, and we all need constant reminders. I mean, just because we are sort of preaching this stuff, it doesn't mean we are perfect by any stretch of the imagination. It’s a constant challenge, and I think that collaboration with health coaches is absolutely the way forward, and I'm delighted to hear about that. But if you have not … some people might say, “I can't do a whole eight or nine days without tech.” Okay, fine. Try it on a Sunday morning. Try going to the park with your kids and don’t take your phone with you. It is a different experience. As soon as I come back, I feel like I've got a holiday just when I'm not on my phone for four hours. It’s just incredible.

Chris: Yes. We don't recognize how much it influences us until we get that break, and I definitely recommend starting tomorrow night. Like you said, don't start with nine days—that's probably going to be too difficult—but start with half a day and or even an hour and see what kind of impact it makes.

Dr. Chatterjee: I've always taken with myself … not always with myself, actually, I am sort of pretty strict with myself, and I’ve got myself into trouble sometimes trying to really stick to some really hard-core health regime. What I learnt what is sustainable are these small changes that are achievable because … let’s say, for example, one of the things I recommend—I talk a lot about strength training, as you do, Chris. It's very much undervalued, when we talk about movement and exercise, people often undervalue how important lean muscle mass is. A few years ago I was telling my patients, I was saying, “Hey, guys, once you go past 30, you can lose up to 5 percent of your muscle mass every 10 years. Your muscle mass is one of the biggest indicators of your health as you get older.” And so you got to join the gym and do some…” A few weeks later they come back, and I say, “How are you getting on?” “Oh, you know, doc, I can't manage it. It’s too far.”

I've always thought, okay, I'm giving advice that they are not able to follow. I never felt that actually, you know what? These guys are not doing what I'm telling them to do. I go, okay, clearly the advice I'm giving them doesn't resonate with them in the context of their life, so I came up with a saying in my book, and I actually did it on one of the shows in Doctor in the House, sort of five-minute kitchen workouts, which is basically a very simple bodyweight workout that anybody can do of any age. I've literally got patients in their 20s doing it, patients in their 70s doing it. You don't need any equipment and you can get a really good strength workout doing it. You don’t have to join the gym. You don’t need to get changed, and I've always looked at, how can I make these things practical for people? And what I found is when they say they don’t have time, then I say, “Well, can you give me five minutes twice a week?” “Yeah, of course I can.” You start off slow, and they do this five minutes twice a week. They start to feel the benefits, and before you know it, they're doing it six times a week.

I talked about this in the book. There’s a couple in their 60s who I taught the five-minute kitchen workout in my clinic room, and they thought I was mad, and they were a little bit skeptical. And they said, “Okay, doc, we'll give it a go here.” And they started it off, and they enjoyed it so much, when they came back to me see me four weeks later, they said, “Look, when we run our evening bath upstairs, on the landing we both do it for about seven minutes now, five nights a week.”

Chris: That’s great.

Dr. Chatterjee: Yes. It's incredible. Wow. Can we really make a difference? When you set the bar low, people achieve it, then they want to do more. If you set the bar too high, people don’t achieve it, they just give up. This approach, I think, is quite different from what I've seen five or six years ago. And like you, Chris, I listen to my patients, I learn from my patients, and this is the approach I think works for the vast majority of people.

Chris: That’s fundamentally a coaching approach. I mean, there's a concept in coaching called “shrink the change,” which means you take a big change you want to make, and you have to break it into smaller, more actionable steps, which is exactly what you did there. I mean, that's why I'm so excited about the coaching program because we assume that people, when they don't change, it's because they don't have enough information. We just need to give them more information, and then they'll change, but really, that's actually not the case. People don't change because they don't know how to change, and we as practitioners don't know how to support them in making that change. Just learning about how human beings actually do change and incorporating some of that into our work can make a huge difference.

Dr. Chatterjee: Yes, absolutely. Chris, before we go, I just want to say how much I respect the work that you have done over the past few years. I think very few people have done as much as you to raise awareness of ancestral approaches, Functional Medicine approaches, lifestyle medicine approaches, and yes, I just want to give a lot of gratitude to you. I think your blog is fantastic, and I'm very much in awe of the work that you’ve done.

Chris: Oh, thank you, Rangan, I appreciate that. Everybody, How to Make Disease Disappear is available today on Amazon and elsewhere. Do check it out. We'll put a link in the show notes to your YouTube channel, Rangan, where people can watch some of the episodes of the show. I think that would be a great thing for everybody to see, and I look forward to seeing you again next time when our paths cross, Rangan, and good luck with the book and everything else.

Dr. Chatterjee: Thanks, Chris. I’ll see you soon.

Chris: All right. Great.

The post RHR: Bringing Functional Medicine to the Masses – with Dr. Rangan Chatterjee appeared first on Chris Kresser.

RHR: Bringing Functional Medicine to the Masses – with Dr. Rangan Chatterjee published first on https://chriskresser.com

[contiinuation]

I think that on some level my mother always blamed herself for my epilepsy. A lot of her theories were based on the fact that I was born a month too soon via c-section. She cites that the doctor may have pulled me out of her too aggressively or something, or perhaps he grabbed me by the neck the wrong way while I entered the world, kicking and screaming. Shortly after I was born, my lung collapsed. My mom has theorized that perhaps I went too long without oxygen and that’s why I found myself fighting a seizure disorder twelve years later. She blamed vaccinations for a while there. She also blamed braces for shifting my teeth around so drastically that I had developed a seizure disorder.

My mother blamed herself and the things she did for my seizures so naturally, she threw her entire being into fighting them.

My mom is a nurse of thirty years and has seen first hand what drugs (legal and not legal) can do to a person. She’s a pretty hard-headed and thick-skinned woman and I couldn’t do what she does on a daily basis. Growing up, her experience in the medical field seeped into our home life. Our family’s medicine cabinet was twice the size of all of my friends’ medicine cabinets and it was always filled to the brim with vitamins and medical supplies, including latex gloves, medical tape, surgical tools and she sometimes kept syringes locked in the other medicine cabinet in her bathroom. I even saw an IV drip bag up there once. I never thought this was weird but in retrospect maybe the syringes were a little bit questionable. It’s nice to know, though, that if the absolute end of time occurred while I lived with my parents, I would have a generally good chance of surviving and repopulating the earth.

With respects to drugs though, my mom was a firm believer that there’s always something natural out there that can cure minor ailments like headaches and period cramps. She liked the idea of curing things naturally rather than turning to harsh drugs to fix things. Advil and Claritin made very rare appearances in our house. Period cramps were treated with a heating pad and this weird tea she brought home from Russia once (which worked). Muscle pain required magnesium. Have a headache? Take a nap and down a litre of water. Allergies? Nettle tea and Vitamin C. Nauseous? Ginger tea. Cold and flu? My grandma used to make this mixture which was basically a full jar of liquid honey that was packed to the brim with lemon and ginger slices along with fifteen to twenty cloves of garlic. I swear one tablespoon cured you within hours.

My mom applied the same logic to my seizure disorder. Before my doctor could put me on meds (I hadn’t had enough seizures/tests done until six months after the first one for him to make a formal diagnosis allowing him to write the appropriate prescription) my mom tried what felt like every possible natural remedy on the face of the planet.

Remedy #1: Aura Cleansing

When I first got sick, I remember having a lot of appointments in a very short time frame. One of the first ones took place in a little apartment building in North York. I’m pretty sure it was an under-the-table operation because this was literally in this little Eastern European lady’s apartment and she was adamant about it being cash-only. My mom explained this appointment to me as “aura cleansing,” something that would “draw negative energy out of my me”.

The Eastern European lady had a few degrees hanging on the wall of her kitchen stating that she was certified in accounting from a local university and one in Russia. She had another certificate hanging next to the accounting degrees allowing her to practice in the field of Holistic health and healing.

I remember looking around and thinking it was a homey apartment. It vaguely resembled my grandmother’s in Poland: there were doilies on every piece of furniture and it smelled somewhat like boiled potatoes. She also had a beautiful cat, Felix, who was long and slender and spotted like a Jaguar and I loved him.

After asking my mom and I a few questions about my general health the lady lead us into a spare bedroom where she had a bookshelf, a loveseat and a massage table. My mom sat down on the loveseat and the lady turned on a radio that played ocean noises at a soft volume. I took my place on the table and the lady asked me to close my eyes and started talking me through deep-breathing exercises, which lasted an entire half-hour. I started getting restless. She then moved on to asking me to stay completely still while she hovered her hands over my entire body in steady, rhythmic motions. I remember thinking, “if the problem is in my brain, then how the hell is this going to help?”

By the end of the appointment I was primarily fixated on finding Felix again. I was relatively smart for a twelve year old. I knew this “aura cleansing” wasn’t going to help a problem in my brain. My mom paid the lady while I hung out on the floor of her foyer with the cat.

In the car my mom and I talked about how I felt about the appointment. I told her I didn’t like sitting still for so long but I didn’t complain. I knew she was just trying to help. We went back a couple more times but eventually I think my mom clued in that I didn’t like going and didn’t think these “aura cleansing” sessions weren’t helping. I continued having seizures regardless of how much this Russian accountant cleansed my aura. The appointments frequently interfered with my normal kid stuff like Girl Guides and homework and whatnot so we never went back.

Remedy #2: Biofeedback Therapy

Around the same time as the aura cleansing sessions, my mom started taking me to an ADD/Biofeedback clinic close to our house. My parents told me that these sessions would help me control my seizures, like when or if they happen and the severity of them. I didn’t fight it because it sounded fantastic in theory - if I could control them then I could theoretically never have a seizure ever again. These appointments would prove to be equally as useless as the aura cleansing. At the very least, these appointments helped me come to terms with how little control I had over my life anymore.

The first appointment was focused on teaching you proper breathing techniques and how to divert your focus to certain parts of your brain. I’m not sure of the specifics of it but it was a weirdly satisfying experience being able to direct my brain processes and I knew it was working because I could feel it. I could literally feel my brain waves diverting themselves at my control. I’ve retained the ability to do that and sometimes I divert my focus for fun.

This clinic was huge and there were individual rooms where patients would be hooked up to a machine that resembled an EEG machine. With this machine you would basically be controlling a virtual game on a computer screen with your brain waves and breathing pattern. My favourite was the roller coaster game: the roller coaster would speed along the track as long as you kept your focus and breathing rate to a certain standard. With every game you completed successfully in a  given time frame you’d be awarded points and eventually you would be able to exchange your points for prizes. It was like a Chuck-E-Cheese for kids with neurological conditions.

When I collected enough points I traded them in for a $20 gift card to Chapters. The day I won the gift card my mom and dad took me to the bookstore and I bought one of those Guinness Book of World Records books. I came across the book in my parents basement a couple weeks ago and smiled.

I wish Biofeedback Therapy worked for me. The outcome sounds like a dream. Being about to control when and where and if you have seizures sounds like a dream. However, unfortunately, they didn’t work. Seizures kept happening regardless of how hard I tried to redirect my brain waves - and believe me, I tried, but they continued.

Remedy #3: Dairy-Free and Gluten-Free Diet

Right after my diagnosis with Epilepsy my mother did a lot of internet research and came to the conclusion that dairy and gluten would be ultimately detrimental to my health. We went back to the aura-cleansing lady - who happened to also have a vast amount of knowledge about the dietary needs of epileptics - who confirmed that dairy and gluten in any form should be avoided in every way possible.

I’d never been a picky eater so this diet never really phased me in the slightest. It didn’t help with my seizures at all but living without dairy and gluten didn’t bother me. I managed to find substitutes for all of my favourite things, some things I ended up liking more than the original anyway.

This diet lasted two years. No one actually forced me to stick to it for this long; I genuinely liked the foods I was eating for those two years and I felt generally more physically healthy, but I started to miss the fun foods that I could technically no longer eat. The fact that I was getting older also didn’t help. I was going out with friends more often and we’d usually eat out or order in, and take-out dairy-free, gluten-free food wasn’t typically available anywhere at that point in time.

One night in 2011 I found myself at Laura’s house. Her mom made a Baked Alaska for her birthday. I wasn’t going to say no to a slice of birthday cake for my best friend’s birthday, so I took a big slice thinking nothing of the potential consequences of eating dairy for the first time in two years.

That night, Laura’s toilet and I spent a long night together. I’ll spare you the gruesome details. I will never put any blame on my mother for my epilepsy, however, I will credit her for the role that she played in my lactose intolerance. Remedy #4: Holistic Electro-Treatment

I’ve scoured the web and I don’t even know what to call this treatment because I can’t find any evidence of it existing, but I know it exists because it’s yet another thing my mom thought would cure me of epilepsy. So I will call it Holistic Electro-Treatment.

I started suffering from hay fever and migraines the spring before I turned seventeen. At this point I was taking medication for my seizures and had been seizure-free for almost three years. I didn’t like mixing drugs so I generally avoided taking antihistamines and pain relievers and I was open to any forms of treatment that would make the itching inside my face go away.

My mom had a friend at work who suggested this treatment that consisted of strategically placed electric currents running through your body that would treat allergies and epilepsy and various other ailments, including my newfound lactose intolerance. This treatment also sounded incredible because it was kind of an all-in-one type deal, but it didn’t work.

My first appointment was with this lady in the basement of an office complex. My mom came with me and sat as I sat on a table and the therapist-lady showed me the pen-shaped device that would omit the slightest current of electricity. She ran through a series of basic questions about my medical history, and then asked if I had any body piercings, as the metal could interfere with the electric currents.

My mom was old-fashioned, and that's why I hadn’t told her about the time I got my navel pierced. She was so incredibly against any body modifications. When I was fifteen I dragged Genn to some sketchy basement apartment where a little non-English speaking woman did tattoos and piercings. I was on a mission to get my nose pierced. Now, the legal age to get such a piercing without parental permission was sixteen, so I was under age, but I was referred there by an acquaintance from school who said that this place doesn’t ID kids who come through there. I was nervous as I was filling out the form with a fake name and age, but I was determined. She pulled a tiny needle out of a sterile package and  pushed it through my nose, and with that I had my first facial piercing. I showed up back at home around 7pm that night and did everything I could to avoid my parents, but they had to see me eventually, right? I eventually ventured upstairs, holding my head down until they eventually noticed the sparkly rhinestone stud sticking out of my face. They were - within their rights - pissed about it. To my surprise, my dad was more pissed than my mom, who later approached me and told me she liked the facial piercing, saying that it was “cute”. My dad hated it and I think he was more pissed that I went out of my way to go somewhere that was probably unsafe to get a foreign lady who ran an illegal operation in her basement to “hole punch my face”, as he so lovingly put it. Not even twenty four hours later he paid me double the cost of the piercing itself to take it out (I was a relentlessly stubborn kid), followed by him driving me to our local LifeLabs to get my blood and urine tested for diseases. Everything came back negative, for the record.

My next piercing after that was a navel piercing that I had done (when I was legal to) at a local tattoo/piercing shop. That was easier to hide, so when my mom took me to this electro-therapy session and the therapist asked me about any piercings I was nervous. I told her no, thinking “why the hell would this woman want to see my belly button,” when she pulled out the electric-pen-type device and tried to start the session. It turns out that (and I could be wrong because I don’t know the specifics of the treatment), when you stimulate certain points on the body with slight electric currents you can normalize the functions that those nerve endings control and the belly button is one of those points that would help with either my allergies, seizures or lactose intolerance. Before she could even touch me with her electric pen, I told her I had to pee and I went to the bathroom to take out the belly ring.  I hoped to God that the appointment would be short enough for me to shove it back in without it closing over or scabbing up. I went back to the table and laid down so the therapist could work her magic with her electric pen. She eventually got to my belly button and saw the very obvious hole in my abdomen and asked me about it. My heart was pounding because I didn’t want my mother hearing about this but I think she was on her phone and fortunately didn’t hear. I told the therapist I had the piercing done recently but took it out soon after. She shrugged it off and continued working. When it was over I went to the bathroom again to put it back in. It slid in without a problem and I left her office after a consultation about my dietary habits and little changes I could make to help with hay fever.

I went back several times because I noticed that the hay fever slowly went away and my digestive system could tolerate moderate amounts of lactose again, which I was happy about. I was able to rediscover my love for half and half in coffee and cheese on sandwiches. I eventually stopped going around August because it got expensive and it got hard to make appointments that I could keep. I was a busy sixteen year old, I guess.

My digestive system’s aversion to lactose eventually came back and I found that my hay fever also came back the following September when the ragweed came out. I can’t say with any level of certainty that it helped with my seizures because I hadn’t had any when this treatment started but I had a couple in January following the treatment’s end in August.

Remedy #5 Ancient Chinese Medicine

In 2009, my parents took me to see a Traditional Chinese Herbalist. I was probably thirteen at the time and we packed up the car and drove up town to North York. I was mad that I was missing the first half of a get-together Genn was hosting for what would turn out to be another disappointing attempt to stop my seizures. I wasn’t on my meds at this point so my mom was adamant that we give this doctor a shot.

I don’t remember much about the appointment itself except for the doctor asking us about my medical history and concluding that I was to be given a potent concoction of various herbs once a week, many of which looked like bark pulled fresh from a tree. The doctor gave us five individually packaged baggies of dried herbs and plants and whatnot and explained to my mom that each package was to be put into a big pot and covered with six cups of boiling water and simmered until only one cup of liquid remained.

I was to drink this potion once a week. So every Saturday morning for five weeks straight I awoke to the smell of what can only be described as the damp remnants of a cedar tree forest fire, charcoal, gasoline and sadness.

Now, like I mentioned before, I’m not a picky eater. I never have been. When I was fifteen I ate a nice, warm spoonful of unseasoned lamb brain and washed it down with tepid beer. However, this traditional herbal medicine-based liquid was something I couldn’t stomach. The fact that I had doubts about it working didn’t help it go down either. Every gulp felt like a hopeless effort into stopping something in my brain that was virtually uncontrollable. However I carried on. At the very least, I told myself I would try.

I got through five weeks of treatment before deciding I had enough. I had a seizure on May 22nd of that year after five rounds of this traditional Chinese medicine and declined another appointment with the herbalist. Actually, thirteen year old me threw a fit and my parents didn’t bother fighting back.

--

I think my mom thought she was doing more good than harm, and realistically there was no harm done, but the more “remedies” for my seizures that my mother tried, the more exhausted I felt. Over time I started resenting her for putting me through the wringer: I felt smothered and tired and I wanted all of her tactics to stop. I was at peace with the idea of dealing with infrequent seizures without the aid of medical intervention.

Eventually she toned it down. When I got headaches or had seizures she was loving and attentive and as I got older I felt less smothered and suppressed by her constant worrying. I’ve since moved out and I only see my parents every other weekend, but I still get a text at 7:30 in the morning and in the evening every day reminding me about my meds. For that I’m thankful: I would forget most days because I’m a little absent-minded in the morning and usually just shut my alarm off and immediately forget about taking my meds.

I always made it clear to her, though, that I love her and I never blamed her for my epilepsy at all. I never understood the guilt she carried until I got older. I don’t currently have kids but I can’t imagine watching your child suffer and not be able to fight the battle for them. She still comes to appointments with me, and it hurts my heart to still see the guilt in her eyes, even though she isn’t as expressive about it anymore. These days, she just looks tired.

[aria-i-adagio]

This Body Breathes From Inertia

Fandom: The Arcana

Wordcount: 4100

Masterpost

Trigger warnings: minor character death, acute grief, self harm, excoriation, dissociation

Five years ago.  The Red Plague.

“You did everything you could.  Literally, I, uh, couldn’t have done anything else.”  The doctor was young, only a few years older than me, and skinny as a bean pole and with the slightest hint of an accent when he spoke the trade language.  Shouldn’t say that.  Everyone had an accent when they spoke the trade language.  That was the point of a trade language.  He had a faint non-Vesuvian accent when he spoke the trade language.  

He wasn’t wearing one of those ghastly masks.  Thank God for that - if God still deserved thanks.  I was more in a mood to lay into God with every invective I knew.  Anna, my aunt, hated those masks.  Claimed they wouldn’t do much more than just covering your mouth with a kerchief anyway.  In the three weeks since her eyes started turning red, I had burnt every kerchief in the house and then given up entirely, assuming that I’d sicken soon enough anyway.

“I’m sorry.”  He took a tiny vial out of his bag and offered it to me.  “Laudanum.  It might help if she’s in pain, but only give her a drop or two at a time.  Anymore will -”

“I have opium.”  I cut him off.  I’m a fucking apothecary; of course, I have opium.  And the implication behind carefully stating just how much would be too much, well, I understood that as well.  “And if I decide that she’d want me to end it, I can think of at least five other admixtures I have the ingredients for that would do the job as well.  Keep that for someone else.  It won’t be very long now anyway.”

He put the bottle back in his bag, talking quietly as he does so, perhaps just to fill the silence as it’s all common knowledge.  “The carts come round in the morning.  I know, if seems awful, but the mass graves, they’re the best way to minimize the contagion being passed on.  You should burn all that bedding too.”

I nodded absently and continued stroking the back of my aunt’s hand, counting the seconds between each increasingly shallow breath.  It didn’t seem awful; it was awful.  But he was right.  Even if the quarantines and the dead wagons - carting off the deceased like so many cattle - have down nothing thus far, they were the best of multiple bad options.

“Hey, do you, um, have anyone else?  Someone to help you, maybe.”

The doctor touched my shoulder, bringing me back from my grim musings.  I looked up at him, paying attention to his face for the first time.  Gray eyes, nearly lost in dark circles - he didn’t look like he’d slept more than I had in the past few weeks.  Friends?  I felt too empty to even think of myself as the type of thing that could have anything, much less friends.  There was Artemis, but she had been trying carefully to avoid the plague victims as much as she could.  It was too easy for her to spread the contagion to already vulnerable women and infants.  But I wanted Asra with me most.  “He’s traveling right now.”  I twisted the ring Asra gave me before he left - two trips ago, maybe, they blur together, he often seems like he’s gone more than he’s here - around on my finger.  He was supposed to return soon and bring with him some of the rarer herbs and medicines that we didn’t stock, that we hoped would do some more good for the plague than what we had tried some far.  But, he was too late.  As usual.  Always running late.

The doctor frowned, rummaged around in the pockets of his coat, and then handed me an unlabeled glass flask.  “For you.  Not officially approved, but it takes the edge off.”

I gave him a skeptical look.  This was not the sort of thing I expected from someone in ‘professional’ medicine.  But, what the hell?  I uncorked the bottle and took a swig, managing not to make a face as the liquor burnt its way down into my stomach.  My second drink was slower.  “It’s not bad.  I like a drink to bite me back, at least a little bit.  What is it?”

“Slivovitsa - plum brandy.  My grannies swear by it for basically everything.  Not that this is as good as theirs.”

I held the flask back out to him, but he shook his head.

“Keep it.”

Another cough racked Anna’s frail body - weaker than the last.  Any strength she had left to try and clear her lungs was fading fast.  I wrapped an arm around her shoulders and rearranged the pillows behind her so that she’s a bit more upright.  Once she’s settled, I held a shallow cup of water to her cracked lips and blotted away what she doesn’t drink - most of it, probably all of it - with a square of cloth.  Another for the burning pile.

When I look up, the doctor was still watching me with those exhausted gray eyes.  There weren’t a lot of sad eyes left in Vesuvia; we’d all become too acclimated to pain and death to show any response on our jaded faces.  But his eyes were curiously, somehow, still melancholic.

“You can go.  I know you can’t do anything.”

“I, uh, I’ll stop by tomorrow.  To check on you.”

“You don’t have to.  We all know how this ends.”

“I will anyway.”

***

A few hours past midnight, her eyes blinked open for a moment, then with a final rattling cough, she died.  I convinced myself that she had looked at me, and faintly, ever so very very faintly, had squeezed my hand.  Maybe it really happened, maybe it was a figment of my sleep deprived imagination.  But believing it made me feel a little better.

I arranged her limbs into something that vaguely looked peaceful, surrounded her with flowers we had dried the past summer - chamomile, lavender, and rose - and knotted the bedsheets into a shroud.   Finally, I gathered her up in my arms, using magic to steady my self on the steps, but taking her diminished weight on myself, sure that I needed to do this last task for her on my own.  Some final, last acknowledgement who she was to me, since I couldn’t bury her properly.  

When dawn came with the wagons to collect the dead, I pacing in front of the shop,  shawl pulled tight against the cool air that passes for winter in the Vesuvian climate, and counting the cobblestones in the street to try to keep the roaring in my head at bay.  As the wagon pulled away, the roaring terminated, and I slumped back against the door of the shop, knees no longer able to bear my weight and curled into a small, shaking bundle of sobs.     

I pulled myself up after a passer by poked me with a stick to see if I was still alive, and staggered back into the shop, into my home.  Forced myself to drink a cup of water.  I should sleep.  I knew that I should sleep.  But I also knew I would dream, and I could predict what those dreams would be.  I didn’t want them.

I started taking apart the upstairs bedroom instead.  By late afternoon, I’d tossed all the bedding from the window to the yard below and dragged it far enough away that I wouldn’t set the shop on fire by mistake.  I summoned a flame, more than I really needed for the pile to catch light, but I was sad and angry, and it felt good to destroy something.  

I watched it burn, then started shooing my chickens - so happily oblivious - into their coop for the night.  As I latched the gate shut on their enclosure, a voice called to me from the gate.  Auburn hair was just visible above the high fence - the doctor from last night?  He had said he’s come by, but I hadn’t believed him.  Certainly that had just been a nice thing to say at the time.  I pulled the gate and looked him up and down.  No uniform, and there’s a wrinkled dog tagging along at his heels.

“Hey, I said I’d check on you.”

“She’s dead.  I’m alive.  Thanks.”  My response bordered on rude - no, actually, quite rude - but I didn’t really care, even if he was trying to be kind.  I didn’t have the emotional reserves to respond in the way I knew that I should.

My answer didn’t seem to put him off.  “Can I, could I step in for a minute?  I wanted to talk to you.”

“Is your dog going to attack my chickens?”

He laughed, and it was an odd sound, almost shocking, maybe even scandalous, to hear laughter.  “Nah, I can promise that she’s too damn lazy to chase a chicken.”

I silently held the gate open for him, and he walked into the back yard.  The fire behind me has turned into a roaring blaze.  “Sorry, I didn’t get your name last night.”

“Oh, um, yeah, Julian Devorak.  You took me seriously about burning the bedding.”

“Yep.”  I folded myself into an ironwork chair.  Iron shouldn’t, couldn’t hold any of the plague.  In folktales iron would counteract the supernatural, quell it, and the longer this pestilence ravaged the city, the more rational accepting a fey, irrational origin for the suffering seemed.  Right?  Iron and fire.  Maybe those were the solutions.  “Cleaned out pretty much everything in that room.”    

“You did that all on your own?”  He sat down in the chair opposite of mine.  “I thought a neighbor or someone would -”

I gestured absently at the chair he’s sitting in and floated it a few inches off the ground.  Ah, yes, this isn’t a folktale and iron doesn’t counteract the supernatural.  Or at least iron doesn’t counteract my magic.  So much for the supernatural as a diagnosis and iron for a prescription.  Back to square one.  Death, lots of death, from an unexplained and untreatable illness.  

As the chair rose, the doctor grabbed the arms and yelped in surprise.  His dog gave me a disapproving look that I did deserve, and I gently let the chair settle back onto the ground.

“I’m not exactly helpless.”

“I see that.”  His face has gone paler, if that was even possible, at the display of magic.  “But still.  I’m sorry that you, uh, had to do that alone.”

“The slivovitsa helped.”  I pulled the bottle out of my shirt pocket and drank the last mouthful.  I’d also been nursing a bottle of whiskey all day, half expecting Anna to step into the room and inform me that day drinking is not a healthy coping strategy.  But she hadn’t.  Of course she hadn’t.  Staring at the fire, I shrugged out of the bulky shirt I had on a sleeveless blouse and tossed it in with everything else.  Despite the fire, the night air chilled me quickly and I wrapped my arms tight around my torso.  I should probably burn all the clothing I’d worn while cleaning, but I supposed that can wait until the doctor - until Julian - leaves.  “Thanks for that.”

“When is your husband getting back?”

“Husband?”  It was staccato and bitter, but I couldn’t help but laugh as I imagined Asra’s face at having that vocabulary applied to him.  His eyebrows would pull together for a moment, then the right one would lift in concert with the corner of his mouth curling in something halfway between amusement and disgust.

“Sorry, I assumed with the ring and you, uh, you said he.”

The alcohol in my blood said he was cute when him stammered.  Or at least, I blamed the alcohol.  

“You’re observant.”  I picked up a stick and poked at the embers.  “He is at best a term of convenience when talking about Asra.  And I don’t know what word you’d use for what we are.”  Lovers?  Non exclusive lovers - what’s the word for that?  Two people who keep coming home to each other, despite whoever and whatever else we got involved with in the interim.  I curled my free hand against my mouth, lips pressed against the ring I’m wearing.  “He should be home in the next week.  Should be.  Doesn’t mean he will be.  He gets distracted sometimes.”  Distracted is also not quite the right word for Asra, but again, I’m not sure what word you would use to explain his convoluted, occasionally non linear sense of time.

“They’ve closed down the port.  I hear they’re planning to seal off the city gates soon.”

“Oh, that won’t stop him.“  I sometimes suspected that Asra could pass through walls and step between mirrors if he so desired.  "Why are you here, Dr. Devorak?  I can’t imagine you take this much interest in the family of every person who dies.”

“I, well, I meant it when I said I thought you did everything you could, and I wanted to know more about what you used.”

“She’s still dead.”  One of the four universals, along with aloneness, lack of meaning, and the terrifying responsibility of free will.  But Death comes for us all, no matter the virtuous or unvirtuous choices we’ve made.  It bleaches them of meaning and abandons us in finitude.  Intellectualizing.  A coping mechanism.  Not always a good one.  But it’s something.

“Yes, but …”

Anna had survived for three weeks after her eyes turned red, instead of the handful of days most plague victims counted.  After watching her become slowly feebler and feebler before slipping into that last long coma, I wasn’t convinced that was a good thing.  Perhaps it was easier to go quickly.  But still, I sighed and began to rattle off what Anna and I tried - first for our neighbors and customers who had come developed then sickness, then for her.  “Boneset and willow bark for the fever and aches.  Start the tincture at the new moon so that it will draw out the active parts of the plant.  Pleurisy root and horehound for the cough and the lung congestion as a oxymel.  A salve of ginger, arnica, and comfrey for swollen joints.  Those should be extracted into an oil while the moon is waning.  I use spellwork to complement the herbs, some of which I can attach to charms, some of which I have to be present to work.  All of that only treats the symptoms.  We tried echinacea and elderberry to build immune systems, but it didn’t work.  I found a reference to an herb from the west that supposedly cured a plague there, but -”  I shrugged, it was a folktale in an old book, not a solid lead.  But library research was one of the things I knew I was good at, and lately I wasn’t feeling very confident in my ability to do anything.  “Asra is supposed to bring some back with him.  But none of it really seems to do any good.  Is there anything else you want to know?”

“I’m sorry.  I didn’t mean to upset you.”

“I’m not upset.  I’m exhausted.”  The dog pushed her head into my hands, and I rubbed her velvety ears absently before pressing my face against her warm body, trying to fight back the tears that I had kept myself from crying for the entire day.  “And the only family that gave a damn about me just died, so excuse me if my conversation skills are lacking.”  I hadn’t heard from the rest of my family in years … not since … well, perhaps I couldn’t blame them.  My mother had - apparently - given up after the third letter I didn’t respond to.  My father had sent a book of sacred texts, littered with notes on scrap paper after I had first come to live with Anna, but nothing since.

He was silent for a minute, then I heard the chair shift as he stood up.  His hand was warm - more comforting than I could admit I wanted - when he placed it on my shoulder.  “Listen.  Just, uh, think about this.  When you’re ready, I could use an assistant, preferably someone who knows something, because nothing I’ve tried works either.”

 I angrily wiped tears away from my eyes.  “What would be the point?  No one recovers from this.”

“I want to be the kind of person who at least tries.”  He squeezed my shoulder and without thinking, my head fell against his arm.  He moved again, kneeling behind the chair until he could wrap both of his arms around me in an awkward, surprisingly welcome hug.  “Just think about it, okay?”

***

I scrubbed the shop: attic to basement.  Hot water and strong vinegar until the skin started to peel from my fingers.  Scalded every piece of fabric I could in the washtub.  Laid the cushions and blankets out for the sun to purify then dragged them all back in.  Paced around the shop with burning sage and hyssop.   I filled the tub with water as hot as I could stand and crawled in, worrying at my hands and arms with a pumice stone until the abrasions began to bleed, like the day bleeding into the night then back again.  And when I couldn’t lift another finger, I fell out on the cushions in the backroom and waited, staring at the ceiling for hours until I thought of something I might forgotten to clean, to burn, to purify.  And then I did it.  First time, second time, third, fifth, eighth - it didn’t matter, so long as it was something to keep the silence beginning to scream again, echoing, roaring like the sea trapped within a conch shell.

Lies.  It was screaming the whole time.

I tried not to close my eyes.

If I closed them, I’d lose grasp on this reality.

This reality because I’m not sure which reality is more real right now.

If I closed my eyes the fey aching tracings are my arms become more real.

Past tense confused with present tense with future tense.  No.  Past perfect.

Fait accompli.

It won’t change anything if I drag a knife along those lines.  They’re already there.

Except I wouldn’t be lying anymore.  Pretending to be something I’m not.  Faking being healed and whole instead of the accumulation of broken parts, the exquisite corpse that I actually am.  No more lies.  Just the nightmare they hide.

But if I kept my eyes open - keep looking for new details in the tapestry on the wall, the brocade of the cushion in clutching, keep looking at anything - those lines are a trick of my mind.  Didn’t happen again.  A misfiring, misrepresentation of something in my brain.  Somatization.  

There are more words, better words, for this reality.  Maybe that makes it the more real one?  If I don’t lose words, I don’t lose this reality.  Derealization.  Dissociation. Depersonalization.  Mad.  Lunatic.  Liar.

No, those aren’t good words.  Real.  But not good.

Real is what I touch.  Fabric.  Wool.  Linen.  Silk.  Cotton.  Jacquard.  Twill.  Herringbone.  Velvet.  Flannelette.  Knit.

I could keep the other reality at bay.  Just barely.  It’s roaring, pacing at the limits.  A lion in a too small cage.  

Cross stitch.  Silk stitch.  French knots.  Applique.  Blanket stitch.  Crow’s foot tack.

But if I don’t close my eyes it won’t take over.  Not yet.  Not already.

Just a little while longer.  Just keep my eyes open a little bit longer.

I think it was the third day that Asra came home.  I was buried under a pile of blankets in the backroom, dozing.  I half roused when his dropped his bundles on the floor, and then his hands were on my shoulders, pulling me upright, pushing hair back out of my face.  “Dema?”  

“She’s dead.  She’s dead, and you weren’t here, and I’ve been alone, and, and …”

“She?  Anna?”  Asra gathered me into his arms.  “Oh.”  He rocked back and forth, pressing his face into the top of my head.  Faust, cool and smooth, wrapped around my shoulders.  Asra shook with the sobs that I had cried out days before day.

At some point, curled together in a little pile of misery, we fell asleep.

He was checking my arms when I wake up.  I couldn’t blame him, and his hands on mine felt more soothing than anything else.  I smiled at him weakly.  "No cuts.  No burns.”  It wasn’t exactly something I should feel accomplished about.  The scrapes from pumice stones were bad enough.  But I did.

“Oh, dear heart.  I’m so sorry.”  He kissed the this of my fingers and the inside of my wrist.  “Can I -?”  I closed my eyes and nodded.  He methodically ran his thumb over each of the scrapes.  The places he touched grew warm for a moment as the skin knitted itself back together.  He settled himself against me, head resting on my breast, and I sighed and ran my hands through his soft hair.

“I made it.  Kind of, at least.”

“You did.  I can hear your heart beating.”

“I finally just laid in here and went through all the different fibers and weaves and stitches.”

“Heh."  He pressed his lips softly against my collarbone.  "I’m glad there are so damn many fabrics in here then.  You’re stronger than you think you are.”

“I’m just a stubborn bitch.”

“Whatever works, my love.”  His fingertips traced along my arm.  I buried my hand in his hair and kneaded my fingers along his scalp.

“I’m sorry, Asra.  I know she was important to you too.” 

“What are you sorry for?”

“Losing it like that.”

He was silent for a moment, fingertips still tracing small circles on my upper arm.  “I understand.  I should have been here.”

“No, no,  You didn’t even know she was sick.  It was just hard.”

“I know.”  He kissed my collarbone again.  “You’re shaking.  When did you last eat?”

My response was more of a noncommittal noise than an answer.  Asra sat back up next to me and runs a hand over my forehead.  "Dema, is there any food in the house?“

"I -"  I tried to remember when I ate.  I couldn’t.  I wasn’t even exactly sure how many days had passed.  I thought I had kept the chickens fed.  I hoped I had kept the chickens fed and watered.  I really didn’t know.  Shit … they might have started eating each other.  They’d do that.  "I’m sorry, I don’t know, I -”

“Sh, it’s okay, love.  It’s fine.”  He leaned down and pressed his forehead to mine.  “I’m going to go upstairs, make some tea, and see if I can find something for you to nibble on, then I’ll go to the market and bring back something good."  Another kiss.  "It’s alright.”

“Asra -” I grabbed at his hands, panicking, afraid that if he left the room again, he wouldn’t be back, wouldn’t have actually been here at all.  “Don’t -”

“Come upstairs with me.” I sat up and curled around my knees, shaking my head.  I wasn’t ready to go back up there, to the stripped and barren space that had been home.  Either cleaning it hadn’t removed the ghosts, or it had sent them away, and I wasn’t sure which idea was more frightening.  I didn’t want to know which it is.  Until I know, until I go back up there, the state is both and neither, and perhaps the space can hold the ghosts of better memories while being purged of those last few weeks.

“Faust.”  Asra said his familiar’s name softly and the snake slid into my lap, a welcome weight.  I ran my fingers over her very real head.  Faust was here, so Asra was here.  Simple math.  “Faust will stay with you.  I’ll be right back, promise.”

I nodded and lifted Faust from my lap, draping her around my neck.  I wish she could talk to be like she does Asra, but just having her with me helps.  “I’m, I’m going to go wash my face.”

“That’s good.” Asra grabbed my hand and pulled me to my feet, looking concerned at my unsteady gait.  I kept a hand on the wall and managed a wan smile for him.  The washroom is on the ground floor, I least won’t have to manage any stairs.  Asra nodded.  “Alright,  I’ll be right back down.”

I splashed some cool water on my face and run my fingers through my hair a few times before stumbling back into my room with its nest of cushions.  Asra isn’t long with a steaming teapot in one hand and a mug in the other.  He set the teapot near me on the floor and pressed the mug into my hands.  Chamomile.  With quite a lot of honey in.

“There isn’t any food left in the house.”  

“Sorry, I might have thrown it all out.  Along with everything else.”

He fumbled through his traveling bag for some coin.  “It’s alright, but I’ve got to go down to the market and get something.”  My fingers tightened around the warm mug.  “Faust will stay with you.  I won’t be gone but for a few minutes.”

I closed my eyes and nodded trying to focus on the warmth of the tea in my hands and the cool weight of Faust draped around my shoulder, but I couldn’t quite slow my breathing.  His hand is on the latch when I open them.  “Asra.”  He stopped and turning before stepping back over to me and leaning down to press his lips to my forehead.  

“I will never not come back to you, dear heart.  I promise.”  His fingertips traced over my jaw.  “And I won’t be long.  Just a few minutes.

***

I reopened the shop a week after Asra returned.  One person knocked on the door to see if I had any herbs left, and then slowly, more people wandered in - more than I thought would have braved the specter of a plague death.  But then, there wasn’t much of anywhere left in the city that wasn’t sepulchral by that point. 

One visitor was the doctor.

Asra was out of the shop, trying to track down honey.  I had run out, and while most of the herbs for coughs were still useful without it, they really did do best compounded in a oxymel.  Having Asra back was a help.  He kept me from tearing up my hands in the hope of cleaning them, generally by holding me tight against him until the impulse had passed.  And he at least got me to sleep through part of the night in addition to naps throughout the day.  

The doctor waited patiently, studying the intricate diagrams with which Anna had decorated the shop, while I explained a charm to a customer.  Customer might not have been the right term.  Anna and I had stopped charging for anything related to treating the plague weeks before.  I wrapped the enchanted trinket -  it didn’t especially matter what I embedded the spell in - the cheapest charm from the market would do as well as the most valuable jewelry - up in paper, and the customer left, doorbell ringing behind them.

“Can I get you something Dr - uhm.”  My voice trailed off as I blanked entirely on his name.

He winked at me and smiled.  “Just call me Julian.  No, I just wanted to check on you.  And thank you.”

“For what?”  I smoothed the remaining sigils from the sand tray I used for spellwork and lined the styluses up in the slots above it.  

“The, um, suggestions you gave me.  They’ve been helping.  Really, more than anything else I was trying.”

“But not a cure,” I said softly as I stepped out from behind the counter.

“No.  But it’s more than what I had to work with before.”  He looked away from me, back to one of the geometric designs on the wall.  “Have you thought about it?”

He began to trace the pattern on the diagram; I pushed his hand away from it.  The lines were part of an array for recombining the energies of various substances.  Anna really shouldn’t have put them on the wall where a curious person could unknowing activate them, even if it was a rather attractive diagram.  

“About what?”  

“Working with me.  I meant it when I said I could use your help.”

“I … actually, I had forgotten.”

“It’s okay.  You’ve been -”

“- but I will.  Think about it, I mean.”

He smiled again.  Lopsided, the left corner of his mouth picking up a moment before the right.  “I’m glad to hear that.  Here.”  He extended his hand, offering me a folded square of paper.  “That’s the address of the clinic I run.  South side.”

I tucked the paper into my pocket.  “I’ll think about it.  Really.”

“I’ll just hope I see you again then.  Soon, maybe.”

Chapter Ten

A/N: This chapter title is taken from a song by the Russian groups Bi-2 and Agata Kristi, ‘Vse kak on skazal.’  The video is actually pretty cool even if you don’t know Russian.