Sync

Mythology resonates resoundingly in the Ancestral Fitness Epistemocracy (AFE).

My longtime friend, Brian Geremia, composed this elegant reflection this weekend to share with fellow 'Patient of One' Epistemocrats in the AFE:

Sync

Modern Americans love to sync things.

However, our mythologies are terribly out-of-sync.

We have chosen to leap forward with our biological (nutrition/fitness) mythology, opting for a narrative promoting genetically altered, fake foods made possible by our impressively evolved intelligence, thus leaving behind our ancestral roots that are still sewn deeply into pre-industrial, hunter-gatherer soil.

On the contrary, we have chosen to remain content with our religious (spiritual, mystical) mythology, opting for a narrative composed and created for a group of well-intentioned beings who lived nearly 2000 years ago, thus denying our impressively evolved intelligence which is capable of creating new, more relevant mythic structures.

A return to previous mythologies must be made with regard to our biology.

A new religious mythology must be adapted in order to create a structure of symbols and stories that bind human beings tightly to their local, and universal existences.

You can clap now (all in sync, of course). Cheers to BG!

Collaboratively, over the last few years, through many hours of creative teamwork, Brian and I co-founded Academic Impact (Ai) and then co-launched and completed our first rendition of Game Plan Academy (GPA) this past Spring successfully (GPA was our first large-scale non-profit GoDoGood project). These social entrepreneurial tinkering efforts in the youth services space represent our best, humble efforts to start conceptualizing, materializing, and operationalizing a novel human development 'school' (*definition of 'school' TBA from the envelope of serendipity), which we like to call one word: Ancestry.

Fostering well-rounded human development is the ultimate goal of education, or at least it should be, and interdisciplinary education should develop people to lead lives, not careers. Brian and I spend our days and nights tutoring, coaching, and mentoring youth in hopes of providing each student with positive support that aids maturation, as well as wholistic personal and interpersonal development (all while improving academic performance, of course).

It's a rewarding, challenging, and valuable process to be involved in; each day brings a new, unexpected lesson in 'grace'.

To good health,

Brent

Fructose Detox: a 12-Step Program for 'Fructose-ics'

I am in fructose detox.

I'm de-leveraging nutritionally with each passing day.

It's a 'healthy liver' thing; fructose is quite a hepatotoxin Dr. Lustig likes to say.

"Goodbye, fructose," is exactly what I heard the sage Dr. Davis say.

Not surprising to me, fructose toxicity yields addictive dynamics and tendencies that mimic, parallel, and resemble alcoholism.

Alcohol is quite a hepatotoxin, by the way.

Metabolically and neurologically, fructose and alcohol act in similar ways: in essence, you can get 'drunk' on that fruit punch soda you used to gulp unceasingly.

Alcoholics Anonymous (aka 'AA') has its own Primal Blueprint with respect to EtOH detox. Alcoholics are addicted to alcohol (EtOH). 'Fructose-ics' are addicted to fructose. Thank high-fructose corn syrup (HFCS) proliferation in contemporary society as the primary culprit for this worrisome, debilitating trend. Think of HFCS like credit card debt: it provides a short-term 'prop' (energy / money to expend / spend) with a high cost (liver toxicity / 20% interest rates) to-be-paid down the road. Acting in this manner like debt, fructose has bankrupt our physiologies all across the globe (thanks to Dave Lull):

"These results suggest that excessive fructose intake may have a role in the worldwide epidemic of obesity and diabetes," said Dr. Richard Johnson of the University of Colorado-Denver, who studied the link between blood pressure and men.

The findings provide the latest evidence of ties between sugar-rich diets and health problems ...

In response to this escalating epidemic, adapting the AA 12-step model for alcoholism detox to fructose-ism seems potentially fruitful, at least to me:

12-Steps to Fructose Detox for Fructose-ics

1. We admitted we were powerless over fructose--that our physiologies had become unhealthy, chronically inflamed with fructose-induced 'protein cement' slavery.

2. Came to believe that Primal / Paleo / Evolutionary / Ancestral Fitness whole foods nutrition possessed battle-tested concepts and prescriptions that are far superior to our SAD (Standard American Diet) modern-day Conventional (Food Pyramid) Wisdom precepts--the statement, "We'd be wise to learn from our ancestors," helps us restore our sanity, energy, and vitality.

3. Made a decision to turn our will ('searching and acting') and our lives over to the care of bottom-up tinkering, 'listening to our bodies' more intimately, engaging in 'n=1' trial-and-error self-experimenting in the Ancestral Fitness Epistemocracy (AFE).

4. Made a searching and fearless health inventory of ourselves.

5. Admitted to a higher power, to ourselves, and to another human being the exact nature of our historical health lapses, missteps, and misguided frustrations resulting from misinformed 'choice architecture' and allegiance to ineffective, non-robust mythologies to live by.

6. Were entirely ready to have Primal / Paleo / Evolutionary / Ancestral Fitness empower us with platforms, grace nudges, and social scaffolding points that help us remove all these diet defects.

7. Humbly asked 'our ancestors' to remove our energy intake and expenditure shortcomings, reconnecting via Levy-flights with our old roots to nourish new, nonlinear and fractal growth.

8. Made a list of all 'negative advice' mantras that could help us stay the course.

9. Made direct action plans based on such idioms, except when to do so would injure our bodies or others'.

10. Continued to take personal inventories, and when we recognized observations that falsify the fructose detox hypothesis, promptly admitted them--open-source science in the name of Popperian Falsification demands this much.

11. Sought through reflection, intermittent fasting, high-intensity / low-duration exercise, sleep, and ancestral nutrition to stretch our physiological headrooms, to capture positive Black Swan hits that emerged from the envelope of serendipity, and to follow the results of our individualized clinical trials to their full conclusions, seeking support from the larger Ancestral Fitness Epistemocracy when we needed power and 'venture capital' to carry these steps out sustainably.

12. Having had a physiological (mental / physical) and spiritual awakening as the result of these steps, we tried to carry this message to other fructose-ics, and to practice these principles in all our affairs.

As I like to reiterate, "Physician, heal thyself."

The AFE is a spiritual place; we, the Patients of One, elect to trust our ancestral physiologies gracefully--they know more than all of us combined, especially when nurtured in the right ecological manner.

Fructose detox is a good place to start.

It's never too late to start.

I like to start at step one.

An Ancestral Fitness 'n=1' Journey: Cheers to Chris!

(Above: Moments before delivering my 'Best Man' speech at my brother's wonderful wedding a few months ago.)

Healthcare Epistemocrat says, "Cheers to Chris, a fellow Epistemocrat!"

All members of the Ancestral Fitness Epistemocracy (AFE), each and every 'Patient of One', engages in his/her own personalized, anthropological 'searching and acting' along the healthcare spectrum through tinkering. This weekend, Chris Owens (@SingleOrigin), a primal / paleo / evolutionary / ancestral fitness 'theory to practice' practitioner, shared with me his 'n=1' clinical trial in body by science self-experimentation--he's on a wholistic, non-linearly meandering and fractally jumping course. Notice, as you read his personal mythology--his story--how his reflective activities (researching, thinking, trial-and-error solution seeking) can be visualized as Levy-flights: intense, focused study in one domain (a newfound CrossFit Web site, for instance) followed by a 'flight' into a novel realm (the Paleo diet, for example) for another vigorous excavation process, turning up unexpected gems and insights as well as serendipitous leads and connections along the way. It's entropy maximizing, with systemic protection against 'tunneling' built in (an 'anti-tunneling' device), given fixed path-length constraints.

So, as an elegant introduction, here is how philosopher David Hume, who shares a kindred and epistemocratic spirit with Nassim Taleb, described his tinkering affairs (warm thanks to Dave Lull):

Can I be sure, that in leaving all established opinions I am following truth; and by what criterion shall I distinguish her, even if fortune shou'd at last guide me on her foot-steps?

In a similar fashion, Chris followed 'fortune' as his 'Eureka(!), I have found it' guiding light, 'leaving all established (SAD) opinions' behind in the falsified dust; he opted, instead, for perceptively pursuing, to their (physio)logical conclusions, the positive Black Swan hits that emerged unexpectedly from the envelope of serendipity (*bolded sections below = emphasis mine):

I had not really given diet or fitness much serious consideration. I have always been thin, but I did start to notice a "softening" in my late twenties. We moved from New York to Atlanta shortly thereafter. In New York, I walked everywhere, and I stood all day for work. Upon arriving in Atlanta, we immediately got a car and I sat ... all the time. Needless to say, this did nothing but add to the softening. On top of that, I was tired all the time and had a general feeling of malaise and depression. I decided something needed to be done. The longer I waited, the harder it was going to be.

I, like most people, thought the key to losing weight was going to be exercise. I started to do some research (I’m always researching something to my wife’s constant annoyance). I knew I wanted this exercise to be functional, but I couldn't figure out exactly what to do. One day, while in one of my coffee shop accounts, I noticed a flyer for the local CrossFit. I read their little blurb and it seemed really good. Well, as good as anything can seem on a flyer. I went home and went online to do some research. Of course I ended up at the main site and dove in. I read the philosophy and watched hours and hours of videos. This seemed like exactly what I wanted to do. At the same time, I was scared out of my mind to try.

While freaking myself out on crossfit.com, I noticed that the diet they recommended was The Zone. This gave me pause, actually, because in my mind this was a fad diet from the 90's. I decided to read up on it and found they had some sound reasoning for using it, and it wasn’t like the cabbage soup diet. But in my research of The Zone, I kept running across The Paleo Diet. Once I read the theory behind it, everything just made sense. I have no other way to explain it. It seemed obvious all of the sudden. I was hooked. I started digging deeper and deeper into paleo/primal/ancestral nutrition and fitness. That's how I discovered people like Art De Vany, Mark Sisson, Robb Wolf, Stephan Guyenet and yourself (as well as a host of others). It has been a revelation.

Although it all seemed too difficult at first, I took it one step at a time. I thought I might die after that first CrossFit workout, but I went back the next day. The same is true with my diet. It was hard at first, but I’ve just tried to move forward everyday. Educating myself on the topic made things a lot easier. I now eat almost completely "paleo" and just started up CrossFit again in August. Since starting this journey, I'm down 20lbs, I'm 8-9% body-fat, feel better, sleep better, my mood has improved dramatically, and I can do a double bodyweight deadlift. In general I feel pretty freaking great! Now, all I want is to keep learning, keep progressing, keep improving and help others do the same.

Take care,
Chris Owens
@SingleOrigin

Again, "Cheers to Chris, a fellow AFE 'Patient of One' Epistemocrat!"

Mythology tells higher truths.

Feel free to contact me anytime to share your 'n=1' mythology with the AFE (community). Each (hero's) journey provides another valuable data-point in the 'book' we are writing collectively.

We're creating quite a healthy '12-Step' program in sugar (debt) detox.

And the positive Black Swan soars in to rid us of our sugar and debt addictions for good: remember, physiological economics keeps (grace) hopes high.

Look alive.

Together, we can thrive.

To good health,

Brent

The Office: Parkour sans Vibrams

My brothers and I watched this last night; absolutely hilarious (laughter is Rx).

Vibram Five Fingers barefooting commercial?

Parkour!

I went to the gym today ...

... with my brother, a bright graduate in Neuroscience from UCLA. We took some pictures; they tell an 'ancestral' Ancestral Fitness story.

First, we played tennis, a fractal game (soaking in the California sun as we rallied):

The strings on my brother's racquet snapped, just like the healthcare insurance industry is about to collapse:

Then, I put on my Vibrams:

And, I did some wall jumps:

Followed by upside-down pushups and handstands:

Mixing in some stretching:

And some balancing:

Interdisciplinary inquiry into the human condition requires flexibility:

Searching for a healthcare (back) bridge to get us out of our mess:

Jumps on one leg up stairs with a 15 lbs. medicine ball above my head:

Arm rotation rolls with medicine ball while stepping back down the stairs:

More 'dynamic yoga' helicopters:

Standing/balancing on an exercise ball (it requires focus):

Hamstring suppleness is important to sports performance:

So, if 'a picture tells a thousand words', this quote from 'The Evolution of Myth' on the Joseph Campbell Foundation Web site tells a thousand more (thanks to Brian Geremia):

We, as a species, are currently facing a great test of our adaptability. And the myth/ritual system we choose may well be the decisive factor.

Remember, we can learn by grace or by hard knocks. Let's respect our ancestry, choose grace, and live in ancestral, stable and sustainable ways.

In this light, for the Congressional testimony record archives, to summarize, here is my Physiological Economics stand--my personal contribution to crafting healthier mythologies to live by:

Sugar is like debt; we need far less of it. Debt props up businesses without sustainable, profitable business models; and, sugar props up bodies without sustainable, healthy physiologies. The 'elephant in the room' for banking reform is debt and for healthcare reform is nutrition (thanks to Dave Lull). If we continue to ignore nutrition (sugar, in particular), like we did with debt, then healthcare finance will experience the same type of collapse that we just saw in banking. Debt leverages economic systems in ways that expose them to negative Black Swan hits, and, in parallel, sugar leverages (inflames) human physiologies in ways that expose them to negative Black Swan hits (heart attacks, diabetes, cancer, etc.). Debt and sugar actively select for such 'hidden' risks. We need debt and sugar 'detox' in order to create societies that are robust to negative Black Swans but are positioned well to take advantage of the positive Black Swan options that emerge from the 'envelope of serendipity' when our economies and physiologies are not 'stretched too thin' with leverage conditions that limit our abilities to pursue life's unexpected opportunities with maximal degrees of freedom (debt reduces entrepreneurial freedom to exercise new options because we must service these repayment contracts; sugar reduces degrees of freedom to think and act in this world by producing chronic inflammatory responses that act as 'protein cement'--hence, the 'shackles' of a longterm debt contract are analogous to chronic inflammation: in both cases, in a sense, human spirit and agency degrade into 'slavery' due to prolonged indebtedness and chronic illness).

Remember, as my epistemocratic comrade Keith Norris at Theory to Practice so aptly said as part of his 'Healthcare Uprising' leadership:

“No system can be created that will not ultimately implode under the weight of a diseased citizenry.”

Our 'banking system' imploded under the weight of indebtedness; let's not let our 'healthcare system' implode under the weight of chronic illness.

Join me in the Ancestral Fitness Epistemocracy (AFE) for sugar and debt detox--we are writing quite a healthy 'AFE 12-Step' mythology to live by.

Keep waving your 'n=1' self-experimentation flags high: you are The Patient of One, triage away.

Hopefully, by moving in more ancestral ways, you will avoid iatrogenesis along the way (hat tip to Nassim Taleb).

Next up: This past Thursday, my brother interviewed Aaron Blaisdell, a Professor in the Department of Psychology at UCLA, who has recently found the Ancestral Fitness lifeway. My brother is in the process of transcribing the interview, which is sure to provide readers with numerous gems that could further serve as venture capital for self-experimenting.

To good health,

Brent

Physiological Economics for Healthcare: Systemic Robustness Against Negative Black Swan Hits

Note: Nassim Taleb testifies--makes a stand--in Congress

Finance and physiology cross-pollinate synergistically, producing a hybrid philosophy that proves quite, dare I say, 'fruitful' in understanding healthcare economics and our current state of medical business affairs.

At the University of California, Davis, as an undergraduate, I proposed my individual Bachelor of Science degree major as:

Physiological Economics for Healthcare

The interdisciplinary nature of my planned course of study (pre-MD/MBA dual-degree) resonated well and seemed 'logical', at least in my mind, with this title.

I settled, contently, on Physiology and Financial Management for Health Care.

Now, I've finished a Master of Health Administration graduate degree from the University of Southern California (USC). Seven years of undergraduate and graduate studies in these domains taught me one thing: physiological economics could inform health policy and administration perspectives in valuable ways--the logic of this philosophy could help increase our healthcare system's systemic robustness against and reduce our system's hidden exposure to negative Black Swan hits.

And we all blow up; we're sitting on dynamite: currently, manifesting as bankruptcies due to our inabilities to pay medical bills, and, in time, if things don't change, emerging as widespread and deep bail outs for the health insurance industry, privatizing the many years of profits made by Aetna, Cigna, United, et al. while socializing their extravagant blowup losses (taxpayers will be on the hook to be sure). It's the illusion of individual responsibility, a clear situation of 'too big to fail', and it concerns me greatly.

We can learn by grace or by hard knocks. Let's choose grace.

As Nassim Taleb argues in his testimony in Congress (above), our investment products and instruments, as a result of 'over-financializing' society, are far too complex for the wild uncertainty, stochastic randomness, and chaotic complexity that define and drive economic life--banking and investing lacked/lacks systemic robustness to negative Black Swan hits. Conceptually, as an important parallel, this lesson is not exclusive to banking.

In 'healthcare economic life', we still have the opportunity to learn by 'grace', rather than by one big 'hard knock'. Health policy and administration leaders and practitioners must 'make a stand' and 'de-complexify' the financial instruments and mechanisms that we use to pay for medical care. Just (re)consider the vast (dis)array of co-pays, co-insurance plans, deductibles, coverage limits, 'doughnut holes', mandated benefits, network restrictions, ICD-9 codes, DRGs, etc., and there is no need to remind you how confusing this bungled 'hoop-jumping' payment system really is. It's not science; it's a downright malaise; and, it's no way to pay for something like a routine hospital stay. Case and point: recently, upon learning that I hold a MHA degree from USC, my neighbor joked, "Great, now you can help us make sense out of our health insurance plan! We can't seem to figure the darn thing out." My neighbor is bright. Luckily, there is a guiding light to set things right: Higher-deductibles (scaled according to wealth/income/'ability to pay') would help tremendously with this fight. Simplify healthcare economic life: You, the Patient of One, empowered as an agent with healthcare resources in your pockets (and not in the United, Aetna, et al. coffers) pay out-of-pocket with savings for everything 'healing' up to your (high) deductible; then, after that, an integrated finance and delivery insurance system--I call it 'Catastrophic Kaiser' (CK)--takes care of you when disaster (unfortunately, but hopefully never) strikes. Those with the highest deductibles (namely, the wealthiest and healthiest), where and when appropriate, can be our social experimental 'guinea pigs' and 'lab rats', serving as those choosy shopping 'consumers at the margin'--a principal in economics that I do find value in--who drive the entrepreneurial engine that 'turns iron into gold' for lower and lower prices. We all benefit in the end.

Much of medical practice has become unsustainable financially because the United, Aetna, et al. third-party payer parasitic engine has disrupted the principal(patient)-agent(physician and care team) healing relationship. De-complexifying our healthcare finance landscape through 'high-deductible, medical savings account, Catastrophic Kaiser (CK)' flavored insurance instruments would go a long way towards, and is absolutely imperative to, increasing our health system's systemic robustness against negative Black Swan hits: In this spirit, what we now call 'insurance' would be restored to real insurance that would prevent bankruptcies and bail outs, at last (!), rather than paying for non-insurable medical events through a complex claims and benefits maze.

Rule CK: The more complex our payment system gets, the more exposed we become to negative Black Swan hits.

As Nassim so eloquently states (thanks to Dave Lull):

Let us move voluntarily into Capitalism 2.0 by helping what needs to be broken break on its own, converting debt into equity, marginalising the economics and business school establishments, shutting down the "Nobel" in economics, banning leveraged buy-outs, putting bankers where they belong, clawing back the bonuses of those who got us here, and teaching people to navigate a world with fewer certainties.

Then we will see an economic life closer to our biological environment: smaller companies, richer ecology, no leverage. A world in which entrepreneurs, not bankers, take the risks, and companies are born and die every day without making the news.

In other words, a place more resistant to black swans.

In other words, physiological economics for healthcare. Nassim Taleb has been delving deeply and reflectively into the history of medicine recently--look for many insightful gems in his next book, Tinkering: How to Live in a World that We Don't Understand--and his use of biology (physiology) analogies to inform his economic conceptions and frameworks reflects the exact same, kindred notion that I felt reverberate in my bones when I set out on this course of inquiry several years ago.

And, this is (some of) what physiological economics has to say:

Sugar is like debt; we need far less of it. Sugar props up human bodies like debt props up businesses, providing calories (capital) sans nutrition (profitable/sustainable business models). Nassim notes that our leverage by debt problem has not been addressed (thanks to Dave Lull), and I say our leverage by sugar must be addressed, otherwise we will be saying something just like this about our healthcare system in a few years:

Today we still have the same amount of debt, but it belongs to governments. Normally debt would get destroyed and turn to air. Debt is a mistake between lender and borrower, and both should suffer. But the government is socializing all these losses by transforming them into liabilities for your children and grandchildren and great-grandchildren. What is the effect? The doctor has shown up and relieved the patient's symptoms – and transformed the tumour into a metastatic tumour. We still have the same disease. We still have too much debt, too many big banks, too much state sponsorship of risk-taking.

First, like Michael Pollan recently said, in regards to nutrition and health system reform ("state sponsorship of risk-taking"):

And so the government is poised to go on encouraging America’s fast-food diet with its farm policies even as it takes on added responsibilities for covering the medical costs of that diet. To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup

Second, we have "too many BIG banks (health insurance companies)"--a situation of 'too big to fail' is cemented in place. United, Aetna, et al. is JP Morgan, AIG, etc.

Third, poor nutrition produces compromised physiologies full of 'hidden negative Black Swan risks'--cancer, chronic illness, diabetes, heart attacks, etc. (metabolic syndrome) events that rear their heads in the future--and health insurers like United, Aetna, et al. are in no position to manage these risks; rather, their business model doesn't work, positioning them with systemic exposure to patients' negative Black Swan health hits; which, of course, they try to outsource their fiduciary responsibility for unethically through recisions, claims denials, and 'cherry picking'.

So, how do we start converting this 'debt'--our unfunded healthcare liabilities to-be-paid due to our dire, worsening health states--into 'equity' (increasing our personal (health) market value, while reducing the (inflammation) claims against it)? Ancestral Fitness nutrition. Remove the cancer-causing agent; and, don't let the cancer metastasize. We must free people from the 'protein cement' shackles of chronic inflammation. In our current state of health affairs, nutrition trumps everything and serves as the most deeply-rooted cause agent that must be addressed first and foremost. We must 'remove the tools (debt & financial models) that (have) killed us', as Pablo Triana says, by excising the SAD (the Standard American Diet and it's theoretical foundation, the Food Pyramid), like Nassim calls for the 'beheading' of VaR (Value-at-Risk), and by displacing the unhealthy narratives that we live by with new mythologies that empower us to thrive. The intricately interconnected nature of human behavior, on multiple levels, provides promise for this cultural revolution (epistemocratic) approach to bottom-up 'health reform' (thanks to Dave Lull).

Health insurance should be a lot more like Vibrams. Conceptually, Vibram Five Finger shoes protect your feet from catastrophe--cuts, scrapes, lacerations--but they do not cushion your feet excessively. Vibrams help you establish a strong sensory feedback experience with the ground. We need more of this type of 'barefooting' in healthcare. The CK health insurance product could act like the simple rubber sole and barebones structural support on Vibram shoes; it's there when you need it (cancer, trauma, etc.), yet it does not interfere when you don't (sinus infection, physical, etc.). If health insurance were more like Vibrams, patients would start 'moving' differently; patients would traverse the healthcare spectrum much more cautiously, I suspect. Right now, most healthcare consumers are wearing 'Army boots with Nike Air Shox soles and Dr. Scholl's inserts', blunted and shunted from experiencing the true costs of medical care (which include iatrogenesis). It's the problem of 'nobody knows the price nor cost of anything in healthcare'. When patients swap these concrete foot covers out for the 'barefooting alternative' in Vibrams, they quickly realize the expensive medical costs associated with their unhealthy lifestyle choices: a more direct feedback system emerges, providing a more realistic, 'grounded' choice architecture for decision making.

Conclusion: My physiological economics hope is clear: As we de-complexify our healthcare finance industry and move more patients into 'high-deductible CK' plans (risk-adjusted, wealth-considered, universal coverage), we will reawaken those 'sensory neurons in our feet', propelling us to respond to this newfound feedback ecology by choosing, with our feet, as empowered healthcare 'shoppers' (the Patient of One triaging away), how to spend the majority of our 'healing' dollars. Wearing Vibrams helps people move in ancestral, healthier, and more stable and cautious ways, so 'wearing' this type of insurance plan could help folks navigate the healthcare system more ancestrally. Namely, by facing the true high-costs of medical care, the Patient of One would quickly experience 'sticker shock' and would respond by searching for ways to prevent disease in the first place. In turn, this exploration process in physiological economics would lead more and more people 'back to square one', and 'n=1' clinical trials in nutrition would rise to the surface as the best way to achieve health in the face of modern day opacity.

Sure, it's a hope, but it's a stand I am willing to make.

Nassim Taleb testifies on Fiduciary Responsibility: From finance to medicine, at some point, someone has to make a stand

(Hat tips: Dave Lull)

At some point, someone has to make a stand.

Nassim Taleb is doing just that, as demonstrated above, nudging toward 'acting' on the 'searching vs. acting' energy expenditure spectrum.

For years, fiduciary responsibility was amiss in the finance industry because of the three-body agency problem.

Agency matters.

The three-body agency problem arises when the principal hires an agent, but that agent subsequently outsources his/her fiduciary responsibility to another party, by choice or for some other reason. For years, financiers unloaded their risks to 'third-party payers', enabling them to operate on 'free options', which fueled unethical practices to spiral out of control.

We have a similar third-party payer, 'three-body' agency problem in our current healthcare affairs. Third-party health insurers like United, Aetna, et al. (Note: this excludes fully integrated systems like Kaiser Permanente, etc.--> they have removed third party parasites from the provision of medical services, aligning payers and practitioners 'under one roof'; though not perfect, it's an imperative nonetheless)--cannot manage the risks that their fiduciary responsibilities entrust them to bear: these 'third bodies' are conducting business in the same 'free option' manner that just collapsed banking in unprecedented ways: it's privatized profits and socialized losses.

Again, the insightful mathematician Henri Poincare has something important to say: attempting to structure, execute, and regulate any 'system' gets unwieldy extremely quickly the more bodies involved.

And, three's a crowd.

In steps Hello Health and similar innovations to restore the principal-agent relationship in medicine by excising third-party parasites as much as possible, pruning this form of 'insurance' payment back to its real catastrophic, insurable and sustainable roots.

Patients, as principals, hire agents--healthcare practitioners (physicians, nurses, etc.--their personal care teams)--and entrust them with the provision of their medical care. In accepting this fiduciary responsibility, these agents agree to conduct themselves professionally and ethically to service this contract risk, receiving commensurate compensation in return. Right now, though, in the United States, under employer-based health insurance and Medicare, which aid and abet third-party parasites like United and Aetna, et al., many patients must turn over their wages as prepaid healthcare dollars to these third-party payers. Instantaneously, health insurance claims become a 'use it or lose it' benefit rather than the more appropriate 'avoid it at all costs' type of thing (ie. hopefully you stay healthy and avoid the medical system all together, but you have catastrophic protection should bad luck strike). Enter the 'three-body' agency problem. The Patient of One never signed up to hire United, Aetna, et al. as their agents for providing medical care--they want to see their personal care team and pay them directly, as much as possible: "I want something that mixes the spirit of Hello Health with the high-deductible integrated Kaiser model for the financing and delivery of catastrophic and unexpected costly care," they say.

There's a better system out there, needless to say, and hopefully, fiduciary responsibility will win the day.

In the meantime, for today, we can all get back to the 'lab' and make our own individual stands: self-experiment away.

Because we know that culture will really win the day ...

Introducing Dr. Swan and Dr. DJ -- Kindred Epistemocrats in the Practice of Healing

“We must look beyond, to play a bit with our own lenses and our own perspectives,” he said. “One must keep an eye out for the sudden materialization of black swans in our lives.”

They call him Dr. Swan, Dr. Black Swan. "Swan is the name and tinkering is my game." The license plate on his car reads: 'BSWANMD'. He practices generalist medicine with the nostalgia of the empirical skeptics, treating the Patient of One each and every day--of course, people have heard him say, "Triage (tinker) away, Doc."

He often consults his colleague, Dr. DJ. "DJ is the name and mixing is my game." The license plate on his car reads: 'MUSICMD'. He practices musical therapy with the enthusiasm of a pop artist, treating the Patient of One each and every day--of course, people have heard him say, "iTunes (mix) away, Doc."

They meet in the middle. These epistemocratic doctors share a love for fractals: the former perceives them physiologically, the latter perceives them musically, but they both recognize the fractical applications of music as a healthy physiological pacesetting mechanism--a largely untapped 'cheap health option' with much upside potential. "Turn on some music," they persuade in every hospital bay where patients stay.

"It's an easy way to surmount linearizing forces in modern day," they both say. In this way, they both defer to Dr. Oliver Sacks' leadership.

They have hobbies, of course. One plays golf; the other in a band. Dr. Black Swan gravitates toward the Levy distribution that defines golf course architecture mathematics, comparing the sport to an ancestral hunt, stalking putts while expending energy in a fractal, patchy way: "Golf forces me to focus, to block out the bombardment of information that we constantly face today, but then relax in between shots and reflect. It's an important balancing act that we all must learn to play. Interestingly, the sport provides a valuable lesson for healthcare reformists: look at what Tiger Woods has accomplished--he reformed the game of golf from the bottom-up, by leading in a healthy way. Tiger 'walked the talk' and transformed the sporting culture of golf, motivating golfers across the planet to approach the game athletically, improve their fitness levels, and keep striving to raise the performance bar. That's how reformation and transformation get done: through cultural revolution from the ground up. The game of golf has never been healthier, in every sense of the word, because Tiger turned the mythological tide in a positive way," Dr. Swan tells his comrade Dr. DJ. Dr. DJ agrees: "Indeed, culture trumps nearly everything--just look at the power that music plays in shaping mythology every day. Music is positioned to be a powerful positive force; music therapy is one such manifestation that I feel. I feel it in my bones, reverberating throughout the atoms, cells, and organ systems governing my body functions. I love that you see the importance of music in that Ancestral Fitness stuff you never stop talking about, Dr. Swan. Music as medicine is the link that unites us, both physiologically and philosophically. It's ancestral medicine applied today."

As a dynamic tinkering and mixing pair, these epistemocrats, of course, diversify their practices as physicians in a Barbell manner--it's Pyrrhonian skepticism in medical practice--sticking to the 'bread and butter' yet-to-be-falsified modalities most of the time while always diversifying the remaining 10-20% of their healing efforts. As expected, Dr. Swan runs numerous inquisitive clinical trials, all with 'n=1', with all of his Patients of One. Population statistics never made much sense to him anyways: "Patients only care about what happens in their specific cases," he often reiterates. He sees his practice as a vibrant health story in motion, emerging and evolving, and he constantly re-edits its details as his patients' self-experiments turnover new leafs, as seasons change. But, the foundational tenants rarely change. The majority of these tinkering trials anchor on Ancestral Fitness concepts, particularly nutrition: "That Michael Pollan summed it up quite succinctly the other day when he said, 'Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.' I made that same conclusion two years ago; in fact, I just wrote this paper titled, 'ATP'. Ever since then, every bit of health policy wonkering has just been background noise that missed the deepest, most far-reaching root of the problem. It's like that Pablo Triana just said, 'it is time for President Obama to help us kill the tool that killed us.' Sure, he was talking about VaR and financial models, but he could be talking about that platonic, faulty Food Pyramid model just as well: both VaR and the Food Pyramid infiltrated / infected (think memes) our decision making processes with lies that had long been falsified. Long-Term Capital Management (LTCM) falsified that VaR myth years ago. I really like that Pablo Triana--I've been meaning to read his latest work, Lecturing Birds on Flying--he is to Nassim Taleb as Son of Grok is to Mark Sisson. The parallels are there. I am happy these two tandems are working diligently to edit the VaR and Food Pyramid stories out of our lifestyle mythologies, cutting these deceptive diamonds with more robust narratives to live by. 'Sugar is like debt,' I just continue to say. Where is Daniel Kahneman anyway? He loves 'maps'. Our mainstream maps for traversing the 'health' landscape just keep causing us to get more and more lost. Kahneman warns that confidence in the 'map' may motivate beneficial action, but Nassim suggests that, in cases like the Food Pyramid (nutrition) and VaR (banking), we would be much better off with no maps at all. Let intuition and humility be our guides. Though, overall, I bet both sides would agree that we'd all be better off with better maps to guide the way. 'That's the Ancestral Fitness way,' is what I keep trying to convey."

"Hey, that's enough with that Ancestral Fitness stuff anyways," interjects Dr. DJ. "You're getting lost in a stochastic song of swans; the last thing we want is that one last swan song, Dr. Swan. I know, I know--Ancestral Fitness is your 'dynamic hedge against swan song uncertainty'--but that's enough epistemocracy for one day. Take a seat Dr. Swan, I have some music I want to play."

"Certainly, triage (mix) away, my good friend, Dr. DJ."

*Hat tip to Dave Lull for many of the links cited above.

Living by Fiction: Lies, Myths, Mythology, and the Stories We Tell Ourselves When No One Else is Looking

We live by fiction.

But that does not mean we (have to) live by lies; lies just don't fly.

Definitions demand distinctions.

Empiricism splits these hairs for epistemocrats.

A lie is a story that empiricism has falsified. A lie has been falsified, but instead of 'editing it out' of our collective mythology, it persists through time. Once upon a time, Ancel Keys told a lie, a lie that had been falsified, when he ostracized fat in a way that would last quite some time.

The SAD (Standard American Diet) is built on lies; it's quite a SAD myth (story) to live by.

Conventional Wisdom is fraught with lies. VaR was a lie.

That's why self-experimentation helps us thrive.

Generally, a myth carries (should carry) both positive and negative connotations because a myth is just a story that we tell ourselves and others to sort out the human condition. Sometimes, these myths communicate 'higher truths'; at other times, they just tell lies. Myths are neutral in this regard. In popular culture, the word 'myth' often carries a negative, lie-like, deceptive vibe. A myth (should be) neutral, since stories come in all shapes and sizes. We all tell stories; we all mythologize. Scientists tell stories; statisticians tell stories; anthropologists tell stories; and, parables are / tell stories. True (negative) empiricism demands that we test all these stories; we must be "'Learned Amateurs' -- Nullius in Verba: 'Nothing upon Another’s Word.’ In other words, trust experimentation, not authority" (thanks to Dave Lull).

Of course, a yet-to-be-falsified myth could turn out to be a lie. Humbly put, it is impossible to know for certain, a priori, which stories will remain unfalsified. But that doesn't mean we can't put self-experimentation to work; in fact, we should accelerate our hoof because the 'Patient of One' doesn't have time to wait around for 'healthcare' reform: these 'n=1' flag-bearing individuals seek 'higher truths' in the form of true 'health' reform.

There is no room for lies--repeatedly falsified stories--in true science; negative empiricism won't let lies hide. Self-experimentation can expose lies, those purported 'beneficial' myths in disguise--our Levy flights will surely maximize the entropy 'leaf-turning' fly. For example, as an epistemocratic empiricist, my self-experimentat with Total FAGE Greek Yogurt demands that I share openly any negative results that would falsify my well-informed and data-embedded story about how this nutrition source provides me with a tremendous mixture of 'good' fat and 'good' bacteria. If, instead, I accept money under the table from FAGE, eat the product but experience (non-lean) weight gain, then sweep this falsification data point under the rug, thinking no one will see, then I am a liar. That's not science; that's deception. Epistemocrats know better.

Alternatively, if my self-experiment tracks along unfalsified, I have not told a lie. I keep my 'eye on the prize'--I see beneficial results--but all the while, I search myself openly and honestly for signs of decline, signs of a lie. I am cognizant of the stories I tell myself when no one else is looking. I want to thrive, not dive.

Therefore, in this mythological context, realizing that we live by fiction tells me one thing: culture trumps everything. We need cultural revolution in regards to healthy lifestyles. We need healthier stories to live by. No top-down design from on high could service an inherently bottom-up cultural transformation need.

Like my comrade Keith said:

“No system can be created that will not ultimately implode under the weight of a diseased citizenry.”

When we take mythology to practice, as we do when we self-experiment, we uncover what works, what doesn't work, where we have been and where we might possibly go. I hope we go back to the drawing board, conjure up healthier mythology to live by, and continue, as Mark says, cracking the Conventional Wisdom stone.

(Healthy) mythology is our culturally reinforced and stabilized bridge out of this mess. We can build, design, and govern this emergent bridge how we choose: it's an emerging epistemocracy for health.

Perhaps, some folks could start by assessing the Ancestral Fitness myth.

It's a myth I live by.

A myth that helps me thrive.

We've taken enough dives.

Let's thrive.